Epma Journal最新文献

{"title":"COVID-19 lessons to protect populations against future pandemics by implementing PPPM principles in healthcare.","authors":"Cuihong Tian,&nbsp;Lois Balmer,&nbsp;Xuerui Tan","doi":"10.1007/s13167-023-00331-7","DOIUrl":"10.1007/s13167-023-00331-7","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has continued for more than 3 years, placing a huge burden on society worldwide. Although the World Health Organization (WHO) has declared an end to COVID-19 as a Public Health Emergency of International Concern (PHEIC), it is still considered a global threat. Previously, there has been a long debate as to whether the COVID-19 emergency will eventually end or transform into a more common infectious disease from a PHEIC, and how should countries respond to similar pandemics in the future more time-efficiently and cost-effectively. We reviewed the past, middle and current situation of COVID-19 based on bibliometric analysis and epidemiological data. Thereby, the necessity is indicated to change the paradigm from reactive healthcare services to predictive, preventive and personalised medicine (PPPM) approach, in order to effectively protect populations against COVID-19 and any future pandemics. Corresponding measures are detailed in the article including the involvement of multi-professional expertise, application of artificial intelligence, rapid diagnostics and patient stratification, and effective protection, amongst other to be considered by advanced health policy.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 3","pages":"329-340"},"PeriodicalIF":6.5,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic characteristics of shoulder based on MRI accurately predict incomplete rotator cuff injuries in patients: relevance for predictive, preventive, and personalized healthcare strategies.","authors":"Hangxing Wu, Zhijie Zuo, Yucong Li, Haoqiang Song, Wanyan Hu, Jingle Chen, Chao Xie, Lijun Lin","doi":"10.1007/s13167-023-00333-5","DOIUrl":"10.1007/s13167-023-00333-5","url":null,"abstract":"<p><strong>Background and pppm-related working hypothesis: </strong>In the diagnosis of incomplete rotator cuff injuries (IRCI), magnetic resonance imaging (MRI) and ultrasound examination often have false-positive and false-negative results, while arthroscopy is expensive, invasive, and complex. From the strategy of predictive, preventive, and personalized medicine (PPPM), shoulder anatomical characteristics based on MRI have been demonstrated to accurately predict IRCI and their clinical applicability for personalized prediction of IRCI.</p><p><strong>Aims: </strong>This study aimed to develop and validate a nomogram based on anatomical features of the shoulder on MRI to identify IRCI for PPPM healthcare strategies.</p><p><strong>Methods: </strong>The medical information of 257 patients undergoing preoperative MRI examination was retrospectively reviewed and served as the primary cohort. Partial-thickness rotator cuff tears (RCTs) and tendinopathy observed under arthroscopy were considered IRCI. Using logistic regression analyses and least absolute shrinkage and selection operator (LASSO), IRCI was identified among various preoperative factors containing shoulder MRI and clinical features. A nomogram was constructed and subjected to internal and external validations (80 patients).</p><p><strong>Results: </strong>The following eight independent risk factors for IRCI were identified:AgeThe left injured sidesThe Goutallier classification of supraspinatus in oblique coronal positionThe Goutallier classification of supraspinatus in the axial positionAcromial thicknessAcromiohumeral distanceCoracohumeral distanceAbnormal acromioclavicular joint signalsThe nomogram accurately predicted IRCI in the development (C-index, 0.932 (95% CI, 0.891, 0.973)) and validation (C-index, 0.955 (95% CI, 0.918, 0.992)) cohorts. The calibration curve was consistent between the predicted IRCI probability and the actual IRCI ratio of the nomogram. The decision curve analysis and clinical impact curves demonstrated that the model had high clinical applicability.</p><p><strong>Conclusions: </strong>Eight independent factors that accurately predicted IRCI were determined using MRI anatomical findings. These personalized factors can prevent unnecessary diagnostic interventions (e.g., arthroscopy) and can assist surgeons in implementing individualized clinical decisions in medical practice, thus addressing the goals of PPPM.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-023-00333-5.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 3","pages":"553-570"},"PeriodicalIF":6.5,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetically predicted the causal relationship between gut microbiota and infertility: bidirectional Mendelian randomization analysis in the framework of predictive, preventive, and personalized medicine.","authors":"Yujia Xi, Chenwei Zhang, Yiqian Feng, Shurui Zhao, Yukai Zhang, Guosheng Duan, Wei Wang, Jingqi Wang","doi":"10.1007/s13167-023-00332-6","DOIUrl":"10.1007/s13167-023-00332-6","url":null,"abstract":"<p><strong>Objective: </strong>Several studies have reported the association between gut microbiota and infertility; however, the causal association between them remains unclear. This study aimed to explore the causal relationship between gut microbiota and infertility and evaluate how specific gut microbiota can support early monitoring and prevention of infertility in the context of predictive, preventive, and personalized medicine (PPPM/3PM).</p><p><strong>Methods: </strong>The gut microbiota GWAS data included 18,340 individuals. Female infertility (6481 cases and 68,969 controls) and male infertility data (680 cases and 72,799 controls) were obtained from the FinnGen consortium. The inverse variance weighting (IVW), MR-Egger, weighted median (WM), Cochran Q tests, MR-PRESSO, and leave-one-out were used as a supplement to Mendelian randomization (MR) results and sensitivity analysis.</p><p><strong>Results: </strong>The results of MR analysis indicated a significant causal association between Eubacterium oxidoreducens (OR = 2.048, <i>P</i> = 0.008), Lactococcus (OR = 1.445, <i>P</i> = 0.042), Eubacterium ventriosum (OR = 0.436, <i>P</i> = 0.018), Eubacterium rectale (OR = 0.306, <i>P</i> = 0.002), and Ruminococcaceae NK4A214 (OR = 0.537, <i>P</i> = 0.045) and male infertility. Genetically predicted Eubacterium ventriosum (OR = 0.809, <i>P</i> = 0.018), Holdemania (OR = 0.836, <i>P</i> = 0.037), Lactococcus (OR = 0.867, <i>P</i> = 0.020), Ruminococcaceae NK4A214 (OR = 0.830, <i>P</i> < 0.050), Ruminococcus torques (OR = 0.739, <i>P</i> = 0.022), and Faecalibacterium (OR = 1.311, <i>P</i> = 0.007) were associated with female infertility. Sensitivity analysis did not detect heterogeneity and pleiotropy (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Our results provided evidence for the causal relationship between some gut microbiota and male and female infertility. These findings might be valuable in providing personalized treatment options for preventing infertility and improving reproductive function by monitoring and regulating the gut microbiota of infertility patients in the context of PPPM. Moreover, detecting the abundance of microbiota in feces can support preventive and personalized strategies, which may benefit more infertility patients.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-023-00332-6.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 3","pages":"405-416"},"PeriodicalIF":6.5,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10425846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ubiquitinomics revealed disease- and stage-specific patterns relevant for the 3PM approach in human sigmoid colon cancers.","authors":"Hua Yang, Na Li, Liang Chen, Lei Zhou, Yuanchen Zhou, Jixiang Liu, Wenshuang Jia, Ruofei Chen, Junwen Su, Lamei Yang, Xiaoxia Gong, Xianquan Zhan","doi":"10.1007/s13167-023-00328-2","DOIUrl":"10.1007/s13167-023-00328-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The patients with sigmoid colorectal cancer commonly show high mortality and poor prognosis. Increasing evidence has demonstrated that the ubiquitinated proteins and ubiquitination-mediated molecular pathways influence the growth and aggressiveness of colorectal cancer. It emphasizes the scientific merits of quantitative ubiquitinomics in human sigmoid colon cancer. We hypothesize that the ubiquitinome and ubiquitination-mediated pathway networks significantly differ in sigmoid colon cancers compared to controls, which offers the promise for in-depth insight into molecular mechanisms, discovery of effective therapeutic targets, and construction of reliable biomarkers in the framework of predictive, preventive, and personalized medicine (PPPM; 3P medicine).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The first ubiquitinome analysis was performed with anti-K-ε-GG antibody beads (PTMScan ubiquitin remnant motif [K-ε-GG])-based label-free quantitative proteomics and bioinformatics to identify and quantify ubiquitination profiling between sigmoid colon cancer tissues and para-carcinoma tissues. A total of 100 human sigmoid colon cancer samples that included complete clinical information and the corresponding gene expression data were obtained from The Cancer Genome Atlas (TCGA). Ubiquitination was the main way of protein degradation; the relationships between differentially ubiquitinated proteins (DUPs) and their differently expressed genes (DEGs) and between DUPs and their differentially expressed proteins (DEPs) were analyzed between cancer tissues and control tissues. The overall survival of those DUPs was obtained with Kaplan-Meier method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1249 ubiquitinated sites within 608 DUPs were identified in human sigmoid colon cancer tissues. KEGG pathway network analysis of these DUPs revealed 35 statistically significant signaling pathways, such as salmonella infection, glycolysis/gluconeogenesis, and ferroptosis. Gene Ontology (GO) analysis of 608 DUPs revealed that protein ubiquitination was involved in 98 biological processes, 64 cellular components, 51 molecule functions, and 26 immune system processes. Protein-protein interaction (PPI) network of 608 DUPs revealed multiple high-combined scores and co-expressed DUPs. The relationship analysis between DUPs and their DEGs found 4 types of relationship models, including DUP-up (increased ubiquitination level) and DEG-up (increased gene expression), DUP-up and DEG-down (decreased gene expression), DUP-down (decreased ubiquitination level) and DEG-up, and DUP-down and DEG-down. The relationship analysis between DUPs and their DEPs found 4 types of relationship models, including DUP-up and DEP-up (increased protein expression), DUP-up and DEP-down (decreased protein expression), DUP-down and DEP-up, and DUP-down and DEP-down. Survival analysis found 46 overall survival-related DUPs in sigmoid colon cancer, and the drug sensitivity of overall sur","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 3","pages":"503-525"},"PeriodicalIF":6.5,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth hormone proteoformics atlas created to promote predictive, preventive, and personalized approach in overall management of pituitary neuroendocrine tumors.","authors":"Lamei Yang, Chunling Li, Tao Song, Xianquan Zhan","doi":"10.1007/s13167-023-00329-1","DOIUrl":"10.1007/s13167-023-00329-1","url":null,"abstract":"<p><p>Human growth hormone (GH) is the indispensable hormone for the maintenance of normal physiological functions of the human body, including the growth, development, metabolism, and even immunoregulation. The GH is synthesized, secreted, and stored by somatotroph cells in adenohypophysis. Abnormal GH is associated with various GH-related diseases, such as acromegaly, dwarfism, diabetes, and cancer. Currently, some studies found there are dozens or even hundreds of GH proteoforms in tissue and serum as well as a series of GH-binding protein (GHBP) proteoforms and GH receptor (GHR) proteoforms were also identified. The structure-function relationship of protein hormone proteoforms is significantly important to reveal their overall physiological and pathophysiological mechanisms. We propose the use of proteoformics to study the relationship between every GH proteoform and different physiological/pathophysiological states to clarify the pathogenic mechanism of GH-related disease such as pituitary neuroendocrine tumor and conduct precise molecular classification to promote predictive preventive personalized medicine (PPPM / 3P medicine). This article reviews GH proteoformics in GH-related disease such as pituitary neuroendocrine tumor, which has the potential role to provide novel insight into pathogenic mechanism, discover novel therapeutic targets, identify effective GH proteoform biomarker for patient stratification, predictive diagnosis, and prognostic assessment, improve therapy method, and further accelerate the development of 3P medicine.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 3","pages":"443-456"},"PeriodicalIF":6.5,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and cost-effectiveness of different breast cancer surgery procedures: a Markov decision tree-based approach in the framework of Predictive, Preventive, and Personalized Medicine.","authors":"Hon-Yi Shi, Chiu-Hui Li, Yen-Chen Chen, Chong-Chi Chiu, Hao-Hsien Lee, Ming-Feng Hou","doi":"10.1007/s13167-023-00326-4","DOIUrl":"10.1007/s13167-023-00326-4","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer is a complex disease with heterogeneous outcomes that may benefit from the implementation of Predictive, Preventive, and Personalized Medicine (PPPM/3PM) strategies. In this study, we aimed to explore the potential of PPPM approaches by investigating the 10-year trends in quality of life (QOL) and the cost-effectiveness of different types of surgeries for patients with breast cancer.</p><p><strong>Methods: </strong>This prospective cohort study recruited 144 patients undergoing breast conserving surgery (BCS), 199 undergoing modified radical mastectomy (MRM), and 44 undergoing total mastectomy with transverse rectus abdominis myocutaneous flap (TRAMF) from three medical centers in Taiwan between June 2007 and June 2010.</p><p><strong>Results: </strong>All patients exhibited a significant decrease in most QOL dimension scores from before surgery to 6 months postoperatively (<i>p</i> < 0.05); however, from postoperative year 1 to 2, improvement in most QOL dimension scores was significantly better in the TRAMF group than in the BCS and MRM groups (<i>p</i> < 0.05). At 2, 5, and 10 years after surgery, the patients' QOL remained stable. In the Markov decision tree model, the TRAMF group had higher total direct medical costs than the MRM and BCS groups (US$ 32,426, US$ 29,487, and US$ 28,561, respectively) and higher average QALYs gained (7.771, 6.773, and 7.385, respectively), with an incremental cost-utility ratio (ICUR) of US$ 2,944.39 and US$ 10,013.86 per QALY gained.</p><p><strong>Conclusions: </strong>TRAMF appeared cost effective compared with BCS and MRM, and it has been proved with considerable QOL improvements in the framework of PPPM. Future studies should continue to explore the potential of PPPM approaches in breast cancer care. By incorporating predictive models, personalized treatment plans, and preventive strategies into routine clinical practice, we can further optimize patient outcomes and reduce healthcare costs associated with breast cancer treatment.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-023-00326-4.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 3","pages":"457-475"},"PeriodicalIF":6.5,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical power normalized to aerated lung predicts noninvasive ventilation failure and death and contributes to the benefits of proning in COVID-19 hypoxemic respiratory failure.","authors":"Giovanni Musso,&nbsp;Claudio Taliano,&nbsp;Marco De Iuliis,&nbsp;Elena Paschetta,&nbsp;Caterina Fonti,&nbsp;Andrea Ferraris,&nbsp;Marta Druetta,&nbsp;Ines Sarah Vianou,&nbsp;Francesca Ranghino,&nbsp;Federica Riedo,&nbsp;Davide Deangelis,&nbsp;Gloria Tirabassi","doi":"10.1007/s13167-023-00325-5","DOIUrl":"https://doi.org/10.1007/s13167-023-00325-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Concern exists that noninvasive ventilation (NIV) may promote ventilation-induced lung injury(VILI) and worsen outcome in acute hypoxemic respiratory failure (AHRF). Different individual ventilatory variables have been proposed to predict clinical outcomes, with inconsistent results.Mechanical power (MP), a measure of the energy transfer rate from the ventilator to the respiratory system during mechanical ventilation, might provide solutions for this issue in the framework of predictive, preventive and personalized medicine (PPPM). We explored (1) the impact of ventilator-delivered MP normalized to well-aerated lung (MP&lt;sub&gt;WAL&lt;/sub&gt;) on physio-anatomical and clinical responses to NIV in COVID-19-related AHRF and (2) the effect of prone position(PP) on MP&lt;sub&gt;WAL&lt;/sub&gt;.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed 216 noninvasively ventilated COVID-19 patients (108 patients receiving PP + NIV and 108 propensity score-matched patients receiving supine NIV) with moderate-to-severe(paO2/FiO2 ratio &lt; 200) AHRF enrolled in the PRO-NIV controlled non-randomized study (ISRCTN23016116).Quantification of differentially aerated lung volumes by lung ultrasonography (LUS) was validated against CT scans. Respiratory parameters were hourly recorded, ABG were performed 1 h after each postural change. Time-weighed average values of ventilatory variables, including MP&lt;sub&gt;WAL&lt;/sub&gt;, and gas exchange parameters (paO2/FiO2 ratio, dead space indices) were calculated for each ventilatory session. LUS and circulating biomarkers were assessed daily.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with supine position, PP was associated with a 34% MP&lt;sub&gt;WAL&lt;/sub&gt; reduction, attributable largely to an absolute MP reduction and secondly to an enhanced lung reaeration.Patients receiving a high MP&lt;sub&gt;WAL&lt;/sub&gt; during the 1&lt;sup&gt;st&lt;/sup&gt; 24 h of NIV [MP&lt;sub&gt;WAL&lt;/sub&gt;(day 1)] had higher 28-d NIV failure (HR = 4.33,95%CI:3.09 - 5.98) and death (HR = 5.17,95%CI: 3.01 - 7.35) risks than those receiving a low MP&lt;sub&gt;WAL&lt;/sub&gt;(day 1).In Cox multivariate analyses, MP&lt;sub&gt;WAL&lt;/sub&gt;(day 1) remained independently associated with 28-d NIV failure (HR = 1.68,95%CI:1.15-2.41) and death (HR = 1.69,95%CI:1.22-2.32).MP&lt;sub&gt;WAL&lt;/sub&gt;(day 1) outperformed other power measures and ventilatory variables as predictor of 28-d NIV failure (AUROC = 0.89;95%CI:0.85-0.93) and death (AUROC = 0.89;95%CI:0.85-0.94).MP&lt;sub&gt;WAL&lt;/sub&gt;(day 1) predicted also gas exchange, ultrasonographic and inflammatory biomarker responses, as markers of VILI, on linear multivariate analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In the framework of PPPM, early bedside MP&lt;sub&gt;WAL&lt;/sub&gt; calculation may provide added value to predict response to NIV and guide subsequent therapeutic choices i.e. prone position adoption during NIV or upgrading to invasive ventilation, to reduce hazardous MP&lt;sub&gt;WAL&lt;/sub&gt; delivery, prevent VILI progression and improve clinical outcomes in COVID-19-related AHRF.&lt;/p&gt;&lt;p&gt;&lt;stro","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":" ","pages":"1-39"},"PeriodicalIF":6.5,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10256581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10676757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a routine blood parameters-based model for screening the occurrence of retinal detachment in high myopia in the context of PPPM.","authors":"Shengjie Li,&nbsp;Meiyan Li,&nbsp;Jianing Wu,&nbsp;Yingzhu Li,&nbsp;Jianping Han,&nbsp;Wenjun Cao,&nbsp;Xingtao Zhou","doi":"10.1007/s13167-023-00319-3","DOIUrl":"https://doi.org/10.1007/s13167-023-00319-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background/aims: &lt;/strong&gt;Timely detection and treatment of retinal detachment (RD) could effectively save vision and reduce the risk of progressing visual field defects. High myopia (HM) is known to be associated with an increased risk of RD. Evidently, it should be clearly discriminated the individuals with high or low risk of RD in patients with HM. By using multi-parametric analysis, risk assessment, and other techniques, it is crucial to create cutting-edge screening programs that may be utilized to improve population eye health and develop person-specific, cost-effective preventative, and targeted therapeutic measures. Therefore, we propose a novel, routine blood parameters-based prediction model as a screening program to help distinguish who should offer detailed ophthalmic examinations for RD diagnosis, prevent visual field defect progression, and provide personalized, serial monitoring in the context of predictive, preventive, and personalized medicine (PPPM/3 PM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This population-based study included 20,870 subjects (HM = 19,284, HMRD = 1586) who underwent detailed routine blood tests and ophthalmic evaluations. HMRD cases and HM controls were matched using a nested case-control design. Then, the HMRD cases and HM controls were randomly assigned to the discovery cohort, validation cohort 1, and validation cohort 2 maintaining a 6:2:2 ratio, and other subjects were assigned to the HM validation cohort. Receiver operating characteristic curve analysis was performed to select feature indexes. Feature indexes were integrated into seven algorithm models, and an optimal model was selected based on the highest area under the curve (AUC) and accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six feature indexes were selected: lymphocyte, basophil, mean platelet volume, platelet distribution width, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Among the algorithm models, the algorithm of conditional probability (ACP) showed the best performance achieving an AUC of 0.79, a diagnostic accuracy of 0.72, a sensitivity of 0.71, and a specificity of 0.74 in the discovery cohort. A good performance of the ACP model was also observed in the validation cohort 1 (AUC = 0.81, accuracy = 0.72, sensitivity = 0.71, specificity = 0.73) and validation cohort 2 (AUC = 0.77, accuracy = 0.71, sensitivity = 0.70, specificity = 0.72). In addition, ACP model calibration was found to be good across three cohorts. In the HM validation cohort, the ACP model achieved a diagnostic accuracy of 0.81 for negative classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We have developed a routine blood parameters-based model with an ACP algorithm that could potentially be applied in the clinic with a PPPM approach for serial monitoring and predicting the occurrence of RD in HM and can facilitate the prevention of HM progression to RD. According to the current study, routine blood measures are essential in patient risk classific","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 2","pages":"219-233"},"PeriodicalIF":6.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10015135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of potential necroinflammation-associated necroptosis-related biomarkers for delayed graft function and renal allograft failure: a machine learning-based exploration in the framework of predictive, preventive, and personalized medicine.","authors":"Qing Bi,&nbsp;Ji-Yue Wu,&nbsp;Xue-Meng Qiu,&nbsp;Yu-Qing Li,&nbsp;Yu-Yao Yan,&nbsp;Ze-Jia Sun,&nbsp;Wei Wang","doi":"10.1007/s13167-023-00320-w","DOIUrl":"https://doi.org/10.1007/s13167-023-00320-w","url":null,"abstract":"<p><p>Delayed graft function (DGF) is one of the key post-operative challenges for a subset of kidney transplantation (KTx) patients. Graft survival is significantly lower in recipients who have experienced DGF than in those who have not. Assessing the risk of chronic graft injury, predicting graft rejection, providing personalized treatment, and improving graft survival are major strategies for predictive, preventive, and personalized medicine (PPPM/3PM) to promote the development of transplant medicine. However, since PPPM aims to accurately identify disease by integrating multiple omics, current methods to predict DGF and graft survival can still be improved. Renal ischemia/reperfusion injury (IRI) is a pathological process experienced by all KTx recipients that can result in varying occurrences of DGF, chronic rejection, and allograft failure depending on its severity. During this process, a necroinflammation-mediated necroptosis-dependent secondary wave of cell death significantly contributes to post-IRI tubular cell loss. In this article, we obtained the expression matrices and corresponding clinical data from the GEO database. Subsequently, nine differentially expressed necroinflammation-associated necroptosis-related genes (NiNRGs) were identified by correlation and differential expression analysis. The subtyping of post-KTx IRI samples relied on consensus clustering; the grouping of prognostic risks and the construction of predictive models for DGF (the area under the receiver operating characteristic curve (AUC) of the internal validation set and the external validation set were 0.730 and 0.773, respectively) and expected graft survival after a biopsy (the internal validation set's 1-year AUC: 0.770; 2-year AUC: 0.702; and 3-year AUC: 0.735) were based on the least absolute shrinkage and selection operator regression algorithms. The results of the immune infiltration analysis showed a higher infiltration abundance of myeloid immune cells, especially neutrophils, macrophages, and dendritic cells, in the cluster A subtype and prognostic high-risk groups. Therefore, in the framework of PPPM, this work provides a comprehensive exploration of the early expression landscape, related pathways, immune features, and prognostic impact of NiNRGs in post-KTx patients and assesses their capabilities as.predictors of post-KTx DGF and graft loss,targets of the vicious loop between regulated tubular cell necrosis and necroinflammation for targeted secondary and tertiary prevention, andreferences for personalized immunotherapy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-023-00320-w.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 2","pages":"307-328"},"PeriodicalIF":6.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-faceted CRISPR/Cas technological innovation aspects in the framework of 3P medicine.","authors":"Vincent Lučanský,&nbsp;Veronika Holubeková,&nbsp;Zuzana Kolková,&nbsp;Erika Halašová,&nbsp;Marek Samec,&nbsp;Olga Golubnitschaja","doi":"10.1007/s13167-023-00324-6","DOIUrl":"https://doi.org/10.1007/s13167-023-00324-6","url":null,"abstract":"<p><p>Since 2009, the European Association for Predictive, Preventive and Personalised Medicine (EPMA, Brussels) promotes the paradigm change from reactive approach to predictive, preventive, and personalized medicine (PPPM/3PM) to protect individuals in sub-optimal health conditions from the health-to-disease transition, to increase life-quality of the affected patient cohorts improving, therefore, ethical standards and cost-efficacy of healthcare to great benefits of the society at large. The gene-editing technology utilizing CRISPR/Cas gene-editing approach has demonstrated its enormous value as a powerful tool in a broad spectrum of bio/medical research areas. Further, CRISPR/Cas gene-editing system is considered applicable to primary and secondary healthcare, in order to prevent disease spread and to treat clinically manifested disorders, involving diagnostics of SARS-Cov-2 infection and experimental treatment of COVID-19. Although the principle of the proposed gene editing is simple and elegant, there are a lot of technological challenges and ethical considerations to be solved prior to its broadly scaled clinical implementation. This article highlights technological innovation beyond the state of the art, exemplifies current achievements, discusses unsolved technological and ethical problems, and provides clinically relevant outlook in the framework of 3PM.</p>","PeriodicalId":54292,"journal":{"name":"Epma Journal","volume":"14 2","pages":"201-217"},"PeriodicalIF":6.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9587934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}