Shear-Improved Smagorinsky Model for Large-Eddy Simulation of Wall-Bounded Turbulent Flows

A shear-improved Smagorinsky model is introduced based on recent results concerning shear effects in wall-bounded turbulence by Toschi et al. (2000). The Smagorinsky eddy-viscosity is modified subtracting the magnitude of the mean shear from the magnitude of the instantaneous resolved strain-rate tensor. This subgrid-scale model is tested in large-eddy simulations of plane-channel flows at two different Reynolds numbers. First comparisons with the dynamic Smagorinsky model and direct numerical simulations, including mean velocity, turbulent kinetic energy and Reynolds stress profiles, are shown to be extremely satisfactory. The proposed model, in addition of being physically sound, has a low computational cost and possesses a high potentiality of generalization to more complex non-homogeneous turbulent flows.Comment: 10 pages, 6 figures, added some reference

Energy Transfer and Triadic Interactions in Compressible Turbulence

Using a two-point closure theory, the Eddy-Damped-Quasi-Normal-Markovian (EDQNM) approximation, we have investigated the energy transfer process and triadic interactions of compressible turbulence. In order to analyze the compressible mode directly, the Helmholtz decomposition is used. The following issues were addressed: (1) What is the mechanism of energy exchange between the solenoidal and compressible modes, and (2) Is there an energy cascade in the compressible energy transfer process? It is concluded that the compressible energy is transferred locally from the solenoidal part to the compressible part. It is also found that there is an energy cascade of the compressible mode for high turbulent Mach number (M(sub t) greater than or equal to 0.5). Since we assume that the compressibility is weak, the magnitude of the compressible (radiative or cascade) transfer is much smaller than that of solenoidal cascade. These results are further confirmed by studying the triadic energy transfer function, the most fundamental building block of the energy transfer

Endovascular Treatment of Aortic Arch Aneurysms

AbstractIntroductionThe aim of this study was to review our clinical experience with endovascular treatment of aortic arch aneurysms using different commercially available grafts (Gore, Talent, Endomed, Cook).MethodsFrom 1999 to 2004, 97 patients received endovascular treatment for diseases of the thoracic aorta. In 30 cases (26 males, 4 females) the aortic arch was involved.The left subclavian artery was overstented (Ishimaru zone ‘2’) in 18 cases (60%). Only in the first three cases had the subclavian artery been revascularized. The left common and subclavian arteries were covered (zone ‘1’) in 6 (20%) cases—all had the carotid artery reconstructed, either simultaneously (five cases) or as a staged procedure (one case). Finally, the whole aortic arch was over-stented (zone ‘0’) in 6 (20%) cases, with simultaneous (five cases) or staged (one case) grafting of the supra-aortic vessels from the ascending aorta.ResultsPerioperative mortality was 2/30 (7%), due to graft migration (zone ‘2’) and intra-operative stroke (zone ‘0’), respectively. One minor stroke was observed. No cases of paraplegia were recorded. Three type I endoleaks were observed. Two resolved at 6 months follow-up; one zone ‘0’ graft is still being followed. There was one surgical conversion for endograft failure 2 weeks after implantation. Thus, the technical success rate was 87% (26/30) cases. The mean follow-up time was 23±17 months. No new onset endoleaks or aneurysm-related deaths were recorded.ConclusionsCurrently available grafts may be deployed in the aortic arch in most instances. De-branching of the aortic arch with surgical revascularization for zone ‘0’ and ‘1’ seems to be adequate to obtain a satisfactory proximal landing zone

Bacterioplankton composition as an indicator of environmental status: proof of principle using indicator value analysis of estuarine communities

Increasing awareness of environmental impacts caused by anthropogenic activities highlights the need to determine indicators of environmental status that can be routinely assessed at large spatial and temporal scales. Microbial communities comprise the greatest share of biological diversity on Earth and can rapidly reflect recent environmental changes while providing a record of past events. However, they have rarely been targeted in the search for ecological indicators of habitat types, environmental conditions, or environmental changes. Here, as a proof of principle, we analysed the bacterioplankton community composition of 4 estuaries in North and South America, Europe, and Asia, and looked for indicators of groups of samples defined using partition techniques, according to primary physicochemical variables typically monitored to infer water quality. Indicator value analysis (IndVal) was conducted to identify indicator operational taxonomic units (OTUs; analogous to species in other fields of ecology) in each group. These bacterioplankton-based indicators exhibited a high capacity to predict the group membership of the samples within each estuary and to correctly assign the samples to the appropriate estuary in a combined data set, employing different machine learning techniques. The indicators were composed of OTUs belonging to several bacterial phyla, which responded significantly and differentially to the environmental variables used to define the groups of samples. Moreover, the predictive values of these bacterial indicators were generally higher than those of other biological assemblages commonly used for environmental monitoring. Therefore, this approach appears to be a promising tool to complement existing strategies for monitoring and conservation of aquatic systems worldwide

Self-occluding Candy-Plug: Implantation Technique to Obtain False Lumen Thrombosis in Chronic Aortic Dissections

Purpose: To describe the implantation steps of the latest generation of candy-plug device (third CP generation [CP III]) and to illustrate its possible pitfalls by discussing a case in whom this device was employed to occlude the false lumen (FL) of a chronic type B aortic dissection. Technique: A 69 year-old male patient who underwent a frozen elephant trunk arch repair due to residual type A aortic dissection developed a FL aneurysmal degeneration limited to the descending thoracic aorta. Two thoracic stent-grafts were deployed into the true lumen up to the celiac trunk origin. Then, the FL was occluded with a self-occluding CP III device (Cook Medical, Bloomington, Indiana), placed at the same level as the distal thoracic stent-graft. The distal un-stented sleeve was pushed upward to allow immediate occlusion of its central lumen, avoiding interference with reno-visceral arteries arising from the FL. Both intraoperative transesophageal echocardiography and follow-up computed tomographic angiography scan demonstrated complete FL thrombosis. Conclusion: The introduction of CP III with its self-occluding mechanism helped to shorten and standardize the procedure. However, adjunctive steps may be needed to immediately obtain FL occlusion and avoid hampering the perfusion of vessels arising from the FL

Sentinel lymph node biopsy in porocarcinoma: A case reports

Introduction: Eccrine porocarcinoma (EPC) is a slow-growing carcinoma arising from the eccrine sweat glands. Based on its clinical presentation it can be confused with malignant and benign skin lesions, both. Histological examination is essential to formulate a correct diagnosis. Surgical excision with clear margins is the standard therapeutic approach while the role of sentinel lymph node biopsy (SNLB) remains controversial. Case presentation: The Authors report two cases of EPC of the lower limbs occurred in two women. Patients were treated by wide surgical excision of the lesion and SNLB. 6 months follow-up was disease free for both patients. Conclusion: Although a rare cutaneous tumor, EPC has to be taken into account in the differential diagnosis of malignant skin lesions because of its possible loco-regional aggressiveness and related morbidity. Among the available treatment options, surgical excision is considered the standard approach whereas the role of SNLB is controversial although the Authors discuss a possible usefulness for staging and diagnosis

Calcium-phosphate glass-based bioresorbable fibre optics for light and drug delivery

Calcium-phosphate glasses (CPGs) are commonly used as scaffolds in tissue engineering. A novel formulation of optically transparent CPG has been recently developed to be used as an optical fibre for biomedical implantable devices. Its purpose is to combine the bioresorbability of CPGs with optical features, thus extending the applications of bioresorbable sensors for in-body monitoring or diagnostics. Modifications of the glass composition or post-treatments on the fibres can tailor the dissolution time and the interaction of the glass with different stimuli as well as with specific cells. The tested glasses both in bulk and fibre shapes showed good strength (from 200 to 350 MPa) with values that are lower than standard silica glass and much higher than common bioresorbable polymers. CPG fibres were also implanted in living rats for several weeks and no clinical signs of any adverse effect have been found. We will present our latest results on these subjects starting from the characterisation of the CPGs by means of dissolution tests, in-vitro, and ex-vivo experiments

Gathering patients and rheumatologists' perceptions to improve outcomes in idiopathic inflammatory myopathies

Objective: Therapeutic targets in Idiopathic Inflammatory Myopathies (IIM) are based on the opinions of physicians/specialists, which may not reflect the main concerns of patients. The authors, therefore, assessed the outcome concerns of patients with IIM and compared them with the concerns of rheumatologists in order to develop an IIM outcome standard set. Methods: Ninety-three IIM patients, 51 rheumatologists, and one physiotherapist were invited to participate. An open questionnaire was initially applied. The top 10 answers were selected and applied in a multiple-choice questionnaire, inquiring about the top 3 major concerns. Answers were compared, and the agreement rate was calculated. Concerns were gathered in an IIM outcome standard set with validated measures. Results: The top three outcome concerns raised by patients were medication side effects/muscle weakness/prevention functionality loss. The top three concerns among rheumatologists were to prevent loss of functionality/to ensure the quality of life/to achieve disease remission. Other's outcomes concerns only pointed out by patients were muscle pain/diffuse pain/skin lesions/fatigue. The agreement rate between both groups was 41%. Assessment of these parameters guided the development of an IIM standard set which included Myositis Disease Activity Assessment Visual Analogue Scale/Manual Muscle Testing/fatigue and pain Global Visual Analogue Scale/Health Assessment Questionnaire/level of physical activity. Conclusion: The authors propose a novel standard set to be pursued in IIM routine follow-up, which includes not only the main patients/rheumatologist outcome concerns but also additional important outcomes only indicated by patients. Future studies are necessary to confirm if this comprehensive approach will result in improved adherence and ultimately in better assistance

Heterogeneity Governs 3D-Cultures of Clinically Relevant Microbial Communities

The intrinsic heterogeneity of bacterial niches should be retained in in vitrocultures to represent the complex microbial ecology. As a case study,mucin-containing hydrogels -CF-Mu3Gel - are generated by diffusion-inducedgelation, bioinspired on cystic fibrosis (CF) mucus, and a microbial nichechallenging current therapeutic strategies. At breathing frequency, CF-Mu3Gelexhibits aG′andG′′equal to 24 and 3.2 Pa, respectively. Notably, CF-Mu3Gelexhibits structural gradients with a gradual reduction of oxygen tensionacross its thickness (280–194μmol L−1). Over the culture period, a steepdecline in oxygen concentration occurs just a few millimeters below theair–mucus interface in CF-Mu3Gel, similar to those of CF airway mucus.Importantly, the distinctive features of CF-Mu3Gel significantly influencebacterial organization and antimicrobial tolerance in mono- and co-cultures ofStaphylococcus aureusandPseudomonas aeruginosathat standard culturesare unable to emulate. The antimicrobial susceptibility determined inCF-Mu3Gel corroborates the mismatch on the efficacy of antimicrobialtreatment between planktonically cultured bacteria and those in patients.With this example-based research, new light is shed on the understanding ofhow the substrate influences microbial behavior, paving the way for improvedfundamental microbiology studies and more effective drug testing anddevelopment