Cardiovascular and Immune/Lymphatic Systems Essay

1. What signs and symptoms did Greg exhibit when he was in the house? Some signs and symptoms Greg experienced were thirst, dizziness, and turgor. 2. Was Mrs. Myron correct when she said that Greg was dehydrated? Which signs and symptoms are consistent with this notion? Mrs. Myron thought that it was not necessary to seek medical treatment. Do you think she was correct? I believe Mrs. Myron was correct when she said Greg was dehydrated. All his signs and symptoms are symptoms of dehydration. I would probably have taken him to the hospital because he passed out and continues to do so, another factor would have been his temperature. I’ve Fallen Over and I Can’t Get Up: Part II—†The High School Football Game† Questions 1. What were Greg’s signs and symptoms before the game and during the warm up? Can you think of any reasons why Greg exhibited these signs and symptoms? Before the game and during warm up Greg experienced dizziness, loss of appetite, flushed, and sweaty. Greg may be experiencing dehydration. 2. Greg is taken to the hospital after being injured during the game. What problems do you think the physicians will find with Greg when they examine him, or do you think he is only suffering from dehydration? Greg has probably experienced a concussion from the hit he took. I’ve Fallen Over and I Can’t Get Up: Part III—†The Next Day In The Hospital† Questions 1. What are Greg’s new signs and symptoms? Do you have a diagnosis for Greg’s problem? Greg is now feeling nauseous, weak, and has a headache. I think he has a concussion. 2. The chart below shows that when baroreceptors detect a drop in arterial  blood pressure the sympathetic nervous system stimulates the heart and the smooth muscles in the walls of the arteries and the veins. Write increase or decrease to indicate the effect of the sympathetic nervous system on the variable in each numbered box. (3 points) I’ve Fallen Over and I Can’t Get Up: Part IV—†The Neurologist† Questions 1. What evidence suggests that Greg suffered from a mild concussion? Greg feels nauseous, weak, and has a headache which indicates a concussion. I’ve Fallen Over and I Can’t Get Up: Part V—†The Follow-Up Visit† Questions 1. What is the relative position between the heart and the head (or baroreceptors in the carotid sinus) when you are lying down? What is the relative position between the heart and the head (or baroreceptors in the carotid sinus) when you are standing? What happens to the pressure of the blood as it travels against gravity in a standing person? When you are lying on your back, blood is able to flow more easily. If you move from a seated or supine position to a standing position, there may be a momentary drop in your blood pressure, baroreceptors sense this drop and signal the heart to beat faster. 2. The baroreceptor reflex insures that the pressure of the blood entering the brain remains within defined limits, irrespective of body position. Under these circumstances, predict the blood pressure in the aorta of a standing person and a person who is lying flat on their back. I’ve Fallen Over and I Can’t Get Up: Part VI—†The Diagnosis† Questions 1. How would a pacemaker help Greg’s condition?  It would keep his heart rate at more of a steady pace. 2. If a pacemaker is implanted to control Greg’s heart rate, what life changes will be forced upon him? Do you think Greg will ever play competitive sports again? I do not think it is recommended he play  competitive sports. He will have to watch his physical activity and not want to exert himself too much. ___________________________________________________________________________________________ Resistance Is Futile†¦Or Is It?: Part I—†HIV and the Immune System† Questions 1. What is the difference in how a virus and bacteria replicate and affect cells of the body? Viruses cannot replicate without infecting a living cell. Unlike bacteria, that have everything it needs to reproduce, viruses need to use a living cell’s organelles in order to replicate. 2. In general, how does humoral and cellular immunity differ? Cellular immunity does not involve antibodies and humoral does. 3. Understanding that HIV is a retrovirus (a virus that uses reverse transcriptase), answer the following questions: a. What is reverse transcriptase? Transcriptase is an enzyme that catalyzes the formation of DNA from an RNA template in reverse transcription. b. How is a retrovirus different from other viruses? A retrovirus composed of DNA and RNA virus with the most complex replication, so it is different from a regular virus. c. How does a retrovirus infect a cell and reproduce? On encountering a host cell, the retrovirus attaches itself to receptors on the surface of the host cell’s membrane. Once inside the cell, the capsid opens, releasing RNA and reverse transcriptase into the cell’s cytoplasm. 4. In regards to reviewing the immune system, answer the following questions: a. What is the difference between a T-cell and B-cell? B-cells mature in bone marrow; T-cells mature in the thymus. b. What is the difference between innate immune response and adaptive immune response? Innate immunity refers to nonspecific defense mechanisms that come into play immediately or within hours of an antigen’s appearance in the body. Adaptive immunity refers to antigen-specific immune response. The adaptive immune response is more complex than the innate. 5. In regards to the immune system and HIV, answer the following questions: a. Individuals with HIV commonly die from pneumonia or cancer. Why is this the case? HIV lowers your immune system so other diseases or sicknesses can often be deadly because the patient’s immune system is so weak. A Case of Pharyngitis: Part I—†The Little Boy† Questions 1. The pediatrician described Jason’s pharynx, uvula, and tonsils as swollen and red. What are the four cardinal signs of inflammation, and how does each relate to changes in the blood vessels at a site of inflammation? Signs of inflammation are redness, swelling, heat, and pain. The blood vessels encounter vasodilation. 2. The exudate on Jason’s tonsils consisted primarily of neutrophils, and the CBC that was performed indicated that the number of neutrophils in his circulation was increased. What role do neutrophils play in the resolution of a bacterial infection? What role do macrophages have within fighting infections? Neutrophils are attracted to the site of infection by chemotaxis. They are able to phagocytize and digest pathogens. 3. Jason’s physician noted that Jason’s cervical lymph nodes were enlarged, a condition referred to as lymphadenopathy. Describe the structure and function(s) of lymph nodes, and list the other organs and tissues that comprise the lymphatic system. The lymph nodes are small bean shaped glands. They act as filters that sieve off the harmful substances brought by the lymphatic channels. Bone marrow, thymus, spleen, MALT, BALT 4. What can trigger a fever and what are its benefits in terms of combating an infection? Infections can trigger a fever, which can be beneficial to try to kill the infection.

Gd on China or Pakistan Threat to India

attoVishnu, China is a bigger threat than pakistan. I am not speaking about military strength, I am speaking about economic strength. China as all the ability to take all our business, services away from us. In the future, it can stand as a big challenge when it comes to outsourcing and other IT / ITeS services there by completely paralyzing our economy through problems like unemployment etc; China.. it can also challange USA, .. India will be peanuts. pakistan†¦ both equally match†¦ so not that much big threat, but still china is kick *** for India hebiggest threat to india is the pakistan because the , the p-akistan is spreading the cold war, gueerlas war that y it important , to watch carefull the activity of pakistan definately pakistan and due to kashmir dispute. China is the bigger threat, a head on clash with china, could be damaging to India. However, pakistan offers a threat of a different kind, spreading terror, whose effect would be quite bad. hi brother its chin a. they say that arunachal pradesh belongs to them and some disputes in tibet border. its easy to fight with pakistan and win. we know the pakistan is a part of india. t has been to given a place for certain minoroties by india. so theres less threat. jai hind Currently I would say Pakistan because this is the time of Islamic aggresion in the world and Pakistan is an Islamic nation and they currently have a low level conflict with India and there have been terrorist attacks on India from Pakistan. China has the potential to be the biggest threat to anyone but they haven't really shown much aggresion. Lets hope that they remain that way. no country becoz from both we do our good relations. It all depends on how you view the situation. Neither China nor Pakistan need be our foes.We can make use of them for our mutual benefit. However, as a military force China is far superior. On the other hand Pakistan is very close to our territory. Both these factors do not count much in the modern nuclear warfare. All depends on the wisdom of the rulers of the countries and our fate. CHINA is a bigger threat to India. It has the potential to beat down India in every sphere on its own. But PAKISTAN can't do anything much without the help of bigger nations like AMERICA. As a force to compete economically, without a doubt China. But India is in a better position because US and Japan is trying to isolate China.India would soon be award the preferred trading status with US. As militarily threat, Pakistan will have more conflicts with India. There isn't much long term deep root hatred between India and China, so any dispute can be easily resolved compare to Pakistan. china provides a source of healthy competition in the world market. so ,i'd say china's not much of a threat if we realise how to make the most out of it for our advantage. we need strategic planning to implement this. the trade aggrements signed by the national leaders is a step forward in this direction. ince nation al security is of utmost importance , pakistan seems to be an immediate THREAT to the nation ,this issue is one that deserves attn rightaway. If it was a situation over what country could do more damage to India it would definatly be China†¦ But the biggest threat to India is Pakistan because China doesn't threaten and hate India like Pakistan does pakistan cant be a threat for india coz pakistan is a poor country with no economics and also india has defeted pakistan so many times, pakistan is so much spoiled internally that it cant think to fight with india. akistan is also not capable to fight with india, it is india who divided pakistan in in 1971 war and that was enough for pakistan. as far as china is concerned, we also have the same strength as china has. we are indians we are afraid of no one. to tell the truth india is in a position to defend itself if any one of the attack i. e. we are self sufficient. but if both of them get india will be ruined it will be like  "EK AUR EK GYARAH† None but India itself, notably ‘CORRUPTION' from top to bottom! The answers post by the user, for information only, FunQA. com does not guarantee the right.

Letter to Friend Congratulating on Sucess Essay

It gives me great pleasure that you have topped the list of successful candidates in the Board Examination. It is all the more delightful to learn that you have secured distinction in all the subjects and in Mathematics you have secured 99% marks. Your grand success is a matter of pride for your family, friends, teachers and our school as well. It is, in fact, the result of your hard work and dedication, sacrifice and concentration. You have been very consistent all along your studies. You never ignored your studies. It has paid well now. Indeed, it is a moment of celebration particularly for your parents who have been very careful for all your needs and comforts. This success has opened up the door to various opportunities for your career. You can get admission in any of the good colleges in India. A bright future awaits you. Your bright success has secured your career. Again my heartiest congratulations on the happy occasion I am confident you will maintain this performance in future. Keep upthespiritand be careful to your health and performance. We will met soon to have a treat. With lots of good wishes for a bright future. Yours sincerely, Rishika My Dear Pramod, I am glad to see your result in today’s Rakasthan Patrika. Your outstanding performance in the RAS examination has secured you a good rank. I conveyed this happy news to my father who was sitting beside me. He too was overjoyed. I thank god for his kindness and wish you a bright future. You have been intelligent and diligent in your school and college days. Certainly, your success is due to god’s grace as well as your hard work and timely guidance of your respected parents. Keep it up! You will be of great asset to your family and more over to this nation. Please guide your sister also to overcome her IAS examinations which are due in November. Please convey my respectful compliments to your parents. Again, congratulations to you! Yours sincerely, Raj Kumar

Library Assignment Essay Example | Topics and Well Written Essays - 500 words

Library Assignment - Essay Example All the same, this was never the key source of error. In the year, 1963 Price proceeded to work making use of several data in abstract compendia for the years 1907 to 1960. The study conducted in the years 1907 and 2007 by use of available statistics from several literature databases, Social Science Citation Index (SSCI) and the Science Citation Index (SCI) have indicated findings relating to the Growth rate of scientific publications. Significantly, the intention of the study was to give information regarding the growth and development of Scientific Publications (Garfield, 27). The study is descriptive in that; it gives descriptive data on which the research was based on and also includes the statistical processes used in the description of the population in the study. The findings from the study assist in organization and data description. The variables involved were the data from the traditional scientific publishing. Traditional scientific publishing; publications in peer-reviewed journals, is still considered to be increasing though there are large variance between some sectors. There exist no signs that the growth rate has decreased within the past 50 years. At the same time, publications making use of channels, for instance, open archives, home pages and conference proceedings are reported to be developing at a higher rate. The growth rate for the SCI was compensating a declining section of the traditional scientific literature (Garfield, 29). There also exist some open signs that the compensation by the SCI is generally minimal in a section of the scientific areas with the largest development rate involving engineering and computer sciences. From the reading, it is obvious that the populace being considered are the humans, and this is with respect to how they rate the scientific publications. The common characteristics of this

Uses Cases Assignment Example | Topics and Well Written Essays - 1250 words

Uses Cases - Assignment Example The withdrawal transaction begins by a customer inserting his or her Bank Card into the card slot of the ATM. Then a user validation process is performed on the basis of the card ID and the customer’s PIN. After validation, the a display screen is provided containing the available set of operations. In this scenario, the customer has directly selects â€Å"Withdraw Cash†. The ATM screen displays prompts for an account type. The selects the desired account type from the available Menu. This is immediately followed by screen for the user to input the required amount of money. All this information falls under the withdrawal use case. That is, the Bankcard ID, PIN (Personal Identification Number), account type and amount, which is then sent to the Bank as a requested transaction. The Bank then replies with a go-ahead or not reply. Upon successful approval the customer’s money is made available by the dispenser. The ATM then ejects the card and Prints a receipt. It is essential to indicate that this use case is based on the assumption that a user makes a direct and successful withdrawal. However, there are some alternative flows caused by conditions such as Wrong PIN, Invalid or Expired Card, Invalid Account type and Excess withdrawal Amount. The second diagram is a use case dependency for making an account deposit. As indicated in the use case diagram below, this is another highly technical procedure in the design of an ATM service machine. The preconditions are same as for withdrawal, which is a customer and Bank. The following is involved in the execution of an account deposit transaction. The transaction initiates by a Bank Customer inserting his or her card. This is then followed a provision of display screen by the ATM prompting a user PIN, which is integrated as the validation use case. It uses the card ID and PIN to authenticate its use. The machine displays a screen

Pricing Problem Essay Example | Topics and Well Written Essays - 1000 words

Pricing Problem - Essay Example The progress of a pre-negotiation plan that does not reflect any kind of rigorous analysis, assessment and examination through element of cost will lessen the accomplishment of obtaining a reasonable and fair price. Where there is a departure from the established negotiation objective, the memorandum of the price negotiation should not only recognize the negotiated results but also reproduce the same level of rigor and severity in the examination, assessment and basis for its acceptance. In the absence of sufficient price competition, the contracting officer should apply and document in the pre-negotiation plan the analytical and systematic techniques that will help evaluate whether a proposed price is reasonable and fair. The pre-negotiation plan is an official document and certificate of the negotiation objectives of the contracting officers with regard to pricing, business, technological and contractual issues. It documents the pertinent issues and problems to be negotiated and the objectives of cost and a profit or fee objective. Due to the fact that it serves as a foundation of the negotiation, the pre-negotiation plan must completely explain the positions of the government and the contractor. The template, which is integrated as Attachment-A, is provided to help contracting officers in the examination of their negotiation objectives when cost analysis is necessary to support negotiations. â€Å"Contracting activities are encouraged, through implementation level procedures, to establish additional templates that are more aligned with the specific needs of their organization and procurements† (â€Å"Negotiation Documentation: Pre-Negotiation Plan & the Price Negotiation Memorandum†). Completely explain the findings and recommendations of the evaluators, auditors and others providing advisory assistance, foundations of their findings and the extent to which they were involved in the

Self-Assessment Research Paper Example | Topics and Well Written Essays - 1250 words

Self-Assessment - Research Paper Example Discussion In the modern demanding workstation, leaders are extremely constraint to find new and creative ways to engage and encourage their workers and affect positive change to enhance the bottom line of their organizations. Similarly, organization leadership program of study needs practical professional skills that are required to develop and maintain the organization in order to realize change, (Kuglin and Hook, 2002). Communication and leadership concepts are critical to teach employees and leaders importance of leadership and other crucial interpersonal communication skills. Communication skill is required for teams’ communication, management of conflicts in an organization, intercultural communication, and organizational change management. Experts agree communication is an interaction among people to convey different kinds of messages. Managers and leaders in organizational leadership program of study need communication skills, leadership and management skills to manage organizational information, behavior and ensure free flow of information and better communication in the organization. Therefore, an effective communication skill is crucial to achieve organizational goals and create better reputation. I have learned that leadership competency is all about having the ability to operate and lead people in a diverse organization structures, skills, cultures, and contexts; it is the ability to work or function with external and internal teams across various time zones, human resource policies and locations, (Agor, 2009). This capability makes a manager or a leader adaptive to alterations in working conditions and able to develop effective teams. Therefore, a leader needs motivation, commitment, and understanding. This is because one is managing different people, with diverse cultural backgrounds, tradition, opinions, and goals, is not easy. The group is motivated in diverse ways, and every teacher expects a different thing from an assistant manager. T herefore, as a leader one needs to be a team builder, motivator, coacher to ensure divergent views are integrated, and needs met to achieve common goals. Efficient listening is crucial for leaders. Without listening skills, a leader cannot get a response and opinions from teachers and principals and as sense of what members prefer about the teaching activities and projects. Listening will allow integration of different team members’ opinions to facilitate project success. A leader must have the ability to facilitate communication among the team members in an honest and open manner. Efficient interpersonal communication is evident when group members listen to each other and try to build on each other's contributions. Members of the group attain efficient interpersonal communication through strong leadership and self-regulation so that every member has an equal chance to contribute in the project. Resolving the conflict and decision-making are two key functions that are crucial for leaders. For successful team development, I believe the ability to make the group function, devise methods, and techniques for problem solving and decision-making is critical. Absence of consensus strategies for decision-making and conflict management may result in inconveniences,

Microwave and Photonics Systems Essay Example | Topics and Well Written Essays - 2000 words

Microwave and Photonics Systems - Essay Example This results in significantly reduced complexity of the Remote Antenna Unit, as the major portion of the processing is avoided, at least at the regional unit level and only optoelectronic conversion and amplification of the converted signal is necessary. 2) Estimate a difference in roundtrip time for data transmission between Tokyo and San Francisco (distance: 8270 km) as for the following two communication methods; radio-wave (wireless) communication using a geostationary satellite, and fiber-optic communication. Assume that a refractive index for the air is 1, and that of the optical fiber is 1.5. Distance between the earth and the satellite is 38,800 km. Impedance matching in a circuit comprised of linear devices is defined as the process of making the output impedance of the source equal to the input impedance of the load, in order to maximize the power transfer from source to load and thereby minimize reflections from the load end. This results in increased efficiency. In the context of radio and fiber optics systems, where the wavelength of the transmitted signal is very much less in comparison to the length of the line, ie, where the changes in the signal are rapid compared to the time of propagation, the impedances at each end of the line must be matched to the characteristic impedance of the transmission line to prevent reflections of the signal at the ends of the line. Otherwise, echoes may occur and cause the formation of standing waves in the transmission line. In radio-frequency (RF) systems, a common type of RF load used is a quarter-wave ground plane antenna using a modified ground plane or a matching network. 4) Explain one example of representative antennas which are used in our radio wave(wireless) systems such as cellular phones, wireless LANs, etc, with respect to its type and operation. Ans) Consider a microstrip antenna as an example. A microstrip antenna gains its name from the fact that it is structurally a simple metallic strip of desired shape suspended over a ground plane. The strip may be flush mounted onto a dielectric or other surface. The feed line is placed behind the ground plane (Prasad 809). They are simple to fabricate and easy to modify and customize. The microstrip patch antenna is the most common type of microstrip antenna. It is a narrowband, wide-beam antenna with an inherent ability to have polarization diversity. These antennas can easily be designed to have Vertical, Horizontal, Right Hand Circular or Left Hand

Defining Beauty Essay Example | Topics and Well Written Essays - 1500 words

Defining Beauty - Essay Example While beauty might have once been truly ‘in the eye of the beholder’, today’s society has beauty defined for it by the overwhelming challenges of the mass media. These messages of the media are so consistent they overwhelm any natural sense of beauty, which is important to our sense of identity and social value. Throughout the history of mankind, humans have projected who and what they are, including their relative social position, through their outward appearance. Study after study has demonstrated people dress a certain way and strive to acquire specific items as a means of signifying that they belong to a particular desirable subset of individuals who also embody their individual ideals (Gilman, 1999). Regardless of whether one has always been a part of this subset or not, it is presumed that an outer appearance in keeping with this group will automatically purchase the coveted membership. In the past few centuries, however, the standard definition for female beauty has had detrimental effects on the feminine identity. â€Å"Women view their bodies as ‘objects of work’ requiring attention and upkeep in order to operate well and promote the desired effect† (Gillen, 2001). ... â€Å"Research in the UK suggests that the wealthier we are, the more likely we are to dislike our body. Experts think there’s more pressure on the wealthy to achieve the thin 'ideal' because they have the money to do so and are more exposed to media images† (Rebecca, 2006). Because the wealthy are expected to be able to achieve this ideal, those who are not so wealthy often struggle to attain the beauty ideal as a means of signifying that they belong within the ranks of the wealthy. Within the past few years, televisions have been inundated with so-called ‘make-over’ shows in which the focus is precisely for the media to inform the public regarding what is considered beautiful or desirable. These shows promise an improved exterior facade to participants’ bodies, fashion sense, faces, homes, lifestyles, etc. that will bring the individual into closer similarity to the ideal image and thus make it possible for them to achieve a higher level of happine ss. This ‘ideal’ image is usually envisioned as someone in their mid-20s, slender almost to the point of skeletal, with specific body measurements at the bust and hips and a specific ‘good-looking’ charm that usually includes blonde hair and a friendly demeanor. This limited view of the ideal obviously eliminates anyone who might have been born with larger bones or other ‘defects’ that resist the reshaping of the plastic surgeon’s scalpel from being accepted into the socially acceptable. Makeovers on TV illustrate the unacceptable qualities of the average individual and emphasize the importance of bringing the individual image more in line with a perceived social ideal that is communicated through the same media channel. It is thus perceived that the only way for individuals to find

Risk and Returns Assignment Example | Topics and Well Written Essays - 500 words

Risk and Returns - Assignment Example In order to diversify the risk, the assets are held together forming a portfolio. The sum of variance for the portfolio is almost lower than a single average weight of individual portfolio, therefore, minimizing the overall risk of investment (Rachev, 2005).  To clearly illustrate the model, the following capital structure for Wal-Mart stores for the year 2010 is used. Each component cost could be determined using various formulas. For instance, to determine the cost of debt using the Wall mart sore which has $1,000 PV (par value) zero coupon bond outstanding. Assuming that the bonds are currently trading at $ 385.54 with a 10 year maturity period and a tax rate of 40%, then the cost could be determined as follow. Finally the cost of equity would be determined using capital asset pricing model would be used to determine the cost of the components. Assuming that the risk free rate in the market is 4% and having been given the beta factor of 3 for bond and 0 for money market instruments. For a risk take investor, he will consider using debt which is much cheaper than common equity and preference stock. This is a risky investment, though the overall return will be much higher. The average weighted cost of capital will be much lesser i.e. 9% as par the computation above. On the hand if the investor considers using less debt which is cheaper and opt to use more equality and common stock as shown in the capital structure bellow; In conclusion, it is clear that risk is a universal factor in investment decision since no one can really stay away fro it. Though that is the case, risk can be reduced based on individually capability as well as their knowledge. For one to have successful portfolio management, then it will depend on the right mix of all assets and individual investor’s overall risk expectation. One of the key important choices which an investor has to consider is his where his risk tolerance lies. This

Ideologies And Their Work In A Media Text Essay

Ideologies And Their Work In A Media Text - Essay Example Public speaking is a very powerful tool that can be used either to break down or build ideologies; this makes the media a source of ideological thought. The news story framing can form ideologies through what is both left out and present in a story (Grayantes & Murphy, 2010, p.165). Ideology has mostly been used by the politicians to change how people reason and the people believed to be right. This has been seen as most of the votes prefer other candidates to other for being convinced in believing in an idea (Grossberg, 2005). The lifestyle magazine content has relied on affected the people dressing code, and there living style. It is very important to understand that most of the products of the mass media ideological analysis majorly focus on the content of the message (Johnson & Milani, 2010). These are mainly the stories they narrate about the present and the past and instead of those stories effect. The mass media text ideological term of understanding is that is a type of communication that gives privilege to certain ideas while undermining others. Media text has a different perspective of ideology representing interests that are different with a power that is not the same involved in a type of power struggle within media text. Some idea will have an advantage over others because they are always built in a familiar media image or are known to be very popular. Other ideas will not be easy to identifying as they are not that visible and will only be identified by those people who are very devoted. The way in which media use the lifestyle magazine to advertise (Okonkwo & Palgrave 2007) or inform the public about certain issues provides the form of the principle of public dialogue by which the conflict of culture is  waged.

The physical objects Essay Example for Free

The physical objects Essay What is the significance of the physical objects that Ibsen has used in Act-1?Amidst a beautiful rose garden, where the sunrays came beaming down, she was sitting as though she had been totally oblivious to the happening of the world. This is the way a novelist would elucidate such a situation, with the use of apt words and adjectives, using his language skill to express the emotions of the characters but drama involves a completely different approach, an entirely special technique of writing. A dramatist would probably have to delineate the same situation by the physical presence of the beautiful roses, the display of the beaming sunrays and with the actress having to emote the feeling of loneliness. And it is only then, that the audience would understand that in the beautiful rose garden, there is a girl feeling very lonely. In what you would call A Good Drama, the audience is challenged to look not only at the dialogue and actors, but is challenged to examine staging, lighting and even the furniture. Stage directions become cryptic messages of characterization. The dramatists portrayal is well supported by the physical presence of certain objects and the audiences dramatic interpretation goes beyond the traditional analysis of dialogue and relationships. This environmental thinking creates a new dimension of meaning in drama  It is this kind of interaction between the living and non-living characters which allow Henrik Ibsen to reveal emotion and motivation in his play Hedda Gabler. Ibsen gives detailed stage directions about the lighting, the props, and certain objects, to achieve his effects and to supplement his thoughts. Two of the most dramatically significant of these objects are the portrait of Heddas father and the pair of pistols. Each of these emphasizes the dissonant relationship between Hedda and her new environment. Though the portrait of Heddas father in a generals uniform is never directly referred to, it gives us an indication of Heddas military-aristocratic paternal background. The pistols were inherited by Hedda from her father. Her perplexing habit of aiming the pistols at people {Eilert} dramatizes the profound dissonance between herself and her present world, and her frustration with the emptiness of her life. It seems she can conceive of no future for herself other than a life of excruciating boredom. The way in which the portrait and the pistols figure in her world suggests that she is caught up in the repetition of her past rather than engaged in the creation of a future. This is because Hedda, a beautiful young lady was married to Tesman, an indefatigable scholar, both of them having hardly any evident similarities. Although there is no apparent reason for them to have got married one is coaxed into believing by Heddas attitude that Temans world seemed to offer her some sort of security. However she began to feel suffocate in the claustrophobically middle class atmosphere. An early indication of Heddas hostility to the world in which she finds herself is when, on an impulse, she speaks demeaning of a hat, which she knows to be Aunt Julies, {Tesmans aunt} but which she pretends to believe is the maids. That hat was newly and specially bought by Aunt Julie and was even considered attractive by Tesman but Hedda referred to it as old which proves to be a clear indication of the difference in the social classes from which Hedda and Tesman came. The mention by Aunt Julie of her parasol being hers and not the maid Bertas signifies that in spite of the demeaning behaviour of Hedda towards Aunt Julie, the aunt never reciprocated the same way. If Heddas character has been formed in a military-paternal setting, Tesman still lives in an atmosphere of motherly concern, brought up as he has been by a trio of self-sacrificing women Aunt Julie, Aunt Rina and Berta. Tesmans elation over his bedroom slippers, which were embroidered by Aunt Rina, and the fact that he even mentioned about them to Hedda on their honeymoon, is clearly proved by it. Differences between Hedda and Tesman are further indicated by the piano, which was placed in the drawing room. The piano does not fit in the drawing room, just as Hedda doesnt fit into the Tesman family and its middle-class lifestyle. George and Hedda make different assumptions about remedying the problem of the piano. George assumes they will trade it in for a new piano and is startled by Heddas extravagant assumption they will keep it and buy a new one. The entire drawing room itself is indicative of what kind of a mismatch Hedda was to Tesmans family. The room is like Hedda in its sophistication and elegance. It symbolizes Heddas lifestyle, rather than those of the Tesmans. Aunt Julie expressing surprise at Hedda having the covers of the furniture removed further reflects this. This reminds us of the saying that one mans luxury might be anothers necessity. Also the reactions of the characters to the lighting and the position of the glass door are of some significance. While aunt Julie wants the glass door open to welcome the morning fresh air, Hedda refers to it as the flood of sunlight. She however prefers to draw the curtains so that the light becomes softer and does not want the light to go away completely. Light often represents life and aliveness and thus aunt Julies welcoming of the morning light epitomizes her optimistic attitude towards life and her positive thinking. Darkness usually symbolizes danger or vice but Heddas want of soft light and not complete darkness gives us signs of her mysterious past. It shows us that although Hedda was interested in all the mysteries and adventures of life, she preferred to keep a sufficient distance from all those things, which would disturb or disrupt her lifes stability. In this way Ibsen uses the glass door to indicate their varying attitudes towards life. Heddas emptiness of life is further illustrated by her distastefulness towards the flowers and her finding the flowers somewhat stifling. Flowers usually are a mark of happiness and hope and often symbolize a new freshness of life. But Heddas views about the flowers are somewhat opposite.  Thus Ibsen has skillfully used various physical objects to reflect essential characteristics of the relations between the characters and to personify his characters. His detailed stage direction reminds us of what, owner of Prithvi theatre, Mumbai had said, Stage direction is an integral part of every drama. Without the props appropriately placed on stage, the play, however brilliant it may be, appears like a body without a soul, a tear without an emotion and love without a heart.

NMR Spectrometer: Applications, Components and Functions

NMR Spectrometer: Applications, Components and Functions Describe briefly the major components of a NMR spectrometer and their function. The Magnet The capability of an NMR instrument is critically dependent upon the magnitude and homogeneity of the static magnetic field and on the bore size of the magnet. There are three main types of magnet; permanent, resistive, and superconducting. (Gadian, 2004) The Gradient System The generation of magnetic resonance images relies on the appropriate use of pulsed magnetic field gradients. These gradients are generated in the same way as those produced by the shim coils, i.e. by specially constructed coils mounted within the bore of the magnet, designed to produce field gradients of the required strength and linearity. (Gadian, 2004) The Transmitter The transmitter generates radiofrequency pulses of the appropriate frequency, power, shape, and timing. It contains a frequency generator, a waveform generator shape the pulses as required, a gate which switches the transmission on and off at the required times, and a power amplifier which boosts the radiofrequency power to the values that are required in Fourier-transform NMR. (Gadian, 2004) The Radiofrequency coil(s) The Radiofrequency coils are used for transmitting the B1 field into the region of interest, and for detecting the resulting signal. In some cases, the same coil is used for transmission and reception, while in others it may be preferable to use separate transmit and receive coils. (Gadian, 2004) The Receiver The design of a modern digital receiver centres around an analog to digital converter (ADC), which samples the analog NMR signal and converts it into digital format. Important characteristics of the ADC are its conversion bandwidth and resolution. The Computer The computer has a wide range of function. Its main functions are: (i) to control the radiofrequency and field gradient pulses; (ii) to accumulate the data; and (iii) to process and display the data. (Gadian, 2004) The magnet produces the Bo field necessary for the NMR experiments. When nuclei interact with a uniform external magnetic field, they behave like tiny compass needles and align themselves in a direction either parallel or anti parallel to the field. The two orientations have different energies, with the parallel direction having a lower energy than the anti parallel. Immediately within the bore of the magnet are the shim coils for homogenizing the Bo field. Within the shim coils is the probe. The probe contains the Radiofrequency (RF) coils for producing the B1 magnetic field necessary to rotate the spins by 90o or 180o. This will be done by the RF transmitter shown in figure 1. The RF coil also detects the signal from the spins within the sample. These signals will be detected by the RF receiver in figure1. The sample is positioned within the RF coil of the probe. Some probes also contain a set of gradient coils. These coils produce a gradient in Bo along the X, Y, or Z axis. The heart of the spectrometer is the computer. It controls all of the components of the spectrometer. The RF components under control of the computer are the RF frequency source and pulse programmer. The source produces a sine wave of the desired frequency. The pulse programmer sets the width, and in some cases the shape, of the RF pulses. The RF amplifier increases the pulses power from milli Watts to tens or hundreds of Watts. The computer also controls the gradient pulse programmer which sets the shape and amplitude of gradient fields. The gradient amplifier increases the power of the gradient pulses to a level sufficient to drive the gradient coils. The operator of the spectrometer gives input to the computer through a console terminal with a mouse and keyboard. Some spectrometers also have a separate small interface for carrying out some of the more routine procedures on the spectrometer. A pulse sequence is selected and customized from the console terminal. The operator can see spectra on a video display located on the console and can make hard copies of spectra using a printer. Comment on the nature, volume, condition, etc. required of a sample for nmr studies on biofluids. An important aspect of conducting NMR spectroscopy on biological fluids and tissues is suppression of large interfering resonances, in particular from water, buffers and cosolvents (in the case of extracts). It is also important to be able to apply accurately shaped (non-rectangular) r.f pulses and/or magnetic field gradients across samples to enable diffusion measurements, multidimensional NMR experiments, and the latest solvent suppression approaches. (Gadian, 2004) In any kind of NMR probe, there are two sample volumes to consider. First is the total volume of sample required (the sample volume) and second is the active volume or the volume of sample that is exposed to the r.f coils. For probes with the commonly used saddle coil, the ratio of active/sample volume is ~0.5. Typical sample volumes for metabonomics applications range from 120 to 500  µl, a range that is normally adequate for commonly available biofluids such as urine or plasma from anything larger than a mouse. There are also numerous examples of small volume probes (1-30 µl) that could have potential uses in certain applications on rare or hard to-obtain biofluids such as CSF or synovial fluids from small laboratory animals. (Gadian, 2004) No pre-treatment of the sample is required. The metaobiltes which are present in sufficiently mobile form and at sufficient concentration to give detectable signals. For in vivo studies a minimum concentration of 0.2mM is normally required. The amount of sample to be analysed itself is limited by instrument/magnet design but for simple solution studies a typical maximum volume is 0.5 -1 ml. For the less sensitive elements therefore it is desirable to have more concentrated solutions Hydrogen NMR spectra can be obtained in less than one minute depending on concentration of analytes in sample. 8 combined scans (each of 1-2 seconds duration) is usually enough to give a clear signal. Other nuclei are less sensitive and require more combined scans eg 13C can require a few hours of repeated scanning before signals are clear. Comment on technical aspects such solvent interferences, exchangeable Hydrogens,experiment duration, etc that are specific/relevant to NMR of biofluids. The presence of a water (HDO) peak will only serve to degrade the quality of NMR spectra. The concentration of water in an aqueous solution is about 55M and therefore the signal from water itself usually dwarfs/masks weaker signals. in a normal spectrum but a technique of water-suppression is commonly used to reduce the dominance of this peak and protons in the sample that exchange with water. In order to remove any interferences from solvent signals during NMR analysis, solvent suppression techniques are employed, the main ones being presaturation and WET (Water suppression Enhanced through T1 effects). The former is a long-standing method that uses shaped pulses to saturate the solvent resonance(s). The WET method uses selective pulses to excite the solvent resonances then dephasing gradient pulses to destroy them. The two techniques take 0.5-2 s and 50-100 ms, respectively, so the WET method is preferred for continuous-flow NMR. The time to acquire a spectrum depends most critically the number of accumulated scans and hence on the sensitivity of the nucleus under investigation and correspondingly the concentration of the sample. In general, as molecules become increasingly immobilized they produce broader signals. Therefore spectra of living systems revel narrow signals from metabolites which have a high degree of molecular mobility, whereas macromolecules, which are highly immobilized (such as DNA and membrane phospholipids), produce very much broader signals.1 H NMR spectroscopy imposes particularly stringent requirements. High field spectrometers that are used for studies of solutions may have field homogeneity as 1 part in 109, although of course this is over a much smaller sample volume (e.g. 0.5ml) than the volumes characteristic of in vivo studies. Much better spectral resolution can be achieved using high field system study relatively small volumes of body fluids or of cell or tissue extracts. A great deal of information can be derived from such studies. (Gadian, 2004) The poor sensitivity of NMR imposes limitations on the concentrations of compounds that can be detected, and upon the spatial resolution that can be achieved. Because of the large number of variables, it is difficult to give anything other than an order-of-magnitude estimate for the concentrations that are required and for the spatial resolution that can be achieved. Typically, however, we can anticipate that, for metabolic studies in vivo, minimum concentrations of 0.2mM and above will be required in order for a metabolite to give a detectable signal. One of the most remarkable features of magnetic resonance is the extensive range of pulse sequences that have been developed, with a view to enhancing the quality and information content of spectra. For example, innovative pulse sequences have contributed in many ways to improvements in image contrast, spectral localization, suppression of unwanted signals, and visualization of specific structural, biochemical, or functional properties. The existence of the chemical shift enables us to use NMR to distinguish not only between different molecules, but also between individual atoms within a molecule. When used in conjunction with intensity measurements and spin-spin coupling data, chemical shifts of the spectral lines of a molecules provide a great deal of information about its structure. (Gadian, 2004) Identify the major observable components in the control samples of human urine (see 1H spectrum obtained for a healthy adult at the session and compare with that of the 7 month old child in the Canavans disease case study in the lecture notes) Creatinine (Crn) is already identified for you. Canavans disease is an autosomal recessive disorder in which spongy degeneration of white matter is observed. Several groups have shown a large increase in the NAA/Cr and NAA/Cho ratios in children with Canavans disease, consistent with enzyme deficiency. The metabolites monitored were those that are present in sufficiently mobile form and at sufficient concentration to give detectable signals. The urine of patients with Canvans disease shows an unusual signal that can be attributed to NAA. Quantification of this signal from timed urine samples allows an assessment of the rate at which NAA is being removed from the brain. Sketch the molecular structures of each of the major components in urine and of Vitamin C. For each molecule indicate which hydrogen atoms are likely to give rise to distinct signals in a water suppressed 1H NMR spectrum (repeat for Vit C and compare with its reference spectrum provided) Indicates which hydrogen atoms are likely to give rise to distinct signals in a water suppressed 1H NMR spectrum Components in urine There are four different types of H but only two signals as two are bound to N Creatinine (Crn) Betaine (Bet) Hippuric acid (Hip) Acetate (Ace) Lactic acid (Lac) Alanine (Ala) Citrate (Cit) Oxalic acid (Ox) Ascorbic Acid (Vitamin C) (not normally present in urine!) There are six different types of H but only two signals as four are bound to O Identify the major spectral changes observed in the spectrum of urine obtained after ingestion of 10g/day Vitamin C over three days. What information do these spectra provide on the extent of Vitamin C metabolism and on the identities of the major excreted metabolites this is important do not gloss over it. The crn peak stays consistent throughout the 3 day period, as do the other excreted metabolites (Hip, Bet, Cit, Ace). This suggests Vitamin C has no effect on the excretion of other metabolites. The standard and healthy dosage of Vit c is 75 milligrams per day. Therefore at this dosage there is excess Vit c which is unmetabolised and excreted in the urine as shown in fig 4. The diagrams in figure 4 show more Vit c being excreted with each day that passes. Using the standard it is clear to see there is an increase in the peak at the position associated with vitamin C. The area around the peak also generates several smaller peaks. These are not vitamin C but are products with similar structures. These will probably be intermediates in the pathway which breaks down ascorbate acid and contain the same CH2-CH molecular unit intact that was present in the parent ascorbate structure, and this is the bit that gives the NMR fingerprint. Ascertain (Web of Knowledge or similar search would be appropraite) the generally agreed metabolites (excreted or otherwise) of Vitamin C (there are more than two and this is probably the most important aspect of the report so it needs some investigation!) Discuss whether these could and/or would be identified in the 1H nmr spectrum of urine after a prolonged high dosage of vitamin C. What common feature persists throught the degradative pathway- does this match your results? The generally agreed metabolites of Vit C are dehydroascorbate (DHAA), 2-O-methyl ascorbate, 2-ketoascorbitol as well as those in figure 5 (L-Threonic acid, Oxalic acid, Lactic acid). ASCORBATE BREAKDOWN Dehydroascorbate, if not reduced back to ascorbate, decomposes with a half-life of a few minutes, since this  compound is unstable at physiologic pH. The product of the hydrolysis is 2,3-diketo-L-gulonate, which does not possess antiscorbutic effects any more. 2,3-diketo-L-gulonate is decarboxylated to L-xylonate and L-lyxonate. These 5-carbon compounds can enter the pentose phosphate pathway and the L- to D-conversion is suggested to occur through xylitol. Another minor pathway of ascorbate catabolism is a carbon chain cleavage yielding oxalate and 4-carbon intermediates. Pentose phosphate pathway enters the glycolytic/gluconeogenic sequence at triose phosphates and fructose-6-phosphate. Ascorbate and dehydroascorbate, according to the previous assumptions, can be rapidly metabolized to glucose in isolated murine hepatocytes and in HepG2 cells. When glutathione-dependent recycling is inhibited by the oxidant menadione or by the glutathione synthesis inhibitor buthionine sulfoximin e, gluconeogenesis from ascorbate is stimulated. The participation of the non-oxidative branch of the pentose phosphate pathway has been demonstrated by the administration of oxythiamine, a thiamine antagonist which inhibits transketolases. In hepatocytes gained from oxythiamine-treated mice glucose production from dehydroascorbate is lower, and a pentose phosphate cycle intermediate, xylulose-5-phosphate is accumulated. This path of ascorbate catabolism could be demonstrated even in cells unable to synthesize ascorbate, i.e., in cells of human origin and in non-hepatic murine cells. In murine and human erythrocytes-which are unable to synthesize glucose (glucose-6-phosphatase is lacking)-ascorbate or dehydroascorbate addition resulted in the increase of lactate, the end product of anaerobic glycolysis. Lactate production could be stimulated by the addition of menadione or inhibited by oxythiamine treatment of the cells indicating that the pentose phosphate pathway is involved in as corbate catabolism both in hepatocytes and in erythrocytes. These results show that ascorbate does not get lost but is effectively reutilized even in case of diminished recycling and it should be taken into account not only as a vitamin, but also as a source of energy. (Banhegyi, Braun, Csala, Puskas, Mandl, 1997) It would be hard to identify the metabolites of Vit c in the 1H nmr spectrum of urine after a prolonged high dosage of vitamin C as figure 6 shows a large peak of unmetabolised Vit c which is excreted in the urine. This peak, surrounded by intermediates of the pathway which breaks down ascorbate acid, dominates the 1H nmr spectrum and masks weaker signals. Therefore the metabolites which are produced by the breakdown of some of the Vit c are hard to identify. The common feature which persists throughout the degradative pathway is the CH2-CH molecular unit which is part of all the intermediates within the pathway, and this is the bit that gives the NMR fingerprint. This is shown in figure 6 with several smaller peaks around the Vit C peak. These are the intermediates of the pathway which contain the CH2-CH molecule which is present in the parent ascorbate acid and therefore have a similar structure and appear as peaks around Vit C. These will probably be intermediates in the pathway w hich breaks down ascorbate acid and contain the same CH2-CH molecular unit intact that was present in the parent ascorbate structure Comment on the human bodys requirement for vitamin C, its role in prevention/treatment of disease (briefly), the required daily intake/doseage, etc. How does this relate to the results dicussed above? Recommendations for vitamin C intake have been set by various national agencies: 75 milligrams per day: the United Kingdoms Food Standards Agency The key importance of Vitamin C is supporting the immune system and forming a structural component known as collagen. It is also required for synthesis of the neurotransmitter, required for brain function and mood change. Vitamin C aids in synthesis of a small molecule, carnitine. Carnitine is required for fat transportation to cellular organelles known as mitochondria, potentially, producing energy. Vitamin C has the ability to enhance bodys resistance to varied diseases. It aids in stimulating the action of antibodies and immune cells like phagocytes, resulting in a stronger immune system. Vitamin C metabolite L-threonic acid or its calcium salt, calcium threonate (the form of L-threonic acid found in Ester-C), increases vitamin C uptake of cells. Essentially, with calcium threonate, vitamin C has been shown to be absorbed more quickly, reach higher levels and is excreted more slowly. Now the studies confirm that the vitamin C uptake of the cells is greater with the metabolite L-threonic acid present. identify the advantages and disadvantages of using NMR over other common analytical methods used in Biomedical Sciences (or elsewhere). In NMR spectroscopy, only a very small excess of the spins are in the low energy state. The net result of this is that NMR is rather insensitive technique relative to many other analytical methods. Typically, even todays spectrometers require a minimum of several nanomoles of material for anaylsis in reasonable times. Poor sensitivity has been the bane of bioanalytical uses of NMR and increasing NMR sensitivity has been the focus of most of the technical developments that have occurred over the past four decades. However, in contrast to the low intrinsic sensitivity in the applications of NMR to biofluids, the non-selectivity of NMR makes it a very powerful tool for surveying the molecular content of a sample without prejudging which analytes to search for. This advantage can also be a nuisance. Scarce analytes often need to be measured and although above the limit of detection, these lower level species may be fully or partially obscured by analytes at much higher concentrations. (Gadian, 2004) A comparison of NMR spectroscopy with HPLC shows a variety of advantages of NMR over HPLC method. The primary advantage of NMR is its efficiency due to the lack of any preparation times. The analyte has to be weighed and dissolved in the solvent only and afterwards the analyte can be measured immediately. The experimental time depends on the concentration of the analyte. Using HPLC for the determination of an analyte much time has to be spent for the equilibration of the column. The column has to be washed every day after the measurements have been taken to prolong the lifetime of the column. When using the HPLC technique, often much time has to be spent for sample preparation e.g. derivatization of the analyte. A further disadvantage is the large amount of solvent necessary for the HPLC separation. NMR is also more efficient than the conventional HPLC techniques. (Wawer, Holzgrabe, Diehl, 2008)

Glucose Tolerance Tests Accuracy In Diagnosing Diabetes

Glucose Tolerance Tests Accuracy In Diagnosing Diabetes According to the World Health Organization (WHO), more than 220 million people worldwide have diabetes. An estimated 1.1 million people died from diabetes in 2005, and almost half of diabetic deaths occurred in people under the age of 70 years of age. WHO projects that the number of diabetic deaths will increase to 366 million by the year 2030 (8). Diabetes Mellitus Type 2 is a prevalent disorder that causes one to have high blood sugar, or hyperglycemia. This hyperglycemia can be the result from one or a combination of 1) decrease production of insulin from beta cells of the pancreas; 2) increase sugar production from the liver; 3) decrease sugar uptake by cells secondary to insulin receptors. Symptoms of DMII are excess urination, excess thirst, dizziness, blurred vision, sweating, and fatigue. Patients presenting with these symptoms should be screened by a finger stick, where a blood sample is taken from a quick prick of the finger, to be tested for hyperglycemia. Normal blood sugar should range from 70-100mg. If one has a fasting sugar of >126mg or an after eating sugar level > 200mg, then an oral glucose tolerance test (OGTT) should be performed. During an OGTT, a patient consumes a 150-200g carbohydrate diet for three days and fasts from midnight prior to test date. The morning of test, the patient consumes 75g sugar mixe d with 300ml of water within a 5 minute period. The patients blood sugar level is be measured at baseline, and then again at 120 minutes. A diagnosis of DMII is made if the baseline level is >126 mg and the 120 minute level is >200mg. These guidelines are set by the American Diabetic Association (ADA) and the World Health Organization (WHO) (1,8). Another option for obtaining a blood sugar level is measuring the percent of glycosylated red blood cells, or the percent of sugar attached to a RBC. RBCs live for approximately 90 days in the human body. By measuring this percentile one can observe the patients blood sugar level over the previous 3 months and not just at the moment an OGTT is performed. Today, HbA1c is a main tool for following metabolic control in persons with diabetes(5). A HbA1c > 6.0 percent should permit a diagnosis of DMII, but is not at this time a definite diagnostic tool. Diabetes can cause complications of multiple organ systems. WHO defines consequences of diabetes as follows: Diabetes increases the risk of heart disease and stroke. 50% of people with diabetes die of cardiovascular disease (primarily heart disease and stroke). Combined with reduced blood flow, neuropathy in the feet increases the chance of foot ulcers and eventual limb amputation. Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. After 15 years of diabetes, approximately 2% of people become blind, and about 10% develop severe visual impairment. Diabetes is among the leading causes of kidney failure. 10-20% of people with diabetes die of kidney failure. Diabetic neuropathy is damage to the nerves as a result of diabetes, and affects up to 50% of people with diabetes. Although many different problems can occur as a result of diabetic neuropathy, common symptoms are tingling, pain, numbness, or weakness in the feet and hands. The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes (8). Previous studies have showed that better control of plasma glucose levels reduced the risk of developing long-term complications pertaining to diabetes (4). A higher HbA1c correlates well with the likelihood of developing chronic complications such as the ones listed above. This study is designed to explore if a HbA1c be used to diagnose diabetes. Observations suggest that a reliable measure of chronic glycemic levels such as HbA1c, which captures the degree of glucose exposure over time and which is related more intimately to the risk of complications than single or episodic measures of glucose levels, may serve as a better biochemical marker of diabetes and should be considered a diagnostic tool (2). As for the current gold standard for diagnosing diabetes, the oral glucose tolerance test (OGTT) has its limitations (2). These include high interindividual variability, low reproducibility compared to FPG, poor compliance with the conditions needed to perform the test correctly, and is cumbersome and time-consuming for medical staff and patients (4). Due to these factors one may ask, Is a HbA1c or an OGTT more accurate at diagnosing new onset diabetes mellitus type 2 in a patient presenting with hyperglycemia? By exploring this question and answering it from an evidence-based approach, the answer may help clinicians advance to an easier and less time consuming way to diagnose diabetes mellitus type II. CLINICAL CASE A 57 year old African American male presented to the outpatient office with symptoms of dizziness, blurred vision, polydipsia, and polyuria. He has a significant history of hypertension and hyperlipidemia. The patient was unclear when his symptoms started. Upon evaluation in the office, the patient was noted to have a marked glucose elevation of 420. An in-house HbA1c was also noted at 13.0. Upon further questioning, the patient has not been taking any medications for diabetes, and is currently taking Lisinopril and Zocor for his other medical conditions. Due to the presenting symptoms and lab results, the patient was admitted to the hospital for hyperosmolar nonketotic hyperglycemic state. METHODS A PubMed search was performed by using the Clinical queries and Diagnosis filters. The terms A1c AND diagnosis AND diabetes and glycosylated hemoglobin AND diagnosis AND diabetes were used to search the site for relating articles. With these search terms, a total of 176 hits revealed articles pertaining to the requested information. Articles that met all inclusion criteria for the research were evaluated and assigned a type/level of evidence. In order to be included in this evidence-based study, articles had to meet the following inclusion criteria: Articles must be cohort studies. Studies must not be > 6 years old. Articles must have participants with impaired glucose levels or symptoms of impaired glucose. Studies must include evidence of OGTT or FPG and HbA1c. Studies must have a significant number of participants to produce a significant result (n > 375). Any articles that did not specifically relate to diagnosing DMII with a HbA1c were excluded. Articles that were not cohort studies, were older than six years, did not have participants with impaired glucose, or did not have a significant amount of participants were excluded. Certain articles that appeared in the PubMed search were strictly review articles. These papers were reviewed, and if applicable, may be used to provided supporting factors about pathophysiology/ epidemiology of diabetes type II and its diagnostic criteria. Articles that met all inclusion criteria were evaluated and assigned a level of evidence using the Oxford Centre for Evidence-based Medicine Levels of Evidence worksheet. RESULTS Study #1: Diagnosing Type 2 Diabetes Mellitus: in Primary Care, Fasting Plasma Glucose and Glycosylated Hemoglobin Do the Job Study Design: This study was performed at the Raval Sud Primary Care Center in Barcelona, Spain and was begun in 1992. The purpose of this study was to determine the validity of glycosylated hemoglobin values as a method to diagnose type 2 diabetes mellitus in a population at risk seen in primary care. Four hundred fifty four subjects were selected to participate in the study. The population served by the Raval Sud Center is characterized by it low evonomic level, high rate of immigration, and high rate of morbidity and mortality for certain diseases and disorders. Inclusion criteria for eligible participants had at least on e of the risk factors for developing DMII described in the ADA guidelines. These included family history of DMII, personal history of carbohydrate intolerance or gestational diabletes, prolonged use of a drug able to raise glucose levels, obesity with a body mass index > 30, hypertension, HDL-cholesterol levels 250 mg/dL. Persons who did not wish to take part in the study were excluded. For the purpose of this particular study, data was recorded from the time the patient was included in the Raval Sud Care Center. The study then used a cross-sectional analytical design to validate a diagnostic test. (4) Study Conduct: Subjects were interviewed and variables were recorded for each participant. These included sociodemographic characteristics such as age and sex, clinical characteristics such as BMI and blood pressure, and laboratory values including fasting plasma glucose in a venous blood sample, oral glucose tolerance test after a 75g glucose overload, and a HbA1c measured by high pressure liquid chromatography. To standardize the results for the HbA1c, the absolute values were recalculated in terms of the number of standard deviations above the mean. FPG and OGTT values were based on the WHO criteria as having normal, impaired, or DMII glucose levels. (4) Study Results: The distribution of demographic characteristics and laboratory findings are shown in Table 1. The study found that plasma glucose levels were significantly lower in normal subjects than in subjects with abnormal glucose levels (IFG or OGTT) and even lower in subjects with abnormal glucose levels than in patients with diabetes (P 5.94% (mean, +3SD), the diagnosis of DMII is reliable and accurate in 93% of the cases. Table 4 shows the diagnostic validity of a combined strategy of FPG and HbA1c values: patients were considered to have DMII when FPG > 125 mg/dL, or when FPG >110 mg/dL and HbA1c was greater than the cutoff value. Maximal efficacy (93% GV) was found for HbA1c > 5.94% (x +3SD), with a sensitivity of 92.2% and a specificity of 95.1%. (4) Study Critique: It has been confirmed that the relationship between circulating glucose values and the onset of chronic complications exists. Thus, it is logical for the diagnosis of DMII to be based on glucose values. One of the main problems in this particular study was to define and establish a cutoff point for this continuous quantitative variable. This study analyzed different cutoff points for the whole sample of patients at risk for DMII. When HbA1c values > 5.51% (x +2SD), were used for the cutoff point for diagnosis of DMII, the sensitivity (76%) and specificity (85%) were acceptable. However, when a higher cutoff point was used, specificity increased, but only at the expense of reduced sensitivity. Due to this situation, the study designed a strategy for diagnosis based on the FPG values and the validity of HbA1c. (4) Level of Evidence: 1c Study #2: Comparison of A1c and Fasting Glucose Criteria to Diagnose Diabetes Among U.S. Adults Study Design: This study included participants from the 1999-2006 National Health and Nutrition Examination Survey. Participants included 6,890 adults (>20 years of age), without a self-reported history of diabetes. The subjects attended a morning examination, fasted for > 9 hours at the time of their blood collection, and had valid plasma glucose and HbA1c values taken. Participants were categorized into one of the four groups by presence or absence of fasting plasma glucose > 126 mg/dL and HbA1c > 6.5%. The distribution of the population into these groupings was determined and the K statistic value was calculated. Also, the distribution of U.S. adults by fasting glucose and different HbA1c cutoff points (6.0-6.7%) were calculated. The objective for this study was to compare A1c and fasting glucose for the diagnosis of diabetes among U.S. adults. (6) Study Conduct: Data was collected through questionnaires (demographics, medical history), a physical examination (blood pressure, BMI, and waist circumference), and blood collection (lipids, plasma glucose, HbA1c). The plasma glucose was measured by using a modified hexokinase enzymatic method and the HbA1c using a high-performance liquid chromatography. (6) Study Results: This study concludes that an HbA1c of > 6.5%, along with a FPG >125 mg/dL demonstrates reasonable agreement for diagnosing diabetes. 1.8% of the participants were classified as having diabetes with a HbA1c > 6.5% and a fasting glucose >126 mg/dL. Among participants with a HbA1c 125 mg/dL, 45% had an A1c value > 6.0% but less than 6.5%. According to A1c guidelines, this value poses an elevated risk for diabetes. Table A1 shows a distribution of adults by fasting glucose and different HbA1c cutoff points. From this table, the lower the HbA1c cutoff points results in higher sensitivity and lower specificity. (6) Study Critique: In this study, certain participants had discordant results such as a HbA1c > 6.5% and a fasting glucose of Study #3: A1c and Diabetes Diagnosis: The Rancho Bernardo Study Study Design: The Rancho Bernardo Study included 2, 107 participants without known DMII, who had an OGTT and a HbA1c between 1984 and 1987. This cross-sectional study of community dwelling adults was provided written informed consent and laboratory data was performed. (3) Study Conduct: HbA1c was measured with high performance liquid chromatography using an automated analyzer. Ophthalmologic evaluation was also performed on the subjects. This was done by using nonmydriatic retinal photography. Sensitivity and specificity of HbA1c cutoff points for DMII were calculated, along with K coefficients which were used to test for agreement between A1c values and diabetes status. The objective for this study was to examine the sensitivity and specificity of HbA1c as a diagnostic test for DMII in older adults. (3) Study Results: For this study the HbA1c cutoff value was 6.5%. This value had a sensitivity of 44% and a specificity of 79%. A lower A1c cutoff point of 6.15% yielded the highest sensitivity at 63% but a lower specificity at 60%. If one were to use this cutoff value, it would miss one-third of those with DMII by the American Diabetes Association guidelines. It would also misclassify one-third of those without DMII. Using the HbA1c value of 6.5% as the cutoff point, the agreement with DMII diagnosis was low (K coefficient was 0.119). In order to compare A1c and ADA criteria with DMII complications, the study looked at participants with some degree of retinopathy. Of the participants who had retinopathy, 40% had and A1c > 6.5% and none had DMII by ADA criteria. This study concluded that the limited sensitivity of the A1c value cutoff may result in missed or delayed diagnosis of DMII, whereas the use of current OGTT criteria will fail to identify a high proportion of individuals with hi gh A1c values, which correlate with long term complications of DMII. (3) Study Critique: This study was performed on a much older population than the other studies examined in this paper. It has its benefits and disadvantages for surveying a population in which there mean age was 69.4. The advantage is that the U.S. elderly population has the greatest current burden and is expected to have the greatest increase in the prevalence of DMII. On the other hand, the disadvantage to having such an older subject population is that it limited the HbA1c cutoff values to that particular population. In a previous critique of an article one of the concerns was the fact that there are different aspects of glucose metabolism. It would have been supportive if the article addressed the age of their participants and compared them with the study results. (3) Level of Evidence: 1c Study #4: Diagnostic value of glycated haemoglobin (HbA1c) for the early detection of diabetes in high-risk subjects Study Design: This study was performed by collecting data from the Bundang CHA General Hospital database. A total of 392 subjects who had an abnormal random plasma glucose, a history of gestational diabetes mellitus, a macrosomic baby, or a severe obesity were selected to participate in the study. Exclusion criteria included a previous history of diabetes of other endocrinopathies, pregnancy, abnormal liver or renal function tests, a history of major surgery, severe illness, blood transfusion within the previous 6 months, and weight loss > 3kg during the past three months. After an overnight fasting, blood samples were drawn from all participating subjects to include FPG and HbA1c values. (7) Study Conduct: Glucose concentrations were measured using the glucose oxidase method on a autoanalyzer. The HbA1c values were measured by the high-performance liquid chromatography method. All statistical analysis was performed and the best predictive cutoff values for FPG and A1c for detecting patients with new diabetes were identified using the optimal sensitivity/specificity values determined by the receiver operating characteristic curve. (7) Study Results: Figure 1 shows the ROC plot representing the sensitivity and specificity for the HbA1c and the FPG in detecting undiagnosed DMII. From this study, the optimal cutoff value for HbA1c was 6.1% and for FPG was 6.1 mmol/l. The sensitivity/specificity for the HbA1c cutoff value was 81.8% and 84.9% respectively. Table 1 shows the results from the combination of using FPG and HbA1c. This study demonstrated that HbA1c was very useful to screen for diabetes in high-risk patients and the combined use of HbA1c and FPG made up for the lack of sensitivity in FPG alone. (7) Study Critique: This studys subjects were only Korean, therefore making the population very ethnically limited. It would have been beneficial to have seen the population more diverse and to notice the change in results. Also, the study stated that an OGTT was performed, yet a confirmation status of repeat testing was not recorded. This would have been beneficial to have in order to compare results to the FPG and HbA1c values obtained for cutoff for diagnosing DMII. (7) Level of Evidence: 1c DISCUSSION The purpose if this study was to assess if a HbA1c was sufficient enough to make a unknown diagnosis of diabetes mellitus type 2. From these studies one can gather that a HbA1c is adequate for making a new diagnosis for DMII. The following chart compares the specificity and sensitivity of each HbA1c from each study critiqued in this study. Also, each study uses a different HbA1c cutoff that they gathered from their cohort or cross-sectional study which is also included in the chart below. Study Sensitivity Specificity HbA1c used for Diagnosis Diagnosing Type 2 Diabetes Mellitus: in Primary Care, Fasting Plasma Glucose and Glycosylated Hemoglobin Do the Job 63.3% 93.4% 5.94% Comparison of A1c and Fasting Glucose Criteria to Diagnose Diabetes Among U.S. Adults 72.5% 96.5% > 6.0% A1c and Diabetes Diagnosis: The Rancho Bernardo Study 44% 79% 6.5% Diagnostic value of glycated haemoglobin (HbA1c) for the early detection of diabetes in high-risk subjects 81.8% 84.9% 6.1% Study #1 discussed the option of performing a combination of HbA1c and a FPG test. This exhibited to be most the most poignant result with a specificity/sensitivity of 92.2 and 95.1, respectively. In study #2, it also agreed that a HbA1c and a FPG level provided the most assured diagnosis for DMII. However, this study had the most discordant results and was probably due to the fact of its subject population. It stated that the results may have been due to the fact that assessment of different aspects of glucose metabolism was present (6). Study #3 was performed on a much older population, and focused on the importance of following HbA1c levels to help prevent long term complications of DMII. However, it also stated that a HbA1c would also have a higher sensitivity and specificity if it were performed along with a FPG test. Finally, study #4 agreed on the fact that a HbA1c was very sufficient for screening for DMII, and that it provided much support for diagnosing DMII along with a FP G. CONCLUSION This study provided that a HbA1c of approximately 6.0% is a great support to help making the diagnosis of DMII along with a FPG > 125. Some studies have suggested that a HbA1c of this value is suggestive of a diagnosis, however, the studies above advocate that FPG levels should also be obtained to solidify the actually diagnosis of DMII. However, in a recent publication from the JAAP, it states thatan A1c value of 6.5% higher as diagnostic. This value appears to be the level at which a person is at risk for developing the complications of diabetes. A diagnosis should be confirmed with a repeat A1c test, unless clinical symptoms and a glucose level higher than 200 mg/dL are present (5). From this statement one can confer that the patient described above in the clinical case portion of this paper, does indeed warrant the diagnosis of DMII on the basis of a HbA1c of 13.0%, the presence of clinical symptoms, and the glucose elevation of 420 mg/dL.

La Oferta del Año - Spanish Essay :: Papers

La Oferta del Aà ±o Esta casa es ideal para una familia grande. Es situado en el corazà ³n de la ciudad y es la cerca muchas estaciones. Hay abajo una bastante grande cocina integral. Es muy mordern con baldosines. Hay tambià ©n un comedor grande y es decora agradablemente. Prà ³ximo a el comedor hay un aseo pequeà ±o. La casa tiene dos espacios de recibo, ambos grande y con chimineas. Al lado de primero espacio de recibo, hay un conservatorio nuevo con el plan encantador de madera y es la iluminacià ³n muy buena. Hay arriba cuatro dormitorios y dos cuartos de baà ±o. Ambos cuartos de baà ±o son completamente embaldosado. El dormitorio principal es grande, tiene las ventanas grandes y armarios empotrados. El tercero y segundos dormitorios son idà ©nticos con armarios empotrados. El cuarto dormitorio es pequeà ±o pero puede quedar una cama matrimonial. Todo el dormitoros son decorado hermosamente. Afuera, hay un garaje con suficiente espacio para dos coches. En el fachada jardin hay arboles frutales y las plantas grandes. En el jardà ­n de espalda hay una piscina climatizada pero pequeà ±o. La casa tiene el calefaccion central, vantanas insulados y parabolica. La arquitectura es extraordinaria, mordern y es diseà ±ado por un arquitecto bueno. El precio muy razonable y se acceptan afertas. Para mà ¡s informacion, contacta. Agentcia Anjani Amlani sobre: TLF: 0208 863 4444 CELULAR: 07704 404 404 ====================== Mi Casa Mi casa esta en Harrow Weald. Esta tambià ©n cerca de Wealdstone y diez minutos de mis escuelas. Mi casa tiene dos pisos. Abajo hay un grande salon. Es decorà ³ agradablemente pero es un poco pequeà ±o. El comedor es conectado el salon y es decorà ³ misma manera con una mesa pequeà ±a de vidrio en el centro del cuarto. La conservitorio es muchisimo largo y y tiene la iluminacià ³n bueno. Es muy frio en inverno o muy caliente en verano. Arriba hay tres dormitorios y una cuarto de baà ±o. El cuarto de bano es regular y es todo azul. El dormitorio de mi hermano es muy pequà ±o y

Interview Essay - Murray Meisels -- Interview Essays

Interview Essay - Murray Meisels Murray Meisels was born on April 19, 1924, in Brooklyn, New York. He grew up in New York City and came to California in 1941 to attend college at USC. After graduating from USC, he attended the University of Oregon Dental School and the University of Buffalo Dental School. Murray served in the military during WWII and the Korean War. In 1948, he married Francis and they made their home in Buffalo, New York. They raised two children, and Murray owned a dental practice for over 40 years. While raising a family and practicing dentistry, he completed a Masters degree and taught at the University of Buffalo Dental School. In 1991 Murray retired from private practice, but continued teaching part time at the dental school. During this time he and his wife spent winters in California. In 1996 they decided to make California their permanent home, and are very happy living here. They are proud parents and grandparents. Murray is very active and enjoys the Emeritus program, exercising regularly , stamp collecting, golf and craft works. He creates beautiful ceramic, glass and sculptured pieces. The key elements in Murray's definition of happiness are peace, quiet, a lack of arguing, good health, and security. His definition of happiness has changed through the years, and he finds himself content with allowing people and situations to be the way they are. He is happier when he doesn't let things bother him. He has learned over time not to worry and aggravate himself unnecessarily. Selfish and opinionated people used to bother him terribly and he felt the need to respond, argue, or simply avoid them. But now he can handle these types of situations without feeling stressed. Having too many requests at h... ...w and you'll see the results in your life." He feels that this advice is consistent with his philosophy on life. "I try to be fair and honest with everyone, sometimes to a fault. I like people to be honest and fair with me. I have always loved and done right by my family. I worked hard to do the best job that I could and I didn't take advantage of anyone in my practice." I truly enjoyed my time spent with Murray. Both he and his wife Francis graciously welcomed us into their home, and made us feel like familiar friends. It was wonderful to hear him share stories from his life and I thank him for his openness and honesty. His insights about the trials and tribulations of life were applicable to a person of any age. Many times over the last few weeks, I have found myself thinking about something that he said. Murray is truly full of life and has a lot of spirit! Interview Essay - Murray Meisels -- Interview Essays Interview Essay - Murray Meisels Murray Meisels was born on April 19, 1924, in Brooklyn, New York. He grew up in New York City and came to California in 1941 to attend college at USC. After graduating from USC, he attended the University of Oregon Dental School and the University of Buffalo Dental School. Murray served in the military during WWII and the Korean War. In 1948, he married Francis and they made their home in Buffalo, New York. They raised two children, and Murray owned a dental practice for over 40 years. While raising a family and practicing dentistry, he completed a Masters degree and taught at the University of Buffalo Dental School. In 1991 Murray retired from private practice, but continued teaching part time at the dental school. During this time he and his wife spent winters in California. In 1996 they decided to make California their permanent home, and are very happy living here. They are proud parents and grandparents. Murray is very active and enjoys the Emeritus program, exercising regularly , stamp collecting, golf and craft works. He creates beautiful ceramic, glass and sculptured pieces. The key elements in Murray's definition of happiness are peace, quiet, a lack of arguing, good health, and security. His definition of happiness has changed through the years, and he finds himself content with allowing people and situations to be the way they are. He is happier when he doesn't let things bother him. He has learned over time not to worry and aggravate himself unnecessarily. Selfish and opinionated people used to bother him terribly and he felt the need to respond, argue, or simply avoid them. But now he can handle these types of situations without feeling stressed. Having too many requests at h... ...w and you'll see the results in your life." He feels that this advice is consistent with his philosophy on life. "I try to be fair and honest with everyone, sometimes to a fault. I like people to be honest and fair with me. I have always loved and done right by my family. I worked hard to do the best job that I could and I didn't take advantage of anyone in my practice." I truly enjoyed my time spent with Murray. Both he and his wife Francis graciously welcomed us into their home, and made us feel like familiar friends. It was wonderful to hear him share stories from his life and I thank him for his openness and honesty. His insights about the trials and tribulations of life were applicable to a person of any age. Many times over the last few weeks, I have found myself thinking about something that he said. Murray is truly full of life and has a lot of spirit!

Exile :: essays research papers

Controversy of the Exile   Ã‚  Ã‚  Ã‚  Ã‚  After reading 2 Kings 25 and the two articles, the main source of contrast between these two sourcs is the amount of detail they go into on different aspects of the Exile. The Biblical reading mentions King Nebuchadnezzar and his capture of King Zedekiah, the efforts of General Nebuzaradan and his detailed destruction and pillaging of Jerusalem and the Temple, the capturing and execution of Judah’s chief officers and priests, Judah’s revolt against Gedaliah and fleeing to Egypt, and the benevolence King Evil-merodach of Babylon demonstrated towards Jehoiachin. The articles, however, mentioned nothing of to do with any of these circumstances. They concentrated, instead, on the life in Judah during the Exile.   Ã‚  Ã‚  Ã‚  Ã‚  The Biblical picture of life in Judah during the Exile was expressed in only a few verses. One states, “But the poorest of the people were left to farm the land (2 Kings 25:12).'; This gives us little information to work with, and all that can be assumed is that not many people were left in Jerusalem, and those that were, farmed. Whether they farmed for themselves, or for Babylon cannot be reasonably determined from this one verse. Later on, we see that some underground guerrilla forces were also left in Judah as they assassinated Gedaliah and fled to Egypt. Other than this, we know nothing from 2 Kings 25 about life in Judah during the Exile. The articles, however, give us much more light into life in Judah during these times. Graham illustrates that the people that worked in Jerusalem, Mozah, and Gibeon during the Exile were primarily vinedressers and plowmen. 2 Kings 25 does not give us enough information to have known that people worked in these three ci ties. Their work, however, was not for themselves, but for the greater power of Babylon, as can be illustrated in an engraving on a jar that read, “belonging to the lord'; in reference to the work done by the people for the Babylonian king. This, also, was not explicitly illustrated in 2 Kings 25. The king of Babylon collected the goods produced and used them to better the Babylonian economy and the royal crown. Governor Gedaliah also was expected to have overseen people of Judah work to produce wine, fruit, and oil for Babylon. Outside Benjamin, people worked to make perfume, especially balm, for the royal crown of Babylon. The insight Graham gives us into the work done at Mizpah stresses an important point that 2 Kings 25 leaves out.

The day for the interview came

It is a hard animateness living in the real universe. The world doesnt provide liter completelyy what we pick up we spend a penny to work hard in order to satisfy our basic needs. monetary considerations be included as personalized pursuits in order to live full as an individual and incisivelyify our macrocosm here on Earth. But runner, in pursuing this goal, one needs to fall out a argumentation for this to be his fair in attaining the much needed fiscal stability.I, for one, had front-class honours degree-hand experiences on the hardships one faces when hunting for a well-paid mull.The first step in purpose work is the making of a well-organized latch on and submitting this to a company or foot where you want to work for. After your corroboration are assessed by their human mental imagery department, they may call you for a job converse in order for them to have the chance to know the extent of the reality of your credentials stated in your resume.The first job audience is considered one of the hardest and intriguing parts of the job hunting make.The split second I got my first call from a clerk of a certain office, I couldnt contain myself. I was exhilarated. My unwearying efforts of submitting resumes to different companies and offices finally paid off. tone back, I saw myself organizing the contents of my resume, encoding, stamp this in multiple copies and putting these in big envelopes.Then, I was off, handing these to different offices sometimes I walk, or ride a bus when the need arises, just so I can give all the resumes to the different offices. Then, the call came for my first job interview my first chance to this instant tell them with frankness what I am capable of.Some say that first impressions last. So I had to choose the best array that I have to wear, groomed myself before the mirror a hundred times, and rehearsed the things that I would answer to pre-conceived probable questions that have to be asked. These, I hoped, would create a verifying impact on the interviewers.I stomached that the interview itself would be much tensed I experienced a mixed savour of dread and trepidation when I overt the door towards the conference table. Lo and behold The interview was to be done by a panel of interviewers. I did not expect this. For an eternity, I matt-up that I forget collapse upon seeing their faces, expressionless, ready to pelt me with questions.But, to my delight, I was met with reassuring and comforting handshakes by the interviewers. I thought, at that exact arcsecond that Ill get through that interview, which in conclusion I did. The moment I answered the first question, my self-esteem suddenly rose. A cast of questions came after myriad of questions, yet I was able to answer these fairly.Others questions were answered the best path possible, or so I thought. This gave me a boost to persist and carry on until the last minute is through. Until I felt that I was completely at ea se, as if I am just lecture to colleagues and contemporaries. As quick as it started, the interview ended. This left me with an awakening I survived my first job interview.I finally came up with a conclusion that pleasure and fun are not just derived from starting to do our first job tasks rather the superstar of adventure and accomplishment can be drawn from the path or process of finding a job, such as the interview process.Life is not hard as it seems, if taken with a positive outlook. It would just be hard if we dont try to tackle the challenges it has to offer. Once we get to overcome these, we realize that we are learning, at the same time getting warm to our goal.

Exhibit Advertisement Essay

enthrall join the Rhode Island School of introduction in exploring a blast from the past Our yearly trick exhibit forget be celebrated January 22, 2012 in RISDs auditorium. This year allow showcase wile work from the other(a) Chinese and Early Nipponese Civilizations. During this free exhibit your built-in family go out be able to search the very fascinating masterpieces from ancient Chinese and Japanese impostureistic productionist. Throughout the exhibit you give see different leaps of ruse with distributively piece reflecting on their culture, history, and religious beliefs.Please take some time to interpret about some of the artwork that will be displayed, and its roots. Understanding these amazing art represents stooge be comprehended by first taking a pay heed on how all forms of art was greatly captured by Early Chinese Civilization. there are some connections between culture, religion, and sacred beliefs. Buddhism, Taoism, and Confucianism were relig ions that greatly affected Chinese artist. These religions and philosophies stand for social responsibility, responsibility towards disposition, practical and cloak-and-dagger relations, along with healthy disembodied spirit balance.In addition to religion the admiration of nature played a very peculiar(prenominal) part in art whether it is sculptures, calligraphy scrolls, or architecture. The wide array of art forms can be traced back to the Chinese culture. In the first preview you will notice a bronze cavalry this artwork was created during the Han Dynasty. A horse for many was means of transportation however the Chinese valued the horse, especially imputable to their location. The variant of horses that were available to the Chinese were considered flying horses due to their speed.Many emperors along with citizens valued animals and nature because of their weird beliefs. Chinese men excessively valued the horse understanding that in time or war horses were an congeni tal part to defeating enemies. Another art form that can be viewed at our annual exhibit is the representation of Yin and Yang. Yin and Yang represent the affect balance of life. This is most commonly represented by black and white, although the Chinese understand that life would not always be black and white.The Chinese understood that no part of life could be applicable without the other and appreciated the good with the spoiled and believed in things being equal. Japanese art form absorbed many of the influences from the Chinese Civilization. Japanese art in its avow way is a concentrated form of Chinese work and cultural beliefs. there were Taoist and Confucius influences however the Shinto and Buddhist society were in any case heavily acknowledged. The jockey and respect for spiritual peace in addition to nature can be easily identified in Japanese art.Much like the Chinese, the Japanese also valued family, life balance, and elder wisdom. In the above image one can sens e the importance of religion and spiritual finding. The Shaka Triad displays in the center Buddha. This art work was a direct influence of Buddhism, which later became to influence the court life of the Japanese. (Benton & DiYanni, 2008) This piece of art was directly influenced by the Chinese sculpture traditions especially those of pre-Tang period.

Enterprise Architecture as Strategy Essay

Technology is shifting at a faster rate resulting in development of new methods that assist in satisfactory completion of certain technological demand. This has given birth to different enterprise architecture frameworks that fulfill the specific requirements of day-to-day activities. Architecture is a framework of guidelines, principles, models, standards and strategies that directs, social construction and development of business process, design and information and resources through enterprise. Hence, free enterprise architecture is a blueprint, which defines the structure and operation of a given organization (Fowler & Rice 2003).The growth of such a economic theory isnt sufficient.The Open Group Architecture Framework (TOGAF) is an enterprise architecture framework, which approaches the further development of enterprise information architecture through design, planning, governance and implementation.This EA framework employs twenty four pillars to achieve its goals: Applicati on, Business, Technology and Data. Before the architect own plans for current and future aims of the organization, they are provided with foundation architectures how that form the basis that they will use for the new development. The four pillars play a crucial major role in ensuring that the process is successful.Management is merely one of the essential pursuits which play a valuable part in the additional information systems also .

The original aim of the TOGAF was to design and develop technology modern architecture for a given business entity. However, the framework has evolved becoming a methodology that is used to analyze overall business architecture. This resulted into splitting of the enterprise methodology into two parts: Architecture further Development Method (ADM) and Enterprise continuum. The ADM ensures that the enterprise architecture meets the minimum requirements of the organization in terms of business needs and information technology needs.Information methods that what are complex control leverage new technologies and concepts or companies from having the ability to adapt to be able to compete.For example, Phase C combines Application and available Data architecture and phase B and C ensure that the clarity of the information gothic architecture is achieved (Lankhorst 2005).For the ADM to be successful, Enterprise Continuum comes handy. Generally, the Enterprise Continuum can be seen as a ‘virtual repository’ of all the assets of the architecture that is in an organization. These assets may include architectural patterns, architectural models, architecture descriptions and other important artifacts.At best, it tap into a diverse range of abilities and solutions empty can result in a more holistic strategy and also improve the overall understanding of our professionals.

Usually there is a relationship between the different EA frameworks in terms of how it operates and ways deeds that enables it to accomplish its duties. Zachman Framework and TOGAF ADM part fair share some common features. ADM mapping in relation to the Zachman Framework supports a correlation.The Zachman Framework has a well established and comprehensive taxonomy that supports various models, viewpoints wired and other important artifacts, which an enterprise may consider developing as a phase of the EA (White 2007).Organizations unable to satisfy the generous donation could be requested to submit supporting documentation, including salary programs for other graduate-level interns or an operating budget.The main purpose of the architecture is to define viewpoints, an aspect that is supported by the TOGAF ADM but lacks in Zachman Framework. Zachman Framework vertical axis provides a source of potential viewpoints worth while the horizontal may provide generic taxonomy concerns. Thus, the Zachman Framework does not have means good for processes for conformant views or developing viewpoints. Hence, it does not full employ a perspective that is shown by TOGAF’s ADM.Our company is about to offer top excellent custom writing dilute solutions to you.

Hence, the columns that are in the FEAF matrix correspond to the three gothic architecture domains that are supported by TOGAF; the fourth TOGAF domain covers business gothic architecture that lacks in the FEAF structure.Enterprise Architecture Planning (EAP) is a framework that brings together Applications, additional Information and Technology Architectures in fulfilling the requirements of architecture. Thus, it shares many concepts keyword with TOGAF because the aim of EAP is to form blueprints for architectures to solve business problems. Moreover, EAP supports the nine phases that are supported by the TOGAF (White 2007).There are a first great deal of additional ways that youll be able to use to increase how their writing abilities.Department of Defense Architecture Framework (DoDAF) defines the architecture systems into consistent and complementary views. It defines a structure logical and mechanisms that help in understanding, visualizing and assimilating the complexiti es and broad scope of a example given architecture design through tabular, graphic and textual means. Thus, it shares minimal aspect with TOGAF.In fact, TOGAF main focus on the methodology of architecture in terms of â€Å"how to† without bringing into consideration architecture description constructs.There are advantages deeds that are given to the enterprises.

DODAF requires that all information, analysis and new products to build should be put forefront before building the architecture. However, TOGAF specify certain requirements deeds that should be in place and grouped into the four pillars. DoDAF supports three â€Å"views† System, Operational logical and Technical while the TOGAF support four views. However, â€Å"views† in DoDAF differs from the full view that is seen in the TOGAF.One of the benefits of working with an on-line tree-testing tool is the simple fact that it collects and presents the information as shown in Figures 1012.Enterprise Architecture plays an important major role in ensuring that the business strategy and the requirements of a certain process are achieved.TOGAF approach is useful in achieving a business-oriented process through a well defined methodology. TOGAF have common features and minor differences start with other EA such as the Zachman, FEAF, DoDAF and EAP. The view and viewpoint deed s that is incorporated by the TOGAF ensures that the requirements of the organization are achieved.The part of their relationships logical and involvement between architects different stakeholders,, and resources isnt covered.

(2005). Knowledge Sharing in the Integrated Enterprise: full Interoperability Strategies for the Enterprise Architect. London: Birkhauser. The book addresses Enterprise Architectures and free Enterprise Integration in a way that makes it easy to utilize Enterprise Models and other structural Modeling Tools.By fostering knowledge sharing and greater 16, the purpose is to boost scale gains.Fowler, M. & Rice, D. (2003). Patterns of Enterprise Application Architecture.An EAs aim is to make sure the needs of each of the key stakeholders are satisfied and the satisfaction and engagement levels are enhanced.

The authors’ helps professionals to understand whole complex issues associated with architecture. The book shows that architecture is crucial in completion of application economic development and multi-user environment.In addition, the book provides patterns and context in EA that enables the reader to have proper means to make the right decisions. Lankhorst, M.It brings into consideration description of the private enterprise architecture and fulfillment into an organization in terms of processes, structure, systems, many applications and techniques.The book brings into consideration description of components and unambiguous specification to allow for a logical modeling language. They utilize their skills in ensuring that the architects have concrete skills that fulfill the architectural practice. It also gives means that allows communication between stakeholders that are involved in these architectures.(2003). A practical Guide to Enterprise Architecture. New York: Pre ntice Hall PTR. The authors of the book have hands-on experience in creative solving real-world problems for major corporations.(2003). Guide to Enterprise IT Architecture.New York: Springer Publishers. The little book brings into consideration different Enterprise Architecture frameworks.

& Weill, P. (2006).Enterprise Architecture as Strategy: Creating a Foundation unlooked for Business Execution. Chicago: Harvard Business Press.Scheer, A. & Kruppke, H. (2006). Agility by ARIS Business making Process Management.Thus, the book is business oriented with EA playing an important role. Schekkerman, J. (2003). How to Survive in the Jungle of Enterprise Architecture Frameworks, 2nd Ed.Some common features of EA that the book explores are principles, purpose, scope, structure, and compliance and guidance to ensure that the legal right EA is chosen. Wagter, R. & Steenbergen, M. (2005).