Celine Carmen Akta, Maximilian Muellner, Kai-Uwe Lewandrowski, Lukas Schönnagel, Anika Mueller, Michael Putzier, Matthias Pumberger, Thilo Khakzad
{"title":"Total En Bloc Spondylectomy in Modern Spine Oncology: Selection-Relevant Survival Signals and Treatment Burden in a Single-Center Cohort.","authors":"Celine Carmen Akta, Maximilian Muellner, Kai-Uwe Lewandrowski, Lukas Schönnagel, Anika Mueller, Michael Putzier, Matthias Pumberger, Thilo Khakzad","doi":"10.3390/jpm16080435","DOIUrl":"10.3390/jpm16080435","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Total en bloc spondylectomy (TES) remains one of the most invasive and selectively used procedures in spine oncology. Its role has become more selective in the modern era of stereotactic body radiotherapy, separation surgery, targeted systemic therapy, immunotherapy, and multidisciplinary cancer care. This study evaluated long-term survival, imaging-defined systemic disease burden, operative morbidity, patient-reported outcomes, and frailty-related variables after TES in a rare single-center cohort, with the goal of identifying selection-relevant survival and treatment-burden signals rather than developing a validated decision algorithm. <b>Methods</b>: We performed a retrospective single-center cohort study of consecutive adults who underwent TES for spinal tumors between 2011 and 2022. Of the 36 screened patients, 30 had sufficient clinical and survival data for analysis; patients without reliable survival or last-contact data were not included. Contrast-enhanced CT and PET-CT were reviewed for extraspinal metastases, lymphadenopathy, pleural effusion, and soft-tissue extension. Survival was analyzed using Kaplan-Meier methods, log-rank testing, and exploratory univariate Cox regression. Patient-reported outcomes included the Oswestry Disability Index (ODI) and SF-36 when available; frailty was summarized with the modified frailty index-5 (mFI-5) when component data were present. Results: The cohort included 13 men and 17 women with a mean age of 54.8 ± 15.2 years. At final follow-up, 18 patients had died, and 12 were alive. Five-year overall survival was approximately 76% in the full cohort. Extraspinal metastases were present in 72.2% of deceased patients compared with 8.3% of survivors and showed the clearest exploratory association with increased mortality (HR 3.46, 95% CI 1.23-9.78; <i>p</i> = 0.019). Metastatic disease demonstrated inferior survival compared with primary bone or soft-tissue tumors. Perioperative blood loss and transfusion burden were substantial but were not associated with survival in univariate analysis. ODI and SF-36 data were available only in small subsets and were therefore interpreted as descriptive signals of treatment burden. <b>Conclusions</b>: TES remains relevant in modern spine oncology, but only as an increasingly selective intervention. In this rare cohort, systemic disease burden, particularly extraspinal metastases, was the clearest selection-relevant survival signal, while blood loss, transfusion requirements, complications, and limited patient-reported outcomes illustrated substantial treatment burden. These findings do not establish a validated selection algorithm but support a contemporary decision threshold that integrates tumor biology, systemic disease status, anticipated margins, physiologic reserve, operative morbidity, and patient goals.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829449","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}
Michele Salati, Alberto Roncon, Gian Marco Guiducci, Michela Tiberi, Mara Romito, Anna Chiara Nanto, Francesco Xiumè, Rosanna Coltrinari, Stefano Falcetta, Paolo Gentili, Abele Donati, Majed Refai
{"title":"Intraoperative Volume Decay Measured Through Mechanical Ventilation as a Predictor of Prolonged Postoperative Air Leak After Uniportal Video-Assisted Thoracic Surgery Lung Resection.","authors":"Michele Salati, Alberto Roncon, Gian Marco Guiducci, Michela Tiberi, Mara Romito, Anna Chiara Nanto, Francesco Xiumè, Rosanna Coltrinari, Stefano Falcetta, Paolo Gentili, Abele Donati, Majed Refai","doi":"10.3390/jpm16080434","DOIUrl":"10.3390/jpm16080434","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Prolonged postoperative air leak (PAL) remains one of the most common complications after lung resection, significantly affecting postoperative recovery and healthcare utilization. While several preoperative risk factors have been identified, reliable intraoperative predictors are still lacking. This study aimed to evaluate whether intraoperative ventilator-derived parameters-volume decay (Vol-Decay) and pressure decay (Pres-Decay)-are associated with the development of PAL following uniportal video-assisted thoracic surgery (VATS) lung resection. <b>Methods</b>: We conducted a single-center study including 277 consecutive patients undergoing uniportal VATS lung resection for neoplastic disease between May 2023 and April 2024. At the end of the surgical procedure, intraoperative Vol-Decay and Pres-Decay were measured using the mechanical ventilator under standardized conditions. PAL was defined as an air leak persisting for more than 5 days within 30 days after surgery. Univariate and multivariate analyses were performed to identify independent predictors of PAL, and the optimal Vol-Decay cut-off was determined using Youden's index. <b>Results</b>: PAL occurred in 18 patients (6.5%). At univariate analysis, higher smoking exposure, lower FEV1, lower FEV1/FVC ratio, and higher Vol-Decay were significantly associated with PAL. At multivariable analysis, only FEV1 (<i>p</i> = 0.013) and Vol-Decay (<i>p</i> = 0.038) remained independent predictors. The optimal Vol-Decay cut-off was 22 mL (AUC 0.64), with high specificity (0.94) but low sensitivity (0.34). Patients with Vol-Decay > 22 mL showed a significantly higher incidence of PAL compared to those with lower values (27.3% vs. 4.7%). <b>Conclusions</b>: Intraoperative Vol-Decay represents a simple, objective, and reproducible parameter associated with the development of prolonged air leak after uniportal VATS lung resection. Its measurement may enable real-time risk stratification and support personalized intraoperative decision-making, potentially guiding targeted corrective strategies. Further prospective multicenter studies are warranted to validate these findings and confirm their clinical applicability.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828934","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":"Imeglimin-Associated Temporal Changes in γ-Glutamyl Transferase and Total Cholesterol: A Post Hoc Exploratory Analysis of the INFINITY Study.","authors":"Takeshi Osonoi, Shinichiro Shirabe, Miyoko Saito, Mitsuru Hosoya, Satako Douguchi, Kensuke Ofuchi, Makoto Katoh","doi":"10.3390/jpm16080433","DOIUrl":"10.3390/jpm16080433","url":null,"abstract":"<p><p><b>Background:</b> Imeglimin is a novel oral antidiabetic agent that improves mitochondrial function and glucose metabolism in patients with type 2 diabetes mellitus (T2DM). Its effects on liver enzymes remain unclear. We investigated the effects of imeglimin on hepatic biomarkers, particularly γ-glutamyl transpeptidase (γ-GTP), and the reversibility of these changes after treatment discontinuation. <b>Methods:</b> This post hoc analysis of the prospective INFINITY Study included 25 patients with T2DM who completed 6 months of imeglimin treatment followed by a 3-month withdrawal period. Clinical parameters were averaged within predefined 3-month study phases. Changes during treatment and after discontinuation were analyzed. <b>Results:</b> Imeglimin significantly improved glycemic control. The geometric mean γ-GTP decreased from 36.2 (27.1-48.4) U/L during the Baseline Phase to 31.1 (23.5-41.1) U/L during the Late Treatment Phase (<i>p</i> < 0.05). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) also showed downward trends, although these changes were not statistically significant. During the Withdrawal Phase, γ-GTP returned to 35.6 (26.4-48.5) U/L (<i>p</i> < 0.05 vs. Late Treatment Phase). Patients with baseline γ-GTP >50 U/L showed larger but non-significant changes. Changes during treatment and after discontinuation were inversely correlated (r = -0.480, <i>p</i> = 0.015). Only total cholesterol correlated with γ-GTP during both treatment (r = 0.554, <i>p</i> = 0.005) and withdrawal (r = 0.450, <i>p</i> = 0.024). <b>Conclusions:</b> γ-GTP levels showed a significant decrease during imeglimin treatment and increased during the post-treatment observation period in patients with T2DM. Exploratory analyses identified an association between changes in γ-GTP and total cholesterol; however, these findings should be interpreted cautiously and require confirmation in prospective studies with prespecified endpoints.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829691","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}
Hugo A Sanchez, Guillermo Ponce de Leon-Ballesteros, Miguel F Herrera
{"title":"Hand-Sewn Gastrojejunal Anastomosis in Laparoscopic Roux-en-Y Gastric Bypass: A Comparison of Absorbable Monofilament Versus Non-Absorbable Multifilament Sutures and Their Impact on the Symptomatic Anastomotic Stricture Rate.","authors":"Hugo A Sanchez, Guillermo Ponce de Leon-Ballesteros, Miguel F Herrera","doi":"10.3390/jpm16080431","DOIUrl":"10.3390/jpm16080431","url":null,"abstract":"<p><p><b>Introduction</b>: Gastrojejunal anastomosis (GJA) stricture is an important complication after laparoscopic Roux-en-Y gastric bypass (LRYGB). The impact of suture material on stricture rate when performing a hand-sewn GJA is not well established. <b>Methods</b>: This is a retrospective analysis of a prospectively maintained database that includes 882 patients who underwent primary or revisional LRYGB with a minimum 12-month follow-up. We compared two consecutive groups of patients who underwent hand-sewn gastrojejunal anastomosis: group 1 (<i>n</i> = 426), utilizing a multifilament non-absorbable/absorbable suture combination (silk/Vicryl<sup>®</sup>), whereas group 2 (<i>n</i> = 456) received an absorbable monofilament suture (Monocryl<sup>®</sup>). The primary outcome was the incidence of symptomatic GJA stricture, defined as an inability to pass a 10 mm gastroscope associated with dysphagia, vomiting, or food intolerance. <b>Results</b>: The symptomatic stricture rate was significantly lower in group 2 (0.7% vs. 6.8%; <i>p</i> < 0.001). On multivariate analysis, the use of monofilament sutures was a stronger protective factor (OR 0.09; 95% CI 0.03-0.30; <i>p</i> < 0.001), whereas revisional surgery was associated with an increased risk of symptomatic stricture (OR 2.61; 95% CI 1.05-6.50; <i>p</i> = 0.03). Type 2 diabetes mellitus and gender were not independent predictors. One-year weight loss was similar between patients who developed symptomatic strictures (and required dilations) and those who did not (<i>p</i> > 0.05). <b>Conclusion</b>: The use of absorbable monofilament sutures for hand-sewn GJA in LRYGB reduces the risk of symptomatic stricture without compromising weight loss outcomes. These findings support a personalized suture strategy, especially in high-risk patients undergoing revisional surgery.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829685","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}
Andrea Coello Hidalgo, Ana Alvear Miquilena, Domenica Yepez Zamora, Diego Quiguango Farias, Luis Chauca Bajaña, Maria Rodriguez Tates, Byron Velasquez Ron
{"title":"Clinical Findings Related to Temporomandibular Disorders in Schoolchildren Aged 4-16 Years: A Multicenter Cross-Sectional Study.","authors":"Andrea Coello Hidalgo, Ana Alvear Miquilena, Domenica Yepez Zamora, Diego Quiguango Farias, Luis Chauca Bajaña, Maria Rodriguez Tates, Byron Velasquez Ron","doi":"10.3390/jpm16080432","DOIUrl":"10.3390/jpm16080432","url":null,"abstract":"<p><p><b>Background</b>: Temporomandibular disorders (TMD) comprise a heterogeneous group of musculoskeletal conditions that may manifest during childhood and adolescence. However, standardized information regarding TMD-related clinical findings in pediatric populations remains limited because of methodological heterogeneity and the inconsistent application of validated diagnostic protocols. <b>Objective</b>: The aim of this study was to characterize clinical findings related to temporomandibular disorders in schoolchildren and to explore their potential contribution to individualized assessment strategies within the framework of personalized pediatric oral healthcare. <b>Methods</b>: A multicenter cross-sectional study was conducted in 1052 schoolchildren recruited from participating educational institutions. All participants underwent a standardized clinical examination that included assessment of masticatory muscle tenderness, temporomandibular joint tenderness, joint sounds, pain intensity, and perceived stress using an adapted pediatric DC/TMD protocol. Categorical variables were summarized as frequencies, percentages, and 95% confidence intervals (95% CIs). Associations between categorical variables were evaluated using Pearson's chi-square test, and multivariable logistic regression was performed to identify factors independently associated with pain. <b>Results</b>: Pain during clinical examination was identified in 111 participants (10.6%; 95% CI: 8.8-12.6%), whereas temporomandibular joint sounds and myofascial pain were detected in 1.4% and 0.3% of participants, respectively. Most pain was classified as mild, and the masseter muscle was the most frequently affected anatomical site. Increasing age and female sex were independently associated with pain. Compared with children aged 4-6 years, participants aged 10-12 years (adjusted OR = 9.61; 95% CI: 2.22-41.51) and 13-16 years (adjusted OR = 35.49; 95% CI: 8.59-146.61) showed significantly greater odds of pain. Female participants also demonstrated higher odds of pain than males (adjusted OR = 7.49; 95% CI: 3.68-15.21; all <i>p</i> < 0.05). <b>Conclusions</b>: Clinically detectable TMD-related findings were generally uncommon among schoolchildren aged 4-16 years and were predominantly mild and muscular. Increasing age and female sex were independently associated with pain, emphasizing the importance of demographic factors in the early clinical expression of TMD. Standardized pediatric clinical examination protocols may facilitate early identification of TMD-related findings and support preventive strategies during childhood and adolescence. These findings support the implementation of individualized clinical assessment strategies for early identification of children at risk of temporomandibular disorders, contributing to personalized preventive and therapeutic approaches in pediatric oral healthcare.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829456","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":"Aortitis as a High-Risk Vascular Syndrome: Integrating Phenotype-Driven Diagnosis, Multidisciplinary Assessment, and Personalised Management.","authors":"Georgios P Georghiou, Klitia Socratous, Sotiris Kyriakou, Konstantinos Lampropoulos, Panos Georghiou, Amalia Georgiou, Marilina Neokleous, Iakovos Ttofi, Nikolas Iosif, Filippos Triposkiadis","doi":"10.3390/jpm16080430","DOIUrl":"10.3390/jpm16080430","url":null,"abstract":"<p><p>Aortitis-inflammation of the aortic wall-presents at the interface of vasculitis, infection, structural aortic disease, and cardiovascular risk. It may occur in giant cell arteritis (GCA), Takayasu arteritis, immunoglobulin G4 (IgG4)-related disease, drug-induced injury, infection, or as an isolated finding after aortic surgery. Modern imaging detects aortic inflammation more frequently, but the main challenge is classification rather than detection: determining whether disease is infectious or immune-mediated, active or dominated by fixed structural damage, systemic or isolated, and whether the dominant threat is aneurysm, dissection, undertreated infection, or avoidable immunosuppression. This review considers aortitis as a high-risk vascular syndrome requiring aetiology-first classification rather than descriptive labelling. Before escalating immunosuppression, infection must be actively excluded and inflammatory activity distinguished from fixed vascular damage. Treatment should be individualised according to phenotype, age, vascular territory, comorbidity, and toxicity risk, with surveillance continuing even after symptoms and inflammatory markers improve. Optimal care depends on multidisciplinary assessment integrating rheumatology, infectious diseases, vascular surgery, radiology, and cardiology expertise. Progress will require standardised imaging definitions, registries linking inflammatory control with structural vascular outcomes, and validation of artificial intelligence (AI) tools before clinical adoption.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829493","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}
Patrycja Brzóska-Ritter, Piotr Żarczyński, Maciej Haberka
{"title":"Residual Inflammatory Potential in Patients with Treated Non-Definite and Definite Familial Hypercholesterolaemia: A Clinical Study.","authors":"Patrycja Brzóska-Ritter, Piotr Żarczyński, Maciej Haberka","doi":"10.3390/jpm16080429","DOIUrl":"10.3390/jpm16080429","url":null,"abstract":"<p><p><b>Background:</b> Familial hypercholesterolemia (FH) is associated with accelerated atherosclerosis and an increased risk of cardiovascular disease. <b>Aims:</b> To evaluate circulating biomarkers of inflammation and atherosclerosis in patients with clinically suspected FH stratified according to the Dutch Lipid Clinic Network (DLCN) criteria. <b>Methods:</b> This cross-sectional study included 80 patients (mean age, 53.4 [13.2] years; 58% women) receiving maximally tolerated lipid-lowering therapy (statins ± ezetimibe). Serum concentrations of lipoprotein-associated phospholipase A<sub>2</sub> (Lp-PLA<sub>2</sub>), tumor necrosis factor-α (TNF-α), apolipoprotein B (ApoB), oxidized low-density lipoprotein (oxLDL), and monocyte chemoattractant protein-1 (MCP-1) were measured. Participants were classified as definite FH (DLCN score > 8; n = 45) or non-definite FH (DLCN score ≤ 8; n = 35). Biomarker concentrations were analyzed according to the above subgroups and sex. <b>Results:</b> Patients with definite FH had significantly higher serum Lp-PLA<sub>2</sub> concentrations (62.2 [33.8] vs. 46.5 [19.9] ng/mL; <i>p</i> = 0.03) and TNF-α concentrations (6.94 [4.53] vs. 4.51 [2.93] pg/mL; <i>p</i> = 0.02) compared to non-definite FH, whereas ApoB, oxLDL, and MCP-1 concentrations did not differ significantly between the subgroups. Women had significantly higher TNF-α concentrations compared to men (6.57 [4.74] vs. 4.60 [2.20] pg/mL; <i>p</i> = 0.04) with no differences among other cytokines. <b>Conclusions:</b> Patients with definite FH exhibited persistently higher circulating Lp-PLA<sub>2</sub> and TNF-α concentrations despite maximally tolerated lipid-lowering therapy, suggesting ongoing activation of specific inflammatory pathways. These findings support further investigation of Lp-PLA<sub>2</sub> and TNF-α as candidate biomarkers for cardiovascular risk assessment in FH.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829519","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}
Andrej Belančić, Marin Golčić, Almir Fajkić, Vlatka Bračić, Marko Skelin, Antonio Markotić, Ivan Ćavar, Dragan Trivanović, Ivana Mikolašević
{"title":"Chronotherapy in Oncology: Aligning Cancer Treatment with Biological Time.","authors":"Andrej Belančić, Marin Golčić, Almir Fajkić, Vlatka Bračić, Marko Skelin, Antonio Markotić, Ivan Ćavar, Dragan Trivanović, Ivana Mikolašević","doi":"10.3390/jpm16080428","DOIUrl":"10.3390/jpm16080428","url":null,"abstract":"<p><p>Circadian rhythms regulate key biological processes central to cancer biology, including cell cycle control, DNA repair, metabolism, immune function, and drug pharmacokinetics. Experimental models consistently demonstrate marked time-of-day differences in the efficacy and toxicity of chemotherapy, targeted agents, and immunotherapies. Clinical studies of chronomodulated chemotherapy-particularly with fluoropyrimidines, platinum compounds, and anthracyclines-show reproducible reductions in treatment-related toxicity, while effects on survival outcomes remain variable and often sex dependent. Emerging clinical evidence also suggests that timing of immune checkpoint inhibitor administration may influence progression-free and overall survival across several tumor types. However, translation into routine oncology practice has been limited by interindividual variability in circadian phase, tumor-specific disruption of clock function, lack of validated biomarkers, and logistical constraints of time-specific drug delivery. Advances in circadian phenotyping, wearable monitoring, and adaptive dosing technologies now offer feasible pathways toward individualized, biology-driven treatment timing. This narrative review critically evaluates mechanistic, preclinical, and clinical evidence for chronotherapy across oncological treatment modalities and examines challenges and opportunities for its integration into precision cancer care.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829509","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}
Tom L Zwijnenberg, Rutger H Schepers, Johan Jansma, Haye H Glas
{"title":"Prediction of Three-Dimensional Soft Tissue Changes Following Mandibular PEEK Implantation (Proof of Concept).","authors":"Tom L Zwijnenberg, Rutger H Schepers, Johan Jansma, Haye H Glas","doi":"10.3390/jpm16080427","DOIUrl":"10.3390/jpm16080427","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Polyetheretherketone (PEEK) implants are increasingly being used for mandibular reconstruction and augmentation, yet predicting the resulting facial soft tissue changes remains challenging. Accurate pre-operative prediction of soft tissue deformation is essential for surgical planning and patient counselling. To the best of our knowledge, this study presents the first application of a computational model for predicting three-dimensional facial soft tissue deformation induced by PEEK implants. <b>Methods</b>: Four patient cases with pre-operative and post-operative cone-beam computed tomography scans were analysed. A mass tensor model was employed to predict soft tissue changes based on the pre-operative soft tissue shape, mandibular anatomy, and the designed PEEK implant. Model accuracy was quantified by comparing predicted outcomes to post-operative scans using landmark-based analysis of chin and jaw positions, as well as surface distance mapping, with a mean error below 2 mm adopted as the criterion for clinically acceptable accuracy. <b>Results</b>: Landmark-based analysis revealed a mean absolute error of 0.9 ± 0.8 mm between the predicted and actual positions. The mean surface distances were 1.3 mm for the jaw-chin region and 1.0 mm for the entire facial region. <b>Conclusions</b>: These results demonstrate the potential of a computational approach for real-time prediction of facial soft tissue changes following PEEK implant placement, achieving clinically relevant accuracy at the cohort level, with a tendency towards under-prediction and one case exceeding the threshold.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829511","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}
Alireza Sharafshah, Colin Hanna, Kai-Uwe Lewandrowski, Mark S Gold, Brian Fuehrlein, Panayotis K Thanos, Igor Elman, Eliot L Gardner, Jag Khalsa, David Baron, Abdalla Bowirrat, Albert Pinhasov, Edward J Modestino, Rossano Kepler Alvim Fiorelli, Sergio L Schmidt, Morgan P Lorio, Keerthy Sunder, Lyle Fried, Michael Slifer, Frank Fornari, Shaurya Mahajan, Yatharth Mahajan, Marco Lindenau, Álvaro Dowling, Rafaela Dowling, João Paulo Bergamaschi, Kyriaki Z Thanos, Paul R Carney, Kenneth Blum
{"title":"Large-Scale Data Analysis of Post-Traumatic Stress Disorder (PTSD) Through GWAS Fine-Mapping and Systems Biology.","authors":"Alireza Sharafshah, Colin Hanna, Kai-Uwe Lewandrowski, Mark S Gold, Brian Fuehrlein, Panayotis K Thanos, Igor Elman, Eliot L Gardner, Jag Khalsa, David Baron, Abdalla Bowirrat, Albert Pinhasov, Edward J Modestino, Rossano Kepler Alvim Fiorelli, Sergio L Schmidt, Morgan P Lorio, Keerthy Sunder, Lyle Fried, Michael Slifer, Frank Fornari, Shaurya Mahajan, Yatharth Mahajan, Marco Lindenau, Álvaro Dowling, Rafaela Dowling, João Paulo Bergamaschi, Kyriaki Z Thanos, Paul R Carney, Kenneth Blum","doi":"10.3390/jpm16080426","DOIUrl":"10.3390/jpm16080426","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Post-Traumatic Stress Disorder (PTSD) is a complex psychiatric condition with a strong polygenic and stress-related biological basis. Although Genome-Wide Association Studies (GWAS) have acknowledged abundant risk variants, translating these findings into biologically meaningful candidates remains challenging. This study introduces an integrative computational approach from raw file preparation by python-coded application into downstream in-depth silico analyses designed to systematically refine GWAS signals for PTSD using fine-mapping, linkage disequilibrium (LD), and haplotype analyses. <b>Methods</b>: GWAS source file for PTSD was obtained from the GWAS Catalog (EFO_0001358) and analyzed using a custom Python pipeline integrating data harmonization, genome-wide visualization, LD estimation via 1000 Genomes reference panels, approximate Bayesian fine-mapping, and Haploview-inspired haplotype inference. SNPs were filtered based on statistical significance, LD structure, and posterior inclusion probability. Downstream systems' biology analyses included protein-protein interaction modeling and pharmacogenomics (PGx) annotations. <b>Results</b>: From the primary GWAS dataset, 100 top-ranked SNPs were selected, leading to the identification of 58 significant loci. LD and haplotype analyses refined these signals to 93 candidate SNPs (66 genes). Following the exclusion of non-protein-coding genes, 45 genes remained, and network-based prioritization generated a final list of 20 biologically connected and pharmacogenetically relevant genes associated with PTSD. <b>Conclusions</b>: This integrative approach provided a robust and reproducible framework for GWAS fine-mapping and variant prioritization, effectively reducing large-scale GWAS outputs to biologically interpretable PTSD risk loci and genes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829005","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}