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The Ka–Ku Dual-Frequency Precipitation Radar (DPR) and the Microwave Imager on board the Global Precipitation Measurement (GPM) mission core satellite have been collecting data for more than 3 years, providing precipitation products over the globe, including oceans and remote areas where ground-based precipitation measurements are not available. The main objective of this work is to validate the GPM-DPR products over a key climatic region with complex orography such as the Italian territory. The performances of the DPR precipitation rate products are evaluated over an 18-month period (July 2015–December 2016) using both radar and rain gauge data. The ground reference network is composed of 22 weather radars and more than 3000 rain gauges. DPR dual-frequency products generally show better performance with respect to the single-frequency (i.e., Ka- or Ku-band only) products, especially when ground radar data are taken as reference. A sensitivity analysis with respect to season and rainfall intensity is also carried out. It was found that the normal scan (NS) product outperforms the high-sensitivity scan (HS) and matched scan (MS) during the summer season. A deeper analysis is carried out to investigate the larger discrepancies between the DPR-NS product and ground reference data. The most relevant improvement of the DPR products’ performance was found by limiting the comparison to the upscaled radar data with a higher quality index. The resulting scores in comparison with ground radars are mean error (ME) = −0.44 mm h−1, RMSE = 3.57 mm h−1, and fractional standard error (FSE) = 142%, with the POD = 65% and FAR = 1% for rainfall above 0.5 mm h−1.

The purpose of this study is to describe a new algorithm based on a neural network approach (Passive microwave Neural network Precipitation Retrieval – PNPR) for precipitation rate estimation from AMSU/MHS observations, and to provide examples of its performance for specific case studies over the European/Mediterranean area. The algorithm optimally exploits the different characteristics of Advanced Microwave Sounding Unit-A (AMSU-A) and the Microwave Humidity Sounder (MHS) channels, and their combinations, including the brightness temperature (TB) differences of the 183.31 channels, with the goal of having a single neural network for different types of background surfaces (vegetated land, snow-covered surface, coast and ocean). The training of the neural network is based on the use of a cloud-radiation database, built from cloud-resolving model simulations coupled to a radiative transfer model, representative of the European and Mediterranean Basin precipitation climatology. The algorithm provides also the phase of the precipitation and a pixel-based confidence index for the evaluation of the reliability of the retrieval. Applied to different weather conditions in Europe, the algorithm shows good performance both in the identification of precipitation areas and in the retrieval of precipitation, which is particularly valuable over the extremely variable environmental and meteorological conditions of the region. The PNPR is particularly efficient in (1) screening and retrieval of precipitation over different background surfaces; (2) identification and retrieval of heavy rain for convective events; and (3) identification of precipitation over a cold/iced background, with increased uncertainties affecting light precipitation. In this paper, examples of good agreement of precipitation pattern and intensity with ground-based data (radar and rain gauges) are provided for four different case studies. The algorithm has been developed in order to be easily tailored to new radiometers as they become available (such as the cross-track scanning Suomi National Polar-orbiting Partnership (NPP) Advanced Technology Microwave Sounder (ATMS)), and it is suitable for operational use as it is computationally very efficient. PNPR has been recently extended for applications to the regions of Africa and the South Atlantic, and an extended validation over these regions (using 2 yr of data acquired by the Tropical Rainfall Measuring Mission precipitation radar for comparison) is the subject of a paper in preparation. The PNPR is currently used operationally within the EUMETSAT Hydrology Satellite Application Facility (H-SAF) to provide instantaneous precipitation from passive microwave cross-track scanning radiometers. It undergoes routinely thorough extensive validation over Europe carried out by the H-SAF Precipitation Products Validation Team.

The Italian Dystonia Registry is a multicenter data collection system that will prospectively assess the phenomenology and natural history of adult-onset dystonia and will serve as a basis for future etiological, pathophysiological and therapeutic studies. In the first 6 months of activity, 20 movement disorders Italian centres have adhered to the registry and 664 patients have been recruited. Baseline historical information from this cohort provides the first general overview of adult-onset dystonia in Italy. The cohort was characterized by a lower education level than the Italian population, and most patients were employed as artisans, builders, farmers, or unskilled workers. The clinical features of our sample confirmed the peculiar characteristics of adult-onset dystonia, i.e. gender preference, peak age at onset in the sixth decade, predominance of cervical dystonia and blepharospasm over the other focal dystonias, and a tendency to spread to adjacent body parts, The sample also confirmed the association between eye symptoms and blepharospasm, whereas no clear association emerged between extracranial injury and dystonia in a body site. Adult-onset dystonia patients and the Italian population shared similar burden of arterial hypertension, type 2 diabetes, coronary heart disease, dyslipidemia, and hypothyroidism, while hyperthyroidism was more frequent in the dystonia population. Geographic stratification of the study population yielded no major difference in the most clinical and phenomenological features of dystonia. Analysis of baseline information from recruited patients indicates that the Italian Dystonia Registry may be a useful tool to capture the real world clinical practice of physicians that visit dystonia patients.

The EUMETSAT Satellite Application Facility on Support to Operational Hydrology and Water Management (H-SAF) was established by the EUMETSAT Council on 3 July 2005, starting activity on 1 September 2005. The Italian Meteorological Service serves as Leading Entity on behalf of twelve European member countries. H-SAF products include precipitation, soil moisture and snow parameters. Some products are based only on satellite observations, while other products are based on the assimilation of satellite measurements/products into numerical models. In addition to product development and generation, H-SAF includes a product validation program and a hydrological validation program that are coordinated, respectively, by the Italian Department of Civil Protection and by the Polish Institute of Meteorology and Water Management. The National Center of Aeronautical Meteorology and Climatology (CNMCA) of the Italian Air Force is responsible for operational product generation and dissemination. In this paper we describe the H-SAF precipitation algorithms and products, which have been developed by the Italian Institute of Atmospheric Sciences and Climate (in collaboration with the international community) and by CNMCA during the Development Phase (DP, 2005–2010) and the first Continuous Development and Operations Phase (CDOP-1, 2010–2012). The precipitation products are based on passive microwave measurements obtained from radiometers onboard different sun-synchronous low-Earth-orbiting satellites (especially, the SSM/I and SSMIS radiometers onboard DMSP satellites and the AMSU-A + AMSU-B/MHS radiometer suites onboard EPS-MetOp and NOAA-POES satellites), as well as on combined infrared/passive microwave measurements in which the passive microwave precipitation estimates are used in conjunction with SEVIRI images from the geostationary MSG satellite. Moreover, the H-SAF product generation and dissemination chain and independent product validation activities are described. Also, the H-SAF program and its associated activities that currently are being carried out or are planned to be performed within the second CDOP phase (CDOP-2, 2012–2017) are presented in some detail. Insofar as CDOP-2 is concerned, it is emphasized that all algorithms and processing schemes will be improved and enhanced so as to extend them to satellites that will be operational within this decade – particularly the geostationary Meteosat Third Generation satellites and the low-Earth-orbiting Core Observatory of the international Global Precipitation Measurement mission. Finally, the role of H-SAF within the international science and operations community is explained.

A multi-sensor analysis of convective precipitation events that occurred in central Italy in autumn 2012 during the HyMeX (Hydrological cycle in the Mediterranean experiment) Special Observation Period (SOP) 1.1 is presented. Various microphysical properties of liquid and solid hydrometeors are examined to assess their relationship with lightning activity. The instrumentation used consisted of a C-band dual-polarization weather radar, a 2-D video disdrometer, and the LINET lightning network. Results of T-matrix simulation for graupel were used to (i) tune a fuzzy logic hydrometeor classification algorithm based on Liu and Chandrasekar (2000) for the detection of graupel from C-band dual-polarization radar measurements and (ii) to retrieve graupel ice water content. Graupel mass from radar measurements was related to lightning activity. Three significant case studies were analyzed and linear relations between the total mass of graupel and number of LINET strokes were found with different slopes depending on the nature of the convective event (such as updraft strength and freezing level height) and the radar observational geometry. A high coefficient of determination (R2 = 0.856) and a slope in agreement with satellite measurements and model results for one of the case studies (15 October 2012) were found. Results confirm that one of the key features in the electrical charging of convective clouds is the ice content, although it is not the only one. Parameters of the gamma raindrop size distribution measured by a 2-D video disdrometer revealed the transition from a convective to a stratiform regime. The raindrop size spectra measured by a 2-D video disdrometer were used to partition rain into stratiform and convective classes. These results are further analyzed in relation to radar measurements and to the number of strokes. Lightning activity was not always recorded when the precipitation regime was classified as convective rain. High statistical scores were found for relationships relating lightning activity to graupel aloft.

This paper shows the results of a tailored version of a previously published methodology, designed to simulate lightning activity, implemented into the Regional Atmospheric Modeling System (RAMS). The method gives the flash density at the resolution of the RAMS grid scale allowing for a detailed analysis of the evolution of simulated lightning activity. The system is applied in detail to two case studies occurred over the Lazio Region, in Central Italy. Simulations are compared with the lightning activity detected by the LINET network. The cases refer to two thunderstorms of different intensity which occurred, respectively, on 20 October 2011 and on 15 October 2012. The number of flashes simulated (observed) over Lazio is 19435 (16231) for the first case and 7012 (4820) for the second case, and the model correctly reproduces the larger number of flashes that characterized the 20 October 2011 event compared to the 15 October 2012 event. There are, however, errors in timing and positioning of the convection, whose magnitude depends on the case study, which mirrors in timing and positioning errors of the lightning distribution. For the 20 October 2011 case study, spatial errors are of the order of a few tens of kilometres and the timing of the event is correctly simulated. For the 15 October 2012 case study, the spatial error in the positioning of the convection is of the order of 100 km and the event has a longer duration in the simulation than in the reality. To assess objectively the performance of the methodology, standard scores are presented for four additional case studies. Scores show the ability of the methodology to simulate the daily lightning activity for different spatial scales and for two different minimum thresholds of flash number density. The performance decreases at finer spatial scales and for higher thresholds. The comparison of simulated and observed lighting activity is an immediate and powerful tool to assess the model ability to reproduce the intensity and the evolution of the convection. This shows the importance of using computationally efficient lightning schemes, such as the one described in this paper, in forecast models.

Background This study investigated perceived preparedness to practice, one year after graduation across osteopathic education institutions (OEIs) and explored possible differences between countries where osteopathy is regulated (Reg) and countries where it is not (Unreg). Methods Two hundred forty-five graduates from 7 OEIs in 4 European countries, already assessed in a previous study, were contacted one year after their graduation to complete the survey. Survey tools included a questionnaire to assess perceived preparedness to practice: Association of American Medical Colleges (AAMC) questionnaire, and a questionnaire to collect socio-demographic information and practice characteristics. Results One hundred sixty-eight graduates (68.6%) completed the survey. The AAMC mean score one year after the graduation (23.19; confidence interval 22.81–23.58) was significantly higher than in the previous study (17.58; 16.90–18.26) ( p  < 0.001). A difference was also found between Reg (23.49; 23.03–23.95) and Unreg (22.34; 21.74–22.94) ( p  = 0.004). Osteopaths with a previous healthcare degree scored significantly higher on AAMC score (25.53; 24.88–26.19) than osteopaths without a previous healthcare degree (22.33; 21.97–22.69) ( p  < 0.001). Regulation and a previous degree were the only significant independent variables in the most predictive multivariate linear model. The model had an r 2  = 0.33. Conclusions Graduates from OEIs where osteopathy is regulated felt significantly better prepared to practice than Unreg. Systematic information searches about graduates’ perception of preparedness to practice, may enable OEIs to strengthen their existing curricula to ensure their graduates are effectively prepared to practice.

The development phase (DP) of the EUMETSAT Satellite Application Facility for Support to Operational Hydrology and Water Management (H-SAF) led to the design and implementation of several precipitation products, after 5 yr (2005–2010) of activity. Presently, five precipitation estimation algorithms based on data from passive microwave and infrared sensors, on board geostationary and sun-synchronous platforms, function in operational mode at the H-SAF hosting institute to provide near real-time precipitation products at different spatial and temporal resolutions. In order to evaluate the precipitation product accuracy, a validation activity has been established since the beginning of the project. A Precipitation Product Validation Group (PPVG) works in parallel with the development of the estimation algorithms with two aims: to provide the algorithm developers with indications to refine algorithms and products, and to evaluate the error structure to be associated with the operational products. In this paper, the framework of the PPVG is presented: (a) the characteristics of the ground reference data available to H-SAF (i.e. radar and rain gauge networks), (b) the agreed upon validation strategy settled among the eight European countries participating in the PPVG, and (c) the steps of the validation procedures. The quality of the reference data is discussed, and the efforts for its improvement are outlined, with special emphasis on the definition of a ground radar quality map and on the implementation of a suitable rain gauge interpolation algorithm. The work done during the H-SAF development phase has led the PPVG to converge into a common validation procedure among the members, taking advantage of the experience acquired by each one of them in the validation of H-SAF products. The methodology is presented here, indicating the main steps of the validation procedure (ground data quality control, spatial interpolation, up-scaling of radar data vs. satellite grid, statistical score evaluation, case study analysis). Finally, an overview of the results is presented, focusing on the monthly statistical indicators, referred to the satellite product performances over different seasons and areas.

A novel algorithm for the detection of precipitation is described and tested. The algorithm is applicable to any modern passive microwave radiometer on board polar orbiting satellites independent of the observation geometry and channel frequency assortment. The algorithm is based on the application of canonical correlation analysis and on the definition of a threshold to be applied to the resulting linear combination of the brightness temperatures in all available channels. The algorithm has been developed using a 2-year data set of co-located Special Sensor Microwave Imager/Sounder (SSMIS) and Tropical Rainfall Measuring Mission precipitation radar (TRMM-PR) measurements and Advanced Microwave Sounding Unit (AMSU) Microwave Humidity Sounder and TRMM-PR measurements. This data set was partitioned into four classes depending on the background surface emissivity (vegetated land, arid land, ocean, and coast) with the same procedure applied for each surface class. In this paper we describe the procedure and evaluate the results in comparison with many well-known algorithms for the detection of precipitation. The algorithm shows a small rate of false alarms and superior detection capability; it can efficiently detect (probability of detection between 0.55 and 0.71) minimum rain rate varying from 0.14 mm h-1 (AMSU over ocean) to 0.41 (SSMIS over coast) with the remarkable result of 0.25 mm h-1 over arid land surfaces.

Objective: To examine the efficacy of fluoxetine in the treatment of depression in patients with probable Alzheimer's disease (AD). Methods: This double-blind, parallel-design study included a consecutive series of 41 AD subjects meeting DSM-IV criteria for major or minor depression who were randomized to receive fluoxetine (up to 40 mg/day) or identical-appearing placebo. All patients received biweekly evaluations consisting of the Hamilton Depression Scale (HAM-D) and the Clinical Global Impression as primary efficacy measures, and the Mini-Mental State Exam, Hamilton Rating Scale for Anxiety, and the Functional Independence Measure as secondary efficacy measures. Results: Complete remission of depression was found in 47% of subjects treated with fluoxetine and in 33% of subjects treated with placebo. Both the fluoxetine and the placebo groups showed a significant decline in HAM-D scores over time, but the magnitude of mood improvement was similar for both groups. Fluoxetine was well tolerated, and most side effects were mild. Conclusion: Fluoxetine treatment for depression in AD did not differ significantly from treatment with placebo. Our study also confirms the presence of a placebo effect in the treatment of depression in AD.