Journal of Personalized Medicine最新文献

{"title":"Multimodal Correlates of Longitudinal Functional Decline in Behavioral Variant Frontotemporal Dementia (bvFTD).","authors":"Electra Chatzidimitriou, Georgios Ntritsos, Eleni Poptsi, Emmanouil Tsardoulias, Andreas L Symeonidis, Magda Tsolaki, Panos Charalambous, Chrissa Sioka, Eleni Aretouli, Ioannis Iakovou, Katherine P Rankin, Panagiotis Ioannidis, Despina Moraitou","doi":"10.3390/jpm16080415","DOIUrl":"10.3390/jpm16080415","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Functional decline is a major determinant of disability, caregiver burden, and loss of independence in behavioral variant frontotemporal dementia (bvFTD). Although bvFTD is characterized by early and rapidly progressive deterioration in everyday functioning, the multimodal contributors associated with longitudinal functional change remain insufficiently understood. The present study aimed to identify the strongest cognitive, behavioral, personality, and neuroimaging correlates of longitudinal functional deterioration in bvFTD using an integrated multimodal framework over a 12-month follow-up period. <b>Methods:</b> Twenty-seven patients diagnosed with bvFTD were recruited from the 2nd Neurology Clinic of the \"AHEPA\" University Hospital in Thessaloniki, Greece, and underwent comprehensive face-to-face neuropsychological assessment for the evaluation of a wide range of cognitive domains, alongside caregiver-based evaluations of behavioral disturbances, personality changes, and functional abilities, at baseline, 6 months, and 12 months. Brain perfusion single-photon emission computed tomography (SPECT) was acquired only at baseline, with regional cerebral blood flow (rCBF) quantified using a Brodmann area (BA)-based approach. Functional status was assessed using the Disability Assessment for Dementia (DAD) as the primary outcome, while the Frontotemporal Dementia Rating Scale (FRS) served as a secondary measure. Repeated-measures analysis of variance (ANOVA) was used to characterize longitudinal changes across cognitive, behavioral, personality, and functional domains, while linear mixed-effects (LME) models were applied to identify longitudinal correlates of functional decline and sources of inter-individual variability in functional outcomes. <b>Results:</b> Significant progressive decline in functional abilities was observed over the 1-year follow-up period, consistent with an aggressive and rapidly deteriorating clinical course in bvFTD. Reductions in functional performance were evident across both basic and instrumental activities of daily living, with deterioration being more pronounced in instrumental activities. Based on the final LME model, greater apathy-related (negative) behavioral symptoms, global cognitive impairment, attentional and processing speed deficits, and impaired inhibitory control were independently associated with poorer longitudinal functional outcomes (<i>p</i> < 0.001). At the neuroimaging level, reduced baseline perfusion in the right BA 24 within the anterior cingulate cortex was also significantly associated with greater loss of functional independence over time (<i>p</i> < 0.001). <b>Conclusions:</b> Longitudinal functional decline in bvFTD reflects the combined disruption of behavioral regulation, global cognition, executive control, and frontal-cingulate network integrity. The findings provide a preliminary foundation for future research investigating factors associated with ","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829173","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":"Integration of Clinical, Cytokine, and Ultrasound Data Using Machine Learning Reveals a Multidimensional Inflammatory Signature in Polymyalgia Rheumatica.","authors":"Christian D'Elia, Edda Russo, Giada Santagata, Riccardo Terenzi, Francesca Li Gobbi, Emanuele Antonio Maria Cassarà, Elisa Cioffi, Valentina Grossi, Francesca Romano, Barbara Lari, Maria Infantino, Mariangela Manfredi, Serena Guiducci, Maurizio Benucci","doi":"10.3390/jpm16080414","DOIUrl":"10.3390/jpm16080414","url":null,"abstract":"<p><p><b>Background</b>: Polymyalgia rheumatica (PMR) is a clinically heterogeneous inflammatory disorder in which conventional acute-phase reactants may inadequately reflect the complexity and biological variability of disease activity. Precision medicine approaches integrating multidimensional clinical and laboratory data may offer a more comprehensive characterization of inflammatory phenotypes. This study investigated whether the combined assessment of cytokine profiles, routine laboratory biomarkers, ultrasound findings, and clinical variables could improve disease activity stratification in PMR. <b>Methods</b>: A total of 103 consecutive patients with PMR were retrospectively analyzed. Disease activity was assessed using the PMR Activity Score (PMR-AS) and, for exploratory purposes, dichotomized according to the cohort median (≥11 vs. <11). Group differences were evaluated using non-parametric statistical methods. The multidimensional structure of the dataset was explored through Spearman correlation analysis, principal component analysis (PCA), and unsupervised clustering. Predictive models, including logistic regression, random forest, and gradient boosting, were developed to evaluate the potential contribution of integrated analytical approaches to patient stratification. <b>Results</b>: The study cohort included 103 patients (63.1% female), with a median age of 76 years (IQR 71-81); 57 patients (55.3%) presented PMR-AS ≥11. Patients with higher disease activity exhibited significantly increased levels of CRP, fibrinogen, platelet count, IL-6, serum amyloid A (SAA), and myeloid-related protein (MRP), together with a higher prevalence of joint effusion and Power Doppler positivity. Among the evaluated biomarkers, SAA demonstrated the strongest correlation with disease activity (Spearman ρ = 0.878; <i>p</i> < 0.001). Multivariate predictive modeling showed high discriminative performance, with random forest achieving the highest cross-validated AUC (0.934), whereas gradient boosting demonstrated the best overall accuracy (0.883). Unsupervised clustering analysis identified a subgroup characterized by a more pronounced inflammatory signature associated with higher PMR-AS values. <b>Conclusions</b>: These findings support the concept that disease activity in PMR may be more effectively represented through an integrated multidimensional inflammatory profile rather than isolated biomarkers. The combined evaluation of routine laboratory parameters, cytokines, and imaging features may contribute to more refined patient stratification within a precision medicine framework. Although exploratory, these results highlight the potential value of advanced data integration strategies for supporting biologically informed disease characterization in PMR, while underscoring the need for external validation before translation into clinical practice.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829779","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":"Personalized Prevention of Osteoradionecrosis of the Jaws: From Clinical Risk Profiling and Site-Specific Dosimetry to Artificial Intelligence and Individualized Treatment-Effect Estimation.","authors":"Luigi Angelo Vaira, Hareem Qadeer, Fabio Maglitto, Giuseppe Consorti, Giulio Cirignaco, Giovanni Salzano, Giacomo De Riu","doi":"10.3390/jpm16080413","DOIUrl":"10.3390/jpm16080413","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Osteoradionecrosis of the jaws remains a severe late complication of head and neck radiotherapy. Current preventive strategies are still frequently based on population-level dose thresholds and broadly standardized dental-clearance protocols, despite substantial heterogeneity in individual risk. This comprehensive review aimed to integrate established preventive guidance with emerging tooth-level, spatial-dosimetric, prognostic, and causal approaches within an integrative conceptual framework for personalized osteoradionecrosis prevention. <b>Methods</b>: Structured searches of five databases were completed on 30 May 2026. Evidence sources were selected and mapped across six a priori thematic domains, with the selection process summarized in a simplified flow diagram and an evidence map. Priority was given to guidelines, systematic reviews, large cohorts, externally validated prediction models, and clinically actionable studies. <b>Results</b>: Osteoradionecrosis risk is determined by interactions among tumor site, surgical anatomy, mandibular dose distribution, dental and periodontal disease, smoking, diabetes, nutritional status, biological susceptibility, and expected survival. Tooth extraction is not uniformly protective, and its potential benefit depends on tooth prognosis, local radiation dose, oncological urgency, and patient-level vulnerability. Dose-volume parameters and site-specific mapping provide more clinically relevant information than prescribed dose alone. Contemporary normal tissue complication probability and machine-learning models increasingly support individualized risk estimation, although calibration, external validation, data quality, and workflow integration remain limiting. Competing-risk and causal-inference approaches may further distinguish baseline risk from the expected benefit of specific preventive interventions. <b>Conclusions</b>: The evidence reviewed can be organized within an integrative conceptual framework combining tooth-level prognosis, spatial dosimetry, systemic susceptibility, competing mortality, and intervention burden. This framework synthesizes and reorganizes existing evidence; it is not a validated clinical model and requires prospective validation and clinical-impact evaluation before routine implementation. Until then, available prediction models should support, rather than replace, multidisciplinary clinical judgement.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829179","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":"Clinical Outcomes of an Individualized Multimodal Chronic Wound Management Protocol Using Type I Collagen-Hyaluronic Acid Pads: Retrospective Observational Study.","authors":"Cristina Stanescu, Catalina Teodora Pintilie, Roxana Elena Bogdan Goroftei, Madalina Nicoleta Matei, Iulia Chiscop, Monica Boev, Florina Popa, Camelia Tamas","doi":"10.3390/jpm16080412","DOIUrl":"10.3390/jpm16080412","url":null,"abstract":"<p><p><b>Background</b>: Chronic wounds pose a persistent therapeutic challenge. Type I collagen and hyaluronic acid (HA) support tissue repair, but real-world evidence for describing their combined use in padformulations is limited. This study provides a real-world description of clinical outcomes observed within a tailored management, including Type I Collagen-Hyaluronic Acid pads (HCHA), on healing trajectories across diverse chronic wound etiologies. <b>Methods</b>: This retrospective observational analysis included 64 patients treated between 2017 and 2024 for chronic wounds, including burns (<i>n</i> = 32) and trophic ulcers of various etiologies (<i>n</i> = 32). Clinical data, including wound characteristics, daily healing rate (DHR), and procedural pain assessed using repeated VAS measurements, were extracted from medical records. <b>Results</b>: The daily healing rate (DHR) ranged from 3.22% in neglected burn wounds to 2.03% in non-burn chronic wounds. Percent area reduction (PAR) analysis at 7, 14, and 30 days showed greater wound area reduction in burn wounds (20%, 36%, and 62%) compared with non-burn wounds (13%, 25%, and 45%). Procedural pain decreased in both cohorts, with burn injuries presenting higher baseline VAS scores but following a similar downward trajectory over time (<i>p</i> < 0.001), converging to comparably low levels by day 30. Overall, the findings describe the outcomes observed within an individualized, multimodal wound care approach, which incorporates HCHA pads tailored to wound-specific characteristics. <b>Conclusions</b>: In this retrospective observational study, patients treated with HCHA pads as part of individualized multimodal wound care exhibited progressive granulation, favorable wound-healing trajectories, and lower procedural pain levels. Further controlled studies are warranted to validate these results and refine the patient selection criteria.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829458","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":"Inflammation Course and Skeletal Muscle Wasting Correlation During the First Week in ICU: A New Approach for Personalised Feeding of Critically Ill Patients?","authors":"Gilberto Gremese, Matteo Comuzzi, Matteo Danielis, Tommaso Piani, Daniele Guerino Biasucci, Giuseppe Cuttone, Ciro Fittipaldi, Francesca Lucchese, Luigi Vetrugno, Cristian Deana","doi":"10.3390/jpm16080409","DOIUrl":"10.3390/jpm16080409","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;: Critically ill patients undergo rapid and clinically significant skeletal muscle loss during the first week of ICU admission, driven by a complex interplay of systemic inflammation, neuroendocrine dysregulation, and accelerated protein catabolism. While CRP is an established marker of the inflammatory response, its temporal relationship with early muscle wasting-specifically whether the initial inflammatory peak or its subsequent persistence most strongly determines muscle loss-remains poorly characterised. This study investigated the serial dynamics of inflammatory biomarkers and their correlation with skeletal muscle changes during the first seven ICU days. &lt;b&gt;Methods&lt;/b&gt;: This is a post hoc analysis of the NUTRITI prospective observational cohort, conducted at a single academic ICU in Udine, Italy (Ethics Committee approval: CEUR-2019-Os-17). Sixty-six adult critically ill patients with an anticipated ICU stay exceeding 72 h and requiring artificial nutritional support were included; patients on renal replacement therapy or with contraindications to bioelectrical impedance analysis (BIA) were excluded. Body composition-skeletal muscle mass (MM, kg) and phase angle (PA°)-was assessed by single-frequency BIA (50 kHz) on Day 1 and Day 7. The primary outcome was ΔMM%, the percentage change in muscle mass between admission and Day 7, calculated as ΔMM% = [(MMd - MMa)/MMa] × 100. Daily inflammatory biomarkers-CRP (mg/L), total WBC (×10&lt;sup&gt;3&lt;/sup&gt;/mm&lt;sup&gt;3&lt;/sup&gt;), and lymphocyte count (×10&lt;sup&gt;3&lt;/sup&gt;/mm&lt;sup&gt;3&lt;/sup&gt;)-were collected throughout. Spearman rank correlations between ΔMM% and serial biomarkers were computed for each day. Given the large number of tests (42 total), Bonferroni false discovery rate corrections were applied. &lt;b&gt;Results&lt;/b&gt;: The cohort had a median age of 68.5 years (IQR 61-77.8), was predominantly male (71.2%), with median APACHE II 21.5 and SOFA 7. Median muscle mass declined significantly from 34.3 kg (IQR 29.9-39.5) at Day 1 to 30.6 kg (IQR 26.5-34.9) at Day 7 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), corresponding to a median MM% of -8.45% (IQR -14.2% to -1.52%). Phase angle also declined significantly (4.9° to 4.5°; &lt;i&gt;p&lt;/i&gt; &lt; 0.01). CRP showed no significant correlation with ΔMM% at Days 1 or 2, but a negative correlation emerged at Day 3 (ρ = -0.297; &lt;i&gt;p&lt;/i&gt; = 0.020) and peaked at Day 4 (ρ = -0.355; &lt;i&gt;p&lt;/i&gt; = 0.006), attenuating thereafter. CRP at Days 5 and 6 correlated with phase angle changes (&lt;i&gt;p&lt;/i&gt; = 0.017 and &lt;i&gt;p&lt;/i&gt; = 0.022, respectively). WBC showed no significant correlations at any time point. Day-7 lymphocyte count was nominally correlated with ΔMM% (ρ = -0.314; &lt;i&gt;p&lt;/i&gt; = 0.040). Neither APACHE II nor SOFA at admission correlated with ΔMM%. No test survived correction for multiple comparisons. &lt;b&gt;Conclusions&lt;/b&gt;: The kinetics of CRP-rather than its initial intensity-seem to be associated with early skeletal muscle catabolism in critically ill patients, with a temporally specific signal emerging at D","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829769","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":"Demirjian Four-Teeth Age Estimation in Thai Children and Adolescents: A Population-Specific Radiographic Validation Study.","authors":"Pennipat Nabheerong, Phuwadon Duangto, Suttiwat Jeamtrakool, Chairat Charoemratrote, Pornpat Theerasopon","doi":"10.3390/jpm16080408","DOIUrl":"10.3390/jpm16080408","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dental age estimation is widely used in clinical and forensic practice. The Demirjian four-teeth methods were developed to simplify age assessment; however, their accuracy varies among populations and requires validation before use in specific ethnic groups. This study aimed to evaluate and compare the accuracy of Demirjian's four-teeth methods I and II for dental age estimation in Southern Thai children and adolescents aged 7-15 years. <b>Methods</b>: This retrospective cross-sectional study included 360 digital panoramic radiographs (180 males and 180 females) from Southern Thai individuals aged 7-15 years. Dental age was estimated using Demirjian's four-teeth method I (teeth 34, 35, 36, and 37) and method II (teeth 31, 34, 35, and 37). Estimated dental ages were compared with chronological ages using the Wilcoxon signed-rank test. Accuracy was assessed by mean error (ME), mean absolute error (MAE), and root mean square error (RMSE). Intra- and inter-observer reliability were evaluated using weighted kappa statistics. <b>Results</b>: Intra- and inter-observer agreement were excellent, ranging from 0.957 to 1.000 and 0.895 to 0.956, respectively. The mean chronological age was 11.53 ± 2.55 years. Both methods overestimated chronological age in males and females. ME ranged from 0.54 to 0.75 years, while MAE ranged from 0.97 to 1.01 years. Method II produced slightly lower estimation errors than method I. Significant differences between dental and chronological ages were found for both methods in both sexes (<i>p</i> < 0.05). <b>Conclusions</b>: Both methods overestimated chronological age by approximately one year in Southern Thai children and adolescents. Method II showed marginally lower errors; however, population-specific calibration may improve age estimation in Thai populations. These findings support the need for population-specific dental age estimation strategies, contributing to more personalized and accurate age estimation for Thai children in both clinical and forensic settings.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829529","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":"Impact of Spread Through Air Spaces on Outcomes After Uniportal VATS Resection for Lung Adenocarcinoma: A Propensity Score-Matched Analysis.","authors":"Michele Salati, Anna Chiara Nanto, Mara Romito, Alberto Roncon, Michela Tiberi, Gian Marco Guiducci, Francesco Xiumè, Francesca Barbisan, Gaia Goteri, Majed Refai","doi":"10.3390/jpm16080410","DOIUrl":"10.3390/jpm16080410","url":null,"abstract":"<p><p><b>Background</b>: Tumor Spread Through Air Spaces (STAS) is a histopathological pattern of invasion associated with aggressive behavior in lung adenocarcinoma. Its prognostic impact and implications for surgical strategy remain controversial. This study evaluated the impact of STAS on survival and recurrence outcomes in patients undergoing uniportal video-assisted thoracoscopic surgery (U-VATS) for lung adenocarcinoma. <b>Methods</b>: We retrospectively analyzed consecutive patients with histologically confirmed lung adenocarcinoma who underwent U-VATS resection between January 2020 and January 2023 at a single tertiary referral center. Propensity score matching (1:1) was performed to reduce selection bias between STAS-positive and STAS-negative patients. Overall survival (OS) and recurrence-free survival (RFS) were analyzed using Kaplan-Meier estimates and log-rank tests. Multivariable Cox proportional hazards regression models were used to identify independent predictors of survival. Subgroup analyses were performed according to the type of resection. <b>Results</b>: Among 365 included patients, 111 (30.4%) were STAS-positive. After propensity score matching, 222 patients were analyzed (111 STAS-positive and 111 STAS-negative). STAS-positive patients showed a higher overall recurrence rate compared with STAS-negative patients (36.9% vs. 27.9%, <i>p</i> = 0.15), with a significantly increased rate of local parenchymal recurrence (18.9% vs. 9.0%, <i>p</i> = 0.03). No significant differences in OS or RFS were observed between matched groups. Multivariable Cox regression analysis confirmed that STAS was not independently associated with OS (HR 0.88, 95% CI 0.50-1.53, <i>p</i> = 0.643). In STAS-positive patients, sublobar resection was associated with significantly worse survival outcomes compared with lobectomy and emerged as an independent predictor of mortality (HR 2.61, 95% CI 1.14-5.97, <i>p</i> = 0.02). <b>Conclusions</b>: STAS was associated with an increased risk of local recurrence but was not independently associated with overall survival after U-VATS resection for lung adenocarcinoma. However, in STAS-positive patients, sublobar resection was independently associated with worse survival outcomes, suggesting that surgical extent plays a critical role in this subgroup. These findings support consideration of a personalized surgical approach in patients with STAS-positive lung adenocarcinoma.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829673","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":"Factors Facilitating Adoption of Pharmacogenetic Testing by Prescribers of Antidepressants in Four US Health Systems: A Multi-Site Cross-Sectional PGx Implementation Science Study.","authors":"Alice B Popejoy, Deborah Cragun, Megan C Roberts, Lisa M Bendz, Sarah Gonzales, Susanne B Haga, R Ryanne Wu, Natasha J Petry, Laura B Ramsey, Ryley Uber, Kaniz Momin, Nina R Sperber","doi":"10.3390/jpm16080411","DOIUrl":"10.3390/jpm16080411","url":null,"abstract":"<p><p><b>Background</b>: Pharmacogenetic (PGx) testing could identify actionable drug-gene interactions, reducing the risks of inappropriate prescribing of certain medications in some patients. An area of growing public health concern is rising global rates of depression and antidepressant use over the last two decades. Prior research has elucidated perspectives of healthcare providers who prescribe antidepressants regarding the clinical utility of genetic information, including PGx testing, but there is a gap in understanding how individual perspectives and systemic contextual factors may combine to influence PGx testing adoption. <b>Objective</b>: The objective of this study was to elucidate combinations of individual and contextual conditions associated with willingness to adopt PGx testing for Cytochrome P450 Subfamily IID, Polypeptide 6 (<i>CYP2D6</i>) and Subfamily IIC, Polypeptide 19 (<i>CYP2C19</i>) among antidepressant prescribers. <b>Methods</b>: We conducted a cross-sectional, mixed-methods study using structured questionnaires and semi-structured interviews with healthcare providers who prescribe antidepressants within their scope of practice across four healthcare systems in the United States. We collected data on implementation science concepts from the Theoretical Domains Framework, the Consolidated Framework for Implementation Research (CFIR), and the Implementation Outcomes Framework. Coincidence analysis (CNA), a case-based, Boolean logic-based method that identifies minimally sufficient combinations of conditions that lead to a particular outcome, was used to identify combinations of conditions for PGx test adoption among antidepressant prescribers. Interviews were also conducted with 10 patients who received pharmacogenetic testing within these healthcare systems to contextualize findings with patient perspectives. <b>Results</b>: Prescribers adopted PGx testing when they believed it would be beneficial to patients and were not deterred by cost-related concerns; the combination of these conditions led to PGx adoption in the most highly supported CNA model. Patient perspectives were also consistent with the selected model, with data suggesting they may have greater willingness to tolerate costs when they perceived or experienced benefits from testing. <b>Conclusions</b>: Insights from this study may be used by health system administrators and public health policymakers to inform future PGx implementation strategies that enhance uptake and awareness of existing evidence for clinical benefits of PGx testing and mitigate cost-related barriers to adoption.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829640","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 Treatment May Improve Whole-Blood Fluidity and Influence Hemorheology in Patients with Type 2 Diabetes Mellitus: A Post Hoc Analysis of the INFINITY Study.","authors":"Takeshi Osonoi, Shinichiro Shirabe, Miyoko Saito, Mitsuru Hosoya, Norie Watahiki, Nana Shiozawa, Satako Douguchi, Kensuke Ofuchi, Makoto Katoh","doi":"10.3390/jpm16080405","DOIUrl":"10.3390/jpm16080405","url":null,"abstract":"<p><p><b>Background</b>: Patients with type 2 diabetes (T2D) frequently exhibit impaired erythrocyte deformability, which contributes to microvascular dysfunction. We previously reported that imeglimin, a mitochondrial-targeted antidiabetic agent, prolongs erythrocyte lifespan. This study investigated the effects of imeglimin on whole-blood fluidity and its clinical implications in patients with T2D. <b>Methods</b>: This post hoc analysis of the INFINITY study included 25 patients with T2D who completed 6 months of imeglimin treatment (2000 mg/day) followed by a 3-month follow-up. Whole-blood fluidity was assessed by measuring whole-blood passage time using a microchannel array flow analyzer (MC-FAN). Hematological parameters, glycemic markers, and vascular indices, including brachial-ankle pulse wave velocity (baPWV) and toe-brachial index (TBI), were also assessed. <b>Results</b>: Whole-blood fluidity, assessed by 3-month averages of whole-blood passage time, showed an improvement trend at Months 1-3 (<i>p</i> = 0.058) and a significant improvement at Months 4-6 (<i>p</i> = 0.016) compared with baseline; this effect was reversed after discontinuation. Erythrocyte lifespan significantly increased by 10-20% during treatment and remained prolonged after discontinuation. Conversely, red blood cell count, hemoglobin, and hematocrit decreased during treatment and returned toward baseline post-discontinuation. At Month 6, baPWV increased, and TBI decreased, both showing reversibility after treatment cessation. <b>Conclusions</b>: In this exploratory post hoc analysis, imeglimin treatment was associated with reduced whole-blood passage time measured using the MC-FAN system, suggesting improved whole-blood fluidity in patients with T2D. The clinical and mechanistic significance of this observation requires confirmation in future controlled prospective studies incorporating direct assessments of erythrocyte rheology and microvascular function.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829708","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":"Emerging Digital Technologies for Monitoring and Rehabilitation Support in Chronic Dust-Induced Lung Diseases: A Scoping Review.","authors":"Nazym Sagandykova, Madina Baurzhan, Alexandr Gulyayev, Sayagul Kairgeldina, Shyngys Sergazy, Gulnur Daniyarova, Karlygash Absattarova, Liudmila Kovalenko, Akmaral Izbassarova","doi":"10.3390/jpm16080407","DOIUrl":"10.3390/jpm16080407","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Chronic dust-induced lung diseases, including pneumoconiosis and asbestosis, require long-term monitoring and individualized management. Conventional rehabilitation and follow-up often depend on in-person visits and may not provide continuous assessment outside clinical settings. This scoping review mapped evidence on digital technologies used to monitor patients, assess respiratory symptoms and functional status, and support rehabilitation follow-up in chronic dust-induced lung diseases. <b>Methods:</b> The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute methodology. PubMed, Scopus, and Web of Science were searched from inception to 29 June 2026 without language restrictions. Five eligible publications were included. <b>Results:</b> The evidence was grouped into three categories: wearable monitoring of activity and respiratory symptoms, analysis of data from a digital rehabilitation platform, and electronic medical record (EMR) analysis. Wearable sensors showed high performance in recognizing basic activity states and cough events under controlled conditions. Platform- and EMR-based approaches showed potential for using clinical and functional data to support patient stratification and monitoring. However, most studies were limited to early technical or algorithmic validation and did not assess long-term home use, patient adherence, integration into clinical workflows, or clinical and rehabilitation outcomes. <b>Conclusions:</b> Digital technologies may support objective monitoring and rehabilitation follow-up in chronic dust-induced lung diseases, but the evidence base remains small and clinically immature. Prospective studies in real-world settings should evaluate usability, external validity, workflow integration, and clinically meaningful outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829469","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}