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Tailoring Inflammatory Biomarker Assessment in Axial Spondyloarthritis: A Comparative Study of Erythrocyte Sedimentation Rate and C-Reactive Protein Across Disease Profiles -
Zebrafish as a Model for Translational Immuno-Oncology -
Comprehensive Management of Cocaine-Induced Midline Destructive Lesions: A Young-IFOS Consensus -
Right Ventricular Longitudinal Strain by Echocardiography: Current Clinical Applications and Future Directions for Mechanics Assessment of the Forgotten Ventricle
Journal Description
Journal of Personalized Medicine
Journal of Personalized Medicine
is an international, peer-reviewed, open access journal on personalized medicine, published monthly online by MDPI. The Inter-American Society for Minimally Invasive Spine Surgery (SICCMI), Korean Society of Brain Neuromodulation Therapy (KBNT) and American Board of Precision Medicine (ABOPM) are affiliated with JPM, and their members receive a discount on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, PMC, Embase, and other databases.
- Journal Rank: CiteScore - Q1 (Medicine (miscellaneous))
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21.5 days after submission; acceptance to publication is undertaken in 3.5 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Latest Articles
From Data to Decisions: Harnessing Multi-Agent Systems for Safer, Smarter, and More Personalized Perioperative Care
J. Pers. Med. 2025, 15(11), 540; https://doi.org/10.3390/jpm15110540 - 6 Nov 2025
Abstract
Background/Objectives: Artificial intelligence (AI) is increasingly applied across the perioperative continuum, with potential benefits in efficiency, personalization, and patient safety. Unfortunately, most such tools are developed in isolation, limiting their clinical utility. Multi-Agent Systems for Healthcare (MASH), in which autonomous AI agents
[...] Read more.
Background/Objectives: Artificial intelligence (AI) is increasingly applied across the perioperative continuum, with potential benefits in efficiency, personalization, and patient safety. Unfortunately, most such tools are developed in isolation, limiting their clinical utility. Multi-Agent Systems for Healthcare (MASH), in which autonomous AI agents coordinate tasks across multiple domains, may provide the necessary framework for integrated perioperative care. This critical review synthesizes current AI applications in anesthesiology and considers their integration within a MASH architecture. This is the first review to advance MASH as a conceptual and practical framework for anesthesiology, uniquely contributing to the AI discourse by proposing its potential to unify isolated innovations into adaptive and collaborative systems. Methods: A critical review was conducted using PubMed and Google Search to identify peer-reviewed studies published between 2015 and 2025. The search strategy combined controlled vocabulary and free-text terms for AI, anesthesiology, perioperative care, critical care, and pain management. Results were filtered for randomized controlled trials and clinical trials. Data were extracted and organized by perioperative phase. Results: The 16 studies (6 from database search, 10 from prior work) included in this review demonstrated AI applications across the perioperative timeline. Preoperatively, predictive models such as POTTER improved surgical risk stratification. Intraoperative trials evaluated systems like SmartPilot and Navigator, enhancing anesthetic dosing and physiologic stability. In critical care, algorithms including NAVOY Sepsis and VentAI supported early detection of sepsis and optimized ventilatory management. In pain medicine, AI assisted with opioid risk assessment and individualized pain-control regimens. While these trials demonstrated clinical utility, most applications remain domain-specific and unconnected from one another. Conclusions: AI has broad potential to improve perioperative care, but its impact depends on coordinated deployment. MASH offers a unifying framework to integrate diverse agents into adaptive networks, enabling more personalized anesthetic care that is safer and more efficient.
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(This article belongs to the Special Issue AI and Precision Medicine: Innovations and Applications)
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Open AccessSystematic Review
Exploring the Evidence for Personalized Pharmacotherapy in Type 2 Diabetes—A Systematic Review
by
Velimir Altabas and Jelena Marinković Radošević
J. Pers. Med. 2025, 15(11), 539; https://doi.org/10.3390/jpm15110539 - 6 Nov 2025
Abstract
Background/Objectives: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance, impaired insulin secretion, and chronic hyperglycemia. Recent studies have identified microRNAs (miRNAs), a class of small non-coding RNAs that regulate gene expression at the post-transcriptional level, as
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Background/Objectives: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance, impaired insulin secretion, and chronic hyperglycemia. Recent studies have identified microRNAs (miRNAs), a class of small non-coding RNAs that regulate gene expression at the post-transcriptional level, as modulators of pathways involved in T2DM pathophysiology. Dysregulated miRNA expression has been detected in various samples collected from patients with T2DM, implicating these molecules in disease onset and progression. Methods: We systematically searched PubMed, Scopus, and Web of Science for studies published from the earliest available records to 18 August 2025 using the following Boolean search terms: “miRNA AND gliclazide”, “miRNA AND glibenclamide”, “miRNA AND gliquidone”, “miRNA AND glimepiride”, “mirRNA AND metformin”, “miRNA AND pioglitazone”, “miRNA AND rosiglitazone”, “miRNA AND sitagliptin”, “miRNA AND vildagliptin”, “miRNA AND alogliptin”, “miRNA and saxagliptin”, “miRNA AND linagliptin”, “miRNA AND liraglutide”, “miRNA and dulaglutide”, “miRNA AND semaglutide”, “miRNA AND tirzepatide”, “miRNA AND lixisenatide”, “miRNA AND empagliflozin”, “miRNA AND dapagliflozin”, miRNA AND insulin glargine”, “miRNA AND insulin detemir”, “miRNA AND insulin degludec”, “miRNA AND insulin aspart”, “miRNA AND insulin glulisine”, and “miRNA AND insulin lispro”. Additionally, gray literature was searched in ClinicalTrials.gov, the EU Clinical Trials Register (EudraCT), and the ISRCTN Registry to identify unpublished studies. Studies were eligible for inclusion if they were clinical interventional studies assessing the impact of currently available antidiabetic treatments on miRNA expression. Only articles published in English were considered. The risk of bias was evaluated using the RoB2 (Risk of Bias 2) and ROBINS-I (Risk Of Bias In Non-randomized Studies—of Interventions) tools. Study characteristics and major findings were tabulated. Results: A total of 1264 manuscripts was identified initially. After removing duplicates, 726 articles remained for further screening. Ultimately, 17 manuscripts reporting interventional clinical trials on the effects of antidiabetic treatment on miRNA were included, encompassing a total of 1093 patients. Key findings included treatment-associated changes in miRNA expression and their potential utility for the prediction of clinical outcomes. Conclusions: Current evidence supports the hypothesis that antidiabetic treatments modulate miRNA expression, with some findings showing predictive value for metabolic outcomes. However, the available data remain limited and of low grade of certainty, and further large-scale clinical studies are needed to provide deeper insights into these associations.
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(This article belongs to the Special Issue Diabetes and Its Complications: From Research to Clinical Practice)
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Open AccessArticle
Sonographic and Clinical Progression of Adenomyosis and Coexisting Endometriosis: Long-Term Insights and Management Perspectives
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Francesco Giuseppe Martire, Claudia d’Abate, Eugenia Costantini, Maria De Bonis, Giuseppe Sorrenti, Gabriele Centini, Errico Zupi and Lucia Lazzeri
J. Pers. Med. 2025, 15(11), 538; https://doi.org/10.3390/jpm15110538 - 6 Nov 2025
Abstract
Objectives: To evaluate the impact of hormonal therapy on the evolution of painful symptoms in premenopausal women with adenomyosis, with or without concomitant endometriosis, over an 18-month follow-up period. This study aimed to compare the symptomatic progression between treated and untreated patients, highlighting
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Objectives: To evaluate the impact of hormonal therapy on the evolution of painful symptoms in premenopausal women with adenomyosis, with or without concomitant endometriosis, over an 18-month follow-up period. This study aimed to compare the symptomatic progression between treated and untreated patients, highlighting the potential role of medical therapy in symptom control and disease stabilization. Secondary, an objective was to explore sonographic changes within our study population, in parallel with clinical outcomes. Methods: This retrospective observational study, conducted at the Endometriosis Referral Center of the University Hospital of Siena, included 40 women with ultrasound evidence of adenomyosis with and without endometriosis. The population was divided into two groups: 20 patients receiving hormone treatment and 20 not receiving hormone treatment. All patients underwent clinical and ultrasound examinations throughout an 18-month follow-up period, during which types, locations, degrees of disease, and associated symptoms were evaluated. Results: Forty patients enrolled in the study presenting with symptoms such as dysmenorrhea, dyspareunia, and heavy menstrual bleeding were included. A total of 22 patients showed isolated adenomyosis, while 18 adenomyosis and endometriosis both. The mean age was 38.5 years (±4.2 SD), with 57.5% being nulliparous. The types of adenomyosis detected were focal in 25%, diffuse in 50%, and mixed (both focal and diffuse) in 25%. Disease severity was classified as mild in 15%, moderate in 45%, and severe in 40%. After 18 months of continuous hormonal therapy, a reduction in focal adenomyosis was observed in 10%, and an improvement of dysmenorrhea and Heavy Menstrual Bleeding (HMB) was noted, while a slight ameliorating of dyspareunia was detected. In contrast, untreated patients showed either unchanged or worsened symptoms. Conclusions: The findings underscore the value of medical therapy in the management of adenomyosis, supporting current recommendations. Given the heterogeneity of clinical presentations and frequent overlap with endometriosis, a personalized treatment approach remains essential. Further larger-scale, long-term studies are needed to confirm these preliminary results and explore the potential impact on fertility preservation.
Full article
(This article belongs to the Special Issue Navigating the Evolving Landscape of Gynecology: From Diagnosis to Treatment)
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Open AccessArticle
Identifying Risk Groups in 73,000 Patients with Diabetes Receiving Total Hip Replacement: A Machine Learning Clustering Analysis
by
Alishah Ahmadi, Anthony J. Kaywood, Alejandra Chavarria, Oserekpamen Favour Omobhude, Adam Kiss, Mateusz Faltyn and Jason S. Hoellwarth
J. Pers. Med. 2025, 15(11), 537; https://doi.org/10.3390/jpm15110537 - 5 Nov 2025
Abstract
Background/Objective: Diabetes mellitus (DM) is a highly prevalent condition that contributes to adverse outcomes in patients undergoing total hip arthroplasty (THA). This study applied machine learning clustering algorithms to identify comorbidity profiles among diabetic THA patients and evaluate their association with postoperative
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Background/Objective: Diabetes mellitus (DM) is a highly prevalent condition that contributes to adverse outcomes in patients undergoing total hip arthroplasty (THA). This study applied machine learning clustering algorithms to identify comorbidity profiles among diabetic THA patients and evaluate their association with postoperative outcomes. Methods: The 2015–2021 National Inpatient Sample was queried using ICD-10 CM/PCS codes to identify DM patients undergoing THA. Forty-nine comorbidities, complications, and clinical covariates were incorporated into clustering analysis. The Davies–Bouldin and Calinski–Harabasz indices determined the optimal number of clusters. Multivariate logistic regression assessed risk of non-routine discharge (NRD), and Kruskal–Wallis H testing evaluated length-of-stay (LOS) differences. Results: A total of 73,606 patients were included. Six clusters were identified, ranging from 107 to 61,505 patients. Cluster 6, enriched for urinary tract infection and sepsis, had the highest risk of NRD (OR 7.83, p < 0.001) and the longest median LOS (9.0 days). Clusters 1–4 had shorter recoveries with median LOS of 2.0 days and narrow variability, while Cluster 5 showed intermediate outcomes. Kruskal–Wallis and post hoc testing confirmed significant differences across clusters (p < 0.001). Conclusions: Machine learning clustering of diabetic THA patients revealed six distinct groups with varied comorbidity profiles. Infection-driven clusters carried the highest risk for non-routine discharge and prolonged hospitalization. This approach provides a novel framework for risk stratification and may inform targeted perioperative management strategies.
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(This article belongs to the Special Issue Precision Orthopedics: Evolving Shoulder, Hip, and Knee Surgery Through Intelligent Technology and Personalized Clinical Care)
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Open AccessArticle
Electroencephalogram Gamma Band Power Correlates with Anhedonia in a Community Sample
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Sarah L. Coleman, Ian D. Evans, Christopher F. Sharpley, Vicki Bitsika, G. Lorenzo Odierna and Kirstan A. Vessey
J. Pers. Med. 2025, 15(11), 536; https://doi.org/10.3390/jpm15110536 - 3 Nov 2025
Abstract
Major depression (MD) is a condition characterised by persistent sadness and apathy, sometimes accompanied by changes in sleep, appetite, and energy levels. It is highly heterogeneous, and depressive subtypes exhibit differing symptom profiles and patterns of brain activity. Background/Objectives: Currently, there are
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Major depression (MD) is a condition characterised by persistent sadness and apathy, sometimes accompanied by changes in sleep, appetite, and energy levels. It is highly heterogeneous, and depressive subtypes exhibit differing symptom profiles and patterns of brain activity. Background/Objectives: Currently, there are no physiological diagnostic means to detect depression or depressive subtypes. An emerging biomarker may be the electroencephalogram (EEG) band, gamma, due to the role of this frequency in reward processing and cognition. The aim of this work was to complete an exploratory study to investigate the interaction between gamma band power, depression, and four depressive subtypes. Methods: A correlative study between resting-state gamma band power and individual scores on the Zung Self-rating Depression Scale (SDS) was completed using exact standardised low-resolution electromagnetic tomography (eLORETA) using EEG data from a community sample of 100 participants, including not depressed and depressed participants, and four depressive subtypes (anhedonia-, cognitive- and somatic-depression and depressed mood). Results: There was no significant positive correlation between gamma band power and overall depression score. However, there was a significant positive correlation between anhedonia and gamma band power, predominantly in the left anterior cingulate cortex, which may be consistent with dysfunctional reward processing, a characteristic of anhedonia. Additional areas of significance included the posterior cingulate cortex and left middle and superior frontal cortex. Conclusions: These results provide preliminary support for neurophysiological indicators of depressive subtypes and may help inform diagnosis and treatment guidance for depression and depressive subtypes in the future.
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(This article belongs to the Special Issue Multiple Biomarkers for the Diagnosis and Precision Treatment of Depression)
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Open AccessReview
Primary Tricuspid Regurgitation: From Neglect to Clinical Relevance
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Mariagrazia Piscione, Jad Mroue, Dario Gaudio, Vivek Mehta and Fadi Matar
J. Pers. Med. 2025, 15(11), 535; https://doi.org/10.3390/jpm15110535 - 3 Nov 2025
Abstract
Primary tricuspid regurgitation (TR) is an underrecognized valve disease characterized by structural abnormalities of the tricuspid valve (TV) apparatus, including leaflet prolapse, flail, rheumatic degeneration, carcinoid involvement and congenital malformations such as Ebstein’s anomaly. Historically neglected and often misclassified as functional, primary TR
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Primary tricuspid regurgitation (TR) is an underrecognized valve disease characterized by structural abnormalities of the tricuspid valve (TV) apparatus, including leaflet prolapse, flail, rheumatic degeneration, carcinoid involvement and congenital malformations such as Ebstein’s anomaly. Historically neglected and often misclassified as functional, primary TR has recently gained attention due to advances in multimodality imaging and increased awareness of its pathophysiological complexity and adverse outcomes. A major challenge that remains is the accurate diagnosis of primary TR, as well as the optimal timing for intervention, particularly in asymptomatic patients. While surgical repair or replacement has been the traditional approach, recent developments in transcatheter therapies, such as tricuspid edge-to-edge repair, have broadened the therapeutic landscape for patients considered at high surgical risk. In this context, personalized medicine has emerged as a central paradigm in the management of this valvular disease. Tailored therapeutic decisions should include anatomical, functional, and clinical parameters, as well as patient-specific risk factors such as age and comorbidities. Advanced imaging modalities, including 3D echocardiography and cardiac magnetic resonance, are essential for guiding this individualized approach. This review summarizes the current understanding of the etiology, pathophysiology, diagnostic tools, and treatment strategies for primary TR, highlighting the critical role of personalized treatment pathways in optimizing clinical outcomes.
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(This article belongs to the Special Issue Updates on Heart Valve Diseases: Personalized Treatment and Management)
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Open AccessReview
Chrononutrition in Gestational Diabetes: Toward Precision Timing in Maternal Care
by
Viktoria Xega and Jun-Li Liu
J. Pers. Med. 2025, 15(11), 534; https://doi.org/10.3390/jpm15110534 - 3 Nov 2025
Abstract
Gestational diabetes mellitus (GDM) is a heterogeneous disorder that compromises maternal and offspring health. Conventional medical nutrition therapy focuses on nutrient composition and caloric targets but largely omits timing and individualized biology. This narrative review synthesizes mechanistic, epidemiologic and interventional evidence linking circadian
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Gestational diabetes mellitus (GDM) is a heterogeneous disorder that compromises maternal and offspring health. Conventional medical nutrition therapy focuses on nutrient composition and caloric targets but largely omits timing and individualized biology. This narrative review synthesizes mechanistic, epidemiologic and interventional evidence linking circadian biology and meal timing (chrononutrition) to maternal glycemic control. Observational cohorts associate late eating and breakfast skipping with worse glycemia, while pilot interventions and CGM-based studies indicate that front-loading carbohydrates, restricting evening carbohydrate, extending overnight fasting (≈10–12 h), and simple within-meal sequencing can reduce postprandial excursions and increase time-in-range. We propose a pragmatic, tiered clinical pathway in which routine second-trimester triage (50 g glucose challenge test and ultrasound abdominal subcutaneous fat thickness) identifies higher-risk women for short-term CGM phenotyping and prioritized chrononutrition counseling. Integrating phenotype-matched timing interventions with dietetic support and digital decision tools allows rapid, individualized adjustments informed by real-time glucose patterns and patient chronotype. In principle, this tiered strategy could improve daily glycemic profiles, reduce the need for pharmacotherapy, and translate into better neonatal outcomes if supported by larger randomized trials. Chrononutrition therefore offers a promising extension of standard care: simple, low-cost adjustments to “when” food is eaten, supported by digital tools, could allow nutrition therapy for GDM to become more precise, more responsive, and ultimately more effective for both mother and child. Key priorities include validating bedside and chrono-omic stratifiers, testing scalable delivery platforms, and ensuring equitable access to personalized chrononutrition in pregnancy.
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(This article belongs to the Special Issue Personalized Medicine of Obesity and Metabolic Disorders)
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Open AccessReview
Partially Ablative Radiotherapy for Bulky Tumors: A Narrative Review of a Developing Concept
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Savino Cilla, Costanza Maria Donati, Milly Buwenge, Gabriella Macchia, Francesco Deodato, Silvia Cammelli and Alessio Giuseppe Morganti
J. Pers. Med. 2025, 15(11), 533; https://doi.org/10.3390/jpm15110533 - 3 Nov 2025
Abstract
The management of large bulky tumors is very challenging. The current treatment options for effective palliation of symptoms are limited. These tumors often present a large burden at the time of diagnosis, growing along critical bony and neural structures and preventing surgical resection
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The management of large bulky tumors is very challenging. The current treatment options for effective palliation of symptoms are limited. These tumors often present a large burden at the time of diagnosis, growing along critical bony and neural structures and preventing surgical resection in most of the cases. These tumors are also known to be relatively resistant to chemotherapy, with very low response rates. In addition, conventional photon-based radiotherapy has a limited effect due to their radioresistance, the use of large treatment fields, and the impossibility of delivering high doses because of the higher risk of normal tissue toxicity. Therefore, more effective radiation treatments for palliation are needed to achieve greater local control rates. A recent approach called partial ablative radiotherapy (PART) has been shown to be potentially able to improve the effectiveness of radiotherapy. This technique is based on the ability of recent advanced delivery techniques to deliver a high “ablative” dose to the central part of the tumor, maintaining a very low and safe dose profile at the periphery to spare the surrounding organs at risk. Although this technique has been evaluated only in small studies and case reports, it showed notable treatment responses and safety profiles. The present narrative review describes the rationale for PART, the current and forthcoming state of evidence, the existing studies, and the future directions for the development of this approach, including the associated challenges.
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(This article belongs to the Special Issue Advances in Precision Medicine of Oncology Radiotherapy)
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Open AccessReview
Artificial Intelligence in Cardiac Electrophysiology: A Comprehensive Review
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Pietro Cipollone, Nicola Pierucci, Andrea Matteucci, Marta Palombi, Domenico Laviola, Raffaele Bruti, Sara Vinciullo, Marco Bernardi, Luigi Spadafora, Angelica Cersosimo, Sara Trivigno, Tommaso Recchioni, Agostino Piro, Cristina Chimenti, Claudio Pandozi, Carmine Dario Vizza, Carlo Lavalle and Marco Valerio Mariani
J. Pers. Med. 2025, 15(11), 532; https://doi.org/10.3390/jpm15110532 - 3 Nov 2025
Abstract
Background: Artificial Intelligence (AI) is a transformative innovation designed to enable machines to perform tasks typically requiring human intelligence. Among various medical fields, cardiology—and particularly electrophysiology—has seen rapid integration of AI technologies. The ability of AI to analyze large and complex datasets is
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Background: Artificial Intelligence (AI) is a transformative innovation designed to enable machines to perform tasks typically requiring human intelligence. Among various medical fields, cardiology—and particularly electrophysiology—has seen rapid integration of AI technologies. The ability of AI to analyze large and complex datasets is reshaping diagnostic and therapeutic approaches. Objectives: This review aims to provide a comprehensive overview of AI models and their applications in cardiac electrophysiology. The focus is on understanding how AI contributes to clinical practice through ECG interpretation, arrhythmia detection, atrial mapping, and catheter ablation, while also exploring its limitations and future potential. Methods: The review discusses various AI approaches, including Machine Learning (ML) and Deep Learning (DL), and highlights relevant literature illustrating their implementation in electrophysiological settings. Key clinical applications are examined thematically, with a narrative synthesis of current capabilities, technologies, and outcomes. Results: AI-based tools have demonstrated effectiveness in identifying supraventricular arrhythmias like atrial fibrillation (AF) and atrial flutter (AFL), as well as complex conditions such as ventricular tachycardias (VTs) and long QT syndrome (LQTS). In procedural contexts, AI enhances electro-anatomical mapping, reduces operative time, and supports tailored post-ablation management. Discussion: While AI offers clear advantages in diagnostic accuracy and procedural efficiency, challenges remain regarding data security, ethical transparency, and clinical adoption. Addressing these limitations will be crucial for integrating AI into routine electrophysiology and maximizing its potential in future cardiology practice.
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(This article belongs to the Special Issue Atrial Fibrillation: Toward Personalized Medicine)
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Open AccessArticle
Data Sharing, Biopsies and Patient Confidentiality in a Precision Medicine Trial for Childhood Cancer: A Mixed Method Study of Parents, Oncologists, and Scientists’ Perspectives
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Yvanna Lei, Kate Hetherington, Rebecca Daly, Niki Rensen, Brittany C. McGill, David S. Ziegler, Loretta M. S. Lau, Vanessa Tyrrell, Jonathan Karpelowsky, Mark J. Cowley, Katherine M. Tucker, Michelle Haber, Paulette Barahona and Claire E. Wakefield
J. Pers. Med. 2025, 15(11), 531; https://doi.org/10.3390/jpm15110531 - 2 Nov 2025
Abstract
Background/Objectives: Precision medicine is transforming care for children with cancer, but raises new challenges. We explored parents’, oncologists’ and scientists’ perspectives on three aspects of a precision medicine trial for poor prognosis childhood cancer: data sharing, requests for additional tumor biopsies, and
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Background/Objectives: Precision medicine is transforming care for children with cancer, but raises new challenges. We explored parents’, oncologists’ and scientists’ perspectives on three aspects of a precision medicine trial for poor prognosis childhood cancer: data sharing, requests for additional tumor biopsies, and confidentiality. Methods: Data were collected through PRISM-Impact, a psychosocial sub-study within the Zero Childhood Cancer Program’s PRISM trial. Parents completed questionnaires at enrolment and one year later, and an optional interview after receiving their child’s trial results. Bereaved parents completed a questionnaire six months after bereavement (T1B). Oncologists and scientists were interviewed one year following trial commencement. Quantitative data were analyzed descriptively, and qualitative data thematically. Results: Parents (n = 126) considered additional tumor biopsies acceptable when risks were low and their child or oncologist supported the request. Oncologists (n = 26) emphasized weighing risk–benefit, ensuring parents felt fully informed, and research value. Most parents supported data sharing (≥89–96%), including after bereavement, despite potential privacy concerns. Parents supported overseas and interstate testing, and scientists having access to identifiable health information. Scientists (n = 10) found working with identifiable data emotionally challenging. Conclusions: Parents, oncologists, and scientists showed high acceptance of procedural aspects of precision medicine. Future trials should address privacy concerns and ensure informed consent recognizes that parents’ high acceptability of procedures may be linked to their hopes for benefit, reinforcing the need for informed consent.
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(This article belongs to the Section Precision Oncology)
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Open AccessArticle
Dynamic Facial Health Predicts Psychological First Impressions with Applications to Tailored Treatments for Facial Paralysis
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Nathaniel E. Helwig, Lauren N. Berry, Tessa A. Hadlock, Stephen J. Guy and Sofía Lyford-Pike
J. Pers. Med. 2025, 15(11), 530; https://doi.org/10.3390/jpm15110530 - 2 Nov 2025
Abstract
Background: Past studies demonstrate that certain facial features systematically affect first impressions of psychological traits. However, no previous studies have examined how individual differences in facial health affect first impressions of psychological traits. Methods: In this study, we asked a large
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Background: Past studies demonstrate that certain facial features systematically affect first impressions of psychological traits. However, no previous studies have examined how individual differences in facial health affect first impressions of psychological traits. Methods: In this study, we asked a large sample of fairgoers to give their first impressions of psychological traits in response to viewing videos of unilateral facial paralysis patients with varying degrees of facial functioning. Then, we used linear mixed-effects regression models to understand how individual differences in facial health predict first impressions. Results: Our results replicate previous findings regarding first impressions of faces, such as the attractiveness halo effect, as well as age (maturity) and gender (masculinity) effects. More importantly, our results reveal that facial health, as measured by a clinician-graded scale, is a significant predictor of first impressions. Specifically, we found that individuals with better dynamic facial health (as assessed by clinicians) were perceived to be more competent and more affiliative, but not more dominant, than individuals with lower levels of dynamic facial functioning. Conclusions: Our results have important implications for personalized medicine via the development and refinement of individually tailored therapies to improve facial reanimation surgery outcomes.
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(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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Open AccessCase Report
A Rare Case of Multilocular Mesothelial Inclusion Cysts of the Pericardium: Diagnosis, Treatment, Follow Up, with Comprehensive Review of the Literature
by
Ali Shadmanian, Kosha Patel, Endre Alács, Henriette Gavallér, Szilva Agocs and Miklós Bitay
J. Pers. Med. 2025, 15(11), 529; https://doi.org/10.3390/jpm15110529 - 2 Nov 2025
Abstract
Background: Multilocular mesothelial inclusion cysts—also known as benign multicystic mesothelioma (BMM)—are rare, typically arising in the peritoneal cavity. Pericardial involvement is extremely uncommon and can pose diagnostic and therapeutic challenges due to their recurrent and infiltrative nature. Accurate diagnosis and surgical strategy are
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Background: Multilocular mesothelial inclusion cysts—also known as benign multicystic mesothelioma (BMM)—are rare, typically arising in the peritoneal cavity. Pericardial involvement is extremely uncommon and can pose diagnostic and therapeutic challenges due to their recurrent and infiltrative nature. Accurate diagnosis and surgical strategy are critical for management and recurrence prevention. Methods: We present the case of a 36-year-old woman with a prior history of malignant melanoma who developed recurrent multilocular cystic masses of the pericardium. Initial imaging with echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) revealed multilocular pericardial cysts. Surgical resection was performed under cardiopulmonary bypass (CPB), but complete excision was limited due to epicardial infiltration. Histopathology confirmed a benign mesothelial origin. One year later, recurrence prompted a second surgical intervention with total pericardiectomy and Gore-Tex patch reconstruction. Results: Postoperative recovery was uneventful in both instances. Follow-up imaging at 6 and 12 months demonstrated no significant recurrence. Histological analysis confirmed benign cysts lined with mesothelial cells, positive for calretinin and WT-1. This represents one of the first documented living cases of pericardial BMM managed with staged surgery and total pericardiectomy. Conclusions: Pericardial BMM is a rare, benign, but potentially recurrent lesion. In cases of extensive or recurrent disease, total pericardiectomy may offer definitive treatment. Multimodal imaging, histopathological evaluation, and personalized surgical planning are essential for effective management.
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(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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Open AccessArticle
Impact of Computed Tomography-to-Angiography Interval Time on Outcomes of Transarterial Embolization in Post-Traumatic Bleeding: A Retrospective Observational Study
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Claudio Carrubba, Francesco Giurazza, Fabio Corvino, Federico Capozzoli and Raffaella Niola
J. Pers. Med. 2025, 15(11), 528; https://doi.org/10.3390/jpm15110528 - 2 Nov 2025
Abstract
Background/Objectives: Transarterial embolization nowadays has a pivotal role in non-operative management strategies of post-traumatic bleeding. Timely control of hemorrhage is critical in trauma care; however, the impact of procedural timing remains underexplored. This single-center study, conducted at a Level II trauma center with
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Background/Objectives: Transarterial embolization nowadays has a pivotal role in non-operative management strategies of post-traumatic bleeding. Timely control of hemorrhage is critical in trauma care; however, the impact of procedural timing remains underexplored. This single-center study, conducted at a Level II trauma center with 24/7 interventional radiology coverage, evaluated the influence of interval time on embolization outcomes in post-traumatic bleeding patients. Methods: In this retrospective study, 182 trauma patients who underwent embolization between June 2020 and June 2025 were analyzed. Patients were stratified by CT-to-angiography interval time (≤1 h [early, n = 46] and >1 h [delayed, n = 136]). Hemodynamic parameters, laboratory values, transfusion needs, and outcomes were compared and adjusted for baseline differences. Results: Early group patients showed more severe baseline physiology, including hypotension, higher lactates, and lower hemoglobin. No significant differences were found in mortality (2.9% vs. 2.5%), hospital stay (18.7 ± 26.1 vs. 18.1 ± 22.2 days), or transfusion requirements. Embolizations within one hour from CT were associated with significant lactate reduction at 24 h in univariate analysis (p = 0.039), but this was not confirmed in multivariate analysis. Re-embolization (8.7% vs. 1.5%, p = 0.036) and surgical rescue (13.0% vs. 3.7%, p = 0.033) rates were more frequent in the early group. Conclusions: Early embolization improves metabolic parameters in post-traumatic bleeding, especially in patients with greater baseline severity of injuries. These findings support prioritization of early embolization and structured interventional radiology networks for timely procedures. A personalized approach according to baseline injury is required.
Full article
(This article belongs to the Special Issue Advances in Interventional Radiology in Oncology)
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Open AccessArticle
Radiomics of Hepatocellular Carcinoma: Identifying Predictors of Microvascular Invasion Using Multi-Phase CT Analysis
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Flavio Spoto, Nicolo’ Cardobi, Riccardo De Robertis, Luca Geraci, Luisa Tomaiuolo, Eda Bardhi, Beatrice Mascarin, Claudio Luchini, Andrea Ruzzenente and Mirko D’Onofrio
J. Pers. Med. 2025, 15(11), 527; https://doi.org/10.3390/jpm15110527 - 2 Nov 2025
Abstract
Objective: To explore radiomic texture features from multi-phase contrast-enhanced CT as potential predictors of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Materials and Methods: This exploratory single-center study retrospectively analyzed 49 patients (54 HCC lesions) who underwent liver resection between 2018–2022. Radiomic analysis
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Objective: To explore radiomic texture features from multi-phase contrast-enhanced CT as potential predictors of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Materials and Methods: This exploratory single-center study retrospectively analyzed 49 patients (54 HCC lesions) who underwent liver resection between 2018–2022. Radiomic analysis extracted 642 features across arterial, venous, and delayed phases using original and 5 mm-expanded tumor margins. Results: The 20–50 mm lesion subgroup (n = 37) provided the most reliable results, with arterial phase texture homogeneity features achieving AUC 0.772. Features from lesions <20 mm (n = 14, 4 MVI+) showed clear evidence of overfitting and were excluded from primary analyses. Delayed phase features showed preliminary associations (AUC 0.8) in a small LR-3/4 subset (n = 20). Limitations: This hypothesis-generating study has significant limitations including small sample size, single-center design, and lack of correction for multiple comparisons. Conclusions: Multi-phase CT radiomic analysis shows potential for MVI prediction in intermediate-sized HCC lesions, though external validation in larger cohorts is essential before clinical application.
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(This article belongs to the Special Issue Recent Innovations and Artificial Intelligence in Interventional Radiology: A Step Towards Personalized Medicine)
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Open AccessSystematic Review
Applying Ecological Momentary Assessment (EMA) to Understand Overweight and Obesity: A Systematic Review
by
Giada Rapelli, Chiara A. M. Spatola, Giulia Landi, Eliana Tossani, Silvana Grandi, Gabriella Martino, Gianluca Castelnuovo, Giada Pietrabissa and Roberto Cattivelli
J. Pers. Med. 2025, 15(11), 526; https://doi.org/10.3390/jpm15110526 - 1 Nov 2025
Abstract
Background: Obesity is a complex health issue influenced by various factors, including behavioral patterns that can be assessed more deeply in real time using Ecological Momentary Assessment (EMA), which can capture the moment in which a person experiences a situation or an emotion
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Background: Obesity is a complex health issue influenced by various factors, including behavioral patterns that can be assessed more deeply in real time using Ecological Momentary Assessment (EMA), which can capture the moment in which a person experiences a situation or an emotion that could trigger an eating behavior. Methods: This systematic review synthesizes findings from 89 studies employing EMA to investigate obesity and overweight-related behaviors. The studies were identified through comprehensive searches across multiple databases and included peer-reviewed articles. The primary aim was to analyze how EMA contributes to understanding the temporal dynamics of eating behaviors, physical activity, and psychological factors associated with overweight and obesity. Results: Key findings indicate that EMA provides a nuanced understanding of real-time contexts influencing behaviors contributing to overweight and obesity. Studies consistently report that EMA captures fluctuations in eating habits, exercise routines, stress levels, and emotional states, elucidating the interplay between these factors and weight status. Methodological variations across studies included differences in EMA implementation (e.g., smartphone apps, electronic diaries), assessment frequency, and duration. These variances highlight the flexibility and adaptability of EMA in capturing diverse behavioral aspects relevant to obesity and overweight research. Moreover, the review discusses methodological challenges such as participant compliance, data integration, and real-time data interpretation in longitudinal analyses. Conclusions: In conclusion, EMA emerges as a powerful tool for exploring the complex, dynamic nature of overweight and obesity-related behaviors. Future research should focus on refining EMA methodologies, enhancing data analysis techniques, and integrating findings into personalized interventions aimed at reducing obesity effectively.
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(This article belongs to the Section Personalized Medical Care)
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Open AccessArticle
Quantifying Morphological Change in Stage III Lipedema: A 3D Imaging Study of Population Trends and Individual Treatment Courses
by
Niels A. Sanktjohanser, Nikolaus Thierfelder, Benjamin Beck, Sinan Mert, Benedikt Fuchs, Paul S. Wiggenhauser, Riccardo E. Giunta and Konstantin C. Koban
J. Pers. Med. 2025, 15(11), 525; https://doi.org/10.3390/jpm15110525 - 1 Nov 2025
Abstract
Background/Objectives: Lipedema is a chronic disorder characterized by disproportionate fat accumulation in the extremities, causing pain, bruising, and reduced mobility. When conservative therapy fails, liposuction is considered an effective treatment option. Prior studies often relied on subjective or non-standardized measures, limiting precision.
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Background/Objectives: Lipedema is a chronic disorder characterized by disproportionate fat accumulation in the extremities, causing pain, bruising, and reduced mobility. When conservative therapy fails, liposuction is considered an effective treatment option. Prior studies often relied on subjective or non-standardized measures, limiting precision. This study aimed to objectively assess volumetric changes after liposuction in stage III lipedema using high-resolution 3D imaging to quantify postoperative changes in circumference and volume, providing individualized yet standardized outcome measures aligned with precision medicine. Methods: We retrospectively analyzed 66 patients who underwent 161 water-assisted liposuctions (WALs). Pre- and postoperative measurements were performed with the VECTRA© WB360 system, allowing reproducible, anatomically specific quantification of limb volumes and circumferences. Secondary endpoints included in-hospital complications. Results: Liposuction achieved significant reductions in all treated regions, most pronounced in the proximal thigh and upper arm. Thigh volume decreased by 4.10–9.25% (q < 0.001), while upper arm volume decreased by 15.63% (left) and 20.15% (right) (q = 0.001). Circumference decreased by up to 5.2% in the thigh (q < 0.001) and 12.27% (q = 0.001) in the upper arm. All changes were calculated relative to baseline values, allowing personalized interpretation of treatment effects. Conclusions: This is the first study to objectively quantify postoperative lipedema changes using whole-body 3D surface imaging. By capturing each patient’s contours pre- and postoperatively, this approach enables individualized evaluation while permitting standardized comparison across patients. It offers a precise understanding of surgical outcomes and supports integration of precision medicine principles in lipedema surgery.
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(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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Open AccessReview
Total Knee Arthroplasty and the Evolution of Coronal Alignment: From Mechanical to Personalized Strategies
by
Virginia Cinelli, Marina Marescalchi, Aurelio Picchi, Gerardo De Mattia, Luca Andriollo, Andrea Fidanza, Giandomenico Logroscino, Rudy Sangaletti, Francesco Benazzo and Stefano Marco Paolo Rossi
J. Pers. Med. 2025, 15(11), 524; https://doi.org/10.3390/jpm15110524 - 1 Nov 2025
Abstract
Total knee arthroplasty (TKA) remains a cornerstone of orthopedic surgery, with optimal coronal alignment playing a pivotal role in determining both clinical outcomes and implant longevity. Traditionally, mechanical alignment has been regarded as the gold standard. However, the emergence of alternative philosophies—such as
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Total knee arthroplasty (TKA) remains a cornerstone of orthopedic surgery, with optimal coronal alignment playing a pivotal role in determining both clinical outcomes and implant longevity. Traditionally, mechanical alignment has been regarded as the gold standard. However, the emergence of alternative philosophies—such as kinematic alignment and hybrid techniques—has shifted the focus toward individualized approaches. Recent advancements in robotic and computer-assisted systems have significantly enhanced the precision of implant positioning, allowing surgeons to better replicate native knee biomechanics and improve patient satisfaction. This narrative review examines current alignment philosophies in TKA, including mechanical, kinematic, and hybrid methods. It analyzes each technique’s principles, functionalities, benefits, and limitations while highlighting ongoing debates regarding their clinical application. Special attention is given to the role of technology in enabling more accurate, patient-specific surgical execution. Despite promising developments, challenges remain in standardizing these techniques and validating their long-term efficacy. To ensure a comprehensive evaluation relevant literature was reviewed, focusing on studies that explore alignment strategies, biomechanical outcomes, and the integration of technology in TKA. This review aims to synthesize current evidence, identify gaps in knowledge, and outline directions for future research needed to optimize alignment strategies in modern knee arthroplasty.
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(This article belongs to the Special Issue Cutting-Edge Innovations in Hip and Knee Joint Replacement)
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Open AccessReview
Novel Treatment Concepts for Cervical Cancer—Moving Towards Personalized Therapy
by
Melina Danisch, Magdalena Postl, Thomas Bartl, Christoph Grimm, Alina Sturdza, Nicole Concin and Stephan Polterauer
J. Pers. Med. 2025, 15(11), 523; https://doi.org/10.3390/jpm15110523 - 1 Nov 2025
Abstract
In recent years, several randomized controlled trials have been published regarding cervical cancer therapy and significantly changed the treatment landscape. Recent advances have improved the treatment options and allow personalized treatment concepts with escalation of treatment in high-risk disease and de-escalation with reduction
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In recent years, several randomized controlled trials have been published regarding cervical cancer therapy and significantly changed the treatment landscape. Recent advances have improved the treatment options and allow personalized treatment concepts with escalation of treatment in high-risk disease and de-escalation with reduction in morbidity in selected low-risk patients. This review aims to provide a comprehensive analysis of the latest landmark studies that are poised to significantly influence clinical practice. Personalized treatment concepts with careful patient selection allow de-escalation in the surgical treatment of cervical cancer. In low-risk cervical cancer patients (lesions of ≤2 cm with limited stromal invasion), simple hysterectomy (SH) was non-inferior to radical hysterectomy in terms of 3-year incidence of pelvic recurrence and was associated with a lower risk of urinary incontinence or retention and improved sexual health and quality of life. Furthermore, sentinel lymphadenectomy is constantly replacing systematic pelvic lymphadenectomy in patients with low-risk cervical cancer. In addition, further studies are necessary to clarify the role of postoperative therapy for patients with intermediate-risk cervical cancer. Starting in 2008, the EMBRACE studies assess the role of Image guided adaptive brachytherapy (IGABT) in LACC in addition to modern external beam radiotherapy concurrent to chemotherapy. The publication of the results of the EMBRACE I prospective study established MRI guided IGABT as state-of-the-art brachytherapy for LACC. EMBRACE II and additional prospective studies emerging from this consortium will address important questions in modern radiotherapy for LACC. Immune checkpoint inhibitors (CPIs) have been evaluated across various clinical settings and are expected to be utilized in numerous scenarios due to several positive randomized trials. Particularly, the combination of platinum-based chemotherapy and pembrolizumab, with or without bevacizumab, has been established as the new standard treatment for primary metastatic or recurrent PD-L1 positive high-risk cervical cancer. In locally advanced cervical cancer, two new treatment escalation regimens—neoadjuvant chemotherapy and adjuvant CPI therapy—have been evaluated in addition to chemoradiation. Furthermore, antibody-drug conjugates, such as tisotumab-vedotin, represent a promising future therapeutic option for recurrent cervical cancer.
Full article
(This article belongs to the Special Issue Novel and Personalized Treatment Concepts in Gynecologic Cancer—2nd Edition)
Open AccessSystematic Review
Robotic-Assisted vs. Laparoscopic Splenectomy in Children: A Systematic Review and Up-to-Date Meta-Analysis
by
Carlos Delgado-Miguel, Juan Camps, Isabella Garavis Montagut, Ricardo Díez, Javier Arredondo-Montero and Francisco Hernández-Oliveros
J. Pers. Med. 2025, 15(11), 522; https://doi.org/10.3390/jpm15110522 - 1 Nov 2025
Abstract
Introduction: Robotic splenectomy has emerged as a promising alternative to laparoscopic surgery, offering potential advantages in precision, ergonomics, and individualized surgical planning. In the context of personalized medicine, robotic technology may enable tailoring of surgical strategies to patient-specific anatomy, spleen size, and
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Introduction: Robotic splenectomy has emerged as a promising alternative to laparoscopic surgery, offering potential advantages in precision, ergonomics, and individualized surgical planning. In the context of personalized medicine, robotic technology may enable tailoring of surgical strategies to patient-specific anatomy, spleen size, and comorbid hematologic conditions. However, its clinical superiority remains uncertain due to limited and heterogeneous evidence. Methods: We performed a systematic review and meta-analysis following PRISMA guidelines, utilizing PubMed, CINAHL, Web of Science, and EMBASE databases to locate studies on robotic splenectomies in children. This review was prospectively registered in PROSPERO (CRD420251104285). Risk of bias was assessed using the ROBINS-I tool for non-randomized studies. Random-effects models were fitted using restricted maximum likelihood (REML), and confidence intervals were adjusted using either Knapp–Hartung (HKSJ) or modified Knapp–Hartung (mKH) methods when appropriate. 95% prediction intervals were calculated, and the certainty of evidence for each outcome was assessed using the GRADE approach. Results: This review included 272 pediatric patients from 16 studies conducted between 2003 and 2025, of which five were included in the meta-analysis. No statistically significant differences were observed between robotic and laparoscopic splenectomy for operative time, intraoperative blood loss, conversion to open surgery, blood transfusions, or complications. However, the direction of effect estimates consistently favored the robotic approach. A statistically significant reduction in hospitalization days (−0.93 days; 95% CI: −1.61 to −0.24; p = 0.01) was found, though this became marginally significant after HKSJ adjustment (p = 0.06). Intraoperative blood loss showed significance in the primary model (−63.88 mL; 95% CI: −120.38 to −7.38; p = 0.03), but not after mKH correction (p = 0.16). Heterogeneity was substantial-to-extreme for several outcomes and was only partially accounted for by leave-one-out sensitivity analyses. All findings were rated as very low certainty according to the GRADE framework. Conclusions: Robotic-assisted splenectomy in pediatric patients has been reported as technically feasible and performed safely in selected cases. However, the small number of studies, their retrospective design, substantial methodological heterogeneity, and the resulting very low certainty of the evidence according to GRADE preclude any firm conclusions about its comparative safety or efficacy versus laparoscopy. Well-designed prospective studies are needed to clarify its clinical benefits.
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(This article belongs to the Special Issue Update on Robotic Gastrointestinal Surgery, 2nd Edition)
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Open AccessArticle
Personalized Adipofascial Flap: A Game-Changer for Post-Traumatic Ulnar Nerve Neuropathy at the Wrist and Elbow
by
Alessandro Greco, Martina Bizzarri, Lucian Lior Marcovici and Alessia Pagnotta
J. Pers. Med. 2025, 15(11), 521; https://doi.org/10.3390/jpm15110521 - 1 Nov 2025
Abstract
Introduction: Post-traumatic and post-surgical ulnar nerve neuropathies at the elbow and wrist remain challenging conditions often associated with significant sensory and motor impairment. Traditional approaches such as neurolysis alone may be insufficient, especially in complex or recurrent cases. Adipofascial flaps have shown promising
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Introduction: Post-traumatic and post-surgical ulnar nerve neuropathies at the elbow and wrist remain challenging conditions often associated with significant sensory and motor impairment. Traditional approaches such as neurolysis alone may be insufficient, especially in complex or recurrent cases. Adipofascial flaps have shown promising outcomes in peripheral nerve surgery. The aim of this study was to evaluate the outcomes of 13 patients with severe ulnar neuropathies who were treated with a size- and shape-personalized adipofascial flap for nerve coverage. Materials and Methods: We retrospectively analyzed 13 patients treated between May 2020 and May 2024 for severe post-traumatic or post-surgical ulnar neuropathies. All underwent surgical decompression, external neurolysis, and adipofascial flap coverage. Pre- and postoperative outcomes were assessed with clinical and neurological evaluations and using the QuickDASH and NRS pain scores. Discussion: All patients showed improvement in pain and sensory-motor function, including those with complications, supporting the role of flap coverage in neuroprotection. This is the first study to describe the use of adipofascial flaps for pseudo-palsy and painful neuroma-in-continuity of the ulnar nerve at the elbow and wrist level. Conclusions: Adipofascial flaps represent a safe, technically feasible, and effective option in complex ulnar nerve injuries, providing both mechanical and biological support. Despite the small cohort, the results suggest strong clinical potential across varied injury patterns.
Full article
(This article belongs to the Special Issue Plastic Surgery: New Perspectives and Innovative Techniques)
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