how far are we from the use of satellite rainfall products in landslide forecasting

Abstract Satellite rainfall products have been available for many years (since '90) with an increasing spatial/temporal resolution and accuracy. Their global scale coverage and near real-time products perfectly fit the need of an early warning landslide system. Notwithstanding these characteristics, the number of studies employing satellite rainfall estimates for predicting landslide events is quite limited. In this study, we propose a procedure that allows us to evaluate the capability of different rainfall products to forecast the spatial-temporal occurrence of rainfall-induced landslides using rainfall thresholds. Specifically, the assessment is carried out in terms of skill scores, and receiver operating characteristic (ROC) analysis. The procedure is applied to ground observations and four different satellite rainfall estimates: 1) the Tropical Rainfall Measurement Mission Multi-satellite Precipitation Analysis, TMPA, real time product (3B42-RT), 2) the SM2RASC product obtained from the application of SM2RAIN algorithm to the Advanced SCATterometer (ASCAT) derived satellite soil moisture (SM) data, 3) the Precipitation Estimation from Remotely Sensed Information using Artificial Neural Network (PERSIANN), and 4) the Climate Prediction Center (CPC) Morphing Technique (CMORPH). As case study, we consider the Italian territory for which a catalogue listing 1414 rainfall-induced landslides in the period 2008–2014 is available. Results show that satellite products underestimate rainfall with respect to ground observations. However, by adjusting the rainfall thresholds, satellite products are able to identify landslide occurrence, even though with less accuracy than ground-based rainfall observations. Among the four satellite rainfall products, CMORPH and SM2RASC are performing the best, even though differences are small. This result is to be attributed to the high spatial/temporal resolution of CMORPH, and the good accuracy of SM2RSC. Overall, we believe that satellite rainfall estimates might be an important additional data source for developing continental or global landslide warning systems

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Lead poisoning caused by Indian ethnic remedies in Italy

Background: Complementary or alternative medicine has become widespread in Western Countries and since the remedies are "natural" they are believed to be free of toxic effects and health risks. Ethnic remedies may contain lead, other metals and toxic substances. Objectives: To show how lead poisoning as a result of using ethnic remedies may be severe enough to cause serious damage to health, and to increase awareness among family doctors and occupational physicians of the risks associated with ethnic remedies. Methods and results: Description of ethnic remedy-related lead poisoning in 2 native Italian adults, with clinical, laboratory and toxicological data. Conclusions: When metal poisoning is diagnosed, ethnic remedies should be included among the putative sources so as to avoid erroneous attribution to workplace exposure and application of unneeded preventive measures

SM2RAIN-CCI: a new global long-term rainfall data set derived from ESA CCI soil moisture

Accurate and long-term rainfall estimates are the main inputs for several applications, from crop modeling to climate analysis. In this study, we present a new rainfall data set (SM2RAIN-CCI) obtained from the inversion of the satellite soil moisture (SM) observations derived from the ESA Climate Change Initiative (CCI) via SM2RAIN (Brocca et al., 2014). Daily rainfall estimates are generated for an 18-year long period (1998–2015), with a spatial sampling of 0.25° on a global scale, and are based on the integration of the ACTIVE and the PASSIVE ESA CCI SM data sets.The quality of the SM2RAIN-CCI rainfall data set is evaluated by comparing it with two state-of-the-art rainfall satellite products, i.e. the Tropical Measurement Mission Multi-satellite Precipitation Analysis 3B42 real-time product (TMPA 3B42RT) and the Climate Prediction Center Morphing Technique (CMORPH), and one modeled data set (ERA-Interim). A quality check is carried out on a global scale at 1° of spatial sampling and 5 days of temporal sampling by comparing these products with the gauge-based Global Precipitation Climatology Centre Full Data Daily (GPCC-FDD) product. SM2RAIN-CCI shows relatively good results in terms of correlation coefficient (median value  &gt;  0.56), root mean square difference (RMSD, median value  &lt;  10.34 mm over 5 days) and bias (median value  &lt;  −14.44 %) during the evaluation period. The validation has been carried out at original resolution (0.25°) over Europe, Australia and five other areas worldwide to test the capabilities of the data set to correctly identify rainfall events under different climate and precipitation regimes.The SM2RAIN-CCI rainfall data set is freely available at https://doi.org/10.5281/zenodo.846259

Satellite rainfall products outperform ground observations for landslide prediction in India

Landslides are among the most dangerous natural hazards, particularly in developing countries, where ground observations for operative early warning systems are lacking. In these areas, remote sensing can represent an important detection and monitoring process to predict landslide occurrence in space and time, particularly satellite rainfall products that have improved in terms of accuracy and resolution in recent times. Surprisingly, only a few studies have investigated the capability and effectiveness of these products in landslide prediction in reducing the impact of this hazard on the population. We have performed a comparative study of ground and satellite-based rainfall products for landslide prediction in India by using empirical rainfall thresholds derived from the analysis of historical landslide events. Specifically, we have tested Global Precipitation Measurement (GPM) and SM2RAIN-ASCAT satellite rainfall products, and their merging, at daily and hourly temporal resolution, and Indian Meteorological Department (IMD) daily rain gauge observations. A catalogue of 197 rainfall-induced landslides that occurred throughout India in the 13-year period between April 2007 and October 2019 has been used. Results indicate that satellite rainfall products outperform ground observations thanks to their better spatial (0.1 vs. 0.25 ) and temporal (hourly vs. daily) resolutions. The better performance is obtained through the merged GPM and SM2RAIN-ASCAT products, even though improvements in reproducing the daily rainfall (e.g. overestimation of the number of rainy days) are likely needed. These findings open a new avenue for using such satellite products in landslide early warning systems, particularly in poorly gauged areas

Validation of the Italian voice handicap index-10

Objective. Time consuming is an important aspect in assessing dysphonic patients. So, the English version of the Voice Handicap Index (VHI-30), a self-administered questionnaire consisting of 30 items used to evaluate patients' self-perception of voice problems, was reduced to 10 items (VHI-10) for clinical purposes. In 2010, an Italian version of VHI-30 was validated, now the aims of this study were to analyze the psychometric properties of an Italian version of VHI-10 and to evaluate its validity in a cohort of patients affected by organic or functional dysphonia. Study Design. Cross-sectional study. Methods. The Italian version of the VHI-30 was submitted to 372 dysphonic participants and 120 healthy control subjects and was conducted again 2 weeks later. The 10 items constituting the VHI-10 were extracted from the VHI-30. For 73 dysphonic patients, the questionnaire was also administered after treatment. Results. The scores of the control group were significantly lower with respect to all diagnostic subgroups (P < 0.001). The Cronbach's alpha, test-retest, and Pearson's correlation index demonstrated high reliability and validity of the Italian VHI-10. The ratio of the VHI-10 and VHI-30 scores was higher than 0.333 in all subgroups. Conclusion. This study demonstrated that the Italian VHI-10 is a robust tool that can adequately represent and replace the VHI-30. The reported results support the use of the VHI-10 for the Italian population in clinical settings owing to its validity and rapid and simple use