The Older Population and the Aged Patient

Modern medical practice requires that the physician and other members of the health team have full appreciation of the impact of disease and disability upon identifiable groups of patients and recognize how nonmedical factors affect treatment and prognosis. It is important for the physician to have some idea of the patient\u27s socioeconomic status and the actual and potential number of patients with not only a common diagnosis, but also similarities in their living conditions. With such knowledge, the physician can be much more realistic and efficient in his therapeutic efforts. Persons 65 years of age and over are commonly referred to as the older population. Brotman (1968) recently identified the special characteristics of those 75 years of age and over, referring to these people as the aged. This subdividing of the older population is of considerable value, as the important health and socioeconomic facts common to a specific group can be lost in the mass of the older population

Extreme-value statistics from Lagrangian convex hull analysis for homogeneous turbulent Boussinesq convection and MHD convection

We investigate the utility of the convex hull of many Lagrangian tracers to analyze transport properties of turbulent flows with different anisotropy. In direct numerical simulations of statistically homogeneous and stationary Navier-Stokes turbulence, neutral fluid Boussinesq convection, and MHD Boussinesq convection a comparison with Lagrangian pair dispersion shows that convex hull statistics capture the asymptotic dispersive behavior of a large group of passive tracer particles. Moreover, convex hull analysis provides additional information on the sub-ensemble of tracers that on average disperse most efficiently in the form of extreme value statistics and flow anisotropy via the geometric properties of the convex hulls. We use the convex hull surface geometry to examine the anisotropy that occurs in turbulent convection. Applying extreme value theory, we show that the maximal square extensions of convex hull vertices are well described by a classic extreme value distribution, the Gumbel distribution. During turbulent convection, intermittent convective plumes grow and accelerate the dispersion of Lagrangian tracers. Convex hull analysis yields information that supplements standard Lagrangian analysis of coherent turbulent structures and their influence on the global statistics of the flow.Comment: 18 pages, 10 figures, preprin

Fluctuation dynamo amplified by intermittent shear bursts in convectively driven magnetohydrodynamic turbulence

Intermittent large-scale high-shear flows are found to occur frequently and spontaneously in direct numerical simulations of statistically stationary turbulent Boussinesq magnetohydrodynamic (MHD) convection. The energetic steady-state of the system is sustained by convective driving of the velocity field and small-scale dynamo action. The intermittent emergence of flow structures with strong velocity and magnetic shearing generates magnetic energy at an elevated rate over time-scales longer than the characteristic time of the large-scale convective motion. The resilience of magnetic energy amplification suggests that intermittent shear-bursts are a significant driver of dynamo action in turbulent magnetoconvection

Haemoglobin and size dependent constraints on swimbladder inflation in fish larvae

In developmental studies of fish species (especially physostomians) it could be demonstrated, that the lack of haemoglobin during larval and juvenile stages is a relatively common phenomenon. Generally it is linked with body translucency. In representatives of the families Galaxiidae, Osmeridae and Clupeidae, partly reared, partly observed immediately after being caught in the wild, it turned out, that this condition coincides with a considerable delay in swimbladder inflation. To determine the moment of its first inflation, larvae placed in a hermetic chamber were observed under a dissecting microscope. While lowering the pressure, the expanding swimbladder showed whether or not its content is really gaseous. The reason postulated to be responsible for the delayed inflation is that larvae lacking haemoglobin do not have the possibility of oxygen transport to their buoyancy organ by means of the blood. Apart of this, capillarity force calculations and body force estimations show that with decreasing size the constraints linked with surface tension increase overproportionally. While in larger sized larvae like trout we could demonstrate inflation by swallowing air, in species with small larvae this was not the case. Below a certain size, even in physostomians, the ductus pneumaticus is no alternative to the blood pathway for swimbladder inflation

The Spatio-Temporal Structure of Spiral-Defect Chaos

We present a study of the recently discovered spatially-extended chaotic state known as spiral-defect chaos, which occurs in low-Prandtl-number, large-aspect-ratio Rayleigh-Benard convection. We employ the modulus squared of the space-time Fourier transform of time series of two-dimensional shadowgraph images to construct the structure factor ${S}({\vec k},\omega )$. This analysis is used to characterize the average spatial and temporal scales of the chaotic state. We find that the correlation length and time can be described by power-law dependences on the reduced Rayleigh number ${\epsilon}$. These power laws have as yet no theoretical explanation.Comment: RevTex 38 pages with 13 figures. Due to their large size, some figures are stored as separate gif images. The paper with included hi-res eps figures (981kb compressed, 3.5Mb uncompressed) is available at ftp://mobydick.physics.utoronto.ca/pub/MBCA96.tar.gz An mpeg movie and samples of data are also available at ftp://mobydick.physics.utoronto.ca/pub/. Paper submitted to Physica

DPP-4 inhibitor dose selection according to manufacturer specifications:A Contemporary Experience From UK General Practice

Recently, 2 dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and saxagliptin, adjusted dosing specification from creatinine clearance to glomerular filtration rate, more typically reported in routine laboratory tests. This cross-sectional study examines all DPP-4 inhibitor initiations that require dose adjustment and the dose selection using data from UK general practice. Results indicate that 34% of patients taking a nonlinagliptin DPP-4 inhibitor were given a higher dose and 11% a lower dose than specified in the Summary of Product Characteristics. This reinforces the deviation from Summary of Product Characteristics prescription of DPP-4 inhibitors identified in earlier studies despite improvement in compatibility with routine reporting. (C) 2019 The Authors. Published by Elsevier Inc

Nonlinear Competition Between Small and Large Hexagonal Patterns

Recent experiments by Kudrolli, Pier and Gollub on surface waves, parametrically excited by two-frequency forcing, show a transition from a small hexagonal standing wave pattern to a triangular ``superlattice'' pattern. We show that generically the hexagons and the superlattice wave patterns bifurcate simultaneously from the flat surface state as the forcing amplitude is increased, and that the experimentally-observed transition can be described by considering a low-dimensional bifurcation problem. A number of predictions come out of this general analysis.Comment: 4 pages, RevTex, revised, to appear in Phys. Rev. Let

Cytokine Profiles of Stimulated Blood Lymphocytes in Asthmatic and Healthy Adolescents Cross the School Year

T cell cytokines play an important role in mediating airway inflammation in asthma. The predominance of a Th2 cytokine profile, particularly interleukin (IL)-4 and IL-5, is associated with the pathogenesis and course of asthma. The aim of this study was to test the hypothesis that a stressful life event alters the pattern of cytokine release in asthmatic individuals. Thirteen healthy controls and 21 asthmatic adolescents gave blood samples three times over a semester: midsemester, during the week of final examinations, and 2-3 weeks after examinations. Interferon-γ (IFN-γ), IL-2, IL-4, and IL-5 were measured from supernatants of cells stimulated with PHA/PMA for 24 h. Cells from asthmatic subjects released significantly more IL-5 during the examination and postexamination periods, whereas cells from healthy controls released significantly more IL-2 during the midsemester and examination periods, thereby indicating a bias for a Th2-like pattern in asthmatics and a Th 1-like pattern in healthy controls. IL-4 and IL-5 production showed a marked decrease during and after examinations in healthy controls, whereas this decline was absent in asthmatics. The ratios of IFN-γ:IL-4 and IFN-γ:IL-5 also revealed significant changes in the profile of cytokine release across the semester. These results indicate differential cytokine responses in asthmatics that may become pronounced during periods of cellular activation

Experiment and Simulation Study of Single Cylinder Diesel Engine Performance, Using Soybean Oil Biodiesel

— The most common fuel uses in the world is made from fossil. Fossil fuel is categorized as a non-renewable energy source. For that reason, there should be an alternative fuel to replace fossil fuel by using biodiesel and one of the stock comes from soybean bean. Before using the biodiesel made from soybean bean oil, there should be a research to find out the properties and the effect of biodiesel from soybean bean oil regarding the performance of the engine. The research can be conducted in experiment and simulation. The properties result of soybean oil biodiesel should be tested to confirm whether this biodiesel have meet the standard requirement of biodieselor not. This biodiesel sproperties are Flash Point value is 182 o C , Pour Point value is -7 o C, Density at 15 o C is 890 Kg/m3, Kinematic Viscosity at 40 o C is 5.58 (cSt), and Lower Heating Value is 42.27686 MJ/kg. The result from this research is the highest power from simulation is 9% higher than the experiment. The highest torque from the experiment is 37% lower than the simulation's torque. Lowest SFOC from experiment is 28% lower than the simulation's SFOC. Highest BMEP from simulation is 20% higher than the highest BMEP from experiment. The highest thermal efficiency from experiment is 6% higher than the highest thermal efficiency from simulation. The engine performance result using soybean oil biodiesel is not better than the Pertamina Dex. For that reason, the use of this biodiesel is not suggested to substitute Pertamina Dex