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Temporary Mechanical Support in Cardiogenic Shock Secondary to Heart Failure: An Evolving Paradigm
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Ultrafast Breast MRI: A Narrative Review
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UNIFLECA-Flecainide Effect on Idiopathic Premature Ventricular Contractions and the Associated Cardiomyopathy
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The Uncommon Phenomenon of Short QT Syndrome: A Scoping Review of the Literature
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
A Design Architecture for Decentralized and Provenance-Assisted eHealth Systems for Enhanced Personalized Medicine
J. Pers. Med. 2025, 15(7), 325; https://doi.org/10.3390/jpm15070325 (registering DOI) - 19 Jul 2025
Abstract
Background/Objectives: Electronic medical record systems play a crucial role in the operation of modern healthcare institutions, enabling the foundational data necessary for advancements in personalized medicine. Despite their importance, the software supporting these systems frequently experiences data availability and integrity issues, particularly concerning
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Background/Objectives: Electronic medical record systems play a crucial role in the operation of modern healthcare institutions, enabling the foundational data necessary for advancements in personalized medicine. Despite their importance, the software supporting these systems frequently experiences data availability and integrity issues, particularly concerning patients’ personal information. This study aims to present a decentralized architecture that integrates both clinical and personal patient data, with a provenance mechanism to enable data tracing and auditing, ultimately supporting more precise and personalized healthcare decisions. Methods: A system implementation based on the solution was developed, and a feasibility study was conducted with synthetic medical records data. Results: The system was able to correctly receive data of 190 instances of the entities designed, which included different types of medical records, and generate 573 provenance entries that captured in detail the context of the associated medical information. Conclusions: For the first cycle of the research, the system developed served to validate the main features of the solution, and through that, it was possible to infer the feasibility of a decentralized EHR and PHR health system with formal provenance data tracking. Such a system lays a robust foundation for secure and reliable data management, which is essential for the effective implementation and future development of personalized medicine initiatives.
Full article
(This article belongs to the Topic eHealth and mHealth: Challenges and Prospects, 2nd Edition)
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Open AccessArticle
Total Thyroidectomy vs. Lobectomy in Papillary Thyroid Microcarcinoma: A Contested Gold Standard
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Enrico Battistella, Luca Pomba, Riccardo Toniato, Andrea Piotto and Antonio Toniato
J. Pers. Med. 2025, 15(7), 324; https://doi.org/10.3390/jpm15070324 - 18 Jul 2025
Abstract
Background: Papillary thyroid microcarcinoma (PTMC), a subtype of papillary thyroid carcinoma ≤ 1 cm in diameter, has shown a marked increase in incidence in recent decades, largely due to the widespread use of neck ultrasonography and fine needle aspiration cytology. Despite its generally
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Background: Papillary thyroid microcarcinoma (PTMC), a subtype of papillary thyroid carcinoma ≤ 1 cm in diameter, has shown a marked increase in incidence in recent decades, largely due to the widespread use of neck ultrasonography and fine needle aspiration cytology. Despite its generally indolent course, optimal management of PTMC remains controversial, with treatment strategies ranging from active surveillance to total thyroidectomy. Methods: This retrospective study analyzes five years of experience at a single tertiary care center, including 130 patients diagnosed with PTMC following thyroid surgery between July 2018 and December 2023. Clinical, cytological, and pathological data were collected and analyzed to identify factors influencing surgical decision-making and postoperative outcomes. Patients underwent either total thyroidectomy or hemithyroidectomy, with central and lateral lymph node dissection performed as indicated. Follow-up included clinical and biochemical surveillance for a mean duration of 3 years. Results: Total thyroidectomy was performed in 89.3% of patients, while hemithyroidectomy was limited to 10.7%. Multifocality was observed in 26.1% of cases, with bilateral involvement in 17.7%. Occult lymph node metastases were found in 14.6% (central compartment) and 3.8% (lateral neck). Postoperative radioactive iodine therapy was administered in 23.8% of patients. At final follow-up, 90.7% were disease-free. No significant predictors of recurrence or adverse outcomes were identified, though multifocality and lymph node involvement influenced surgical planning. Conclusions: Our findings support a risk-adapted surgical approach to PTMC, favoring total thyroidectomy in patients with suspicious or multifocal disease to avoid reoperation. While active surveillance and minimally invasive techniques are emerging, total thyroidectomy remains a safe and effective strategy in selected cases. Prospective, multicenter studies are needed to further refine management guidelines for this increasingly common thyroid malignancy.
Full article
(This article belongs to the Section Evidence Based Medicine)
Open AccessArticle
Children and Adolescents with Mucopolysaccharidosis and Osteogenesis Imperfecta: The Dentistry on the Multiprofessional Team
by
Mariana Laís Silva Celestino, Natália Cristina Ruy Carneiro, Heloisa Vieira Prado, Glória Maria Pimenta Cabral, Mauro Henrique Nogueira Guimarães Abreu and Ana Cristina Borges-Oliveira
J. Pers. Med. 2025, 15(7), 323; https://doi.org/10.3390/jpm15070323 - 18 Jul 2025
Abstract
Background/Objectives: To identify factors associated with the referral by a multiprofessional team to dental services for children and adolescents with rare genetic diseases. Methods: A cross-sectional study was developed with 87 children/adolescents with mucopolysaccharidosis (n = 26) and osteogenesis imperfecta (n
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Background/Objectives: To identify factors associated with the referral by a multiprofessional team to dental services for children and adolescents with rare genetic diseases. Methods: A cross-sectional study was developed with 87 children/adolescents with mucopolysaccharidosis (n = 26) and osteogenesis imperfecta (n = 61) and their caregivers. Recruitment took place at reference centers for rare genetic conditions in five Brazilian states. The caregivers answered a questionnaire on the children. They were examined for malocclusion, dental anomalies, caries experience, and gingivitis. Bivariate and multivariate analyses of the data were performed, considering a 95% confidence level. Results: The average age of children/adolescents was 10.4 years (±5.6) and 17.3% had never gone to a dentist. Among those with past dental experience, the reason for most appointments was oral prophylaxis/preventive maintenance (62.1%). With regard to referrals to a dentist by the multidisciplinary team, 29.9% had never received a referral. The likelihood of having been referred to a dentist by the multiprofessional team was 2.67 times greater for female patients (95% CI: 0.96–7.42) and 7.74 times greater for children/adolescents with a history of toothache (95% CI: 1.61–37.14). Conclusions: Female children/adolescents with mucopolysaccharidosis and osteogenesis imperfecta and those with a history of dental pain were more likely to have been advised by the multiprofessional team to seek dental treatment.
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(This article belongs to the Special Issue Advances in Oral Health: Innovative and Personalized Approaches)
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Open AccessPerspective
Prenatal Psychosocial Distress Screening for Individuals Experiencing Pregnancies Complicated by Fetal Anomalies
by
Kara Hansen, Lisa Mische Lawson and Abigail Wilpers
J. Pers. Med. 2025, 15(7), 322; https://doi.org/10.3390/jpm15070322 - 18 Jul 2025
Abstract
Pregnant individuals who receive a fetal anomaly diagnosis experience significantly elevated rates of depression, anxiety, and traumatic stress—up to four to six times higher than those for individuals with low-risk pregnancies. In low-risk pregnancies, perinatal mental health conditions are the leading cause of
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Pregnant individuals who receive a fetal anomaly diagnosis experience significantly elevated rates of depression, anxiety, and traumatic stress—up to four to six times higher than those for individuals with low-risk pregnancies. In low-risk pregnancies, perinatal mental health conditions are the leading cause of maternal mortality and are associated with adverse birth outcomes, including preterm birth and low birth weight. These risks are likely compounded in pregnancies involving fetal anomalies due to the intersecting psychological and social burdens that complicate maternal well-being and access to care. However, there is a critical gap in understanding how these mental health symptoms translate into diagnoses, treatments, and outcomes due to the absence of a validated screening tool tailored to this population’s unique psychosocial needs. This perspective article reviews evidence, highlights the urgent need for specialized screening, and introduces ongoing research aimed at developing and validating an instrument that integrates both mental health symptoms and broader psychosocial distress. By bridging this gap, structured psychosocial screening has the potential to improve care coordination, facilitate earlier intervention, and mitigate long-term distress for individuals navigating pregnancies affected by fetal anomalies.
Full article
(This article belongs to the Special Issue Personalized Approaches to Prenatal Screening and Diagnosis)
Open AccessArticle
Clinical Characteristics and Survival Trends of Male Breast Cancer in the United States: A Propensity Score Matched Analysis
by
Jayasree Krishnan, Malak Alharbi, Kristopher Attwood and Arya Mariam Roy
J. Pers. Med. 2025, 15(7), 321; https://doi.org/10.3390/jpm15070321 - 17 Jul 2025
Abstract
Background: Male breast cancer (MBC) is extremely rare, representing less than 1% of breast cancer (BC). Owing to the rarity, there is a substantial knowledge gap regarding the survival trends of MBC compared with female breast cancer (FBC). Methods: We queried the National
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Background: Male breast cancer (MBC) is extremely rare, representing less than 1% of breast cancer (BC). Owing to the rarity, there is a substantial knowledge gap regarding the survival trends of MBC compared with female breast cancer (FBC). Methods: We queried the National Cancer Database for BC patients diagnosed during 2004–2018 and utilized an inverse propensity weighted cox regression model assessed the association between sex and overall survival (OS) and survival trends over time by sex. Results: We identified 24,055 MBC and 2,532,470 FBC patients. Patients with MBC were older (mean age: 65.6 vs. 61.4 years), and more likely to have stage IV at diagnosis (7% vs. 4.7%), larger tumors (cT4: 6% vs. 3.7%), and node-positive disease (18.5% vs. 15.5%) (p < 0.001) compared with FBC. MBC were more likely to be estrogen (ER) (88.5% vs. 78.5%) and progesterone receptor (PR) (79.6% vs. 68%) positive and less likely to be HER2 receptor positive (7.9% vs. 9.3%) or triple negative (2.8% vs. 7.6%) compared with FBC (all p < 0.001). The OS rates were lower in MBC compared with FBC (5-year: 73% vs. 83%; 10-year: 54% vs. 70%, p < 0.001). In the propensity weighted cox-regression model, males had higher mortality than females with BC (HR 2.8, 95% CI 2.88–2.9, p < 0.001). The 5-year OS rates increased steadily for FBC from 2004–2015; however, the survival rates did not improve for MBC over the last decade. Conclusions: Our study shows that MBC patients continue to have poor OS compared with patients with FBC and no significant improvement in survival of MBC patients over the past decade. These results underscore the need to investigate personalized treatment interventions for patients with MBC to improve outcomes.
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(This article belongs to the Section Personalized Therapy and Drug Delivery)
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Open AccessArticle
Clinical Outcomes of 3D-Printed Titanium Patient-Specific Implants in Lumbar Interbody Fusion: A Prospective Clinical Trial with a Systematic Review of Conventional Techniques
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Kevin A. Seex, Ralph J. Mobbs, Marc Coughlan, Matthew Pelletier, William R. Walsh, Jackson C. Hill and William C. H. Parr
J. Pers. Med. 2025, 15(7), 320; https://doi.org/10.3390/jpm15070320 - 16 Jul 2025
Abstract
Background: Lumbar Interbody Fusion (LIF) is a surgical procedure aimed at addressing a range of pathological conditions affecting the structure and function of the spine. Patient-Specific Interbody Cages (PSICs) are an emerging technology that are used in LIF; however, there is a
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Background: Lumbar Interbody Fusion (LIF) is a surgical procedure aimed at addressing a range of pathological conditions affecting the structure and function of the spine. Patient-Specific Interbody Cages (PSICs) are an emerging technology that are used in LIF; however, there is a lack of clinical outcome data, making it difficult to assess the potential risks, benefits, and value of PSICs. The purpose of this present study is to contribute data to the field on this new emerging technology. The aims were to investigate Quality of Life (QoL), pain, and the complications of PSICs in LIF. To provide a comparative cohort, we performed a systematic review of patient-reported outcomes of conventional fusion techniques. Methods: This study reports on a multi-surgeon, multi-centre clinical trial of patients with lumbar degenerative disc disease, necessitating discectomy and fusion. All patients underwent LIF procedures with 3D-printed PSICs. Pain Visual Analogue Scale (VAS) and QoL (EQ-5D) scores were collected pre-operatively and at 6m, 12m, and 24m post-operatively. For comparative purposes, we performed a systematic review of the VAS scores from traditional LIF cages and analysed the Australian Spine Registry QoL data. Results: The literature search yielded 4272 publications. The studies were subdivided into four groups based on the interbody device type. All the groups demonstrated improvements in the VAS (for back pain) scores post-operatively. In total, 78 patients (109 instrumented levels) underwent LIF procedures with 3DP PSICs. There were three reoperations (3.8%) and no revisions of any PSIC. The mean VAS scores improved significantly (p < 0.01) from 7.85 (1.50 SD) pre-operatively to 2.03 (2.13 SD) at 24 months post-operatively. The mean QoL index scores improved significantly (p < 0.01) from a pre-operative 0.257 (0.332 SD) to 0.815 (0.208 SD) at 24 months. Conclusions: The systematic review indicated that device fixation to the interbody space was associated with lower VAS scores. The results from the investigational cohort suggest that PSICs may represent a new progression in implant design for spinal fusion, with an associated clinical benefit for LIF.
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(This article belongs to the Special Issue Personalized Approaches to Spine Surgery: Innovations and Future Directions)
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Open AccessCase Report
Awake Craniotomy for the Excision of a Pediatric Cerebral Arteriovenous Malformation for Language Preservation: A Case Description
by
Melody Long, C. Thiaghu, Tien Meng Cheong, Ramez W. Kirollos, Julian Han, Lee Ping Ng and Sharon Y. Y. Low
J. Pers. Med. 2025, 15(7), 319; https://doi.org/10.3390/jpm15070319 - 15 Jul 2025
Abstract
Background: Awake craniotomy (AC) surgeries are less common in the pediatric population in comparison to their adult counterparts. Nonetheless, they can be considered for selected cases whereby speech preservation is paramount during maximal safe resection of intracranial lesions. We describe a case of
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Background: Awake craniotomy (AC) surgeries are less common in the pediatric population in comparison to their adult counterparts. Nonetheless, they can be considered for selected cases whereby speech preservation is paramount during maximal safe resection of intracranial lesions. We describe a case of AC for the excision of a brain arteriovenous malformation (bAVM) with language mapping in a pediatric patient. Methods: A previously well 16-year-old male presented with a spontaneous left frontal intracranial hemorrhage. Neuroimaging confirmed the cause to be a left antero-temporal bAVM centered in the insula. A decision was made for AC bAVM excision with language mapping for speech preservation. Results: As part of the pre-operative preparation, the patient and his caregivers were reviewed by a multidisciplinary team. For the conduct of the AC, the asleep–awake–asleep technique was used with processed EEG to guide anesthesia management. Additional modifications to make the patient comfortable included the avoidance of rigid cranial skull pins, urinary catheterization and central line insertion at the start of the surgery. Conclusions: Our experience concurs with the evidence that AC in children is a feasible option for select individuals. To our knowledge, this is the first detailed case description of a pediatric patient undergoing AC with language mapping for a bAVM. Emphases include a strong rapport between the patient and the managing multidisciplinary team, flexibility to adjust conventional workflows and limitations of neuroimaging adjuncts.
Full article
(This article belongs to the Special Issue Personalized Approaches in Neurosurgery)
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Open AccessReview
The Role of Intravascular Imaging in Coronary Chronic Total Occlusion PCI: Enhancing Procedural Success Through Real-Time Visualization
by
Hussein Sliman, Rim Kasem Ali Sliman, Paul Knaapen, Alex Nap, Grzegorz Sobieszek and Maksymilian P. Opolski
J. Pers. Med. 2025, 15(7), 318; https://doi.org/10.3390/jpm15070318 - 15 Jul 2025
Abstract
Coronary chronic total occlusions (CTOs) are diagnosed in a significant portion of patients undergoing coronary angiography and represent one of the most complex scenarios in contemporary percutaneous coronary interventions (PCI). This review systematically examines how adjunctive imaging modalities’—intravascular ultrasound (IVUS), optical coherence tomography
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Coronary chronic total occlusions (CTOs) are diagnosed in a significant portion of patients undergoing coronary angiography and represent one of the most complex scenarios in contemporary percutaneous coronary interventions (PCI). This review systematically examines how adjunctive imaging modalities’—intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary computed tomography angiography (CCTA)—co-registration enhances the precision and success rates of CTO-PCI during the procedure. The strategic integration of these technologies enables the development of patient-specific intervention strategies tailored to individual vascular architecture and lesion characteristics. This personalized approach marks a transition from standardized protocols to precision interventional cardiology, potentially optimizing procedural success rates while minimizing complications.
Full article
(This article belongs to the Special Issue Interventional Cardiology: Latest Technology, Progress and Challenge)
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Open AccessSystematic Review
Early vs. Late Oral Feeding After Surgery for Patients with Esophageal Malignancy: A Systematic Review and Meta-Analysis of Postoperative Clinical Outcomes and Quality of Life
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Raghad Fahad Alrasheed, Abdullah Salem Laradhi, Reema Saeed Alqahtani, Sarah Mazin Alharthi, Waleed Amin Alamoudi, Zainudheen Faroog, Sham Yasser Almohammad, Jana Ayman Basmaih, Nasser Turki Alotaibi, Ahmed Elaraby, Raed A. Albar and Ayman M. A. Mohamed
J. Pers. Med. 2025, 15(7), 317; https://doi.org/10.3390/jpm15070317 - 15 Jul 2025
Abstract
Introduction: Esophagectomy for esophageal cancer traditionally involves delayed postoperative oral feeding due to concerns about complications like anastomotic leakage. Enhanced Recovery After Surgery (ERAS) protocols favor early oral feeding (EOF), but its safety and benefits remain debated. This systematic review and meta-analysis compared
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Introduction: Esophagectomy for esophageal cancer traditionally involves delayed postoperative oral feeding due to concerns about complications like anastomotic leakage. Enhanced Recovery After Surgery (ERAS) protocols favor early oral feeding (EOF), but its safety and benefits remain debated. This systematic review and meta-analysis compared EOF versus late oral feeding (LOF) after esophagectomy. Methods: We systematically searched PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library through March 2025 for primary studies comparing EOF (≤7 days post-op) with LOF (>7 days or delayed) in adult patients after esophagectomy. Outcomes included anastomotic leakage, pneumonia, other complications, gastrointestinal recovery, length of hospital stay (LOS), quality of life (QoL), and mortality. Results: Twenty-nine studies involving 3962 patients were included. There was no significant difference in the risk of anastomotic leakage between the two groups (RR: 1.03, 95% CI: 0.80–1.33, p = 0.82, I2 = 0%). EOF was associated with a significantly shorter time to first flatus (Cohen’s d: −1.26, 95% CI: −1.93 to −0.58, p < 0.001) and first defecation (Cohen’s d: −0.87, 95% CI: −1.51 to −0.22, p = 0.01) and a shorter LOS (p = 0.01). No significant differences were found for other complications (acute respiratory distress syndrome [ARDS], chyle leak, conduit issues, ileus, sepsis, wound infection) or mortality rates (in-hospital, 30-day, 90-day, overall). QoL assessment suggested potential improvement in emotional function with EOF. Conclusions: EOF after esophagectomy appears safe, as it does not increase the risk of anastomotic leakage or other major complications compared to LOF. It is associated with faster gastrointestinal recovery and shorter hospital stays, supporting its use within ERAS protocols.
Full article
(This article belongs to the Special Issue Gastrointestinal Cancers: New Advances and Challenges)
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Open AccessArticle
Long-Term Outcome of Unprotected Left Main Percutaneous Coronary Interventions—An 8-Year Single-Tertiary-Care-Center Experience
by
Orsolya Nemeth, Tamas Ferenci, Tibor Szonyi, Sandor Szoke, Gabor Fulop, Tunde Pinter, Geza Fontos, Peter Andreka and Zsolt Piroth
J. Pers. Med. 2025, 15(7), 316; https://doi.org/10.3390/jpm15070316 - 15 Jul 2025
Abstract
Background/Objectives: Randomized studies of patients with unprotected left main coronary artery (ULMCA) disease involve highly selected populations. Therefore, we sought to investigate the 60-month event-free survival of consecutive patients undergoing ULMCA percutaneous coronary intervention (PCI) and determine the best risk score system
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Background/Objectives: Randomized studies of patients with unprotected left main coronary artery (ULMCA) disease involve highly selected populations. Therefore, we sought to investigate the 60-month event-free survival of consecutive patients undergoing ULMCA percutaneous coronary intervention (PCI) and determine the best risk score system and independent predictors of event-free survival. Methods: All patients who underwent ULMCA PCI at our center between 1 January 2007 and 31 December 2014 were included. The primary endpoint was the time to cardiac death, target lesion myocardial infarction, or target lesion revascularization (whichever came first) with a follow-up of 60 months. Results: A total of 513 patients (mean age 68 ± 12 years, 64% male, 157 elective, 356 acute) underwent ULMCA PCI. The 60-month incidence of events was 16.8% and 38.0% in elective and acute patients, respectively. There were significantly more events in the acute group during the first 6.5 months. Of the risk scores, the ACEF (AUC = 0.786) and SYNTAX II (AUC = 0.716) scores had the best predictive power in elective and acute patients, respectively. The SYNTAX score proved to be the least predictive in both groups (AUC = 0.638 and 0.614 in the elective and acute groups, respectively). Left ventricular function (hazard ratio (HR) for +10% 0.53 [95% CI, 0.38–0.75] and 0.81 [95% CI, 0.71–0.92] in elective and acute patients, respectively) and, in acute patients, access site (femoral vs. radial HR 1.76 [95% CI, 1.11–2.80]), hyperlipidemia (HR 0.58 [95% CI, 0.39–0.86]), and renal function (HR for +10 mL/min/1.73 m2 higher GFR: 0.87 [95% CI, 0.78–0.97]) were independent predictors of event-free survival. Conclusions: Acute ULMCA PCI patients have worse prognosis than elective patients, having more events during the first 6.5 months. Besides anatomical complexity, clinical and procedural parameters determine the prognosis.
Full article
(This article belongs to the Special Issue Complex and High-Risk Coronary Interventional Procedures)
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Open AccessSystematic Review
Key Determinants Influencing Treatment Decision-Making for and Adherence to Active Surveillance for Prostate Cancer: A Systematic Review
by
Pani Nasseri, Jorien Veldwijk, Christa Niehot, Esmee F. H. Mulder, Esther W. de Bekker-Grob, Monique J. Roobol and Lionne D. F. Venderbos
J. Pers. Med. 2025, 15(7), 315; https://doi.org/10.3390/jpm15070315 - 15 Jul 2025
Abstract
Background/Objectives: Men choosing active surveillance (AS) for low- and intermediate risk prostate cancer (PCa) must weigh its harms and benefits against those of active treatment (AT). To understand factors influencing treatment decision-making (TDM) for and adherence to AS, we performed a systematic
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Background/Objectives: Men choosing active surveillance (AS) for low- and intermediate risk prostate cancer (PCa) must weigh its harms and benefits against those of active treatment (AT). To understand factors influencing treatment decision-making (TDM) for and adherence to AS, we performed a systematic review. Methods: This systematic review followed the PRISMA guidelines and was registered with PROSPERO (ID CRD42024490427). A comprehensive search strategy from 1990 to 2024 was executed across multiple databases, including Medline and Embase. Studies were included if they examined factors influencing TDM for AS or active monitoring (AM) and adherence to AS/AM. Results: Of the 8316 articles identified, 223 articles were eligible for inclusion. The decision for AS was influenced by different factors, including comprehensive information about treatment options, social support, and wanting to avoid side-effects. Key reasons to choose AT over AS included a lack of information from healthcare professionals about AS and fear of disease progression. Reasons for adhering to the AS protocol included better quality of life and social support. While non-adherence to the AS protocol is prompted by, e.g., biopsy burden and uncertainty, AS discontinuation is generally a results of medical reasons (namely disease upgrading) or from anxiety and family pressure. Conclusions: Numerous factors influence men’s treatment pathway choices. Involving family members in shared decision-making and ensuring that patients have detailed information about AS as a treatment option could help to improve AS uptake. Addressing psychosocial challenges through education and family involvement could improve AS adherence. These insights can help healthcare providers by addressing men’s needs during TDM and AS.
Full article
(This article belongs to the Section Personalized Therapy and Drug Delivery)
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Open AccessArticle
Integrating Telemedical Supervision, Responder Apps, and Data-Driven Triage: The RuralRescue Model of Personalized Emergency Care
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Klaus Hahnenkamp, Steffen Flessa, Timm Laslo and Joachim Paul Hasebrook
J. Pers. Med. 2025, 15(7), 314; https://doi.org/10.3390/jpm15070314 - 14 Jul 2025
Abstract
Background/Objectives: This study aimed to evaluate a regional implementation project for rural emergency care (RuralRescue) and to examine how its components and outcomes may support personalized approaches in emergency medicine. While not originally designed as a personalized medicine intervention, the project combined
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Background/Objectives: This study aimed to evaluate a regional implementation project for rural emergency care (RuralRescue) and to examine how its components and outcomes may support personalized approaches in emergency medicine. While not originally designed as a personalized medicine intervention, the project combined digital, educational, and organizational innovations that enable patient-specific adaptation of care processes. Methods: Conducted in the rural district of Vorpommern-Greifswald (Mecklenburg–Western Pomerania, Germany), the intervention included (1) standardized cardiopulmonary resuscitation (CPR) training for laypersons, (2) a geolocation-based first responder app for medically trained volunteers, and (3) integration of a tele-emergency physician (TEP) system with prehospital emergency medical services (EMSs). A multi-perspective pre–post evaluation covered medical, economic, and organizational dimensions. Primary and secondary outcomes included bystander CPR rates, responder arrival times, telemedical triage decisions, diagnostic concordance, hospital transport avoidance, economic simulations, workload, and technology acceptance. Results: Over 12,600 citizens were trained in CPR and the responder app supported early intervention in hundreds of cases. TEPs remotely assisted 3611 emergency calls, including delegated medication in 17.8% and hospital transport avoidance in 24.3% of cases. Return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) was achieved in 35.6% of cases with early CPR. Diagnostic concordance reached 84.9%, and documentation completeness 92%. Centralized coordination of TEP units reduced implementation costs by over 90%. Psychological evaluation indicated variable digital acceptance by role and experience. Conclusions: RuralRescue demonstrates that digitally supported, context-aware, and regionally integrated emergency care models can contribute significantly to personalized emergency medicine and can be cost-effective. The project highlights how intervention intensity, responder deployment, and treatment decisions can be tailored to patient needs, professional capacity, and regional structures—even in resource-limited rural areas.
Full article
(This article belongs to the Special Issue Emergency Medicine: Clinical Advances and Challenges in Diagnosis and Treatment, 2nd Edition)
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Open AccessArticle
Psychiatric Comorbidities Associated with Food Addiction in Post-Bariatric Patients: Toward Personalized Mental Health Screening and Postoperative Care
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Ligia Florio, Maria Olivia Pozzolo Pedro, Kae Leopoldo, Maria Amalia Accari Pedrosa and João Mauricio Castaldelli-Maia
J. Pers. Med. 2025, 15(7), 313; https://doi.org/10.3390/jpm15070313 - 14 Jul 2025
Abstract
Background: Food addiction (FA) is an emerging construct that mirrors the behavioral and neurobiological characteristics of substance use disorders. Despite growing interest, its association with specific psychiatric disorders among bariatric patients remains understudied. Objective: Our aim was to examine the prevalence and strength
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Background: Food addiction (FA) is an emerging construct that mirrors the behavioral and neurobiological characteristics of substance use disorders. Despite growing interest, its association with specific psychiatric disorders among bariatric patients remains understudied. Objective: Our aim was to examine the prevalence and strength of associations between FA and seven major psychiatric disorders in individuals who underwent bariatric surgery. Methods: In a sample of 100 post-bariatric patients referred for psychiatric evaluation, FA was assessed using the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Logistic regression models were used to estimate adjusted odds ratios (aORs) for the association between FA and each psychiatric disorder, controlling for sex, age, body mass index (BMI), employment status, the number of children, clinical comorbidities, physical activity, family psychiatric history, and region of residence. Results: FA was present in 40% of the sample. Descriptive analyses revealed a significantly higher prevalence of major depressive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, agoraphobia, obsessive–compulsive disorder, and bulimia nervosa among individuals with FA. Multivariate models showed robust associations between FA and bulimia nervosa (aOR = 14.77, p < 0.01), generalized anxiety disorder (aOR = 6.99, p < 0.01), panic disorder (aOR = 6.83, p = 0.02), and major depressive disorder (aOR = 6.31, p < 0.01). Conclusions: FA is strongly associated with a range of psychiatric comorbidities in post-bariatric patients, reinforcing the need for comprehensive mental health screening in this population. These findings underscore the potential role of FA as a clinical marker for stratified risk assessment, supporting more personalized approaches to mental health monitoring and intervention following bariatric surgery.
Full article
(This article belongs to the Special Issue Recent Advances in Bariatric Surgery)
Open AccessArticle
Stereotactic Body Radiotherapy for the Treatment of Oligometastases Located in the Peritoneum or in the Abdominal Wall: Preliminary Results from a Mono-Institutional Analysis
by
Francesco Cuccia, Salvatore D’Alessandro, Marina Campione, Vanessa Figlia, Gianluca Mortellaro, Antonio Spera, Giulia Musicò, Antonino Abbate, Salvatore Russo, Carlo Messina, Giuseppe Carruba, Livio Blasi and Giuseppe Ferrera
J. Pers. Med. 2025, 15(7), 312; https://doi.org/10.3390/jpm15070312 - 14 Jul 2025
Abstract
Purpose/Objective(s): Peritoneal carcinosis can occur in several gastrointestinal or gynecological malignancies and its prognosis is usually poor. With the advent of more effective systemic agents, the overall survival of metastatic patients has been revolutionized and isolated peritoneal or abdominal wall metastases might benefit
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Purpose/Objective(s): Peritoneal carcinosis can occur in several gastrointestinal or gynecological malignancies and its prognosis is usually poor. With the advent of more effective systemic agents, the overall survival of metastatic patients has been revolutionized and isolated peritoneal or abdominal wall metastases might benefit from local treatments; Stereotactic Body Radiotherapy (SBRT) might be considered in selected patients with oligometastatic presentation. Materials/Methods: Oligometastases were defined according to recent ESTRO/EORTC consensus. Inclusion criteria were as follows: ECOG PS ≤ 2, written informed consent, up to five lesions to be treated at the same time, patients treated with radiotherapy schedules applying minimum 6 Gy per fraction. The primary endpoint of the study was local control (LC); acute and late toxicity, distant progression-free survival (DPFS), time-to-next systemic treatment (TNST), polymetastatic-free survival (PMFS) and overall survival (OS) were secondary endpoints. Toxicity was assessed according to CTCAE criteria v5.0. Statistical associations between clinical variables and outcomes were assessed using Fisher’s exact test, and Kruskal–Wallis test, as appropriate. Survival outcomes were estimated using the Kaplan–Meier method and compared using the log-rank test. Results: Between April 2020 and September 2024 a total of 26 oligometastatic lesions located in the peritoneum or in the abdominal wall detected in 20 patients received SBRT with Helical Tomotherapy. All cases have been assessed by a multidisciplinary team. Only in three patients out of twenty did more than one lesion receive SBRT: two lesions in two patients, and five lesions in a single case of colorectal cancer with ongoing third-line systemic treatment. Median total dose was 30 Gy (27–35 Gy) in five fractions (3–5). The most frequent primary neoplasm was ovarian cancer in 14/20, endometrial in 2/20, while the remaining were colorectal, vaginal, pancreatic and non-small cell lung cancer. Four lesions were located in the abdominal wall, while the remaining twenty-two were located in the peritoneum. Concurrent systemic therapy was administered in 18/20 patients. With a median follow-up of 15 months (range, 6–59), our 1-year LC was 100%, while 1-year DPFS, PMFS, TNTS and OS rates were 54%, 69%, 61% and 83%, respectively. Abdominal wall location and treatment of a subsequent oligometastatic recurrence with a second course of SBRT were both significantly associated with improved OS (p = 0.03 and p = 0.04, respectively). No G ≥ 3 adverse events occurred. Conclusion: Our preliminary data support the use of SBRT in selected cases of oligometastatic disease located in the peritoneum or in the abdominal wall with excellent results in terms of tolerability and promising clinical outcomes.
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(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Oligometastatic Disease)
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Open AccessReview
Individualized Trimethoprim-Sulfamethoxazole Dosing in Non-HIV Patients with Pneumocystis Pneumonia: A Narrative Review of Current Evidence
by
Ilias E. Dimeas, George E. Dimeas, George E. Zakynthinos and Vasiliki Tsolaki
J. Pers. Med. 2025, 15(7), 311; https://doi.org/10.3390/jpm15070311 - 14 Jul 2025
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Background: Pneumocystis jirovecii pneumonia (PJP) remains a serious threat to non-HIV immunocompromised patients, who often experience rapid disease progression, delayed diagnosis, and higher mortality. Standard treatment with high-dose trimethoprim-sulfamethoxazole (TMP-SMX) is based primarily on data from HIV-positive populations, despite differences in immune
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Background: Pneumocystis jirovecii pneumonia (PJP) remains a serious threat to non-HIV immunocompromised patients, who often experience rapid disease progression, delayed diagnosis, and higher mortality. Standard treatment with high-dose trimethoprim-sulfamethoxazole (TMP-SMX) is based primarily on data from HIV-positive populations, despite differences in immune response and drug tolerability. Objective: This narrative review critically synthesizes the available evidence on lower-dose TMP-SMX strategies for PJP in non-HIV patients and explores the potential role of individualized dosing approaches to improve outcomes. Findings: Emerging retrospective data suggest that lower-dose regimens (<15 mg/kg/day) may provide similar survival outcomes with fewer adverse effects. The intense inflammatory response observed after treatment initiation in non-HIV patients, potentially exacerbated by high-dose therapy, may contribute to clinical deterioration. This raises the possibility that TMP-SMX dosing itself could influence immune-mediated lung injury. While adjunctive corticosteroids are frequently used to temper inflammation, their benefit remains uncertain. Conclusions: Existing data suggest that lower-dose TMP-SMX may be effective and better tolerated in some non-HIV patients with PJP. A personalized approach to dosing, informed by clinical and host-specific factors, represents a promising strategy to optimize outcomes and minimize harm. Future research should prioritize precision medicine frameworks and prospective evaluation of individualized dosing protocols.
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Open AccessArticle
The Role of Neutrophil-to-Lymphocyte Ratio as a Predictor of Orchiectomy or Testicular Atrophy After Torsion in Children: A Multicentric Study
by
Carlos Delgado-Miguel, Javier Arredondo-Montero, Julio César Moreno-Alfonso, Isabella Garavis Montagut, María San Basilio, Irene Hernández, Noela Carrera, Leopoldo Martínez, Estíbalitz Iraola, Inmaculada Ruiz Jiménez, Pablo Aguado Roncero, Ennio Fuentes, Ricardo Díez and Francisco Hernández-Oliveros
J. Pers. Med. 2025, 15(7), 310; https://doi.org/10.3390/jpm15070310 - 13 Jul 2025
Abstract
Introduction: Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker (hemogram-derived-ratio) related to ischemic-inflammatory diseases. Its usefulness in the diagnosis of pediatric testicular torsion (TT) has recently been reported, although its prognostic implication has not been evaluated. Our aim is to analyze the role
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Introduction: Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker (hemogram-derived-ratio) related to ischemic-inflammatory diseases. Its usefulness in the diagnosis of pediatric testicular torsion (TT) has recently been reported, although its prognostic implication has not been evaluated. Our aim is to analyze the role of NLR in the evolution of TT in children, determining its potential for predicting the risk of adverse outcomes such as orchiectomy or testicular atrophy. Methods: We performed a retrospective multicentric case-control study in patients with clinical and ultrasound suspicion of TT, in whom surgical testicular examination was performed between 2016–2022 in seven pediatric hospitals. Patients’ outcomes were analyzed according to the intraoperative and postoperative evolution (orchiectomy/testicular atrophy or not). Demographics and clinical, ultrasound and laboratory features at admission were analyzed. Sensitivity and specificity were determined by the area under the curve (AUC) represented on the receiver operating characteristic (ROC) curves. Results: A total of 455 patients (median age 13.2 years; interquartile range 10.6–14.4 years) were included, in whom 87 orchiectomies (19.1%) were performed and 34 cases of testicular atrophy (7.5%) were observed during follow-up (median follow-up: 10 months). When comparing clinical, ultrasound and laboratory predictors of both events on ROC curves, NLR was the most sensitive and specific parameter for predicting orchiectomy (AUC = 0.834; p < 0.001), as well as testicular atrophy (AUC = 0.849; p < 0.001). Compared with other parameters, the designed cut-off point of NLR = 5.2 had maximum sensitivity and specificity (82.2% and 77.0%, respectively) for predicting orchiectomy or atrophy after testicular torsion. Conclusions: NLR may be considered the best predictor for the risk of orchiectomy or testicular atrophy following torsion in pediatric patients, helping the identification of high-risk cases. It can be useful both for obtaining more accurate preoperative information on patient prognosis and for closer follow-up of high-risk testicular atrophy patients.
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(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Urological Diseases)
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Open AccessReview
Updated Insights into the Molecular Pathophysiology of Olfactory Neuroblastoma Using Multi-Omics Analysis
by
Enes Demir, Deondra Montgomery, Varun Naravetla and Michael Karsy
J. Pers. Med. 2025, 15(7), 309; https://doi.org/10.3390/jpm15070309 - 13 Jul 2025
Abstract
Background/Objectives: Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare neuroectodermal malignancy of the nasal cavity characterized by aggressive local invasion and variable metastatic potential, with diverse clinical behavior, often presenting at advanced stages. ONB poses challenges for targeted therapeutic strategies,
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Background/Objectives: Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare neuroectodermal malignancy of the nasal cavity characterized by aggressive local invasion and variable metastatic potential, with diverse clinical behavior, often presenting at advanced stages. ONB poses challenges for targeted therapeutic strategies, despite advances in surgical and multimodal treatment strategies, because of the rarity of this disease and the limited understanding of its molecular pathophysiology. Methods: A comprehensive review of genomic, multi-omic, and molecular studies was performed to integrate known targeted sites in ONB with the current understanding of its pathophysiology. Results: Recent genetic and molecular studies have identified significant epigenetic and signaling pathway alterations that are critical in pathogenesis and treatment resistance and may serve as potential therapeutic targets. Additionally, novel discovered immunohistochemical and transcriptomic markers, such as IDH2, NEUROD1, and OTX2, offer improved diagnostic specificity and prognostication. Multi-genomic platforms (i.e., multi-omics), involving the combined integration of transcriptomics, epigenetics, and proteomics findings, have led to several recent insights, including the subclassification of neural and basal genomic subtypes, the identification of key driver mutations, and new insights into disease development. This review synthesizes current knowledge on the molecular landscape of ONB, including its tumor origin, immune microenvironment, genetic alterations, and key molecular pathways involved in its pathogenesis. Conclusions: Future research may benefit from integrating these findings into precision medicine approaches, enabling earlier diagnosis and more accurate prognosis.
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(This article belongs to the Section Mechanisms of Diseases)
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Open AccessArticle
An Artificial Intelligence-Based Model to Predict Pregnancy After Intrauterine Insemination: A Retrospective Analysis of 9501 Cycles
by
Jaume Minano Masip, Camille Grysole, Penelope Borduas, Isaac-Jacques Kadoch, Simon Phillips, Doina Precup and Daniel Dufort
J. Pers. Med. 2025, 15(7), 308; https://doi.org/10.3390/jpm15070308 - 12 Jul 2025
Abstract
Background/Objectives: Intrauterine insemination (IUI) is a common first-line approach in the treatment of numerous infertile couples, especially in cases of unexplained infertility. Its relatively low success rate, however, could benefit from the development of AI-based support tools to predict its outcome, thus helping
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Background/Objectives: Intrauterine insemination (IUI) is a common first-line approach in the treatment of numerous infertile couples, especially in cases of unexplained infertility. Its relatively low success rate, however, could benefit from the development of AI-based support tools to predict its outcome, thus helping the clinical management of patients undergoing IUI cycles. Our objective was to develop a robust and accurate machine learning model that predicts pregnancy outcomes following IUI. Methods: A retrospective, observational, and single-center study was conducted. In total, 3535 couples (aged 18–43 years) that underwent IUI between January 2011 and December 2015 were recruited. Twenty-one clinical and laboratory parameters of 9501 IUI cycles were used to train different machine learning algorithms. Accuracy of pregnancy outcome was evaluated by an area under the curve (AUC) analysis. Results: The linear SVM outperformed AdaBoost, Kernel SVM, Random Forest, Extreme Forest, Bagging, and Voting classifiers. Pre-wash sperm concentration, the ovarian stimulation protocol, cycle length, and maternal age were strong predictors of a positive pregnancy test following IUI (AUC = 0.78). Paternal age was found to be the worst predictor. Conclusions: Our Linear SVM model predicts a positive pregnancy outcome following IUI. Although this model shows value for the clinical management of infertile patients and informed decision-making by the patients, further validation using independent datasets is required prior to clinical implementation.
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(This article belongs to the Section Omics/Informatics)
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Open AccessArticle
A Value Framework for Evaluating Population Genomic Programs: A Mixed Methods Approach
by
David Campbell, Scott Spencer, Ashley Kang, Rajshree Pandey, Sarah Katsandres and David Veenstra
J. Pers. Med. 2025, 15(7), 307; https://doi.org/10.3390/jpm15070307 - 12 Jul 2025
Abstract
Background/Objectives: Value frameworks are useful tools to explicitly define the dimensions and criteria important for decision-making, but no existing frameworks capture the broad value domains of population genomic programs. Using a mixed methods approach, we aimed to develop a novel value framework
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Background/Objectives: Value frameworks are useful tools to explicitly define the dimensions and criteria important for decision-making, but no existing frameworks capture the broad value domains of population genomic programs. Using a mixed methods approach, we aimed to develop a novel value framework for evaluating population genomic programs (PGPs). Methods: We first conducted a targeted literature review of published evidence on the value of PGPs and existing frameworks to evaluate and quantify their impact. Value domains and elements were extracted and summarized to develop a preliminary framework. Semi-structured stakeholder interviews on the preliminary framework were conducted from March 2024 to October 2024 with 11 experts representing 9 countries. A thematic analysis of interview transcripts was conducted to map value elements to domains of the final framework. Results: We identified 348 potentially relevant articles from MEDLINE-indexed and the gray literature sources. After title and abstract screening, 23 articles met the inclusion criteria and underwent full-text review, and 8 reported value elements were extracted and mapped to a preliminary framework for testing in interviews. Stakeholder themes were summarized into the value domains and elements of the final framework, which included health as a primary domain, education and research, enterprise and finance, and labor as the core domains, and agriculture and security as extended domains. Domains and elements may be excluded based on stakeholder objectives and program characteristics. Conclusions: This novel framework for assessing the comprehensive value of PGPs provides a foundational step to assess the value of these programs and may promote more efficient and informed allocation of resources.
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(This article belongs to the Section Omics/Informatics)
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Open AccessArticle
The Anesthesiologic Impact of Single-Port Robot-Assisted Partial Nephrectomy: A Tertiary Referral Comparative Analysis Between Full-Flank Transperitoneal, Retroperitoneal, and Supine Lower Anterior Access (LAA)
by
Luca Lambertini, Matteo Pacini, Paolo Polverino, Nikki R. Wilkinson, Ruben Sauer Calvo, Donato Cannoletta, Antony Angelo Pellegrino, Greta Pettenuzzo, Fabrizio Di Maida, Andrea Mari, Gabriele Bignante, Francesco Lasorsa, Alessandro Zucchi, Sergio Serni, Andrea Minervini, David B. Glick and Simone Crivellaro
J. Pers. Med. 2025, 15(7), 306; https://doi.org/10.3390/jpm15070306 - 11 Jul 2025
Abstract
Objective: To explore the impact of supine retroperitoneal single-port robot-assisted partial nephrectomy with lower anterior access on perioperative ventilatory, cardiovascular, and pain-related outcomes compared to a cohort of patients treated with single-port robot-assisted retroperitoneal or transperitoneal partial nephrectomy with standard flank patient positioning.
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Objective: To explore the impact of supine retroperitoneal single-port robot-assisted partial nephrectomy with lower anterior access on perioperative ventilatory, cardiovascular, and pain-related outcomes compared to a cohort of patients treated with single-port robot-assisted retroperitoneal or transperitoneal partial nephrectomy with standard flank patient positioning. Materials and Methods: Clinical and surgical data of all consecutive patients treated with single-port robot-assisted partial nephrectomy between March 2019 and January 2024 were prospectively collected and retrospectively analyzed. Specific same-day-discharge guidelines were applied to all cases. Failed same-day discharge was defined as the presence of early (<90 days) perioperative complications or the absence of opioid-free postoperative recovery. Results: Overall, 105 consecutive patients treated with single-port robot-assisted partial nephrectomy were analyzed. No differences emerged in baseline features. Peak inspiratory pressure and plateau pressure changes were significantly lower in the supine retroperitoneal lower anterior access group from the time of CO2 insufflation throughout every 30-min operative setpoint assessment (p = 0.02, p = 0.03, and p = 0.02, respectively). The transperitoneal group showed significantly higher values of mean, systolic, and diastolic blood pressure compared to retroperitoneal approaches. The supine lower anterior access group also showed significantly lower non-surgical operative room time, perioperative opioid administration, and postoperative median VAS pain score. Conclusions: The adoption of supine lower anterior access improved perioperative ventilatory, cardiovascular, and pain-related outcomes, also optimizing operating room efficiency. Further multicenter series with longer follow-ups are still needed to validate our preliminary results.
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(This article belongs to the Special Issue Targeted Surgery and Artificial Intelligence in Personalized Medicine and Robotic Surgery: Current Challenges and Future Prospects)
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