Journal of Personalized Medicine最新文献

{"title":"Perioperative Outcomes Following Single-Stage Surgery for Tandem Spinal Stenosis-A Single-Center Retrospective Cohort.","authors":"Adham M Khalafallah, Manav Daftari, Tanuj Prajapati, Sebastian Vargas-George, Anurag Aka, Christian K Ramsoomair, Malek Bashti, Seth S Tigchelaar, Timur Urakov","doi":"10.3390/jpm16070347","DOIUrl":"10.3390/jpm16070347","url":null,"abstract":"<p><p><b>Objectives</b>: Tandem spinal stenosis (TSS) is often underdiagnosed and traditionally managed with multi-stage surgery (MSS). Single-stage surgery (SSS) is an alternative, but prior studies largely emphasize younger, healthier patients. This study evaluated perioperative and functional outcomes after SSS for TSS in a surgically diverse cohort. <b>Methods</b>: A retrospective chart review included 20 patients who underwent SSS for TSS at a single academic institution. Mean age was 63.75 years, and median modified frailty index was 2. Etiologies included degenerative, traumatic, and neoplastic disease across cervical, thoracic, and lumbar regions. Outcomes included operative characteristics, complications, readmissions, and functional recovery measured by Visual Analog Scale (VAS) pain and modified Japanese Orthopaedic Association (mJOA) scores. <b>Results</b>: The mean number of operated levels was 5.2, mean operative time was 232.4 min, total OR time was 355.1 min, and length of stay was 6.9 days. Surgical complications occurred in 15% of patients, medical complications in 25%, and 90-day readmission in 15%, with no 30-day mortality. Mean mJOA improved from 12.86 at baseline to 16.08 at first follow-up and 16.46 at 3 months; REML mixed-effects modeling showed a significant timepoint effect (F (4, 34.55) = 9.15, <i>p</i> < 0.001), with significant Sidak-adjusted improvement at both timepoints. VAS pain showed no significant longitudinal effect. <b>Conclusions</b>: SSS for TSS appears feasible in a real-world, surgically diverse cohort including older and moderately frail patients. These findings support individualized SSS candidacy assessment.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Versus Posterior Stabilization of Subaxial Cervical Spine Fracture-Dislocations, Dislocations and Subluxations: A Retrospective Cohort Study of Neurological and Radiological Outcomes.","authors":"Gorazd Kovac, Ernst Josef Müller, Martin Liebhauser, Jochen Jung, Haro Stettner, Martin Halbherr","doi":"10.3390/jpm16070348","DOIUrl":"10.3390/jpm16070348","url":null,"abstract":"<p><p><b>Background</b>: Dislocations and fracture-dislocations of the lower cervical spine represent complex injuries with a high risk of neurological damage. Especially in the presence of a confirmed traumatic disc lesion, an anterior surgical approach is described as favoured in the literature. However, studies show that with sufficient reduction technique, even in the presence of a confirmed disc protrusion, posterior stabilization can be considered a safe therapeutic option. The aim of this study is to analyze anterior and posterior treatment of dislocations and fracture-dislocations of the subaxial cervical spine with regard to neurological and radiological outcomes. <b>Methods</b>: In our monocentric cohort study, we investigated the immediate postoperative radiological and neurological outcome depending on the chosen surgical approach and the presence of a disc protrusion. Patients treated at our centre between January 2005 and June 2025 were included. Patients with preoperative complete spinal cord injury were excluded. Neurological status was assessed using the ASIA score preoperatively at admission and postoperatively at discharge or prior to staged surgery. <b>Results</b>: A total of 92 patients were included in the study. Most patients showed an ASIA score C (33.7%). A total of 49 patients (53.3%) were operated anteriorly and 42 patients (45.6%) posteriorly. One patient was primarily stabilized bilaterally. Nine patients initially treated anteriorly had to be secondarily stabilized additionally from posterior. In both groups, neurological deterioration occurred in one case. All other patients remained stable on the ASIA score or improved by at least one point on the scale. <b>Conclusions</b>: The findings provide evidence in favour of a personalized, pathology-oriented approach to lower cervical spine fracture-dislocations rather than selecting the surgical approach based solely on the presence of traumatic disc protrusion. Further prospective studies are needed to validate these observations.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspective for CAR T-Cell Therapy in Underrepresented Populations: A Hypothesis-Generating CD19 Genomic Analysis.","authors":"Maysa Al-Hussaini, Anas Al Okaily, Osama Alsmadi","doi":"10.3390/jpm16070343","DOIUrl":"10.3390/jpm16070343","url":null,"abstract":"<p><p>CD19-directed chimeric antigen receptor (CAR) T-cell therapy has fundamentally transformed the treatment landscape for relapsed and refractory B-cell malignancies, yet antigen escape remains a persistent therapeutic challenge that limits long-term remission durability. While antigen loss is typically considered a somatic event acquired during tumor evolution under therapeutic selective pressure, germline CD19 polymorphisms could theoretically influence CAR-binding kinetics, alter epitope presentation, and modulate therapeutic outcomes in ways that remain largely not characterized. Unfortunately, Middle Eastern populations are underrepresented in pharmacogenomic databases and CAR-T clinical trials, creating a knowledge gap that may perpetuate global health disparities in access to precision immunotherapy. We analyzed publicly available whole-exome sequencing data from 1196 individuals of Arab origin to comprehensively characterize CD19 variants with potential relevance to CAR T-cell immunotherapy. The L174V (rs2904880) variant stood out, and showed the Valine/Valine (V/V) genotype frequency was 65.3%, corresponding to a V174 allelic frequency of 76.6%, while the minor allele, L174, has a frequency of 23.4%. The missense mutation (c.520C > G) responsible for this variant results in a leucine-to-valine (L174V) substitution at position 174 of the CD19 protein, relative to the reference genome. The cohort genotypes (CC, CG, and GG) exhibited a significant deviation from Hardy-Weinberg equilibrium (<i>p</i> < 0.00001). While this deviation is consistent with the high consanguinity rates (25-60%) amongst Arab populations, it remains not fully explained, and may be attributed to population structure, relatedness, or technical factors. We further emphasize that our computational analysis cannot establish any direct clinical or functional impact due to this variant, and therefore we refrain from suggesting any specific actions at the current time. In light of these findings, we hypothesize that the distinctive genetic architecture of consanguineous populations should not be viewed as a confounding variable. Instead, it presents a unique opportunity to investigate the clinical relevance of germline variation in the context of precision oncology, particularly at therapy-relevant loci, pending functional validation.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellofemoral Joint Replacement for Isolated Patellofemoral Osteoarthritis: Mid- to Long-Term Survivorship and Functional Outcomes.","authors":"Fernando Diaz Dilernia, Mutaz Tageldein, Emad Anam, Aaron Campbell, Gavin Wood","doi":"10.3390/jpm16070345","DOIUrl":"10.3390/jpm16070345","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Patellofemoral joint (PFJ) replacement is a bone-preserving option for isolated patellofemoral osteoarthritis; however, reported survivorship and failure patterns remain variable. This study evaluated implant survivorship, functional outcomes, reoperations, and failure mechanisms following PFJ replacement using standard second-generation implant systems, with or without patellar resurfacing. <b>Methods:</b> We retrospectively reviewed a consecutive cohort of 39 patients (48 knees) who underwent PFJ replacement for isolated patellofemoral osteoarthritis between 2011 and 2021. Median age at surgery was 59 years, and median body mass index (BMI) was 31 kg/m². Median follow-up for clinical and revision surveillance was 9 years (IQR 8-10). Functional outcomes were assessed using the Oxford Knee Score (OKS) and SF-12 Physical and Mental Component Scores (PCS and MCS). Implant survivorship was analyzed using Kaplan-Meier methodology, with conversion to total knee arthroplasty (TKA) as the endpoint. Statistical analyses were primarily descriptive and exploratory because only five TKA revisions occurred. <b>Results:</b> Median OKS improved from 19 (IQR 16-24) preoperatively to 36 (IQR 24-42) at the latest follow-up, with a median paired improvement of 17 points. SF-12 PCS improved from 25 to 47, and SF-12 MCS from 36 to 55. Eight knees (16.7%) underwent non-revision reoperation, and five knees (10.4%) underwent conversion to TKA. All TKA revisions were performed for the progression of tibiofemoral osteoarthritis. Kaplan-Meier survivorship free from TKA revision was 89.6% at 9 years (95% CI 76.8-95.5). No clear difference in TKA-free survivorship was detected between resurfaced and non-resurfaced knees. <b>Conclusions:</b> PFJ replacement demonstrated substantial functional improvement and mid- to long-term survivorship comparable to published registry ranges in a selected cohort with isolated patellofemoral osteoarthritis. TKA revision was uncommon and was attributable to the progression of tibiofemoral osteoarthritis. Because of the retrospective design, small cohort size, bilateral cases, and limited number of revision events, subgroup and risk-factor analyses should be interpreted as exploratory.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Models for Mortality and Outcome Prediction in Intensive Care Unit Sepsis: A Systematic Review.","authors":"Giuseppe Mazza, Giuseppe Neri, Helenia Mastrangelo, Alessandro Russo, Isabella Aquila, Matteo Antonio Sacco, Jessica Ielapi, Corrado Pelaia, Mario Cannataro, Chiara Lupia, Francesca Serapide, Federico Longhini, Vincenzo Bosco, Zaninni Caroleo, Andrea Bruni, Eugenio Garofalo, The Sepsis-Umg Collaborative Group","doi":"10.3390/jpm16070346","DOIUrl":"10.3390/jpm16070346","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives:&lt;/b&gt; Artificial intelligence (AI), machine-learning (ML), and deep-learning (DL) models are increasingly used for prognostic prediction in intensive care unit (ICU) sepsis, but their clinical readiness remains uncertain. This systematic review aimed to evaluate AI-, ML-, and DL-based models for mortality and clinically relevant outcome prediction in adult ICU patients with sepsis or septic shock. &lt;b&gt;Methods&lt;/b&gt;: PubMed/MEDLINE, Scopus, and the Cochrane Library were searched up to April 2026. Eligible studies included adult ICU sepsis or septic shock cohorts evaluating AI/ML/DL-based prognostic models. Screening, full-text assessment, and data extraction were performed independently by two reviewers. Outcomes, model families, validation strategies, discrimination, calibration, clinical utility, explainability, comparative performance versus conventional severity scores, risk of bias, and reporting completeness were synthesized. Risk of bias was assessed using PROBAST domains supplemented by PROBAST + AI considerations, and reporting completeness was evaluated according to TRIPOD/TRIPOD + AI domains. &lt;b&gt;Results&lt;/b&gt;: Seventy-five studies were included, comprising 50 PubMed-derived and 25 additional Scopus-derived studies. AUROC or C-statistic was extractable in 64 studies, external validation was reported in 27, prospective evaluation in three, calibration in 38, decision-curve analysis or clinical utility assessment in 37, and explainability in 64. Across 17 directly extractable within-study comparisons from nine studies, AI/ML models usually, but not uniformly, achieved higher discrimination than conventional severity scores, with a median paired ΔAUROC of +0.108 (IQR, +0.082 to +0.148; range, -0.013 to +0.203). Externally validated fixed-horizon models showed clinically relevant but heterogeneous discrimination across sepsis phenotypes, with stronger evidence in selected sepsis-induced coagulopathy cohorts and more variable transportability in respiratory and liver-injury subgroups. However, 45 studies were judged at high risk of bias, mainly because of limitations in the analysis domain. &lt;b&gt;Conclusions:&lt;/b&gt; AI/ML models for adult ICU sepsis show a recurrent signal of prognostic discrimination and often perform comparably to or better than conventional severity scores in directly extractable within-study comparisons; however, this signal should be interpreted cautiously given clinical and methodological heterogeneity, limited prospective validation, incomplete calibration, and frequent high risk of bias. The strongest evidence comes from externally validated, phenotype-specific models, although routine clinical implementation remains limited by heterogeneous endpoints, incomplete calibration, insufficient prospective validation, and scarce workflow-level evaluation. Future studies should shift from retrospective AUROC optimization toward calibrated, externally validated, clinically actionable, and workflow-integrate","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-Driven Clinical Phenotyping of Adult Epilepsy Using Latent Class Analysis: A Regional Cohort Study from Southern Kazakhstan.","authors":"Nurlybek Mombekov, Nigara Yerkhojayeva, Aliya Ualiyeva, Nazira Zharkinbekova, Cigdem Ozkara, Gulnaz Nuskabayeva, Karlygash Sadykova, Assylbek Mombek, Bakhytkul Yernazarova, Tangsholpan Zholdassova, Rissalat Abdullayeva, Aziz Nabiyev, Nursultan Nurdinov","doi":"10.3390/jpm16070344","DOIUrl":"10.3390/jpm16070344","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Adult epilepsy is clinically heterogeneous, and individual clinical predictors may not fully capture the multidimensional burden associated with drug-resistant epilepsy (DRE). This study aimed to identify latent clinical phenotypes in adults with epilepsy and examine their cross-sectional associations with DRE and broader disease burden. <b>Methods:</b> This regional observational cohort study used a source database of 1100 patients with epilepsy. After excluding two patients aged <18 years, the adult analytic cohort included 1098 patients. Complete-case latent class analysis (LCA) was performed in 1054 patients using age at onset, disease duration, seizure type, seizure frequency, serial seizures/status, postictal confusion, neurological status, neuroimaging category, and number of antiseizure medications. Model selection was based on statistical fit, class size, and clinical interpretability. Internal clinical validation outcomes included DRE, quality of life, cognitive screening, and stigma scores. Post hoc characterization described the classes by epilepsy etiology, derived epilepsy type, and seizure categories aligned with current terminology. <b>Results:</b> A three-class solution was selected, with class sizes of 314, 465, and 275. DRE prevalence increased stepwise across classes: 5.7%, 14.2%, and 33.1%, respectively (<i>p</i> < 0.001). In adjusted analysis, Class 2 had higher odds of DRE than Class 1 (odds ratio 2.70, 95% confidence interval 1.56-4.67), while Class 3 showed the strongest association (odds ratio 8.19, 95% confidence interval 4.15-16.16; both <i>p</i> < 0.001). Higher-burden classes showed lower quality-of-life and cognitive scores and higher stigma scores. <b>Conclusions:</b> LCA identified three clinically interpretable, burden-enriched phenotypic profiles associated with a stepwise gradient in DRE and broader multidimensional disease burden. These cross-sectional profiles may provide a useful framework for describing clinical heterogeneity in adult epilepsy and generating hypotheses for future validation studies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolactin as a Candidate Biomarker in Non-Small Cell Lung Cancer: Implications for Personalized Medicine and Post-Treatment Risk Stratification.","authors":"Filip Gajewski, Grzegorz Kurec, Aleksandra Litkowska, Joanna Pec, Jakub Kleinrok, Weronika Pająk, Oliwia Burdan, Paweł Krawczyk, Agnieszka Korolczuk","doi":"10.3390/jpm16070342","DOIUrl":"10.3390/jpm16070342","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Non-small cell lung cancer (NSCLC) remains associated with high mortality, frequent late-stage diagnosis, biological heterogeneity, and recurrence after treatment. Although molecular and immunohistochemical biomarkers have transformed treatment selection, there remains a need for accessible, repeatable, and clinically practical circulating biomarkers that may support prognosis and post-treatment monitoring. This review discusses prolactin (PRL) as a candidate supplementary biomarker in NSCLC, with particular emphasis on its biological rationale, potential prognostic relevance, and possible role in personalized risk stratification after systemic therapy. <b>Methods:</b> This narrative review summarizes current evidence on established biomarkers in NSCLC, the physiology and regulation of PRL, PRL/PRLR signaling in cancer biology, mechanisms of PRL dysregulation in lung cancer, and available clinical observations concerning PRL alterations in NSCLC. Particular attention is given to the distinction between prognostic and predictive biomarkers, longitudinal monitoring, pituitary involvement, immune checkpoint inhibitor-related endocrine effects, and biological, pharmacological, and analytical confounders affecting PRL interpretation. <b>Results:</b> Current evidence suggests that PRL may be biologically relevant in NSCLC through its involvement in pathways related to cell proliferation, survival, angiogenesis, invasion, epithelial-mesenchymal transition, immune modulation, and possible therapy resistance. Clinical observations indicate that altered PRL levels may occur in advanced disease, pituitary involvement, systemic inflammation, stress, or during anticancer and supportive treatment. However, PRL lacks cancer specificity and is influenced by multiple confounders, including circadian rhythm, stress, endocrine disorders, macroprolactin, cachexia, medications, and assay variability. Available clinical data remain limited and are largely derived from small studies or case-based evidence. <b>Conclusions:</b> PRL should not currently be considered a standalone diagnostic, predictive, or treatment-selective biomarker in NSCLC. Its most realistic potential role is as a supplementary circulating marker within multimarker prognostic and monitoring models. Prospective validation with standardized sampling, assay procedures, and confounder adjustment is required before clinical implementation.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capillary-Large Vessel Segmentation on OCTA for Predicting Anti-VEGF Treatment Outcomes in Diabetic Macular Edema.","authors":"Rui-Bin Huang, Jia-Pang Jhang, Bo-Da Huang, Mansour Abtahi, Albert K Dadzie, Behrouz Ebrahimi, Xincheng Yao, Yi-Ting Hsieh","doi":"10.3390/jpm16070341","DOIUrl":"10.3390/jpm16070341","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to evaluate the predictability of baseline optical coherence tomography angiography (OCTA) metrics utilizing a specialized capillary-large vessel segmentation analysis framework in patients with diabetic macular edema (DME) undergoing anti-vascular endothelial growth factor (anti-VEGF) therapy. <b>Methods:</b> Forty-two treatment-naïve eyes with DME receiving three monthly loading anti-VEGF injections were included. Superficial capillary plexus (SCP) images from 3 × 3 mm OCTA scans were processed to isolate the capillary network from the large vessels via image processing. Vessel density and skeleton density were extracted for the total, large-vessel, and capillary components. Multiple linear and logistic regression models were used to identify independent predictors of post-treatment best-corrected visual acuity (BCVA) and \"good visual outcome\" (≥3-line improvement or final BCVA of 20/40 or better). <b>Results:</b> Following three monthly anti-VEGF injections, the mean BCVA significantly improved from 0.57 ± 0.36 to 0.37 ± 0.30 LogMAR (<i>p</i> < 0.0001), and the mean central retinal thickness decreased from 424.3 ± 117.7 μm to 316.9 ± 84.7 μm (<i>p</i> < 0.0001). The proportion of patients who achieved a good visual outcome was 73.8%. Baseline central retinal thickness was associated with baseline BCVA (<i>p</i> = 0.049) but not predictive of post-treatment BCVA (<i>p</i> = 0.38) or good visual outcomes (<i>p</i> = 0.79). Baseline capillary vessel density was identified as a significant independent predictor of post-treatment BCVA (<i>p</i> = 0.024), whereas total and large-vessel metrics were not. Capillary vessel density was also the only significant predictor of good visual outcomes (<i>p</i> = 0.044). <b>Conclusions:</b> Baseline capillary vessel density is a robust predictor of visual prognosis after anti-VEGF therapy in patients with DME, underscoring the importance of capillary network integrity in functional recovery.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Venous Closure Devices for Femoral Venous Access in Interventional Cardiology: A Systematic Review and Meta-Analysis.","authors":"Andrea Giovanni Parato, Vincenzo Mirco La Fazia, Marco Marino, Marcello Marchetta, Laura Colarocchio, Giovanni Albano, Francesco Pocelli, Emanuele Chiarazzo, Alessandro Di Francesco, Lorenzo Gerardi, Weili Marco Xu, Valerio Marongiu, Giuseppe Stifano, Andrea Natale","doi":"10.3390/jpm16070340","DOIUrl":"10.3390/jpm16070340","url":null,"abstract":"<p><p><b>Background:</b> Venous closure devices (VCDs) are being increasingly used after femoral venous access to facilitate recovery, but their comparative efficacy and safety versus manual compression or figure-of-eight suture remain uncertain. Because femoral venous access management is influenced by patient-related and procedural factors, VCDs may contribute to a more personalized postprocedural recovery strategy. <b>Objective:</b> Evaluation of the impact of VCDs on procedural recovery and vascular complications in patients undergoing cardiac procedures via femoral venous access. <b>Methods:</b> We systematically searched PubMed, Embase, and CENTRAL through to April 2025 for randomized controlled trials (RCTs) comparing VCDs with manual compression and/or figure-of-eight suture. Primary efficacy outcomes were time to hemostasis (TTH), time to ambulation (TTA), time to discharge (TTD), and time to discharge eligibility (TTDe). Safety outcomes were major and minor vascular complications. Risk of bias was assessed with RoB 2, and certainty of evidence assessed with GRADE. Random-effects models were used to pool standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs). <b>Results:</b> Seven RCTs (<i>n</i> = 948) were included. VCDs use significantly reduced TTH (SMD: -1.00; 95% CI: -1.57 to -0.42) and TTA (SMD: -1.50; 95% CI: -2.42 to -0.58). TTD showed a non-significant trend favoring VCDs (SMD: -0.99; 95% CI: -2.13 to 0.15), while TTDe was consistently shorter with VCDs across three trials. Major vascular complications were rare and similar between groups (RR: 0.41; 95% CI: 0.09-1.89). Minor vascular complications were significantly reduced with VCDs (RR: 0.42; 95% CI: 0.22-0.79). <b>Conclusions:</b> In patients requiring femoral venous access for interventional cardiology procedures, VCDs improve time to hemostasis and ambulation and reduce minor vascular complications without increasing major events. These findings support VCDs as an effective and safe strategy for venous closure.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Ethical Issues in Precision Psychiatry: Mapping Unresolved Tensions Across Modalities.","authors":"Christos Doukas, Petros Galanis, Athanasios Douzenis, Panagiota Bali, Marie Louise Psarra, Ioannis Michopoulos, Nikolaos Smyrnis, Konstantinos Tasios","doi":"10.3390/jpm16070337","DOIUrl":"10.3390/jpm16070337","url":null,"abstract":"<p><p>Precision psychiatry promises a more objective and effective approach to psychiatric care, yet its implementation raises growing ethical challenges as technology advances. This narrative review offers a qualitative synthesis of the ethical issues reported in 62 studies, with emphasis on the practical tensions that arise when core principles conflict. Rather than organising concerns around traditional ethical principles, the review maps them across the main modalities of precision psychiatry, namely genomics, neuroimaging, digital phenotyping, and AI-driven interventions. Four explicit positions are advanced. First, equity must be engineered from the outset rather than assumed. Second, interpretability should outweigh marginal gains in accuracy in a field built on subjective report. Third, stigma is bidirectional and contingent on framing and the availability of meaningful intervention. Fourth, individualised care must demonstrate clinical and economic superiority over standardised approaches. Precision psychiatry is likely to reshape psychiatric practice and the therapeutic relationship itself. Interdisciplinary collaboration, clear guidelines, and continuous ethical vigilance will be essential for responsible adoption and sustained public trust.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}