Wednesday, May 6, 2020

Ethics of Genocide and Eugenics Essay - 1407 Words

Gene Therapy: Genocide and Eugenics or Striving for a More Perfect Population Controversy and Ethics Just as there are different types of people who look at one glass of water and describe it as half full or half empty, the public has many different views on the future of our society. Gene therapy is also a glass that can be viewed in different angles – different perspectives. Some say it has great potential to shape the ideals of our future, while others believe it signifies intolerance for disabilities, imperfections that supposedly deplete from a person’s interests, opportunities and welfare (quoted by Peter Singer, xviii). This global issue has brought people with different opinions in the open, arguing their views using history,†¦show more content†¦They were set from the day you were born, influencing every physical trait about you; whether you were tall or short, the color of your hair, eyes and skin tone. But now, genes have been found able to be flexible for some change. Instead of just settling on the outcome of the â€Å"genetic lottery† (Sin ger, xx), we now have the ability to determine our own characteristics through gene therapy, the treatment that replaces a defective gene with a normal one to cure genetic disorders. Many scientists and others believe that if gene therapy can be refined, it could be implemented to ultimately put an end to genetic disorders. The parents would have the children they want, and the children who had the natural disposition towards a genetic disorder could possibly become a normal child, whereas otherwise they would probably end up losing their life due to abortion. Those that support gene therapy view it as a win-win strategy: â€Å"For who is harmed by the genetic supermarket? The parents are not harmed by having the healthier, handsomer and more intelligent children that they want. Are the children harmed?† (Singer, foreword) If a treatment is implicated before the child is born – germline gene therapy – he or she could lose all trace of that defective gene, and therefore wouldn’t pass the disease on to future generations. In somatic gene therapy, treatment is conducted when the patient is anShow MoreRelatedEugenics Essay1545 Words   |  7 PagesEugenics, the word that got its bad reputation years ago through an event that changed history: the Holocaust. First dubbed by Francis Galton in the 1880’s, the word Eugenics stemmed from the words â€Å"good† and â€Å"generation.† (Eugenics-Meanings) Eugenics means the study of or belief in the possibility of improving the qualities of the human species or a human population. This improvement is done through discouraging reproduction by persons having genetic defects or presumed to have inheritable undesirableRead MoreDna Knowledge And Its Effects On The Human Of Individuals And Their Families1681 Words   |  7 Pa gesknowledge (De las Mercedes O Lery, 2006). This discovery allowed a more effective and purposeful manipulation in our genome and, therefore, the hereditary constitution of the humanity (De las Mercedes O Lery, 2006). 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Although there is no social distinction between the Hutus and the Tutsis, the conflict betweenRead MoreThe And Its Impact On Society2002 Words   |  9 Pagesabortion. But, what happens when the choice of becoming pregnant is stole away from an eligible mother? This is where the term â€Å"Eugenics† has crept back into our vocabularies. It is strongly association with genocide of millions of Jews in Nazi Germany. Many people assume that it has never ha ppened in the United States because in United States history there has never been genocide aimed at an entire race of people. Others may assume that even if the dogma was used in America, there was no lasting impactRead MoreEthical Issues of Wrongful Conception2854 Words   |  11 Pagesto enter the abortion debate or make a determination about whether defective children should be born. Many famous persons had been disabled in various ways yet still made contributions to society, and in any case the court did not wish to endorse eugenics. In 1978, the New York Court of Appeals ruled in Becker v. Schwartz that a woman over 35 who gave birth to a child with Down syndrome and not been warned of the potential danger by the family physician should be able to collect financial damagesRead MoreEssay on Genocide of the Holocaust2735 Words   |  11 PagesGenocide of the Holocaust Arthur Caplan, editor of When Medicine Went Mad: Bioethics and the Holocaust, states, The Holocaust, unlike many other instances of mass killing, was scientifically inspired, supervised and meditated genocide. Since all genocides are a grand-scale effort to systematically eradicate populations, their success hinges on having large portions of a nation going along with genocidal policy. The individuals in a society must be convinced of genocidesRead MoreThe Birth Control Of Women1501 Words   |  7 Pagesclinical trials (Marks, 2001). Within the advent of the birth control pill, there are issues to consider as far as ethics as well as the concept of eugenics. Margaret Sanger, particularly, is viewed by some as a â€Å"racist, anti-Semitic, eugenicist† who wanted to eliminate the poor and â€Å"forcibly sterilize.† This has been debunked by many historians, in that the concept of eugenics of her time period was a vision in which the human race was improved by a healthier environment and healthier populationRead MoreCharles Darwin s Theory Of Evolution Essay2312 Words   |  10 PagesHeredity and Variation, Hunter introduces the idea that mankind should be improved in the same way as domesticated animals by means of selecting which variations and characteristics are viewed as more desirable and which are not. He goes on to write of eugenics, which is the idea that society should forcefully prevent the passing down of traits that are considered undesirable. He claims â€Å"When people marry there are certain things that the individual as well as the race should demand. The most important

Tuesday, May 5, 2020

Acute Kidney Injury And Chronic Kidney Disease as Interconnected Syndr

Question: Explain about the case study on Acute Kidney Injury And Chronic Kidney Disease as Interconnected Syndromes? Answer: Chronic Kidney Disease Chronic Kidney Disease is considered as the condition that can be characterized by the loss of kidney function over a span of time. This disorder is also referred to as the Chronic Renal Failure. It can be clearly estimated that almost 15,000,000 people dies due to the Chronic Kidney Disorder. Definition CKD, which is formally as known as Chronic Kidney generally, focuses towards the loss of kidney functioning among the patients. It is been often observed that kidney tend to filter the excess fluids which are associated to the blood along with other waste materials efficiently. These particles are then excreted through urine (Thadhani et al. 2012). Thereby, it can be stated that when a patient suffers from such disease, then there are huge abnormal symptoms observed. Some of the most significant accumulations include electrolytes, toxic fluids and wastes. The primary stage of the CKD is symbolized by limited symptoms. It can be stated that in the primary stage, the disorder may not become apparent physically. The treatment for the Chronic Kidney Disorder mainly focuses toward the condition where there is a limitation to the kidney metabolism to a huge extent (Stevens and Levin 2013). The adverse effect of Kidney impairment finally results in complete failure of the kidney. On the large extent, Artificial Filtering Protocol (which is also known as Dialysis) or the Kidney Transplant therapy are considered as effective measures to prevent patients suffering from Chronic Kidney Disorder significantly. Classification The various stages of Chronic Kidney Disorder are stated in the table below, which tend to estimate (or measure) the factors of GFR (Glomerular Filtration Rate). One a basic note, Chronic Kidney Disorder is characterized by five stages, where the primary stages (Stage 1 and 2) and considered to be the minimal affecting stages for a Kidney Disorder. Table 1: Table representing the Stages associated to Chronic Kidney Disorder Stages Glomerular Filtration Rate Description of the Event Treatment 1 85+ There is a normal functioning of the urine, however there are structural abnormalities or the genetic trait point Controlling the blood pressure and thereby managing the effect of Stages 1 2 CKD 2 55-80 The kidney functioning is mildly reduced. Controlling the blood pressure and thereby managing the effect of Stages 1 2 CKD 3A 40-55 There is a moderate reduction of the kidney function Controlling the blood pressure and thereby managing the effect of Stage 3 CKD 3B 32-40 4 16-31 The kidney functioning is significantly reduced Effective planning for the stage of renal limitation, supported by the management of Stage 4 5 CKD 5 The condition is very severe, often highlights to complete failure of the kidney (Renal Failure) Effective planning for the stage of renal limitation, supported by the management of Stage 4 5 CKD (Source: Thadhani et al. 2012) Investigation Biochemical A large number of Biochemical investigation therapies are generally carried out in case of Chronic Kidney Disease (CKD). The most common types of therapies that are carried out include the following factors: Serum Sodium: The level of serum sodium is usually diagnosed to be normal but the level of serum sodium is found to be comparatively low in case of patients suffering from Chronic Kidney Disease (CKD) Plasma Glucose: Monitoring of the plasma glucose helps in detecting the undiagnosed diabetes. This in turn helps in assessing the diabetes of control. Serum Bicarbonate: In comparison to the normal patients, the sodium bicarbonate level of the affected person is found to be very low. Serum Potassium: In comparison to the level in case of normal patients, the serum potassium levels in case of patients who are suffering from Chronic Kidney Disease are generally found to be high in comparison to the standard value. Serum Albumin: In case of nephritic and /or malnourished patients, the Hypoalbuminaemia in patients are found to be low. Serum Calcium: The level of serum calcium for patients who are suffering from Chronic Kidney Disease is found to be normal. But in many cases, patients with high levels of serum calcium have been also diagnosed due to initiation of different kind sof metabolism. Serum Phosphate: Patients suffering from Chronic Kidney Disease has been diagnosed with high levels of serum phosphate. Serum Alkaline Phosphate: Higher value of serum alkaline phosphate has been observed for patients suffering from CKD. Serum Cholesterol and Triglycerides: Dyslipidaemia is a common disease that is generally found among patients suffering from Chronic Kidney Disease. Serum Parathyroid Hormone: The level of Serum Parathyroid Hormone tends to increase considerably that is directly associated with deterioration of the renal functioning. e-GFR e-FGR is a cell surface protein. The cell surface protein specifically binds to the epidermal growth factor. The protein on binding with the ligand produces a change associated with dimerization of the receptor along with autophosphorylation of the Tyrosine residue. This in turn causes proliferation of cells. Mutation in the given gene causes lung cancer. e-GFR is primarily used for screening. It also helps in monitoring the status of the kidney for a particular patient. It is generally performed by initiating a creatinine test that specifically helps to calculate the rate of glomerular filtration thus estimated. The creatinine test forms a component of the routine Comprehensive Metabolic Panel (CMP) and Basic Metabolic Panel (BMP). The creatinine test thus helps a care provider to estimate present position of the patients kidney. The mechanism of the e-GFR is proficiently determined without involving any kind of added testing. Similarly the blood sample has been effectively sent for the measurement of the cretainine efficiency at the same period of time. The National Kidney Foundation has clearly stated that the creatinine efficiency can be automatically measured each time when a patient is subjected for a creatinine test. In order to evaluate the renal functioning for a particular individual, a creatinine test along with e-GFR is al ways initiated. Thus, the health practitioner who forms an effective part of the health diagnosis considers it as an important part. Thus, it is also applicable for patients suffering from renal dysfunctioning or for those who have been suspected by the health care giver. The warning signs of the mechanisms are discussed below: Swelling and puffiness is generally observed around the eyes and also in face, thighs, ankles, wrists and abdomen. The color of urine formed is either bloody or coffee. Patients suffering from renal disorder have a decrease in the amount of urine formation Different kinds of urination problems are also observed that specifically includes abnormal discharge during the process of urination or burning feeling. This is also associated with change in urination frequency (during the night time). Patients are diagnosed with a very high blood pressure (hypertension) Thus, implementation of the e-GFT test helps to detect kidney diseases. This is considered more consistent than the normal Creatinine test because it provides a better calculation of works. This particularly aims in measuring the reduction and deterioration of the kidney functioning. As per the concepts of National Kidney Foundation (NFK) it can be thus analyzed that the actual values is found to be around 60mL/min. As the normal value tends to vary between 90-120 mL/min, which is found below the average value (i.e 60 mL/min), it is thus recommended that there has been formation of different kinds of kidney impairment in an individual (Zhang et al. 2013). Table 2: Table representing the Kidney Damage Stages and the Subsequent Findings Stages related to the Kidney Damage Observation Glomerular Filtration Rate Associated Findings 1 Minimal or the Normal Kidney damage associated to the normal function of GFR Above 90 The Albumin or the Protein Concentration are considered to be higher 2 Mild decrease in the GFR concentration 55-85 The Albumin or the Protein Concentration are considered to be higher 3 Moderate decrement in the GFR 32-54 4 Effective Decrease in the GFR 14-25 5 Complete Failure of the Kidney Functioning 15 (Source: Qaseem et al. 2013) Creatinine Clearance Creatinine Clearance Test mainly provides the information regarding the normal functioning of the kidneys. This test is mainly associated to the comparison study regarding the creatinine level found in the urine along with the level found in blood. The level of creatinine is mainly found to be considered as breakdown of the final product of creatinine, which is important for muscular development. Creatinine Clearance Test is considered to be highly useful for both the blood and urine sample as it has a shelf life of only 1 day (24 hours). This test is used in order to estimate the GFR level associated to the sample. The factor of GFR can be measured in order to ensure the normal functioning of the kidney filtering (glomeruli) units. On a normal scale, this Clearance Test estimates 96 to 136 ml/min (in case of male) and 87 to 127 ml/min (in case of female). ACR and PCR ACR is commonly known as Albumin Creatinine Ration is mainly used to screen people suffering from various chronic disorders. This includes the factors of high blood pressure and diabetes, thereby triggering the consequence of Chronic Kidney Disorder. Identification of the patients suffering from the disorder at a very early stafe often helps the patient for treatment. Controlling the parameters of diabetes along with Hypertension generally helps to maintain the glycemic control. This often helps in reducing the effective blood pressure which helps in preventing the progression of kidney disease. As soon as the traces of Albumin is detercted in the urine sample, the test need to be repeated to confirm the concentration of the other periods. The test is generally measured by calculating the ratio of Albumin/Creatinine (A/C) ratio. Thie effective helps to determine the Albumin level which tend to escape from the kidney and enters to urine. This concentration of urine tend to vary throug hout the day. The PCR, which is also known as Protein Creatinine Ratio provide the number of milligrams (proteins) associated to sample. This test reports the ration associated to protein of creatinine. When the Protein/ Creatinine (of Urine) ratio is higher than 100mg protein/ g of Creatinine, then it indicates towards the occurance of the disorder. When this ratio exceeds more than 3000, then it can be clearly noted that there is a serious damage of the kidney. Efficiency of ACR (Compared to PCR) ACR possess higher specificity along with positive predicative value (better than PCR, 100mg/mmol) When the value of ACR is 60mg/mmol, then it signifies towards the identification of proteinuria in the primary care The cut off value associated to ACR45mg/mmol are found to be higher than the normal Statistical Value as compared to ACR60mg/mmol along with PCR100mg/mmol The ACR45MG/MMOL can be considered to be acceptable for referring proteinuria The reporting value of ACR45mg/mmol are considered necessary in order to monitor and manage proteinuria (24 hours measurement). This helps to quantify the proteinuria after the referral of secondary care (Jamal et al. 2013). Non-Biochemical ECG and Imaging of the Renal Tracking Protocol This system is mainly detects the ventricular hypertrophy and ischemia. This helps to assess the cardiac functioning of the patient. Often it is observed that a patient suffering from Chronic Kidney Disease tend to develop effective malfunctioning in the cardiac muscles. Thus, implementing ECG becomes a subordinate parameter, which is essential in investigating the normal functioning of the heart. Imaging plays a crucial role in investigating the renal functioning of a person. Two types of renal functioning are commonly encountered for investigating Chronic Kidney Disease. These are as follows: Plain Abdominal X-Ray: This may show radio opaque stones or nephrocalcinosis for the patients suffering from Chronic Kidney Disease Intravenous (IV) Pyelogram: This is not often used for the patients suffering from renal disorders. This is because it has a potential for contrast nephropathy. Apart from these, there are significant parameters associated to Renal Ultrasound. IN renal ultrasound mechanism, small echogenic kidneys are seen in the advanced Chronic Kidney Disease stage. It has been estimated that the kidneys are observed to be of larger size, which ultimately becomes of normal size in advanced diabetic nephropathy. Moreover, structural abnormalities are also observed in the cased of polycystic kidneys (Mencarelli, Busutti and Montini 2015). Finally, it is used for screening hydronephrosis, which is mainly caused by Urinary Track Obstrction, or due to the involvement of the retroperitoneum with fibrosis, diffuse adenopathy or tumor. Renal Ultrasound Scanning can be efficiently advised to every patient suffering from Chronic Kidney Disorder. To be more specific about the consequences, which need to be analyzed for Renal Ultrasound parameter, involves the following factors: Having accelerated progression associated to Chronic Kidney Disease Have a possible visible or persistent invisible haematuria Having effective symptoms identifying Urinary Tract Obstruction Having a family record history of Polycystic Kidney Disease (may be genetical factor) and are aged over 20 years Having a GFR of less than 30ml/ minute/ 1.73 m2 Considered by Nephrologists in order to highlight towards the parameters of renal biopsy The Renal Pyelogram tends to indicate towards the clinical suspicion of obstruction despite a negative ultrasound study finding (Gansevoort et al. 2013). Renal Radionuclide Scan Radionuclide scan generally helps in various parameters. These are as follows: It is estimated to be useful to screen for renal artery stenosis when performed with captopril administration. However, many of the medical practitioners believe that Renal Radionuclide Scan is unreliable for GFR of less than 30 ml/ minute (Findlay and Isles 2015). Moreover, this scanning mechanism also quantifies differential renal contribution to the total GFR. CT scan CT scan defines the renal masses along with the presence of cysts, which are clearly highlighted by observing under the influence of ultrasounds. This is considered as the most sensitive test, which is used for identifying renal stones (Olesen et al. 2012). Magnetic Resonance Angiography (MRI) Some patients require CT scan but cannot receive the IV contrast. For such patients, MRI scanning becomes an effective parameter to investigate the presence of renal disorders associated to the individual (Coca, Singanamala and Parikh 2012). The benefits, which are associated to MRI scanning, are as follows: Like the protocol of CT scan and renal venography, MRI scanning is considered as a reliable mechanism that is mainly used for diagnosing the presence or renal vein thrombosis. Magnetic Resonance Angiography is also considered as a useful protocol, which mainly targets for diagnosing renal artery stenosis, although the renal arteriography remains the investigation of choice for such patients. Other Investigation Mechanisms The other commonly accepted Chronic Kidney Disease Investigation mechanisms includes: Micturating Cystourethrogram: This is used mainly for diagnosing vesicoureteric reflux (Chawla et al. 2014) Renal Biopsy: After surgery, the removed tissue is often encountered for a renal biopsy test. The test is often used to detect the presence of oncogenes in the tissue. Positive Biopsy Test generally indicates towards the fact that the patient is highly susceptible in developing cancer in the future. Monitoring The parameter of Monitoring mainly triggers towards wide range of parameters. These parameters are efficiently described below: The factor of e-GFR need to be monitored systematically. The occurrence of frequency generally depend on severity of renal impairment The patients suffering from Chronic Kidney Disorder generally possesses higher level of Proteinuris. Assessment of CKD needs to be conducted yearly. The parameter of Proteinuria needs to be assessed by measuring the PCR or ACR values. The detection of primary abnormal e-GFR protocol results to promote the clinical assessment of patients. This is followed by a repetition test within the two weeks in order to ensure the fluctuation of GFR rate. When the mechanism is found to be stable, then advanced test need to be performed by 90 days to completely evaluate the occurance of CKD When the diagnosis of CKD is completely confirmed, then it can be assumed that e-GFR assessment therapy should not be followed within 3 months The detection at the primary level of proteinuria (equivalent to 0.6g/day of total protein) need early confirmation because of the repeat tests. This is generally performed on the early morning specimen of urine. Consequences Chronic Kidney Disorder triggers effective and immediate consequences which generally formulates higher immunological alterations. In the primary stage, CKD causes various chronic simulations associated to the Rennin Angiotensin Aldosterone System (RAAS). Based on this parameter, the effective simulation causes polarization associated to the TH17 cells. The effective alterations generally occur due to the presence of dendritic polarized cells along with the retention of the sodium level (Coca, Singanamala and Parikh 2012). Second of all, Chronic Kidney Disease results to yhe deficiency of Vitamin D level causing uremic barrier in the intestine and thereby resulting to the dysfunction. It often results the cytokine accumulation resulting to the consequences. The combo effect result in formation of the systemic inflammation (Chawla et al. 2014). Finally, Chronic Kidney Disorder forms immune-suppression. This is mainly associated to the accumulation of metabolites (toxic) causing renal failure. Conclusion Thus, it can be concluded from the above study that CKD at the early stage can be cured if effective strategies are implemented. The mechanism of Kidney Dialysis along with Transplantation is considered to be highly accepted medical tool which tend to limit the dysfunctioning of kidneys to a large extent. Countries such as the United Kingdom or the United States of America focuses towards the development of more effective strategies to prevent Chronic Kidney Disorder in a more logical and systemic manner. References Chawla, L.S., Eggers, P.W., Star, R.A. and Kimmel, P.L., 2014. Acute Kidney Injury And Chronic Kidney Disease As Interconnected Syndromes.New England Journal of Medicine,371(1), pp.58-66. Coca, S.G., Singanamala, S. and Parikh, C.R., 2012. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis.Kidney international,81(5), pp.442-448. de Zeeuw, D., Akizawa, T., Audhya, P., Bakris, G.L., Chin, M., Christ-Schmidt, H., Goldsberry, A., Houser, M., Krauth, M., Lambers Heerspink, H.J. and McMurray, J.J., 2013. Bardoxolone methyl in type 2 diabetes and stage 4 chronic kidney disease.New England Journal of Medicine,369(26), pp.2492-2503. Findlay, M. and Isles, C., 2015. Managing Pain in Chronic Kidney Disease. InClinical Companion in Nephrology(pp. 171-175). Springer International Publishing. Gansevoort, R.T., Correa-Rotter, R., Hemmelgarn, B.R., Jafar, T.H., Heerspink, H.J.L., Mann, J.F., Matsushita, K. and Wen, C.P., 2013. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention.The Lancet,382(9889), pp.339-352. Hering, D., Esler, M.D. and Schlaich, M.P., 2013. Chronic kidney disease: role of sympathetic nervous system activation and potential benefits of renal denervation.EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology,9, pp.R127-35. Jamal, S.A., Vandermeer, B., Raggi, P., Mendelssohn, D.C., Chatterley, T., Dorgan, M., Lok, C.E., Fitchett, D. and Tsuyuki, R.T., 2013. Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis.The Lancet,382(9900), pp.1268-1277. Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., Saran, R., Wang, A.Y.M. and Yang, C.W., 2013. Chronic kidney disease: global dimension and perspectives.The Lancet,382(9888), pp.260-272. Levey, A.S. and Coresh, J., 2012. Chronic kidney disease.The Lancet,379(9811), pp.165-180. Mencarelli, F., Busutti, M. and Montini, G., 2015. Chronic Kidney Disease. InPediatric Urology(pp. 353-363). Springer Milan. Olesen, J.B., Lip, G.Y., Kamper, A.L., Hommel, K., Kber, L., Lane, D.A., Lindhardsen, J., Gislason, G.H. and Torp-Pedersen, C., 2012. Stroke and bleeding in atrial fibrillation with chronic kidney disease.New England Journal of Medicine,367(7), pp.625-635. Parsa, A., Kao, W.L., Xie, D., Astor, B.C., Li, M., Hsu, C.Y., Feldman, H.I., Parekh, R.S., Kusek, J.W., Greene, T.H. and Fink, J.C., 2013. APOL1 risk variants, race, and progression of chronic kidney disease.New England Journal of Medicine,369(23), pp.2183-2196. Qaseem, A., Hopkins, R.H., Sweet, D.E., Starkey, M. and Shekelle, P., 2013. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians.Annals of internal medicine,159(12), pp.835-847. Stevens, P.E. and Levin, A., 2013. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline.Annals of internal medicine,158(11), pp.825-830. Thadhani, R., Appelbaum, E., Pritchett, Y., Chang, Y., Wenger, J., Tamez, H., Bhan, I., Agarwal, R., Zoccali, C., Wanner, C. and Lloyd-Jones, D., 2012. Vitamin D therapy and cardiac structure and function in patients with chronic kidney disease: the PRIMO randomized controlled trial.Jama,307(7), pp.674-684. Tonelli, M., Muntner, P., Lloyd, A., Manns, B.J., Klarenbach, S., Pannu, N., James, M.T., Hemmelgarn, B.R. and Alberta Kidney Disease Network, 2012. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study.The Lancet,380(9844), pp.807-814. TrialistsCollaboration, B.P.L.T., 2013. Blood pressure lowering and major cardiovascular events in people with and without chronic kidney disease: meta-analysis of randomised controlled trials. Vaziri, N.D., Wong, J., Pahl, M., Piceno, Y.M., Yuan, J., DeSantis, T.Z., Ni, Z., Nguyen, T.H. and Andersen, G.L., 2013. Chronic kidney disease alters intestinal microbial flora.Kidney international,83(2), pp.308-315. Yale, J.F., Bakris, G., Cariou, B., Yue, D., Davidà ¢Ã¢â€š ¬Ã‚ Neto, E., Xi, L., Figueroa, K., Wajs, E., Usiskin, K. and Meininger, G., 2013. Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney disease.Diabetes, Obesity and Metabolism,15(5), pp.463-473. Zhang, L., Wang, F., Wang, L., Wang, W., Liu, B., Liu, J., Chen, M., He, Q., Liao, Y., Yu, X. and Chen, N., 2012. Prevalence of chronic kidney disease in China: a cross-sectional survey.The Lancet,379(9818), pp.815-822.

Wednesday, April 15, 2020

After Going To The Tradeport Website, I Have Decided To Do My Paper On

After going to the Tradeport website, I have decided to do my paper on a US federal government agency. I explored a few of the agencies and decided to choose the US Trade and Development Agency. The US Trade and Development Agency (TDA) is a small independent agency. It is comprised of about forty-one people. The director is Mr. J. Joseph Grandmaison, who was nominated by President Bill Clinton. The TDA with the help of the Trade Promotion Coordinating Committee works with the Department of Commerce, the Export-Import Bank, the Overseas Private Investment Corporation, and other agencies to advance American business interest in other countries. They are primarily involved in the agriculture, energy, environment, health care, information technology manufacturing, mining and mineral development, telecommunications, transportation, and water resources areas. This is the TDA Mission Statement: The U. S. Trade and Development Agency assists in the creation of jobs for Americans by helping U.S. companies pursue overseas business opportunities. Through the funding of feasible studies, orientation visits, specialized training grants, business workshops, and various forms of technical assistance, we enable American businesses to compete for infrastructure and industrial projects in middle-income and developing countries (1). The TDA funds project planning activities which directly influences the decisions related to major industrial projects. In other words, these are projects that represent millions of dollars in US export potential. "TDA works to ensure that the services and products needed for projects will be stamped ?Made in the USA'" (How TDA Operates 1). An example of some of the goods and services are radar for airports in Asia and process controls for refineries in Latin America. The TDA is active in over forty countries throughout the world. Sometimes, however, statutory, and policy restraints either prevent or limit the availability of TDA programs in certain countries. All activities of the TDA are carried out by US firms. The TDA looks at many things before deciding to implement a project. The look at eligibility of the country, the environmental impact, effect on US jobs, need to work with other trade promotion agencies, the relationship with financing institutions, cost sharing and success fees, feasible studies, and definitional missions and desk studies. Definitional Studies are teams of technical specialists contracted to visit a host country for a short time. These teams gather any additional information needed for the project. A Desk Study also involves gathering information for the project, but there is no need to go overseas. TDA also sponsors conferences and reverse trade missions called "orientation visits". Both of theses activities familiarize foreign decision makers with American-made products and services, build business relationships, and encourage US companies to export to developing and middle-income countries (How TDA Works 2). Also in certain regions, the TDA provides trade-related training, which provide the means for host country project personnel to receive technical and managerial support. There are no application fees for TDA services. However, in most feasible study grants, TDA requires that the company share the cost. If the project is implemented, then TDA requires reimbursement for their share of the study cost. " Because of its focused mission, TDA only considers projects that have potential to mature into significant business opportunities for US companies" (TDA Questions & Answers 1). For projects to be considered, they must: 1) Face strong competition from foreign companies 2) Be a development priority of the country where the project will be located 3) have the endorsement of the US Embassy in that area 4) Represent an opportunity for sales of US goods or services 5) Be likely to receive implementation financing, and have a procurement process open to US firms (Questions & Answers 1). To obtain TDA funding one must do a few things. First and foremost, project must meet the above requirements. Next one need to prepare documentation and research that clearly shows how the project meets the above requirements. The information should include a one to two page summary. Be sure to include information about your company, its resources, capabilities, and the personnel. One should also obtain a copy of TDA's "Feasible Study Model Format", which one can get from the website. Follow the instructions carefully and fill in the appropriate information. After all this is done, contact the TDA Country Manager who is responsible for

Thursday, March 12, 2020

A Summary of Chansons de Geste

A Summary of Chansons de Geste The chansons de geste (songs of deeds) were Old French epic poems centering around heroic historical figures. Dealing primarily with events of the 8th and 9th centuries, chansons de geste focused on real individuals, but with a large infusion of legend. Those chansons that survive in manuscript form, of which there are more than 80, date to the 12th through 15th centuries. Whether they were composed then or survived in oral tradition from the 8th and 9th centuries is under dispute. The authors of only a few of the poems are known; the vast majority were written by anonymous poets. Poetic Form of the Chansons de Geste A chanson de geste was composed in lines of 10 or 12 syllables, grouped into irregular rhyming stanzas called laisses. Earlier poems had more assonance than rhyme. The length of the poems ranged from about 1,500 to 18,000 lines. Chanson de Geste Style The earliest poems are highly heroic in both theme and spirit, focusing on feuds or epic battles and on the legal and moral aspects of loyalty and allegiance. Elements of courtly love appeared after the 13th century, and ​enfances (childhood adventures) and the exploits of ancestors and descendants of the main characters were related, as well. The Charlemagne Cycle A large proportion of the chansons de geste revolves around Charlemagne. The emperor is depicted as the champion of Christendom against pagans and Muslims, and he is accompanied by his court of Twelve Noble Peers. These include Oliver, Ogier the Dane, and Roland. The most well-known chanson de geste, and possibly the most important, is the Chanson de Roland, or Song of Roland. Charlemagne legends are known as the matter of France. Other Chanson Cycles In addition to the Charlemagne Cycle, there is a group of 24 poems centering on Guillaume dOrange, a supporter of Charlemagnes son Louis, and another cycle about the wars of powerful French barons. Influence of Chansons de Geste The chansons influenced medieval literary production throughout Europe. Spanish epic poetry owed a clear debt to the chansons de geste, as is most notably demonstrated by the 12th-century epic Cantar de mio Cid (Song of my Cid). The incomplete epic Willehalm by the 13th-century German poet Wolfram von Eschenbach was based on the stories told in the chansons of Guillaume dOrange. In Italy, tales about Roland and Oliver (Orlando and Rinaldo) abounded, culminating in the Renaissance epics Orlando innamorato by Matteo Boiardo and Orlando furioso by Ludovico Ariosto. The matter of France was an essential element of French literature for centuries, influencing both prose and poetry well beyond the Middle Ages.

Tuesday, February 25, 2020

Love. Spare Time Case Study Example | Topics and Well Written Essays - 500 words

Love. Spare Time - Case Study Example Furthermore, many businesses have been seen to make cost leadership their strategy, business such as Wal-Mart adhere to cost leadership in order to differentiate and maintain their competitive advantage, but Mark does not want to opt for that option either. The fact that no other retailer within a five-mile radius offers the brands being offered by Mark is an edge Mark has over the other retailers if the quality of the brands being offered by him is perceived to be superior by his customers. Even then it is just a matter of time till the growing trend of e-commerce engulfs this point of differentiation of Spare Time Equipment. The facts stated above show that as of now, Spare Time Equipment does not have a sustainable competitive advantage and customers do not come to an outlet just to make friends and build relationships. One thing which Mark has been doing right is to try and differentiate himself on the basis of the service Spare Time Equipment provides over other retailers, the tagline â€Å"We do it right the first time† is attention grabbing and has a feel of excellence in business. As mentioned above, most of Mark’s experience has been in the services sector; therefore differentiating on the basis of providing good service seems very apt and achievable. However, in order for people to avail the services at Spare Time Equipment it is essential for people to first buy the product for which Mark needs to become more flexible. Some amount of consumer promotion to introduce the product with the customers would do more good to Mark than harm. Promotions of limited time discount offers could be run on the radio spots and print ads which Mark has previously used to create awareness about Spare Time Equipment. This would help increase customer traffic at Spare Time Equipment and then it wo uld be up to the sales staff to seal the deal. If Mark does not want to reduce the price of his

Sunday, February 9, 2020

CSI and the Post Modern Body Assignment Example | Topics and Well Written Essays - 500 words

CSI and the Post Modern Body - Assignment Example Therefore, it may not be fully dependable for the development of forensic science, as it seems more fictional. The CSI emphasizes more on the role of forensic science, including the relationships of DNA while undertaking investigations, while attaching less significance to the role of informers or even the detectives’ work (Harrington, 2007). The foundation of CSI is based on the fact that the identity given by the DNA tests undertaken is indisputable and accurately points to the suspect, regardless of the fact that the body could be mutilated. Most significant is the fact that it is impossible to accurately determine the actual gender of the victim, without the application of science. Therefore, the case of identity of the suspect becomes a puzzle to solve, up until the forensic science is applied, which identifies the suspect as a man, who has been living as a woman conducting surgeries and killing the victims (Harrington, 2007). The strength of the argument presented here is the fact that science is the undisputable basis of presenting an accurate identity of the individuals involved in crime. This is because; through forensic science, where the DNA of the suspects involved can be traced, then the real identity of those involved can be unquestionably noted (Harrington, 2007). Considering that through transsexual surgeries, the gender of an individual can be changed, then, it makes the investigations through detectives more complicated. This is because, while the investigation could point to the suspect of the crime from a certain gender, then tracing them would be difficult since they can change that. However, through forensic science, the real identity will always remain, as the DNA of an individual can never be changed (Harrington, 2007). Thus, the argument presents science as the basis of providing society with the unbiased truth of identity. The role of the detectives,

Thursday, January 30, 2020

The Reason Why Women Live Longer Than Men Essay Example for Free

The Reason Why Women Live Longer Than Men Essay Scientists are finally beginning to understand one of life’s enduring mysteries why women live, on average, longer than men. The new research describes how mutations to the DNA of the mitochondria can account for differences in the life expectancy of males and females. Mitochondria, which exist in almost all animal cells, are vital for life because they convert our food into the energy that powers the body. Dr Damian Dowling and PhD student Florencia Camus, from Monash School of Biological Sciences in the U. S., worked with Dr David Clancy from Lancaster University to uncover differences in longevity and biological ageing across male and female fruit flies that carried mitochondria of different origins. They found that genetic variation across these mitochondria were reliable predictors of life expectancy in males, but not in females. Dr Dowling said the results point to numerous mutations within mitochondrial DNA that affect how long males live, and the speed at which they age. He said: Intriguingly, these same mutations have no effects on patterns of ageing in females they only affect males. All animals possess mitochondria, and the tendency for females to outlive males is common to many different species. Our results therefore suggest that the mitochondrial mutations we have uncovered will generally cause faster male ageing across the animal kingdom. The researchers said the mutations can be entirely attributed to a quirk in the way that mitochondrial genes are passed down from parents to offspring. Dr Dowling said: While children receive copies of most of their genes from both their mothers and fathers, they only receive mitochondrial genes from their mothers. This means that evolution’s quality control process, known as natural selection, only screens the quality of mitochondrial genes in mothers. If a mitochondrial mutation occurs that harms fathers, but has no effect on mothers, this mutation will slip through the gaze of natural selection, unnoticed. Over thousands of generations, many such mutations have accumulated that harm only males, while leaving females unscathed. The study builds on previous findings by Dr Dowling and his team who investigated the consequences of maternal inheritance of mitochondria in causing male infertility. Dr Dowling added: Together, our  research shows that the mitochondria are hotspots for mutations affecting male health. What we seek to do now is investigate the genetic mechanisms that males might arm themselves with to nullify the effects of these harmful mutations and remain healthy.