Journal of Personalized Medicine

26 pages, 359 KB

Open AccessEditor’s ChoiceReview

Opportunities and Challenges of Chatbots in Ophthalmology: A Narrative Review

by Mehmet Cem Sabaner, Rodrigo Anguita, Fares Antaki, Michael Balas, Lars Christian Boberg-Ans, Lorenzo Ferro Desideri, Jakob Grauslund, Michael Stormly Hansen, Oliver Niels Klefter, Ivan Potapenko, Marie Louise Roed Rasmussen and Yousif Subhi

J. Pers. Med. 2024, 14(12), 1165; https://doi.org/10.3390/jpm14121165 - 21 Dec 2024

Cited by 6 | Viewed by 2662

Abstract

Artificial intelligence (AI) is becoming increasingly influential in ophthalmology, particularly through advancements in machine learning, deep learning, robotics, neural networks, and natural language processing (NLP). Among these, NLP-based chatbots are the most readily accessible and are driven by AI-based large language models (LLMs). [...] Read more.

Artificial intelligence (AI) is becoming increasingly influential in ophthalmology, particularly through advancements in machine learning, deep learning, robotics, neural networks, and natural language processing (NLP). Among these, NLP-based chatbots are the most readily accessible and are driven by AI-based large language models (LLMs). These chatbots have facilitated new research avenues and have gained traction in both clinical and surgical applications in ophthalmology. They are also increasingly being utilized in studies on ophthalmology-related exams, particularly those containing multiple-choice questions (MCQs). This narrative review evaluates both the opportunities and the challenges of integrating chatbots into ophthalmology research, with separate assessments of studies involving open- and close-ended questions. While chatbots have demonstrated sufficient accuracy in handling MCQ-based studies, supporting their use in education, additional exam security measures are necessary. The research on open-ended question responses suggests that AI-based LLM chatbots could be applied across nearly all areas of ophthalmology. They have shown promise for addressing patient inquiries, offering medical advice, patient education, supporting triage, facilitating diagnosis and differential diagnosis, and aiding in surgical planning. However, the ethical implications, confidentiality concerns, physician liability, and issues surrounding patient privacy remain pressing challenges. Although AI has demonstrated significant promise in clinical patient care, it is currently most effective as a supportive tool rather than as a replacement for human physicians. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

19 pages, 329 KB

Open AccessEditor’s ChoiceReview

Decoding Kidney Pathophysiology: Omics-Driven Approaches in Precision Medicine

by Charlotte Delrue and Marijn M. Speeckaert

J. Pers. Med. 2024, 14(12), 1157; https://doi.org/10.3390/jpm14121157 - 19 Dec 2024

Cited by 6 | Viewed by 2205

Abstract

Chronic kidney disease (CKD) is a major worldwide health concern because of its progressive nature and complex biology. Traditional diagnostic and therapeutic approaches usually fail to account for disease heterogeneity, resulting in low efficacy. Precision medicine offers a novel approach to studying kidney [...] Read more.

Chronic kidney disease (CKD) is a major worldwide health concern because of its progressive nature and complex biology. Traditional diagnostic and therapeutic approaches usually fail to account for disease heterogeneity, resulting in low efficacy. Precision medicine offers a novel approach to studying kidney disease by combining omics technologies such as genomics, transcriptomics, proteomics, metabolomics, and epigenomics. By identifying discrete disease subtypes, molecular biomarkers, and therapeutic targets, these technologies pave the way for personalized treatment approaches. Multi-omics integration has enhanced our understanding of CKD by revealing intricate molecular linkages and pathways that contribute to treatment resistance and disease progression. While pharmacogenomics offers insights into expected responses to personalized treatments, single-cell and spatial transcriptomics can be utilized to investigate biological heterogeneity. Despite significant development, challenges persist, including data integration concerns, high costs, and ethical quandaries. Standardized data protocols, collaborative data-sharing frameworks, and advanced computational tools such as machine learning and causal inference models are required to address these challenges. With the advancement of omics technology, nephrology may benefit from improved diagnostic accuracy, risk assessment, and personalized care. By overcoming these barriers, precision medicine has the potential to develop novel techniques for improving patient outcomes in kidney disease treatment. Full article

(This article belongs to the Special Issue Advances in Omics Technologies for Precision Medicine in Kidney Diseases)

13 pages, 454 KB

Open AccessEditor’s ChoiceReview

The Future of Pharmacogenomics: Integrating Epigenetics, Nutrigenomics, and Beyond

by Jeffrey A. Shaman

J. Pers. Med. 2024, 14(12), 1121; https://doi.org/10.3390/jpm14121121 - 27 Nov 2024

Cited by 8 | Viewed by 2750

Abstract

Pharmacogenomics (PGx) has revolutionized personalized medicine by empowering the tailoring of drug treatments based on individual genetic profiles. However, the complexity of drug response mechanisms necessitates the integration of additional biological and environmental factors. This article explores integrating epigenetics, nutrigenomics, microbiomes, protein interactions, [...] Read more.

Pharmacogenomics (PGx) has revolutionized personalized medicine by empowering the tailoring of drug treatments based on individual genetic profiles. However, the complexity of drug response mechanisms necessitates the integration of additional biological and environmental factors. This article explores integrating epigenetics, nutrigenomics, microbiomes, protein interactions, exosomes, and metabolomics with PGx to enhance personalized medicine. In addition to discussing these scientific advancements, we examine the regulatory and ethical challenges of translating multi-omics into clinical practice, including considerations of data privacy, regulatory oversight, and equitable access. By framing these factors within the context of Medication Adherence, Medication Appropriateness, and Medication Adverse Events (MA³), we aim to refine therapeutic strategies, improve drug efficacy, and minimize adverse effects, with the goal of improving personalized medicine. This approach has the potential to benefit patients, healthcare providers, payers, and the healthcare system as a whole by enabling more precise and effective treatments. Full article

(This article belongs to the Section Pharmacogenetics)

► Show Figures

Figure 1

17 pages, 1523 KB

Open AccessEditor’s ChoiceReview

Left Atrial Strain: State of the Art and Clinical Implications

by Niloofar Javadi, Nadera N. Bismee, Mohammed Tiseer Abbas, Isabel G. Scalia, Milagros Pereyra, Nima Baba Ali, Sogol Attaripour Esfahani, Kamal Awad, Juan M. Farina, Chadi Ayoub and Reza Arsanjani

J. Pers. Med. 2024, 14(11), 1093; https://doi.org/10.3390/jpm14111093 - 5 Nov 2024

Cited by 7 | Viewed by 3791

Abstract

The assessment of left atrial strain (LAS) has emerged as an essential component in the evaluation of cardiac function, especially in pathologies such as heart failure and atrial fibrillation. This narrative review aims to outline the available methods for assessing LAS with a [...] Read more.

The assessment of left atrial strain (LAS) has emerged as an essential component in the evaluation of cardiac function, especially in pathologies such as heart failure and atrial fibrillation. This narrative review aims to outline the available methods for assessing LAS with a major emphasis on speckle-tracking echocardiography techniques. Other imaging modalities, including cardiac magnetic resonance and cardiac computed tomography, also provide important information on LA dynamics but have disadvantages with respect to cost and availability. The current narrative review underlines basic concepts such as the accurate assessment of LAS and discusses the clinical relevance of LAS by pointing out its significant diagnostic and prognostic role in several cardiovascular conditions. The aim of this article is to discuss the current integration of LAS into clinical practice with a view to further improving patient management and treatment strategies. Full article

(This article belongs to the Special Issue The Development of Echocardiography in Heart Disease)

► Show Figures

Figure 1

28 pages, 6016 KB

Open AccessEditor’s ChoiceReview

Intratumoral Microbiota: Insights from Anatomical, Molecular, and Clinical Perspectives

by Claudia Lombardo, Rosanna Fazio, Marta Sinagra, Giuseppe Gattuso, Federica Longo, Cinzia Lombardo, Mario Salmeri, Guido Nicola Zanghì and Carla Agata Erika Loreto

J. Pers. Med. 2024, 14(11), 1083; https://doi.org/10.3390/jpm14111083 - 31 Oct 2024

Cited by 4 | Viewed by 3177

Abstract

The human microbiota represents a heterogeneous microbial community composed of several commensal, symbiotic, and even pathogenic microorganisms colonizing both the external and internal body surfaces. Despite the term “microbiota” being commonly used to identify microorganisms inhabiting the gut, several pieces of evidence suggest [...] Read more.

The human microbiota represents a heterogeneous microbial community composed of several commensal, symbiotic, and even pathogenic microorganisms colonizing both the external and internal body surfaces. Despite the term “microbiota” being commonly used to identify microorganisms inhabiting the gut, several pieces of evidence suggest the presence of different microbiota physiologically colonizing other organs. In this context, several studies have also confirmed that microbes are integral components of tumor tissue in different types of cancer, constituting the so-called “intratumoral microbiota”. The intratumoral microbiota is closely related to the occurrence and development of cancer as well as to the efficacy of anticancer treatments. Indeed, intratumoral microbiota can contribute to carcinogenesis and metastasis formation as some microbes can directly cause DNA damage, while others can induce the activation of proinflammatory responses or oncogenic pathways and alter the tumor microenvironment (TME). All these characteristics make the intratumoral microbiota an interesting topic to investigate for both diagnostic and prognostic purposes in order to improve the management of cancer patients. This review aims to gather the most recent data on the role of the intratumoral microbiota in cancer development, progression, and response to treatment, as well as its potential diagnostic and prognostic value. Full article

(This article belongs to the Special Issue Novel Biomarkers in the Diagnostics of Cancer)

► Show Figures

Figure 1

16 pages, 938 KB

Open AccessEditor’s ChoiceReview

Three-Dimensional Printing Technology in Drug Design and Development: Feasibility, Challenges, and Potential Applications

by Maria C. Simon, Konstantinos Laios, Ioannis Nikolakakis and Theodore G. Papaioannou

J. Pers. Med. 2024, 14(11), 1080; https://doi.org/10.3390/jpm14111080 - 29 Oct 2024

Cited by 7 | Viewed by 3499

Abstract

Background/Objectives: The present investigation evaluates the impact of 3D-printing technology on the design of pharmaceutical drugs, considering the feasibility issues and problems concerning technological, pharmaceutical, and clinical matters. This paper aims to review how 3D printing can modify the traditional manufacturing of drugs [...] Read more.

Background/Objectives: The present investigation evaluates the impact of 3D-printing technology on the design of pharmaceutical drugs, considering the feasibility issues and problems concerning technological, pharmaceutical, and clinical matters. This paper aims to review how 3D printing can modify the traditional manufacturing of drugs with personalized medicine-therapy outcomes being individualized and optimized, hence improving patients’ compliance. Methods: The historical development of 3D printing from rapid prototyping to advanced pharmaceutical applications is discussed. A comparison is then made between traditional drug manufacturing approaches and the different techniques of 3D printing, including stereolithography, material extrusion, and binder jetting. Feasibility is assessed based on clinical trials and studies evaluating the efficacy, safety, bioavailability, and cost-effectiveness of 3D-printed drugs. Results: Current evidence indicates that material selection, regulatory barriers, and scalability issues are some of the major challenges to be overcome for wider acceptance. Other matters, such as ethical issues concerning patient data privacy, the misuse of 3D-printing technology, and technical complexities related to pharmaceutical 3D printing, are discussed further. Future applications also include bioprinting and in situ printing together with their implications for personalized drug delivery, which will also be discussed. Conclusions: This review stresses that intersectoral collaboration and the updating of regulatory frameworks are a must to overcome the barriers that confront 3D-printing applications in drug development. can could be an opportunity for innovative licensing and manufacturing techniques in pharmaceutical product development that can change the paradigm of personalized medicine through modern printing techniques. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

► Show Figures

Figure 1

17 pages, 758 KB

Open AccessEditor’s ChoiceReview

Maximizing Knee OA Treatment: A Comparative Look at Physiotherapy and Injections

by Danilo Donati, Federica Giorgi, Tarantino Domiziano, Luigi Tarallo, Fabio Catani, Daniela Platano and Roberto Tedeschi

J. Pers. Med. 2024, 14(11), 1077; https://doi.org/10.3390/jpm14111077 - 26 Oct 2024

Cited by 5 | Viewed by 2371

Abstract

Background: Knee osteoarthritis (OA) is a prevalent and disabling condition often managed with physiotherapy or intra-articular injections. However, the comparative effectiveness of these treatments remains unclear. This systematic review aimed to evaluate and compare the efficacy of physiotherapy and intra-articular injections in managing [...] Read more.

Background: Knee osteoarthritis (OA) is a prevalent and disabling condition often managed with physiotherapy or intra-articular injections. However, the comparative effectiveness of these treatments remains unclear. This systematic review aimed to evaluate and compare the efficacy of physiotherapy and intra-articular injections in managing knee OA. Methods: A systematic search of PubMed, Scopus, Web of Science, PEDro, and Cochrane Library was conducted. Randomized controlled trials (RCTs) comparing physiotherapy and intra-articular injections in knee OA patients were included. Key outcomes included pain (VAS), function (WOMAC, KOOS), range of motion (ROM), and quality of life. Data from five studies with a total of 552 participants were analyzed. Results: Intra-articular injections, particularly botulinum toxin and hyaluronic acid, were found to provide rapid pain relief, outperforming physiotherapy in short-term pain management. However, physiotherapy contributed significantly to long-term functional improvements, particularly in early-stage OA. Combination therapy of injections and physiotherapy yielded the best short-term pain relief and functional outcomes. Heterogeneity in study designs and follow-up periods limited the generalizability of findings. Conclusions: Intra-articular injections are effective for immediate pain control, while physiotherapy plays a crucial role in maintaining joint function, especially for long-term management. Combining both interventions may offer the most comprehensive benefits. Further research is needed to determine the long-term efficacy of these treatments. Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

► Show Figures

Figure 1

13 pages, 3063 KB

Open AccessEditor’s ChoiceArticle

Therapeutic Drug Monitoring of Elexacaftor, Tezacaftor, and Ivacaftor in Adult People with Cystic Fibrosis

by Susanne Naehrig, Christina Shad, Magdalena Breuling, Melanie Goetschke, Katharina Habler, Sarah Sieber, Johanna Kastenberger, Alexandra Katharina Kunzelmann, Olaf Sommerburg, Uwe Liebchen, Juergen Behr, Michael Vogeser and Michael Paal

J. Pers. Med. 2024, 14(10), 1065; https://doi.org/10.3390/jpm14101065 - 17 Oct 2024

Cited by 5 | Viewed by 2238

Abstract

Background/Objectives: Elexacaftor, tezacaftor, and ivacaftor (ETI) have significantly improved lung function in people with cystic fibrosis (pwCF). Despite exceptional improvements in most cases, treatment-related inter-subject variability and drug–drug interactions that complicate modulator therapy have been reported. Methods: This retrospective analysis presents data on [...] Read more.

Background/Objectives: Elexacaftor, tezacaftor, and ivacaftor (ETI) have significantly improved lung function in people with cystic fibrosis (pwCF). Despite exceptional improvements in most cases, treatment-related inter-subject variability and drug–drug interactions that complicate modulator therapy have been reported. Methods: This retrospective analysis presents data on the serum concentration of ETI in our pwCF with full or reduced dosage from August 2021 to December 2023 via routine therapeutic drug monitoring (TDM). The data were compared with the maximum drug concentrations (Cmax) from the pharmaceutical company’s summary of product characteristics. Results: A total of 786 blood samples from 155 pwCF (41% female, 59% male) were analyzed. The examinations were divided into four groups: full dose within the given tmax (38.5% of all measurements), full dose outside the tmax (29%), reduced dose within the tmax (19.2%), and reduced dose outside the tmax (13.2%). In pwCF receiving the full dose and blood taken within the tmax, 45.3% of serum concentrations of elexacaftor, 51.1% of serum concentrations of ivacaftor, and 8.9% of serum concentrations of tezacaftor were found to be above the Cmax, respectively. For those on reduced doses within the tmax, 24.5% had a serum concentration of elexacaftor, 23.2% had a serum concentration of ivacaftor, and 2.5% had a serum concentration of tezacaftor above the Cmax, respectively. Conclusions: Many pwCF under ETI therapy have Cmax values for elexacaftor and ivacaftor above the recommended range, even on reduced doses or before the tmax was reached. This highlights the value of a TDM program. Further pharmacokinetic studies are necessary. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

► Show Figures

Figure 1

12 pages, 1626 KB

Open AccessEditor’s ChoiceArticle

Soft Tissue Facial Morphology in Growing Patients with Different Occlusal Classes

by Niccolò Cenzato, Marco Farronato, Francesco Carlo Tartaglia, Lucia Giannini, Angelo Michele Inchingolo, Gianna Dipalma, Cinzia Maspero and Francesco Inchingolo

J. Pers. Med. 2024, 14(10), 1042; https://doi.org/10.3390/jpm14101042 - 7 Oct 2024

Cited by 4 | Viewed by 2453

Abstract

Introduction: The study of facial profiles in the dental field is very important for the diagnosis and the dental and orthodontic treatment plan. The aim of this study is to analyze the three-dimensional morphology of the faces of 269 growing patients with Class [...] Read more.

Introduction: The study of facial profiles in the dental field is very important for the diagnosis and the dental and orthodontic treatment plan. The aim of this study is to analyze the three-dimensional morphology of the faces of 269 growing patients with Class I and II occlusions, focusing on children aged between 6 and 9 years old. The analysis was conducted using a non-invasive computerized system, which allowed for the automatic collection of facial landmarks and the subsequent reconstruction of three-dimensional coordinates. Materials and methods: The sample comprised 269 children within the specified age range. Each child’s facial features were captured using the non-invasive computerized system, which utilized two infrared CCD cameras, real-time hardware for label recognition, and software for three-dimensional landmark reconstruction. Sixteen cutaneous facial landmarks were automatically collected for each participant. From these landmarks, 10 angular and 15 linear measurements, as well as five direct distance rates, were derived. The mean values for each age class were calculated separately for children with bilateral Angle Class I occlusion and compared with those for children with bilateral Class II occlusion. In all children, the left and right occlusal classes were measured as suggested by Katz. Results: The analysis revealed notable differences, primarily in the three-dimensional angular measurements between children with Class I and II occlusions. Specifically, Class II children exhibited more convex faces in the sagittal plane and a less prominent lower jaw compared to Class I children. However, no significant differences were observed in linear measurements, except for the lower facial height rate, which varied inconsistently across age groups between the two occlusion types. Discussion and Conclusions: the findings of this research highlight distinct three-dimensional facial morphological differences between children with Class I and II occlusions. While Class II children tended to have more convex facial profiles and less prominent lower jaws, linear measurements showed minimal variation between the two occlusion types. These results underscore the importance of three-dimensional analysis in understanding facial morphology in growing patients with different occlusal patterns. Full article

(This article belongs to the Special Issue Orthodontics and Oral Surgery in Personalized Medicine: 2nd Edition)

► Show Figures

Figure 1

16 pages, 1223 KB

Open AccessEditor’s ChoiceReview

Risk Factors for Ovarian Cancer in South America: A Literature Review

by Sergio Jara-Rosales, Roxana González-Stegmaier, Elena S. Rotarou and Franz Villarroel-Espíndola

J. Pers. Med. 2024, 14(9), 992; https://doi.org/10.3390/jpm14090992 - 18 Sep 2024

Cited by 5 | Viewed by 2531

Abstract

Background/Objectives: In 2020, ovarian cancer ranked fourth in global incidence among gynecological cancers and remains the deadliest cancer affecting women’s health. Survival rates are significantly higher when the disease is detected at early stages; however, the lack of effective early detection methods underscores [...] Read more.

Background/Objectives: In 2020, ovarian cancer ranked fourth in global incidence among gynecological cancers and remains the deadliest cancer affecting women’s health. Survival rates are significantly higher when the disease is detected at early stages; however, the lack of effective early detection methods underscores the importance of identifying risk factors in order to implement preventive strategies. The objective of this work is to provide an overview of the risk factors of ovarian cancer in South America, emphasizing those linked to social determinants, genetic components, and comorbidities. Methods: A literature search was performed using PubMed and Google Scholar. MeSH descriptors and keywords, such as “BRCA1 genes,” “BRCA2 genes”, “Latin America”, and “ovarian neoplasms” were used, along with terms related to socioeconomic and health factors. Inclusion criteria focused on original studies published in the last five years involving South American women. Results: Studies were identified from Argentina, Brazil, Chile, Colombia, Ecuador, and Peru. These studies addressed genetic factors, health status at diagnosis, and sociodemographic factors, revealing important data gaps, particularly on contraception and hormone replacement therapy. The prevalence of BRCA1 and BRCA2 mutations in South America is estimated to be 15–20% among women with inherited risk factors. Social, demographic and economic factors vary by country, although commonalities include a higher prevalence among women over 50 years of age, those with limited education, and those who face barriers to accessing health care. Conclusions: Although the literature does not conclusively establish a direct link between obesity and/or diabetes and the development of ovarian cancer, the indirect association highlights the need for further clinical studies. A general research gap related to risk factors of ovarian cancer could be observed in the South American region. Full article

(This article belongs to the Special Issue New Perspectives, Challenges and Innovations in Modern Personalized Gynaecologic Oncology)

► Show Figures

Figure 1

29 pages, 1103 KB

Open AccessEditor’s ChoiceReview

Integrating Machine Learning with Multi-Omics Technologies in Geroscience: Towards Personalized Medicine

by Nikolaos Theodorakis, Georgios Feretzakis, Lazaros Tzelves, Evgenia Paxinou, Christos Hitas, Georgia Vamvakou, Vassilios S. Verykios and Maria Nikolaou

J. Pers. Med. 2024, 14(9), 931; https://doi.org/10.3390/jpm14090931 - 31 Aug 2024

Cited by 20 | Viewed by 5621

Abstract

Aging is a fundamental biological process characterized by a progressive decline in physiological functions and an increased susceptibility to diseases. Understanding aging at the molecular level is crucial for developing interventions that could delay or reverse its effects. This review explores the integration [...] Read more.

Aging is a fundamental biological process characterized by a progressive decline in physiological functions and an increased susceptibility to diseases. Understanding aging at the molecular level is crucial for developing interventions that could delay or reverse its effects. This review explores the integration of machine learning (ML) with multi-omics technologies—including genomics, transcriptomics, epigenomics, proteomics, and metabolomics—in studying the molecular hallmarks of aging to develop personalized medicine interventions. These hallmarks include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, disabled macroautophagy, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, chronic inflammation, and dysbiosis. Using ML to analyze big and complex datasets helps uncover detailed molecular interactions and pathways that play a role in aging. The advances of ML can facilitate the discovery of biomarkers and therapeutic targets, offering insights into personalized anti-aging strategies. With these developments, the future points toward a better understanding of the aging process, aiming ultimately to promote healthy aging and extend life expectancy. Full article

(This article belongs to the Special Issue The Intersection of Multi-Omics Data and Machine Learning in Medicine)

► Show Figures

Graphical abstract

25 pages, 655 KB

Open AccessEditor’s ChoiceReview

Systematic Review and Clinical Insights: The Role of the Ketogenic Diet in Managing Glioblastoma in Cancer Neuroscience

by Jose Valerio, Matteo Borro, Elisa Proietti, Livia Pisciotta, Immanuel O. Olarinde, Maria Fernandez Gomez and Andres Mauricio Alvarez Pinzon

J. Pers. Med. 2024, 14(9), 929; https://doi.org/10.3390/jpm14090929 - 31 Aug 2024

Cited by 7 | Viewed by 8601

Abstract

Recent scientific research has shown that the ketogenic diet may have potential benefits in a variety of medical fields, which has led to the diet receiving a substantial amount of attention. Clinical and experimental research on brain tumors has shown that the ketogenic [...] Read more.

Recent scientific research has shown that the ketogenic diet may have potential benefits in a variety of medical fields, which has led to the diet receiving a substantial amount of attention. Clinical and experimental research on brain tumors has shown that the ketogenic diet has a satisfactory safety profile. This safety profile has been established in a variety of applications, including the management of obesity and the treatment of drug-resistant epileptic cases. However, in human studies, the impact of ketogenic therapy on the growth of tumors and the life expectancy of patients has not provided results that are well characterized. Consequently, our purpose is to improve the comprehension of these features by succinctly presenting the developments and conclusions that have been gained from the most recent study that pertains to this non-pharmacological technique. According to the findings of our study, patients with brain tumors who stick to a ketogenic diet are more likely to experience improved survival rates. However, it is required to conduct additional research on humans in order to more accurately define the anti-tumor efficiency of this diet as well as the underlying processes that support the therapeutic effects of this dieting regimen. Full article

(This article belongs to the Special Issue Advancements in Neurosurgical Oncology: Bridging Neurosurgery and Cancer Neuroscience)

► Show Figures

Figure 1

18 pages, 5712 KB

Open AccessEditor’s ChoiceArticle

Urolithin A Ameliorates the TGF Beta-Dependent Impairment of Podocytes Exposed to High Glucose

by Barbara Lewko, Milena Wodzińska, Agnieszka Daca, Agata Płoska, Katarzyna Obremska and Leszek Kalinowski

J. Pers. Med. 2024, 14(9), 914; https://doi.org/10.3390/jpm14090914 - 28 Aug 2024

Cited by 4 | Viewed by 1641

Abstract

Increased activity of transforming growth factor-beta (TGF-β) is a key factor mediating kidney impairment in diabetes. Glomerular podocytes, the crucial component of the renal filter, are a direct target of TGF-β action, resulting in irreversible cell loss and progression of chronic kidney disease [...] Read more.

Increased activity of transforming growth factor-beta (TGF-β) is a key factor mediating kidney impairment in diabetes. Glomerular podocytes, the crucial component of the renal filter, are a direct target of TGF-β action, resulting in irreversible cell loss and progression of chronic kidney disease (CKD). Urolithin A (UA) is a member of the family of polyphenol metabolites produced by gut microbiota from ellagitannins and ellagic acid-rich foods. The broad spectrum of biological activities of UA makes it a promising candidate for the treatment of podocyte disorders. In this in vitro study, we investigated whether UA influences the changes exerted in podocytes by TGF-β and high glucose. Following a 7-day incubation in normal (NG, 5.5 mM) or high (HG, 25 mM) glucose, the cells were treated with UA and/or TGF-β1 for 24 h. HG and TGF-β1, each independent and in concert reduced expression of nephrin, increased podocyte motility, and up-regulated expression of b3 integrin and fibronectin. These typical-for-epithelial-to-mesenchymal transition (EMT) effects were inhibited by UA in both HG and NG conditions. UA also reduced the typically elevated HG expression of TGF-β receptors and activation of the TGF-β signal transducer Smad2. Our results indicate that in podocytes cultured in conditions mimicking the diabetic milieu, UA inhibits and reverses changes underlying podocytopenia in diabetic kidneys. Hence, UA should be considered as a potential therapeutic agent in podocytopathies. Full article

(This article belongs to the Section Disease Biomarkers)

► Show Figures

Graphical abstract

17 pages, 328 KB

Open AccessEditor’s ChoiceReview

Recommendations for the Application of Sex and Gender Medicine in Preclinical, Epidemiological and Clinical Research

by Annamaria Cattaneo, Maria Bellenghi, Eliana Ferroni, Cristina Mangia, Matteo Marconi, Paola Rizza, Alice Borghini, Lorena Martini, Maria Novella Luciani, Elena Ortona, Alessandra Carè, Marialuisa Appetecchia and Ministry of Health-Gender Medicine Team

J. Pers. Med. 2024, 14(9), 908; https://doi.org/10.3390/jpm14090908 - 27 Aug 2024

Cited by 4 | Viewed by 4053

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

22 pages, 1132 KB

Open AccessEditor’s ChoiceReview

IgE-Mediated Legume Allergy: A Pediatric Perspective

by Carla Mastrorilli, Fernanda Chiera, Stefania Arasi, Arianna Giannetti, Davide Caimmi, Giulio Dinardo, Serena Gracci, Luca Pecoraro, Michele Miraglia Del Giudice and Roberto Bernardini

J. Pers. Med. 2024, 14(9), 898; https://doi.org/10.3390/jpm14090898 - 25 Aug 2024

Cited by 8 | Viewed by 3959

Abstract

Legumes are an inexpensive and essential protein source worldwide. The most consumed legumes include peanuts, soybeans, lentils, lupines, peas, common bean and chickpeas. In addition, the food industry is growing interested in expanding the use of legumes to partially replace or substitute cereals. [...] Read more.

Legumes are an inexpensive and essential protein source worldwide. The most consumed legumes include peanuts, soybeans, lentils, lupines, peas, common bean and chickpeas. In addition, the food industry is growing interested in expanding the use of legumes to partially replace or substitute cereals. Legumes were described to cause IgE-mediated allergies, and their growing use may also increase the incidence of allergy. The epidemiology of legume allergy varies by region; peanuts and soybeans are the legumes most involved in food allergies in Western countries, whereas lentils, peas, and chickpeas are reported as culprit allergens mainly in the Mediterranean area and India. This review, edited by the Italian Society of Pediatric Allergology and Immunology, summarizes the scientific literature on legume allergy in children and proposes a diagnostic workup and therapeutic approach. Full article

(This article belongs to the Section Personalized Medical Care)

► Show Figures

Figure 1

21 pages, 2611 KB

Open AccessEditor’s ChoiceReview

Advancing the Diagnosis of Diabetic Neuropathies: Electrodiagnostic and Skin Autofluorescence Methods

by Dan Trofin, Bianca-Margareta Salmen, Teodor Salmen, Daniela Marilena Trofin and Delia Reurean-Pintilei

J. Pers. Med. 2024, 14(8), 884; https://doi.org/10.3390/jpm14080884 - 21 Aug 2024

Cited by 4 | Viewed by 1923

Abstract

Introduction: Diabetic neuropathy (DN) is a generic term for various neuropathies coexisting in a single patient. Clinical diagnosis alone can be misleading, yet routine electrodiagnostic studies in diabetes care are rare. Skin autofluorescence (SAF) is a recognized DN risk factor with potential screening [...] Read more.

Introduction: Diabetic neuropathy (DN) is a generic term for various neuropathies coexisting in a single patient. Clinical diagnosis alone can be misleading, yet routine electrodiagnostic studies in diabetes care are rare. Skin autofluorescence (SAF) is a recognized DN risk factor with potential screening value. This article highlights the diagnostic challenges and raises awareness of the often underdiagnosed neuropathic conditions in diabetes patients. Material and Methods: We present common entrapment neuropathy cases from our diabetes clinic’s electrodiagnosis laboratory in Iași, Romania. We selected seven type 2 diabetes patients with sensory or sensory-motor distal polyneuropathy and atypical DN presentations investigated through electroneurography (ENG) and electromyography (EMG) with the Neurosoft^® EMG instrument and SAF measured by standard procedures. Subsequently, a narrative literature review was conducted. Results: Entrapment neuropathies were diagnosed in all the patients: three carpal tunnel syndromes, two ulnar neuropathies (one proximal, one distal), one peroneal neuropathy, and one case of meralgia paresthetica. The lower-limb cases showed radiculoplexopathy, and there was one case of superficial radial nerve neuropathy. The SAF values ranged from 2.5 AU to 3.4 AU. Conclusions: Electrodiagnosis is essential for detecting focal neuropathies in patients with sensory-motor distal polyneuropathy. Elevated SAF levels may correlate with symptom severity, although further research, including large cohorts, is needed. Full article

(This article belongs to the Special Issue Diabetes and Its Complications: From Research to Clinical Practice)

► Show Figures

Figure 1

19 pages, 1888 KB

Open AccessEditor’s ChoiceReview

Chatbots in Cancer Applications, Advantages and Disadvantages: All that Glitters Is Not Gold

by Georgios Goumas, Theodoros I. Dardavesis, Konstantinos Syrigos, Nikolaos Syrigos and Effie Simou

J. Pers. Med. 2024, 14(8), 877; https://doi.org/10.3390/jpm14080877 - 19 Aug 2024

Cited by 8 | Viewed by 5092

Abstract

The emergence of digitalization and artificial intelligence has had a profound impact on society, especially in the field of medicine. Digital health is now a reality, with an increasing number of people using chatbots for prognostic or diagnostic purposes, therapeutic planning, and monitoring, [...] Read more.

The emergence of digitalization and artificial intelligence has had a profound impact on society, especially in the field of medicine. Digital health is now a reality, with an increasing number of people using chatbots for prognostic or diagnostic purposes, therapeutic planning, and monitoring, as well as for nutritional and mental health support. Initially designed for various purposes, chatbots have demonstrated significant advantages in the medical field, as indicated by multiple sources. However, there are conflicting views in the current literature, with some sources highlighting their drawbacks and limitations, particularly in their use in oncology. This state-of-the-art review article seeks to present both the benefits and the drawbacks of chatbots in the context of medicine and cancer, while also addressing the challenges in their implementation, offering expert insights on the subject. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

► Show Figures

Figure 1

17 pages, 1456 KB

Open AccessEditor’s ChoiceSystematic Review

Anatomical Features in Inguinal-Pubic-Adductor Area That May Contribute to Gender Difference in Susceptibility to Groin Pain Syndrome

by Gian Nicola Bisciotti, Andrea Bisciotti, Alessio Auci, Alessandro Bisciotti and Piero Volpi

J. Pers. Med. 2024, 14(8), 860; https://doi.org/10.3390/jpm14080860 - 14 Aug 2024

Cited by 4 | Viewed by 1746

Abstract

Groin pain syndrome (GPS) is often a diagnostic challenge for sport physicians. Despite this diagnostic difficulty, the incidence of GPS in athletes is relatively high, afflicting 10–20% of the total sports population. In the literature, a certain number of studies demonstrate an important [...] Read more.

Groin pain syndrome (GPS) is often a diagnostic challenge for sport physicians. Despite this diagnostic difficulty, the incidence of GPS in athletes is relatively high, afflicting 10–20% of the total sports population. In the literature, a certain number of studies demonstrate an important gender-based difference in the incidence of GPS in both sexes, with a ratio of female:male athletes clearly in favor of the female gender being relatively less prone to GPS. Indeed, some anatomical differences between the two sexes seem to represent a protective factor against the onset of GPS in women, although the current literature still needs to clarify the validity of these findings. It is the aim of this systematic review to examine all the anatomical differences between men and women that may be responsible for the difference in the onset of GPS in the two sexes. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

► Show Figures

Figure 1

16 pages, 2693 KB

Open AccessEditor’s ChoiceReview

Blocking the IL-4/IL-13 Axis versus the JAK/STAT Pathway in Atopic Dermatitis: How Can We Choose?

by Laura Calabrese, Martina D’Onghia, Laura Lazzeri, Giovanni Rubegni and Elisa Cinotti

J. Pers. Med. 2024, 14(7), 775; https://doi.org/10.3390/jpm14070775 - 22 Jul 2024

Cited by 9 | Viewed by 5857

Abstract

Atopic dermatitis (AD) is an immune-mediated skin disorder with a chronic-relapsing course and a multifactorial pathogenesis. In contrast to the traditional concept of AD as solely a type 2 immune-activated disease, new findings highlight the disease as highly heterogeneous, as it can be [...] Read more.

Atopic dermatitis (AD) is an immune-mediated skin disorder with a chronic-relapsing course and a multifactorial pathogenesis. In contrast to the traditional concept of AD as solely a type 2 immune-activated disease, new findings highlight the disease as highly heterogeneous, as it can be classified into variable phenotypes based on clinical/epidemiological or molecular parameters. For many years, the only therapeutic option for moderate–severe AD was traditional immunosuppressive drugs. Recently, the area of systemic therapy of AD has significantly flourished, and many new substances are now marketed, licensed, or in the last step of clinical development. Biological agents and small molecules have enriched the therapeutic armamentarium of moderate-to-severe AD, such as dupilumab, tralokinumab, lebrikizumab (monoclonal antibodies targeting the IL-4/13 pathway), abrocitinib, upadacitinib, and baricitinib (JAK inhibitors). Indeed, the AD treatment paradigm is now split into two main approaches: targeting the IL-4/13 axis or the JAK/STAT pathway. Both approaches are valid and have strong evidence of preclinical and clinical efficacy. Therefore, the choice between the two can often be difficult and represents a major challenge for dermatologists. Indeed, several important factors must be taken into account, such as the heterogeneity of AD and its classification in phenotypes, patients’ comorbidities, age, and personal preferences. The aim of our review is to provide an overview of the clinical and molecular heterogeneities of AD and to explore the factors and parameters that, in clinical practice, may help inform clinical decision-making. Full article

(This article belongs to the Special Issue Personalized Treatment and Management in Dermatology)

► Show Figures

Figure 1

23 pages, 11038 KB

Open AccessEditor’s ChoiceArticle

A Multi-Omics Analysis of an Exhausted T Cells’ Molecular Signature in Pan-Cancer

by Christos Rigopoulos, Ilias Georgakopoulos-Soares and Apostolos Zaravinos

J. Pers. Med. 2024, 14(7), 765; https://doi.org/10.3390/jpm14070765 - 18 Jul 2024

Cited by 5 | Viewed by 3928

Abstract

T cells are essential tumor suppressors in cancer immunology, but their dysfunction induced by cancer cells can result in T cell exhaustion. Exhausted T cells (Tex) significantly influence the tumor immune environment, and thus, there is a need for their thorough investigation across [...] Read more.

T cells are essential tumor suppressors in cancer immunology, but their dysfunction induced by cancer cells can result in T cell exhaustion. Exhausted T cells (Tex) significantly influence the tumor immune environment, and thus, there is a need for their thorough investigation across different types of cancer. Here, we address the role of Tex cells in pan-cancer, focusing on the expression, mutations, methylation, immune infiltration, and drug sensitivity of a molecular signature comprising of the genes HAVCR2, CXCL13, LAG3, LAYN, TIGIT, and PDCD1across multiple cancer types, using bioinformatics analysis of TCGA data. Our analysis revealed that the Tex signature genes are differentially expressed across 14 cancer types, being correlated with patient survival outcomes, with distinct survival trends. Pathway analysis indicated that the Tex genes influence key cancer-related pathways, such as apoptosis, EMT, and DNA damage pathways. Immune infiltration analysis highlighted a positive correlation between Tex gene expression and immune cell infiltration in bladder cancer, while mutations in these genes were associated with specific immune cell enrichments in UCEC and SKCM. CNVs in Tex genes were widespread across cancers. We also highlight high LAYN methylation in most tumors and a negative correlation between methylation levels and immune cell infiltration in various cancers. Drug sensitivity analysis identified numerous correlations, with CXCL13 and HAVCR2 expressions influencing sensitivity to several drugs, including Apitolisib, Belinostat, and Docetaxel. Overall, these findings highlight the importance of reviving exhausted T cells to enhance the treatment efficacy to significantly boost anti-tumor immunity and achieve better clinical outcomes. Full article

(This article belongs to the Special Issue Advances of Precision Medicine in Oncology)

► Show Figures

Figure 1

18 pages, 658 KB

Open AccessEditor’s ChoiceSystematic Review

A Systematic Review of the Effects of EEG Neurofeedback on Patients with Schizophrenia

by Dan Cătălin Oprea, Iasmin Mawas, Cătălina Andreea Moroșan, Vlad Teodor Iacob, Eliza Mihaela Cămănaru, Ana Caterina Cristofor, Romeo Petru Dobrin, Bogdan Gireadă, Florin Dumitru Petrariu and Roxana Chiriță

J. Pers. Med. 2024, 14(7), 763; https://doi.org/10.3390/jpm14070763 - 18 Jul 2024

Cited by 4 | Viewed by 6162

Abstract

Schizophrenia is a neuropsychiatric disorder affecting approximately 1 in 300 people worldwide. It is characterized by a range of symptoms, including positive symptoms (delusions, hallucinations, and formal thought disorganization), negative symptoms (anhedonia, alogia, avolition, asociality, and blunted affect), and cognitive impairments (impaired memory, [...] Read more.

Schizophrenia is a neuropsychiatric disorder affecting approximately 1 in 300 people worldwide. It is characterized by a range of symptoms, including positive symptoms (delusions, hallucinations, and formal thought disorganization), negative symptoms (anhedonia, alogia, avolition, asociality, and blunted affect), and cognitive impairments (impaired memory, attention, executive function, and processing speed). Current treatments, such as psychopharmacology and psychotherapy, often do not fully address these symptoms, leading to impaired everyday functionality. In recent years, there has been a growing interest in neuromodulation due to computer and engineering science making extraordinary computational advances. Those put together have reinitiated the spark in the field of neurofeedback (NF) as a means for self-regulation and neuromodulation with the potential to alleviate the daily burden of schizophrenia. We review, in a systematic way, the primary reports of electroencephalogram (EEG)-based NF as a therapeutical tool for schizophrenia. The main body of research consists mostly of case studies and case reports. The results of a few randomized controlled studies, combined with case studies/series, underscore the potential use of NF as an add-on treatment option for improving the lives of suffering individuals, being sustained by the changes in brain function and symptomatology improvement. We aim to provide important evidence of neuromodulation using NF in patients with schizophrenia, summarizing the effects and conclusions found in several clinical trials. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

► Show Figures

Figure 1

17 pages, 9270 KB

Open AccessEditor’s ChoiceReview

Point of Care Ultrasound (POCUS) in the Management of Heart Failure: A Narrative Review

by Nicki Naddaf, Neda Dianati Maleki, Marc E. Goldschmidt and Andreas P. Kalogeropoulos

J. Pers. Med. 2024, 14(7), 766; https://doi.org/10.3390/jpm14070766 - 18 Jul 2024

Cited by 7 | Viewed by 9499

Abstract

Assessing for volume overload is a key component of both short and long-term management of heart failure patients. Physical examination findings are neither sensitive nor specific for detecting congestion, and subclinical congestion may not be evident at the time of examination. Point of [...] Read more.

Assessing for volume overload is a key component of both short and long-term management of heart failure patients. Physical examination findings are neither sensitive nor specific for detecting congestion, and subclinical congestion may not be evident at the time of examination. Point of care ultrasound (POCUS) is an efficient and non-invasive way to assess heart failure patients for volume overload. The aim of our narrative review is to summarize how each of the following ultrasound modalities can be used to assess for congestion in the heart failure population: 2D and Doppler echocardiography, lung ultrasound, inferior vena cava ultrasound, internal jugular vein ultrasound, and venous excess grading. While each of these modalities has their limitations, their use in the acute and outpatient space offers the potential to reduce heart failure readmissions and mortality. Full article

(This article belongs to the Section Evidence Based Medicine)

► Show Figures

Figure 1

19 pages, 4557 KB

Open AccessFeature PaperEditor’s ChoiceArticle

Clinical Results of Holmium-166 Radioembolization with Personalized Dosimetry for the Treatment of Hepatocellular Carcinoma

by Christian Kühnel, Alexander Köhler, Tim Brachwitz, Philipp Seifert, Falk Gühne, René Aschenbach, Robert Freudenberg, Martin Freesmeyer and Robert Drescher

J. Pers. Med. 2024, 14(7), 747; https://doi.org/10.3390/jpm14070747 - 14 Jul 2024

Cited by 6 | Viewed by 2386

Abstract

Transarterial radioembolization (TARE) with ¹⁶⁶Ho-loaded microspheres is an established locoregional treatment for hepatocellular carcinoma (HCC), introduced in 2010. This study evaluates the clinical outcome of patients with HCC who underwent ¹⁶⁶Ho-TARE with personalized dosimetry. Twenty-seven patients with 36 TARE procedures were [...] Read more.

Transarterial radioembolization (TARE) with ¹⁶⁶Ho-loaded microspheres is an established locoregional treatment for hepatocellular carcinoma (HCC), introduced in 2010. This study evaluates the clinical outcome of patients with HCC who underwent ¹⁶⁶Ho-TARE with personalized dosimetry. Twenty-seven patients with 36 TARE procedures were analyzed. Treatment planning, execution, and evaluation was possible without complications in all cases. At the 3-month follow-up, disease control in the treated liver was achieved in 81.8% of patients (complete remission, partial remission, and stable disease in 36.4%, 31.8%, and 13.6%, respectively). The median overall survival (OS) was 17.2 months, and progression-free survival (PFS) in the treated liver was 11 months. Statistically significant positive correlations were observed between the achieved radiation dose for the tumor and both PFS (r = 0.62, p < 0.05) and OS (r = 0.48, p < 0.05), suggesting a direct dose–response relationship. The calculated achieved dose was 8.25 Gy lower than the planned dose, with relevant variance between planned and achieved doses in individual cases. These results confirm the efficacy of the ¹⁶⁶Ho-TARE holmium platform and underscore the potential of voxel-based, personalized dosimetry to improve clinical outcomes. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

► Show Figures

Graphical abstract

17 pages, 693 KB

Open AccessEditor’s ChoiceReview

Natural Language Processing and Schizophrenia: A Scoping Review of Uses and Challenges

by Antoine Deneault, Alexandre Dumais, Marie Désilets and Alexandre Hudon

J. Pers. Med. 2024, 14(7), 744; https://doi.org/10.3390/jpm14070744 - 12 Jul 2024

Cited by 6 | Viewed by 4021

Abstract

(1) Background: Approximately 1% of the global population is affected by schizophrenia, a disorder marked by cognitive deficits, delusions, hallucinations, and language issues. It is associated with genetic, neurological, and environmental factors, and linked to dopaminergic hyperactivity and neurotransmitter imbalances. Recent research reveals [...] Read more.

(1) Background: Approximately 1% of the global population is affected by schizophrenia, a disorder marked by cognitive deficits, delusions, hallucinations, and language issues. It is associated with genetic, neurological, and environmental factors, and linked to dopaminergic hyperactivity and neurotransmitter imbalances. Recent research reveals that patients exhibit significant language impairments, such as reduced verbal output and fluency. Advances in machine learning and natural language processing show potential for early diagnosis and personalized treatments, but additional research is required for the practical application and interpretation of such technology. The objective of this study is to explore the applications of natural language processing in patients diagnosed with schizophrenia. (2) Methods: A scoping review was conducted across multiple electronic databases, including Medline, PubMed, Embase, and PsycInfo. The search strategy utilized a combination of text words and subject headings, focusing on schizophrenia and natural language processing. Systematically extracted information included authors, population, primary uses of the natural language processing algorithms, main outcomes, and limitations. The quality of the identified studies was assessed. (3) Results: A total of 516 eligible articles were identified, from which 478 studies were excluded based on the first analysis of titles and abstracts. Of the remaining 38 studies, 18 were selected as part of this scoping review. The following six main uses of natural language processing were identified: diagnostic and predictive modeling, followed by specific linguistic phenomena, speech and communication analysis, social media and online content analysis, clinical and cognitive assessment, and linguistic feature analysis. (4) Conclusions: This review highlights the main uses of natural language processing in the field of schizophrenia and the need for more studies to validate the effectiveness of natural language processing in diagnosing and treating schizophrenia. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

► Show Figures

Figure 1

18 pages, 2135 KB

Open AccessEditor’s ChoiceReview

Emerging Applications of Nanoparticles in the Diagnosis and Treatment of Breast Cancer

by Josephine B. Oehler, Weranga Rajapaksha and Hugo Albrecht

J. Pers. Med. 2024, 14(7), 723; https://doi.org/10.3390/jpm14070723 - 4 Jul 2024

Cited by 25 | Viewed by 8704

Abstract

Breast cancer remains the most prevalent cancer among women worldwide, driving the urgent need for innovative approaches to diagnosis and treatment. This review highlights the pivotal role of nanoparticles in revolutionizing breast cancer management through advancements of interconnected approaches including targeted therapy, imaging, [...] Read more.

Breast cancer remains the most prevalent cancer among women worldwide, driving the urgent need for innovative approaches to diagnosis and treatment. This review highlights the pivotal role of nanoparticles in revolutionizing breast cancer management through advancements of interconnected approaches including targeted therapy, imaging, and personalized medicine. Nanoparticles, with their unique physicochemical properties, have shown significant promise in addressing current treatment limitations such as drug resistance and nonspecific systemic distribution. Applications range from enhancing drug delivery systems for targeted and sustained release to developing innovative diagnostic tools for early and precise detection of metastases. Moreover, the integration of nanoparticles into photothermal therapy and their synergistic use with existing treatments, such as immunotherapy, illustrate their transformative potential in cancer care. However, the journey towards clinical adoption is fraught with challenges, including the chemical feasibility, biodistribution, efficacy, safety concerns, scalability, and regulatory hurdles. This review delves into the current state of nanoparticle research, their applications in breast cancer therapy and diagnosis, and the obstacles that must be overcome for clinical integration. Full article

(This article belongs to the Special Issue Nanomedicine in Cancer Therapy: What's New)

► Show Figures

Figure 1

33 pages, 1709 KB

Open AccessEditor’s ChoiceReview

Evolving Management of Breast Cancer in the Era of Predictive Biomarkers and Precision Medicine

by Muhammad Zubair Afzal and Linda T. Vahdat

J. Pers. Med. 2024, 14(7), 719; https://doi.org/10.3390/jpm14070719 - 3 Jul 2024

Cited by 4 | Viewed by 3918

Abstract

Breast cancer is the most common cancer among women in the world as well as in the United States. Molecular and histological differentiation have helped clinicians optimize treatments with various therapeutics, including hormonal therapy, chemotherapy, immunotherapy, and radiation therapy. Recently, immunotherapy has become [...] Read more.

Breast cancer is the most common cancer among women in the world as well as in the United States. Molecular and histological differentiation have helped clinicians optimize treatments with various therapeutics, including hormonal therapy, chemotherapy, immunotherapy, and radiation therapy. Recently, immunotherapy has become the standard of care in locally advanced triple-negative breast cancer and an option across molecular subtypes for tumors with a high tumor mutation burden. Despite the advancements in personalized medicine directing the management of localized and advanced breast cancers, the emergence of resistance to these therapies is the leading cause of death among breast cancer patients. Therefore, there is a critical need to identify and validate predictive biomarkers to direct treatment selection, identify potential responders, and detect emerging resistance to standard therapies. Areas of active scientific and clinical research include novel personalized and predictive biomarkers incorporating tumor microenvironment, tumor immune profiling, molecular characterization, and histopathological differentiation to predict response and the potential emergence of resistance. Full article

(This article belongs to the Special Issue Biomarkers and Personalized Therapy in Solid Tumors)

► Show Figures

Figure 1

26 pages, 435 KB

Open AccessFeature PaperEditor’s ChoiceReview

Diagnosis, Prevention, and Management of Fetal Growth Restriction (FGR)

by Panagiotis Tsikouras, Panos Antsaklis, Konstantinos Nikolettos, Sonia Kotanidou, Nektaria Kritsotaki, Anastasia Bothou, Sotiris Andreou, Theopi Nalmpanti, Kyriaki Chalkia, Vlasis Spanakis, George Iatrakis and Nikolaos Nikolettos

J. Pers. Med. 2024, 14(7), 698; https://doi.org/10.3390/jpm14070698 - 28 Jun 2024

Cited by 12 | Viewed by 10929

Abstract

Fetal growth restriction (FGR), or intrauterine growth restriction (IUGR), is still the second most common cause of perinatal mortality. The factors that contribute to fetal growth restriction can be categorized into three distinct groups: placental, fetal, and maternal. The prenatal application of various [...] Read more.

Fetal growth restriction (FGR), or intrauterine growth restriction (IUGR), is still the second most common cause of perinatal mortality. The factors that contribute to fetal growth restriction can be categorized into three distinct groups: placental, fetal, and maternal. The prenatal application of various diagnostic methods can, in many cases, detect the deterioration of the fetal condition in time because the nature of the above disorder is thoroughly investigated by applying a combination of biophysical and biochemical methods, which determine the state of the embryo–placenta unit and assess the possible increased risk of perinatal failure outcome and potential for many later health problems. When considering the potential for therapeutic intervention, the key question is whether it can be utilized during pregnancy. Currently, there are no known treatment interventions that effectively enhance placental function and promote fetal weight development. Nevertheless, in cases with fetuses diagnosed with fetal growth restriction, immediate termination of pregnancy may have advantages not only in terms of minimizing perinatal mortality but primarily in terms of reducing long-term morbidity during childhood and maturity. Full article

(This article belongs to the Special Issue Obstetrics and Gynecology and Women's Health—2nd Edition)

12 pages, 1002 KB

Open AccessEditor’s ChoiceArticle

Real-World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab-Treated People with Relapsing Multiple Sclerosis

by Francisco J. Barrero Hernández, Ana Romero Villarrubia, Carmen Muñoz Fernández, Virginia Guillén Martinez, Almudena Aguilera Del Moral, José María Barrios-López, Maria A. Ramírez Rivas, Antonio J. Gálvez Muñoz and Raquel Piñar Morales

J. Pers. Med. 2024, 14(7), 692; https://doi.org/10.3390/jpm14070692 - 27 Jun 2024

Cited by 4 | Viewed by 2974

Abstract

Serum neurofilament light chain (sNfL) levels have been proposed as a biomarker of the clinical activity, disability progression, and response to treatment of people with multiple sclerosis (PwMS); however, questions remain about its implementation in clinical practice. Ocrelizumab (OCR) has proven effective in [...] Read more.

Serum neurofilament light chain (sNfL) levels have been proposed as a biomarker of the clinical activity, disability progression, and response to treatment of people with multiple sclerosis (PwMS); however, questions remain about its implementation in clinical practice. Ocrelizumab (OCR) has proven effective in improving clinical and radiological outcomes and reducing sNfL levels. This real-life study followed the sNfL levels of 30 PwMS treated for 12 months with OCR and evaluated the usefulness of this biomarker for their short-term prognosis, considering expanded disability status scale (EDSS), annualized relapse rate (ARR), radiological activity, and NEDA-3 values. OCR reduced ARR in 83% of PwMS and radiological activity in 80%. EDSS was maintained, while NEDA-3 was achieved in 70% at 12 months. OCR produced an early reduction in sNfL levels (at 3 months). At baseline, greater MRI-evaluated radiological activity was associated with higher sNfL levels. sNfL levels over the first 12 months of treatment did not predict a suboptimal response or sustained control of the disease. Longer-term studies are needed to explore the predictive usefulness of sNfL levels in PwMS treated with high-efficacy drugs. Full article

(This article belongs to the Section Disease Biomarkers)

► Show Figures

Figure 1

18 pages, 1027 KB

Open AccessEditor’s ChoiceReview

Revolutionizing Pathology with Artificial Intelligence: Innovations in Immunohistochemistry

by Diana Gina Poalelungi, Anca Iulia Neagu, Ana Fulga, Marius Neagu, Dana Tutunaru, Aurel Nechita and Iuliu Fulga

J. Pers. Med. 2024, 14(7), 693; https://doi.org/10.3390/jpm14070693 - 27 Jun 2024

Cited by 6 | Viewed by 3296

Abstract

Artificial intelligence (AI) is a reality of our times, and it has been successfully implemented in all fields, including medicine. As a relatively new domain, all efforts are directed towards creating algorithms applicable in most medical specialties. Pathology, as one of the most [...] Read more.

Artificial intelligence (AI) is a reality of our times, and it has been successfully implemented in all fields, including medicine. As a relatively new domain, all efforts are directed towards creating algorithms applicable in most medical specialties. Pathology, as one of the most important areas of interest for precision medicine, has received significant attention in the development and implementation of AI algorithms. This focus is especially important for achieving accurate diagnoses. Moreover, immunohistochemistry (IHC) serves as a complementary diagnostic tool in pathology. It can be further augmented through the application of deep learning (DL) and machine learning (ML) algorithms for assessing and analyzing immunohistochemical markers. Such advancements can aid in delineating targeted therapeutic approaches and prognostic stratification. This article explores the applications and integration of various AI software programs and platforms used in immunohistochemical analysis. It concludes by highlighting the application of these technologies to pathologies such as breast, prostate, lung, melanocytic proliferations, and hematologic conditions. Additionally, it underscores the necessity for further innovative diagnostic algorithms to assist physicians in the diagnostic process. Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

► Show Figures

Figure 1

13 pages, 2383 KB

Open AccessEditor’s ChoiceReview

Electrical Impedance Tomography, Artificial Intelligence, and Variable Ventilation: Transforming Respiratory Monitoring and Treatment in Critical Care

by Iacopo Cappellini, Lorenzo Campagnola and Guglielmo Consales

J. Pers. Med. 2024, 14(7), 677; https://doi.org/10.3390/jpm14070677 - 24 Jun 2024

Cited by 5 | Viewed by 3798

Abstract

Background: Electrical Impedance Tomography (EIT), combined with variable ventilation strategies and Artificial Intelligence (AI), is poised to revolutionize critical care by transitioning from reactive to predictive approaches. This integration aims to enhance patient outcomes through personalized interventions and real-time monitoring. Methods: this narrative [...] Read more.

Background: Electrical Impedance Tomography (EIT), combined with variable ventilation strategies and Artificial Intelligence (AI), is poised to revolutionize critical care by transitioning from reactive to predictive approaches. This integration aims to enhance patient outcomes through personalized interventions and real-time monitoring. Methods: this narrative review explores the principles and applications of EIT, variable ventilation, and AI in critical care. EIT impedance sensing creates dynamic images of internal physiology, aiding the management of conditions like Acute Respiratory Distress Syndrome (ARDS). Variable ventilation mimics natural breathing variability to improve lung function and minimize ventilator-induced lung injury. AI enhances EIT through advanced image reconstruction techniques, neural networks, and digital twin technology, offering more accurate diagnostics and tailored therapeutic interventions. Conclusions: the confluence of EIT, variable ventilation, and AI represents a significant advancement in critical care, enabling a predictive, personalized approach. EIT provides real-time insights into lung function, guiding precise ventilation adjustments and therapeutic interventions. AI integration enhances EIT diagnostic capabilities, facilitating the development of personalized treatment plans. This synergy fosters interdisciplinary collaborations and sets the stage for innovative research, ultimately improving patient outcomes and advancing the future of critical care. Full article

(This article belongs to the Section Personalized Medical Care)

► Show Figures

Figure 1

15 pages, 921 KB

Open AccessEditor’s ChoiceReview

Future Horizons: The Potential Role of Artificial Intelligence in Cardiology

by Octavian Stefan Patrascanu, Dana Tutunaru, Carmina Liana Musat, Oana Maria Dragostin, Ana Fulga, Luiza Nechita, Alexandru Bogdan Ciubara, Alin Ionut Piraianu, Elena Stamate, Diana Gina Poalelungi, Ionut Dragostin, Doriana Cristea-Ene Iancu, Anamaria Ciubara and Iuliu Fulga

J. Pers. Med. 2024, 14(6), 656; https://doi.org/10.3390/jpm14060656 - 19 Jun 2024

Cited by 7 | Viewed by 4804

Abstract

Cardiovascular diseases (CVDs) are the leading cause of premature death and disability globally, leading to significant increases in healthcare costs and economic strains. Artificial intelligence (AI) is emerging as a crucial technology in this context, promising to have a significant impact on the [...] Read more.

Cardiovascular diseases (CVDs) are the leading cause of premature death and disability globally, leading to significant increases in healthcare costs and economic strains. Artificial intelligence (AI) is emerging as a crucial technology in this context, promising to have a significant impact on the management of CVDs. A wide range of methods can be used to develop effective models for medical applications, encompassing everything from predicting and diagnosing diseases to determining the most suitable treatment for individual patients. This literature review synthesizes findings from multiple studies that apply AI technologies such as machine learning algorithms and neural networks to electrocardiograms, echocardiography, coronary angiography, computed tomography, and cardiac magnetic resonance imaging. A narrative review of 127 articles identified 31 papers that were directly relevant to the research, encompassing a broad spectrum of AI applications in cardiology. These applications included AI models for ECG, echocardiography, coronary angiography, computed tomography, and cardiac MRI aimed at diagnosing various cardiovascular diseases such as coronary artery disease, hypertrophic cardiomyopathy, arrhythmias, pulmonary embolism, and valvulopathies. The papers also explored new methods for cardiovascular risk assessment, automated measurements, and optimizing treatment strategies, demonstrating the benefits of AI technologies in cardiology. In conclusion, the integration of artificial intelligence (AI) in cardiology promises substantial advancements in diagnosing and treating cardiovascular diseases. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

► Show Figures

Figure 1

14 pages, 1591 KB

Open AccessEditor’s ChoiceArticle

Code Stroke Alert: Focus on Emergency Department Time Targets and Impact on Door-to-Needle Time across Day and Night Shifts

by Florina Buleu, Daian Popa, Carmen Williams, Anca Tudor, Dumitru Sutoi, Cosmin Trebuian, Covasala Constantin Ioan, Aida Iancu, Gabriel Cozma, Ana-Maria Marin, Ana-Maria Pah, Ion Petre and Ovidiu Alexandru Mederle

J. Pers. Med. 2024, 14(6), 596; https://doi.org/10.3390/jpm14060596 - 2 Jun 2024

Cited by 5 | Viewed by 2785

Abstract

Background and objectives: To minimize stroke-related deaths and maximize the likelihood of cerebral reperfusion, medical professionals developed the “code stroke” emergency protocol, which allows for the prompt evaluation of patients with acute ischemic stroke symptoms in pre-hospital care and the emergency department (ED). [...] Read more.

Background and objectives: To minimize stroke-related deaths and maximize the likelihood of cerebral reperfusion, medical professionals developed the “code stroke” emergency protocol, which allows for the prompt evaluation of patients with acute ischemic stroke symptoms in pre-hospital care and the emergency department (ED). This research will outline our experience in implementing the stroke code protocol for acute ischemic stroke patients and its impact on door-to-needle time (DTN) in the ED. Methods: Our study included patients with a “code stroke alert” upon arrival at the emergency department. The final sample of this study consisted of 258 patients eligible for intravenous (IV) thrombolysis with an onset-to-door time < 4.5 h. ED admissions were categorized into two distinct groups: “day shift” (from 8 a.m. to 8 p.m.) (n = 178) and “night shift” (from 8 p.m. to 8 a.m.) (n = 80) groups. Results: An analysis of ED time targets showed an increased median during the day shift for onset-to-ED door time of 310 min (IQR, 190–340 min), for door-to-physician (emergency medicine doctor) time of 5 min (IQR, 3–9 min), for door-to-physician (emergency medicine doctor) time of 5 min (IQR, 3–9 min), and for door-to-physician (neurologist) time of 7 min (IQR, 5–10 min), also during the day shift. During the night shift, an increased median was found for door-to-CT time of 21 min (IQR, 16.75–23 min), for door-to-CT results of 40 min (IQR, 38–43 min), and for door-to-needle time of 57.5 min (IQR, 46.25–60 min). Astonishingly, only 17.83% (n = 46) of these patients received intravenous thrombolysis, and the proportion of patients with thrombolysis was significantly higher during the night shift (p = 0.044). A logistic regression analysis considering the door-to-needle time (minutes) as the dependent variable demonstrated that onset-to-ED time (p < 0.001) and door-to-physician (emergency medicine physicians) time (p = 0.021) are predictors for performing thrombolysis in our study. Conclusions: This study identified higher door-to-CT and door-to-emergency medicine physician times associated with an increased DTN, highlighting further opportunities to improve acute stroke care in the emergency department. Further, door-to-CT and door-to-CT results showed statistically significant increases during the night shift. Full article

(This article belongs to the Special Issue Emergency Medicine: Clinical Advances and Challenges in Diagnosis and Treatment, 2nd Edition)

► Show Figures

Figure 1

14 pages, 2551 KB

Open AccessEditor’s ChoiceArticle

Perspectives on Clinical Adoption Barriers to Blood-Based Multi-Cancer Early Detection Tests across Stakeholders

by Monica M. Schroll, Elissa Quinn, Daryl Pritchard, Allina Chang, Kristen Garner Amanti, Omar Perez, Arushi Agarwal and Gary Gustavsen

J. Pers. Med. 2024, 14(6), 593; https://doi.org/10.3390/jpm14060593 - 1 Jun 2024

Cited by 4 | Viewed by 3828

Abstract

Current United States Preventive Services Task Force (USPSTF) recommendations include routine screening for breast, cervical, colorectal, and lung cancer; however, two out of every three cancer cases occur in other indications, leading to diagnoses in advanced stages of the disease and a higher [...] Read more.

Current United States Preventive Services Task Force (USPSTF) recommendations include routine screening for breast, cervical, colorectal, and lung cancer; however, two out of every three cancer cases occur in other indications, leading to diagnoses in advanced stages of the disease and a higher likelihood of mortality. Blood-based multi-cancer early detection (MCED) tests can impact cancer screening and early detection by monitoring for multiple different cancer types at once, including indications where screening is not performed routinely today. We conducted a survey amongst healthcare providers (HCPs), payers, and patients within the U.S. health system to understand the current utilization of cancer screening tests and the anticipated barriers to widespread adoption of blood-based MCED tests. The results indicated that the community favors the adoption of blood-based MCED tests and that there is broad agreement on the value proposition. Despite this recognition, the survey highlighted that there is limited use today due to the perceived lack of clinical accuracy and utility data, high out-of-pocket patient costs, and lack of payer coverage. To overcome the hurdles for future widespread adoption of blood-based MCED tests, increased investment in data generation, education, and implementation of logistical support for HCPs will be critical. Full article

(This article belongs to the Section Disease Biomarkers)

► Show Figures

Graphical abstract

15 pages, 1291 KB

Open AccessEditor’s ChoiceReview

Sudden Cardiac Death, Post-Mortem Investigation: A Proposing Panel of First Line and Second Line Genetic Tests

by Fabio Del Duca, Alessandro Ghamlouch, Alice Chiara Manetti, Gabriele Napoletano, Elena Sonnini, Biancamaria Treves, Alessandra De Matteis, Raffaele La Russa, Mary N. Sheppard, Vittorio Fineschi and Aniello Maiese

J. Pers. Med. 2024, 14(5), 544; https://doi.org/10.3390/jpm14050544 - 20 May 2024

Cited by 6 | Viewed by 2893

Abstract

Investigating the causes of Sudden cardiac death (SCD) is always difficult; in fact, genetic cardiac conditions associated with SCD could be “silent” even during autopsy investigation. In these cases, it is important to exclude other aetiology and assist to ask for genetic investigations. [...] Read more.

Investigating the causes of Sudden cardiac death (SCD) is always difficult; in fact, genetic cardiac conditions associated with SCD could be “silent” even during autopsy investigation. In these cases, it is important to exclude other aetiology and assist to ask for genetic investigations. Herein, the purpose of this review is to collect the most-implicated genes in SCD and generate a panel with indications for first line and second line investigations. A systematic review of genetic disorders that may cause SCD in the general population was carried out according to the Preferred Reporting Item for Systematic Review (PRISMA) standards. We subsequently listed the genes that may be tested in the case of sudden cardiac death when the autopsy results are negative or with no evidence of acquired cardiac conditions. To make genetic tests more specific and efficient, it is useful and demanded to corroborate autopsy findings with the molecular investigation as evident in the panel proposed. The genes for first line investigations are HCM, MYBPC3, MYH7, TNNT2, TNNI3, while in case of DCM, the most implicated genes are LMNA and TTN, and in second line for these CDM, ACTN2, TPM1, C1QPB could be investigated. In cases of ACM/ARVC, the molecular investigation includes DSP, DSG2, DSC2, RYR2, PKP2. The channelopathies are associated with the following genes: SCN5A, KCNQ1, KCNH2, KCNE1, RYR2. Our work underlines the importance of genetic tests in forensic medicine and clinical pathology; moreover, it could be helpful not only to assist the pathologists to reach a diagnosis, but also to prevent other cases of SCD in the family of the descendant and to standardise the type of analysis performed in similar cases worldwide. Full article

(This article belongs to the Special Issue Clinical Advances in Functional Genomics)

► Show Figures

Figure 1

32 pages, 840 KB

Open AccessEditor’s ChoiceReview

Interactions and Trends of Interleukins, PAI-1, CRP, and TNF-α in Inflammatory Responses during the Perioperative Period of Joint Arthroplasty: Implications for Pain Management—A Narrative Review

by Arabela-Codruta Cocea and Cristian Ioan Stoica

J. Pers. Med. 2024, 14(5), 537; https://doi.org/10.3390/jpm14050537 - 17 May 2024

Cited by 6 | Viewed by 2908

Abstract

Inflammation during the perioperative period of joint arthroplasty is a critical aspect of patient outcomes, influencing both the pathophysiology of pain and the healing process. This narrative review comprehensively evaluates the roles of specific cytokines and inflammatory biomarkers in this context and their [...] Read more.

Inflammation during the perioperative period of joint arthroplasty is a critical aspect of patient outcomes, influencing both the pathophysiology of pain and the healing process. This narrative review comprehensively evaluates the roles of specific cytokines and inflammatory biomarkers in this context and their implications for pain management. Inflammatory responses are initiated and propagated by cytokines, which are pivotal in the development of both acute and chronic postoperative pain. Pro-inflammatory cytokines play essential roles in up-regulating the inflammatory response, which, if not adequately controlled, leads to sustained pain and impaired tissue healing. Anti-inflammatory cytokines work to dampen inflammatory responses and promote resolution. Our discussion extends to the genetic and molecular influences on cytokine production, which influence pain perception and recovery rates post-surgery. Furthermore, the role of PAI-1 in modulating inflammation through its impact on the fibrinolytic system highlights its potential as a therapeutic target. The perioperative modulation of these cytokines through various analgesic and anesthetic techniques, including the fascia iliac compartment block, demonstrates a significant reduction in pain and inflammatory markers, thus underscoring the importance of targeted therapeutic strategies. Our analysis suggests that a nuanced understanding of the interplay between pro-inflammatory and anti-inflammatory cytokines is required. Future research should focus on individualized pain management strategies. Full article

(This article belongs to the Special Issue Challenges and Opportunities in Personalized Management of Bone and Joint Infections)

► Show Figures

Figure 1

21 pages, 1072 KB

Open AccessEditor’s ChoiceReview

Review: A Contemporary, Multifaced Insight into Psoriasis Pathogenesis

by Rucsandra Cristina Dascălu, Andreea Lili Bărbulescu, Loredana Elena Stoica, Ștefan Cristian Dinescu, Cristina Elena Biță, Horațiu Valeriu Popoviciu, Răzvan Adrian Ionescu and Florentin Ananu Vreju

J. Pers. Med. 2024, 14(5), 535; https://doi.org/10.3390/jpm14050535 - 16 May 2024

Cited by 16 | Viewed by 5702

Abstract

Psoriasis is a chronic recurrent inflammatory autoimmune pathology with a significant genetic component and several interferences of immunological cells and their cytokines. The complex orchestration of psoriasis pathogenesis is related to the synergic effect of immune cells, polygenic alterations, autoantigens, and several other [...] Read more.

Psoriasis is a chronic recurrent inflammatory autoimmune pathology with a significant genetic component and several interferences of immunological cells and their cytokines. The complex orchestration of psoriasis pathogenesis is related to the synergic effect of immune cells, polygenic alterations, autoantigens, and several other external factors. The major act of the IL-23/IL-17 axis, strongly influencing the inflammatory pattern established during the disease activity, is visible as a continuous perpetuation of the pro-inflammatory response and keratinocyte activation and proliferation, leading to the development of psoriatic lesions. Genome-wide association studies (GWASs) offer a better view of psoriasis pathogenic pathways, with approximately one-third of psoriasis’s genetic impact on psoriasis development associated with the MHC region, with genetic loci located on chromosome 6. The most eloquent genetic factor of psoriasis, PSORS1, was identified in the MHC I site. Among the several factors involved in its complex etiology, dysbiosis, due to genetic or external stimulus, induces a burst of pro-inflammatory consequences; both the cutaneous and gut microbiome get involved in the psoriasis pathogenic process. Cutting-edge research studies and comprehensive insights into psoriasis pathogenesis, fostering novel genetic, epigenetic, and immunological factors, have generated a spectacular improvement over the past decades, securing the path toward a specific and targeted immunotherapeutic approach and delayed progression to inflammatory arthritis. This review aimed to offer insight into various domains that underline the pathogenesis of psoriasis and how they influence disease development and evolution. The pathogenesis mechanism of psoriasis is multifaceted and involves an interplay of cellular and humoral immunity, which affects susceptible microbiota and the genetic background. An in-depth understanding of the role of pathogenic factors forms the basis for developing novel and individualized therapeutic targets that can improve disease management. Full article

(This article belongs to the Special Issue Immune-Mediated Diseases)

► Show Figures

Figure 1

18 pages, 1020 KB

Open AccessEditor’s ChoiceReview

Exploring the Gut Microbiome’s Role in Inflammatory Bowel Disease: Insights and Interventions

by Despoina Gyriki, Christos Nikolaidis, Elisavet Stavropoulou, Ioanna Bezirtzoglou, Christina Tsigalou, Stergios Vradelis and Eugenia Bezirtzoglou

J. Pers. Med. 2024, 14(5), 507; https://doi.org/10.3390/jpm14050507 - 11 May 2024

Cited by 17 | Viewed by 6248

Abstract

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic and relapsing inflammatory condition of the intestine that significantly impairs quality of life and imposes a heavy burden on healthcare systems globally. While the exact etiology of IBD [...] Read more.

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic and relapsing inflammatory condition of the intestine that significantly impairs quality of life and imposes a heavy burden on healthcare systems globally. While the exact etiology of IBD is unclear, it is influenced by genetic, environmental, immunological, and microbial factors. Recent advances highlight the gut microbiome’s pivotal role in IBD pathogenesis. The microbial dysbiosis characteristic of IBD, marked by a decline in beneficial bacteria and an increase in pathogenic microbes, suggests a profound connection between microbial imbalance and disease mechanisms. This review explores diagnostic approaches to IBD that integrate clinical assessment with advanced microbiological analyses, highlighting the potential of microbiome profiling as a non-invasive diagnostic tool. In addition, it evaluates conventional and emerging treatments and discusses microbiome-targeted intervention prospects, such as probiotics, symbiotics, and faecal microbiota transplantation. The necessity for future research to establish their efficacy and safety is emphasised. Full article

(This article belongs to the Special Issue Gut Microbiome and Its Impact on Human Health)

► Show Figures

Figure 1

18 pages, 967 KB

Open AccessEditor’s ChoiceReview

Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease

by Raluca Eugenia Iorga, Damiana Costin, Răzvana Sorina Munteanu-Dănulescu, Elena Rezuș and Andreea Dana Moraru

J. Pers. Med. 2024, 14(5), 501; https://doi.org/10.3390/jpm14050501 - 9 May 2024

Cited by 10 | Viewed by 3610

Abstract

Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in the microcirculation may predict the cardiovascular mortality. The retinal vasculature can be used as a model to study vascular alterations associated with cardiovascular disease. In order to quantify microvascular [...] Read more.

Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in the microcirculation may predict the cardiovascular mortality. The retinal vasculature can be used as a model to study vascular alterations associated with cardiovascular disease. In order to quantify microvascular changes in a non-invasive way, fundus images can be taken and analysed. The central retinal arteriolar (CRAE), the venular (CRVE) diameter and the arteriolar-to-venular diameter ratio (AVR) can be used as biomarkers to predict the cardiovascular mortality. A narrower CRAE, wider CRVE and a lower AVR have been associated with increased cardiovascular events. Dynamic retinal vessel analysis (DRVA) allows the quantification of retinal changes using digital image sequences in response to visual stimulation with flicker light. This article is not just a review of the current literature, it also aims to discuss the methodological benefits and to identify research gaps. It highlights the potential use of microvascular biomarkers for screening and treatment monitoring of cardiovascular disease. Artificial intelligence (AI), such as Quantitative Analysis of Retinal vessel Topology and size (QUARTZ), and SIVA–deep learning system (SIVA-DLS), seems efficient in extracting information from fundus photographs and has the advantage of increasing diagnosis accuracy and improving patient care by complementing the role of physicians. Retinal vascular imaging using AI may help identify the cardiovascular risk, and is an important tool in primary cardiovascular disease prevention. Further research should explore the potential clinical application of retinal microvascular biomarkers, in order to assess systemic vascular health status, and to predict cardiovascular events. Full article

(This article belongs to the Special Issue New Advances in Diagnostic and Surgical Treatment of Ocular Diseases)

► Show Figures

Figure 1

15 pages, 1412 KB

Open AccessFeature PaperEditor’s ChoiceArticle

The Sound of Memory: Investigating Music Therapy’s Cognitive Benefits in Patients with Dementia—A Network Meta-Analysis of Randomized Controlled Trials

by Berne Ting, Chen-Hsin Su, Daniel Tzu-Li Chen, Wei-Ti Hsu, Chia-Lin Tsai, Pan-Yen Lin and Li Jingling

J. Pers. Med. 2024, 14(5), 497; https://doi.org/10.3390/jpm14050497 - 8 May 2024

Cited by 5 | Viewed by 8451

Abstract

Numerous previous studies have shown the effectiveness of music therapy in enhancing cognitive functions in patients with dementia. Despite this, robust evidence in this field, especially concerning the comparison of different music therapy types, is lacking. Therefore, randomized controlled trials (RCTs) focusing on [...] Read more.

Numerous previous studies have shown the effectiveness of music therapy in enhancing cognitive functions in patients with dementia. Despite this, robust evidence in this field, especially concerning the comparison of different music therapy types, is lacking. Therefore, randomized controlled trials (RCTs) focusing on music therapy and cognitive functions in dementia patients, termed by “music” AND “dementia” OR “Alzheimer’s disease” AND “cognitive”, were identified from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome focused on the impact on cognitive functions, and the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY202430082). A total of 14 RCTs with 1056 participants were enrolled, examining interventions including Active Music Therapy (AMT), Active Music Therapy with Singing (AMT + Sing), Rhythmic Music Therapy (RMT), Listening to Music (LtM), and Singing (Sing). The results indicated that RMT, AMT + Sing, and AMT all significantly improve cognitive functions in dementia patients, of which the SMD were 0.76 (95% CI = 0.32–1.21), 0.79 (95% CI = 0.03–1.49), and 0.57 (0.18–0.96), respectively. Compared with the control group (usual care), no music therapy type was associated with an increased dropout risk. In conclusion, music therapy can improve cognitive functions in patients with dementia without increasing the risk of dropout, particularly RMT, AMT + Sing, and AMT. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

► Show Figures

Figure 1

34 pages, 1308 KB

Open AccessEditor’s ChoiceReview

IL-8 (CXCL8) Correlations with Psychoneuroimmunological Processes and Neuropsychiatric Conditions

by Anton Shkundin and Angelos Halaris

J. Pers. Med. 2024, 14(5), 488; https://doi.org/10.3390/jpm14050488 - 3 May 2024

Cited by 8 | Viewed by 4153

Abstract

Interleukin-8 (IL-8/CXCL8), an essential CXC chemokine, significantly influences psychoneuroimmunological processes and affects neurological and psychiatric health. It exerts a profound effect on immune cell activation and brain function, suggesting potential roles in both neuroprotection and neuroinflammation. IL-8 production is stimulated by several factors, [...] Read more.

Interleukin-8 (IL-8/CXCL8), an essential CXC chemokine, significantly influences psychoneuroimmunological processes and affects neurological and psychiatric health. It exerts a profound effect on immune cell activation and brain function, suggesting potential roles in both neuroprotection and neuroinflammation. IL-8 production is stimulated by several factors, including reactive oxygen species (ROS) known to promote inflammation and disease progression. Additionally, CXCL8 gene polymorphisms can alter IL-8 production, leading to potential differences in disease susceptibility, progression, and severity across populations. IL-8 levels vary among neuropsychiatric conditions, demonstrating sensitivity to psychosocial stressors and disease severity. IL-8 can be detected in blood circulation, cerebrospinal fluid (CSF), and urine, making it a promising candidate for a broad-spectrum biomarker. This review highlights the need for further research on the diverse effects of IL-8 and the associated implications for personalized medicine. A thorough understanding of its complex role could lead to the development of more effective and personalized treatment strategies for neuropsychiatric conditions. Full article

(This article belongs to the Section Disease Biomarkers)

► Show Figures

Figure 1

19 pages, 1257 KB

Open AccessEditor’s ChoiceReview

Enhancing Lung Cancer Care in Portugal: Bridging Gaps for Improved Patient Outcomes

by Raquel Ramos, Conceição Souto Moura, Mariana Costa, Nuno Jorge Lamas, Renato Correia, Diogo Garcez, José Miguel Pereira, Carlos Sousa and Nuno Vale

J. Pers. Med. 2024, 14(5), 446; https://doi.org/10.3390/jpm14050446 - 24 Apr 2024

Cited by 5 | Viewed by 2385

Abstract

Lung cancer has the highest incidence and cancer-related mortality worldwide. In Portugal, it ranks as the fourth most common cancer, with nearly 6000 new cases being diagnosed every year. Lung cancer is the main cause of cancer-related death among males and the third [...] Read more.

Lung cancer has the highest incidence and cancer-related mortality worldwide. In Portugal, it ranks as the fourth most common cancer, with nearly 6000 new cases being diagnosed every year. Lung cancer is the main cause of cancer-related death among males and the third cause of cancer-related death in females. Despite the globally accepted guidelines and recommendations for what would be the ideal path for a lung cancer patient, several challenges occur in real clinical management across the world. The recommendations emphasize the importance of adequate screening of high-risk individuals, a precise tumour biopsy, and an accurate final diagnosis to confirm the neoplastic nature of the nodule. A detailed histological classification of the lung tumour type and a comprehensive molecular characterization are of utmost importance for the selection of an efficacious and patient-directed therapeutic approach. However, in the context of the Portuguese clinical organization and the national healthcare system, there are still several gaps in the ideal pathway for a lung cancer patient, involving aspects ranging from the absence of a national lung cancer screening programme through difficulties in histological diagnosis and molecular characterization to challenges in therapeutic approaches. In this manuscript, we address the most relevant weaknesses, presenting several proposals for potential solutions to improve the management of lung cancer patients, helping to decisively improve their overall survival and quality of life. Full article

(This article belongs to the Section Personalized Medical Care)

► Show Figures

Figure 1

12 pages, 278 KB

Open AccessEditor’s ChoiceArticle

Impact of Thrombophilic Polymorphisms in Antenatal Women on Perinatal Health: A Single-Center Prospective Study

by Vesna Sokol Karadjole, Antonio D’Amato, Milan Milošević, Mislav Herman, Mislav Mikuš, Antonio Simone Laganà, Vito Chiantera and Andrea Etrusco

J. Pers. Med. 2024, 14(4), 433; https://doi.org/10.3390/jpm14040433 - 19 Apr 2024

Cited by 5 | Viewed by 2561

Abstract

Background: Despite pregnancy’s hypercoagulable state, the correlation between inherited thrombophilia and thrombotic adverse pregnancy outcomes remains uncertain. The objective of this study was to determine the prevalence of inherited thrombophilic polymorphisms among asymptomatic pregnant individuals and to examine their potential correlation with adverse [...] Read more.

Background: Despite pregnancy’s hypercoagulable state, the correlation between inherited thrombophilia and thrombotic adverse pregnancy outcomes remains uncertain. The objective of this study was to determine the prevalence of inherited thrombophilic polymorphisms among asymptomatic pregnant individuals and to examine their potential correlation with adverse perinatal outcomes. Methods: in this single-center prospective study, 105 healthy pregnant women were included. Genotyping was conducted for factor V Leiden (FVL), prothrombin gene mutation, methylenetetrahydrofolate reductase enzyme (MTHFR) C677T, MTHFR A1298C, and plasminogen activator inhibitor-1 (PAI-1), alongside the assessment of protein C (PC), protein S (PS), and antithrombin (AT) levels. The study analyzed the association between inherited thrombophilic polymorphisms and pregnancy complications linked to placental insufficiency, such as gestational hypertension (GH), preeclampsia (PE), intrauterine death (IUD), fetal growth restriction (FGR), and placental abruption. Results: The prevalence of identifiable thrombophilic polymorphism mutations was 61.9% (95% confidence interval—CI 52.4–70.8%), with the most common single mutation being PAI-1 4G/5G (12/105, 11.4%, 95% CI 6.4–18.5). The most frequent combined mutation was heterozygosity for MTHFR C677T and PAI-1 (12/105, 11.4%, 95% CI 6.4–18.5). Notably, no FVL homozygous carriers or single homozygous and heterozygous carriers for prothrombin polymorphisms were found. Additionally, no deficiencies in PC and AT were detected among participants. Except for homozygosity for PAI-1, none of the studied polymorphisms demonstrated a significant association with pregnancy complications linked to placental insufficiency. Conclusions: The asymptomatic carriers of inherited thrombophilic polymorphisms do not have an increased risk of adverse perinatal outcomes. Full article

(This article belongs to the Special Issue Obstetrics and Gynecology and Women's Health)

12 pages, 546 KB

Open AccessEditor’s ChoiceArticle

Identifying Progression-Specific Alzheimer’s Subtypes Using Multimodal Transformer

by Diego Machado Reyes, Hanqing Chao, Juergen Hahn, Li Shen, Pingkun Yan and for the Alzheimer’s Disease Neuroimaging Initiative

J. Pers. Med. 2024, 14(4), 421; https://doi.org/10.3390/jpm14040421 - 15 Apr 2024

Cited by 4 | Viewed by 2689

Abstract

Alzheimer’s disease (AD) is the most prevalent neurodegenerative disease, yet its current treatments are limited to stopping disease progression. Moreover, the effectiveness of these treatments remains uncertain due to the heterogeneity of the disease. Therefore, it is essential to identify disease subtypes at [...] Read more.

Alzheimer’s disease (AD) is the most prevalent neurodegenerative disease, yet its current treatments are limited to stopping disease progression. Moreover, the effectiveness of these treatments remains uncertain due to the heterogeneity of the disease. Therefore, it is essential to identify disease subtypes at a very early stage. Current data-driven approaches can be used to classify subtypes during later stages of AD or related disorders, but making predictions in the asymptomatic or prodromal stage is challenging. Furthermore, the classifications of most existing models lack explainability, and these models rely solely on a single modality for assessment, limiting the scope of their analysis. Thus, we propose a multimodal framework that utilizes early-stage indicators, including imaging, genetics, and clinical assessments, to classify AD patients into progression-specific subtypes at an early stage. In our framework, we introduce a tri-modal co-attention mechanism (Tri-COAT) to explicitly capture cross-modal feature associations. Data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (slow progressing = 177, intermediate = 302, and fast = 15) were used to train and evaluate Tri-COAT using a 10-fold stratified cross-testing approach. Our proposed model outperforms baseline models and sheds light on essential associations across multimodal features supported by known biological mechanisms. The multimodal design behind Tri-COAT allows it to achieve the highest classification area under the receiver operating characteristic curve while simultaneously providing interpretability to the model predictions through the co-attention mechanism. Full article

(This article belongs to the Special Issue Neuromuscular and Neurodegenerative Diseases: Towards Personalized Medicine, Therapeutics and Improved Mechanistic Understanding, 2nd Edition)

► Show Figures

Figure 1

17 pages, 551 KB

Open AccessEditor’s ChoiceReview

Precision Medicine—Are We There Yet? A Narrative Review of Precision Medicine’s Applicability in Primary Care

by William Evans, Eric M. Meslin, Joe Kai and Nadeem Qureshi

J. Pers. Med. 2024, 14(4), 418; https://doi.org/10.3390/jpm14040418 - 15 Apr 2024

Cited by 12 | Viewed by 7940

Abstract

Precision medicine (PM), also termed stratified, individualised, targeted, or personalised medicine, embraces a rapidly expanding area of research, knowledge, and practice. It brings together two emerging health technologies to deliver better individualised care: the many “-omics” arising from increased capacity to understand the [...] Read more.

Precision medicine (PM), also termed stratified, individualised, targeted, or personalised medicine, embraces a rapidly expanding area of research, knowledge, and practice. It brings together two emerging health technologies to deliver better individualised care: the many “-omics” arising from increased capacity to understand the human genome and “big data” and data analytics, including artificial intelligence (AI). PM has the potential to transform an individual’s health, moving from population-based disease prevention to more personalised management. There is however a tension between the two, with a real risk that this will exacerbate health inequalities and divert funds and attention from basic healthcare requirements leading to worse health outcomes for many. All areas of medicine should consider how this will affect their practice, with PM now strongly encouraged and supported by government initiatives and research funding. In this review, we discuss examples of PM in current practice and its emerging applications in primary care, such as clinical prediction tools that incorporate genomic markers and pharmacogenomic testing. We look towards potential future applications and consider some key questions for PM, including evidence of its real-world impact, its affordability, the risk of exacerbating health inequalities, and the computational and storage challenges of applying PM technologies at scale. Full article

(This article belongs to the Section Personalized Medical Care)

► Show Figures

Figure 1

13 pages, 750 KB

Open AccessEditor’s ChoiceReview

Challenges in Diagnosis and Therapeutic Strategies in Late-Onset Multiple Sclerosis

by Viviana Nociti, Marina Romozzi and Massimiliano Mirabella

J. Pers. Med. 2024, 14(4), 400; https://doi.org/10.3390/jpm14040400 - 10 Apr 2024

Cited by 6 | Viewed by 3132

Abstract

Multiple sclerosis (MS) is a chronic inflammatory and degenerative demyelinating disease of the central nervous system of unknown etiology, which affects individuals in their early adulthood. However, nearly 5–10% of people with MS can be diagnosed at ages above 50 years old, referred [...] Read more.

Multiple sclerosis (MS) is a chronic inflammatory and degenerative demyelinating disease of the central nervous system of unknown etiology, which affects individuals in their early adulthood. However, nearly 5–10% of people with MS can be diagnosed at ages above 50 years old, referred to as late-onset multiple sclerosis (LOMS). Some studies have reported a distinctive presentation, clinical course, and prognosis for LOMS, implicating a different diagnostic and therapeutic approach for this population. Furthermore, similar manifestations between LOMS and other age-related conditions may lead to potential misdiagnosis and diagnostic delays, and a higher burden of multimorbidity associated with aging can further complicate the clinical picture. This review aims to explore the clinical characteristics, the disease course, and the differential diagnosis of LOMS and addresses therapeutic considerations for this population. Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

► Show Figures

Figure 1

17 pages, 922 KB

Open AccessEditor’s ChoiceReview

Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus

by Alessandro Lavoro, Giovanni Cultrera, Giuseppe Gattuso, Cinzia Lombardo, Luca Falzone, Candido Saverio, Massimo Libra and Mario Salmeri

J. Pers. Med. 2024, 14(4), 386; https://doi.org/10.3390/jpm14040386 - 3 Apr 2024

Cited by 8 | Viewed by 3557

Abstract

Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, [...] Read more.

Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, and labial mucosa causing a significant reduction in the quality of life. Currently, there are no specific treatments for this disease, and the available therapies with topical and systemic corticosteroids only reduce symptoms. Although the etiopathogenesis of this pathological condition has not been completely understood yet, several exogenous and endogenous risk factors have been proposed over the years. The present review article summarized the underlying mechanisms of action involved in the onset of OLP and the most well-known triggering factors. According to the current data, oral microbiota dysbiosis could represent a potential diagnostic biomarker for OLP. However, further studies should be undertaken to validate their use in clinical practice, as well as to provide a better understanding of mechanisms of action and develop novel effective intervention strategies against OLP. Full article

(This article belongs to the Special Issue Novel Biomarkers in the Diagnostics of Cancer)

► Show Figures

Figure 1

13 pages, 2880 KB

Open AccessEditor’s ChoiceArticle

Personalized Diabetes Management with Digital Twins: A Patient-Centric Knowledge Graph Approach

by Fatemeh Sarani Rad, Rasha Hendawi, Xinyi Yang and Juan Li

J. Pers. Med. 2024, 14(4), 359; https://doi.org/10.3390/jpm14040359 - 28 Mar 2024

Cited by 18 | Viewed by 6510

Abstract

Diabetes management requires constant monitoring and individualized adjustments. This study proposes a novel approach that leverages digital twins and personal health knowledge graphs (PHKGs) to revolutionize diabetes care. Our key contribution lies in developing a real-time, patient-centric digital twin framework built on PHKGs. [...] Read more.

Diabetes management requires constant monitoring and individualized adjustments. This study proposes a novel approach that leverages digital twins and personal health knowledge graphs (PHKGs) to revolutionize diabetes care. Our key contribution lies in developing a real-time, patient-centric digital twin framework built on PHKGs. This framework integrates data from diverse sources, adhering to HL7 standards and enabling seamless information access and exchange while ensuring high levels of accuracy in data representation and health insights. PHKGs offer a flexible and efficient format that supports various applications. As new knowledge about the patient becomes available, the PHKG can be easily extended to incorporate it, enhancing the precision and accuracy of the care provided. This dynamic approach fosters continuous improvement and facilitates the development of new applications. As a proof of concept, we have demonstrated the versatility of our digital twins by applying it to different use cases in diabetes management. These include predicting glucose levels, optimizing insulin dosage, providing personalized lifestyle recommendations, and visualizing health data. By enabling real-time, patient-specific care, this research paves the way for more precise and personalized healthcare interventions, potentially improving long-term diabetes management outcomes. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

► Show Figures

Graphical abstract

13 pages, 3790 KB

Open AccessEditor’s ChoiceArticle

Pathology Laboratory Archives: Conservation Quality of Nucleic Acids and Proteins for NSCLC Molecular Testing

by Albino Eccher, Davide Seminati, Vincenzo L’Imperio, Gabriele Casati, Daniela Pilla, Umberto Malapelle, Isabella Piga, Greta Bindi, Alessandro Marando, Emanuela Bonoldi, Emanuele Dainese, Mattia Riefolo, Antonia D’Errico, Matteo Costantini, Alberto Lugli, Stefano Grassi, Aldo Scarpa, Angelo Paolo Dei Tos and Fabio Pagni

J. Pers. Med. 2024, 14(4), 333; https://doi.org/10.3390/jpm14040333 - 22 Mar 2024

Cited by 4 | Viewed by 2584

Abstract

In the molecular era, proper archival conditions within pathology laboratories are crucial, especially for formalin-fixed paraffin-embedded (FFPE) tissue specimens retrieved years after the original diagnosis. Indeed, improper preservation can impact the integrity of nucleic acids and protein antigens. This study evaluates the quality [...] Read more.

In the molecular era, proper archival conditions within pathology laboratories are crucial, especially for formalin-fixed paraffin-embedded (FFPE) tissue specimens retrieved years after the original diagnosis. Indeed, improper preservation can impact the integrity of nucleic acids and protein antigens. This study evaluates the quality status of stored FFPE blocks using multilevel omics approaches. FFPE blocks from 45 Non-Small Cell Lung Carcinoma (NSCLC) cases were analyzed. The blocks were collected from six different pathology archives across Italy with distinct environmental characteristics. Nucleic acids’ quantity and quality, as well as protein antigens, were assessed using various techniques, including MALDI-MSI. RNA was quantitatively higher, but more fragmented, compared to DNA. DNA quantity and quality were suitable for molecular analyses in 94.4% and 62.3% of samples, respectively. RNA quantity was adequate across all samples, but it was optimal only in 22.3% of cases. DNA quality started to deteriorate after 6–8 years, whereas RNA quality diminished only after 10 years of storage. These data might suggest a particular DNA susceptibility to FFPE blocks conservation. Immunohistochemical intensity decreased significantly after 6–8 years of storage, and MALDI-MSI analysis revealed that younger tissue blocks contained more unique proteomic signals than the older ones. This study emphasizes the importance of proper FFPE archiving conditions for molecular analyses. Governance should prioritize attention to pathology archives to ensure quality preservation and optimize predictive testing. By elucidating the nuances of FFPE block storage, this research paves the way for enhanced molecular diagnostics and therapeutic insights regarding oncology and beyond. Full article

(This article belongs to the Section Omics/Informatics)

► Show Figures

Figure 1

14 pages, 1182 KB

Open AccessEditor’s ChoiceArticle

Effects of Dry Needling on Active Myofascial Trigger Points and Pain Intensity in Tension-Type Headache: A Randomized Controlled Study

by Sofía Monti-Ballano, Sergio Márquez-Gonzalvo, María Orosia Lucha-López, Loreto Ferrández-Laliena, Lucía Vicente-Pina, Rocío Sánchez-Rodríguez, Héctor José Tricás-Vidal and José Miguel Tricás-Moreno

J. Pers. Med. 2024, 14(4), 332; https://doi.org/10.3390/jpm14040332 - 22 Mar 2024

Cited by 4 | Viewed by 6068

Abstract

Tension-type headache is the most prevalent type of headache and is commonly associated with myofascial pain syndrome and the presence of active myofascial trigger points. This randomized controlled trial aimed to assess the impact of dry needling on the total number of active [...] Read more.

Tension-type headache is the most prevalent type of headache and is commonly associated with myofascial pain syndrome and the presence of active myofascial trigger points. This randomized controlled trial aimed to assess the impact of dry needling on the total number of active trigger points, pain intensity, and perceived clinical change in tension-type headache subjects. Thirty-two subjects were randomly assigned to the control and dry needling groups. The presence of active trigger points in 15 head and neck muscles, the headache intensity, and the perceived clinical change were evaluated. A single dry needling technique was administered at each active trigger point across three sessions. Significant differences were observed in the post-treatment measures favouring the dry needling group, including reductions in the headache intensity scores (p = 0.034) and the total number of active trigger points (p = 0.039). Moreover, significant differences in the perception of clinical change were found between the control and treatment groups (p = 0.000). Dry needling demonstrated positive effects in reducing the number of active trigger points and improving the short-term headache intensity in tension-type headache patients. A single dry needling session applied in the cranio-cervical area resulted in a self-perceived improvement compared to the control subjects. Full article

(This article belongs to the Special Issue New Advances in the Prevention and Treatment of Neurological Diseases)

► Show Figures

Graphical abstract

16 pages, 8663 KB

Open AccessEditor’s ChoiceArticle

Digital Validation in Breast Cancer Needle Biopsies: Comparison of Histological Grade and Biomarker Expression Assessment Using Conventional Light Microscopy, Whole Slide Imaging, and Digital Image Analysis

by Ji Eun Choi, Kyung-Hee Kim, Younju Lee and Dong-Wook Kang

J. Pers. Med. 2024, 14(3), 312; https://doi.org/10.3390/jpm14030312 - 16 Mar 2024

Cited by 4 | Viewed by 2242

Abstract

Given the widespread use of whole slide imaging (WSI) for primary pathological diagnosis, we evaluated its utility in assessing histological grade and biomarker expression (ER, PR, HER2, and Ki67) compared to conventional light microscopy (CLM). In addition, we explored the utility of digital [...] Read more.

Given the widespread use of whole slide imaging (WSI) for primary pathological diagnosis, we evaluated its utility in assessing histological grade and biomarker expression (ER, PR, HER2, and Ki67) compared to conventional light microscopy (CLM). In addition, we explored the utility of digital image analysis (DIA) for assessing biomarker expression. Three breast pathologists assessed the Nottingham combined histological grade, its components, and biomarker expression through the immunohistochemistry of core needle biopsy samples obtained from 101 patients with breast cancer using CLM, WSI, and DIA. There was no significant difference in variance between the WSI and CLM agreement rates for the Nottingham grade and its components and biomarker expression. Nuclear pleomorphism emerged as the most variable histologic component in intra- and inter-observer agreement (kappa ≤ 0.577 and kappa ≤ 0.394, respectively). The assessment of biomarker expression using DIA achieved an enhanced kappa compared to the inter-observer agreement. Compared to each observer’s assessment, DIA exhibited an improved kappa coefficient for the expression of most biomarkers with CLM and WSI. Using WSI to assess prognostic and predictive factors, including histological grade and biomarker expression in breast cancer, is acceptable. Furthermore, incorporating DIA to assess biomarker expression shows promise for substantially enhancing scoring reproducibility. Full article

(This article belongs to the Special Issue Digital Pathology in Translational Medicine and Clinical Practice)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Editor’s Choice Articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI