Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy

OBJECTIVES: To investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city. METHODS: Citizens of Varese aged 6518 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1\u2009\ub5g/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models. RESULTS: The 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5\u2009\ub5g/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95%\u2009CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models. CONCLUSIONS: Long-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue

Prognosis based on primary breast carcinoma instead of pathological nodal status.

In breast cancer patients, prognostic information required to plan post-surgical therapy is obtained mainly through axillary dissection. This study was designed to establish a new prognostic score based solely on parameters of the primary tumour as an alternative to axillary surgery in assessing prognosis. Eight different prognostic factors, including menopausal status, tumour size, grading, lymphatic invasion, desmoplasia, necrosis, c-erbB-2 and laminin receptor expression, were evaluated retrospectively on a large series of primary breast carcinoma patients. From multivariate analysis, four independent parameters were selected and examined, alone and in combination, for their prognostic potential. These parameters were used to generate a prognostic score that was analysed retrospectively in 467 N0-N1a patients to determine its predictive value for survival. The score, which includes variables such as tumour size, grading, laminin receptor and c-erbB-2 overexpression, was established based on the number of negative prognostic factors: score 1 refers to cases in which all four parameters reflect a good prognosis, scores 2 and 3 refer to tumours in which, respectively, one or two of the four parameters reflect a poor prognosis, whereas score 4 refers to tumours with three or four poor prognosis factors. Analysis of the overall survival of the four score groups shows that patients with score 1 tumours (22% of the total) had the best prognosis with a 15 year survival of 82%, patients with score 2 and 3 had an intermediate prognosis, whereas score 4 patients had the poorest prognosis with a 15 year survival of only 38%. Moreover, survival in the N+ score 1 cases was found to be longer than that in the total N- patients. Our data suggest that the primary tumour score provides more reliable prognostic information than pathological nodal status, and that axillary dissection can be avoided in a large number of patients

Chemodivergent Photocatalytic Synthesis of Dihydrofurans and β,γ-Unsaturated Ketones

A synthetic procedure, catalysed by Ir(ppy)3 under visible-light irradiation, for the chemodivergent synthesis of 2,3-dihydrofurans (3) or β,γ-unsaturated ketones (7) starting from α-halo ketones (1) and alkenes (2) has been developed. The mild reaction conditions and the redox-neutral nature of the process make it particularly sustainable avoiding the use of both sacrificial reactants and stoichiometric strong oxidants. Careful experimental investigations, supported by DFT calculations, allowed to disclose in details a possible mechanistic pathway and to direct the synthesis chemodivergently either toward 3 or 7, depending not only on the nature of the substrates, but also on the choice of the experimental conditions. (Figure presented.)

Italian randomized trial among womenwith histerectomy: tamoxifen and hormone-dependent breast cancer in hight-risk women

Abstract Tamoxifen improves outcome in women with breast cancer and reduces the incidence of estrogen receptor-positive (ER+) breast tumors in prevention trials. Tamoxifen use is associated with an increased risk of potentially serious adverse events, principally endometrial cancer and venous thromboembolic events and, therefore, detailed knowledge of the effects of tamoxifen is important. With more cases of breast cancer being found as the follow-up time increases, it is now possible to perform more detailed analysis of the Italian Randomized Trial of Tamoxifen. Women with hysterectomy (N = 5408) were randomly assigned to receive 20 mg tamoxifen per day (N = 2700) or placebo (N = 2708). After a median of 81.2 months of follow-up, 79 case subjects (34 in the tamoxifen arm and 45 in the placebo arm) were diagnosed with breast cancer. We were able to identify a group of women at increased risk of ER+ breast cancers (high-risk group) on the basis of baseline as well as reproductive and hormonal characteristics (height, age at menarche, parity, age at first birth, and oophorectomy). Tamoxifen administered to women in the high-risk group showed statistically significantly reduced incidence of breast cancer (tamoxifen, 3 and placebo, 15; P =.003), but no such effect was seen in the low-risk group (tamoxifen, 31 and placebo, 30; P =.89). The positive effect of tamoxifen on breast cancer among high-risk women is most marked for ER+ tumors (tamoxifen, 1 and placebo, 11; P =.002). Chemoprevention of breast cancer with tamoxifen appears to be effective in women at high risk of ER+ tumors but not among women at low risk, who may well be protected naturally by late age at menarche or early first pregnancy, or artificially by removal of the ovaries. Tamoxifen could be offered as a preventive agent to women identified at high-risk of breast cancer because of hormone-related risk factors. Such a strategy would greatly reduce the numbers of women who would need to take tamoxifen to obtain the same absolute reduction in breast cancer. These findings are exploratory and need to be confirmed in other randomized trials

Allenamides Playing Domino: A Redox-Neutral Photocatalytic Synthesis of Functionalized 2-Aminofurans

A photoredox catalytic synthesis of functionalized 2-aminofurans is proposed starting from α-halo carbonyl substrates and N-allenamides. The protocol proves to be efficient and sustainable thanks to: i) the use of visible light as green energy source, ii) the redox-neutral nature of the transformation, allowing to avoid additives and strong oxidants, iii) the mild reaction conditions and the functional groups tolerance, iv) the low photocatalyst loading and the absence of excess reagents, v) the one-pot formation of three new bonds in a domino sequence. According to our mechanistic hypothesis, the transformation is configured as a double radical-polar crossover reaction, in which the photocatalyst is excited, oxidized and reduced twice for each molecule of 2-aminofuran produced. The novelty of the designed synthetic approach also lies in the use of N-allenamides as substrates, which, after the addition of the first electrophilic radical, preserve a further reactive π-system, making possible the addition of a second α-keto radical and enabling the installation of a keto functionality at a remote position. The good yields, the broad scope, and the possibility to further synthetically elaborate the obtained furans make this protocol particularly promising for the construction of useful products. (Figure presented.)

Analysis of local and regional recurrences in breast cancer after conservative surgery

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Advantages of manual and automatic computer-aided compared to traditional histopathological diagnosis of melanoma: A pilot study

Background: Cutaneous malignant melanoma (CMM) accounts for the highest mortality rate among all skin cancers. Traditional histopathologic diagnosis may be limited by the pathologists’ subjectivity. Second-opinion strategies and multidisciplinary consultations are usually performed to overcome this issue. An available solution in the future could be the use of automated solutions based on a computational algorithm that could help the pathologist in everyday practice. The aim of this pilot study was to investigate the potential diagnostic aid of a machine-based algorithm in the histopathologic diagnosis of CMM. Methods: We retrospectively examined excisional biopsies of 50 CMM and 20 benign congenital compound nevi. Hematoxylin and eosin (H&E) stained WSI were reviewed independently by two expert dermatopathologists. A fully automated pipeline for WSI processing to support the estimation and prioritization of the melanoma areas was developed. Results: The spatial distribution of the nuclei in the sample provided a multi-scale overview of the tumor. A global overview of the lesion's silhouette was achieved and, by increasing the magnification, the topological distribution of the nuclei and the most informative areas of interest for the CMM diagnosis were identified and highlighted. These silhouettes allow the histopathologist to discriminate between nevus and CMM with an accuracy of 96% without any extra information. Conclusion: In this study we proposed an easy-to-use model that produces segmentations of CMM silhouettes at fine detail level

Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial. Italian Chemoprevention Group.

The combination of tamoxifen and transdermal hormone replacement therapy (HRT) may potentially reduce risks and side-effects of either agent, but an adverse interaction could attenuate their beneficial effects. We assessed the effects of their combination on cardiovascular risk factors within a prevention trial of tamoxifen. Baseline and 12-month measurements of total, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, platelets and white blood cells were obtained in the following four groups: tamoxifen (n = 1117), placebo (n = 1112), tamoxifen and HRT (n = 68), placebo and HRT (n = 87). The analysis was further extended to women who were on HRT at randomization but discontinued it during the 12-month intervention period (n = 33 on tamoxifen and n = 35 on placebo) and to women who were not on HRT but started it during intervention (n = 36 in both arms of the study). Compared with small changes in the placebo group, tamoxifen was associated with changes in total, LDL- and HDL-cholesterol of approximately -9%, -19% and +0.2% in continuous HRT users compared with -9%, -14% and -0.8% in never HRT users. Similarly, there was no interaction on platelet count. In contrast, the decrease in total and LDL-cholesterol levels induced by tamoxifen was blunted by two-thirds in women who started HRT while on tamoxifen (P = 0.051 for the interaction term). We conclude that the beneficial effects of tamoxifen on cardiovascular risk factors are unchanged in current HRT users, whereas they may be attenuated in women who start transdermal HRT while on tamoxifen. Whereas a trial of tamoxifen in women already on transdermal HRT is warranted, prescription of HRT during tamoxifen may attenuate its activity

“Els primers dies” herramienta de integración para chicos y chicas extranjeros

La gran cantidad de chicos y chicas de otros países que en este momento se escolarizan en los Institutos de Cataluña, hace que profesionales de diferentes áreas se planteen cuáles son las dificultades con las que se encuentran y, busquen establecer vínculos eficaces para la inmersión de estos jóvenes en el ambiente educativo y social del país. Es evidente que para todos ellos, la principal dificultad es la lengua, para poder comunicarse con los amigos, con los profesores... Pero no debemos olvidar tampoco, que ellos y ellas hablan ya una lengua y han aprendido unas pautas culturales en su país de origen. También conviene recordar que no se trata de niños pequeños y por lo tanto, no deben aprender con soportes o frases infantiles, aunque la imagen y el sonido son elementos importantísimos en su aprendizaje. Un equipo formado por psicopedagogos, profesorado de secundaria y estudiosos de la lengua, conscientes de la situación, han diseñado un instrumento muy pautado en su primer momento que va abriéndose progresivamente, el cual permite un acercamiento informático visual y acústico a los aspectos más cotidianos de la vida juvenil. Ya sea en forma cooperativa o de autoaprendizaje.Eje: Educación psicosocial / Atención a la diversidadRed de Universidades con Carreras en Informática (RedUNCI