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Mesotherapy (local intradermal therapy, LIT) is a technique used to slowly spread drugs in tissues underlying the site of injection to prolong the pharmacological effect with respect to intramuscular injection. Recommendations for proper medical use of this technique have been made for pain medicine and rehabilitation, chronic venous disease, sport medicine, musculoskeletal disorders, several dermatological conditions, skin ageing, and immune-prophylaxis. Although mesotherapy is considered a valid technique, unresolved questions remain, which should be answered to standardize methodology and dosing regimen as well as to define the right indications in clinical practice. New randomized controlled trials are needed to test single products (dose, frequency of administration, efficacy and safety). Even infiltration of substances for dermo-cosmetic purposes must be guided by safety and efficacy tests before being proposed by mesotherapy. In this article, we put forth a preclinical and clinical research plan and a health technology assessment as a call to action by doctors, researchers and scientific societies to aid national health authorities in considering mesotherapy for prevention, treatment and rehabilitation paths., Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/bIuRhGQsUjs

On April 2020, during the outburst of the COVID-19 pandemic in Italy, the SIAARTI (“Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva”) Research Group on Vascular Access has formulated some essential recommendations for the optimization of the selection, insertion, and maintenance of the vascular access devices, with the aim of guarantee the operator safety, ensure the effectiveness of the maneuvers, and reduce the risk of complications. Here we describe the key elements of clinical management of vascular access in patients affected by COVID-19.

During the last decades, the age of pregnant women significantly increased. The incidence of maternal and labor complications is higher among older women, but conclusive data have not been delivered whether labor epidural analgesia (EA) may affect the duration of labor and delivery outcomes in this population of patients. The aim of this study is to evaluate the effect of EA among women aged over 35 years.We retrospectively reviewed medical records of all, singleton, at term deliveries, laboring with EA, between December 2011 and October 2017. Women aged ≥35 years (study group) were compared with women aged35 years (control group) to evaluate EA effects on the duration of labor and neonatal outcome.The study enrolled 459 women with EA: 122 women were included in the study group and 337 in the control group. The multiple regression analysis showed that parity was an independent variable for a shorter dilation period (Results of this study indicate that women aged ≥35 with EA may have labor duration and neonatal short-term outcomes similar to younger women with EA.

In patients undergoing thoracoabdominal aorta repair, spinal cord ischemia (SCI) remains one of the most common and important complications resulting in transient paraparesis through to permanent flaccid paraplegia. In this manuscript, after a brief introduction to spinal cord ischemia complication and its prevention in thoracoabdominal endovascular aortic repair (TEVAR), we propose a new clinical protocol potentially able to prevent such complication. The proposed protocol suggests the use of high dosages of corticosteroids by epidural route, along with drainage of cerebrospinal fluid and controlled vascular hypertension, to reduce the incidence of SCI in TEVAR. Moreover, we paid particular attention to the control of the hemodynamic parameters to obtain adequate peripheral tissue perfusion (oxygen delivery), including in the spinal cord. We applied this new protocol in 50 consecutive patients treated with TEVAR for thoracoabdominal aortic aneurysms (TAAs); 47 patients completed the procedure: 27 patients Crawford type I and 20 Crawford type II. Three patients died during surgery because of untreatable aneurysm rupture. The results show that in all patients there were no cases of SCI, after 5 days from TEVAR. To the best of our knowledge, there are no clinical studies on the use of epidural corticosteroids in patients undergoing treatment of aortic syndrome (both in “open surgery” and endovascular aortic repair). This initial study on 50 consecutive patients has shown that the clinical protocol used could be of great interest to prevent one of the worse complications of TEVAR. Its limitations are the low number of patients studied till now, and the non-randomized protocol adopted. Further studies would be necessary. Our experience and the results obtained with this new perioperative protocol with epidural corticosteroid and accurate hemodynamic control have been encouraging and it seems a valid proposal to be explored in future by well-structured prospective, randomized protocols.

This work focuses on the evaluation of the effective thermal conductivity of ultra-light materials, as the highly porous two-phase systems (foams). The main aim of the paper is to show that the exact mathematical solution of the heat conduction equation, based on the constitutive Fourier law and without any empirical constant nor ad hoc assumptions, is possible under an assumed thermal condition. To cover the range of real thermal conditions the present theoretical approach employs the two extreme thermal assumptions, i.e. parallel isothermal lines and parallel heat fluxes. The analysis is carried out upon an elementary cubic cell investigating the effect of structure, porosity, saturating fluid and solid material of open-cells foams. Comparisons among the present purely theoretical results and some experimental data of the literature confirm favorably the present approach.

Herpes Zoster (HZ) is the reactivation of a well-known viral disease which manifests itself with painful skin lesions. An effective analgesic method during the acute phase of HZ can contribute to decrease the incidence of postherpetic neuralgia (PHN) by reducing neural sensitization. Sciatic nerve block (SNB) is useful in the management of distal lower extremity pain sustained by the sciatic nerve. We describe our experience with a continuous ultrasound guided subgluteus sciatic nerve block in a patient with herpetic neuralgia- (HN-) related refractory acute left leg pain.

Experimental thermal conductivity of alumina nanoparticles in water is measured with the transient thermal probe, in the presence of sonication (i.e., with ultrasounds), or not. We investigate two types of alumina particles, with the diameter equal to 7 nm and 50 nm. The experimental results, with and without sonication, show that the effective thermal conductivity is greater for the alumina nanoparticle with the smaller diameter. The effective thermal conductivity is greater in the presence of sonication, with a larger relative increase for the smaller diameter nanofluid. We compare the present experimental thermal conductivity with the empirical/theoretical prediction models of the literature with a reasonable good agreement.

The frequent finding of thrombocytopenia in patients with severe SARS-CoV-2 infection (COVID-19) and previous evidence that several viruses enter platelets suggest that SARS-CoV-2 might be internalized by platelets of COVID-19. Aim of our study was to assess the presence of SARS-CoV-2 RNA in platelets from hospitalized patients with aconfirmed diagnosis of COVID-19. RNA was extracted from platelets, leukocytes and serum from 24 COVID-19 patients and 3 healthy controls, real-time PCR and ddPCR for viral genes were carried out. SARS-CoV-2 RNA was not detected in any of the samples analyzed nor in healthy controls, by either RT-PCR or ddPCR, while RNA samples from nasopharyngeal swabs of COVID-19 patients were correctly identified. Viral RNA was not detected independently of viral load, of positive nasopharyngeal swabs, or viremia, the last detected in only one patient (4.1%). SARS-CoV-2 entry in platelets is not acommon phenomenon in COVID-19 patients, differently from other viral infections.

The aim of the present paper is to study experimentally the enhancement of heat transfer, due to the presence of a layer of aluminum foam covering a smooth circular cylinder. The measurements are carried on with the impingement of a rectangular jet of air, which has a transversal dimension equal or smaller than the cylinder diameter, or jet flow, and full flow (or uniform flow, which has a greater dimension than the cylinder diameter). Literature does not report any paper dealing with this multiple problem. Experimental heat transfer and fluid dynamics measurements are carried out at Reynolds number ranging from ReD=2200 to ReD=24,750. The layer of the aluminum foam, 8 mm thick, is glued onto the smooth cylinder, with an external diameter of D = 10 mm. The height of the slot jet is H = 10 mm, with a width of W = 135 mm. Jet flow visualizations are performed for the smooth and the foam-covered cylinder to explain the heat transfer results from the fluid dynamics point of view. The flow visualizations show that the jet flow always penetrates into the foam, wetting it completely, while the reattachment never occurs downstream. In the smooth cylinder, the jet completely envelops the cylinder, at greater Reynolds numbers and a distance of x/H = 7, with a small recirculation zone, showing that the rear surface also participates in the heat transfer. The heat transfer on the foam-covered cylinder increases, mainly, because of the large increase in the exchange surface, while it is somewhat penalized, at the higher Reynolds values and at the greater distance from the slot exit, because the rear surface is little involved in the heat transfer.

Intradermal therapy, known as mesotherapy, is a technique used to inject a drug into the surface layer of the skin. In particular, it involves the use of a short needle to deposit the drug in the dermis. The intradermal microdeposit modulates the drug’s kinetics, slowing absorption and prolonging the local mechanism of action. It is successfully applied in the treatment of some forms of localized pain syndromes and other local clinical conditions. It could be suggested when a systemic drug-sparing effect is useful, when other therapies have failed (or cannot be used), and when it can synergize with other pharmacological or nonpharmacological therapies. Despite the lack of randomized clinical trials in some fields of application, a general consensus is also reached in nonpharmacological mechanism of action, the technique execution modalities, the scientific rationale to apply it in some indications, and the usefulness of the informed consent. The Italian Mesotherapy Society proposes this position paper to apply intradermal therapy based on scientific evidence and no longer on personal bias.

From the first description in 2016 till today, hundreds of studies have extensively presented Erector Spinae Plane block as an excellent perioperative analgesic technique especially in a multimodal pain management scenario. Only in few cases, this technique was used alone to provide surgical anesthesia.

Magnetic nano drug targeting, with an external magnetic field, can potentially improve the drug absorption in specific locations of the body. However, the effectiveness of the procedure can be reduced due to the limitations of the magnetic field intensity. This work investigates this technique with the Computational Fluid Dynamics (CFD) approach. A single rectangular coil generates the external magnetic field. A patient-specific geometry of the Trachea, with its primary and secondary bronchi, is reconstructed from Digital Imaging and Communications in Medicine (DICOM) formatted images, throughout the Vascular Modelling Tool Kit (VMTK) software. A solver, coupling the Lagrangian dynamics of the magnetic nanoparticles with the Eulerian dynamics of the air, is used to perform the simulations. The resistive pressure, the pulsatile inlet velocity and the rectangular coil magnetic field are the boundary conditions. The dynamics of the injected particles is investigated without and with the magnetic probe. The flow field promotes particles adhesion to the tracheal wall. The particles volumetric flow rate in both cases has been calculated. The magnetic probe is shown to increase the particles flow in the target region, but at a limited extent. This behavior has been attributed to the small particle size and the probe configuration.

The paper carries on numerical mass transfer and fluid flow of a Non-Newtonian (Casson-like) blood in a complete patient specific Circle of Willis (CoW), for the first time in the literature. Pressures, fluid flow and mass transfer variables are presented. As far as the distribution of Wall Shear Stress (WSS) is concerned, the paper shows that regions with WSS greater than the fisiologic limit (equal to 150 dyne/cm2) tend to superimpose to vascular zones, typical of saccular cerebral aneurysms. Zones with high WSS coincide with those of high MGS, where, according to literature, the formation of cerebral aneurysms is more probable, as close to arterial branchings and cross section changes. As far as mass transfer of LDL and Glucose are concerned, greater concentrations are observed in zones more exposed to atherosclerosis risk. Zones with greater values of Sherwood number coincide with the regions with greater frequency of atherosclerotic plaques.

Magnetic nano drug targeting, through the use of an external magnetic field, is a new technique for the treatment of several diseases, which can potentially avoid the dispersion of drugs in undesired locations of the body. Nevertheless, due to the limitations on the intensity of the magnetic field applied, the hydrodynamic forces can reduce the effectiveness of the procedure. This technique is studied in this paper with the Computational Fluid Dynamics (CFD), focusing on the influence of the magnetic probe position, and the direction of the circulating electric current. A single rectangular coil is used to generate the external magnetic field. A patient-specific geometry of the coeliac trunk is reconstructed from DICOM images, with the use of VMTK. A new solver, coupling the Lagrangian dynamics of the nanoparticles with the Eulerian dynamics of the blood, is implemented in OpenFOAM to perform the simulations. The resistive pressure, the Womersley’s profile for the inlet velocity and the magnetic field of a rectangular coil are implemented in the software as boundary conditions. The results show the influence of the position of the probe, as well as the limitations associated with the rectangular coil configuration.

The influence of the degree of residual stenosis (DOR) on the hemodynamics inside coronary arteries is investigated through three-dimensional (3D) numerical simulations. The vascular wall permeability is investigated and the effect of the non-Newtonian viscosity discussed. The results agree in predicting an abrupt increase in wall permeability above 45% DOR, indicating that the implant could lead to a massive restenosis. This behavior is considered to be due to the shift of the regions involved by low and oscillatory wall shear stress (WSS), from the zone adjacent to the struts toward the center of the stent meshes.

Natural convection around a vertical cylindrical, immersed in a fluid-saturated porous medium, is investigated experimentally. The porous medium is made of glass beads with particles of the same diameter, 3 mm, and is saturated with water. The vertical cylinder, with diameter of 1.5 mm and long 150 mm, is a thermal probe, containing an electric heater and a thermocouple. Natural convection around the vertical cylinder is investigated experimentally with the help of three temperature sensors, at different heights on the external surface of the cylinder. Average and local Nusselt numbers along the vertical cylinder are calculated and compared with the available theoretical-numerical data of the literature.

The present work extends the approach of using the mass and energy-capital conservation equations to forecast the price evolution of oil when accumulation or depletion is present. The price evolution is then dependent on the consumption rate of the oil, besides the ratio of mass extraction to mass consumption rates, and the usual economic parameters, e.g. the interest rates of non-extracted and extracted resources. The main conclusions are that a ratio of mass extraction to consumption rates different from unity, i.e. when accumulation or depletion of the oil is present, can modify the approach of the oil price forecast without accumulation or depletion of the resources.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. The paper investigates the transient flow evolution, up to the steady state, of a rectangular free jet of air with aspect ratio AR=6.3. The Reynolds number, Re, defined according to the hydraulic diameter, D, of the rectangular slot of height H, equal to about D=2H, spans in the range from Re=48,000 to Re=3400. A centrifugal fan generates the jet flow with a velocity increasing, as a ramp, from zero up to a constant steady state value. In the transient state of the flow the jet is composed of a primary vortex (PV) and a quasi-stable stem. In the transient 2D experimental instant images the stem of the jet has a height equal to that of the slot and a length increasing with the time up to a maximum value, which is greater than the lengths observed in the steady state, i.e. Negligible Disturbance Flow (NDF) and Small Disturbance Flow (SDF). The experimental jet evolution, observed with measurements and image processing, show that the primary vortex pinch-off does not occur for all the Reynolds numbers investigated, while the leading vortex structure becomes progressively incoherent and breaks down into turbulence. Two-dimensional (2D) Large Eddy Simulations (LES) of mass transfer and fluid flow evolution confirm the experimental images. The transient LES simulations are in good agreement with the experimental results.

Numerical results are presented for flow evolution, mass transfer and evaluation of the turbulent Schmidt number in a turbulent submerged free jet of air with small laminar Schmidt number (Sc = 0.1). A series of Large Eddy Simulation (LES) are carried on in the Reynolds number range from 5000 to 40,000. The numerical results are reported in terms of instantaneous and mean velocities, static pressure, passive scalar fields and turbulent Schmidt number. The numerical results show that the instantaneous cross-stream velocity and the static pressure are null in the Negligible Disturbance Flow (NDF) and the Small Disturbance Flow (SDF) of the instantaneous jet evolution, allowing a new definition of NDF and SDF. Similarly, the numerical mean static pressure is null in the Undisturbed Region of Flow (URF) of the mean evolution, allowing a new definition of URF. The turbulent Schmidt number shows differences at the two smallest Reynolds numbers, Re = 5000 and 10,000, in comparison to the previous numerical results, obtained with a laminar Schmidt number equal to Sc = 1. A theoretical model is proposed for the passive scalar diffusion in the Undisturbed Region of Flow (URF) and the Potential Core Region (PCR), under the hypotheses of self-similarity, according to the Tollmien and Gortler approaches. The solutions of the present theoretical models, at Sc = 0.1, are self-similar in the PCR and in good agreement with the LES numerical results of the passive scalar, while the passive scalar profiles are not self-similar in the URF at the smaller Reynolds numbers, differently from what happens with a laminar Schmidt number in the range 1–100. The theoretical model assumes a turbulent Schmidt number inversely proportional to the mean velocity gradient in the PCR, as suggested by the LES results. The numerical results of the ScT in the URF are variable in the range 0–0.85, which is a value commonly suggested in the literature. In the PCR the values of ScT are variable between zero and a maximum which is one order of magnitude greater than in the URF.

The paper investigates the mean mass transfer/passive scalar spreading in turbulent submerged round jets. Two regions of flow are present in the jet evolution: the Near-Field Region (NFR) and the Fully Developed Region (FDR). This group of research investigates from some years the mean evolution of turbulent rectangular jets with the new physical finding that two sub-regions (not a single one) are present in the NFR. The first region of the two is the newly discovered Undisturbed Region of Flow (URF), while the second one is the known Potential Core Region (PCR). In a recent paper we showed that the flow evolution of turbulent round jets, as far as momentum spreading is concerned, is self-similar also in the NFR. Literature shows that mass transfer spreading is self-similar only in FDR. The present paper presents new mean mass transfer results of the numerical Large Eddy Simulation (LES) in turbulent round jets. Four Reynolds numbers, from 2492 to 19,988, and two laminar Schmidt numbers, 1 and 10, are investigated. The first novel result of this paper is that mass transfer is self-similar in the NFR. The second result is that two new analytical models describe the passive scalar spreading in the URF and PCR. The third result is that two new self-similar laws describe the passive scalar spreading in the FDR. The fourth result states that the well-known power-law relationship, between passive scalar and axial momentum in the FDR, holds regardless of the modeling of turbulent viscosity and turbulent Schmidt number.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Self-Similarity in turbulent round jets has been the object of investigation from several decades. The evolution of turbulent submerged jets is characterized by the presence of two regions: the region of flow establishment, or near field region (NFR) and the fully developed region (FDR), or far-field region (FFR). The momentum spreading in the FDR is known to be self-similar and few mathematical models have been presented in the past to describe it. The flow evolution in the NFR has been rarely studied since there is a certain consensus on the idea that the flow in the NFR is not self-similar. In this work, we study the flow evolution of a turbulent submerged round jet by means of large eddy simulation (LES) at several Reynolds numbers ranging from 2492 to 19,988. Three new self-similar laws are proposed to describe the flow evolution in the NFR, one for the initial region, called Undisturbed Region of Flow, (URF), and two for the final region, the potential core region (PCR). The numerical results presented in this work are also validated with the self-similar laws for the FDR proposed by Tollmien (1926) and Görtler (1942), and the experimental data of Hussein et al. (1994), and Panchapakesan and Lumley (1993), in the FDR; those of Davies et al. (1963), in the PCR; and van Hout et al. (2018), in the URF. The conclusion is that previous inability to find the self-similarity law in the NFR is due to the attempt to find a unique self-similar variable to describe the momentum spreading in both the URF and the PCR.

The passive scalar spreading of fluids with laminar Prandtl or Schmidt number, Pr, Sc, equal to 1 in turbulent rectangular submerged free jets is analyzed by means of numerical simulation and theoretical analysis in the Reynolds number range 5000–40,000. The numerical investigation is carried out by means of a three-dimensional (3D) Large Eddy Simulation (LES) approach with the dynamic Smagorinsky model. A new mathematical model allows to obtain a simplified description of the passive scalar spreading in the largest area of the flow field, the Fully Developed Region (FDR). The present three-dimensional (3D) investigation shows that the passive scalar spreading follows a self-similarity law in the Fully Developed Region (FDR), as well as in the mean Undisturbed Region of Flow (URF) and in the Potential Core Region (PCR), similarly to what found in the Near Field Region (NFR) of rectangular submerged free jets, investigated with a two-dimensional (2D) approach. The turbulent Prandtl or Schmidt number is evaluated numerically and is found to be inversely proportional to the mean velocity gradient in the PCR. The present 3D numerical results show that the turbulent Prandtl or Schmidt number is zero in most part of the mean URF, and PCR, while it assumes different values outside. In the FDR the turbulent Prandtl or Schmidt number is constant and approximately equal to 0.7, in agreement with the literature, showing that turbulence affects momentum and passive scalar in a different way.

The paper investigates the anisotropic thermal efficiency of symmetric composites made of two components, matrix and fiber reinforcement. The anisotropic degree of the composite is the ratio between the effective thermal conductivity in the direction parallel to the fiber reinforcement, and that in the perpendicular direction. The potential anisotropy of the materials is the ratio between the thermal conductivity of the fiber to that of the matrix. The anisotropic thermal efficiency is the ratio between the anisotropy degree of the composite, and the potential anisotropy of the two materials. The theoretical model solves the heat conduction equation under the two thermal assumptions of parallel isotherms and parallel heat fluxes, and without any empirical constant nor analogy with other phenomena, evaluating the anisotropic thermal efficiency of the symmetric composite. The variation of the anisotropic thermal efficiency is investigated versus the potential anisotropy of the materials and the ratio between fiber and matrix thicknesses. The anisotropic thermal efficiency has a maximum versus the ratio between fiber and matrix thicknesses, and decreases with the increase of the potential anisotropy, reaching a minimum, which is only dependent on the geometrical configuration of the symmetric composite.

Fluid dynamics in two different stent configurations, peak-to-valley (S1) and peak-to-peak (S2), within a fully expanded situation and a 30% restenosis is investigated. Numerical simulations are carried out in order to evaluate the conditions promoting atherosclerotic events when a self-expanding bare metal stent is applied. The conclusions are that the two configurations, S1 and S2, have a similar fluid dynamics behavior as far as wall shear stress is concerned, but oscillatory shear and relative residence time maps suggest that the peak-to-peak configuration, S2, has a better behavior than the peak-to-valley, S1.

The paper presents Large Eddy Simulations (LES) of mass transfer and fluid flow evolutions of a submerged rectangular free jet of air in the range of Reynolds numbers from Re = 3400 to Re = 22,000, with the Reynolds number, Re, defined with the hydraulic diameter of the rectangular slot, of height H. The numerical simulations are 3D for Re = 3400 and 6800, while 2D for Re = 10,400 and 22,000 to reduce computational time costs. The average and instant LES numerical simulations are compared with the concentration visualizations, obtained with the Particle Image Velocimetry (PIV) technique, and the fluid dynamics variables, velocity and turbulence, measured with the PIV technique and the Hot Film Anemometry (HFA). In the numerical simulations, the Schmidt number is equal to 100 to compare the air concentration in the PIV experiments, while the turbulence on the exit of the slot is equal to the value measured experimentally, and ranging between 1% and 2%. The average 2-3D LES simulations are in agreement with the concentration and the fluid dynamics experimental results in the Undisturbed Region of Flow (URF) and in the Potential Core Region (PCR), while the vortex breakdown is captured only by the 3D LES approach. As far as the instant flow evolution is concerned, the 2-3D LES simulations reproduce the Negligible Disturbances Flow (NDF), where the jet height maintains constant, and the Small Disturbances Flow (SDF), where the jet height oscillates, with contractions and enlargements, but without the vortex formation. Average and instant velocity and turbulence numerical simulations on the centreline are in good agreement to the experimental PIV measurements.

Experimental results for the Sherwood number variation near the lateral edge of the active surface of a smooth, finite-width flat plate in turbulent boundary layer flow are presented. Using naphthalene sublimation, local mass transfer rates are found for two different free stream velocities. A semi-empirical correlation of the experimental data is presented, allowing calculation of the increase of mass transfer near the edge and the size of the region affected by the lateral edge. The effect is shown to scale more so with the diffusion thickness than the boundary layer thickness.