All around suboptimal health — a joint position paper of the Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine
This article demonstrates advanced strategies in bio/medical sciences and healthcare focused on suboptimal health conditions in the frame-work of Predictive, Preventive and Personalised Medicine (3PM/PPPM). Potential benefits in healthcare systems and for society at large include but are not restricted to an improved life-quality of major populations and socio-economical groups, advanced professionalism of healthcare-givers and sustainable healthcare economy. Amongst others, following medical areas are proposed to strongly benefit from PPPM strategies applied to the identification and treatment of suboptimal health conditi...
Source: EPMA Journal - September 13, 2021 Category: International Medicine & Public Health Source Type: research

Diagnosing hospital bacteraemia in the framework of predictive, preventive and personalised medicine using electronic health records and machine learning classifiers
ConclusionsOur results provide cutting-edge metrics of interest in predictive medical models with values that exceed the medical practice threshold and previous results in the literature using classical modelling techniques in specific types of bacteraemia. Additionally, the consistency of results is reasserted because the three classifiers ’ importance ranking shows similar features that coincide with those that physicians use in their manual heuristics. Therefore, the efficacy of these machine learning techniques confirms their viability to assist in the aims of predictive and personalised medicine once the disease...
Source: EPMA Journal - August 31, 2021 Category: International Medicine & Public Health Source Type: research

Caution, “normal” BMI: health risks associated with potentially masked individual underweight—EPMA Position Paper 2021
AbstractAn increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised “normal” body weight and individually optimal weight. To this end, the basic principle of personalised medicine “one size does not fit all” has to be applied. Contextually, “normal” but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyl...
Source: EPMA Journal - August 17, 2021 Category: International Medicine & Public Health Source Type: research

Wrist actigraphic approach in primary, secondary and tertiary care based on the principles of predictive, preventive and personalised (3P) medicine
AbstractSleep quality and duration as well as activity-rest-cycles at individual level are crucial for maintaining physical and mental health. Although several methods do exist to monitor these parameters, optimal approaches are still under consideration and technological development. Wrist actigraphy is a non-invasive electro-physical method validated in the field of chronobiology to record movements and to allow for monitoring human activity-rest-cycles. Based on the continuous recording of motor activity and light exposure, actigraphy provides valuable information about the quality and quantity of the sleep –wake ...
Source: EPMA Journal - August 6, 2021 Category: International Medicine & Public Health Source Type: research

Endothelin-1 axes in the framework of predictive, preventive and personalised (3P) medicine
This article provides an in-depth analysis of the involvement of ET-1 and related regulatory pathways in physiological and pathophysiological processes and estimates its ca pacity asa predictor of ageing and related pathologies,a sensor of lifestyle quality and progression of suboptimal health conditions to diseases for their targeted preventionand as a potent target for cost-effective treatments tailored to the person. (Source: EPMA Journal)
Source: EPMA Journal - August 4, 2021 Category: International Medicine & Public Health Source Type: research

Targeting phytoprotection in the COVID-19-induced lung damage and associated systemic effects —the evidence-based 3PM proposition to mitigate individual risks
AbstractThe risks related to the COVID-19 are multi-faceted including but by far not restricted to the following: direct health risks by poorly understood effects of COVID-19 infection, overloaded capacities of healthcare units, restricted and slowed down care of patients with non-communicable disorders such as cancer, neurologic and cardiovascular pathologies, among others; social risks —restricted and broken social contacts, isolation, professional disruption, explosion of aggression in the society, violence in the familial environment; mental risks—loneliness, helplessness, defenceless, depressions; and econ...
Source: EPMA Journal - August 3, 2021 Category: International Medicine & Public Health Source Type: research

Complex analysis of the personalized pharmacotherapy in the management of COVID-19 patients and suggestions for applications of predictive, preventive, and personalized medicine attitude
ConclusionWe recommend that  particularly for patients with comorbidities to avoid serious DDIs, the predictive, preventive, and personalized medicine (PPPM, 3 PM) strategies have to be applied for COVID-19 treatment, and genetic tests should be performed for drugs with actionable pharmacogenes, especially in some ethnic g roups with a higher frequency of functional variations, as our analysis showed. We also suggest that drugs associated with higher ethnic genetic differences should be given priority in future pharmacogenetic studies for COVID-19 management. To facilitate translation of our results int...
Source: EPMA Journal - July 16, 2021 Category: International Medicine & Public Health Source Type: research

Overview of omics biomarkers in pituitary neuroendocrine tumors to design future diagnosis and treatment strategies
AbstractPituitary neuroendocrine tumors (PitNETs) are the second most common type of intracranial neoplasia. Since their manifestation usually causes hormone hypersecretion, effective management of PitNETs is indisputably necessary. Most of the non-functioning PitNETs pose a real challenge in diagnosis as they grow without giving any signs. Despite the good response of prolactinomas to dopamine agonist therapy, some of these tumors persist or recur; also, about 20% are resistant and 10% behave aggressively. The silent corticotropinomas may not cause symptoms until the tumor mass causes a complication. In somatotropinomas, ...
Source: EPMA Journal - June 26, 2021 Category: International Medicine & Public Health Source Type: research

Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine
This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach. (Source: EPMA Journal)
Source: EPMA Journal - June 8, 2021 Category: International Medicine & Public Health Source Type: research

Positive influence of gut microbiota on the effects of Korean red ginseng in metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial
ConclusionIn this study, the effects of KRG on the glucose metabolism in MS patients were influenced by the relative abundances of gut microbial population and differed according to the individual enterotype. Therefore,  the analysis of enterotype categories is considered to be helpful in predicting the effectiveness of KRG on glucose homeostasis of MS patients individually. This will further help to decide on the appropriate treatment strategy for MS, in compliance with the perspective of PPPM. (Source: EPMA Journal)
Source: EPMA Journal - June 3, 2021 Category: International Medicine & Public Health Source Type: research

The interplay between the vaginal microbiome and innate immunity in the focus of predictive, preventive, and personalized medical approach to combat HPV-induced cervical cancer
AbstractHPVs representing the most common sexually transmitted disease are a group of carcinogenic viruses with different oncogenic potential. The immune system and the vaginal microbiome represent the modifiable and important risk factors in HPV-induced carcinogenesis. HPV infection significantly increases vaginal microbiome diversity, leading to gradual increases in the abundance of anaerobic bacteria and consequently the severity of cervical dysplasia. Delineation of the exact composition of the vaginal microbiome and immune environment before HPV acquisition, during persistent/progressive infections and after clearance...
Source: EPMA Journal - May 18, 2021 Category: International Medicine & Public Health Source Type: research

Flavonoids as an effective sensitizer for anti-cancer therapy: insights into multi-faceted mechanisms and applicability towards individualized patient profiles
This article analyzes most recently updated data focused on the potent capacity of flavonoids to promote anti-cancer therapeutic effects and interprets all the collected research achievements in the frame-work of predictive, preventive, and personalized (3P) medicine. Main pillars considered are:- Predictable anti-neoplastic, immune-modulating, drug-sensitizing effects;- Targeted molecular pathways to improve therapeutic outcomes by increasing sensitivity of cancer cells and reversing their resistance towards currently applied therapeutic modalities. (Source: EPMA Journal)
Source: EPMA Journal - May 17, 2021 Category: International Medicine & Public Health Source Type: research

Metabo-tip: a metabolomics platform for lifestyle monitoring supporting the development of novel strategies in predictive, preventive and personalised medicine
ConclusionMetabo-tip analysis may have a large number of practical applications due to its analytical power, non-invasive character and the potential of frequent sampling, especially regarding the individualised monitoring of specific lifestyle and influencing factors. The extraordinarily rich individualised metabolomics data provided by metabo-tip offer direct access to individual metabolic activities and will thus support predictive preventive personalised medicine. (Source: EPMA Journal)
Source: EPMA Journal - May 4, 2021 Category: International Medicine & Public Health Source Type: research

Periodontal health related –inflammatory and metabolic profiles of patients with end-stage renal disease: potential strategy for predictive, preventive, and personalized medicine
AbstractObjectivesTo compare the periodontal health related –inflammatory and metabolic differences between patients with end-stage renal disease (ESRD) and healthy controls (HC), and to identify potential biomarkers in gingival crevicular fluid (GCF) and serum of ESRD patients for predictive, preventive, and personalized medicine (PPPM).MethodsPatients with ESRD (ESRD group;n = 52) and healthy controls (HC group;n = 44) were recruited. Clinical periodontal parameters were recorded. The differential metabolites in the GCF and serum were identified by liquid chromatography/mass spectrometry...
Source: EPMA Journal - April 22, 2021 Category: International Medicine & Public Health Source Type: research

Blood transcriptome profiling as potential biomarkers of suboptimal health status: potential utility of novel biomarkers for predictive, preventive, and personalized medicine strategy
AbstractThe early identification of Suboptimal Health Status (SHS) creates a window opportunity for the predictive, preventive, and personalized medicine (PPPM) in chronic diseases. Previous studies have observed the alterations in several mRNA levels in SHS individuals. As a promising “omics” technology offering comprehension of genome structure and function at RNA level, transcriptome profiling can provide innovative molecular biomarkers for the predictive identification and targeted prevention of SHS. To explore the potential biomarkers, biological functions, and signalling pathways involved in SHS, an RNA s...
Source: EPMA Journal - April 20, 2021 Category: International Medicine & Public Health Source Type: research

Making a complex dental care tailored to the person: population health in focus of predictive, preventive and personalised (3P) medical approach
AbstractAn evident underestimation of the targeted prevention of dental diseases is strongly supported by alarming epidemiologic statistics globally. For example, epidemiologists demonstrated 100% prevalence of dental caries in the Russian population followed by clinical manifestation of periodontal diseases. Inadequately provided oral health services in populations are caused by multi-factorial deficits including but not limited to low socio-economic status of affected individuals, lack of insurance in sub-populations, insufficient density of dedicated medical units. Another important aspect is the “participatory&rd...
Source: EPMA Journal - April 19, 2021 Category: International Medicine & Public Health Source Type: research

Education for future biobankers - The  state-of-the-art and outlook
AbstractBiobanking as a quickly growing branch of personalised medicine has undergone enormous progress during last two decades. Nowadays it is a well developed and structured multidisciplinary field that reflects developments and advances of biomedical research based on principles of predictive, preventive and personalised medicine (PPPM/3PM). All these trends in PPPM progress have to be translated into practice and education of new generation of scientists and healthcare givers. The importance of biobanks for multitasking research, personalised treatment, and health care systems was emphasised by many scientists and heal...
Source: EPMA Journal - March 10, 2021 Category: International Medicine & Public Health Source Type: research

Health screening program revealed risk factors associated with development and progression of papillomacular bundle defect
AbstractBackground/aimsThe papillomacular bundle (PMB) area is an important anatomical site associated with central vision. As preventive medicine and health screening examinations are now becoming commonplace, the incidental detection of papillomacular bundle defect (PMBD) on fundus photography has been increasing. However, clinical significance of incidental PMBD has not been well documented to date. Thus, through long-term and longitudinal observation, we aimed to investigate the risk factors for the development and progression of PMBD and its predictive role associated with systemic diseases and glaucoma.MethodsThis lo...
Source: EPMA Journal - March 4, 2021 Category: International Medicine & Public Health Source Type: research

Mitochondrial impairments in aetiopathology of multifactorial diseases: common origin but individual outcomes in context of 3P medicine
AbstractMitochondrial injury plays a key role in the aetiopathology of multifactorial diseases exhibiting a “vicious circle” characteristic for pathomechanisms of the mitochondrial and multi-organ damage frequently developed in a reciprocal manner. Although the origin of the damage is common (uncontrolled ROS release, diminished energy production and extensive oxidative stress to life-important biomol ecules such as mtDNA and chrDNA), individual outcomes differ significantly representing a spectrum of associated pathologies including but not restricted to neurodegeneration, cardiovascular diseases and cancers. ...
Source: EPMA Journal - March 4, 2021 Category: International Medicine & Public Health Source Type: research

Optical coherence tomographic patterns in patients with retinal vein occlusion and macular edema treated by ranibizumab: a predictive and personalized approach
ConclusionThe effectiveness of IVI of ranibizumab depends on baseline morphological and functional changes. The obtained mathematical model allows for predicting the outcomes of therapy, determining individualized algorithms to increase the  treatment effectiveness and to prevent low vision that corresponds to the principles of predictive, preventive, and personalized medicine. (Source: EPMA Journal)
Source: EPMA Journal - March 3, 2021 Category: International Medicine & Public Health Source Type: research

Human growth hormone proteoform pattern changes in pituitary adenomas: Potential biomarkers for 3P medical approaches
ConclusionThese findings provide the first hGH proteoform pattern changes in GH-secreting pituitary adenoma tissues compared to control pituitary tissues, and the status of partial PTMs in hGH proteoforms. Those data provide in-depth insights into biological roles of hGH in GH-related diseases, and identify hGH proteoform pattern biomarkers for treatment of a GH-secreting pituitary adenoma in the context of 3P medicine –predictive diagnostics, targeted prevention, and personalization of medical services. (Source: EPMA Journal)
Source: EPMA Journal - March 3, 2021 Category: International Medicine & Public Health Source Type: research

Challenging management of severe chronic disorders in acute pandemic situation: Chronic liver disease under COVID-19 pandemic as the proof-of-principle model to orchestrate the measures in 3PM context
AbstractChronic liver disease management is a comprehensive approach requiring multi-professional expertise and well-orchestrated healthcare measures thoroughly organized by responsible medical units. Contextually, the corresponding multi-faceted chain of healthcare events is likely to be severely disturbed or even temporarily broken under the force majeure conditions such as global pandemics. Consequently, the chronic liver disease is highly representative for the management of any severe chronic disorder under lasting pandemics with unprecedented numbers of acutely diseased persons who, together with the chronically sick...
Source: EPMA Journal - March 3, 2021 Category: International Medicine & Public Health Source Type: research

Cultural bias in motor function patterns: Potential relevance for predictive, preventive, and personalized medicine
ConclusionsOur results support the existence of a population-specific bias in motor function patterns in young healthy adults. This needs to be considered when motor function is assessed and used for clinical decisions, especially for personalized predictive and preventive medical purposes. The bias affected only the performance of specific items and parameters and is not fully explained by population-specific ethnic differences in body stature. It may be partially explained as cultural bias related to motor habits. Observed effects were small but are expected to be larger in a non-controlled cross-cultural application of ...
Source: EPMA Journal - March 3, 2021 Category: International Medicine & Public Health Source Type: research

Intestinal alkaline phosphatase modulation by food components: predictive, preventive, and personalized strategies for novel treatment options in chronic kidney disease
AbstractAlkaline phosphatase (AP) is a ubiquitous membrane –bound glycoprotein that catalyzes phosphate monoesters’ hydrolysis from organic compounds, an essential process in cell signaling. Four AP isozymes have been described in humans, placental AP, germ cell AP, tissue nonspecific AP, and intestinal AP (IAP). IAP plays a crucial role in gut microbia l homeostasis, nutrient uptake, and local and systemic inflammation, and its dysfunction is associated with persistent inflammatory disorders. AP is a strong predictor of mortality in the general population and patients with cardiovascular and chronic kidney dis...
Source: EPMA Journal - November 18, 2020 Category: International Medicine & Public Health Source Type: research

Infections of the lung: a predictive, preventive and personalized perspective through the lens of evolution, the emergence of SARS-CoV-2 and its pathogenesis
AbstractThe long evolutionary battle between humans and pathogens has played an important role in shaping the current network of host-pathogen interactions. Each organ brings new challenges from the perspective of a pathogen to establish a suitable niche for survival while subverting the protective mechanisms of the host. Lungs, the organ for oxygen exchange, have been an easy target for pathogens due to its accessibility. The organ has evolved diverse capabilities to provide the flexibility required for an organism ’s health and at the same time maintain protective functionality to prevent and resolve assault by pat...
Source: EPMA Journal - November 13, 2020 Category: International Medicine & Public Health Source Type: research

Voice perturbations under the stress overload in young individuals: phenotyping and suboptimal health as predictors for cascading pathologies
AbstractVerbal communication is one of the most sophisticated human motor skills reflecting both —the mental and physical health of an individual. Voice parameters and quality changes are usually secondary towards functional and/or structural laryngological alterations under specific systemic processes, syndrome and pathologies. These include but are not restricted to dry mouth and Sicca synd romes, body dehydration, hormonal alterations linked to pubertal, menopausal, and andropausal status, respiratory disorders, gastrointestinal reflux, autoimmune diseases, endocrinologic disorders, underweight versus overweight a...
Source: EPMA Journal - November 12, 2020 Category: International Medicine & Public Health Source Type: research

Induced sputum metabolomic profiles and oxidative stress are associated with chronic obstructive pulmonary disease (COPD) severity: potential use for predictive, preventive, and personalized medicine
This study thus aimed to reveal the role of induced sputum metabolomics in predicting COPD severity. In this pilot study, a total of 20 COPD patients were included. The induced sputum metabolites were assayed using a liquid chromatography-mass spectrometry (LC-MS/MS) system. Five oxidative stress products (myeloperoxidase (MPO), superoxide dismutase (SOD), glutathione (GSH), neutrophil elastase (NE), and 8-iso-PGF2 α) in induced sputum were measured by ELISA, and the metabolomic profiles were distinguished by principal component analysis (PCA) and orthogonal projections to latent structures discriminant analysis (OPL...
Source: EPMA Journal - November 4, 2020 Category: International Medicine & Public Health Source Type: research

Cell-free nucleic acid patterns in disease prediction and monitoring —hype or hope?
This article highlights the involvement of circulating CFNAs in local and systemic processes dealing with the question, whether specific patterns of CFNAs in blood, their detection, quantity and quality (such as  their methylation status) might be instrumental to predict a disease development/progression and could be further utilised for accompanying diagnostics, targeted prevention, creation of individualised therapy algorithms, therapy monitoring and prognosis. Presented considerations conform with princ iples of 3P medicine and serve for improving individual outcomes and cost efficacy of medical services provided t...
Source: EPMA Journal - October 29, 2020 Category: International Medicine & Public Health Source Type: research

Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status
AbstractBackgroundSuboptimal health status (SHS) is a reversible state between ideal health and illness and it can be effectively reversed by risk prediction, disease prevention, and personalized medicine under the global background of predictive, preventive, and personalized medicine (PPPM) concepts. More and more Chinese nurses have been troubled by psychological symptoms (PS). The correlation between PS and SHS is unclear in nurses. The purpose of current study is to investigate the prevalence of SHS and PS in Chinese nurses and the relationship between SHS and PS along with predisposing factors as well as to discuss th...
Source: EPMA Journal - October 14, 2020 Category: International Medicine & Public Health Source Type: research

Quantitative proteomics revealed energy metabolism pathway alterations in human epithelial ovarian carcinoma and their regulation by the antiparasite drug ivermectin: data interpretation in the context of 3P medicine
ConclusionsOur findings revealed that the Warburg and reverse Warburg effects coexisted in human ovarian cancer tissues, provided the first multiomics-based molecular alteration spectrum of ovarian cancer energy metabolism pathways (aerobic glycolysis, Kreb ’s cycle, oxidative phosphorylation, and lactate shuttle), and demonstrated that the antiparasite drug ivermectin effectively regulated these changed molecules in energy metabolism pathways and had strong capability to inhibit cell proliferation and cell cycle progression and promote cell apoptosi s in ovarian cancer cells. The observed molecular changes in energy...
Source: EPMA Journal - October 10, 2020 Category: International Medicine & Public Health Source Type: research

Endothelial progenitor cells as the target for cardiovascular disease prediction, personalized prevention, and treatments: progressing beyond the state-of-the-art
AbstractStimulated by the leading mortalities of cardiovascular diseases (CVDs), various types of cardiovascular biomaterials have been widely investigated in the past few decades. Although great therapeutic effects can be achieved by bare metal stents (BMS) and drug-eluting stents (DES) within months or years, the long-term complications such as late thrombosis and restenosis have limited their further applications. It is well accepted that rapid endothelialization is a promising approach to eliminate these complications. Convincing evidence has shown that endothelial progenitor cells (EPCs) could be mobilized into the da...
Source: EPMA Journal - September 20, 2020 Category: International Medicine & Public Health Source Type: research

10th Anniversary of the European Association for Predictive, Preventive and Personalised (3P) Medicine  - EPMA World Congress Supplement 2020
AbstractIn 2019, the EPMA celebrated its 10th anniversary at the 5th World Congress in Pilsen, Czech Republic. The history of the International Professional Network dedicated to Predictive, Preventive and Personalised Medicine  (PPPM / 3PM) is rich in achievements. Facing the coronavirus COVID-19 pandemic it is getting evident globally that the predictive approach, targeted prevention and personalisation of medical services is the optimal paradigm in healthcare demonstrating the high potential to save lives and to bene fit the society as a whole. The EPMA World Congress Supplement 2020 highlights advances in...
Source: EPMA Journal - August 18, 2020 Category: International Medicine & Public Health Source Type: research

REM sleep loss –induced elevated noradrenaline could predispose an individual to psychosomatic disorders: a review focused on proposal for prediction, prevention, and personalized treatment
AbstractHistorically and traditionally, it is known that sleep helps in maintaining healthy living. Its duration varies not only among individuals but also in the same individual depending on circumstances, suggesting it is a dynamic and personalized physiological process. It has been divided into rapid eye movement sleep (REMS) and non-REMS (NREMS). The former is unique that adult humans spend the least time in this stage, when although one is physically asleep, the brain behaves as if awake, the dream state. As NREMS is a pre-requisite for appearance of REMS, the latter can be considered a predictive readout of sleep qua...
Source: EPMA Journal - August 12, 2020 Category: International Medicine & Public Health Source Type: research

Integration of quantitative phosphoproteomics and transcriptomics revealed phosphorylation-mediated molecular events as useful tools for a potential patient stratification and personalized treatment of human nonfunctional pituitary adenomas
ConclusionsThis study provided the first large-scale phosphoprotein profiling and phosphorylation-related signaling pathway network alterations in human NFPA tissues. Further, overlapping analysis of phosphoproteins and invasive DEGs revealed the phosphorylation-mediated signaling pathway network changes in invasive NFPAs. These findings are the precious resource for in-depth insight into the molecular mechanisms of NFPAs, as well as for the discovery of effective phosphoprotein biomarkers and therapeutic targets for invasive NFPAs. (Source: EPMA Journal)
Source: EPMA Journal - August 12, 2020 Category: International Medicine & Public Health Source Type: research

Optimal multiparametric set-up modelled for best survival outcomes in palliative treatment of liver malignancies: unsupervised machine learning and 3  PM recommendations
In conclusion, multi-faceted cancer control within the palliative care of liver malig nancies is crucial for improved disease outcomes including individualised patient profiling, predictive models and implementation of corresponding cost-effective risks mitigating measures detailed in the paper. The “proof-of-principle” model is presented. (Source: EPMA Journal)
Source: EPMA Journal - August 9, 2020 Category: International Medicine & Public Health Source Type: research

Insomnia and obstructive sleep apnea as potential triggers of dementia: is personalized prediction and prevention of the pathological cascade applicable?
DiscussionCurrently, the general medical consensus has poorly addressed the role of sleep disorders in exacerbating the risk of dementia. Critically, studies such as the present one emphasizes that the treatment of sleep disorders could be one the preventive measures to evade or to improve dementia symptoms. Additionally, elderly individuals often manifest different sleep deficiency symptoms than younger ones. Given this, an improved age-specific categorization and evaluation methods for sleep deficiency need to be implemented in diagnosing dementia in order to enable personalized assessments and treatments. Collectively, ...
Source: EPMA Journal - July 29, 2020 Category: International Medicine & Public Health Source Type: research

COVID-19 what have we learned? The rise of social machines and connected devices in pandemic management following the concepts of predictive, preventive and personalized medicine
ConclusionInadequate data for risk assessment on speed and urgency of COVID-19, combined with increased globalization of human society, led to the rapid spread of COVID-19. Despite an abundance of digital methods that could be used in slowing or stopping COVID-19 and future pandemics, the world remains unprepared, and lessons have not been learned from previous cases of pandemics. We present a summary of predictive, preventive and personalized digital methods that could be deployed fast to help with the COVID-19 and future pandemics. (Source: EPMA Journal)
Source: EPMA Journal - July 29, 2020 Category: International Medicine & Public Health Source Type: research

Flavonoids against the Warburg phenotype —concepts of predictive, preventive and personalised medicine to cut the Gordian knot of cancer cell metabolism
AbstractThe Warburg effect is characterised by increased glucose uptake and lactate secretion in cancer cells resulting from metabolic transformation in tumour tissue. The corresponding molecular pathways switch from oxidative phosphorylation to aerobic glycolysis, due to changes in glucose degradation mechanisms known as the ‘Warburg reprogramming’ of cancer cells. Key glycolytic enzymes, glucose transporters and transcription factors involved in the Warburg transformation are frequently dysregulated during carcinogenesis considered as promising diagnostic and prognostic markers as well as treatment targets. F...
Source: EPMA Journal - July 29, 2020 Category: International Medicine & Public Health Source Type: research

Identification of pathology-specific regulators of m 6 A RNA modification to optimize lung cancer management in the context of predictive, preventive, and personalized medicine
ConclusionThis study provided the first view of the pathology-specific regulators of m6A RNA modification in lung cancers and identified the three-m6A-regulator signature (KIAA1429, METTL3, and IGF2BP1) as an independent prognostic model to classify lung cancers into high- and low-risk groups for patient stratification, prognostic assessment, and personalized treatment toward PPPM in lung cancers. (Source: EPMA Journal)
Source: EPMA Journal - July 28, 2020 Category: International Medicine & Public Health Source Type: research

Prostate cancer management: long-term beliefs, epidemic developments in the early twenty-first century and 3PM dimensional solutions
AbstractIn the early twenty-first century, societies around the world are facing the paradoxal epidemic development of PCa as a non-communicable disease. PCa is the most frequently diagnosed cancer for men in several countries such as the USA. Permanently improving diagnostics and treatments in the PCa management causes an impressive divergence between, on one hand, permanently increasing numbers of diagnosed PCa cases and, on the other hand, stable or even slightly decreasing mortality rates. Still, aspects listed below are waiting for innovate solutions in the context of predictive approaches, targeted prevention and per...
Source: EPMA Journal - June 25, 2020 Category: International Medicine & Public Health Source Type: research

Differences in cohort study data affect external validation of artificial intelligence models for predictive diagnostics of dementia - lessons for translation into clinical practice
In conclusion, this study exposes challenges in external validation of AI models on cohort study data and is one of the rare cases in the neurology field in which such external validation was performed. The presented model represents a proof of concept that reliable models for personalized predictive diagnostics are feasible, which, in turn, could lead to adequate disease prevention and hereby enable the PPPM paradigm in the dementia field. (Source: EPMA Journal)
Source: EPMA Journal - June 21, 2020 Category: International Medicine & Public Health Source Type: research

A risk model of prenatal screening markers in first trimester for predicting hypertensive disorders of pregnancy
ConclusionThe use of prenatal screening markers during early pregnancy can identify fetal aneuploidy and can also predict HDPs. The development of innovative screening strategies for gravidas and the targeted prevention of HDPs in high-risk gravidas are essential for perinatal care and early intervention, thus creating significant opportunities for predictive and preventive personalized medicine. In our study, we found that the combination of a series of prenatal screening markers in early pregnancy is better than a single marker; our data clearly demonstrate the diagnostic value of combining PAPP-A, free β-hCG, and N...
Source: EPMA Journal - June 18, 2020 Category: International Medicine & Public Health Source Type: research

Comparative cerebrospinal fluid metabolites profiling in glioma patients to predict malignant transformation and leptomeningeal metastasis with a potential for preventive personalized medicine
In this study, we examined whether cerebrospinal fluid (CSF) metabolome profiles can reflect glioma grade, difference with non-glial tumor, and LM status. We selected 32 CSF samples from glioma patients, and compared them with 10 non-tumor control and seven non-glial brain tumor (medulloblastoma) samples. A total of 10,408 low-mass ions (LMIs) were detected as a candidate of metabolites using mass spectrometry, and representative LMIs were identified via the Human Metabolome Database. Grade IV gliomas showed eight LMIs, including acetic acid, of higher levels (summed sensitivity and specificity> 180%) than grade III gli...
Source: EPMA Journal - June 17, 2020 Category: International Medicine & Public Health Source Type: research

Biobanks in the era of big data: objectives, challenges, perspectives, and innovations for predictive, preventive, and personalised medicine
AbstractBiobanking is entering the new era —era of big data. New technologies, techniques, and knowledge opened the potential of the whole domain of biobanking. Biobanks collect, analyse, store, and share the samples and associated data. Both samples and especially associated data are growing enormously, and new innovative approaches are r equired to handle samples and to utilize the potential of biobanking data. The data reached the quantity and quality of big data, and the scientists are facing the questions how to use them more efficiently, both retrospectively and prospectively with the aim to discover new preven...
Source: EPMA Journal - June 17, 2020 Category: International Medicine & Public Health Source Type: research

Genoprotective activities of plant natural substances in cancer and chemopreventive strategies in  the context of 3P medicine
AbstractSevere durable changes may occur to the DNA structure caused by exogenous and endogenous risk factors initiating the process of carcinogenesis. By evidence, a large portion of malignancies have been demonstrated as being preventable. Moreover, the targeted prevention of cancer onset is possible, due to unique properties of plant bioactive compounds. Although genoprotective effects of phytochemicals have been well documented, there is an evident lack of articles which would systematically present the spectrum of anticancer effects by phytochemicals, plant extracts, and plant-derived diet applicable to stratified pat...
Source: EPMA Journal - May 28, 2020 Category: International Medicine & Public Health Source Type: research

Anti-parasite drug ivermectin can suppress ovarian cancer by regulating lncRNA-EIF4A3-mRNA axes
AbstractRelevanceIvermectin, as an old anti-parasite drug, can suppress almost completely the growth of various human cancers, including ovarian cancer (OC). However, its anticancer mechanism remained to be further studied at the molecular levels. Ivermectin-related molecule-panel changes will serve a useful tool for its personalized drug therapy and prognostic assessment in OCs.PurposeTo explore the functional significance of ivermectin-mediated lncRNA-EIF4A3-mRNA axes in OCs and ivermectin-related molecule-panel for its personalized drug therapy monitoring.MethodsBased on our previous study, a total of 16 lncRNA expressi...
Source: EPMA Journal - May 27, 2020 Category: International Medicine & Public Health Source Type: research

Early decrease in blood platelet count is associated with poor prognosis in COVID-19 patients —indications for predictive, preventive, and personalized medical approach
ConclusionsIn the early stage, platelet count can dynamically reflect the pathophysiological changes in COVID-19 patients. Early decrease in platelet count was associated with mortality in patients with COVID-19. Causality, however, cannot be deduced from our data. (Source: EPMA Journal)
Source: EPMA Journal - May 13, 2020 Category: International Medicine & Public Health Source Type: research

Sleep disorders in migrants and refugees: a systematic review with implications for personalized medical approach
Conclusions and implicationsConsidering the differences in risk factors, vulnerability, and traumatic life events for different migrant populations, origins of sleep difficulties vary, depending on the migrant populations. Effects on sleep disturbances and sleep quality may be a result of integration in the host country, including changes of lifestyle, such as diet and working hours with implication for OSAS (obstructive sleep apnea) and insomnia. Compared with migrant populations, sleep disturbances in refugee populations are more correlated with mental health symptoms and disorders, especially PTSD (post-traumatic stress...
Source: EPMA Journal - May 12, 2020 Category: International Medicine & Public Health Source Type: research

Covid-19 pandemic by the “real-time” monitoring: the Tunisian case and lessons for global epidemics in the context of 3PM strategies
AbstractCovid-19 is neither the first nor the last viral epidemic which societies around the world are, were and will be affected by. Which lessons should be taken from the current pandemic situation? The Covid-19 disease is still not well characterised, and many research teams all over the world are working on prediction of the epidemic scenario, protective measures to populations and sub-populations, therapeutic and vaccination issues, amongst others. Contextually, countries with currently low numbers of Covid-19-infected individuals such as Tunisia are intended to take lessons from those countries which already reached ...
Source: EPMA Journal - April 24, 2020 Category: International Medicine & Public Health Source Type: research

Microbial and metabolomic analysis of gingival crevicular fluid in general chronic periodontitis patients: lessons for a predictive, preventive, and personalized medical approach
This study aimed to analyze the oral microbiome, the oral metabolome, and the link between them and to identify potential molecules as useful biomarkers for predictive, preventive, and personalized medicine (PPPM) in GCP.MethodsIn this study, gingival crevicular fluid (GCF) samples were collected from patients with GCP (n = 30) and healthy controls (n = 28). The abundance of oral microbiota constituents was obtained by Illumina sequencing, and the relative level of metabolites was measured by gas chromatography-mass spectrometry. Full-mouth probing depth, clinical attachment loss, and bleeding o...
Source: EPMA Journal - April 15, 2020 Category: International Medicine & Public Health Source Type: research