Search

In this review, sex, racial, and ethnic differences in acute coronary syndromes on a global scale are summarized. The relationship between disparities in presentation and management of acute coronary syndromes and effect on worse clinical outcomes in acute coronary syndromes are discussed. The effect of demographic, geographic, racial, and ethnic factors on acute coronary syndrome care disparities are reviewed. Differences in risk factors including systemic inflammatory disorders and pregnancy-related factors and the pathophysiology underlying them are discussed. Finally, breast arterial calcification and coronary calcium scoring are discussed as methods to detect subclinical atherosclerosis and start early treatment in an attempt to prevent clinical disease.

Introduction: Breast cancer is the most common tumor in women and represents the leading cause of cancer death. Radiation therapy plays a key-role in the treatment of all breast cancer stages. Therefore, the adoption of evidence-based treatments is warranted, to ensure equity of access and standardization of care in clinical practice.Method: This national document on the highest evidence-based available data was developed and endorsed by the Italian Association of Radiation and Clinical Oncology (AIRO) Breast Cancer Group. We analyzed literature data regarding breast radiation therapy, using the SIGN (Scottish Intercollegiate Guidelines Network) methodology (www.sign.ac.uk). Updated findings from the literature were examined, including the highest levels of evidence (meta-analyses, randomized trials, and international guidelines) with a significant impact on clinical practice. The document deals with the role of radiation therapy in the treatment of primary breast cancer, local relapse, and metastatic disease, with focus on diagnosis, staging, local and systemic therapies, and follow up. Information is given on indications, techniques, total doses, and fractionations.Results: An extensive literature review from 2013 to 2021 was performed. The work was organized according to a general index of different topics and most chapters included individual questions and, when possible, synoptic and summary tables. Indications for radiation therapy in breast cancer were examined and integrated with other oncological treatments. A total of 50 questions were analyzed and answered. Four large areas of interest were investigated: (1) general strategy (multidisciplinary approach, contraindications, preliminary assessments, staging and management of patients with electronic devices); (2) systemic therapy (primary, adjuvant, in metastatic setting); (3) clinical aspects (invasive, non-invasive and micro-invasive carcinoma; particular situations such as young and elderly patients, breast cancer in males and cancer during pregnancy; follow up with possible acute and late toxicities; loco-regional relapse and metastatic disease); (4) technical aspects (radiation after conservative surgery or mastectomy, indications for boost, lymph node radiotherapy and partial breast irradiation). Appendixes about tumor bed boost and breast and lymph nodes contouring were implemented, including a dedicated web application. The scientific work was reviewed and validated by an expert group of breast cancer key-opinion leaders.Conclusions: Optimal breast cancer management requires a multidisciplinary approach sharing therapeutic strategies with the other involved specialists and the patient, within a coordinated and dedicated clinical path. In recent years, the high-level quality radiation therapy has shown a significant impact on local control and survival of breast cancer patients. Therefore, it is necessary to offer and guarantee accurate treatments according to the best standards of evidence-based medicine.

(Abstracted from Prenat Diagn2022;42:1575–1586Methods for diagnosis of genetic abnormalities have recently undergone substantial improvement. Noninvasive prenatal testing (NIPT) is performed early in pregnancy, typically at the end of the first trimester using cell-free DNA (cfDNA) to identify 3 commonly occurring trisomies (13, 18, and 21).

Satellite remote sensing of aerosol is largely conducted at moderate or coarse spatial resolution around 1–10 km. Nevertheless, at urban areas with high human activity, aerosol can originate from complex emission sources and may also vary strongly in space. Therefore, aerosol characterization at fine spatial resolution is essential for air quality study and assessment of anthropogenic pollution as well as climate effects. However, space‐borne instruments with high spatial resolution are usually limited in swath width or spectral coverage which result in lowering information content required for aerosol and surface retrieval. Based on the Generalized Retrieval of Atmosphere and Surface Properties (GRASP) algorithm, we propose a hybrid approach by combining fine and coarse spatial resolution measurements to retrieve aerosol and surface properties simulataneously at fine spatial resolution. The instruments with coarse spatial resolution and high revisting time can provide advanced aerosol characterization. At the same time, the instruments with fine spatial resolution are sensitive to spatial variability of aerosol nearby sources. In this study, the GRASP/Hybrid approach is demonstrated and tested based on the European Space Agency Sentinel‐5p/TROPOMI together with the Italian Space Agency PRISMA satellite data. Specifically, the detailed aerosol microphysical properties from Sentinel‐5p/TROPOMI 10 km retrievals are used as a priori information for PRISMA to derive aerosol loading and surface properties at 100 meter (m) spatial resolution. The PRISMA 100 m aerosol and surface retrieval based on the developed GRASP/Hybrid approach are evaluated using available ground‐based and satellite measurements, including AERONET, VIIRS/DB aerosol and PRISMA Level 2 surface reflectance products. Both aerosol and surface characterization at high spatial resolution are always highly demanded especially over densely populated urban areas. However, the high spatial resolution space‐borne instruments typically have small swaths that, in general, reduce the possibility of aerosol and surface decoupling. In this paper, we develop a hybrid approach based on GRASP algorithm (GRASP/Hybrid) to retrieve aerosol and surface properties at fine spatial granularity by combining fine and coarse spatial resolution satellite data. The GRASP/Hybrid approach is demonstrated using European Space Agency (ESA) Sentinel‐5p/TROPOMI and Italian Space Agency (ASI) PRISMA (Hyperspectral Precursor of the Application Mission) measurements. Specifically, the detailed aerosol microphysical properties from Sentinel‐5p/TROPOMI 10 km retrievals are used as a priori information to derive aerosol loading and surface properties exploiting PRISMA at 100 m spatial resolution. Overall, the results obtained in this study demonstrate the big potential of the approach based on the combination of instruments for a number of climate and environment monitoring studies. Generalized Retrieval of Atmosphere and Surface Properties (GRASP)/Hybrid approach is developed and demonstrated using Sentinel‐5p/TROPOMI and PRISMA measurementsPRISMA 100 m aerosol and surface properties are retrieved based on GRASP/Hybrid approach and evaluated using reference data setsWe demonstrate the big potential of hybrid approach based on the combination of instruments for climate and environment studies Generalized Retrieval of Atmosphere and Surface Properties (GRASP)/Hybrid approach is developed and demonstrated using Sentinel‐5p/TROPOMI and PRISMA measurements PRISMA 100 m aerosol and surface properties are retrieved based on GRASP/Hybrid approach and evaluated using reference data sets We demonstrate the big potential of hybrid approach based on the combination of instruments for climate and environment studies

The phenotype of early embryonic fourth branchial arch defects encompasses a wide spectrum of clinical conditions including DiGeorge syndrome (DGS), velocardiofacial syndrome, and conotruncal anomaly face syndrome. The majority of the patients have a 22q11.2 deletion. However, in 6% to 17% of patients, the identification of a genetic cause remains unknown through fluorescence in situhybridization. In these patients, the clinical features and the immunological abnormalities are not well defined.