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Reproductive Ecology of the Dusky Mud Hopper, Periophthalmus modestus in Western Korea (한국 서해산 말뚝망둥어, Periophthalmus modestus의 번식생태)

  • Yang, Hyoung-Su;Chung, Ee-Yung;Sin, Moon-Seup;Choi, Dae-Up
    • Korean Journal of Ichthyology
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    • v.19 no.4
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    • pp.306-317
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    • 2007
  • Reproductive cycle with the gonad developmental phases, first sexual maturity, spawning frequency, sex ratio of the dusky mud hopper, Periophthalmus modestus were investigated by histological observations. Monthly variations of the gonadosomatic index (GSI) began to increase in May and reached a maximum in June when the gonad was getting mature during the period of higher ground (water) temperature-long day length. Changes in the GSI showed a negative correlation to the HSI, but coincided with the fatness index. The reproductive cycle can be classified into five successive stages: in female, early growing stage (April to May), late growing stage (April to May), mature stage (May to June), ripe and spent stage (June to August), and recovery and resting stage (August to March); in males, growing stage (April to May), mature stage (May to June), ripe and spent stage (June to August), and recovery and resting stage (August to March); According to the frequency distributions of egg diameters during the breeding season, Periophthalmus modestus is presumed to be a summer breeder, asynchronous group and polycyclic species to spawn 2 times or more during the spawning season. Total eggs and mature eggs in absolute fecundity and relative fecundity (per cm) increased with the increase of body length. Total eggs and mature eggs in absolute fecundity and relative fecundity (per g) did not increase with the increase of body weight. Percentages of first sexual maturity of females and males ranging from 5.1 to 5.5 cm in body length are over 50%, and 100% for fish over 7.1 cm in body length. The sex ratios of females to males over 5.1 cm in body length were not significantly different from a 1 : 1 sex ratio.

A Study of Community Residents' Consciousness of Taking Herb Medicine (지역사회 주민의 한약복용에 대한 의식 조사 연구)

  • Kim Sung-Jin;Nam Chul-Hyun;Kang Young-Woo;Suh Ho-Suk;Jeon Bong-Cheon;Chang Young-Jin
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.15-35
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    • 2002
  • This study was conducted to provide basic data for policy of Oriental medicine by analyzing community resident's consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 2001 to May 31, 2001. The results of this study are summarized as follows. 1) The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 2) In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. 3) 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 4) According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it because persons around them recommended it. 5) 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain food should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 6) In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 7) 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 8) 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 51.9% does not know whether taking herb medicine in summer is effective or not because the effect is different according to their physical constitutions. 35.5% thinks that taking herb medicine is summer is effective because their physical stamina is weakened after sweated a lot, while 12.6% thinks that it is not effective because the effect of herb medicine disappears with sweat. 9) According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 10) According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

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The Role of Video-Assisted Thoracic Surgery in the Diagnosis and the Treatment of a Mediastinal Mass (종격동 병변의 진단 및 치료와 비디오 흉강경의 역할 -흉강경에 의한 종격동 병변 진단 치료-)

  • Baek, Hyo-Chae;Park, Han-Gi;Bae, Gi-Man;Lee, Du-Yeon
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.769-776
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    • 1996
  • The application of video-assisted thoracic surgery (VATS) in the examination of the thoracic cavity can be a new option in patients with mediastinal tumor because it provides outstanding visibility of the structures of the mediastinum. By clear viewing through the thoracoscope, a mediastinal tumor can be biopsied or resected, depending on the findings during an operation. We reviewed all patients who underwent curative or diagnostic operations from March 1990 to August 1995 under the impression of a mediastinal mass. The total number of patients were 113 with 59 males and 54 females. Group A underwent resection of tu or by thoracotomy(38 patients: 18 males, 20 females), and group B underwent resection of tumor by VATS (36 patients : 20 males and 16 females). Seven patients in group B were excluded because they underwent thoracotomy due to pleural adhesion or intra-operative bleeding ; therefore, the true VATS group numbered 29 cases. Group C underwent Iymph node biopsy by VATS(33 patients'16 males, 17 females), and group D(6 patients: 5 males, 1 female) underwent Iymph node biopsy through anterior mediastinotomy. The mean age in group A was 36.2 years compared to 41.3 years In group B. We compared operation time, frequency of injection for pain control, duration of chest tube insertion, postoperative hospital stay, and diagnostic yield. In group A, they were 164 minutes, 3.4 times, 5.2 days, and 11.3 days, respectively, in comparison to 152 minutes, 2 times, 4.7 days, and 8.3 days, respectively, in group B. These data revealed that the day of discharge was significantly shorter in group B (p valu : 0.03). In group C, the mean age was 45.8 years (range 1 ∼70). The operation time was from 30 to 335 minutes (mean 105), pain control was required from 0 to 15 times(mean 3.2), and a chest tube was needed for 1 to 36 days (mean 6.1). In group D, mean age was 53.3 years, operation time 121 minutes, pall control injec- tion frequency 2.6 times, and mean chest tube duration 10.5 days. The diagnostic yield in group C was 8 oyo compared to 100 oyo in group D although the number of patients in group D is small.

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Antrum Formation and Growth of Mouse Pre-antral Follicles Cultured in Two Different Culture Media without Hormones

  • Kim, Ju-Hwan;Kim, Hwan-Tae;Park, Kee-Sang;Song, Hai-Bum;Chun, Sang-Sik
    • Proceedings of the KSAR Conference
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    • 2001.03a
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    • pp.8-8
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    • 2001
  • Mouse follicles require the addition of gonadotropins (Gns) to complete maturation and ovulation of oocyte and antrum formation of follicles in vitro. However, we tried examination of in vitro growth of mouse pre-antral follicles in medium without Gns and physiological factors. And also, pre-antral follicles were isolated from ovaries by mechanical method. Our present studies were conducted to evaluate on the growth of follicles and intra-follicular oocytes and antrum formation in vitro of mouse pre-antral follicles in two different media. Pre-antral follicles (91-120${\mu}{\textrm}{m}$) were isolated mechanically by fine 30G needles not using enzymes from ovary of 3-6 weeks old female ICR mice. Isolated pre-antral follicles were cultured in 20 ${mu}ell$ droplets of TCM (n=17; follicles: 107.8 $\pm$ 1.58 ${\mu}{\textrm}{m}$; oocytes: 59.9$\pm$1.2 ${\mu}{\textrm}{m}$) or MEM (n=12; follicles: 109.3$\pm$2.53 ${\mu}{\textrm}{m}$; oocytes: 55.4 $\pm$1.6${\mu}{\textrm}{m}$) under mineral oil on the 60mm culture dish. All experimental media was supplemented with 10% FBS but without Gns and/or physiological factors. Pre-antral follicles were individually cultured in drops for 8 days. Antrum formation and growth of pre-antral follicles and intra-follicular oocytes were evaluated using a precalibrated ocular micrometer at $\times$200 magnifications during in vitro culture. Results between different groups were analyzed using combination of Student's t-test and Chi-square, and considered statistically significant when P<0.05. Antrum formation of pre-antral follicles had started in two culture media on day-2. On day-8, antrum formation had occurred in 58.3%(7/12) of pre-antral follicles cultured in MEM, but only in 23.5% (4/17) of those cultured in TCM (P=0.0364). Growth of pre-antral follicles and intra-follicular oocytes were observed on day-4 and -8. On day-4, follicular diameters was similar (P=0.1338) in TCM (119.4$\pm$2.58 ${\mu}{\textrm}{m}$) and MEM (125.4$\pm$4.52 ${\mu}{\textrm}{m}$). However, on day-8, diameters of pre-antral follicles cultured in MEM (168.9$\pm$17.29 ${\mu}{\textrm}{m}$) was significantly (P=0.0248) bigger than that in TCM (126.7$\pm$4.28 ${\mu}{\textrm}{m}$). On day-4 and -8, diameters of intra-follicular oocytes were similar TCM (67.1$\pm$1.3 and 72.4$\pm$0.9${\mu}{\textrm}{m}$) and MEM (65.2$\pm$1.7 and 73.3$\pm$1.5 ${\mu}{\textrm}{m}$), respectively. We can conform that medium not supplemented with Gns and/or physiological factors can be used for in vitro antrum formation and growth of mouse pre-antral follicles and intra-follicular oocytes. In conclusion, MEM supplemented with FBS can be used for growth in vitro of mouse pre-antral follicles isolated mechanically.

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Anastomosis Site Stricture after Using Stapler Devices in a Total Gastrectomy (위전절제술에서 자동단단문합기 사용 후 문합부 협착에 대한 고찰)

  • Ku, Do-Hoon;Suh, Byoung-Jo;Han, Won-Sun;Yu, Hang-Jong;Kim, Jin-Pok
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.252-256
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    • 2004
  • Purpose: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. Materials and Methods: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. Results: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3:1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in $14\%$ (32/228) of the total gastrectomy cases, in$15.9\%$ (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in $13.2\%$ (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases ($12.5\%$) and 25 of the remaining 172 cases ($14.5\%$) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. Conclusion: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.

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Analysis of Cancer Incidence in Zhejiang Cancer Registry in China during 2000 to 2009

  • Du, Ling-Bin;Li, Hui-Zhang;Wang, Xiang-Hui;Zhu, Chen;Liu, Qing-Min;Li, Qi-Long;Li, Xue-Qin;Shen, Yong-Zhou;Zhang, Xin-Pei;Ying, Jiang-Wei;Yu, Chuan-Ding;Mao, Wei-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5839-5843
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    • 2014
  • Objective: The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. Methods: Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. Results: The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was $271.5/10^5$ during 2000 to 2009 (male $305.41/10^5$, female $236.58/10^5$), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were $147.1/10^5$ and $188.2/10^5$, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was $209.6/10^5$ in 2000, and it increased to $320.20/10^5$ in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. Conclusions: Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.

Analysis of Sleep Questionnaires of Patients who Performed Overnight Polysomnography at the University Hospital (한 대학병원에서 철야 수면다원검사를 시행한 환자들의 수면설문조사 결과 분석)

  • Kang, Ji Ho;Lee, Sang Haak;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik;Park, Yong Moon
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.76-82
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    • 2006
  • Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

The Outcome of Glioblastoma Patients Treated with Surgery and Radiation Therapy (두개 내 다형성아교모세포종 환자의 방사선치료 결과)

  • Nam Hee Rim;Lim Do Hoon;Ahn Yong Chan;Lee Jung I1;Nam Do-Hyun;Kim Jong Hyun;Hong Seung-Chyul;Lee Jeong Eun;Kang Min Kyu;Park Young Je;Kim Kyung Ju;Park Won;Huh Seung Jae
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.91-97
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    • 2004
  • Propose: To Analyze the survival outcomes and prognostic factors In glioblastoma patients treated with surgery and radiation therapy. Materials and Methods : One hundred twenty glloblastoma patients treated with postoperative radiation therapy from 1994 to 2003 at Samsung Medical Center were retrospectively reviewed. Surgical extents were gross total resection in 22 patients (18$\%$), subtotal resection in 69 (58$\%$), and biopsy only in 29 (24$\%$). The median radiation dose was 50 Gy, ranging from 45 Gy to 72 Gy The median follow-up period was 12 months ranging from 2 to 52 months. Results The overall 1- and 2-year survival rates were 52$\%$ and 14$\%$, respectively, and the median survival duration was 13 months. Favorable prognostic factors by Uunivarlate analyses of prognostic factors on 1-year survival rate were revealed that age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.03), single lesion (p=0.02), and gross total resection (p=0.04), were the favorable prognostic (actors. and by Mmultlvarlate analyses were revealed that female (p<0.01), age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.05) and gross total resection (p=0.05) were the favorable prognostic factors. Conclusions : The results of our study were comparable with those previously reported. To Improve treatment outcome, various modifications, Including radiation dose escalation through newer radiation therapy techniques and use of effective chemotherapy regimen, should be further Investigated. Investigated. Also Furthermore, the application of Individualized treatment strategy based on 4he patient's prognostic factors might be needed.

A study on Hospital based Home Health Care Service and the Level of Client Satisfaction (일 대학 병원의 가정간호시범사업 서비스 내용 및 만족도에 대한 조사연구)

  • Kim Chung Nam;Kwan Young Sook;Koh Hyo Jung;Kim Myung Ae;Park Chung Ja;Shin Yeong Hee;Lee Byung Sook;Lee Kyung Hee;Seo Hanng Suk
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.246-259
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    • 2000
  • The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

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Amounts of physical activity and sedentary behavior patterns in older adults: using an accelerometer and a physical activity diary (노인의 신체활동량 및 좌식행동패턴 : 가속도계와 신체활동일기를 이용하여)

  • Go, Na-Young;Ndahimana, Didace;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.52 no.1
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    • pp.36-46
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    • 2019
  • Purpose: This study evaluated amounts of physical activity and sedentary behavior patterns in older adults using an accelerometer and physical activity diary. Methods: Forty-nine older adults (male 26, female 23) participated in this study. They wore a triaxial accelerometer (ActiGraph wGT3X-BT) for one week and wrote a physical activity diary concurrently for three days. Amounts of physical activity, sedentary behavior patterns, and percentage of meeting the World health organization (WHO) physical activity guidelines were analyzed using an accelerometer. In addition, the contents recorded in the physical activity diary were reclassified to 18 levels and the average daily times spent on each level and physical activity level (PAL) were calculated. Results: The subjects were sitting more than half of the day except for bedtime and shower time (59.2%). The numbers of prolonged ${\geq}30$, 40 minutes sedentary bouts were significantly higher in males ($3.10{\pm}1.34$, $1.78{\pm}1.09$, respectively) than in females ($2.34{\pm}1.22$, $1.32{\pm}1.07$, respectively) and the number of breaks per sedentary hour was significantly less in males ($5.74{\pm}0.89$) than in females ($6.44{\pm}0.71$). Among the activities corresponding to sedentary behavior surveyed by the physical activity diary, only the amount of time spent 'resting, speaking and watching TV' showed a significant correlation with the sedentary behavior pattern measured by the accelerometer. The persistence of sedentary behavior was interrupted primarily when low intensity activity was performed. Only 22.4% of the subjects met WHO physical activity guidelines. Conclusion: Based on these results, the physical activity guidelines for older adults should be developed that reflects the appropriate strength, including low activity level and maintenance time of moderate to vigorous physical activity.