The Six Minute Walk Distance ( 6 Mwd ) - 847 Words

Galie’s et al. compared the six-minute walk distance (6-MWD) in patients twelve years or older with symptomatic pulmonary arterial hypertension (PAH) who took placebo versus 4 doses of oral tadalafil with or without bosentan. This multi-center, double-blind, placebo-controlled, randomized controlled study lasted 16 weeks. The patients were placed into 5 different groups: tadalafil 2.5mg, 10mg, 20mg, 40mg, or placebo once daily, and stratification was based on walking distance of 325m, type of PAH, and bosentan use. Patients were not qualified to participate in this study if they had a 6-mintue walk distance 150m or 450m. Safety was determined by the level of adverse events severity. It was shown that all doses, but 2.5mg, improved 6-MWD at week 16, although, the tadalafil 40mg was the only one that was statistically significant (p0.01). Compared with placebo, tadalafil 40mg had statistical significance of 6-MWD without bosentan therapy at 44m, versus patients with bosentan wi th a 6-MWD of 23m. The WHO functional class was not statistically significant in comparison with placebo because patients with better WHO functional class showed no difference in comparison to people with worse WHO functional class. After the 341 patients completed the 16 week trial, 334 of them accepted participation in another 16 week trial. Their 6-MWD slightly improved from 37m to 38m after 44 weeks, which was shown to be statistically significant (95% CI, 29 to 47). In addition, WHO functionalShow MoreRelatedSecurity Forces51988 Words   |  208 Pages(TECH. TRNG.) STUDY GUIDE (SG) L3ABR3P031 0S1C SECURITY FORCES STUDY GUIDE (SG L3ABR3PO31 OS1C) DESIGNED TO ENHANCE FORMAL CLASSROOM TRAINING AREA INSTRUCTION BLOCK IV TABLE OF CONTENTS UNIT Unit 1 Unit 2 Unit 3 Unit 4 Unit 5 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 Unit 11 Unit 12 Unit 13 Unit 14 Unit 15 Unit 16 Acronyms TITLE Defense Concepts Threats and Detection Random Antiterrorism Measures Communications Fire Control Measures Field Considerations Captives, Detainees, and PrisonersRead More1000 Word Essay85965 Words   |  344 Pagesnumber of months necessary to permit completion. (AR 600-85 Mar 2006 / 5-6 / PDF 31) Will Soldiers who are command referred to ASAP be flagged? Yes, IAW AR600-8-2 (Suspension of Favorable Personnel Action (flags)). (AR 600-85 Mar 2006 / 5-7 / PDF 31) What Does ACS stand for? Army Community Service (AR 608-1 Dec 2004) What does the ACS symbol represent? The heart = giving, the cross = help, the gyroscope = stability Page 6 / 389  © Copyright 1999-2012 ArmyStudyGuide.com Version 5.3 (AR 608-1

Islam And The Middle East - 1057 Words

In the Middle East, emphasis is put on names; Arabic honorific names are often used in preference to given names (Shaker, F. 2011). Eventually, they could share the same language, nationality or religion but having different life styles. Muslims eating habits are expected to be in function of their religious beliefs, by Islam regulations as described in the Qur’an and dictated by the Sunnah of the Prophet Muhammed. Muslims consume all kind of food, except for the ones prohibited in Islam. Food cleanliness is one of their priority, nails, hair, mouth, teeth must be properly washed to prevent food contamination, and they use a â€Å"Mismark† before every meal which is a specific tooth cleaner proper to their culture. Islam teaching them that their food is provide by Allah for their survival and to maintain good health. Therefore, before starting eating, they must bless the food in the name of Allah; Muslims are advised to eat slowly with moderation. Muslims believe in sharing with others and eating together is value to them it brings harmony and facilitate better family relationships. Some Muslims were meat lovers in Guyana: The diet of the Pathan Afghan Guyanese was quite different from that of the Indian Muslims but eventually the authentic cuisine of the Afghans died as the few remaining Afghans interbred with non-Afghan Muslims. Her family’s physical features, culture and diet stood out among their Muslims brethren community. She always had an entourage of peopleShow MoreRelatedIslam And The Middle East Essay2164 Words   |  9 Pagesdemonstrated an interest in the Middle East in Islam, due to Americans frequent contact with the Middle East in the early 1960s. Islam and the Middle East have played a remarkable role in Americans discussion and reaction to the events that took place on September 11th, 2001. During this time Americans were beginning to regard the Middle East, Muslims, and Islam as one entity. 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When the Muslim armies swarmed through the Arab frontier, their experience with the terrain and their self-determination allowedRead MoreFounded in the Middle East, Islam is an Interesting Religion527 Words   |  2 PagesIslam is a very interesting religion founded in the Middle Eas t during the 6th century C.E. and is still thriving as a religion today with over 1.6 billion adherents. The term Islam actually represents what the people of Islam wish for their religion to represent. The word â€Å"Islam† in Arabic means â€Å"acceptance† or â€Å"commitment† which may differ from many peoples stereotypical depictions of the Islamic people as harsh and evil. These people who follow the religion of Islam are called Muslims, so MuslimRead More Does Islam Cause Violence in the Middle East? Essay3400 Words   |  14 Pageslarge focus of the Western Powers, like the United States, has been on the Middle East. Out of this has come a conclusion that this area of the world is prone to be more violent than other parts and this is largely to due to the Islamic religion. This the West has concluded in large part through observation coupled with some qualitative data. However, is this an adequate assertion of the area, and of the religion of Islam? To begin various types of violence will be explored quantitatively and qualitativelyRead MoreDoes the Violence in the Middle East Have to Do with Islam?2594 Words   |  10 Pageslarge focus of the Western Powers, like the United States, has been on the Middle East. Out of this has come a conclusion that this area of the world is prone to be more violent than other parts and this is largely to due to the Islamic religion. This the West has concluded in large part through observation coupled with some qualitative data. However, is this, an adequate assertion of the area, and of the religion of Islam? 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Today there is no real universal consensus as to how this sect formed and perspectives on them vary. The Western perspective is that they descended from ancient middle eastern people’s. The Alawites themselves believe they are descendants of Hasan al-Askari and Muhammad ibn NusayrRead MoreEssay about Islam: The Rich Culture of the Middle East936 Words   |  4 Pagesreligion of Islam is the second most popular religion over the entire globe, and follows a strict set of rules derived from the teachings of the Prophet Muhammad, a messenger of God, or Allah. Founded in 622 C.E. (also known as A.D.) in Mecca, Saudi Arabia, Islam is a strictly monotheistic religion that drew inspiration from earlier religions like Christianity and Judaism. It is divided into three different sections- the Sunni, Shi’a and Sufi sects. The Qur’an is the holy book of Islam, and is considered

Molecular Biology of the Cell Cardiovascular System

Question: Discuss about the Molecular Biology of the Cell for Cardiovascular System. Answer: Cardiovascular system consists of different parts like heart, arteries, capillaries, veins, coronary vessels and portal veins. Heart performs function of supplying oxygenated blood to the tissues of the body and deoxygenated blood to the lungs. Superior and inferior vena cava brings deoxygenated blood from lung to the right atrium. This deoxygenated blood is emptied into the right ventricle by passing through the tricuspid valve into the right ventricle. From right ventricle this blood is pumped into the pulmonary artery through pulmonary valve for re-oxygenation and removal of carbon dioxide. Blood is purified in the lungs and this newly purified and oxygenated blood enters left atrium through pulmonary vein. This blood then passed through the mitral valve into the left ventricle. From left ventricle blood is pumped to the different parts of the body through aortic semilunar valve and aorta which is main artery of the body. Aorta gives many branches called as arteries and these arteries supplies oxygenated blood to the all other body parts. Wall of aorta is elastic and this aid in maintaining blood pressure through entire human body. Aorta gives rise to arteries of larger size at its origin and its size goes on decreasing at the end. These arteries further become narrower into the arterioles which are small diameter blood vessel and these arterioles has muscular wall. These arterioles further branched into the capillaries and these capillaries are the smallest blood vessels in the human body with one cell layer thickness. Diameter of these capillaries is around 5 10 m. These capillaries are the connecting link between arterioles and venules. These capillaries facilitate the exchange of oxygen, carbon dioxide, water, nutrients and waste matter between blood and body tissues. Individual capillaries do not carry out this function; however network of capillaries those are supplying to the different tissues and organs perform this function of transport. Venules are the small blood vessel which supplies deoxygenated blood from the capillaries to the veins. Venules have the diameter in the range form 7-50 m. Walls of venules comprised of three layers such as inner endothelium, middle layer of muscle and el astic tissue and outer fibrous connective tissue. Many venules combine to form veins. These veins carry deoxygenated blood from the body tissues to the heart and pulmonary and umbilical veins are exception for this, as these veins carry oxygenated blood to the heart. Veins are also called as capacitance vessels because around 60 % blood volume is contained in the veins. Adult human body has about four to five liters of blood. Blood is a liquid connective tissue and performs the function of transport of nutrients, waste matter and gases and helps in maintaining homeostasis of the body. Blood is comprised of red blood cells, white blood cell, platelets and liquid plasma. Red blood cells are biconcave in shape and it performs the function of transport of oxygen in the blood. White blood cells functions as bodys immune system. Part 2. Respiratory system component Structure Function Trachea Is a cartilaginous tube, In Adult human inner diameter of trachea is about has 25 millimetres and a length is approximately 10 to 16 centimetres, trachea contains about 15-20 C-shaped tracheal hyaline cartilages. Trachea performs the function of transporting the air which person breaths in through nose to the lungs. Trachea also performs function of preventing entry of microbes and harmful substances into the lungs. Bronchus Trachea divides into right bronchus and left bronchus. In adult human, right bronchus is 2.5 cm long and left bronchus is 5 cm long Alveolar ducts and alveoli of bronchus contain squamous epithelium and it permits exchange of gases like oxygen and carbon dioxide between lungs and blood in the blood vessels which spreads across the alveolar ducts and alveoli. Bronchiole Bronchi divide further into bronchioles. Bronchioles are approximately less than 1 mm in diameter and its wall consist of ciliated cuboidal epithelium and a layer of smooth muscle. Bronchioles carry oxygen from nose to the alveoli or air sacs in the lungs and stabilize ventilation. Constricting and expanding property of smooth muscular walls of the bronchioles help to control airflow and stop irritants from entering in the lungs. Lungs Human has right lung and left lung. Total weight of lung is approximately 1.3 kg. Lungs are located in the chest region in between rib cages. Right lung is divided in to three parts like upper, m idle and lower lobe. Horizontal fissure separates upper lobe form the middle lobe. Oblique fissure separates middle and upper lobe. Oblique fissure divides left lung into upper and lower lobe. Lung performs function of breathing in which air enters and leaves the lung. In respiration, oxygen is inhaled into the body through nose and expelled carbon dioxide from the blood. Air is inhaled into the lungs in inspiration and it is expelled put in expiration. This exchange of gas occurs at alveoli of lung. Lung performs function of protection from infection due to presence of clilia on the epithelium and contains mucous. Lung clears all the air-borne infection through a process called mucociliary secretion. Diaphragm Diaphragm is a dome shaped sheet of skeletal muscle and fibrous tissue. Diaphragm performs important role in breathing. When diaphragm contract, thoracic cavity volume increase and air is drained into the lungs. Part 3. Digestive system component Structure Function Mouth Mouth contains salivary glands, teeth and the tongue. Vestibule and the oral cavity proper are the two regions of the mouth. Mouth is lined by mucous membrane. Moth performs function of chewing and breaking of food and mixing with saliva to make food more absorbable. Esophagus Esophagus is a muscular tube between pharynx and stomach. In adults its average length id 25 cm. Esophagus is divided into cervical, thoracic and abdominal parts. Esophagus transports food from mouth to stomach through muscular peristalsis. Stomach Stomach is J shaped organ and connects duodenum and esophagus. Stomach is divided into four sections like gastric cardia, fundus, body and pylorus. Gastric acid comprising of hydrochloric and sodium chloride, plays significant role in the digestive process. Pylorus aids in emptying food content in the small intestine. Small intestine Small intestine connects stomach to the large intestine. In human adults, average length of small intestine is around 7.0 m and diameter is around 2.5-3 cm. Small intestine is divided in to three parts like duodenum (approximately 20-25 cm long), jejunum (approximately 2.5 m long) and ileum (approximately 3.0 m long). Small intestine performs function of proteins, carbohydrate and lipids under the influence of photolytic enzymes, amylases and lipases respectively. Villi and microvilli present on the inner wall of the intestine facilitate absorption of nutrients. Gut flora in the intestine supports immune system of the body. Large intestine In human average length of large intestine is approximately 1.5 metre. It comprises of cecum (8.7 cm inner corcumference), colon, rectum (5.7 cm), and anal canal. Colon comprises of ascending (6.6 cm), transverse (5.8 cm) and descending colon (6.3 cm). Large intestine is specifically performing function of processing waste material. Alveoli Alveoli is a hollow cavity at the end of respiratory tree. Exchange of gases between lungs and blood. Nasal cavity Nasal cavity is a hollow space and the entry point of respiratory tract. It is lined with mucus membrane and hairs. Air enters into body and get filtered through nasal cavity. Larynx Hollw muscular organ between laryngopharynx to the trachea. Aid air passage to lungs. Epiglottis It is made of elastic cartilage present at entrance of larynx. It prevents aspiration. TAQ.2: Air is inhaled and exhaled in and out of the body through nose. At the time of inspiration oxygen enters into the body and during expiration carbon dioxide is thrown out form the body. This whole process is called as breathing or ventilation. When air is inhaled, diaphragm gets contracted and there is increase in the volume of thoracic cavity and decrease in the pressure in the thorax region which results in the enlargement of the lungs and this leads to the entry of the inhaled air along with oxygen into the lungs through trachea, bronchi, and bronchioles. In trachea due to the presence of cilia and mucociliary action air and oxygen without contamination enters the lung. At the terminal end of the bronchiole alveolar ducts and sacs are present. These alveolar ducts and sacs are innervated with the blood capillaries. Surface of alveoli are main location for the gaseous exchange. Oxygen inhaled from the environment which is present in the alveolar duct and sacs passed through the alve olar capillaries into the blood stream through process of diffusion. This oxygenated blood enters the left atrium of the heart and pumped into left ventricle. From left ventricle blood is transported to different parts of the body through aorts, arteries. These arteries are innervated to different parts of the body and supply oxygen through the blood. Also carbon dioxide which is collected as waste product forms the different parts of the body comes into contact with the surface of alveolar ducts and sacs through alveolar capillaries. Superior and inferior vena cava collect deoxygenated blood from the lung to the right atrium and again pass on to the right ventricle. From right ventricle blood pumped into the pulmonary artery and carried to the lungs for re-oxygenation. This deoxygenated blood while transporting through lungs comes into contact with alveolar air and there is a very thin wall of approximately 0.5 m thickness present between blood and air. Hence, pressure of gas (PO2 and PCo2) in the blood automatically gets equilibrated with the alveoli. Increase in the PCo2 leads to the slight decrease in the PO2 and this result in the deep and faster breathing and inhalation of more oxygen until PO2 returns to normal level. On the other side if PCo2 falls and PO2 increases and this leads to the slower breathing and exhalation of carbon dioxide gets reduced. Gas exchange in the lungs mainly occurs through the process of diffusion that means gases like oxygen and carbon dioxide moves from the high concentration to the low concentration. If PO2 is less in alveoli, oxygen diffuse into alveoli and if PCo2 is more in blood capillaries, carbon dioxide diffuse into alveoli and exhaled through expiration. This carbon dioxide gets transported into the alveolar venules through diffusion. This carbon dioxide once entered into the alveoli, gets expelled out through the route of bronchiole, bronchi, trachea and nose. During this exhalation of carbon dioxide diaphragm gets relaxed and chest and abdomen returns to their elasticity directed position. This resting position of the thorax leads to the exhalation of the carbon dioxide. TAQ.3. Digestive enzymes are the enzymes which break down macromolecular polymers like fats, carbohydrate and proteins in to their smaller forms and convert them into easily absorbable form. Based on their target macromolecules enzymes can be classified as lipases which break down proteins into their peptides and amino acids, amylases break down polymeric carbohydrates into monomeric carbohydrates, lipases break down fats and lipids into fatty acids and glycerol. Different parts of the digestive tract secrets different enzymes and these enzymes plays different role in the digestion of the food. Salivary glands in the mouth secrets different enzymes like lingual lipase, salivary amylase and lysozyme. Enzymes of the salivary gland perform both the functions of digestion of food substances and prevention of infection due to food. Stomach secrets gastric enzymes. Pepsin secreted by the stomach breaks down proteins into peptide and amino acids. This protein digestion for the first time starts in the stomach and digestion of carbohydrates and fays starts in the mouth. Gastric chief cells secrets gastric lipase which is an acidic lipase facilitates fat hydrolysis. Pancreatic juice of the pancreases secrets different enzymes like trypsinogen, chymotrypsinogen carboxypeptidase and elastases are the proteolytic enzymes. Pancreatic lipases and amylase digest lipids and carbohydrate respectively. Pancreas also secrets sterol esterase and phospholipase. Some of the enzymes available in the small intestine are primarily secreted by the pancreas and transported to the small intestine through pancreatic duct. These enzymes enter the small intestine under the influence of cholecystokinin hormone. Across the lining of the small intestine there are many enzymes secreted and these enzymes digest chime form stomach into smaller particles which are more absorbable. Peptones and polypeptides get converted in to amino acids by erepsin. Maltose gets converted into glucose by maltase. Lactose gets converted into glucose and galactose by lactase. Sucrose gets converted into glucose and fructose by sucrose. Cardiovascular System: Cardiovascular system through its numerous blood vessels and blood transport important nutrients, oxygen, hormones and enzymes to cells in the entire body. Cardiovascular system also performs function of removing nitrogenous waste from the body and expelling carbon dioxide from the blood. Cells need oxygen and n the blood capillaries, oxygen diffuses out of the blood and transports in the cells of the human body. Cells required to remove carbon dioxide, gets absorbed into blood circulation transported to the lungs for purification. Cells requisite nutrients like carbohydrates, proteins, fats, minerals and vitamins. Blood supplies these nutrients to the cells. Respiratory system: Oxygen intake and removal of carbon dioxide is very essential for cells for normal functioning. Respiratory system inhale oxygen from the atmosphere through breathing. This inhaled oxygen enters lungs and oxygen enters into the blood capillaries (arteries). This inhaled oxygen through blood capillaries (arteries) transported to the cells present in the different parts of the body. Carbon dioxide exchange occurs between cells of the body and blood capillaries (venules). Carbon dioxide transported from the blood capillaries to the heart and subsequently to the lungs. From lungs carbon dioxide expeleeted through breathing. Gastrointestinal system: Every cell requires nutrients for their growth and maintenance. Digestive system brakes down the consumed food in the form of macromolecules into the smaller and easily absorbable particles. Carbohydrates, fats, and proteins get digested into sugars, fatty acids, and amino acids, respectively. These sugars, fatty acids, and amino acids can be easily absorbed. This digestive process occurs both through mechanical and enzymatic means. This digested food material easily gets absorbed through the intestine as intestine is the main site for the absorption. Intestine contains villi and microvilli and this villus contains blood vessels and food gets absorbed. Absorbed food nutrient is transported to the cells through blood vessels. References: Alberts, B., Johnson, A., Lewis, J., Raff, M., Roberts, K., Walters, P., Molecular Biology of the Cell , (4th ed.). New York and London, Garland Science, 2002. Tortora, G. J., Anagnostakos, N. P., Principles of anatomy and physiology, Seventh ed. New York, Harper Row, Publishers, 1993. Arthur, G. and John, H., Guyton Textbook of Medical Physiology. 11 th edn. Elsevier Saunders, 2006. Kong, F. and Singh, R.P, Disintegration of solid foods in human stomach, Journal of Food Science, vol. 73, no. 5, 2008, p. R67. Tortora, G. J., Anagnostakos, N. P., Principles of anatomy and physiology, Seventh ed. New York, Harper Row, Publishers, 1993. West, J.B., Respiratory physiology-the essentials. Baltimore: Williams Wilkins, 2011. Tortora, G. J., Anagnostakos, N. P., Principles of anatomy and physiology, Seventh ed. New York, Harper Row, Publishers, 1993.

my paper Essays - Supply Chain Management, Manufacturing, Management

Alpargatas S.A. Baxter Supply chain management is the management of a network of interconnected businesses involved in the ultimate provision of product and service packages required by end customers. Supply chain management spans all movement and storage of raw materials, work-in-process inventory, and finished goods from point of origin to point of consumption. In order to have an effective supply chain management a company would beat competitors to market with functional and ground-breaking products. Globalization, outsourcing and information technology have enabled many organizations, such as Dell and Hewlett Packard, to successfully operate solid collaborative supply networks in which each specialized business partner focuses on only a few key strategic activities. Organizations increasingly find that they must rely on effective supply chains, or networks, to compete in the global market and networked economy. Alpargatas are a sort of shoe that is worn by rural workers. Alpargatas was founded in 1883 by Juan Echegarary and Robert Fraser that symbolized the European heritage that is part of Argentina?s culture. In 1907, the company opened a subsidiary in San Pablo, Brazil. The company expanded as Argentina continued to grow with more immigrants and economic expansion. Alpargatas served as a textile operation that found uses for its scraps to produce floor clothes, grid clothes, and flannel. It had textile mills for the fabrication of canvas and a cotton mill that supplied the raw material for the production system. In 1989 Argentina?s election and initial transition to democracy resulted in economic turmoil accompanied by hyperinflation of up to 200% per month. With the economy in turmoil Alpargatas decided to concentrate all its efforts on its core business which is textiles and shoes. The Convertibility Plan was an economic plan that was implemented by the Economic Minister, Domingo Cavallo. As a result of privatization of government-owned companies being pursued vigorously, inflation dropped to an annual rate of 10%. In 1993, the Nike and Topper brand sports shoe had an internal transported volume of 400 thousand and an export of 60 to 70 thousand pairs per month. Casual footwear had a transported volume of 4 million a year and textiles of 30,000 outer packs (160 thousand units). Demand management is focused efforts to estimate and manage customers? demand, with the intention of using the information to shape operating costs. An issue that can occur with demand management is the lack of coordination between department?s results in little or no coordinated response to demand information. Too much emphasis is placed on forecasts of demand; with less attention on the collaborative efforts and the strategic and operational plans that need to be developed from the forecasts is another issue in demand management. A third issue is demand information is used more for tactical and operational than for strategic purposes. The end result of these issues would be to better match demand as it occurs with appropriate availability of needed product in the marketplace. Order fulfillment is in the most general sense the complete process from point of sales inquiry to delivery of a product to the customer. Sometimes Order fulfillment is used to describe the narrower act of distribution or the logistics function, however, in the broader sense it refers to the way firms respond to customer orders. An order management system is a computer software system used in a number of industries for order entry and processing. Order Management requires multiple steps in a sequential process like Capture, Validation, Fraud Check, Payment Authorization, Sourcing, Backorder management, Pick, pack, ship and associated customer communications. Order management systems usually have workflow capabilities to manage this process. Logistics might control order fulfillment, which generally consists of activities involved with filling and shipping customer orders. Order fulfillment is important because the distribution factor is the time that elapses from when a customer plac es an order until the customer receives a satisfactory fulfillment of the order. Customer service addresses strategic, tactical, and operational aspects of order management. It can be described as a philosophy, as performance measures, or as an activity. Fixed order quantity is an arrangement in which inventory level is continuously monitored and replenishment stock is ordered is fixed quantity whenever at-hand stock falls to the reorder point. Economic order quantity is the level of inventory that minimizes total