Search Results (239)

Background: In nuclear medicine, numerous cancer types are treated via internal irradiation with radiopharmaceuticals, including low-LET (linear energy transfer) beta-emitting radionuclides like Lu-177. In most cases, such treatments lead to low-dose exposure of organ systems with β-irradiation, which induces only few isolated DSBs (double-strand breaks) in the nuclei of hit cells, the most threatening DNA damage type. That damaging effect contrasts with the clustering of DNA damage and DSBs in nuclei traversed by high-LET particles (α particles, ions, etc.). Methods: After in-solution β-irradiation for 1 h with Lu-177 leading to an absorbed dose of about 100 mGy, we investigated the spatial nano-organization of chromatin at DSB damage sites, of repair proteins and of heterochromatin marks via single-molecule localization microscopy (SMLM) in PBMCs. For evaluation, mathematical approaches were used (Ripley distance frequency statistics, DBScan clustering, persistent homology and similarity measurements). Results: We analyzed, at the nanoscale, the distribution of the DNA damage response (DDR) proteins γH2AX, 53BP1, MRE11 and pATM in the chromatin regions surrounding a DSB. Furthermore, local changes in spatial H3K9me3 heterochromatin organization were analyzed relative to γH2AX distribution. SMLM measurements of the different fluorescent molecule tags revealed characteristic clustering of the DDR markers around one or two damage foci per PBMC cell nucleus. Ripley distance histograms suggested the concentration of MRE11 molecules inside γH2AX-clusters, while 53BP1 was present throughout the entire γH2AX clusters. Persistent homology comparisons for 53BP1, MRE11 and γH2AX by Jaccard index calculation revealed significant topological similarities for each of these markers. Since the heterochromatin organization of cell nuclei determines the identity of cell nuclei and correlates to genome activity, it also influences DNA repair. Therefore, the histone H3 tri methyl mark H3K9me3 was analyzed for its topology. In contrast to typical results obtained through photon irradiation, where γH2AX and H3K9me3 markers were well separated, the results obtained here also showed a close spatial proximity (“co-localization”) in many cases (minimum distance of markers = marker size), even with the strictest co-localization distance threshold (20 nm) for γH2AX and H3K9me3. The data support the results from the literature where only one DSB induced by low-dose low LET irradiation (<100 mGy) can remain without heterochromatin relaxation for subsequent repair. Full article

Background: In malignant pleural mesothelioma, epithelioid histology is traditionally considered a favorable prognostic marker. However, it remains clinically undetermined whether the intensity of an oncogenic insult can disrupt this link. Radiation-induced cases serve as an unconfounded biological model to dissect such trajectories masked by asbestos confounding. Methods: We performed an Individual Patient Data (IPD) synthesis of 20 strictly asbestos-unexposed human cases, applying clinically established dose stratification (intermediate: 20–45 Gy vs. high: >45 Gy). To confirm the observed pattern, we examined data from 829 dogs in the Colorado State University (CSU) Beagle Study. Results: In the intermediate-dose group (n = 13), a significant positive correlation persisted between age at radiotherapy and the latent period (ρ = 0.567, p = 0.043). Conversely, high-dose exposure (>45 Gy) showed a disruption of this age-dependent pattern, with a trend toward inverse correlation (ρ = −0.754, p = 0.084). Interaction analysis confirmed a statistically significant divergence between these dose-dependent trends (p = 0.005). The CSU Beagle Study (n = 829) demonstrated the physical basis of this phenomenon: in the canine model, high-dose exposure (≥0.74 Gy) triggered a “Step-Jump” in cumulative incidence (30.4% at 0.5 years), indicating instantaneous carcinogenic onset distinct from cumulative biological aging. Conclusions: This kinetic divergence points to a “Diagnostic Trap.” We propose a ‘Single- to Double-Brake’ framework where intermediate doses preserve age-dependent progression, whereas high doses likely trigger catastrophic genomic failure (chromothripsis) that bypasses the time required for morphological dedifferentiation. Consequently, morphologically indolent epithelioid tumors in high-dose survivors may harbor aggressive molecular profiles not predicted by histology alone, necessitating risk-stratified precision surveillance. Full article

This study assessed elemental exposure and health risks in 35 prepared livestock and poultry dishes from Zhejiang Province using inductively coupled plasma mass spectrometry (ICP-MS). Aluminum (Al) showed the highest concentrations, while strontium (Sr) and barium (Ba) were moderate; other elements (molybdenum (Mo), chromium (Cr), lead (Pb), cadmium (Cd), thallium (Tl), cobalt (Co), arsenic (As)) were low; and nickel (Ni) was undetected. All dishes complied with GB 2762-2022 limits. Although seven dishes showed mild-to-moderate single-factor contamination, Nemerow indices confirmed safe levels (P_c < 0.7). Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA) indicated that processing methods drove contamination profiles, with deep-fried products accumulating higher metal levels than stir-fried or boiled ones. While non-carcinogenic risks were acceptable for adults, children showed higher susceptibility with Total Target Hazard Quotients (TTHQ) values nearly double those of adults, exceeding safety thresholds in certain dishes primarily due to As and Cr. Carcinogenic risks for hexavalent chromium (Cr(VI)) and inorganic arsenic (iAs) were acceptable (1 × 10⁻⁶ to 1 × 10⁻⁴) for 32 dishes. After speciation-based recalibration, the remaining three dishes also fell within safe limits. Overall, exposure risks are low, though specific deep-fried products warrant monitoring. Full article

Background: Prehospital emergency professionals are exposed to high psychosocial demands that may impact their mental health, but pre-COVID-19 baseline data from Spanish services are scarce. This study aimed to assess the general health and psychosocial risk factors in a regional prehospital emergency service before the COVID-19 pandemic. Methods: We conducted a cross-sectional descriptive study (September–December 2019) including 51 physicians, nurses, and emergency medical technicians working at the 061 Health Emergency Center in Granada (Andalusia, Spain). General health and chronic problems were assessed with the Goldberg General Health Questionnaire (GHQ-28/CGHQ-28), and work-related psychosocial risks were evaluated using the COPSOQ-ISTAS21 questionnaire. Descriptive statistics, group comparisons, and exploratory Spearman correlations between health indicators and psychosocial dimensions were performed. Results: Most participants reported good self-perceived general health, but the chronic coding of the GHQ (CGHQ-28) indicated long-term difficulties mainly related to social dysfunction, somatic symptoms, and anxiety/insomnia. Exposure to unfavorable psychosocial risk was frequent, particularly in psychological demands, double presence (work–family conflict), and low esteem, with intermediate–unfavorable patterns in active job/development, insecurity, and social support/leadership. Exploratory correlations suggested that double presence was the psychosocial factor most consistently associated with chronic distress. Conclusions: In this pre-COVID-19 cohort of prehospital emergency professionals, good perceived general health coexisted with chronic psychological strain and high exposure to adverse psychosocial work factors. These findings support the need for organizational measures to reduce psychological demands and work–family conflict and to strengthen social support and leadership in prehospital emergency teams. Full article

The growing production and use of silver nanoparticles continues to raise questions about their consequences for human and animal health. The method of production, particle stabilization, particle size, concentration, and duration of exposure to cells can affect their reactivity and, consequently, their toxicity. This study was conducted to determine the degree of harmfulness of colloidal silver compounds, including silver nanoparticles produced via the HVAD method, to mitotic chromosomes in chinchilla’s cells. Thanks to the sister chromatid exchange (SCE) test, chromosome damage during cell division, i.e., the actual toxic effect of the tested compounds, could be assessed. For this purpose, whole peripheral blood from chinchillas was exposed in vitro to three colloidal silver compounds (unstable AgNP-HVAD, sodium citrate-stabilized silver nanoparticles—[AgNP+C], and silver nitrate) for 3, 6, and 24 h. The toxicity of these compounds was assessed at concentrations of 5, 10, and 20 µg/L and the occurrence of sister chromatid exchanges on chromosomes, resulting from double-strand DNA breaks, was analyzed. The studies revealed a notable increase in SCEs compared to the control group, suggesting the genotoxic properties of the examined AgNPs. The highest level of chromosome damage was observed following exposure to citrate-stabilized silver nanoparticles. Further research is needed to better understand the toxicological mechanisms of AgNPs produced via the HVAD method and their effects on mammalian somatic cells. Full article

Background/Objectives: Motorcycle accidents have grown to become a significant public health thread worldwide. Most of the victims are described to be males of young age, some of lower socioeconomic status. Throughout the literature, head and spinal injuries are described as the most common injuries, while chest injuries and lower extremity fractures are also frequently described. Moreover, driving under the influence of alcohol has been widely described as a major predisposing factor. We conducted a retrospective cohort study to categorize risk factors, including demographic information and alcohol/psychoactive substance consumption, as well as pre-existing medical conditions. Correspondingly, we identified the most common injury patterns and attempted to establish a connection between time to hospital and survival rates. Methods: Cases of motorcycle-related road traffic accidents (RTAs) examined by the authors during 2021–2023 were included in the study sample (94 cases in total). This retrospective cohort study assessed survival time (in days) from accident to death. Kaplan–Meier curves, stratified by key categorical variables, were used to analyze survival probabilities over time. Univariate Cox regression was used to assess each variable’s effect on survival. The association between exposure and mortality was analyzed using hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Head injuries were associated with poorer outcomes. Chest injuries reduced median survival to 1.68 h compared to 5.85 days in cases that had not sustained chest injuries. Abdominal injuries also shortened survival (1.632 h vs. 1.896 h), as did multiple-site injuries (1.584 h vs. 0.2 days for single/double-site). Positive toxicology for psychoactive substances lowered survival to 1.32 h compared to 1.752 h in cases with negative toxicological findings. Multiple-site injuries and head, chest and abdominal injuries appeared to significantly affect the survival of victims. Positive toxicological examination results for psychoactive substances also appeared to heavily impact survival. Full article

The development of unconventional resources continues to be propelled by innovations that enhance economic efficiency and maximize reservoir contact within operational constraints. Among the most recent of these is the U-shaped, or “horseshoe,” well design, which connects two parallel horizontal laterals with a 180° turn, effectively doubling the reservoir exposure from a single wellhead. This paper provides a comprehensive literature review of the current state of knowledge on U-shaped well technology. It surveys the operational drivers for their adoption, the critical drilling, and completion technologies that have enabled its successful implementation and discusses key design considerations for a successful operation. Field data from major North American shale basins, including the Permian, Eagle Ford, Bakken, and Haynesville, demonstrate substantial economic benefits, such as capital cost savings of approximately 20–25% compared to traditional methods. Lifecycle assessments indicate notable environmental advantages, including a 29.3% reduction in carbon emissions, a 15.8% reduction in water use, and a 50% decrease in land disturbance. Despite these clear benefits, gaps remain regarding long-term performance validation, stimulation of curved sections, and fracture modeling accuracy. Addressing these gaps is essential to fully realize the potential of U-shaped wells as a sustainable and economically attractive approach in the evolving landscape of unconventional energy development. Full article

Background: Few trials have evaluated liquid chromatography–mass spectrometry (LC–MS)–standardized ready-to-drink formulations, and short-term responses of composite lipid–glucose indices under controlled intake remain unquantified. This study assessed 8-week changes in Atherogenic and triglyceride–glucose indices (AIP and TyG) after the consumption of a Hibiscus–inulin (HIB–INU) beverage and tested whether baseline risk modified these effects. Methods: A randomized, double-blind, placebo-controlled trial was conducted in adults aged 18–50 years with BMI ≥ 25 kg/m² (n = 100: 50 per group) who consumed a daily 60 mL Hibiscus–inulin shot or sensory-matched placebo for 8 weeks. The Hibiscus–inulin shot was LC–MS–standardized to ensure reproducible exposure; co-primary outcomes were AIP and TyG (pre-specified as exploratory), and secondary outcomes were mean arterial pressure (MAP) and pulse pressure (PP). ANCOVA adjusted for baseline, age, and sex was used to estimate between-group differences and to test for interactions by baseline risk. Results: Adjusted 8-week differences versus placebo were −0.09 for AIP (95% CI −0.15 to −0.03; p = 0.004) and −0.14 for TyG (−0.26 to −0.03; p = 0.020). MAP and PP showed no significant differences between the groups (p > 0.05). Effects were larger in high-risk baseline strata. Conclusions: A standardized hibiscus–inulin shot produced short-term improvements in composite lipid–glucose indices without hemodynamic change. Because minimal clinically important differences for AIP/TyG have not been established for short durations, these findings reflect analytical responsiveness rather than clinical benefits, supporting their exploratory use in short-term nutrition trials and cardiometabolic monitoring. Full article

Background: The maintenance of an aseptic barrier between the surgical team and patient aids in the prevents the exposure of the patient to pathogens. Variations in gloving practice may have safety implications due to glove failure. Indicator gloving, where two pairs of different colored gloves are worn, is thought to add protection as it alerts the wearer to a breach. The aim of this systematic review and meta-synthesis was to assess the evidence in the literature on the benefit of indicator systems versus other forms of double gloving on puncture identification during surgery. Methods: A four-arm, parallel, systematic review of the literature was undertaken in accordance with the PRISMA statement using four distinct research questions regarding glove fit, double gloving, indicator gloves, and the association between glove damage and glove change frequency. Searches on PubMed, Embase, Cochrane Collaboration of Systematic Reviews and Metanalyses, and Google Scholar were performed between 1 May 2022 and 24 January 2023. Studies were assessed for eligibility against pre-defined inclusion and exclusion criteria. Risk of bias was determined using multiple assessment tools. Results: This systematic review included 32 studies, 10 of which were high-quality Level IA trials, alongside multiple observational analyses. Across studies, indicator glove systems consistently demonstrated a two- to six-fold higher detection rate of glove perforations compared with standard double-gloving using identical glove colors. The majority of studies confirmed that early perforation identification significantly reduces intraoperative contamination risk and improves maintenance of the aseptic barrier. However, evidence regarding the direct impact on surgical site infections remains limited due to study heterogeneity. Conclusions: The use of an indicator glove provides a two- to six-fold higher rate of glove perforation detection, compared to two standard gloves of the same color, therefore aiding the maintenance of the aseptic barrier between surgical team members and patients. Further research into the impact of double gloving on the incidence of surgical site infections is required. Full article

Facing the increasingly scarce supply of rare-earth resources, a cobalt-doped metal–organic framework-derived carbon–metallic sulfide composite (Co-FeS₂@C) was successfully synthesized via the hydrothermal method and the following carbonization/sulfidation treatments and used for the efficient electrosorption of rare earths from aqueous solution. Comparative characterizations revealed that Co doping effectively expanded the interlayer spacing of FeS₂, introduced crystalline defects, and optimized the electronic structure, thereby synergistically enhancing active site exposure and electron transfer kinetics. In addition, the electrochemical analysis demonstrated a significant increase in the surface-controlled capacitive contribution from 57.1% to 83.3%, indicating the markedly improved electric double-layer effects and mass transport efficiency. Under the optimal conditions, the Co-FeS₂@C electrode achieved a high Yb³⁺ adsorption capacity of 129.2 mg g⁻¹ along with an exceptional cycling stability (92.63% retention after 20 cycles), substantially outperforming the undoped counterpart FeS₂ (88.4 mg g⁻¹ and 74.61%). Furthermore, the mechanistic investigations confirmed that the electrosorption process follows a monolayer physico-chemical synergistic mechanism, primarily driven by the pseudo-capacitive effect arising from the redox reaction of FeS₂ and the enhanced charge-transfer driving force resulting from the higher electronegativity of cobalt. This work provides an innovative electronic structure modulation strategy for developing the high-performance capacitive deionization electrodes for rare earth recovery via the electrosorption process. Full article

As an emerging concept, steganography without embedding (SWE) hides a secret message without directly embedding it into a cover. Thus, SWE has the unique advantage of being immune to typical steganalysis methods and can better protect the secret message from being exposed. However, existing SWE methods are generally criticized for their poor payload capacity and low fidelity of recovered secret messages. In this paper, we propose a novel steganography-without-embedding technique, named DF-SWE, which addresses the aforementioned drawbacks and produces diverse and natural stego images. Specifically, DF-SWE employs a reversible circulation of double flow to build a reversible bijective transformation between the secret image and the generated stego image. Hence, it provides a way to directly generate stego images from secret images without a cover image. Besides leveraging the invertible property, DF-SWE can invert a secret image from a generated stego image in a nearly lossless manner and increase the fidelity of extracted secret images. To the best of our knowledge, DF-SWE is the first SWE method that can hide multiple images into one image with the same size, significantly enhancing the payload capacity. According to the experimental results, the payload capacity of DF-SWE achieves 24–72 BPP, which is 8000∼16,000 times more compared to its competitors while producing diverse images to minimize the exposure risk. Importantly, DF-SWE can be applied in the steganography of secret images in various domains without requiring training data from the corresponding domains. This domain-agnostic property suggests that DF-SWE can (1) be applied to hiding private data and (2) be deployed in resource-limited systems. Full article

Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the Modified Coronally Advanced Flap (mCAF) with an envelope design. Recent literature also reported the association of different biomaterials to the mCAF procedure. In light of these considerations, a systematic review (SR) was conducted to determine and compare the efficacy of all mCAF adjunctive techniques for the treatment of multiple adjacent GR-type (MAGR) defects. Methods: An electronic search was conducted in 2025 on studies published between 2013 and 2025, using PubMed, Scopus, Web of Science, and Cinahl Complete, to address the focused question: “which is the efficacy of different mCAF adjunctive techniques for the treatment of multiple adjacent GR-type defects, in terms of root coverage (RC), esthetic outcomes, and keratinized tissue (KT) augmentation?”. Randomized controlled trials with a minimum follow-up of 6 months with ≥ 5 patients treated for coverage of MAGR were included. Risk of bias was assessed with RoB 2 Tool. A meta-analysis was performed using RevMan5.4 software and the level of evidence of included studies was analyzed with GRADEPro GDT. Results: A total of 17 studies were included in the SR, 9 of which evaluating mCAF + sCTG (subepithelial connective tissue graft) vs. mCAF adjunctive techniques [Collagen Matrix (CM), xenogeneic acellular dermal matrix (XADM), Platelet-Rich Fibrin (PRF), Enamel Matrix Derivatives (EMD), sCTG harvested double blade scalpel] were then included in the meta-analysis. The primary outcomes of complete root coverage (CRC) and keratinized tissue width variation (ΔKTW) were statistically significant ([CRC: Odds Ratio (OR) 1.70; 95% CI (confidence interval) 1.18, 2.44; p = 0.004]; [ΔKTW: SMD (standardized mean difference) 0.37; 95% CI 0.11, 0.63; p = 0.005]) in favor of mCAF + CTG. Meanwhile, no statistically significant difference was observed in terms of RES. The certainty assessment highlighted relevant results: despite the lack of evidence in the long-term, a high level of evidence showed that sCTG was more effective than XADM in terms of CRC (p = 0.002) and ΔKTW (p = 0.0001). A low level of evidence revealed that sCTG achieved a greater ΔKTW compared to CM (p = 0.0006). Although no significant differences were observed, a low level of evidence suggested that mCAF + EMD and mCAF + sCTG (DBS) may provide good results. To date, only one RCT showed long-term stable results of CTG in terms of RC. Conclusions: The association of sCTG to mCAF demonstrated better results in terms of RC and KTW augmentation in short- and medium-term follow-ups. Long-term studies are needed to confirm the efficacy of the other mCAF adjunctive techniques, considering limitations due to heterogeneity in follow-ups, distribution of techniques analyzed, and different study designs. Registration in PROSPERO (International prospective register of systematic reviews) was performed with ID CRD420251085823. Full article

Cryopreservation is a well-established method for extending platelet shelf-life and addressing supply shortages. Traditionally, this involves dimethyl sulfoxide (DMSO) as a cryoprotective agent (CPA), but recent studies suggest that using controlled rate freezing (CRF) with only NaCl may offer a less toxic alternative. To explore further optimization, this study assessed whether adding 10% choline chloride–glycerol, a deep eutectic solvent (DES), could enhance platelet quality in CRF/NaCl cryopreservation. Ten double-dose buffy coat platelet units were divided into test (DES-treated) and control (NaCl-only) groups. After DES exposure (10% for 20 min), all units were prepared using the NaCl protocol and frozen at −80 °C with CRF equipment, then stored for over 90 days. Upon thawing and reconstitution in AB plasma, no significant differences were observed in platelet content post-thaw between control and test units (255 ± 43 vs. 257 ± 41 × 10⁹/unit), post-thaw recovery (>85%): respectively, Δψ (JC-1% pos 63 ± 15 vs. 68 ± 17), LDH (% of total 10 ± 6 vs. 9 ± 6), (CD63% 77 ± 9 vs. 82 ± 7), (CD62P % 72 ± 15 vs. 76 ± 11), (CD42b % 78 ± 9 vs. 80 ± 9), (CD61% 79 ± 9 vs. 78 ± 9), (CD41% 81 ± 11 vs. 83 ± 7), (PAC-1% 33 ± 10 vs. 32 ± 8), (Pecam-1% 78 ± 11 vs. 80 ± 8), (GPIV % 72 ± 10 vs. 74 ± 11), (LAMP-1% 26 ± 14 vs. 11 ± 9), (MPCD61+ % 41 ± 11 vs. 46 ± 10), (ROTEM CT 56 ± 7 vs. 55 ± 6), (ROTEM CFT 110 ± 70 vs. 106 ± 67) and (ROTEM MCF 35 ± 6 vs. 36 ± 6). These findings support the feasibility of CPA-free CRF-based platelet cryopreservation while maintaining functional integrity. Full article

Microphysiological systems (MPSs) have emerged as alternatives to animal testing in drug development, following the FDA Modernization Act 2.0. Double-layer channel-type MPS chips with porous membranes are widely used for modeling various organs, including the intestines, blood–brain barrier, renal tubules, and lungs. However, these chips faced challenges owing to optical interference caused by light scattering from the porous membrane, which hinders cell observation. Trans-epithelial electrical resistance (TEER) measurement offers a non-invasive method for assessing barrier integrity in these chips. However, existing electrode-integrated MPS chips for TEER measurement have non-uniform current densities, leading to compromised measurement accuracy. Additionally, chips made from polydimethylsiloxane have been associated with drug absorption issues. This study developed an electrode-integrated MPS chip for TEER measurement with a uniform current distribution and minimal drug absorption. Through a finite element method simulation, electrode patterns were optimized and incorporated into a polyethylene terephthalate (PET)-based chip. The device was fabricated by laminating PET films, porous membranes, and patterned gold electrodes. The chip’s performance was evaluated using a perfused Caco-2 intestinal model. TEER levels increased and peaked on day 5 when cells formed a monolayer, and then they decreased with the development of villi-like structures. Concurrently, capacitance increased, indicating microvilli formation. Exposure to staurosporine resulted in a dose-dependent reduction in TEER, which was validated by immunostaining, indicating a disruption of the tight junction. This study presents a TEER measurement MPS platform with a uniform current density and reduced drug absorption, thereby enhancing TEER measurement reliability. This system effectively monitors barrier integrity and drug responses, demonstrating its potential for non-animal drug-testing applications. Full article

Background and Objectives: Laryngeal cancer imposes a disproportionate burden on speech, airway protection and long-term quality of life. Contemporary population-based data for Central and Eastern Europe remain scarce, and the post-pandemic trajectory is uncertain. Materials and Methods: We performed a nationwide, retrospective ecological time-series study using Romanian mortality registers and hospital-discharge files for 2017–2023. Crude and age-standardised mortality rates (ASMRs) were calculated, county-level indirect standardisation and spatial autocorrelation assessed and joinpoint regression quantified temporal trends. Forecasts to 2040 combined Holt–Winters/ARIMA models with Elliott-wave heuristics anchored to Fibonacci retracements. Results: In 2023, 798 laryngeal cancer deaths yielded a crude mortality of 3.65/100,000 (95% CI 3.41–3.91). Male mortality (7.07/100,000) exceeded female mortality 18-fold. Rural residents experienced a higher rate than urban counterparts (4.26 vs. 3.04/100,000), a difference unchanged after indirect age standardisation. National ASMR fell by 3.7% annually (p < 0.01), yet five counties formed a high-risk corridor (standardised mortality ratios 1.59–1.82); Moran’s I = 0.27 (p < 0.01) indicated significant spatial clustering. Pandemic-era surgical throughput collapsed by 48%, generating a backlog projected to persist beyond 2030. Ensemble forecasting anticipates a doubling of discharges and mortality between 2034 and 2037 unless smoking prevalence falls by ≥30% and radon exposure is curtailed. Conclusions: Although overall laryngeal cancer mortality in Romania is declining, the pace lags behind Western Europe and is threatened by geographic inequities and pandemic-related care delays. Aggressive tobacco control, radon-remediation policies and expansion of surgical and radiotherapeutic capacity are required to avert a forecasted surge in the next decade. Full article