Genomic insights into heart health: Exploring the genetic basis of cardiovascular disease.

Cardiovascular diseases (CVDs) are considered as the leading cause of death worldwide. CVD continues to be a major cause of death and morbidity despite significant improvements in its detection and treatment. Therefore, it is strategically important to be able to precisely characterize an individual's sensitivity to certain illnesses. The discovery of genes linked to cardiovascular illnesses has benefited from linkage analysis and genome-wide association research. The last 20 years have seen significant advancements in the field of molecular genetics, particularly with the development of new tools like genome-wide association studies. In this article we explore the profound impact of genetic variations on disease development, prognosis, and therapeutic responses. And the significance of genetics in cardiovascular risk assessment and the ever-evolving realm of genetic testing, offering insights into the potential for personalized medicine in this domain. Embracing the future of cardiovascular care, the article explores the implications of pharmacogenomics for tailored treatments, the promise of emerging technologies in cardiovascular genetics and therapies, including the transformative influence of nanotechnology. Furthermore, it delves into the exciting frontiers of gene editing, such as CRISPR/Cas9, as a novel approach to combat cardiovascular diseases. And also explore the potential of stem cell therapy and regenerative medicine, providing a holistic view of the dynamic landscape of cardiovascular genomics and its transformative potential for the field of cardiovascular medicine.

Dosimetric Comparison of Various Spot Placement Techniques in Proton Pencil Beam Scanning.

Purpose: To present quantitative dosimetric evaluations of five proton pencil beam spot placement techniques. Materials and Methods: The spot placement techniques that were investigated include two grid-based (rectilinear grid and hexagonal grid, both commonly available in commercial planning systems) and three boundary-contoured (concentric contours, hybrid, and optimized) techniques. Treatment plans were created for two different target volumes, one spherical and one conical. An optimal set of planning parameters was defined for all treatment plans and the impact of spot placement techniques on the plan quality was evaluated in terms of lateral/distal dose falloff, normal tissue sparing, conformity and homogeneity of dose distributions, as well as total number of spots used. Results: The results of this work highlight that for grid-based spot placement techniques, the dose conformity is dependent on target cross-sectional shape perpendicular to beam direction, which changes for each energy layer. This variable conformity problem is mitigated by using boundary contoured spot placement techniques. However, in the case of concentric contours, the conformity is improved but at the cost of decreased homogeneity inside the target. Hybrid and optimized spot placement techniques, which use contoured spots at the boundary and gridlike interior spot patterns, provide more uniform dose distributions inside the target volume while maintaining the improved dose conformity. The optimized spot placement technique improved target coverage, homogeneity of dose, and minimal number of spots. The dependence of these results on spot size is also presented for both target shapes. Conclusion: This work illustrates that boundary-contoured spot placement techniques offer marked improvement in dosimetry metrics when compared to commercially available grid-based techniques for a range of proton scanned beam spot sizes.

An optimized approach for robust spot placement in proton pencil beam scanning.

Maintaining a sharp lateral dose falloff in pencil beam scanning (PBS) proton therapy is crucial for sparing organs at risk (OARs), especially when they are in close proximity to the target volume. The most common approach to improve lateral dose falloff is through the use of physical beam shaping devices, such as brass apertures or collimator based systems. A recently proposed approach focuses on proton beam spot placements, moving away from traditional grid-based placements to concentric-contours based schemes. This improves lateral dose falloff in two ways: (1) by better conforming all spots to the tumor boundary and (2) allowing for 'edge enhancement', where boundary spots deliver higher fluence than more central spots, thereby creating a steeper lateral dose falloff. However, these benefits come at the expense of maintaining uniformity of spot distribution inside the target volume. In this work we have developed a new optimized spot placement scheme that provides robust spot distributions inside the target. This approach achieves the boundary conformity of a concentric-contours based approach and uses a fast-iterative method to distribute the interior spots in a highly uniform fashion in an attempt to improve both the lateral dose falloff and uniformity. Furthermore, we quantified the impact of this new approach through direct comparison with grid, contour, and hybrid spot placements schemes, showing improvements for this new approach. The results were validated in homogeneous medium for two different target shapes having concave and convex geometry.