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In this study, we perform a data assimilation (DA) experiment on a very large number (>700) of small‐ and medium‐scale (150–10,000 km2) European catchments to assess the impact of satellite soil moisture (SM) DA on streamflow simulations for different climatic and hydrologic conditions. In the experiment, Climate Change Initiative SM active, passive and combined products are assimilated over a time period 2003–2016 via an Ensemble Kalman Filter (EnKF). The results show that, on average, the assimilation of the three products provides relatively small improvements as compared to analogous open loop (OL) results (i.e., with an increase on median Kling‐Gupta Efficiency equal to 0.0048, 0.0033, and 0.0022 [−] for the active, the passive, and the combined products, respectively). OL performance itself is found to be a significant driver of the assimilation results: greater improvements are observed in catchments with poor OL streamflow predictions and inaccurate precipitation estimates. The remotely sensed product accuracy also emerges as relevant for assimilation efficiency, while factors affecting SM retrievals such as vegetation density, topographic complexity and basin area are found to have only a limited impact on the spatial pattern of performance. Small and detrimental effects of SM assimilation are observed over fully humid catchments and at high latitudes where pre‐storm soil moisture has reduced control on runoff generation as well as in basins where the hydrological model contains structural limitations. Key Points: The added value of satellite soil moisture assimilation on runoff simulations is assessed within 700 European catchmentsThe assimilation of the European Space Agency Climate Change Initiative, satellite soil moisture products show limited improvements, with the active product providing the best resultsThe impact of open loop model performance, remotely sensed data accuracy, climate conditions and catchment characteristics are evaluated [ABSTRACT FROM AUTHOR]

Although proprioceptive impairment is likely to affect in a significant manner the capacity of stroke patients to recover functionality of upper limb, clinical assessment methods currently in use are rather crude, with a low level of reliability and a limited capacity to discriminate the relevant features of this severe deficit. In the present paper, we describe a new technique based on robot technology, with the goal of providing a reliable, accurate, and quantitative evaluation of kinesthetic acuity, which can be integrated in robot therapy. The proposed technique, based on a pulsed assistance paradigm, has been evaluated on a group of healthy subjects. [ABSTRACT FROM PUBLISHER]

This paper deals with the construction of a class of high-order accurate residual distribution schemes for advection-diffusion problems using conformal meshes. The problems considered range from pure diffusion to pure advection. The approximation of the solution is obtained using standard Lagrangian finite elements and the total residual of the problem is constructed taking into account both the advective and the diffusive terms in order to discretize with the same scheme both parts of the governing equation. To cope with the fact that the normal component of the gradient of the numerical solution is discontinuous across the faces of the elements, the gradient of the numerical solution is reconstructed at each degree of freedom of the grid and then interpolated with the same shape functions used for the solution. Linear and nonlinear schemes are constructed and their accuracy is tested with the discretization of advection-diffusion and anisotropic diffusion problems. [ABSTRACT FROM AUTHOR]

SUMMARY A complete set of equivalence conditions, relating the mass-lumped Bubnov-Galerkin finite element (FE) scheme for Lagrangian linear elements to node-centred finite volume (FV) schemes, is derived for the first time for conservation laws in a three-dimensional cylindrical reference. Equivalence conditions are used to devise a class of FV schemes, in which all grid-dependent quantities are defined in terms of FE integrals. Moreover, all relevant differential operators in the FV framework are consistent with their FE counterparts, thus opening the way to the development of consistent hybrid FV/FE schemes for conservation laws in a three-dimensional cylindrical coordinate system. The two-dimensional schemes for the polar and the axisymmetrical cases are also explicitly derived. Numerical experiments for compressible unsteady flows, including expanding and converging shock problems and the interaction of a converging shock waves with obstacles, are carried out using the new approach. The results agree fairly well with one-dimensional simulations and simplified models. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

SUMMARY We are interested in the numerical approximation of steady scalar convection-diffusion problems by means of high order schemes called Residual Distribution schemes. In the inviscid case, one can develop nonlinear Residual Distribution schemes that are nonoscillatory, even in the case of very strong discontinuities, while having the most possible compact stencil, on hybrid unstructured meshes. This paper proposes and compare extensions of these schemes for the convection-diffusion problem. This methodology, in particular in terms of accuracy, is evaluated on problem with exact solutions. Its nonoscillatory behavior is tested against the Smith and Hutton problem. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background The elderly are characterized by a high prevalence of chronic heart failure (CHF) and frailty, which is a complex interaction of physical, psychological and social impairment. This study aimed to examine the predictive role of frailty on long-term mortality in elderly subjects with CHF. Materials and methods The study assessed long-term mortality after 12-year follow up in 120 subjects with CHF and 1139 subjects without CHF, selected in 1992, from a random sample of the elderly population in the Campania region of Italy. Frailty was assessed according to a ‘Frailty Staging System’. Results Subjects with CHF were prevalently female (60%) and older than 75 years (mean 75·9 ± 6·7); subjects without CHF were prevalently female (56·4%) and younger than 75 years (mean 74·0 ± 6·3). In subjects with and without CHF stratified into classes of frailty there was a statistically significant increase in age, comorbidity, disability and low social support, and a decrease in MMSE score. Moreover, death progressively increased more with frailty in subjects (70·0% to 94·4%, P < 0·03) than in those without (43·8.% to 88·3%, P < 0·0001) CHF. The Kaplan–Meier analysis shows that at 9 years the probability of survival progressively decreased as frailty increased (45·5% to 0%) in subjects with CHF and from 62·8% to 25·9% in subjects without CHF. The Cox regression analysis indicated that frailty is predictive of mortality in the multivariate model adjusted for several variables including sex and age in subjects with and without CHF. Moreover, the analysis showed that frailty is more predictive of mortality in elderly subjects with CHF when it was analyzed either as continuous (1·48 vs. 1·36) or as a dummy (3 vs. 1 = 1·62 vs. 1·24) variable. Conclusions Thus mortality among elderly subjects with or without CHF increases with frailty. Moreover, frailty is more predictive of long-term mortality in elderly subjects with than in those without CHF. Hence, frailty represents a new independent variable for predicting long-term mortality in elderly subjects with CHF. [ABSTRACT FROM AUTHOR]

Matching of donor and recipient for the class I human leukocyte antigen-C (HLA-C)-encoded natural killer (NK) epitopes has been reported to influence stem-cell (SC) graft outcome, but a consistent picture has not yet emerged. We have analyzed transplant outcome in 104 unrelated SC grafts in relation to NK epitope (C1 and C2) matching and donor killer cell immunoglobulin-like receptor (KIR) genotype. NK epitope mismatching in the rejection direction was strongly associated with an increased probability of rejection subsequent to engraftment. The prevalence of grades III–IV acute graft-vs-host disease (GVHD) was significantly higher and occurred significantly earlier when there was NK epitope mismatching in the GVH direction. Higher transplant-related mortality and lower disease-free survival rates were associated with epitope mismatching regardless of the mismatch direction. A greater number of KIR receptors, both activating and inhibitory, in the donor protected against grades III–IV GVHD and improved survival. [ABSTRACT FROM AUTHOR]

We have described previously a novel single-tube polymerase chain reaction (PCR) amplification (STAmp) protocol for the efficient sequencing-based typing (SBT) of human leukocyte antigen (HLA)-DRB1. The PCR amplification mix includes primers to each of seven allele group-sequence motifs. We have applied this principle to the simultaneous SBT of HLA-DRB3, -DRB4, and -DRB5 using locus specific primers. We report here a multicenter international evaluation of the STAmp protocols performed as a component of the 13th International Histocompatibility Workshop. Identical amplification primer mixes, sequencing primers, and DNA were sent to participating laboratories. The primer mixes contained the amplification primers and the PCR buffer. Each laboratory was requested to amplify the DNA with the primer mixes and perform SBT on the resulting PCR protocols, using their own protocols, and return the typing results for analysis. The reported results indicated that the expected sequence could be obtained with a variety of PCR amplification and sequencing platforms and protocols. There were difficulties but these seemed unrelated to STAmp reagents and suggest that optimal SBT results can be obtained if bi-directional sequencing is performed and software is used for sequence verification and editing. This indicates that SBT by STAmp can be applied in many laboratories for high-throughput HLA-DRAB and HLA-DRAB,4,5 SBT. [ABSTRACT FROM AUTHOR]

HLA allele mismatches will provoke T-cell alloreactivity after allogeneic stem cell transplantation. As donors and recipients are usually HLA matched, the public HLA epitopes that are recognized by natural killer (NK) cells (NK epitopes) are rarely mismatched, and therefore there is rarely potential for NK alloreactivity arising from the absence of ligands for inhibitory killer immunoglobulin-like receptors ( KIR). Transplants using related donors sharing only one haplotype (haploidentical donors) represent a setting in which NK epitopes are often mismatched, thus resulting in the potential for NK alloreactivity. We have analyzed engraftment, acute graft vs host disease (GVHD), leukemia relapse, and survival in 62 haploidentical transplants in relationship with potential NK alloreactivity, inhibitory, and activating KIR genes of class I HLA NK epitopes. Potential NK alloreactivity in the rejection direction was not associated with any outcome variable. Potential NK alloreactivity in the GVHD direction was associated with an increased incidence of severe GVHD and poorer patient survival but not with non-engraftment nor leukemia relapse. A higher number of activating KIR receptors in the genome of the donor was associated with a higher prevalence of GVHD. These results suggest that lack of extensive T-cell depletion in haploidentical transplantation is associated with high GVHD rates and diminishes the benefits of NK-cell alloreactivity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Preinfarction angina, a clinical equivalent of ischemic preconditioning, seems to protect against in-hospital death, cardiogenic shock, and the combined endpoints in adult but not in elderly patients with acute myocardial infarction. Experimental evidence indicates that caloric restriction may restore ischemic preconditioning in aged animals. OBJECTIVE: The objective was to verify whether body mass index (BMI) influences the cardioprotective effect of preinfarction angina in the elderly. DESIGN: We retrospectively studied 820 patients aged >/= 65 y with acute myocardial infarction by evaluating BMI and major (death and cardiogenic shock) and minor in-hospital outcomes. RESULTS: In-hospital death, cardiogenic shock, and the combined endpoints were not significantly different between elderly patients with and without preinfarction angina. Interestingly, in-hospital death, cardiogenic shock, and the combined endpoints were significantly fewer in elderly patients with than without preinfarction angina in the subset of patients with the lowest BMI (P < 0.01, < 0.01, and < 0.01, respectively). Regression analysis showed that preinfarction angina did not protect against in-hospital death when analyzed in all patients independently of BMI, whereas it was protective in the subset of patients with the lowest BMI (odds ratio: 0.06; 95% CI: 0.00, 0.54). CONCLUSIONS: Preinfarction angina does not protect against in-hospital death, cardiogenic shock, or the combined endpoints in elderly patients with acute myocardial infarction. With stratification by quartiles of BMI, the protective effect of preinfarction angina is preserved in elderly patients with the lowest BMI. Copyright © 2003 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

The article presents a case study of a patient suffering from a long-standing dactylitis-like aspect of the left thumb. It reports that dactylitis is a typical manifestation of spondyloarthropathies and is due to flexor tenosynovitis. Synovitis of the metacarpophalangeal, proximal and distal interphalangeal joints is a facultative condition and extensor tenosynovitis may also be present as an adjunctive sign. Physical examination is sufficient for the diagnosis of dactylitis. The patient had a six-year history of sub continuous arthralgias localized in the peripheral joints, mainly the wrists and ankles.