In western cultures, the MTL may unfold rightward (with the past on the left and the future on the right) since people read and write from left to right. Western calendars also continue this trend by placing the past on the left with the future progressing toward the right. Conversely, Arabic, Farsi, Urdu and Israeli-Hebrew speakers read from right to left, and their MTLs unfold leftward (past on the right with future on the left), and evidence suggests these speakers organize time events in their minds like this as well.This linguistic evidence that abstract concepts are based in spatial concepts also reveals that the way humans mentally organize time events varies across cultures––that is, a certain specific mental organization system is not universal. So, although Western cultures typically associate past events with the left and future events with the right according to a certain MTL, this kind of horizontal, egocentric MTL is not the spatial organization of all cultures. Although most developed nations use an egocentric spatial system, there is recent evidence that some cultures use an allocentric spatialization, often based on environmental features.A recent study of the indigenous Yupno people of Papua New Guinea focused on the directional gestures used when individuals used time-related words. When speaking of the past (such as "last year" or "past times"), individuals gestured downhill, where the river of the valley flowed into the ocean. When speaking of the future, they gestured uphill, toward the source of the river.
Additionally, it can be diagnosed through sarcopenia, or loss of skeletal muscle mass.Laboratory markers are used in evaluation of people with cachexia, including albumin, prealbumin, C-reactive protein, or hemoglobin. However, laboratory metrics and cut-off values are not standardized across different diagnostic criteria. Acute phase reactants (IL-6, IL-1b, tumor necrosis factor-a, IL-8, interferon-g) are sometimes measured but correlate poorly with outcomes. There are no biomarkers to identify people with cancer who may develop cachexia.In the effort to better classify cachexia severity, several scoring systems have been proposed including the Cachexia Staging Score (CSS) and Cachexia Score (CASCO). The CSS takes into account weight loss, subjective reporting of muscle function, performance status, appetite loss, and laboratory changes to categorize patients into non-cachexia, pre-cachexia, cachexia, and refractory cachexia. The Cachexia SCOre (CASCO) is another validated score that includes evaluation of body weight loss and composition, inflammation, metabolic disturbances, immunosuppression, physical performance, anorexia, and quality of life.Evaluation of changes in body composition is limited by the difficulty in measuring muscle mass and health in a non-invasive and cost-effective way. Imaging with quantification of muscle mass has been investigated including bioelectrical impedance analysis, computed tomography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging but are not widely used. Definition
Identification, treatment, and research of cachexia have historically been limited by the lack of a widely accepted definition of cachexia.