Human activities have raised the atmosphere’s carbon dioxide (CO₂) content by 50% in less than 200 years and by 10% in the last 15 years. Climate change is a great threat and presents a unique opportunity to protect cardiovascular health in the next decades. CO₂ equivalent emission is the most convenient unit for measuring the greenhouse gas footprint corresponding to ecological cost. Medical imaging contributes significantly to the CO₂ emissions responsible for climate change, yet current medical guidelines ignore the carbon cost. Among the common cardiac imaging techniques, CO₂ emissions are lowest for transthoracic echocardiography (0.5–2 kg per exam), increase 10-fold for cardiac computed tomography angiography, and 100-fold for cardiac magnetic resonance. A conservative estimate of 10 billion medical examinations per year worldwide implies that medical imaging accounts for approximately 1% of the overall carbon footprint. In 2016, CO₂ emissions from magnetic resonance imaging and computed tomography, calculated in 120 countries, accounted for 0.77% of global emissions. A significant portion of global greenhouse gas emissions is attributed to health care, which ranges from 4% in the United Kingdom to 10% in the United States. Assessment of carbon cost should be a part of the cost-benefit balance in medical imaging.

With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.

Epidemiological studies have reported adverse associations between long-term exposure to ambient particulate matter (PM_2.5) and several health outcomes. One issue in this field is exposure assessment and, in particular, the role of secondary PM_2.5, often neglected in environmental and health risk assessment. Thus, the aim of this work was to evaluate the long-term environmental and health impact of primary and secondary PM_2.5 concentrations originating from a single industrial source. As a case study, we considered a coal power plant which is a large emitter of both primary PM_2.5 and secondary PM_2.5 precursors. PM_2.5 concentrations were estimated using the Calpuff dispersion model. The health impact was expressed in terms of number of non-accidental deaths potentially attributable to the power plant. Results showed that the estimated secondary PM_2.5 extended over a larger area than that related to primary PM_2.5 with maximum concentration values of the two components well separated in space. Exposure to secondary PM_2.5 increased significantly the estimated number of annual attributable non-accidental deaths. Our study indicates that the impact of secondary PM_2.5 may be relevant also at local scale and ought to be considered when estimating the impact of industrial emissions on population health.

Numerical simulations compared with measurements are used to investigate the effect of sea breeze circulation on the ozone accumulation over a highly industrialized peninsula in southern Italy, where high levels of ozone concentration are often registered. A frequent meteorological phenomenon in this region during weak summer synoptic conditions is the development of complex sea breeze systems from the coastlines, with convergence areas within the peninsula. A case study characterized by strong winds alternating with sea breeze circulations was selected. The simulations show that during weak synoptic conditions, sea breezes transport ozone and its precursors over land from the sea, as well as from the coastlines where the largest industrialized districts are localized. The overlapping breezes lead to ozone accumulation in the area where sea breeze convergence occurs. This may explain the high values of ozone registered close to the sea breeze convergence lines. The comparison between predictions and experimental data indicates that the numerical system successfully reproduces both weather and ground level ozone concentration in different meteorological conditions, resulting in a fundamental tool for both scientific comprehension of the evolution of air contaminants and interpretation of the monitoring data. Copyright © 2009 Royal Meteorological Society

Gender medicine studies how health status and diseases differ between men and women in terms of prevention, therapeutic approach, prognosis, and psychological and social impact. Sex and gender analyses have been demonstrated to improve science, contributing to achieving real appropriateness and equity in the cure for each person. Therefore, it is fundamental to consider, both in preclinical and clinical research, the different clinical and biological features associated with sex and/or gender, where sex differences are mainly influenced by biological determinants and gender ones by socio-cultural and economic matters. This article was developed to provide knowledge and methodological tools for the development of studies/research protocols in which sex and gender should be taken into account.