Does this mean that you should go back and use a 4GL to do what you used to do in or with APL, i.e. now use the 4GL to write programs like they did instead of structured programming? Far from it. 4GLs are typically very inefficient and difficult to use in the context of processing data. But they can provide tremendous productivity gain within the context of presenting data. For example, the U.S. Department of Energy (DOE) has embarked on an ambitious program to create a super computer capable of processing about 50 million exaflops (50 exajarps) by 2005. That is roughly equal to one petaflop (one petarps) of power. To put this in perspective, the average computer today can process about one quadrillion (108) floating point operations per second (FLOPS) and has a clock rate of about 1GHz, which is not a whole lot of speed compared to these DOE efforts. The DOE is simply doubling the FLOPS per second, and the clock rate per node is currently between 100 and 1000 gigahertz, as opposed to 1 gigahertz. For some perspective, a computer built with today’s technology that has 50 exajarps and clock rate of 1 terahertz (1015 gigahertz) would be over 10,000 times faster than the average consumer PC. Alarm bells should sound for anyone thinking about Moore’s Law and its relationship to power consumption. Put another way, the exajarps/terahertz PC is almost 10,000 times faster than the existing 500 MHz computer, a 500,000 times increase in FLOPS plus a 100,000 times increase in clock speed is not linear. It is going to be a big, very expensive problem. So the DOE is putting a lot of effort into building huge clusters and writing a million lines of code for a petaflop of power. In the process they are also writing a lot of code to facilitate their efforts. I have a feeling that a core component of their code is written in 4GL. We have to assume that is true, since we have no access to the software. However, our experience at other areas of science have been that you can learn 40 times what you could from a piece of software. Especially in the large quantities of code they are producing, since the human eye does not have the time to scan the code for errors or risk spending hours to find an error. 81555fee3f

image line gross beat vst crackIntroduction

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Gout, an articular disease, is characterized by acute attacks of pain and inflammation of the affected joints.

Objectives

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We present a case of a 81 year-old woman with a history of hypertension and hyperlipidaemia, who presented with severe attacks of gouty arthropathy that was refractory to medical treatment.

Case report

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A 81 year-old woman, who suffered from arthralgia of the big toe for the last 20 years, consulted our clinic. She had a history of hypertension and hyperlipidaemia. She had used medication for these two diseases with no adverse effect in the past. In addition, she had daily intake of the antioxidant vitamin E. Three months ago, she had an episode of acute pain at the big toe joint that was relieved after administration of nonsteroidal anti-inflammatory drugs. However, since then, she had frequent attacks of similar episodes, and had taken medications as needed. Physical examination revealed severe pain with severe tenderness of her big toe joints. Laboratory tests were normal. To exclude the possibility of drug-induced arthralgia, we started to administer oral gold sodium thiosulfate (GST) at a dose of 200 mg/day. After 5 days of this treatment, her attacks of arthralgia disappeared. In addition, even after 7 days, her big toe joints were no longer swollen.

Conclusion

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GST is a basic material for the synthesis of new uric acid products such as metallopurines. Its antipurine action is considered to inhibit uric acid production by the host in order to prevent acute gout attacks. In some cases of chronic gout, the attacks of the disease are gradually being suppressed by taking a large amount of GST. In addition, it is reported that GST has an antioxidant effect. However, the possible mechanism of such effects is not yet clarified. We report a case of a patient with severe attacks of gout. Although an association of urate hyperphosphatemia with gout has been reported, in this case, her serum urate levels were not elevated.

Consent

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Written informed consent was obtained from the patient for publication of this case report.

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