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The I2-RED (Improved I-RED) database includes the annual maximum rainfall depths in 1, 3, 6, 12 and 24 consecutive hours from more than 5000 rain gauge stations across Italy, recorded starting from the early 1900s. All the rainfall measurements included in the database are expressed in mm, while the positions of all the rain gauges are converted in the Universal Transverse Mercator coordinate system (WGS 84 UTM 32 N - EPSG 32632). An advanced data quality control in terms of consistency, redundancy, gap-filling of records and systematic geographical checks has been carried out while creating I2-RED.

Data set from Laforgia P, Bandera F, Alfonzetti E, Guazzi M. Exercise chronotropic incompetence phenotypes the level of cardiovascular risk and exercise gas exchange impairment in the general population. An analysis of the Euro-EX prevention trial. Eur J Prev Cardiol. 2020 Mar;27(5):526-535. doi: 10.1177/2047487319863506. Epub 2019 Jul 25. PMID: 31345056. This is the article: Background: Chronotropic insufficiency (CI) is defined as the inability of the heart to increase its rate commensurate with increased demand. Exercise CI is an established predictor of major adverse cardiovascular events in patients with cardiovascular diseases. Aim: The aim of this study was to evaluate how exercise CI phenotypes different levels of cardiovascular risk and how it may better perform in defining cardiovascular risk when analysed in the context of cardiopulmonary exercise test (CPET)-derived measures and standard echocardiography in a healthy population with variable cardiovascular risk profile. Methods: Apparently healthy individuals (N = 702, 53.8% females) with at least one major cardiovascular risk factor (MCVRF; hypertension, diabetes, tabagism, dyslipidaemia, body mass index > 25), enrolled in the Euro-EX prevention trial, underwent CPET. CI was defined as the inability to reach 80% of the chronotropic index, that is, the ratio of peak heart rate - rest heart rate/peak heart rate - age predicted maximal heart rate (AMPHR: 220 - age), they were divided into four groups according to the heart rate reserve (<80%>) and respiratory gas exchange ratio (RER; < 1.05>) as a marker of achieved maximal performance. Subjects with a RER < 1.05 (n = 103) were excluded and the final population (n = 599) was divided into CI group (n = 472) and no-CI group (n = 177). Results: Compared with no-CI, CI subjects were more frequently females with a history of hypertension in a high rate. CI subjects also exhibited a significantly lower peak oxygen uptake (VO2) and circulatory power and an echocardiographic pattern indicative of higher left atrial volume index and left ventricular mass index. An inverse stepwise relationship between heart rate reserve and number of MCVRFs was observed (one MCVRF: 0.71 ± 0.23; two MCVRFs: 0.68 ± 0.24, three MCVRFs: 0.64 ± 0.20; four MCVRFs: 0.64 ± 0.23; five MCVRFs: 0.57 ± 18; p < 0.01). In multivariate analysis the only variable found predicting CI was peak VO2 (p < 0.05; odds ratio 0.91; confidence interval 0.85-0.97). Conclusions: In a population of apparently healthy subjects, exercise CI is common and phenotypes the progressive level of cardiovascular risk by a tight relationship with MCVRFs. CI patients exhibit some peculiar abnormal exercise gas exchange patterns (lower peak VO2 and exercise oscillatory ventilation) and echo-derived measures (higher left atrium size and left ventricle mass) that may well anticipate evolution toward heart failure.

Data set from Fantini F, Toso A, Menicanti L, Moroni F, Castelvecchio S. Restrictive filling pattern in ischemic cardiomyopathy: Insights after surgical ventricular restoration. J Thorac Cardiovasc Surg. 2019 Oct 30:S0022-5223(19)32349-9. doi: 10.1016/j.jtcvs.2019.09.173. Epub ahead of print. PMID: 31767363. This is the abstract: Objective: To examine factors possibly involved in the resolution or persistence of restrictive filling pattern (RFP) after surgical ventricular restoration (SVR) in a series of patients with ischemic cardiomyopathy (ICM) and RFP. Methods: Echocardiography was performed at baseline (pre-SVR), discharge, and follow-up in 43 patients with ICM and RFP (E/A ratio ≥2). Patients were divided into 2 groups based on E/A ratio at discharge: improved (E/A ratio <2; 22 patients) and unchanged (E/A ratio ≥2; 21 patients). Results: The improved group had a significantly increased mean deceleration time (from 137 ± 22 ms to 194 ± 68 ms; P = .002) and mean A wave velocity (from 43 ± 10 cm/s to 92 ± 37 cm/s; P = .001), and decreased E/e' ratio (from 27.7 ± 9.5 to 19.2 ± 7.8; P = .01) after SVR. The unchanged group did not show any significant variations in diastolic parameters. The only significant differences at baseline between the two groups were thinner left ventricle posterior wall and lower relative wall thickness (RWT) in the unchanged group. RWT was the sole baseline parameter independently associated with persistent RFP. Conclusions: RFP was reversed after SVR in 22 of our 43 patients with ICM with a response that remained stable over time, associated with improved New York Heart Association class. RWT was the sole baseline echocardiographic parameter significantly associated with the evolution of RFP after

Datset from the article de Abreu RM, Catai AM, Cairo B, Rehder-Santos P, da Silva CD, Signini ÉF, Sakaguchi CA, Porta A. A Transfer Entropy Approach for the Assessment of the Impact of Inspiratory Muscle Training on the Cardiorespiratory Coupling of Amateur Cyclists. Front Physiol. 2020 Feb 25;11:134. doi: 10.3389/fphys.2020.00134. PMID: 32158402; PMCID: PMC7052290. Abstract The strength of cardiorespiratory interactions diminishes with age. Physical exercise can reduce the rate of this trend. Inspiratory muscle training (IMT) is a technique capable of improving cardiorespiratory interactions. This study evaluates the effect of IMT on cardiorespiratory coupling in amateur cyclists. Thirty male young healthy cyclists underwent a sham IMT of very low intensity (SHAM, n = 9), an IMT of moderate intensity at 60% of the maximal inspiratory pressure (MIP60, n = 10) and an IMT of high intensity at the critical inspiratory pressure (CIP, n = 11). Electrocardiogram, non-invasive arterial pressure, and thoracic respiratory movement (RM) were recorded before (PRE) and after (POST) training at rest in supine position (REST) and during active standing (STAND). The beat-to-beat series of heart period (HP) and systolic arterial pressure (SAP) were analyzed with the RM signal via a traditional non-causal approach, such as squared coherence function, and via a causal model-based transfer entropy (TE) approach. Cardiorespiratory coupling was quantified via the HP-RM squared coherence at the respiratory rate (K 2 HP-R M), the unconditioned TE from RM to HP (TER M → HP) and the TE from RM to HP conditioned on SAP (TER M → HP| SAP). In PRE condition we found that STAND led to a decrease of TER M → HP| SAP. After SHAM and CIP training this tendency was confirmed, while MIP60 inverted it by empowering cardiorespiratory coupling. This behavior was observed in presence of unvaried SAP mean and with usual responses of the baroreflex control and HP mean to STAND. TER M → HP and K 2 HP- RM were not able to detect the post-training increase of cardiorespiratory coupling strength during STAND, thus suggesting that conditioning out SAP is important for the assessment of cardiorespiratory interactions. Since the usual response of HP mean, SAP mean and baroreflex sensitivity to postural stressor were observed after MIP60 training, we conclude that the post-training increase of cardiorespiratory coupling during STAND in MIP60 group might be the genuine effect of some rearrangements at the level of central respiratory network and its interactions with sympathetic drive and vagal activity.

Data set from the article Magon A, Arrigoni C, Moia M, Mancini M, Dellafiore F, Manara DF, Caruso R. Determinants of health-related quality of life: a cross-sectional investigation in physician-managed anticoagulated patients using vitamin K antagonists. Health Qual Life Outcomes. 2020 Mar 16;18(1):73. doi: 10.1186/s12955-020-01326-y. PMID: 32178684; PMCID: PMC7077005. Abstract Background: Literature has paid little attention in describing the specific contribution of each modifiable and non-modifiable characteristics on health-related quality of life (HRQoL) in physician-managed anticoagulated patients using vitamin K antagonists (VKAs). To describe how patients' treatment-specific knowledge, health literacy, treatment beliefs, clinical, and socio-demographic characteristics influence HRQoL in Italian physician-managed anticoagulated patients using VKAs. Methods: Cross-sectional multicentre study with a consecutive sampling strategy, enrolling 164 long-term anticoagulated patients. Clinical and socio-demographic characteristics were collected from electronic medical records. Valid and reliable questionnaires were used to collect patients' treatment-specific knowledge, health literacy, beliefs about VKAs, physical and health perceptions. Results: Obtaining and understanding health information (i.e., communicative health literacy) positively predicts both adequate mental (ORadjusted = 10.9; 95%CI = 1.99-19.10) and physical (ORadjusted = 11.54; 95%CI = 1.99-34.45) health perceptions. Conversely, the ability to perform proper health decision making (i.e., critical health literacy) was associated with lower rates of adequate mental health perception (ORadjusted = 0.13; 95%CI = 0.03-0.63). Further, age negatively predicted physical health perception (ORadjusted = 0.87; 95%CI = 0.81-0.93). Conclusions: Health literacy plays an interesting role in predicting HRQoL. The relationship between critical health literacy and mental health perception could be influenced by some psychological variables, such as distress and frustration, which could be present in patients with higher levels of critical health literacy, as they could be more inclined for self-monitoring. For this reason, future research are needed to identify the most suitable patients' profile for each OAC-management model, by longitudinally describing the predictive performance of each modifiable and non-modifiable determinant of HRQoL.

Data set from the article Dozio E, Ruscica M, Vianello E, Macchi C, Sitzia C, Schmitz G, Tacchini L, Corsi Romanelli MM. PCSK9 Expression in Epicardial Adipose Tissue: Molecular Association with Local Tissue Inflammation. Mediators Inflamm. 2020 Jun 4;2020:1348913. doi: 10.1155/2020/1348913. PMID: 32565719; PMCID: PMC7292972. Abstract Epicardial adipose tissue (EAT) has the unique property to release mediators that nourish the heart in healthy conditions, an effect that becomes detrimental when volume expands and proinflammatory cytokines start to be produced. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a proinflammatory mediator involved in atherosclerosis, is also produced by visceral fat. Due to the correlation of inflammation with PCSK9 and EAT enlargement, we evaluated whether PCSK9 was expressed in EAT and associated with EAT inflammation and volume. EAT samples were isolated during surgery. EAT thickness was measured by echocardiography. A microarray was used to explore EAT transcriptoma. The PCSK9 protein levels were measured by Western Blot in EAT and ELISA in plasma. PCSK9 was expressed at both the gene and protein levels in EAT. We found a positive association with EAT thickness and local proinflammatory mediators, in particular, chemokines for monocytes and lymphocytes. No association was found with the circulating PCSK9 level. The expression of PCSK9 in EAT argues that PCSK9 is part of the EAT secretome and EAT inflammation is associated with local PCSK9 expression, regardless of circulating PCSK9 levels. Whether reducing EAT inflammation or PCSK9 local levels may have beneficial effects on EAT metabolism and cardiovascular risk needs further investigations.

Dataset from the comment Nania T, Dellafiore F, Caruso R, Barello S. Risk and protective factors for psychological distress among Italian university students during the COVID-19 pandemic: The beneficial role of health engagement. Int J Soc Psychiatry. 2020 Jul 28:20764020945729. doi: 10.1177/0020764020945729. Epub ahead of print. PMID: 32721256. Introduction We read with great interest the study by Torales et al. (2020) and colleagues on the impact of COVID-19 on the global and mental health of citizens across countries. They stated that global health initiatives should be employed to manage psychosocial stressors, particularly those related to the experience of isolation and quarantine among the general population. There have been reports on the psychological impact of the epidemic on citizens, patients, medical workforce, children, and older adults (Barello et al., 2020; Dubey et al., 2020; Garnier-Crussard et al., 2020; Li et al., 2020; Lima et al., 2020). However, few studies on the mental health status of Italian university students facing the epidemic has been conducted to date. At this regard, university students should be considered as a potentially higher risk population for mental health disorders related to the COVID-19 pandemic, as they were asked to deeply reframe their daily habits. The continuous spread of the epidemic, strict isolation measures, being often far from home and lack of interpersonal relationships across Italy, may have hugely affected the mental health of university students. Furthermore, university students, more than others social groups, had to tackle the ‘infodemic’ of misinformation about COVID-19, due to their higher social media exposure (Rovetta & Bhagavathula, 2020). The re-organization of learning activities and of their habits could represent a challenging demand for students, which requires adequate institutional responses to make them able to manage anxiety and stress. Therefore, we believe that a wider understanding of those factors that might contribute in exacerbating anxiety and poor mental health outcomes in university students is warranted to address this issue to provide high-quality, timely crisis-oriented psychological services to this vulnerable population (Tang et al., 2020). Specifically, further studies should encompass positive and negative determinants of students’ Covid-19–related distress.

Data set from the article Dozio E, Sitzia C, Pistelli L, Cardani R, Rigolini R, Ranucci M, Corsi Romanelli MM. Soluble Receptor for Advanced Glycation End Products and Its Forms in COVID-19 Patients with and without Diabetes Mellitus: A Pilot Study on Their Role as Disease Biomarkers. J Clin Med. 2020 Nov 23;9(11):3785. doi: 10.3390/jcm9113785. PMID: 33238596; PMCID: PMC7700384. Abstract The receptor for advanced glycation end products (RAGE), a well-known player of diabetes mellitus (DM)-related morbidities, was supposed to be involved in coronavirus disease-19 (COVID-19), but no data exist about COVID-19, DM, and the soluble RAGE (sRAGE) forms. We quantified total sRAGE and its forms, the endogenously secretory esRAGE and the membrane-cleaved cRAGE, in COVID-19 patients with and without DM and in healthy individuals to explore how COVID-19 may affect these molecules and their potential role as biomarkers. Circulating sRAGE and esRAGE were quantified by enzyme-linked-immunosorbent assays. cRAGE was obtained by subtracting esRAGE from total sRAGE. sRAGE, esRAGE, cRAGE, and the cRAGE/esRAGE ratio did not differ between DM and non-DM patients and had the same trend when compared to healthy individuals. Levels of total sRAGE, cRAGE, and cRAGE/esRAGE ratio were upregulated, while esRAGE was downregulated. The lack of difference between DM and non-DM COVID-19 patients in the levels of sRAGE and its forms supports the hypothesis that in COVID-19 the RAGE system is modulated regardless of glycemic control. Identifying how sRAGE and its forms associate to COVID-19 prognosis and the potential of RAGE as a therapeutic target to control inflammatory burden seem of relevance to help treatment of COVID-19.

data set from Mollica G, Senesi P, Codella R, Vacante F, Montesano A, Luzi L, Terruzzi I. L-carnitine supplementation attenuates NAFLD progression and cardiac dysfunction in a mouse model fed with methionine and choline-deficient diet. Dig Liver Dis. 2020 Mar;52(3):314-323. doi: 10.1016/j.dld.2019.09.002. Epub 2019 Oct 10. PMID: 31607566. This is the abstract: Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disorder. NAFLD, associated lipotoxicity, fibrosis, oxidative stress, and altered mitochondrial metabolism, is responsible for systemic inflammation, which contributes to organ dysfunction in extrahepatic tissues, including the heart. We investigated the ability of L-carnitine (LC) to oppose the pathogenic mechanisms underlying NAFLD progression and associated heart dysfunction, in a mouse model of methionine-choline-deficient diet (MCDD). Mice were divided into three groups: namely, the control group (CONTR) fed with a regular diet and two groups fed with MCDD for 6 weeks. In the last 3 weeks, one of the MCDD groups received LC (200 mg/kg each day) through drinking water (MCDD + LC). The hepatic lipid accumulation and oxidative stress decreased after LC supplementation, which also reduced hepatic fibrosis via modulation of α-smooth muscle actin (αSMA), peroxisome-activated receptor gamma (PPARγ), and nuclear factor kappa B (NfƙB) expression. LC ameliorated systemic inflammation, mitigated cardiac reactive oxygen species (ROS) production, and prevented fibrosis progression by acting on signal transducer and activator of transcription 3 (STAT3), extracellular signal-regulated kinase 1-2 (ERK1-2), and αSMA. This study confirms the existence of a relationship between fatty liver disease and cardiac abnormalities and highlights the role of LC in controlling liver oxidative stress, steatosis, fibrosis, and NAFLD-associated cardiac dysfunction.

Qualitative data set from: The potential of micro-CT for dating post-cranial bone fractures: a macroscopic, radiographic, and microtomography stud