Variational description of multi-fluid hydrodynamics: Uncharged fluids

We present a formalism for Newtonian multi-fluid hydrodynamics derived from an unconstrained variational principle. This approach provides a natural way of obtaining the general equations of motion for a wide range of hydrodynamic systems containing an arbitrary number of interacting fluids and superfluids. In addition to spatial variations we use ``time shifts'' in the variational principle, which allows us to describe dissipative processes with entropy creation, such as chemical reactions, friction or the effects of external non-conservative forces. The resulting framework incorporates the generalization of the entrainment effect originally discussed in the case of the mixture of two superfluids by Andreev and Bashkin. In addition to the conservation of energy and momentum, we derive the generalized conservation laws of vorticity and helicity, and the special case of Ertel's theorem for the single perfect fluid. We explicitly discuss the application of this framework to thermally conducting fluids, superfluids, and superfluid neutron star matter. The equations governing thermally conducting fluids are found to be more general than the standard description, as the effect of entrainment usually seems to be overlooked in this context. In the case of superfluid He4 we recover the Landau--Khalatnikov equations of the two-fluid model via a translation to the ``orthodox'' framework of superfluidity, which is based on a rather awkward choice of variables. Our two-fluid model for superfluid neutron star matter allows for dissipation via mutual friction and also ``transfusion'' via beta-reactions between the neutron fluid and the proton-electron fluid.Comment: uses RevTeX 4; 20 pages. To appear in PRD. v2: removed discussion of charged fluids and coupling to electromagnetic fields, which are submitted as a separate paper for a clearer presentation v3: fixed typo in Eq.(9), updated some reference

A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: A secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Background Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity. Methods In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg −1 min −1 and peak oxygen consumption (VO 2 peak) >16 ml kg −1 min −1, cut-points that represent a reduced risk of postoperative complications. Results Five questions were identified to have dominance in predicting AT>11 ml kg −1 min −1 and VO 2 peak>16 ml.kg −1min −1. These items were included in the M-DASI-5Q and retained utility in predicting AT>11 ml.kg −1.min −1 (area under the receiver-operating-characteristic [AUROC]-AT: M-DASI-5Q=0.67 vs original 12-question DASI=0.66) and VO 2 peak (AUROC-VO2 peak: M-DASI-5Q 0.73 vs original 12-question DASI 0.71). Conversely, in a sensitivity analysis we removed one potentially sensitive question related to the ability to have sexual relations, and the ability of the remaining four questions (M-DASI-4Q) to predict an adequate functional threshold remained no worse than the original 12-question DASI model. Adding a dynamic component to the M-DASI-4Q by assessing the chronotropic response to exercise improved its ability to discriminate between those with VO 2 peak>16 ml.kg −1.min −1 and VO 2 peak<16 ml.kg −1.min −1. Conclusions The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management