Journal of Personalized Medicine

3 pages, 162 KiB

Open AccessEditorial

Diagnostics and Therapeutics in Ophthalmology

by Andreas Arnold-Vangsted and Yousif Subhi

J. Pers. Med. 2025, 15(1), 28; https://doi.org/10.3390/jpm15010028 - 14 Jan 2025

Clinical research aims to answer questions that are of importance to daily clinical practice in order to improve and optimize disease diagnosis and therapy, which ultimately impacts patients’ well-being [...] Full article

(This article belongs to the Special Issue Diagnostics and Therapeutics in Ophthalmology)

25 pages, 3206 KiB

Open AccessArticle

A Novel CNN-Based Framework for Alzheimer’s Disease Detection Using EEG Spectrogram Representations

by Konstantinos Stefanou, Katerina D. Tzimourta, Christos Bellos, Georgios Stergios, Konstantinos Markoglou, Emmanouil Gionanidis, Markos G. Tsipouras, Nikolaos Giannakeas, Alexandros T. Tzallas and Andreas Miltiadous

J. Pers. Med. 2025, 15(1), 27; https://doi.org/10.3390/jpm15010027 - 14 Jan 2025

Abstract

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that poses critical challenges in global healthcare due to its increasing prevalence and severity. Diagnosing AD and other dementias, such as frontotemporal dementia (FTD), is slow and resource-intensive, underscoring the need for automated approaches. [...] Read more.

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that poses critical challenges in global healthcare due to its increasing prevalence and severity. Diagnosing AD and other dementias, such as frontotemporal dementia (FTD), is slow and resource-intensive, underscoring the need for automated approaches. Methods: To address this gap, this study proposes a novel deep learning methodology for EEG classification of AD, FTD, and control (CN) signals. The approach incorporates advanced preprocessing techniques and CNN classification of FFT-based spectrograms and is evaluated using the leave-N-subjects-out validation, ensuring robust cross-subject generalizability. Results: The results indicate that the proposed methodology outperforms state-of-the-art machine learning and EEG-specific neural network models, achieving an accuracy of 79.45% for AD/CN classification and 80.69% for AD+FTD/CN classification. Conclusions: These results highlight the potential of EEG-based deep learning models for early dementia screening, enabling more efficient, scalable, and accessible diagnostic tools. Full article

(This article belongs to the Special Issue Personalized Treatment of Neurological Diseases)

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Graphical abstract

20 pages, 2972 KiB

Open AccessReview

Intraoperative Monitoring of Sensory Evoked Potentials in Neurosurgery: A Personalized Approach

by Evgeny A. Levin

J. Pers. Med. 2025, 15(1), 26; https://doi.org/10.3390/jpm15010026 - 13 Jan 2025

Abstract

Sensory evoked potentials (EPs), namely, somatosensory, visual, and brainstem acoustic EPs, are used in neurosurgery to monitor the corresponding functions with the aim of preventing iatrogenic neurological complications. Functional deficiency usually precedes structural defect, being initially reversible, and prompt alarms may help surgeons [...] Read more.

Sensory evoked potentials (EPs), namely, somatosensory, visual, and brainstem acoustic EPs, are used in neurosurgery to monitor the corresponding functions with the aim of preventing iatrogenic neurological complications. Functional deficiency usually precedes structural defect, being initially reversible, and prompt alarms may help surgeons achieve this aim. However, sensory EP registration requires presenting multiple stimuli and averaging of responses, which significantly lengthen this procedure. As delays can make intraoperative neuromonitoring (IONM) ineffective, it is important to reduce EP recording time. The possibility of speeding up EP recording relies on differences between IONM and outpatient clinical neurophysiology (CN). Namely, in IONM, the patient is her/his own control, and the neurophysiologist is less constrained by norms and standards than in outpatient CN. Therefore, neurophysiologists can perform a personalized selection of optimal locations of recording electrodes, frequency filter passbands, and stimulation rates. Varying some or all of these parameters, it is often possible to significantly improve the signal-to-noise ratio (SNR) for EPs and accelerate EP recording by up to several times. The aim of this paper is to review how this personalized approach is or may be applied during IONM for recording sensory EPs of each of the abovementioned modalities. Also, the problems hindering the implementation and dissemination of this approach and options for overcoming them are discussed here, as well as possible future developments. Full article

(This article belongs to the Special Issue Personalized Approaches in Neurosurgery)

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18 pages, 748 KiB

Open AccessArticle

Health Professionals’ Preferences for Next-Generation Sequencing in the Diagnosis of Suspected Genetic Disorders in the Paediatric Population

by Mario Cesare Nurchis, Gerardo Altamura, Gian Marco Raspolini, Enrico Capobianco, Luca Salmasi and Gianfranco Damiani

J. Pers. Med. 2025, 15(1), 25; https://doi.org/10.3390/jpm15010025 - 10 Jan 2025

Abstract

Background/Objectives: Next-generation sequencing (NGS) can explain how genetics influence morbidity and mortality in children. However, it is unclear whether health providers will perceive and use such treatments. We conducted a discrete choice experiment (DCE) to understand Italian health professionals’ preferences for NGS to [...] Read more.

Background/Objectives: Next-generation sequencing (NGS) can explain how genetics influence morbidity and mortality in children. However, it is unclear whether health providers will perceive and use such treatments. We conducted a discrete choice experiment (DCE) to understand Italian health professionals’ preferences for NGS to improve the diagnosis of paediatric genetic diseases. Methods: The DCE was administered online to 125 health professionals in Italy. We documented attributes influencing professionals’ decisions of NGS, including higher diagnostic yield, shorter counselling periods, cost, turnaround time, and the identification of fewer variants of unknown significance. Results: Results show that factors such as higher diagnostic yield, shorter counselling periods, lower costs, and faster turnaround times positively influenced the adoption of NGS tests. Willingness to pay (WTP) estimates varied from EUR 387 (95% CI, 271.8–502.9) for 7% increase in the diagnostic yield to EUR 469 (95% CI, 287.2–744.9) for a decrease of one week in the turnaround time. Responders would reduce diagnostic yield by 7% to decrease the turnaround time by one week in both the preference and the willingness to trade (WTT) spaces. Respondents prioritised diagnostic yield (RI = 50.36%; 95% CI 40.2–67.2%) compared to other attributes. Conclusions: therefore, health professionals value NGS for allowing earlier, more accurate genetic diagnoses. Full article

(This article belongs to the Section Omics/Informatics)

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11 pages, 915 KiB

Open AccessArticle

Assessing the TNM Classification for Periprosthetic Joint Infections of the Knee: Predictive Validity for Functional and Subjective Outcomes

by Arne Kienzle, Sandy Walter, Paul Köhli, Clemens Gwinner, Sebastian Hardt, Michael Müller, Carsten Perka and Stefanie Donner

J. Pers. Med. 2025, 15(1), 24; https://doi.org/10.3390/jpm15010024 - 10 Jan 2025

Abstract

Background: Periprosthetic joint infection (PJI) following knee arthroplasty can significantly compromise patient mobility and quality of life. The newly proposed TNM classification system, adapted from oncology, categorizes PJI severity but has not yet been correlated with both subjective and objective outcomes post PJI [...] Read more.

Background: Periprosthetic joint infection (PJI) following knee arthroplasty can significantly compromise patient mobility and quality of life. The newly proposed TNM classification system, adapted from oncology, categorizes PJI severity but has not yet been correlated with both subjective and objective outcomes post PJI treatment. Objective: This study evaluates the applicability of the TNM classification system for predicting outcomes in knee PJI revision surgeries. Methods: We conducted a retrospective analysis of 108 patients who underwent revision surgeries for knee PJI at our institution from January 2012 to January 2023. We assessed the correlation between the TNM classification and postoperative outcomes using the Knee Society Score (KSS) function and knee score, as well as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The TNM classification demonstrated that higher ‘T’ stages were significantly associated with worse functional and subjective outcomes. The ‘N’ classification had limited predictive value, likely due to treatment adjustments based on pathogen type. The ‘M’ classification correlated with functional outcomes but not with subjective scores, suggesting that patients with more severe preoperative comorbidities might adjust their expectations. Conclusions: While the TNM classification shows potential, its current form as a prognostic tool in PJI management is limited. Enhancing the ‘T’ component, coupled with the integration of a validated morbidity score such as the CCI could improve its prognostic value. Despite its shortcomings, the TNM system may still provide valuable prognostic insights for both patients and surgeons in tackling complex PJI. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

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13 pages, 265 KiB

Open AccessArticle

Prostatic Artery Embolization in Elderly Comorbid Patients with Benign Prostatic Hyperplasia: Safety, Efficacy, and Predictive Factors of Clinical Failure

by Federico Zorzi, Giulio Rossin, Michelangelo Digregorio, Simone Lavecchia, Andrea Piasentin, Fabio Traunero, Carmelo Morreale, Michele Rizzo, Tommaso Cai, Carlo Trombetta, Alessandro Zucchi and Giovanni Liguori

J. Pers. Med. 2025, 15(1), 23; https://doi.org/10.3390/jpm15010023 - 10 Jan 2025

Abstract

Background: This study aims to evaluate the safety and efficacy of prostatic artery embolization (PAE) in elderly, multimorbid patients with benign prostatic hyperplasia (BPH). Additionally, it seeks to identify technical and clinical factors that predict clinical failure at the mid-term follow-up. Methods [...] Read more.

Background: This study aims to evaluate the safety and efficacy of prostatic artery embolization (PAE) in elderly, multimorbid patients with benign prostatic hyperplasia (BPH). Additionally, it seeks to identify technical and clinical factors that predict clinical failure at the mid-term follow-up. Methods: We analyzed the clinical records of 175 consecutive patients who underwent PAE. Technical success was defined as achieving embolization on at least one side. Safety was assessed using the Clavien–Dindo classification. The pre-procedural international prostate symptom score (IPSS), quality of life (QoL) score, prostate volume (PV), prostate-specific antigen (PSA), maximum urinary flow rate (Qmax), and post-void residual urine (PVR) were compared with values assessed at the follow-up evaluation. Clinical failure was defined as no improvement or worsening of lower urinary tract symptoms (LUTS) based on the IPSS at the follow-up evaluation. Univariate and multivariate regression models were applied to identify predictors of clinical failure. Results: 158 patients met the inclusion criteria. The median age was 74 years (68, 79), with a median ASA score of 2 (2, 3) and a Charlson comorbidity index (CCI) of 5 (4, 7). Follow-up assessments were carried out at a median of 12 months (0, 1). IPSS decreased by −5 points (−8, 0), QoL by −1 point (−1, 0), PV by −19 cc (−26, −8), PVR by −45 cc (−25 to −80), and PSA by −1.1 ng/mL (−2.5, −0.2) (p < 0.01); while Qmax improved by 4 mL/s (2, 6) (p < 0.01). A total of 44 patients (30.3%) experienced clinical failure, which was significantly correlated with unilateral embolization (p < 0.01). Multivariate regression analysis indicated that higher CCI, elevated PVR, and the use of larger microspheres were associated with poorer clinical outcomes, with odds ratios of 2.17 (95% CI: 1.4–3.38), 1.02 (95% CI: 1.01–1.03), and 26.83 (95% CI: 4.81–149.8), respectively (p < 0.01). Conclusions: PAE is a safe and effective treatment for elderly multimorbid patients with BPH. Comprehensive pre-procedural clinical assessment, incorporating the CCI and PVR, is essential to optimize treatment outcomes. Full article

(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Urological Diseases)

15 pages, 1149 KiB

Open AccessArticle

A Mediation Appraisal of Neuropathic-like Symptoms, Pain Catastrophizing, and Central Sensitization-Related Signs in Adults with Knee Osteoarthritis—A Cross-Sectional Study

by Fausto Salaffi, Marina Carotti, Sonia Farah, Carlo Ciccullo, Antonio Pompilio Gigante, Francesca Bandinelli and Marco Di Carlo

J. Pers. Med. 2025, 15(1), 22; https://doi.org/10.3390/jpm15010022 - 10 Jan 2025

Abstract

Objective. To investigate the relationships among neuropathic pain (NP), pain catastrophizing (PC), and central sensitization (CS) in relation to functional status and radiological damage in patients with knee osteoarthritis (OA). Methods. This cross-sectional study included knee OA patients derived from an observational cohort. [...] Read more.

Objective. To investigate the relationships among neuropathic pain (NP), pain catastrophizing (PC), and central sensitization (CS) in relation to functional status and radiological damage in patients with knee osteoarthritis (OA). Methods. This cross-sectional study included knee OA patients derived from an observational cohort. The Spearman correlation test was used to analyze the relationship between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the PainDetect Questionnaire (PDQ), Central Sensitization Inventory (CSI), and Pain Catastrophizing Scale (PCS). The Kruskal–Wallis test was employed to compare WOMAC scores according to CSI categories. A multivariate analysis was conducted to identify predictors of functional ability, with the WOMAC score as the dependent variable and the independent variables including pain-related indices such as PCS, PDQ, and CSI, along with Kellgren–Lawrence (K-L) grading and demographic characteristics. Results. This study included 149 patients (76.5% female; mean age 71.5 years; mean duration of pain 8.1 years). In total, 23.5% exhibited NP, 30.9% showed PC, and 33.6% had CS. Higher mean values of WOMAC were correlated with CSI categories (p < 0.0001). WOMAC showed a significant relationship with CSI (rho = 0.791; p < 0.0001), PDQ (rho = 0.766; p < 0.0001), and PCS (rho = 0.536; p < 0.0001). In the multiple regression analysis, WOMAC was independently associated with CSI (p < 0.0001), PDQ (p < 0.0001), and PC (p = 0.0001). No association was observed between the K-L grading and the other variables. Conclusions. A reduced functional capacity in patients with knee OA is correlated with the presence of NP, PC and CS, without being significantly associated with radiological damage. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

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21 pages, 702 KiB

Open AccessReview

The Role of Artificial Intelligence and Emerging Technologies in Advancing Total Hip Arthroplasty

by Luca Andriollo, Aurelio Picchi, Giulio Iademarco, Andrea Fidanza, Loris Perticarini, Stefano Marco Paolo Rossi, Giandomenico Logroscino and Francesco Benazzo

J. Pers. Med. 2025, 15(1), 21; https://doi.org/10.3390/jpm15010021 - 9 Jan 2025

Abstract

Total hip arthroplasty (THA) is a widely performed surgical procedure that has evolved significantly due to advancements in artificial intelligence (AI) and robotics. As demand for THA grows, reliable tools are essential to enhance diagnosis, preoperative planning, surgical precision, and postoperative rehabilitation. AI [...] Read more.

Total hip arthroplasty (THA) is a widely performed surgical procedure that has evolved significantly due to advancements in artificial intelligence (AI) and robotics. As demand for THA grows, reliable tools are essential to enhance diagnosis, preoperative planning, surgical precision, and postoperative rehabilitation. AI applications in orthopedic surgery offer innovative solutions, including automated hip osteoarthritis (OA) diagnosis, precise implant positioning, and personalized risk stratification, thereby improving patient outcomes. Deep learning models have transformed OA severity grading and implant identification by automating traditionally manual processes with high accuracy. Additionally, AI-powered systems optimize preoperative planning by predicting the hip joint center and identifying complications using multimodal data. Robotic-assisted THA enhances surgical precision with real-time feedback, reducing complications such as dislocations and leg length discrepancies while accelerating recovery. Despite these advancements, barriers such as cost, accessibility, and the steep learning curve for surgeons hinder widespread adoption. Postoperative rehabilitation benefits from technologies like virtual and augmented reality and telemedicine, which enhance patient engagement and adherence. However, limitations, particularly among elderly populations with lower adaptability to technology, underscore the need for user-friendly platforms. To ensure comprehensiveness, a structured literature search was conducted using PubMed, Scopus, and Web of Science. Keywords included “artificial intelligence”, “machine learning”, “robotics”, and “total hip arthroplasty”. Inclusion criteria emphasized peer-reviewed studies published in English within the last decade focusing on technological advancements and clinical outcomes. This review evaluates AI and robotics’ role in THA, highlighting opportunities and challenges and emphasizing further research and real-world validation to integrate these technologies into clinical practice effectively. Full article

(This article belongs to the Special Issue Artificial Intelligence for Personalized Medicine: Bridging Innovative Technologies and Patient-Centric Care)

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15 pages, 11124 KiB

Open AccessArticle

Intraoperative Augmented Reality for Vitreoretinal Surgery Using Edge Computing

by Run Zhou Ye and Raymond Iezzi

J. Pers. Med. 2025, 15(1), 20; https://doi.org/10.3390/jpm15010020 - 6 Jan 2025

Abstract

Purpose: Augmented reality (AR) may allow vitreoretinal surgeons to leverage microscope-integrated digital imaging systems to analyze and highlight key retinal anatomic features in real time, possibly improving safety and precision during surgery. By employing convolutional neural networks (CNNs) for retina vessel segmentation, [...] Read more.

Purpose: Augmented reality (AR) may allow vitreoretinal surgeons to leverage microscope-integrated digital imaging systems to analyze and highlight key retinal anatomic features in real time, possibly improving safety and precision during surgery. By employing convolutional neural networks (CNNs) for retina vessel segmentation, a retinal coordinate system can be created that allows pre-operative images of capillary non-perfusion or retinal breaks to be digitally aligned and overlayed upon the surgical field in real time. Such technology may be useful in assuring thorough laser treatment of capillary non-perfusion or in using pre-operative optical coherence tomography (OCT) to guide macular surgery when microscope-integrated OCT (MIOCT) is not available. Methods: This study is a retrospective analysis involving the development and testing of a novel image-registration algorithm for vitreoretinal surgery. Fifteen anonymized cases of pars plana vitrectomy with epiretinal membrane peeling, along with corresponding preoperative fundus photographs and optical coherence tomography (OCT) images, were retrospectively collected from the Mayo Clinic database. We developed a TPU (Tensor-Processing Unit)-accelerated CNN for semantic segmentation of retinal vessels from fundus photographs and subsequent real-time image registration in surgical video streams. An iterative patch-wise cross-correlation (IPCC) algorithm was developed for image registration, with a focus on optimizing processing speeds and maintaining high spatial accuracy. The primary outcomes measured were processing speed in frames per second (FPS) and the spatial accuracy of image registration, quantified by the Dice coefficient between registered and manually aligned images. Results: When deployed on an Edge TPU, the CNN model combined with our image-registration algorithm processed video streams at a rate of 14 FPS, which is superior to processing rates achieved on other standard hardware configurations. The IPCC algorithm efficiently aligned pre-operative and intraoperative images, showing high accuracy in comparison to manual registration. Conclusions: This study demonstrates the feasibility of using TPU-accelerated CNNs for enhanced AR in vitreoretinal surgery. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

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11 pages, 2369 KiB

Open AccessArticle

Preference for On-Demand Fexuprazan Therapy in Gastroesophageal Reflux Disease: A Prospective Cohort Study

by Byung Wook Jung, Chan Hyuk Park and Chang Soo Eun

J. Pers. Med. 2025, 15(1), 19; https://doi.org/10.3390/jpm15010019 - 6 Jan 2025

Abstract

Introduction: Maintenance therapy is crucial in managing and preventing symptom relapse in gastroesophageal reflux disease (GERD), with continuous and on-demand therapy being the common approaches. However, maintenance therapy using potassium-competitive acid blockers (P-CABs), such as fexuprazan, remains incompletely evaluated. Methods: This single-center, single-arm, [...] Read more.

Introduction: Maintenance therapy is crucial in managing and preventing symptom relapse in gastroesophageal reflux disease (GERD), with continuous and on-demand therapy being the common approaches. However, maintenance therapy using potassium-competitive acid blockers (P-CABs), such as fexuprazan, remains incompletely evaluated. Methods: This single-center, single-arm, prospective cohort study enrolled individuals with weekly heartburn or acid regurgitation and confirmed erosive esophagitis. The participants received 40 mg fexuprazan daily for 4 weeks as initial therapy, followed by 4 weeks of maintenance therapy. Patients chose either continuous or on-demand therapy for maintenance, according to their preference. The primary endpoint was the proportion of patients selecting on-demand therapy. The symptom scores were assessed using the GERD questionnaire (GERD-Q) and patient assessment of upper-gastrointestinal-disorders symptoms questionnaire (PAGI-SYM). Results: The 31 included participants showed a significant reduction in symptom scores after initial treatment (baseline vs. 4-week: GERD-Q, 9.0 vs. 6.5, p < 0.001; PAGI-SYM, 29.0 vs. 10.8, p < 0.001). Twenty-one (67.7%) patients chose on-demand therapy after initial treatment. The symptom scores did not differ significantly before and after maintenance therapy (4-week vs. 8-week: GERD-Q, 6.5 vs. 6.0, p = 0.225; PAGI-SYM, 10.8 vs. 9.0, p = 0.354). Although this relation was not significant, patients experiencing larger decreases in symptom scores tended to prefer on-demand therapy. After maintenance therapy, the symptom scores did not differ between continuous and on-demand therapy (GERD-Q, 5.3 vs. 6.3, p = 0.342; PAGI-SYM, 9.4 vs. 8.8, p = 0.611). Conclusions: Fexuprazan was effective as an initial and maintenance therapy in patients with GERD who showed typical symptoms. Approximately 68% of the patients preferred on-demand therapy as a maintenance treatment. Based on the patient’s preference for maintenance therapy, symptom control did not differ between continuous and on-demand therapy. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

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13 pages, 2186 KiB

Open AccessArticle

Stroke-SCORE: Personalizing Acute Ischemic Stroke Treatment to Improve Patient Outcomes

by Jessica Seetge, Balázs Cséke, Zsófia Nozomi Karádi, Edit Bosnyák and László Szapáry

J. Pers. Med. 2025, 15(1), 18; https://doi.org/10.3390/jpm15010018 - 4 Jan 2025

Abstract

Background/Objectives: Acute ischemic stroke (AIS) is a leading cause of disability and mortality worldwide. Despite advances in interventions such as thrombolysis (TL) and mechanical thrombectomy (MT), current treatment protocols remain largely standardized, focusing on general eligibility rather than individual patient characteristics. To [...] Read more.

Background/Objectives: Acute ischemic stroke (AIS) is a leading cause of disability and mortality worldwide. Despite advances in interventions such as thrombolysis (TL) and mechanical thrombectomy (MT), current treatment protocols remain largely standardized, focusing on general eligibility rather than individual patient characteristics. To address this gap, we introduce the Stroke-SCORE (Simplified Clinical Outcome Risk Evaluation), a predictive tool designed to personalize AIS management by providing data-driven, individualized recommendations to optimize treatment strategies and improve patient outcomes. Methods: The Stroke-SCORE was derived using retrospective data from 793 AIS patients admitted to the University of Pécs (February 2023–September 2024). Logistic regression analysis identified age, National Institutes of Health Stroke Scale (NIHSS) score at admission, and pre-morbid modified Rankin Scale (pre-mRS) score as key predictors of unfavorable outcomes at 90 days (defined as modified Rankin Scale [mRS] score > 2). Based on these predictors, a simplified risk score was developed to stratify patients into low-, moderate-, and high-risk groups, guiding treatment decisions on TL, MT, combination therapy (TL + MT), or standard care (SC). Internal validation was performed to assess the model’s predictive performance via receiver operating characteristic (ROC) analysis and isotonic regression calibration with bootstrapping. Results: The Stroke-SCORE was moderately positively correlated with a 90-day mRS score > 2 (odds ratio [OR] = 0.70, 95% confidence interval [CI]: 0.58–0.83, p < 0.001), with an area under the curve (AUC) of 0.86, a sensitivity and specificity of 79% and 81%, respectively, and an overall accuracy of 80%. Simulations indicated that personalized treatment guided by the Stroke-SCORE significantly reduced unfavorable outcomes. Conclusions: The Stroke-SCORE demonstrates strong predictive performance as a practical, data-driven approach for personalizing AIS treatment decisions. In the future, external, multicenter prospective validation is needed to confirm its applicability in real-world settings. Full article

(This article belongs to the Topic Diagnosis and Management of Acute Ischemic Stroke)

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16 pages, 3367 KiB

Open AccessArticle

Patient-Specific Variability in Interleukin-6 and Myeloperoxidase Responses in Osteoarthritis: Insights from Synthetic Data and Clustering Analysis

by Laura Jane Coleman, John L. Byrne, Stuart Edwards and Rosemary O’Hara

J. Pers. Med. 2025, 15(1), 17; https://doi.org/10.3390/jpm15010017 - 4 Jan 2025

Abstract

Objectives: This study investigated the inflammatory responses of fibroblast-like synoviocytes (FLS) isolated from osteoarthritis (OA) patients, stimulated with lipopolysaccharide (LPS) and interleukin-6 (IL-6). Both experimental and synthetic data were utilised to investigate the variability in IL-6 and myeloperoxidase (MPO) production and its implications [...] Read more.

Objectives: This study investigated the inflammatory responses of fibroblast-like synoviocytes (FLS) isolated from osteoarthritis (OA) patients, stimulated with lipopolysaccharide (LPS) and interleukin-6 (IL-6). Both experimental and synthetic data were utilised to investigate the variability in IL-6 and myeloperoxidase (MPO) production and its implications for OA pathogenesis. Methods: Synovial biopsies were obtained from OA patients undergoing joint replacement surgery. FLS were isolated, cultured, and stimulated with varying concentrations of LPS and IL-6. The production of IL-6 and MPO was measured using enzyme-linked immunosorbent assays (ELISA). Synthetic data generation techniques expanded the dataset to support comprehensive statistical analyses. Results: The patterns of inflammatory responses revealed distinct patient subgroups, highlighting individual variability. The integration of synthetic data with experimental observations validated their reliability and demonstrated dose-dependent differences in IL-6 and MPO production across patients. Conclusions: The results highlighted the importance of patient-specific factors in OA inflammation and demonstrated the utility of combining experimental and synthetic data to model individual variability. The results support the development of personalised treatment strategies in OA. Future research should include larger patient datasets and an exploration of molecular mechanisms underlying these responses. Full article

(This article belongs to the Section Mechanisms of Diseases)

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9 pages, 215 KiB

Open AccessBrief Report

Alopecia Areata Is Associated with an Increased Risk for Prediabetes and Obesity: A Nationwide Case—Control Study

by Yonit Wohl, Jacob Mashiah, Oberkovich Noy, Yarden Drutin, Shiraz Vered and Amir Ben-Tov

J. Pers. Med. 2025, 15(1), 16; https://doi.org/10.3390/jpm15010016 - 3 Jan 2025

Abstract

Background and Aims: Alopecia areata (AA) is a non-scarring inflammatory hair loss condition associated with various immune-mediated comorbidities. Prediabetes, characterized by elevated blood glucose levels not yet high enough to be classified as diabetes, significantly increases the risk of developing type 2 diabetes [...] Read more.

Background and Aims: Alopecia areata (AA) is a non-scarring inflammatory hair loss condition associated with various immune-mediated comorbidities. Prediabetes, characterized by elevated blood glucose levels not yet high enough to be classified as diabetes, significantly increases the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular complications. The associations between AA obesity and prediabetes have long been investigated in an attempt to identify preventable risk factors, yet the literature is relatively scarce and inconclusive. This study aimed to explore the association between AA, prediabetes, obesity, and T2DM in a large population cohort. Methods: All patients diagnosed with AA between 2005 and 2019 within Maccabi Healthcare Services (MHS) in Israel were compared with age-matched and gender-matched healthy controls for prediabetes, T2DM and obesity, using logistic regression models for all analyses. A total of 33,401 patients with AA and 66,802 controls were included in the analysis. Results: The prevalence of prediabetes was significantly higher in AA patients (26.3%) compared to controls (18.1%), with an odds ratio (OR) of 1.62. Obesity prevalence was also higher in AA patients (17.2% vs. 13.3%, OR 1.35). T2DM prevalence was similar between groups. Prediabetes prevalence notably increased with age in AA patients, especially in those aged 40 and older (OR 2.02). Discussion: The study highlights a significant association between prediabetes and alopecia areata, with prediabetes risk emerging prominently in AA patients. Obesity also showed a strong link with AA. These findings suggest the need for regular screening and early management of prediabetes and obesity in patients with AA to potentially mitigate associated health risks. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

12 pages, 1771 KiB

Open AccessArticle

Corrected Axial Length and Choroidal Thickness: A Correlation Analysis for Scientific Purposes

by Marco Gioia, Maddalena De Bernardo, Ferdinando Cione, Martina De Luca and Nicola Rosa

J. Pers. Med. 2025, 15(1), 15; https://doi.org/10.3390/jpm15010015 - 2 Jan 2025

Abstract

Purpose: Choroidal thickness (ChT) is an important measurement for evaluating eye and systemic disorders, but it is influenced by numerous elements, especially axial length (AL). It is known that the presence of a linear relationship between ChT and AL exists, but recently it [...] Read more.

Purpose: Choroidal thickness (ChT) is an important measurement for evaluating eye and systemic disorders, but it is influenced by numerous elements, especially axial length (AL). It is known that the presence of a linear relationship between ChT and AL exists, but recently it has been shown that the AL measurement obtained with the current optical biometry is not very precise and needs to be corrected. This study aimed to verify if a similar correlation also persists with this corrected AL (ALc). Methods: All subjects underwent a complete eye examination, including spectral domain optical coherence tomography (OCT) with enhanced depth image (EDI) mode and AL measurement with IOLMaster. After a normality check of the data, the correlations between ChT with AL and ALc were investigated through the Pearson correlation coefficient. p values < 0.05 were considered statistically significant. Results: In total, 100 eyes of 50 healthy patients were evaluated. The mean AL was 24.36 ± 1.23 mm and mean ALc was 24.25 ± 1.22 mm. The mean nasal ChT, subfoveal ChT, and temporal ChT were, respectively, 250.57 ± 93.93 µm, 307.18 ± 101.66 µm, and 313.72 ± 88.86 µm. A significant negative linear correlation was found by comparing both AL and ALc to ChT (all r < −0.500, all p < 0.050). The negative linear correlation was stronger between nasal ChT and both AL and ALc (all r = −0.581). Conclusions: Through OCT and optical biometry, we confirmed that a statistically significant correlation persists between ALc and ChT, equal to the uncorrected AL. On these bases, in ChT studies or protocols, we recommend stratifying population according to ALc because linear correlation is still present; however, the cut-off values should be changed according to the systematic errors in optical biometry. In addition, both AL and ChT changes should be evaluated according to ALc. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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12 pages, 1624 KiB

Open AccessArticle

Expression of Tissue Remodeling- and Inflammation-Related Factors During the Wound-Healing Process in Humans

by Dimitrios Vardakostas, Athanasios Moustogiannis, Zoe Garoufalia, Elli Karatza, Anastassios Philippou, Gregory Kouraklis, Michael Koutsilieris and Dimitrios Mantas

J. Pers. Med. 2025, 15(1), 14; https://doi.org/10.3390/jpm15010014 - 2 Jan 2025

Abstract

Background/Objectives: There is a growing interest in the research of wound healing mechanisms worldwide. Particular attention has been paid to the expression of tissue remodeling- and inflammation-related factors. Herein, we investigate the expression patterns of TGF-β1, IL-6, TNF-a, uPA, uPA receptors, MMP-2, [...] Read more.

Background/Objectives: There is a growing interest in the research of wound healing mechanisms worldwide. Particular attention has been paid to the expression of tissue remodeling- and inflammation-related factors. Herein, we investigate the expression patterns of TGF-β1, IL-6, TNF-a, uPA, uPA receptors, MMP-2, and MMP-9 through the four phases of the normal wound-healing process in humans. Methods: Twenty-two individuals presenting with a first episode of pilonidal sinus underwent surgical excision and the wound was left to heal by secondary intention. Sequential biopsies were collected on day 0 (operation), day 2 (inflammatory phase), day 9 (proliferative phase), and day 14 (tissue remodeling phase). The expression levels of the proteins were evaluated using reverse transcription–quantitative PCR. Statistical analyses were performed using GraphPad Prism software. One-way analysis of variance (ANOVA) with Dunn’s Multiple Comparison post hoc test was used. Results: The results showed statistically significant differences in the expressions of the factors during wound healing (p < 0.05). TGF-b1 increased on days 2 and 9. TNF-a increased on day 2 and then decreased on day 9. Il-6 was increased on day 2 and decreased on days 9 and 14. uPa mRNA increased up to day 9 but its receptor exhibited high expression throughout the observation time. Finally, MMP-2 mRNA expression increased on day 2 and declined on days 9 and 14, while MMP-9 was highly expressed until the 14th postoperative day. Conclusions: Each factor investigated in this study has an important and distinct role in the normal wound repair procedure. Further investigation is required to evaluate the tissue-specific regulation of these factors and their potential use as therapeutic targets or prognostic biomarkers in wound healing. Full article

(This article belongs to the Special Issue Clinical and Experimental Surgery in Personalized Molecular Medicine)

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15 pages, 8467 KiB

Open AccessCase Report

In Situ Fixation and Intertrochanteric Osteotomy for Severe Slipped Capital Femoral Epiphysis Following Femoral Neck Fracture: A Case Report with Application of Virtual Surgical Planning and 3D-Printed Patient-Specific Instruments

by Giovanni Trisolino, Grazia Chiara Menozzi, Alessandro Depaoli, Olaf Stefan Schmidt, Marco Ramella, Marianna Viotto, Marco Todisco, Massimiliano Mosca and Gino Rocca

J. Pers. Med. 2025, 15(1), 13; https://doi.org/10.3390/jpm15010013 - 1 Jan 2025

Abstract

Background: Femoral neck fractures are rare but serious injuries in children and adolescents, often resulting from high-energy trauma and prone to complications like avascular necrosis (AVN) and nonunion. Even rarer is the development of slipped capital femoral epiphysis (SCFE) following femoral neck [...] Read more.

Background: Femoral neck fractures are rare but serious injuries in children and adolescents, often resulting from high-energy trauma and prone to complications like avascular necrosis (AVN) and nonunion. Even rarer is the development of slipped capital femoral epiphysis (SCFE) following femoral neck fracture, which presents unique diagnostic and treatment challenges. SCFE can destabilize the femoral head, with severe cases requiring complex surgical interventions. Case presentation: This report details a case of a 15-year-old male with autism spectrum disorder (ASD) who developed severe SCFE one month after treatment for a Delbet type III femoral neck fracture. The condition was managed with an Imhäuser intertrochanteric osteotomy (ITO), in situ fixation (ISF), and osteochondroplasty (OChP), supported by virtual surgical planning (VSP) and 3D-printed patient-specific instruments (PSIs) for precise correction and fixation. Discussion: The surgery was completed without complications. Six months after the operation, the patient exhibited a pain-free, mobile hip with radiographic evidence of fracture healing and no signs of AVN. Functional outcomes were favorable despite rehabilitation challenges due to ASD. Conclusions: The Imhäuser ITO, combined with ISF and OChP, effectively addressed severe SCFE after femoral neck fracture, minimizing AVN risk. VSP and PSIs enhanced surgical accuracy and efficiency, demonstrating their value in treating rare and complex pediatric orthopedic conditions. Full article

(This article belongs to the Special Issue Orthopedic Trauma: New Perspectives and Innovative Techniques)

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8 pages, 775 KiB

Open AccessBrief Report

Descriptive Analysis of Patients Treated with Diroximel Fumarate and Dimethyl Fumarate—A Real-Life Experience

by Marina Blanco-Ruiz, Belén Sánchez-Rodríguez, Maria Luisa Ruiz-Franco, Emilio Molina Cuadrado, Francisco Sierra García and Carmen Muñoz Fernández

J. Pers. Med. 2025, 15(1), 12; https://doi.org/10.3390/jpm15010012 - 31 Dec 2024

Abstract

Background: Dimethyl fumarate (DMF) and diroximel fumarate (DRF) are two treatments used for multiple sclerosis (MS) that have been shown to be effective in controlling MS patients. DRF was introduced in 2019 with the aim of decreasing the gastrointestinal side effects caused by [...] Read more.

Background: Dimethyl fumarate (DMF) and diroximel fumarate (DRF) are two treatments used for multiple sclerosis (MS) that have been shown to be effective in controlling MS patients. DRF was introduced in 2019 with the aim of decreasing the gastrointestinal side effects caused by DMF. Few real-life studies verify the data provided in the clinical trials. Methods: A retrospective descriptive study was conducted on MS patients at the Hospital Universitario Torrecárdenas under treatment with DRF and DMF. Demographic, clinical, and analytical variables were studied and compared between groups. Results: A total of 60 patients were recruited, 30 with each treatment, observing similar baseline characteristics. Fewer gastrointestinal (GI) effects were observed in the DRF group, while more infections were detected in the DMF group. We recorded lower levels in the DRF group, with four cases of moderate-severe lymphopenia in the DRF group vs. none in the DMF group. In addition, we observed a decrease in lymphocytes after the change from DMF to DRF in patients with a change. Conclusions: Our real-life analysis of patients treated with DMF or DRF supports several studies’ findings regarding decreased GI side effects with DRF vs. DMF without decreasing efficacy. However, our data show a greater reduction in lymphocytes in patients with DRF compared to DMF, so more studies are necessary. Full article

(This article belongs to the Special Issue Clinical Updates and Challenges of Multiple Sclerosis and Related Disorders)

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2 pages, 140 KiB

Open AccessRetraction

RETRACTED: Chung et al. Long-Lasting Exendin-4-Loaded PLGA Nanoparticles Ameliorate Cerebral Ischemia/Reperfusion Damage in Diabetic Rats. J. Pers. Med. 2022, 12, 390

by Cheng-Hsun Chung, Shiu-Dong Chung, Yu-Hsuan Cheng, Chun-Pai Yang and Chiang-Ting Chien

J. Pers. Med. 2025, 15(1), 11; https://doi.org/10.3390/jpm15010011 - 31 Dec 2024

Abstract

The Journal retracts the article “Long-Lasting Exendin-4-Loaded PLGA Nanoparticles Ameliorate Cerebral Ischemia/Reperfusion Damage in Diabetic Rats” [...] Full article

(This article belongs to the Section Omics/Informatics)

21 pages, 353 KiB

Open AccessReview

The Constrained Disorder Principle Overcomes the Challenges of Methods for Assessing Uncertainty in Biological Systems

by Yaron Ilan

J. Pers. Med. 2025, 15(1), 10; https://doi.org/10.3390/jpm15010010 - 28 Dec 2024

Abstract

Different disciplines are developing various methods for determining and dealing with uncertainties in complex systems. The constrained disorder principle (CDP) accounts for the randomness, variability, and uncertainty that characterize biological systems and are essential for their proper function. Per the CDP, intrinsic unpredictability [...] Read more.

Different disciplines are developing various methods for determining and dealing with uncertainties in complex systems. The constrained disorder principle (CDP) accounts for the randomness, variability, and uncertainty that characterize biological systems and are essential for their proper function. Per the CDP, intrinsic unpredictability is mandatory for the dynamicity of biological systems under continuously changing internal and external perturbations. The present paper describes some of the parameters and challenges associated with uncertainty and randomness in biological systems and presents methods for quantifying them. Modeling biological systems necessitates accounting for the randomness, variability, and underlying uncertainty of systems in health and disease. The CDP provides a scheme for dealing with uncertainty in biological systems and sets the basis for using them. This paper presents the CDP-based second-generation artificial intelligence system that incorporates variability to improve the effectiveness of medical interventions. It describes the use of the digital pill that comprises algorithm-based personalized treatment regimens regulated by closed-loop systems based on personalized signatures of variability. The CDP provides a method for using uncertainties in complex systems in an outcome-based manner. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

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