Search Results (109)

Vitellaria paradoxa subsp. paradoxa C.F.Gaertn., is one of the most important components of sub-Saharan agroforestry systems, providing to rural communities, especially women, with socio- economic, environmental, and nutritional benefits. Despite its importance, the species is threatened and remains semi-domesticated. To better preserve and improve this resource, the genetic diversity and structure of 88 mother trees originated from Senegal and Burkina Faso were studied by analysing 17 phenotypic traits and 3196 SNP markers. The results revealed similar level of observed heterozygosity (Ho) between the Senegalese and Burkinabe populations (Ho = 0.16), whereas the average number of alleles per population (Na) and the expected heterozygosity (He) ranged from 0.33 to 0.34 and 0.38 to 0.39, respectively, indicating moderate to low genetic diversity. Furthermore, the polymorphic information content ranged from 0.15 for Senegal to 0.25 for Burkina Faso. Both ADMIXTURE and cluster analysis delineated our collection into two groups depending on the origin. The AMOVA showed that the highest fraction of variation was within individual, indicating a very low genetic differentiation (Fst = 0.0006) between population. At the phenotypic level, the G2 cluster representing the Senegalese genepool recorded the highest performance in terms of nut and kernel attributes, cariten and unsaponifiable matters contents, while higher crude fat, Diglyceride, Triglyceride, and Triacylglycerol Mono Stearoyl Olein Stearin contents were observed in the Burkina Faso collection (G1). The present findings on the species’ genetic diversity and genetic structure constitute a good start to strengthen the species tree improvement and conservation programs. Full article

Background: Prostate cancer in the Middle East and North Africa (MENA) region is shaped by a complex interplay of behavioral and environmental risk factors, yet comprehensive estimates of preventable cases remain scarce. To address this gap, we estimated population-attributable fractions (PAFs) for a range of modifiable exposures among men aged 50 years and older and assessed potential reductions in incidence under feasible intervention scenarios. Methods: Regional prevalence data were combined with relative risks from meta-analyses to compute closed-form PAFs for tobacco smoking, obesity, physical inactivity, high dairy and calcium intake, heavy alcohol use, drinking water nitrates, trihalomethanes, arsenic, lead, selenium status, ambient PM_2.5 and NO₂, and occupational diesel exhaust, covering an estimated 47 million men. Estimates were validated using a synthetic cohort simulation of 100,000 individuals, with uncertainty quantified through Monte Carlo sampling. Results: Results showed that drinking water nitrate exposure accounted for the largest single fraction (17.4%), followed by tobacco smoking (9.5%), physical inactivity (6.7%), and trihalomethane exposure (5.0%), while other exposures contributed smaller but meaningful shares. Joint elimination of all exposures projected a 45.5% reduction in incidence, and simultaneous feasible reductions in four targeted exposures yielded a combined potential impact fraction of 12.1%. Conclusions: These findings suggest that integrated water quality management, tobacco control, lifestyle interventions, and targeted environmental surveillance should be prioritized to reduce prostate cancer burden in the MENA region. However, estimates of drinking-water nitrate exposure rely on limited evidence from a single case–control study with a relatively small sample size, and should therefore be considered exploratory and primarily hypothesis-generating. Full article

Background/Objectives: Heart failure with reduced ejection fraction (HFrEF) is associated with significant neuropsychological burden, including cognitive impairment and mood disturbances. While sacubitril/valsartan has demonstrated cardiovascular benefits, its effects on cognitive and emotional functioning remain underexplored, particularly in Middle Eastern populations. We aimed to evaluate the impact of sacubitril/valsartan on intellectual capacity, cognitive function and mood in patients with HFrEF using an idiographic study design. Methods: This study was conducted in adult patients with HFrEF selected to take sacubitril/valsartan to improve their clinical status. Participants were assessed at baseline and 3 months after treatment initiation using Al Khoudh Cognitive Test, PHQ-9 and Raven’s Progressive Colored Matrices. Results: Following three months of treatment, participants showed a statistically significant improvement in left ventricular ejection fraction (LVEF) (p = 0.043), depression severity (p = 0.025) and a non-significant trend toward improvement in abstract reasoning scores (p = 0.051). On the other hand, participants did not demonstrate significant improvements in the cognitive subdomains assessed by the Al Khoudh Test. Among these subdomains, the largest improvement was observed with verbal fluency (p = 0.057). Improvements in LVEF were not significantly associated with the changes in mood (p = 0.93), cognitive function (p = 0.34) or verbal fluency (p = 0.46). Conclusions: This study provides preliminary, hypothesis-generating evidence of potential short-term improvement in mood and reasoning scores in HFrEF patients treated with sacubitril/valsartan. Notably, these changes were not attributed to the observed improvements in cardiac function. These findings underscore the need for further investigation into the neurocognitive benefits of sacubitril/valsartan in larger and more diverse populations. Full article

While the inflammatory properties of ambient air pollution may exacerbate osteoarthritis (OA), evidence on the population-level impact of multi-pollutant mixtures remains limited. This study quantifies the acute effects of short-term exposure to a complex mixture of six-criteria air pollutants on OA outpatient visits. In total, 8,146,141 OA visits from two national health insurance databases across 192 Chinese cities (2013–2017) were analyzed using a two-stage, time-stratified case-crossover design, combining conditional logistic regression with random-effects meta-analysis. The results showed that an interquartile range increase in the concentrations of PM_2.5, PM₁₀, NO₂, SO₂, O₃, and CO was associated with significant increases in OA visits of 1.75%, 2.26%, 4.01%, 3.42%, 1.98%, and 1.87%, respectively. NO₂ and SO₂ demonstrated the strongest associations across OA subtypes. Multi-pollutant models confirmed that the risk of OA visits increased significantly under combined pollutant exposure. Population attributable fractions ranged from 2.15% for PM_2.5 to 6.41% for NO₂. This large-scale analysis provides novel evidence that transient exposure to complex pollution mixtures, rather than to individual pollutants, drives OA-related healthcare demand, with gaseous pollutants (NO₂/SO₂) being critical components. Our findings advocate for integrative air quality management strategies targeting co-emitted pollutants to mitigate OA exacerbations. Full article

Background: Pregnancy induces substantial cardiovascular remodeling, yet whether maternal cardiac adaptation differs across ethnic groups remains unclear. Body size, ventricular geometry, and thoracoabdominal configuration may modulate key functional indices such as left ventricular ejection fraction (LVEF) and global longitudinal strain (LV-GLS). This systematic review compared echocardiographic characteristics between Asian and Western healthy pregnant women in late gestation and explored physiological mechanisms underlying observed differences. Methods: A comprehensive search of PubMed, Scopus, and EMBASE identified studies reporting transthoracic echocardiography in healthy singleton third-trimester pregnancies across Asian and Western populations. Extracted variables included anthropometry, ventricular dimensions and volumes, LVEF, and LV-GLS. Pooled estimates were calculated using inverse-variance weighting, with heterogeneity quantified using the I² statistic. Study quality was assessed with the NIH Case–Control Quality Assessment Tool. Comparative forest plots visualized population differences. Results: Twenty studies involving 1431 participants (578 Asian and 853 Western women) met inclusion criteria. Asian women consistently exhibited smaller ventricular chambers, higher LVEF, and more favorable LV-GLS. Importantly, these differences persisted after indexing LV-GLS to BSA, indicating that body-size normalization attenuates—but does not eliminate—population differences in myocardial deformation. Western women demonstrated slightly attenuated GLS despite preserved LVEF, plausibly attributable to larger cardiac size, higher wall stress, greater diaphragmatic elevation, and increased extrinsic thoracic compression. Between-study heterogeneity was substantial (I² > 95%) due to variation in imaging platforms, strain software, and population characteristics. Methodological quality was fair, with frequent lack of sample-size justification and incomplete confounder adjustment. Conclusions: Healthy Asian pregnant women display a hyperdynamic systolic phenotype, whereas Western women show a physiologically appropriate, load-related attenuation of LV-GLS with preserved LVEF. These findings highlight the need for ethnicity-associated and anatomy-aware echocardiographic reference values and support incorporating thoracic geometric indices, such as the modified Haller Index, into strain interpretation during pregnancy. Full article

Adeno-associated viruses (AAVs) are a leading vector for gene therapy, yet their clinical utility is limited by the lack of robust quality control methods to distinguish between empty (AAV_empty), partially loaded (AAV_partial), and fully DNA loaded (AAV_full) capsids. Current analytical techniques provide partial insights but remain limited in sensitivity, throughput, or resolution. Here we present a multimodal plasmonic nanopore sensor that integrates optical trapping with electrical resistive-pulse sensing to characterize AAV9 capsids at the single-particle level in tens of μL sample volumes and fM range concentrations. As a model system, we employed AAV9 capsids not loaded with DNA, capsids loaded with a self-complementary 4.7 kbp DNA (AAV_scDNA), and ones loaded with single-stranded 4.7 kbp DNA (AAV_ssDNA). Ground-truth validation was performed with analytical ultracentrifugation (AUC). Nanosensor data were acquired concurrently for optical step changes (occurring at AAV trapping and un-trapping) both in transmittance and reflectance geometries, and electrical nanopore resistive pulse signatures, making for a total of five data dimensions. The acquired data was then filtered and clustered by Gaussian mixture models (GMMs), accompanied by spectral clustering stability analysis, to successfully separate between AAV species based on their DNA load status (AAV_empty, AAV_partial, AAV_full) and DNA load type (AAV_scDNA versus AAV_ssDNA). The motivation for quantifying the AAV_empty and AAV_partial population fractions is that they reduce treatment efficacy and increase immunogenicity. Likewise, the motivation to identify AAV_scDNA population fractions is that these have much higher transfection rates. Importantly, the results showed that the nanosensor could differentiate between AAV_scDNA and AAV_ssDNA despite their identical masses. In contrast, AUC could not differentiate between AAV_scDNA and AAV_ssDNA. An equimolar mixture of AAV_scDNA, AAV_ssDNA and AAV_empty was also measured with the sensor, and the results showed the expected population fractions, supporting the capacity of the method to differentiate AAV load status in heterogeneous solutions. In addition, less common optical and electrical signal signatures were identified in the acquired data, which were attributed to debris, rapid entry re-entry to the optical trap, or weak optical trap exits, representing critical artifacts to recognize for correct interpretation of the data. Together, these findings establish plasmonic nanopore sensing as a promising platform for quantifying AAV DNA loading status and genome type with the potential to extend ultra-sensitive single-particle characterization beyond the capabilities of existing methods. Full article

Background: Robust evidence demonstrates that tobacco use acts as a causal and, therefore, modifiable risk factor for the development of type 2 diabetes mellitus (T2DM). However, its specific population-level impact in Mexico has not yet been quantified. Objective: This study aimed to estimate the population attributable fraction (PAF) of T2DM associated with tobacco use among Mexican adults, utilizing data from the 2021 National Health and Nutrition Survey (ENSANUT). Methods: A nested case–control analysis was conducted within the complex sampling design of the ENSANUT. Adults aged 20 years or older were included. Cases were defined as individuals with a self-reported medical diagnosed T2DM diagnosis; controls were individuals without T2DM. Exposure status was categorized as current person who smokes, former person who smokes, and never person who smokes. A logistic regression model was employed, adjusting for key covariates including age, sex, socioeconomic status, and comorbidities. The PAF was subsequently calculated using the Miettinen formula. Results: The adjusted PAF for T2DM attributable to smoking was 10.1% (95% CI: 4.07–14.97). This finding suggests that approximately one in eight T2DM cases could be prevented through the elimination of tobacco use. The association was more pronounced among men and individuals with a history of heavy tobacco use. Conclusion: The estimated PAF for T2DM due to tobacco use underscores the significant contribution of policies established within the WHO Framework Convention on Tobacco Control to the prevention of chronic diseases. The implementation and strengthening of such policies, including increased tobacco taxes, comprehensive smoking bans in public places, on-package warnings, and advertising prohibitions, would prove highly beneficial. These findings show a strong population-level association between tobacco use and T2DM, but causality cannot be established. Future longitudinal studies in Mexico are needed to confirm these results. Full article

Vegetation is a fundamental component of ecosystems and plays a vital role in maintaining ecological processes. It contributes to soil conservation, climate regulation, and landscape quality. Kunming, widely known as the “Spring City,” relies heavily on vegetation to sustain its ecological and social environment. This study employs moderate resolution imaging spectroradiometer (MODIS) and Normalized Difference Vegetation Index (NDVI) data in combination with temperature, precipitation, population, and gross domestic product (GDP) records to analyze the spatiotemporal dynamics and driving factors of NDVI-derived vegetation index in Kunming from 2000 to 2020 using trend and correlation analyses. We derived fractional vegetation coverage (FVC) from MODIS NDVI using the pixel dichotomy model, analyzed its temporal trends with linear regression, and applied pixel-wise Pearson correlation analysis to identify the spatial relationship between FVC and precipitation. The main findings can be summarized as follows: (1) The NDVI-derived vegetation index pattern in Kunming is generally higher in the west than in the east and higher in mountainous areas than in plains and basins. From 2000 to 2020, overall NDVI-derived vegetation index increased, with the mean NDVI rising from 0.48 to 0.545. Notably, the NDVI values in 2010 and 2012 declined sharply, likely due to drought conditions caused by reduced rainfall in the preceding years. (2) During the study period, 26.86% of the area showed moderate (NDVI slope: 0.005–0.016) improvement and 10.35% showed significant (NDVI slope: 0.016–0.063) improvement, while 10.28% exhibited degradation. Spatially, improvements were concentrated in Xundian County, parts of Dongchuan District, northern Luquan County, and northern border areas adjoining Yiliang and Shilin Counties. Areas with clear degradation were primarily located in Kunming’s main urban area and along the corridor from the airport to Songming. (3) Correlation analysis revealed that 53.3% of areas exhibited a positive relationship between temperature and NDVI-derived vegetation index, while 18.6% showed a significant negative correlation, mainly in the lower Pudu River basin, the Fumin–Luquan border, and the basin areas of Songming and Shilin Counties. This negative relationship may be attributed to increased evapotranspiration under higher temperatures, which exacerbates soil moisture loss and imposes drought stress on vegetation, thereby inhibiting plant growth. Similarly, 53% of areas showed a positive correlation between precipitation and FVC, whereas only 8.3% showed a significant negative correlation, underscoring the strong influence of precipitation on vegetation dynamics in Kunming. (4) Over the past two decades, Kunming’s GDP increased tenfold. In comparison with NDVI-derived vegetation index data for the same period, this indicates that areas of higher GDP are often associated with lower NDVI-derived vegetation index. Full article

Background/Objectives: Perinatal mental disorders are important health issues that affect both mothers and their children. The Mediterranean diet (MD) is one of the most well-recognized healthy dietary patterns worldwide. Recent evidence suggests that MD may prevent or reduce the risk of perinatal mental disorders. This study investigated the association between MD adherence during pregnancy and psychological distress in a large cohort of Japanese births. Methods: Data were obtained from 80,271 pregnant women who participated in the Japan Environment and Children’s Study. Adherence to the MD was assessed using three scoring methods: the Mediterranean Diet Score (MDS), relative Mediterranean Diet (rMED), and Mediterranean Diet Score for Pregnancy (PMDS). Psychological distress was defined as a score of ≥13 on the Kessler 6-item Psychological Distress Scale (K6). Modified Poisson regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Population attributable fractions (PAFs) were calculated to quantify the proportion of psychological distress attributable to low MD adherence. Results: The adjusted RR for psychological distress in the low PMDS group was 1.17 (95% CI: 1.07, 1.28) compared with the high PMDS group. The adjusted PAF for low PMDS was 10.43% (95% CI: 4.81, 16.06). No statistically significant associations were detected between psychological distress and the MDS or rMED scores. Conclusions: This study suggests that high adherence to MD based on the PMDS during pregnancy may reduce the risk of psychological distress in Japanese women. Therefore, promoting MD during pregnancy could be a potential strategy for preventing perinatal mental disorders. Full article

Background: Vitamin B12 deficiency, hyperhomocysteinemia, and diabetes are emerging determinants of cardiovascular risk, particularly among women. Early detection and treatment represent an important public health opportunity to reduce the burden of disease and promote health equity. Objective: We aimed to quantify the prevalence of vitamin B12 deficiency, hyperhomocysteinemia, and diabetes, and to evaluate the potential impact of detecting and addressing these conditions on reducing CVD risk in adult Mexican women. Methods: We analyzed data from 1197 women aged 20–49 years from Mexico’s 2022–2023 National Health and Nutrition Survey (ENSANUT). Serum vitamin B12, folate, and homocysteine were quantified, and 10-year CVD risk was estimated using Framingham and Globorisk models. Population-attributable fractions and cost–benefit analyses were used to assess preventable CVD cases and the economic feasibility of nationwide vitamin B12 supplementation. Results: Nationwide, 37.2% of women have vitamin B12 deficiency, and 30.6% have borderline levels. In Southern Mexico, the prevalence of vitamin B12 deficiency is higher, reaching 52.4%. Elevated homocysteine levels were detected in 12.3% of women. The predicted number of preventable CVD cases ranged from 10,000 to 14,000, and the benefit–cost ratio exceeded 1, supporting economic feasibility. Conclusions: Vitamin B12 deficiency and hyperhomocysteinemia are very common among Mexican women and are associated with an increased cardiovascular risk, especially in those aged 40 to 49. The analysis showed that implementing a national vitamin B12 supplementation strategy could be a cost-effective preventive measure, with a benefit–cost ratio ranging from 1.93 in the base case to 2.98 when broader societal savings are taken into account. These findings highlight the potential of targeted nutritional interventions to reduce the burden of cardiovascular disease in women. Full article

Background: Immunization coverage has increased substantially in the Western Pacific Region, saving millions of lives and supporting disease elimination efforts. However, gaps in coverage and inequitable vaccine access persist, leaving millions unvaccinated. Wealth-based inequalities remain a critical barrier to achieving equitable immunization coverage and maximizing the health benefits of vaccination programs. Methods: We analyzed full immunization coverage among 1-year-olds in 10 middle-income countries of the Western Pacific Region using data from the WHO Health Inequalities Data Repository. National and wealth quintile-specific coverage rates and within-country inequalities were assessed using absolute and relative measures (difference, ratio, slope index of inequality, and relative index of inequality). Trends over time were examined in countries with longitudinal data (n = 5), identifying pro-rich or pro-poor changes based on shifts in quintile-specific coverage. We also calculated the population attributable risk (PAR) and fraction (PAF) to estimate the potential increase in national coverage if wealth-based inequalities were eliminated. Findings: Substantial gaps in immunization coverage persist across all countries studied (n = 10), but with substantial between- and within-country disparities. Coverage was higher among the richest quintiles in half of the countries, with the rest showing no significant disparities. Trends in inequalities were mixed: Cambodia, Mongolia, and Viet Nam experienced pro-poor improvements over time; the Philippines saw widening pro-rich inequalities; and Lao PDR showed little change. Population attributable risks (PAR) showed that eliminating wealth-based inequalities could increase national coverage significantly in five countries (Fiji, Lao PDR, Papua New Guinea, Samoa, and Tonga), with relative gains that could increase national coverage by up to 50% while achieving equity gains. Conclusions: Addressing wealth-based inequalities in immunization could drive substantial gains in national coverage across the Western Pacific Region. Sustained, equity-oriented approaches are essential to achieving universal vaccine access and ensuring no population is left behind. Inequality patterns can guide equity-focused policies to reach underserved and disadvantaged populations. Full article

Colorectal cancer (CRC) has a complex etiology involving genetic, lifestyle, and environmental factors. This study investigates the association between exposure to water contaminants and the risk of developing CRC in Lebanon. Population Attributable Fraction (PAF) was calculated using exposure prevalence from environmental reports and water quality assessments. Relative risks (RR) were obtained from multiple meta-analyses and epidemiological studies to quantify the contribution of five water contaminants to CRC incidence: nitrates, mercury, arsenic, trihalomethanes (THMs), and microbial pollutants (E. coli). A synthetic cohort was simulated using national exposure data and probabilistic techniques, employing multivariate logistic regression models to ensure precise CRC risk and controlling for lifestyle covariates. Adjusted PAF values were calculated using regression data to determine the proportion of CRC cases attributable to each water contaminant. THMs and E. coli showed the strongest association with CRC, with adjusted PAF values of 25.76% and 23.65%, respectively. Exposure to nitrates, arsenic, and mercury contributed less to CRC risk (1.02%, 0.52% and 2.20%, respectively). Multivariate regression confirmed that THMs and E. coli remained the strongest independent predictors of CRC risk (OR = 1.37, p = 0.001) and (OR = 1.79, p < 0.0001) among water contaminants, respectively. Our model-based approach carries limitations due to reliance on indirect exposure and risk estimates, which may introduce uncertainty stemming from data gaps and underlying assumptions. This study highlights the importance of water quality management in CRC prevention as exposure to drinking water contaminants contributes meaningfully to disease burden. Full article

Background/Objectives: Rhodiola rosea L. (Crassulaceae), a perennial adaptogenic herb native to Northern Europe, Asia, and North America, is renowned for its therapeutic properties attributed to phenolic compounds including flavonoids, phenylethanoids, phenylpropanoids, and cinnamyl alcohol glycosides. The plant’s antioxidant and anti-inflammatory activities align with its traditional use in boosting physical and cognitive performance, reducing fatigue, and improving stress resilience. However, conventional dosage forms present compliance challenges, particularly for vulnerable populations with swallowing difficulties. This study aimed to develop and optimize orally disintegrating tablets (ODTs) containing standardized Rhodiola rosea root and rhizome (RR) dry extract to ensure rapid disintegration and acceptable taste, thereby improving patient compliance. Methods: Dried Rhodiola rosea root and rhizome (particle size 2–3 mm) were extracted using 70% m/m ethanol using the fractionated maceration methodology. The resulting dry RR extract was standardized to 3.0% m/m rosavin content by blending batches of the extract and analyzed using validated chromatographic methods. The standardized dry extract was formulated into ODTs via direct compression technology. Various excipients were evaluated to achieve rapid disintegration while masking the characteristic bitter taste of RR extract. Results: The optimized ODT formulation (500 mg, 11 mm ø, 20% standardized RR dry extract) disintegrated within 3 min and effectively masking the characteristic bitterness of the RR extract. The formulation maintained content uniformity and did not exhibit loss of active compounds during processing, meeting European Pharmacopoeia requirements for ODTs. Conclusions: The developed ODTs containing standardized Rhodiola rosea extract offer a patient-friendly alternative for oro-mucosal administration, supporting improved compliance in populations with swallowing difficulties while retaining the extract’s phytochemical integrity and sensory acceptability. Full article

Accurate assessment of protein content in Foods for Special Medical Purposes (FSMPs) is critical for patients with chronic kidney disease, who require tightly regulated protein intake. This study aimed to develop and apply a rapid, low-volume, and reproducible microchip-based gel electrophoresis method for analyzing total nitrogen (TN) content and electrophoretic profiles in FSMPs. Products of different consistencies (powder, liquid, yoghurt-like) were tested to evaluate the influence of common additives (e.g., milk proteins, stabilizers, sweeteners) on TN levels and protein patterns. The results revealed considerable variation in fractions among brands, largely attributable to additive composition. Notably, TN levels often exceeded the declared protein content, potentially leading to unintended nitrogen overconsumption in clinical settings. Statistical analysis identified significant TN differences between infant and adult FSMPs in liquid formulations, while powdered forms showed no such distinction. These findings highlight the clinical importance of precise analytical monitoring, as discrepancies between measured TN and labeled protein content could compromise dietary management in vulnerable populations. The proposed method provides a reliable tool for FSMP quality control and supports safer nutritional planning in therapeutic diets. Full article

Breast-conserving surgery followed by external beam Radiotherapy (RT) is a standard approach for early-stage Breast Cancer (BC). This retrospective study aims to determine the risk of RT-induced lung cancer for both standard and hypofractionated treatments. Fifty-eight Sicilian women treated at Humanitas Istituto Clinico Catanese (Misterbianco, Italy) between 2015 and 2021 with standard fractionated 3D-CRT (50 Gy in 2 Gy/fraction) were included. All treatment plans were designed using a hypofractionated schedule (42.56 Gy in 2.66 Gy/fraction). An Eclipse™ plug-in script was developed using the Eclipse Scripting Application Programming Interface (ESAPI) to extract patient and treatment data from the Treatment Planning System and compute Organ At Risk (OAR) volume, Organ Equivalent Dose (OED), Excess Absolute Risk (EAR), and Lifetime Attributable Risk (LAR) using the Schneider Mechanistic Model and reference data from regional populations, A-bomb survivors, and patients with Hodgkin’s Disease (HD). The OED distributions exhibited a statistically significant shift toward higher values in standard fractionated plans (p < 0.01, one-tailed paired Student’s t-test), leading to increased EAR and LAR. These results indicate that hypofractionated treatment may lower the risk of radiation-induced lung cancer. The feasibility of a priori risk estimation was evaluated by integrating the script into the TPS, allowing rapid comparison of SF and HF plans during planning. Full article