Passive scalars in turbulent channel flow at high Reynolds number

We study passive scalars in turbulent plane channels at computationally high Reynolds number, thus allowing us to observe previously unnoticed effects. The mean scalar profiles are found to obey a generalized logarithmic law which includes a linear correction term in the whole lower half-channel, and they follow a universal parabolic defect profile in the core region. This is consistent with recent findings regarding the mean velocity profiles in channel flow. The scalar variances also exhibit a near universal parabolic distribution in the core flow and hints of a sizeable log layer, unlike the velocity variances. The energy spectra highlight the formation of large scalar-bearing eddies with size proportional to the channel height which are caused by a local production excess over dissipation, and which are clearly visible in the flow visualizations. Close correspondence of the momentum and scalar eddies is observed, with the main difference being that the latter tend to form sharper gradients, which translates into higher scalar dissipation. Another notable Reynolds number effect is the decreased correlation of the passive scalar field with the vertical velocity field, which is traced to the reduced effectiveness of ejection event

High-Reynolds-number effects on turbulent scalings in compressible channel flow

The effect of the Reynolds number in a supersonic isothermal channel flow is studied using a direct numerical simulation (DNS). The bulk Mach number based on the wall temperature is 1.5, and the bulk Reynolds number is increased up to Reτ ≈ 1000. The use of van Driest velocity transformation in the presence of heated walls has been questioned due to the poor accuracy at low Reynolds number. For this reason alternative transformations of the velocity profile and turbulence statistics have been proposed, as, for instance, semi-local scalings. We show that the van Driest transformation recovers its accuracy as the Reynolds number is increased. The Reynolds stresses collapse on the incompressible ones, when properly scaled with density, and very good agreement with the incompressible stresses is found in the outer layer

Preanalytical investigations of phlebotomy: methodological aspects, pitfalls and recommendations

Phlebotomy is often addressed as a crucial process in the pre-analytical phase, in which a large part of laboratory errors take place, but to date there is not yet a consolidated methodological paradigm. Seeking literature, we found 36 suitable investigations issued between 1996 and 2016 (April) dealing with the investigation of pre-analytical factors related to phlebotomy. We found that the largest part of studies had a cohort of healthy volunteers (22/36) or outpatients (11/36), with the former group showing a significantly smaller median sample size (N = 20, IQR: 17.5-30 and N = 88, IQR: 54.5-220.5 respectively, P < 0.001). Moreover, the largest part investigated one pre-analytical factor (26/36) and regarded more than one laboratory test (29/36), and authors preferably used paired Student’s t-test (17/36) or Wilcoxon’s test (11/36), but calibration (i.e. sample size calculation for a detectable effect) was addressed only in one manuscript. The Bland-Altman plot was often the preferred method used to estimate bias (12/36), as well as the Passing-Bablok regression for agreement (8/36). However, often papers did assess neither bias (12/36) nor agreement (24/36). Clinical significance of bias was preferably assessed comparing to a database value (16/36), and it resulted uncorrelated with the size of the effect produced by the factor (P = 0.142). However, the median effect size (ES) resulted significantly larger if the associated factor was clinically significant instead of non-significant (ES = 1.140, IQR: 0.815-1.700 and ES = 0.349, IQR: 0.228-0.531 respectively, P < 0.001). On these evidences, we discussed some recommendations for improving methodological consistency, delivering reliable results, as well as ensuring accessibility to practical evidences

Phlebotomy, a bridge between laboratory and patient

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to “bridge” patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient’s compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper

Timeliness “at a glance”: assessing the turnaround time through the six sigma metrics

Almost thirty years of systematic analysis have proven the turnaround time to be a fundamental dimension for the clinical laboratory. Several indicators are to date available to assess and report quality with respect to timeliness, but they sometimes lack the communicative immediacy and accuracy. The six sigma is a paradigm developed within the industrial domain for assessing quality and addressing goal and issues. The sigma level computed through the Z-score method is a simple and straightforward tool which delivers quality by a universal dimensionless scale and allows to handle non-normal data. Herein we report our preliminary experience in using the sigma level to assess the change in urgent (STAT) test turnaround time due to the implementation of total automation. We found that the Z-score method is a valuable and easy to use method for assessing and communicating the quality level of laboratory timeliness, providing a good correspondence with the actual change in efficiency which was retrospectively observed

Valproic acid induces apoptosis, p16INK4A upregulation and sensitization to chemotherapy in human melanoma cells.

It is known that melanoma develops as a consequence of multifactorial alterations. To date several studies indicate the effective implication of p16 as a tumor suppressor gene with a major role in either the development or progression of human melanoma. Deregulation of melanoma cell growth has been widely associated with mutations in the p16-cyclin D/cdk4-pRb pathway. Recently anticancer therapies are focused on restoration of p16 CDK inhibitory function and other proteins unregulated in melanoma cell cycle pathway (e.g., c-myc, p27). A combined strategy for restoration of normal homeostasis in the melanoma skin with targeted delivery of apoptosis-inducing agents does not seems to be far obtained. New class of antitumoral agents are emerging: histone deacetylase (HDAC) inhibitors have attracted much interest because of their ability to arrest cell growth, induce cell differentiation, and in some cases, induce apoptosis of cancer cells. Recently, attention has been focused on the ability of HDAC inhibitors to induce perturbation in cell cycle regulatory protein (e.g., p21(CIP1)) and down-regulation of survival signalling pathway. In the present study, we have examined the effect of valproic acid (VPA) on M14 human melanoma cell line. Here we observed that VPA induces cell cycle arrest and apoptosis sensitising melanoma cells to cis-platin and etoposide treatment. IC(50) dose (2.99 mM) of VPA was able to induce G(1) arrest (up to 75%) in association with upregulation of p16, p21 and cyclin-D1 related to Rb ipo-phosphorilation. In addition VPA activated apoptosis (50%) in M14 cells, when given alone or in combination with antitumoral agents. The ability of valproic acid to reestablished the G(1) pathway in melanoma cells suggests a potential application of VPA in melanoma therapeutic protocols

STREAmS: a high-fidelity accelerated solver for direct numerical simulation of compressible turbulent flow

We present STREAmS, an in-house high-fidelity solver for large-scale, massively parallel direct numerical simulations (DNS) of compressible turbulent flows on graphical processing units (GPUs). STREAmS is written in the Fortran 90 language and it is tailored to carry out DNS of canonical compressible wall-bounded flows, namely turbulent plane channel, zero-pressure gradient turbulent boundary layer and supersonic oblique shock-wave/boundary layer interactions. The solver incorporates state-of-the-art numerical algorithms, specifically designed to cope with the challenging problems associated with the solution of high-speed turbulent flows and can be used across a wide range of Mach numbers, extending from the low subsonic up to the hypersonic regime. The use of cuf automatic kernels allowed an easy and efficient porting on the GPU architecture minimizing the changes to the original CPU code, which is also maintained. We discuss a memory allocation strategy based on duplicated arrays for host and device which carefully minimizes the memory usage making the solver suitable for large scale computations on the latest GPU cards. Comparison between different CPUs and GPUs architectures strongly favor the latter, and executing the solver on a single NVIDIA Tesla P100 corresponds to using approximately 330 Intel Knights Landing CPU cores. STREAmS shows very good strong scalability and essentially ideal weak scalability up to 2048 GPUs, paving the way to simulations in the genuine high-Reynolds number regime, possibly at friction Reynolds number $Re_{\tau} > 10^4$. The solver is released open source under GPLv3 license and is available at https://github.com/matteobernardini/STREAmS.Comment: 11 pages, 11 figure

Analytical performance evaluation of the new GEM® Premier™ 5000 analyzer in comparison to the GEM® Premier™ 4000 and the RapidPoint® 405 systems

Abstract Aim of the study Blood gas analysis (BGA) is essential for the diagnosis and management of acid-base imbalances. We evaluated and compared the analytical characteristics of the new GEM® Premier™ 5000 (GP5000) (Instrumentation Laboratory, Bedford, MA, United States) BGA point-of-care (POC) device with those of the GEM® Premier™ 4000 (GP4000) (Instrumentation Laboratory, Bedford, MA, United States) and RapidPoint® 405 (RP405) (Siemens Healthcare, Milan, Italy) POC analyzers. The effect of sample mixing on patient results was also studied. Material and methods Quantitative measurement of pH, pCO2, pO2, Na+, K+, Cl−, iCa2+, glucose, lactate, tHb, COHb, MetHb, O2Hb, HHb and Hct were carried out. The imprecision study (IS) and method comparison study (MS) were performed according to CLSI EP guidelines, using respectively internal as well as external quality controls (IS) and whole blood samples collected from the routine analysis (MS). Results GP5000 demonstrated satisfactory characteristics in the IS showing comparable (GM4000) or even better (RP405) imprecision results than the routine POC devices. Good performance was observed in the MS both using GP4000 and RP405 as reference instruments. Pre-analytical sample management can heavily affect the accuracy of BGA results. In the specimen mixing evaluation, a significant improvement in results accuracy was observed when mixing procedures were more meticulous. Conclusions Considering the overall analytical performance observed, the ease of use of the system, the rapid time-to-results and the innovative Intelligent Quality Management technology (iQM2®), GP5000 seems suitable to be used in clinical care for safe patient management. Additionally, effective sample mixing upon draw and before analysis is strongly advisable in order to ensure the most clinically reliable BGA results

Artificial intelligence and thyroid disease management: considerations for thyroid function tests

Artificial intelligence (AI) is transforming healthcare and offers new tools in clinical research, personalized medicine, and medical diagnostics. Thyroid function tests represent an important asset for physicians in the diagnosis and monitoring of pathologies. Artificial intelligence tools can clearly assist physicians and specialists in laboratory medicine to optimize test prescription, tests interpretation, decision making, process optimization, and assay design. Our article is reviewing several of these aspects. As thyroid AI models rely on large data sets, which often requires distributed learning from multi-center contributions, this article also briefly discusses this issue

Urine Parameters in Patients with COVID-19 Infection

ABSTRACT A urine test permits the measure of several urinary markers. This is a non-invasive method for early monitoring of potential kidney damage. In COVID-19 patients, alterations of urinary markers were observed. This review aims to evaluate the utility of urinalysis in predicting the severity of COVID-19. A total of 68 articles obtained from PubMed studies reported that (i) the severity of disease was related to haematuria and proteinuria and that (ii) typical alterations of the urinary sediment were noticed in COVID-19-associated AKI patients. This review emphasizes that urinalysis and microscopic examination support clinicians in diagnosing and predicting COVID-19 severity