Wind influences human activities both directly and indirectly. Directly, it affects, among others, transportation and wind energy systems through its direction and intensity, while extreme wind events can cause severe damage to infrastructure and buildings and even casualties. Indirectly, the movement of air masses is strictly associated with all meteorological phenomena, highlighting the crucial role of wind in shaping weather conditions. In the context of climate change, anomalies in global and regional circulation patterns modify the characteristics of surface winds. Consequently, investigating long-term wind variability and trends is essential for assessing climate change impacts on the environment and society. The climatology of near-surface (10 m) winds over Greece for the period 1991–2020 is examined using a high-resolution regional reanalysis dataset, focusing on the mean wind speed, mean daily maximum wind gust, and the frequency of strong-wind days. The results reveal substantial spatial and temporal variability, with the most pronounced upward trends of these parameters observed over the Aegean Sea and northeastern Greece. Statistically significant trends are detected mainly during winter and summer. In particular, January and August exhibit the strongest positive trends, locally exceeding 0.05 m s−1 per year for mean wind speed and 0.1 m s−1 per year for mean daily maximum wind gust. Moreover, the frequency of strong-wind days increases in several regions with local trends exceeding 0.2 days per year. These findings highlight the value of high-resolution regional reanalyses for characterizing near-surface wind variability and trends over areas of complex terrain.

The authors describe the case of a girl with IBD that manifested 10 years after the diagnosis of seronegative hepatitis.

Background and Aim: Double-balloon enteroscopy (DBE) is a well-established procedure for direct visualisation of the entire small bowel mucosa, and, in contrast with other imaging techniques, allows to perform biopsies and therapeutic interventions. The aim of this study was to evaluate the indications, diagnostic yield, therapeutic yield, and complications of DBE in a cohort of consecutive patients according to patients’ age. Methods: We conducted a retrospective study of consecutive patients who underwent DBE in our endoscopy unit between January 2006 and December 2021. Results: A total of 387 consecutive patients who underwent 460 DBE procedures were included. Mean age of the patients was 63 years. The overall diagnostic yield was 67.6%; vascular lesions were the predominant endoscopic findings (31.5%), followed by polyps or neoplastic masses (17.6%). Older patients (≥65 years) showed statistically higher rates of clinically relevant findings than adult patients (18–65 years) (p = 0.001). Crohn’s disease and polyps or neoplastic masses were more frequent in the younger group (p = 0.009 and p = 0.066, respectively), while vascular lesions and non-specific inflammation were the most common findings in the older group (p < 0.001 and p < 0.001, respectively). The therapeutic intervention rate was 31.7%. Rates of endoscopic treatment were significantly higher in the older group (p < 0.001). Total complications occurred in five procedures (1.1%). Conclusion: In clinical practice, DBE is an efficient diagnostic and therapeutic tool with a high safety profile, particularly in the elderly population.

Eosinophilic oesophagitis (EoE) is a chronic, immune-mediated or antigen-mediated oe-sophageal disease. Therapeutic first-line options currently available for EoE are elimina-tion diets, proton pump inhibitors (PPIs) and steroids. The ultimate goal of the therapy is to avoid irreversible stricturing disease. Despite the rising prevalence of EoE, there has been little therapeutic advancement until recently. Dupilumab is one of the potential disease-modifying biologics used in various stages of clinical trials. The paper describes the case of a 10-year-old boy presenting with sub-oesophageal stricture in eosinophilic oesophagitis and steroid-dependence for disease control who was successfully treated with dupilumab.

As a result of two research projects conducted over the years from 2005 to 2011, this paper describes the configuration of a coupled hydrometeorological flood forecasting system set up for the Red river basin (169,000 km2 at the outlet) and the Ca river basin (23,830 km2 at the outlet), across China and Vietnam, and Laos and Vietnam, respectively. The research objectives were to setup a hydrometeorological chain to forecast the discharge flowing into reservoirs and at some control sections for flood control in downstream areas of the Red river and Ca river. These areas include the heavily populated Northern Delta of Red river and, for the Ca river, the Vinh area. Both these areas are in fact experiencing a rapid population and economic development. The distributed hydrological model DIMOSHONG, which implements a modified Green and Ampt or an SCS—type routing scheme of the soil–water content, is forced by Quantitative Precipitation Forecasts provided by the BOLAM and the MOLOCH meteorological models or by raingauge observations. The forecasting chain has an Extended Kalman Filtering updating module based on hydrometric measurements now available in real-time for two pilot stations installed in Ghenh Ga section and Nam Dan section, in the Red and Ca rivers, respectively. Several floods in the basins, including the August 1971 and October 2010 catastrophic ones which flooded the Red river and the Ca river regions, were simulated providing useful results in view of improving flood alert systems.

Barrier winds form when a sufficiently high mountain range causes a stratified airflow directed towards the orographic barrier to slow down at the low levels, producing a pressure imbalance, which in turn generates a mountain-parallel wind. The present study analyses barrier wind occurrence in the Italian region and surrounding seas from both a climatological and dynamical perspective. The main goals are to assess the applicability of the linear theory of upstream blocking to real-world cases and to investigate the role of atmospheric moist processes in promoting the formation and influencing the evolution of barrier winds. A 2-year climatology of barrier winds reveals that they occur more frequently than the opposite regime of flow over the orography, especially in the cold season. Barrier wind events are found to be associated with an upstream flow having a significantly higher inverse Froude number (or non-dimensional mountain height) values than flow-over events on average, consistently with the theory. An Alpine case study is simulated using numerical models and sensitivity tests are performed to investigate the dependence of barrier wind development and properties on the non-dimensional mountain height. Simulations reveal the strong influence of precipitation-related diabatic processes on the development of an upstream cold pool, which in turn supports barrier wind maintenance and strengthens its intensity. Idealized numerical experiments with varying upstream flow moisture shed light on processes leading to significant strengthening of barrier wind intensity, in particular on the crucial role of latent heat exchanges associated with precipitation.

Although the phenomenon has been known, and investigated, as early as the nineteenth century, the interest in understanding Alpine lee cyclogenesis (often called Genoa cyclogenesis) has grown since the middle twentieth century, when it was realized that the largest fraction of cyclones affecting the central-eastern Mediterranean and later Eastern Europe originated in the area south of the Alps, more often in the Gulf of Genoa. Forecasting this type of cyclogenesis remained a challenging task until at least the mid-late 1980s, even after the development of the earlier NWP models, which failed in predicting this phenomenon, lacking the ability to adequately represent the orographic forcing. Monitoring and understanding of cyclogenesis in the lee of the Alps was the main objective of field projects, the most important being GARP-ALPEX in 1982. The following years were full of ideas and theories about this phenomenon, which is representative of orographic cyclogenesis in other regions of the world. The main steps in understanding the complex phenomenon of lee cyclogenesis, with particular reference to the Alps, are outlined here, focusing on theoretical explanations.

The celebration of the 25th anniversary of the Piedmont flood was organized by the University of Piemonte Orientale in Alessandria, a town that was severely affected in November 1994. It has been an opportunity to reexamine the meteorological event and assess the potential of CNR-ISAC models, after more than 20 years of development, to accurately simulate the heavy precipitation at different lead times. The predictability of this extreme event has been studied on a wide range of space and time scales, from subseasonal to convection resolving, using a variety of model setups and initial conditions. The subseasonal experiment produces a precipitation anomaly that, even if underestimated, indicates some predictability beyond the second forecast week. At shorter ranges, results indicate that there is a consistent improvement in the precipitation forecast going from low-resolution hydrostatic to high-resolution nonhydrostatic models. It is only at very high resolution (500 m) that the convective activity extending to the north of the divide line of the Ligurian Apennines, which was responsible for the flood of the Tanaro River, is predicted with an intensity comparable with rain gauge observations. The main mesoscale phenomena that played a role in the different phases of the event have been also identified.

The Adriatic basin is regularly affected by cold, strong and gusty bora winds blowing from the northeast, especially during winter. These events are characterized by intense air–sea interactions and produce important meteorological effects not only over the eastern Adriatic basin, where bora originates and attains its maximum intensity, but also downstream over the Italian peninsula where heavy rainfall and snowfall can occur.The present study aims at evaluating the impact of surface fluxes of sensible and latent heat, that characterize air–sea interaction during a bora episode, on wind strength and profiles over the Adriatic Sea, in relation to intense precipitation affecting the Apennines and the Italian coast. High‐resolution numerical simulations are used in order to assess the role of surface fluxes in modulating the atmospheric water balance, modifying the thermodynamic characteristic of the boundary layer and, in turn, the dynamics of the orographic flow regime.Results show that while surface evaporation is responsible for a relatively small contribution to the total atmospheric water budget over the Adriatic area, surface fluxes still have a remarkable impact on precipitation via dynamical processes. Both sensible and latent heat fluxes modify the speed, temperature and moisture profiles of the low‐level bora wind, sensibly changing the dynamical characteristics of interaction of the flow with the downstream orography. The orographic flow regime determines the intensity and location of orographically induced uplift and hence precipitation. Therefore, the picture that directly associates the precipitation amount upstream and over the Apennines with the degree of moistening of air during its passage over the sea and with orographic uplift is shown to be too simplistic. The variations of the wind speed and static stability due to surface fluxes involve complex and nonlinear effects, changing the flow regime in response to the orographic forcing and thus determining amount and location of heavy precipitation.

Background: The aim of our study was to test the long-term efficacy of Endo-SPONGE® therapy in a group of patients treated in our center with vacuum-assisted therapy because of anastomotic leakages after colorectal surgery. Methods: Eleven patients [male: 6; mean age: 71 (range: 44-82) years] who had anastomotic leakage treated with Endo-SPONGE® placement were included in the study. Patient records were examined retrospectively. All patients with documented anastomotic leakage on abdominal computed tomography following an anterior resection of the rectum for rectal cancer underwent sigmoidoscopy to determine the extent of the anastomotic defect and the size of the presacral abscess. Results: Ten of the 11 patients (90.9%) showed closure of the anastomotic leakage after a mean of 16 sponge changes. During follow up [mean: 29 (range: 6-64) months], we observed two cases of anastomotic stricture. Treatment failure was observed in one patient who presented an increased size of dehiscence after 23 sessions of endoscopic treatment, despite an initial good response. Conclusions: Our study substantially confirms previous conclusions and reaffirms that Endo-SPONGE® treatment for colorectal anastomotic leakages, performed in suitable patients, represents a successful and safe approach. The reduction in wound closure time, mild-to-moderate discomfort and possibly shorter hospitalization suggest that Endo-SPONGE® treatment can be a prominent therapeutic regimen with adequate patient acceptance.

Esophagitis dissecans is most often idiopathic, but it can be associated with use of nonsteroidal anti-inflammatory drugs or bisphosphonates, consumption of hot beverages, celiac disease, or autoimmune bullous dermatoses (2). Histological features include the following: parakeratosis, intraepithelial splitting at varying degrees above the basal layer, occasional association with intraepithelial bullae and minimal or no inflammatory component, and unusually long, detached fragments of superficial epithelium (3).

A detailed analysis of a Mediterranean tropical‐like cyclone (MTLC) that occurred in January 2014 has been conducted. After having identified the cyclone path and its general features, the GLOBO, BOLAM and MOLOCH numerical weather prediction (NWP) models, developed at the National Research Council ‐ Institute of Atmospheric Sciences and Climate (CNR–ISAC) in Bologna, were used to simulate the phenomenon. Particular attention was paid to the Mediterranean phase of the system life cycle as well as to the Atlantic phase, since the cyclone showed a well‐defined precursor up to 3 days before the formation of the mean sea‐level pressure (MSLP) minimum over the Alboran Sea. The Mediterranean phase was studied using different combinations of the aforementioned models, so as to evaluate the sensitivity to boundary and initial conditions. The analysis of the cyclone thermal phase showed the presence of a deep warm‐core quasi‐symmetric structure, thus confirming the tropical‐like nature of the system. In the Atlantic phase, the precursor, in the form of a low‐pressure system, was traced from North America to the Mediterranean. The thermal phase analysis showed evidence of a deep cold‐core asymmetric structure during the whole Atlantic phase, while the first contact with the Mediterranean Sea caused a sudden transition to a shallow warm‐core structure. The examination of potential vorticity (PV) three‐dimensional structure revealed the presence of a PV streamer that formed individually over the Labrador Sea and subsequently interacted with the low‐pressure system near the northwestern coast of the Iberian peninsula, favouring the first phase of the cyclone intensification.

Quality of wind prediction is of great importance since a good wind forecast allows the prediction of available wind power, improving the penetration of renewable energies into the energy market. Here, a 1-year (1 December 2012 to 30 November 2013) three-model ensemble (TME) experiment for wind prediction is considered. The models employed, run operationally at National Research Council – Institute of Atmospheric Sciences and Climate (CNR-ISAC), are RAMS (Regional Atmospheric Modelling System), BOLAM (BOlogna Limited Area Model), and MOLOCH (MOdello LOCale in H coordinates). The area considered for the study is southern Italy and the measurements used for the forecast verification are those of the GTS (Global Telecommunication System). Comparison with observations is made every 3 h up to 48 h of forecast lead time. Results show that the three-model ensemble outperforms the forecast of each individual model. The RMSE improvement compared to the best model is between 22 and 30 %, depending on the season. It is also shown that the three-model ensemble outperforms the IFS (Integrated Forecasting System) of the ECMWF (European Centre for Medium-Range Weather Forecast) for the surface wind forecasts. Notably, the three-model ensemble forecast performs better than each unbiased model, showing the added value of the ensemble technique. Finally, the sensitivity of the three-model ensemble RMSE to the length of the training period is analysed.

Results of the assimilation of high-density data to initialize the high-resolution meteorological model MOLOCH (CNR-ISAC) are described. The local analysis and prediction system (LAPS), a mesoscale data assimilation system developed at NOAA, is applied to modeling a case study of heavy precipitation that occurred over Liguria, north-western Italy, on November 4, 2011, causing severe flood in the city of Genoa. This case is representative of some episodes that affected the region in the last few years, where the coastal orography, besides enhancing the convective uplift, contributed to the formation of convergence lines over the sea, responsible for the onset of convective cells. The present work aims at the implementation of a model-based operational short-range prediction system, with particular focus on quantitative precipitation forecasting in a time range up to 12-24 h. The use of LAPS analysis as initial condition for the MOLOCH model shows a positive impact on the intensity and distribution of the simulated precipitation with respect to the simulations where only large-scale analyses are employed as initial conditions. Effects on the models simulations are due to the assimilation of surface network data, radio-sounding profiles, radar and satellite (SEVIRI/MSG) data.

The Liguria coastal region in Italy was affected by two heavy rainfall episodes and subsequent severe flooding that occurred at the end of October and the beginning of November 2011. In both cases, the very large accumulated precipitation maxima were associated with intense and quasi-stationary convective systems that developed near the coast, both related to orographic lift and similar low-level mesoscale flow patterns over the Ligurian Sea, giving rise to pronounced convergence lines. This study aims at analysing the main dynamical processes responsible for the onset, lifecycle, intensity and localisation/propagation of the precipitating systems, using the ISAC convection-permitting model MOLOCH applied at different spatial resolutions and comparing model output fields with available observations. The ability of the model in quantitative precipitation forecasting (QPF) is tested with respect to initial conditions and model horizontal resolution. Although precipitation maxima remain underestimated in the model experiments, it is shown that errors in QPF in both amount and position tend to decrease with increasing grid resolution. It is shown that model accuracy in forecasting rainfall amounts and localisation of the precipitating systems critically depends on the ability to represent the cold air outflow from the Po Valley to the Ligurian Sea, which determines the position and intensity of the mesoscale convergence lines over the sea. Such convergence lines controls, together with the lifting produced by the Apennines chain surrounding the coast, the onset of the severe convection.

The general objective of the international MEDiterranean EXperiment (MEDEX) was the better understanding and forecasting of cyclones that produce high impact weather in the Mediterranean. This paper reviews the motivation and foundation of MEDEX, the gestation, history and organisation of the project, as well as the main products and scientific achievements obtained from it. MEDEX obtained the approval of World Meteorological Organisation (WMO) and can be considered as framed within other WMO actions, such as the ALPine EXperiment (ALPEX), the Mediterranean Cyclones Study Project (MCP) and, to a certain extent, THe Observing System Research and Predictability EXperiment (THORPEX) and the HYdrological cycle in Mediterranean EXperiment (HyMeX). Through two phases (2000–2005 and 2006–2010), MEDEX has produced a specific database, with information about cyclones and severe or high impact weather events, several main reports and a specific data targeting system field campaign (DTS-MEDEX-2009). The scientific achievements are significant in fields like climatology, dynamical understanding of the physical processes and social impact of cyclones, as well as in aspects related to the location of sensitive zones for individual cases, the climatology of sensitivity zones and the improvement of the forecasts through innovative methods like mesoscale ensemble prediction systems.