Reply to Böning et al. Comment on "Ceruti et al. Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients. J. Clin. Med. 2022, 11, 788".

We would like to thank Böning et al. for all the important issues raised in the present commentary [...].

Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients.

Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tension at which hemoglobin is saturated by oxygen at 50%. The aim of this study was to analyze Hb-O2 affinity features over time in a cohort of critically ill COVID-19 patients, through the analysis of ODC p50 behavior. A retrospective analysis was performed; through multiple arterial blood gas (ABG) analyses, each p50 was calculated and normalized according to PaCO2, pH and temperature; patients' p50 evolution over time was reported, comparing the first 3 days (early p50s) with the last 3 days (late p50s) of ICU stay. A total of 3514 ABG analyses of 32 consecutive patients were analyzed. The majority of patients presented a left shift over time (p = 0.03). A difference between early p50s and late p50s was found (20.63 ± 2.1 vs. 18.68 ± 3.3 mmHg, p = 0.03); median p50 of deceased patients showed more right shifts than those of alive patients (24.1 vs. 18.45 mmHg, p = 0.01). One-way ANOVA revealed a p50 variance greater in the early p50s (σ2 = 8.6) than in the late p50s (σ2 = 3.84), associated with a reduction over time (p < 0.001). Comparing the Hb-O2 affinity in critically ill COVID-19 patients between ICU admission and ICU discharge, a temporal shift in the ODC was observed.

A Neapolitan miracle.

The Italian scientific renaissance, that started when the Second World War was drawing to a close and reached its apex early in the Sixties--is widely discussed in literature. But there is also a second, maybe less visible but not less important renaissance in the Italian scientific world of the Fifties and Sixties: the Neapolitan renaissance, in which biophysics plays an important role.

Perspectives on Open Science and scientific data sharing:an interdisciplinary workshop.

Looking at Open Science and Open Data from a broad perspective. This is the idea behind "Scientific data sharing: an interdisciplinary workshop", an initiative designed to foster dialogue between scholars from different scientific domains which was organized by the Istituto Italiano di Antropologia in Anagni, Italy, 2-4 September 2013.We here report summaries of the presentations and discussions at the meeting. They deal with four sets of issues: (i) setting a common framework, a general discussion of open data principles, values and opportunities; (ii) insights into scientific practices, a view of the way in which the open data movement is developing in a variety of scientific domains (biology, psychology, epidemiology and archaeology); (iii) a case study of human genomics, which was a trail-blazer in data sharing, and which encapsulates the tension that can occur between large-scale data sharing and one of the boundaries of openness, the protection of individual data; (iv) open science and the public, based on a round table discussion about the public communication of science and the societal implications of open science. There were three proposals for the planning of further interdisciplinary initiatives on open science. Firstly, there is a need to integrate top-down initiatives by governments, institutions and journals with bottom-up approaches from the scientific community. Secondly, more should be done to popularize the societal benefits of open science, not only in providing the evidence needed by citizens to draw their own conclusions on scientific issues that are of concern to them, but also explaining the direct benefits of data sharing in areas such as the control of infectious disease. Finally, introducing arguments from social sciences and humanities in the educational dissemination of open data may help students become more profoundly engaged with Open Science and look at science from a broader perspective.

[Epidemiological imaginary in Campania Region]. / L'immaginario epidemiologico in Campania.

The interviews on the epidemiological imaginary, collected within the framework of the project Sebiorec,(1) clearly demonstrate that also in Campania, on the border between the provinces of Naples and Caserta - where the issue of waste and land devastation take forms that are unprecedented compared to any other part of Europe - there is a widespread, strong, sacrosanct demand of participation in environment and health management. The request of deliberative ecological democracy is pressing.(2) There is an urgent need to meet that plethora of rights emerging in the "knowledge society" and in the "risk society" that someone has called "rights for scientific citizenship."(3) This request of the population of Campania, net of local cultural specificity, it is quite similar to that of the people of any other region of Europe. The context in which this request of participation is expressed, however, is quite different. Not only and not just for that real or perceived social pre-modern and familist web that would replace a modern civil society in Campania and all across the Southern Italian regions, but also and especially for some structural causes that we here try to list. Campania is a unique region in Europe - in many ways different even from other regions of southern Italy - due to the conjunction of at least five factors, not independent from each other. 1) The presence of a widespread organized crime which, in many areas, metropolitan and non-metropolitan alike, and especially in the provinces of Naples and Caserta, is a sort of state against the State and has one of its main levers of power and a major source of its wealth in the illegal control of the territory, in its different dimensions (military, but also economic, social and even cultural). 2) A huge social and economic disintegration, exacerbated in the last twenty years by a process of deindustrialization (until the early nineties Naples was the fifth industrial city of Italy, today it is a desert where few productive oases survive) that has had few parallels in Europe and that, unlike other areas of the Old Continent, where the old manufacturing industries were closed, has not seen any serious plan to realize policy renewal and a reconstruction of its economy. 3) A huge population density, which makes at least part of the Campania region - particularly in the area straddling the provinces of Naples and Caserta - one single "in-finite" city, an "in-complete" megalopolis in which there is no solution of continuity between the rural and urban realities; in which cities, towns and countryside are piled up without order - without any order, because in the past, even in the recent past, that order somehow existed; houses, warehouses, roads and farmland, cement, fields, unauthorized dumping sites and again cement, in a state of chaos and, often, of deterioration that is, once again, almost unique in Europe. 4) The contemporary presence of two large migration flows, one incoming (usually non-EU), the other outgoing (with a very high number of migrant graduates), are interwoven in a way chaotic to further contributing to tear the already tattered social fabric. 5) Last but not least, the authoritative answer of the State that, in its various forms, now explicitly (through laws and decrees) now implicitly (through activities or omissions of bureaucracies) effectively inhibits at all levels the demand of participation, of transparency and even of simple information. The authoritarianism of the State and its bureaucracies was recently only scratched by the evolution of the local and national political events.

Anomalous origin of the coronary arteries in children: diagnostic role of three-dimensional coronary MR angiography.

When the anomalous origin of coronary arteries (AOCA) is suspected in children (especially athletes), due to signs and symptoms of myocardial ischemia or on the basis of echocardiographic assessment, three-dimensional coronary magnetic resonance angiography (3D-CMRA) can be proposed for the fine morphological evaluation of coronary branches anatomy and course. We tested the diagnostic potential of CMRA angiography in a prospective study on AOCA in young patients. Between July 2005 and June 2008, 15 patients aged 6-29 years (mean age, 13.5 years+/-5.6 S.D.; median, 14) with clinical and echocardiographic suspicion of AOCA underwent CMRA (1.5 T), 3D whole-heart, free-breathing technique, without the use of contrast medium and beta-blockers, with a mean examination time of 30 min. We acquired a second scan of all patients to ameliorate the quality of the acquisition and to improve our experience. AOCA was confirmed by 3D-CMRA in 8 out of 15 cases (53%) and three different anatomical variants were demonstrated, that is, ectopic origin of the left circumflex artery arising from the right coronary artery with retro-aortic course in four cases, single coronary artery arising from the right sinus of Valsalva with interarterial course in one case, ectopic right coronary artery arising from the left sinus of Valsalva with interarterial course in one case; in two patients without anomalies of origin of the coronary arteries, elongated LMCA with angulation of the proximal segment of the left circumflex artery was present. When AOCA is suspected particularly in children (especially athletes), CMRA without the use of contrast medium is an effective diagnostic technique, which is useful to clarify the spatial position of the anomalous course of the main coronary branches in order to suggest the most convenient management of the disease. CMRA does not need contrast medium, needles, and beta-blockers; is repeatable in the same examination without the exposure to X-rays; allows a parent to stay near the child; and needs low collaboration in low-stress conditions.

Indoor exposure to environmental tobacco smoke and dampness: respiratory symptoms in Sardinian children--DRIAS study.

Indoor exposures at home, environmental tobacco smoke (ETS) and mould/dampness adversely affect respiratory health of children. Disturbi Respiratori nell'Infanzia e Ambiente in Sardegna (DRIAS) (Respiratory Symptoms in children and the Environment in Sardegna, Italy) aims at relating the prevalence of respiratory and allergic symptoms to indoor exposures in Sardinian children. DRIAS, a cross-sectional investigation of respiratory symptoms/diseases, used a modified version of ISAAC questionnaire, included 4122 children attending 29 primary schools in the school year 2004-2005. If both parents smoke the prevalence for current wheeze and current asthma is almost doubled in comparison with never smokers, for persistent cough and phlegm a role is suggested when only mother smokes. Among mothers smoking in pregnancy, the prevalence of current wheeze and current asthma is increased. Exposure to ETS and family atopy have a joint effect resulting in an almost tripling of prevalence for current wheeze and more than four times for current asthma. Exposure to "dampness" (mould or dampness) both during the first year of life and currently is associated with increased prevalence of current wheeze, persistent cough or phlegm and current rhino-conjunctivitis; if exposure is only during the first year of life a doubling or more of prevalence is observed for current wheeze, current asthma, and persistent cough or phlegm. DRIAS results add evidence to the causal role of childhood exposure to ETS in the development of respiratory symptoms (cough, phlegm, and wheezing) and asthma. The joint effect of ETS and family atopy is corroborated. The results strengthen the evidence for a causal association between "dampness" and respiratory health, pointing to its possible independent role in causing asthma, a long-lasting exposure entails a doubled prevalence for both asthmatic and bronchitis symptoms.

Multidetector computed tomography and 2- and 3-dimensional postprocessing in the evaluation of congenital thoracic vascular anomalies.

OBJECTIVE: We report examples of congenital anomalies of the thoracic vessels studied with multidetector computed tomography (MDCT), with special respect to bidimensional (2D) and 3-dimensional (3D) postprocessing. METHODS: Nonselected patients with vascular and nonvascular disorders underwent chest MDCT with the use of a 16-row scanner. Postprocessing was done to obtain 2D and 3D postprocessing images. CONCLUSION: MDCT with 2D and 3D postprocessing is helpful in evaluating complex vascular congenital anomalies of the chest.

The COPD Italian Lung Information Needs Questionnaire (LINQ): development, preliminary validation, and findings.

Chronic obstructive pulmonary disease (COPD) patients have poor knowledge about the disease. Until now, it has not been possible to check the information needs of these patients. The Lung Information Needs Questionnaire (LINQ), however, could fill this particular need. The aims of this study were to identify patient perceptions about COPD, and what information patients need, and to verify whether the questionnaire is comprehensible. Data demonstrate that LINQ is easily understood: 82% answered all questions with "I have properly understood the question". LINQ is quick to apply (approx. 6 min to complete). Sixty-seven per cent of patients had incorrect knowledge about their prognosis. Thirty-six per cent did not know when to call an ambulance. Eight per cent of smokers said that no one had ever told them to stop smoking. Compliance with therapy results was not sufficient. Patients had poor knowledge of the causes of COPD, and they knew little about the whys and wherefores of COPD treatment. LINQ represents a valid means of investigating patients afflicted with COPD and managing pathology control by the doctor and by the patient. LINQ represents a fundamental means of investigating otherwise-unknown COPD issues.

Multi-slice computed tomography and the detection of anomalies of coronary arteries.

OBJECTIVES: Congenital anomalies of the coronary arteries, even if rare, may have sudden death or myocardial infarction as the first clinical manifestations: thus, it is clear that an early diagnosis has a paramount importance for patients at risk. We present a set of cases advocating the use of multi-slice computed tomography (MSCT) in the detection of coronary artery anomalies. The majority of cases had previously undergone conventional coronary angiography, which, despite being considered the gold standard for the diagnosis of the coronary artery pathologies, often yielded incomplete results. METHODS: In 439 consecutive patients examined over 22 months by MSCT for the study of heart and coronary arteries, 11 were diagnosed for anomalous coronary artery. All patients were symptomatic for one or more of the following: chest pain, dyspnoea, palpitations, myocardial infarction and resuscitated cardiac arrest. Eight patients had previously undergone a coronary angiography. RESULTS: In the selected patients, seven different types of coronary anomalies were found by MSCT examination. In all cases, this technique was able to recognize the origin of the anomalous coronary artery, its three-dimensional course and its spatial relationship with the adjacent structures, even when conventional coronary angiography was performed but was unable to provide sufficient information for a correct and complete diagnosis. CONCLUSIONS: MSCT is an accurate technique for detecting coronary artery anomalies and visualizing their three-dimensional origin and course, and their relationship with the great vessels. It may be considered as the first-choice imaging modality when an anomalous coronary artery is suspected.

[Role of multidetectori compted tomography angiography and three-dimensional post-processing in a case of a Valsalva graft in aortic valve repair and replacement with the Cabrol procedure]. / Ruolo dell'angio-tomografia multidetettore e del post-processing tridimensionale in un caso di ectasia aortica corretta secondo la tecnica di Cabrol.

Patients with combined valvular-aortic disease undergo surgical reconstruction of the aortic root with a valved composite graft. Two of the techniques used to replace the aortic valve and ascending aorta are Bentall and Cabrol procedures. Cabrol surgical procedure uses a Dacron tube that enables coronary artery revascularization. Graft limb occlusion may however occur. Digital subtraction angiography, magnetic resonance angiography and multidetector computed tomography angiography are useful imaging methods for the evaluation of surgical-related complications. We report the case of a patient treated by the Cabrol technique, who was studied with contrast-enhanced multidetector computed tomography angiography to evaluate long-term post-surgical complications and coronary vessels patency.

Noninvasive evaluation of a fistula between a giant coronary aneurysm and coronary sinus performed via multidetector row computed tomography.

Coronary artery fistula (CAF) is an uncommon anomaly of congenital and rarely iatrogenic etiology. Most of the patients are asymptomatic, and the anomaly is incidentally recognized during a coronary angiography performed for other reasons. Also, coronary artery aneurysms are rare. We report a case of CAF associated with a giant aneurysm evaluated using multidetector row computed tomography.