1 61 132 A HEALTH SURVEILLANCE SOFTWARE FRAMEWORK TO DELIVER INFORMATION ON PREVENTIVE HEALTHCARE STRATEGIES. A SOFTWARE FRAMEWORK CAN REDUCE COSTS RELATED TO THE DEVELOPMENT OF AN APPLICATION BECAUSE IT ALLOWS DEVELOPERS TO REUSE BOTH DESIGN AND CODE. RECENTLY, COMPANIES AND RESEARCH GROUPS HAVE ANNOUNCED THAT THEY HAVE BEEN EMPLOYING HEALTH SOFTWARE FRAMEWORKS. THIS PAPER PRESENTS THE DESIGN, PROOF-OF-CONCEPT IMPLEMENTATIONS AND EXPERIMENTATION OF THE HEALTH SURVEILLANCE SOFTWARE FRAMEWORK (HSSF). THE HSSF IS A FRAMEWORK THAT TACKLES THE DEMAND FOR THE RECOMMENDATION OF SURVEILLANCE INFORMATION AIMING AT SUPPORTING PREVENTIVE HEALTHCARE STRATEGIES. EXAMPLES OF SUCH STRATEGIES ARE THE AUTOMATIC RECOMMENDATION OF SURVEILLANCE LEVELS TO PATIENTS IN NEED OF HEALTHCARE AND THE AUTOMATIC RECOMMENDATION OF SCIENTIFIC LITERATURE THAT ELUCIDATES EPIGENETIC PROBLEMS RELATED TO PATIENTS. HSSF WAS CREATED FROM TWO SYSTEMS WE DEVELOPED IN OUR PREVIOUS WORK ON HEALTH SURVEILLANCE SYSTEMS: THE AUTOMATIC-SL AND CISS SYSTEMS. THE AUTOMATIC-SL SYSTEM AIMS TO ASSIST HEALTHCARE PROFESSIONALS IN MAKING DECISIONS AND IN IDENTIFYING CHILDREN WITH DEVELOPMENTAL PROBLEMS. THE CISS SERVICE ASSOCIATES GENETIC AND EPIGENETIC RISK FACTORS RELATED TO CHRONIC DISEASES WITH PATIENT'S CLINICAL RECORDS. TOWARDS EVALUATING THE HSSF FRAMEWORK, TWO NEW SYSTEMS, CISS+ AND CISS-SW, WERE CREATED BY MEANS OF ABSTRACTIONS AND INSTANTIATIONS OF THE FRAMEWORK (DESIGN AND CODE). WE SHOW THAT HSSF SUPPORTED THE DEVELOPMENT OF THE TWO NEW SYSTEMS GIVEN THAT THEY BOTH RECOMMEND SCIENTIFIC PAPERS USING MEDICAL RECORDS AS QUERIES EVEN THOUGH THEY EXPLOIT DIFFERENT COMPUTATIONAL TECHNOLOGIES. IN AN EXPERIMENT USING SIMULATED PATIENTS' MEDICAL RECORDS, WE SHOW THAT CISS, CISS+, AND CISS-SW SYSTEMS RECOMMENDED MORE CLOSELY RELATED AND SOMEWHAT RELATED DOCUMENTS THAN GOOGLE, GOOGLE SCHOLAR AND PUBMED. CONSIDERING RECALL AND PRECISION MEASURES, CISS+ SURPASSES CISS-SW IN TERMS OF PRECISION. 2016 2 6760 29 WORKGROUP ON NAPA'S SCIENTIFIC AGENDA FOR A NATIONAL INITIATIVE ON ALZHEIMER'S DISEASE. THIS REPORT OUTLINES A GOAL-DIRECTED SCIENTIFIC AGENDA FOR A NATIONAL INITIATIVE TO OVERCOME THE ALZHEIMER'S DISEASE (AD) CRISIS. THE STATEMENT, WHICH REFLECTS THE COLLECTIVE VIEWS AND RECOMMENDATIONS OF LEADERS IN AD RESEARCH, IS INTENDED TO AID THE IMPLEMENTATION OF THE NATIONAL ALZHEIMER'S PROJECT ACT (NAPA)'S NATIONAL PLAN TO DEFEAT AD. THE PRIMARY PUBLIC POLICY AIMS OF THIS 10-YEAR SCIENTIFIC AGENDA ARE TO DISCOVER, VALIDATE, AND DEVELOP: (1) A BROAD RANGE OF TECHNOLOGIES, TOOLS AND ALGORITHMS FOR EARLY DETECTION OF PEOPLE WITH SYMPTOMATIC AD, AND ASYMPTOMATIC INDIVIDUALS AT ELEVATED RISK FOR AD AND OTHER DEMENTIAS; AND (2) A WIDE RANGE OF INTERVENTIONS TO PRESERVE AND/OR RESTORE HEALTH AND NORMAL NEURAL FUNCTION, AIMING TO MAINTAIN INDEPENDENT FUNCTIONING FOR AS LONG AS POSSIBLE. THE LONG-TERM SCIENTIFIC PUBLIC HEALTH OBJECTIVES OF THIS COMPREHENSIVE PLAN ARE TO: (1) REDUCE THE NUMBER OF PEOPLE WITH CHRONIC DISABLING SYMPTOMS WHO WILL REQUIRE PROLONGED CARE AND, EVENTUALLY, REDUCE THE NUMBER OF ASYMPTOMATIC PEOPLE AT ELEVATED RISK FOR AD/DEMENTIA; (2) DELAY THE ONSET OF CHRONIC DISABILITY FOR PEOPLE WITH AD AND OTHER DEGENERATIVE BRAIN DISORDERS; AND (3) LOWER THE COST AND BURDEN OF CARE. THE PLAN CALLS FOR SIGNIFICANT EXPANSION OF RESEARCH PROGRAMS TO IDENTIFY AND VALIDATE THE CAUSE(S) AND PATHOGENESIS OF AD, GENETIC AND EPIGENETIC FACTORS THAT CONTRIBUTE TO AD RISK, THERAPEUTIC TARGETS THAT AFFECT DISEASE PROGRESSION, SURROGATE BIOMARKERS OF AD PATHOBIOLOGY, AND TECHNOLOGIES FOR EARLY DETECTION OF AD. 2012 3 196 24 ACID REFLUX AND OESOPHAGEAL CANCER. BARRETT'S METAPLASIA IS ONE OF THE COMMONEST PREMALIGNANT LESIONS IN THE WESTERN WORLD FOLLOWING COLORECTAL ADENOMAS. ONE IN 50 OF THE ADULT POPULATION DEVELOPS BARRETT'S AS A CONSEQUENCE OF CHRONIC GASTRO-OESOPHAGEAL REFLUX. THE MUCOSAL INFLAMMATION SEEN WITHIN PATIENTS WITH GASTRO-OESOPHAGEAL REFLUX SEEMS LIKELY TO DRIVE THE GROWTH OF THE METAPLASTIC MUCOSA AND ALSO HELP DIRECT FURTHER ONCOLOGICAL CHANGE, YET THE MOLECULAR EVENTS THAT CHARACTERIZE THE PATHWAY FROM INFLAMMATION TO METAPLASIA TO DYSPLASIA AND ADENOCARCINOMA ARE POORLY UNDERSTOOD. THERE IS HOPE THAT UNDERSTANDING THE ROLE OF OESOPHAGEAL INFLAMMATION WILL PROVIDE IMPORTANT INSIGHT INTO THE DEVELOPMENT OF BARRETT'S METAPLASIA AND OESOPHAGEAL CANCER. THIS CHAPTER WILL DISCUSS THE INFLAMMATION SEEN WITHIN CONTEXT OF BARRETT'S OESOPHAGUS AND ALSO CLINICAL TRIALS WHICH HOPE TO ADDRESS THIS COMMON PREMALIGNANT DISEASE. THERE ARE SEVERAL ONGOING CLINICAL TRIALS WHICH ARE AIMING TO PROVIDE DATA USING ANTI-INFLAMMATORY THERAPIES TO TACKLE THIS IMPORTANT PREMALIGNANT CONDITION. THERE IS NEW DATA PRESENTED WHICH SUGGESTS THAT DATA FROM THE ASPIRIN ESOMEPRAZOLE CHEMOPREVENTION TRIAL (ASPECT) MAY HOLD THE CLUE TO DISEASE TREATMENT AND THAT THE CYTOKINE TNF-ALPHA SEEMS TO BE A KEY SIGNALLING MOLECULE IN THE METAPLASIA-DYSPLASIA-CARCINOMA SEQUENCE. SPECIFICALLY IT APPEARS THAT BOTH EPIGENETIC AND INHERITED GENETICS COOPERATE TO MODULATE THE PROGNOSIS. 2011 4 6712 26 VIRUS-HOST INTERPLAY IN HEPATITIS B VIRUS INFECTION AND EPIGENETIC TREATMENT STRATEGIES. WORLDWIDE, CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS A MAJOR HEALTH PROBLEM AND NO CURE EXISTS. IMPORTANTLY, HEPATOCYTE INTRUSION BY HBV PARTICLES RESULTS IN A COMPLEX DEREGULATION OF BOTH VIRAL AND HOST CELLULAR GENETIC AND EPIGENETIC PROCESSES. AMONG THE ATTEMPTS TO DEVELOP NOVEL THERAPEUTIC APPROACHES AGAINST HBV INFECTION, SEVERAL OPTIONS TARGETING THE EPIGENOMIC REGULATION OF HBV REPLICATION ARE GAINING ATTENTION. THESE INCLUDE THE EXPERIMENTAL TREATMENT WITH 'EPIDRUGS'. MOREOVER, AS A TARGETED APPROACH, THE PRINCIPLE OF 'EPIGENETIC EDITING' RECENTLY IS BEING EXPLOITED TO CONTROL VIRAL REPLICATION. SILENCING OF HBV BY SPECIFIC REWRITING OF EPIGENETIC MARKS MIGHT DIMINISH VIRAL REPLICATION, VIREMIA, AND INFECTIVITY, EVENTUALLY CONTROLLING THE DISEASE AND ITS COMPLICATIONS. ADDITIONALLY, EPIGENETIC EDITING CAN BE USED AS AN EXPERIMENTAL TOOL TO INCREASE OUR LIMITED UNDERSTANDING REGARDING THE ROLE OF EPIGENETIC MODIFICATIONS IN VIRAL INFECTIONS. AIMING FOR PERMANENT EPIGENETIC REPROGRAMMING OF THE VIRAL GENOME WITHOUT UNSPECIFIC SIDE EFFECTS, THIS BREAKTHROUGH MAY PAVE THE ROADS FOR AN AMBITIOUS TECHNOLOGICAL PURSUIT: TO START DESIGNING A CURATIVE APPROACH UTILIZING MANIPULATIVE MOLECULAR THERAPIES FOR VIRAL INFECTIONS IN VIVO. 2017 5 4865 28 ORO-FACIAL PAIN AND TEMPOROMANDIBULAR DISORDERS CLASSIFICATION SYSTEMS: A CRITICAL APPRAISAL AND FUTURE DIRECTIONS. IT IS A DIFFICULT UNDERTAKING TO DESIGN A CLASSIFICATION SYSTEM FOR ANY DISEASE ENTITY, LET ALONE FOR ORO-FACIAL PAIN (OFP) AND MORE SPECIFICALLY FOR TEMPOROMANDIBULAR DISORDERS (TMD). A FURTHER COMPLICATION OF THIS TASK IS THAT BOTH PHYSICAL AND PSYCHOSOCIAL VARIABLES MUST BE INCLUDED. TO AUGMENT THIS PROCESS, A TWO-STEP SYSTEMATIC REVIEW, ADHERING TO PRISMA GUIDELINES, OF THE CLASSIFICATION SYSTEMS PUBLISHED DURING THE LAST 20 YEARS FOR OFP AND TMD WAS PERFORMED. THE FIRST SEARCH STEP IDENTIFIED 190 POTENTIAL CITATIONS WHICH ULTIMATELY RESULTED IN ONLY 17 ARTICLES BEING INCLUDED FOR IN-DEPTH ANALYSIS AND REVIEW. THE SECOND STEP RESULTED IN ONLY 5 ARTICLES BEING SELECTED FOR INCLUSION IN THIS REVIEW. FIVE ADDITIONAL ARTICLES AND FOUR CLASSIFICATION GUIDELINES/CRITERIA WERE ALSO INCLUDED DUE TO EXPANSION OF THE SEARCH CRITERIA. THUS, IN TOTAL, 14 DOCUMENTS COMPRISING ARTICLES AND GUIDELINES/CRITERIA (8 PROPOSALS OF CLASSIFICATION SYSTEMS FOR OFP; 6 FOR TMD) WERE SELECTED FOR INCLUSION IN THE SYSTEMATIC REVIEW. FOR EACH, A DISCUSSION AS TO THEIR ADVANTAGES, STRENGTHS AND LIMITATIONS WAS PROVIDED. SUGGESTIONS REGARDING THE FUTURE DIRECTION FOR IMPROVING THE CLASSIFICATION PROCESS WITH THE USE OF ONTOLOGICAL PRINCIPLES RATHER THAN TAXONOMY ARE DISCUSSED. FURTHERMORE, THE POTENTIAL FOR EXPANDING THE SCOPE OF AXES INCLUDED IN EXISTING CLASSIFICATION SYSTEMS, TO INCLUDE GENETIC, EPIGENETIC AND NEUROBIOLOGICAL VARIABLES, IS EXPLORED. IT IS THEREFORE RECOMMENDED THAT FUTURE CLASSIFICATION SYSTEM PROPOSALS BE BASED ON COMBINED APPROACHES AIMING TO PROVIDE ARCHETYPAL TREATMENT-ORIENTED CLASSIFICATIONS. 2018 6 264 34 ADVANCING ASTHMA CARE: THE GLASS IS ONLY HALF FULL! OVER THE PAST 20 YEARS, THERE HAS BEEN A CONCERTED EFFORT IN THE UNITED STATES TO REDUCE MORBIDITY RELATED TO CHRONIC DISEASE, INCLUDING ASTHMA. ATTENTION WAS INITIALLY DIRECTED TOWARD ASTHMA IN RESPONSE TO THE RECOGNITION THAT ASTHMA MORTALITY WAS INCREASING AND THAT THE BURDEN OF DISEASE WAS SIGNIFICANT. THESE EFFORTS TO ADDRESS ASTHMA MORTALITY LED TO MANY NEW INITIATIVES TO DEVELOP CLINICAL PRACTICE GUIDELINES, IMPLEMENT THE ASTHMA GUIDELINES INTO CLINICAL PRACTICE, CONDUCT RESEARCH TO FILL THE GAPS IN THE GUIDELINES, AND CONTINUOUSLY REVISE THE ASTHMA GUIDELINES AS MORE INFORMATION BECAME AVAILABLE. AN ASSESSMENT OF OUR PROGRESS SHOWS SIGNIFICANT ACCOMPLISHMENTS IN RELATION TO REDUCING ASTHMA MORTALITY AND HOSPITALIZATIONS. CONSEQUENTLY, WE ARE NOW AT A CROSSROADS IN ASTHMA CARE. ALTHOUGH WE HAVE RECOGNIZED SOME REMARKABLE ACCOMPLISHMENTS IN REDUCING ASTHMA MORTALITY AND MORBIDITY, THE AVAILABILITY OF NEW TOOLS TO MONITOR DISEASE ACTIVITY, INCLUDING BIOMARKERS AND EPIGENETIC MARKERS, ALONG WITH INFORMATION TECHNOLOGY SYSTEMS TO MONITOR ASTHMA CONTROL HOLD SOME PROMISE IN IDENTIFYING GAPS IN DISEASE MANAGEMENT. THESE ADVANCES SHOULD PROMPT THE EVOLUTION OF NEW STRATEGIES AND NEW TREATMENTS TO FURTHER REDUCE DISEASE BURDEN. IT NOW BECOMES IMPERATIVE TO CONTINUE A FOCUS ON WAYS TO FURTHER REDUCE THE BURDEN OF ASTHMA AND PREVENT ITS ONSET. 2011 7 6708 30 VIRAL INDUCED EFFECTS ON A VULNERABLE EPITHELIUM; LESSONS LEARNED FROM PAEDIATRIC ASTHMA AND EOSINOPHILIC OESOPHAGITIS. THE EPITHELIUM IS INTEGRAL TO THE PROTECTION OF MANY DIFFERENT BIOLOGICAL SYSTEMS AND FOR THE MAINTENANCE OF BIOCHEMICAL HOMEOSTASIS. EMERGING EVIDENCE SUGGESTS THAT PARTICULAR CHILDREN HAVE EPITHELIAL VULNERABILITIES LEADING TO DYSREGULATED BARRIER FUNCTION AND INTEGRITY, THAT RESULTANTLY CONTRIBUTES TO DISEASE PATHOGENESIS. THESE EPITHELIAL VULNERABILITIES LIKELY DEVELOP IN UTERO OR IN EARLY LIFE DUE TO VARIOUS GENETIC, EPIGENETIC AND ENVIRONMENTAL FACTORS. ALTHOUGH VARIOUS EPITHELIA ARE UNIQUELY STRUCTURED WITH SPECIFIC FUNCTION, PREVALENT ALLERGIC-TYPE EPITHELIAL DISEASES IN CHILDREN POTENTIALLY HAVE COMMON OR PARALLEL DISEASE PROCESSES. THESE INCLUDE INFLAMMATION AND IMMUNE RESPONSE DYSREGULATION STEMMING FROM ATYPICAL EPITHELIAL BARRIER FUNCTION AND INTEGRITY. TWO DISEASES WHERE AETIOLOGY AND PATHOGENESIS ARE POTENTIALLY LINKED TO EPITHELIAL VULNERABILITIES INCLUDE PAEDIATRIC ASTHMA AND EOSINOPHILIC OESOPHAGITIS (EOE). FOR EXAMPLE, RHINOVIRUS C (RV-C) IS A KNOWN RISK FACTOR FOR PAEDIATRIC ASTHMA DEVELOPMENT AND IS KNOWN TO DISRUPT RESPIRATORY EPITHELIAL BARRIER FUNCTION CAUSING ACUTE INFLAMMATION. IN ADDITION, EOE, A PREVALENT ATOPIC CONDITION OF THE OESOPHAGEAL EPITHELIUM, IS CHARACTERISED BY SIMILAR INNATE IMMUNE AND EPITHELIAL RESPONSES TO VIRAL INJURY. THIS REVIEW EXAMINES THE CURRENT LITERATURE AND IDENTIFIES THE GAPS IN THE FIELD DEFINING VIRAL-INDUCED EFFECTS ON A VULNERABLE RESPIRATORY EPITHELIUM AND RESULTING CHRONIC INFLAMMATION, DRAWING FROM KNOWLEDGE GENERATED IN ACUTE WHEEZING ILLNESS, PAEDIATRIC ASTHMA AND EOE. BESIDES HIGHLIGHTING THE IMPORTANCE OF EPITHELIAL STRUCTURE AND BARRIER FUNCTION IN ALLERGIC DISEASE PATHOGENESIS REGARDLESS OF SPECIFIC EPITHELIAL SUB-TYPES, THIS REVIEW FOCUSES ON THE IMPORTANCE OF EXAMINING OTHER PARALLEL ALLERGIC-TYPE DISEASE PROCESSES THAT MAY UNCOVER COMMONALITIES DRIVING DISEASE PATHOGENESIS. THIS IN TURN MAY BE BENEFICIAL IN THE DEVELOPMENT OF COMMON THERAPEUTICS FOR CURRENT CLINICAL MANAGEMENT AND DISEASE PREVENTION IN THE FUTURE. 2021 8 6905 25 [THE ROLE OF EPIGENETIC REGULATIONS IN EARLY CHILDHOOD DISEASES]. WITH THE ACCEPTANCE OF "THE DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE" CONCEPT IN THE 1990S, IT BECAME CLEAR THAT EPIGENETIC INHERITANCE, WHICH DO NOT INVOLVE CHANGES IN THE DNA SEQUENCE HAS IMPORTANT ROLE IN THE PATHOGENESIS OF DISEASES. EPIGENETIC REGULATION SERVES THE ADAPTATION TO THE CHANGING ENVIRONMENT AND MAINTAINS THE REPRODUCTIVE FITNESS EVEN ON THE DRAWBACK OF INCREASED RISK OF DISEASES IN LATER LIFE. THE ROLE OF EPIGENETIC MECHANISMS IN CHRONIC NON-COMMUNICABLE DISEASES HAS BEEN WELL ESTABLISHED. RECENT STUDIES HAVE REVEALED THAT EPIGENETIC CHANGES HAVE ALSO CAUSAL ROLE IN CERTAIN PEDIATRIC DISEASES. THE REVIEW EVALUATES THE RECENT EPIGENETIC FINDINGS IN THE PATHOMECHANISM OF COMMON PEDIATRIC DISEASES. THE WIDE RANGE AND LONG-LASTING DURATION OF EPIGENETIC REGULATIONS GIVE IMPORTANCE TO THE SUBJECT. METHODS ARE ALREADY AVAILABLE TO EVALUATE A PART OF THE EPIGENETIC CHANGES IN THE CLINICAL PRACTICE, PRESENTLY AIMING PRIMARILY THE ESTIMATION OF THE DISEASE RISK OR DEFINITION OF DIAGNOSIS. FURTHERMORE, THERE ARE ALREADY AVAILABLE LIMITED MEANS TO INFLUENCE THE EPIGENETIC REGULATION. 2019 9 5163 33 PRECISION/PERSONALIZED MEDICINE IN ALLERGIC DISEASES AND ASTHMA. LIKE MANY OTHER CHRONIC DISEASES, EVERY ALLERGIC PATIENT HAS DIFFERENT CHARACTERISTICS BASED ON CLINICAL COURSE, TREATMENT RESPONSIVENESS AND DISEASE OUTCOMES, WHICH ARE ASSOCIATED WITH THE GENETIC AND EPIGENETIC CONTROL OF MOLECULAR MECHANISMS AND ENVIRONMENT. THIS VARIABILITY NECESSITATES THE ESTABLISHMENT OF PATIENT-TAILORED AND PRECISION APPROACHES IN HANDLING ALLERGIC DISORDERS. BETTER UNDERSTANDING OF THE UNDERLYING PATHOPHYSIOLOGICAL MECHANISMS FOR THE DEVELOPMENT OF ALLERGIC DISORDERS WILL PROVIDE MORE RATIONALE STRATEGIES BASED ON INDIVIDUAL CASES IN CONTROLLING AND TREATING THESE DISORDERS. ENDOTYPING, PHENOTYPING, GENOTYPING AND THERATYPING, AND BIOMARKERS ARE KEYWORDS IN THIS AREA AND HAVE BEEN GAINING LOTS OF ATTENTION IN THE FIELD OF PRECISION MEDICINE, WHICH AIMS TO REVOLUTIONIZE PATIENT CARE AND DEVELOP BETTER PREVENTION AND TREATMENT STRATEGIES. IN ADDITION, PRECISION HEALTH IS A NEW CONCEPT THAT BRINGS PRECISE APPROACHES TO THE SCENE FOR BEING HEALTHY AND PREVENTION OF ALLERGIC DISEASE AND ASTHMA. THE SPECIALTY OF ALLERGY HAS A LEADING ROLE IN THE FIELD, BECAUSE ALLERGEN-SPECIFIC IMMUNOTHERAPY STARTED 105 YEARS AGO, AND IS HISTORICALLY A LEADING PERSONALIZED/PRECISION MEDICINE APPROACH IN ALL MEDICINE DISCIPLINES PROVIDING THE POSSIBILITY OF CURE IN AN INDIVIDUALIZED MANNER INSTEAD OF CONVENTIONAL SYMPTOMATIC TREATMENTS. 2018 10 5161 35 PRECISION AND PERSONALIZED MEDICINE: HOW GENOMIC APPROACH IMPROVES THE MANAGEMENT OF CARDIOVASCULAR AND NEURODEGENERATIVE DISEASE. LIFE EXPECTANCY HAS GRADUALLY GROWN OVER THE LAST CENTURY. THIS HAS DEEPLY AFFECTED HEALTHCARE COSTS, SINCE THE GROWTH OF AN AGING POPULATION IS CORRELATED TO THE INCREASING BURDEN OF CHRONIC DISEASES. THIS REPRESENTS THE INTERESTING CHALLENGE OF HOW TO MANAGE PATIENTS WITH CHRONIC DISEASES IN ORDER TO IMPROVE HEALTH CARE BUDGETS. EFFECTIVE PRIMARY PREVENTION COULD REPRESENT A PROMISING ROUTE. TO THIS END, PRECISION, TOGETHER WITH PERSONALIZED MEDICINE, ARE USEFUL INSTRUMENTS IN ORDER TO INVESTIGATE PATHOLOGICAL PROCESSES BEFORE THE APPEARANCE OF CLINICAL SYMPTOMS AND TO GUIDE PHYSICIANS TO CHOOSE A TARGETED THERAPY TO MANAGE THE PATIENT. CARDIOVASCULAR AND NEURODEGENERATIVE DISEASES REPRESENT SUITABLE MODELS FOR TAKING FULL ADVANTAGE OF PRECISION MEDICINE TECHNOLOGIES APPLIED TO ALL STAGES OF DISEASE DEVELOPMENT. THE AVAILABILITY OF HIGH TECHNOLOGY INCORPORATING ARTIFICIAL INTELLIGENCE AND ADVANCEMENT PROGRESS MADE IN THE FIELD OF BIOMEDICAL RESEARCH HAVE BEEN SUBSTANTIAL TO UNDERSTAND HOW GENES, EPIGENETIC MODIFICATIONS, AGING, NUTRITION, DRUGS, MICROBIOME AND OTHER ENVIRONMENTAL FACTORS CAN IMPACT HEALTH AND CHRONIC DISORDERS. THE AIM OF THE PRESENT REVIEW IS TO ADDRESS HOW PRECISION AND PERSONALIZED MEDICINE CAN BRING GREATER CLARITY TO THE CLINICAL AND BIOLOGICAL COMPLEXITY OF THESE TYPES OF DISORDERS ASSOCIATED WITH HIGH MORTALITY, INVOLVING TREMENDOUS HEALTH CARE COSTS, BY DESCRIBING IN DETAIL THE METHODS THAT CAN BE APPLIED. THIS MIGHT OFFER PRECIOUS TOOLS FOR PREVENTIVE STRATEGIES AND POSSIBLE CLUES ON THE EVOLUTION OF THE DISEASE AND COULD HELP IN PREDICTING MORBIDITY, MORTALITY AND DETECTING CHRONIC DISEASE INDICATORS MUCH EARLIER IN THE DISEASE COURSE. THIS, OF COURSE, WILL HAVE A MAJOR EFFECT ON BOTH IMPROVING THE QUALITY OF CARE AND QUALITY OF LIFE OF THE PATIENTS AND REDUCING TIME EFFORTS AND HEALTHCARE COSTS. 2020 11 6048 28 THE CONCEPTS OF ASTHMA ENDOTYPES AND PHENOTYPES TO GUIDE CURRENT AND NOVEL TREATMENT STRATEGIES. ASTHMA, A COMMON, NON-COMMUNICABLE CHRONIC DISEASE AFFECTS OVER 300 MILLION INDIVIDUALS WORLDWIDE. THE WESTERN WORLD LIFESTYLE IS CLAIMED TO BE RESPONSIBLE FOR THIS HIGH AND INCREASING PREVALENCE. ASTHMA HAS BEEN DEFINED AS A SYNDROME WITH VARIOUS PHENOTYPES AND ENDOTYPES, ALLERGIC ASTHMA AND TYPE 2 ASTHMA BEING THE MOST FREQUENT. A GREAT INCREASE IN PREVALENCE OF ALLERGIC DISEASES HAS NECESSITATED INTENSIVE INVESTIGATIONS BOTH FOR UNDERSTANDING THE UNDERLYING MECHANISMS AND FOR THE DEVELOPMENT OF NOVEL THERAPY OPTIONS WITH LONG-TERM EFFICACY AND LIMITED SIDE-EFFECTS. ALLERGIC PATIENTS DEMONSTRATE UNIQUE PRESENTATIONS WITH VARIABLE VISIBLE CHARACTERISTICS AND DISEASE OUTCOMES DEPENDING ON DIFFERENT MOLECULAR MECHANISMS, RELATED TO INFLUENCE OF GENES AND EPIGENETIC CONTROL BY MICRO- AND MACRO-ENVIRONMENT. AREAS COVERED: THIS ARTICLE REVIEWS THE DEFINITION OF ASTHMA PHENOTYPES AND POSSIBLE ENDOTYPES, ADVANCES IN ALLERGY-IMMUNOLOGY FIELD AND CONTEMPORARY PERSONALIZED THERAPY OPTIONS FOR ASTHMA. EXPERT COMMENTARY: BETTER UNDERSTANDING OF THE COMPLEX IMMUNE NETWORK OF ALLERGIC INFLAMMATION AND KEY PLAYERS OF IMMUNITY IS CONTINUOUSLY BEING PROVIDED FOR CLARIFICATION OF ASTHMA SUB-TYPES. SUCCESSFUL THERAPY OF ASTHMA REQUIRES BETTER DEFINITION OF UNDERLYING PATHOGENESIS, WHICH SEQUENTIALLY COULD END UP WITH 'CUSTOM-TAILORED' INDIVIDUALIZED, EVIDENCE-BASED AND MORE PRECISE THERAPY OPTIONS; A NEW ERA TERMED AS 'PRECISION MEDICINE'. ENDOTYPE, PHENOTYPE, THERATYPE AND BIOMARKER TERMS ARISE AS MAJOR KEYWORDS IN PRECISION/PERSONALIZED MEDICINE. 2018 12 3011 25 GENETICS AND EPIGENETICS IN THE FIBROGENIC EVOLUTION OF CHRONIC LIVER DISEASES. RECENT YEARS HAVE SEEN UNPRECEDENTED PROGRESS IN THE IDENTIFICATION AND CHARACTERIZATION OF GENETIC INFORMATION RELATED TO CHRONIC LIVER DISEASES (CLDS). HOWEVER, DESPITE THE CONCEPTUAL BENEFIT IN EARLY RECOGNITION OF AT-RISK POPULATIONS AMENABLE TO PRE-EMPTIVE TREATMENT AND/OR SURVEILLANCE STRATEGIES, RECENT GENOMIC RESEARCH IN THE FIELD HAS PLACED FOCUS ON UNRAVELLING THE GENETIC ARCHITECTURE OF DISEASE SUSCEPTIBILITY, WHILE DATA ON GENETIC MARKERS ANTICIPATING AN ACCELERATED FIBROGENESIS IN AN INDIVIDUAL ARE STILL LIMITED. LIKEWISE, SEQUENCE VARIATION ASSIGNING RAPID FIBROGENIC EVOLUTION COMMON TO CLDS IRRESPECTIVE OF ETIOLOGY ARE POORLY DEFINED ASIDE FROM PNPLA3 (ADIPONUTRIN) AS A PROMINENT EXCEPTION. THE EMERGING FIELD OF EPIGENETICS IN HEPATOLOGY HAS MOSTLY BEEN STUDIED UNDER THE PERSPECTIVE OF GENE REGULATION, LESS SO AS A HERITABLE ALTERATION IN GENE ACTIVITY. IN THIS ARTICLE WE WILL CRITICALLY DISCUSS RECENT FINDINGS IN GENOMIC HEPATOLOGY WITH SPECIAL FOCUS ON THE (EPI)GENETIC CONTRIBUTION TO THE FIBROGENIC EVOLUTION OF CLDS. 2011 13 6392 26 THE ROLE OF THE GUT MICROBIOTA IN SCHIZOPHRENIA: CURRENT AND FUTURE PERSPECTIVES. OBJECTIVES: SCHIZOPHRENIA IS A POORLY UNDERSTOOD CHRONIC DISEASE. ITS PATHOPHYSIOLOGY IS COMPLEX, DYNAMIC, AND LINKED TO EPIGENETIC MECHANISMS AND MICROBIOTA INVOLVEMENT. NOWADAYS, CORRELATING SCHIZOPHRENIA WITH THE ENVIRONMENT MAKES SENSE OWING TO ITS MULTIDIMENSIONAL IMPLICATIONS: TEMPORAL AND SPATIAL VARIABILITY. MICROBIOTA INVOLVEMENT AND EPIGENETIC MECHANISMS ARE FACTORS THAT ARE CURRENTLY BEING CONSIDERED TO BETTER UNDERSTAND ANOTHER DIMENSION OF SCHIZOPHRENIA. METHODS: THIS REVIEW SUMMARISES AND DISCUSSES CURRENTLY AVAILABLE INFORMATION, FOCUSSING ON THE MICROBIOTA, EPIGENETIC MECHANISMS, TECHNOLOGICAL APPROACHES AIMED AT PERFORMING EXHAUSTIVE ANALYSES OF THE MICROBIOTA, AND PSYCHOTHERAPIES, TO ESTABLISH FUTURE PERSPECTIVES. RESULTS: THE CONNECTION BETWEEN THE MICROBIOTA, EPIGENETIC MECHANISMS AND TECHNOLOGICAL DEVELOPMENTS ALLOWS FOR FORMULATING NEW APPROACHES OBJECTIVELY ORIENTED TOWARDS THE DEVELOPMENT OF ALTERNATIVE PSYCHOTHERAPIES THAT MAY HELP TREAT SCHIZOPHRENIA. CONCLUSIONS: IN THIS REVIEW, THE GUT MICROBIOTA AND EPIGENETIC MECHANISMS WERE CONSIDERED AS KEY REGULATORS, REVEALING A POTENTIAL NEW AETIOLOGY OF SCHIZOPHRENIA. LIKEWISE, CONTINUOUS TECHNOLOGICAL ADVANCES (E.G. CULTUROMICS), AIMED AT THE MICROBIOTA-GUT-BRAIN AXIS GENERATE NEW EVIDENCE ON THIS CONCEPT. 2018 14 5263 29 PROMISING BIOMARKERS OF HUMAN AGING: IN SEARCH OF A MULTI-OMICS PANEL TO UNDERSTAND THE AGING PROCESS FROM A MULTIDIMENSIONAL PERSPECTIVE. THE AGING PROCESS HAS BEEN LINKED TO THE OCCURRENCE OF CHRONIC DISEASES AND FUNCTIONAL IMPAIRMENTS, INCLUDING CANCER, SARCOPENIA, FRAILTY, METABOLIC, CARDIOVASCULAR, AND NEURODEGENERATIVE DISEASES. NONETHELESS, AGING IS HIGHLY VARIABLE AND HETEROGENEOUS AND REPRESENTS A CHALLENGE FOR ITS CHARACTERIZATION. IN THIS SENSE, INTRINSIC CAPACITY (IC) STANDS AS A NOVEL PERSPECTIVE BY THE WORLD HEALTH ORGANIZATION, WHICH INTEGRATES THE INDIVIDUAL WELLBEING, ENVIRONMENT, AND RISK FACTORS TO UNDERSTAND AGING. HOWEVER, THERE IS A LACK OF QUANTITATIVE AND QUALITATIVE ATTRIBUTES TO DEFINE IT OBJECTIVELY. THEREFORE, IN THIS REVIEW WE ATTEMPT TO SUMMARIZE THE MOST RELEVANT AND PROMISING BIOMARKERS DESCRIBED IN CLINICAL STUDIES AT DATE OVER DIFFERENT MOLECULAR LEVELS, INCLUDING EPIGENOMICS, TRANSCRIPTOMICS, PROTEOMICS, METABOLOMICS, AND THE MICROBIOME. TO AID GERONTOLOGISTS, GERIATRICIANS, AND BIOMEDICAL RESEARCHERS TO UNDERSTAND THE AGING PROCESS THROUGH THE IC. AGING BIOMARKERS REFLECT THE PHYSIOLOGICAL STATE OF INDIVIDUALS AND THE UNDERLYING MECHANISMS RELATED TO HOMEOSTATIC CHANGES THROUGHOUT AN INDIVIDUAL LIFESPAN; THEY DEMONSTRATED THAT AGING COULD BE MEASURED INDEPENDENTLY OF TIME (THAT MAY EXPLAIN ITS HETEROGENEITY) AND TO BE HELPFUL TO PREDICT AGE-RELATED SYNDROMES AND MORTALITY. IN SUMMARY, WE HIGHLIGHT THE AREAS OF OPPORTUNITY AND GAPS OF KNOWLEDGE THAT MUST BE ADDRESSED TO FULLY INTEGRATE BIOMEDICAL FINDINGS INTO CLINICALLY USEFUL TOOLS AND INTERVENTIONS. 2020 15 2459 21 EPIGENETIC THERAPIES FOR NON-ONCOLOGY INDICATIONS. CHRONIC AND DEGENERATIVE DISORDERS ARE A MAJOR, AND GROWING, HUMAN HEALTH BURDEN, AND CURRENT TREATMENTS ARE IN MANY CASES INADEQUATE OR VERY EXPENSIVE. EPIGENETIC THERAPIES ARE ATTRACTIVE OPTIONS FOR TREATING SUCH DISORDERS BECAUSE THEY MANIPULATE THE PROCESSES THAT MAINTAIN CELLS IN AN ABNORMAL TRANSCRIPTIONAL STATE. THE CHALLENGES LIE IN IDENTIFYING THE MOST APPROPRIATE DISEASES AND THE ENZYMES THAT SHOULD BE TARGETED. THIS REVIEW DESCRIBES THE DIFFERENT APPROACHES THAT CAN BE USED TO ADDRESS THIS PROBLEM, FOCUSING PARTICULARLY ON CNS DISORDERS (ESPECIALLY MENTAL RETARDATION, NEURODEGENERATIVE DISEASE, PSYCHIATRIC DISORDERS AND DRUG ADDICTION), DIABETES AND DIABETIC COMPLICATIONS, AND AUTOIMMUNITY AND INFLAMMATORY DISEASES. 2010 16 5724 23 SKELETAL MUSCLE WASTING AND ITS RELATIONSHIP WITH OSTEOARTHRITIS: A MINI-REVIEW OF MECHANISMS AND CURRENT INTERVENTIONS. PURPOSE OF REVIEW: OSTEOARTHRITIS (OA) IS A SUBSET OF JOINT DISORDERS RESULTING IN DEGENERATION OF SYNOVIAL JOINTS. THIS LEADS TO PAIN, DISABILITY AND LOSS OF INDEPENDENCE. KNEE AND HIP OA ARE EXTREMELY PREVALENT, AND THEIR OCCURRENCE INCREASES WITH AGEING. SIMILARLY, LOSS OF MUSCLE MASS AND FUNCTION, SARCOPENIA, OCCURS DURING AGEING. RECENT FINDINGS: LITTLE IS KNOWN ABOUT THE IMPACT OF MUSCLE WASTING ON OA PROGRESSION; NEVERTHELESS, IT HAS BEEN SUGGESTED THAT MUSCLE WASTING DIRECTLY AFFECTS THE STABILITY OF THE JOINTS AND LOSS OF MOBILITY LEADS TO GRADUAL DEGENERATION OF ARTICULAR CARTILAGE. THE MOLECULAR MECHANISMS UNDERLYING MUSCLE WASTING IN OA ARE NOT WELL UNDERSTOOD; HOWEVER, THESE ARE PROBABLY RELATED TO CHANGES IN GENE EXPRESSION, AS WELL AS EPIGENETIC MODIFICATIONS. IT IS BECOMING CLEAR THAT SKELETAL MUSCLE WASTING PLAYS AN IMPORTANT ROLE IN OA DEVELOPMENT AND/OR PROGRESSION. HERE, WE DISCUSS MECHANISMS, CURRENT INTERVENTIONS, SUCH AS EXERCISE, AND POTENTIALLY NOVEL APPROACHES, SUCH AS MODULATION OF MICRORNAS, AIMING AT AMELIORATING OA SYMPTOMS THROUGH MAINTAINING MUSCLE MASS AND FUNCTION. 2019 17 1859 37 EMBEDDING THE COMMUNITY AND INDIVIDUALS IN DISEASE PREVENTION. THE PRIMARY PREVENTION OF NON-COMMUNICABLE DISEASES IS ONE OF THE MOST CHALLENGING AND EXCITING ASPECTS OF MEDICINE AND PRIMARY CARE THIS CENTURY. FOR CANCER, IT IS AN URGENT MATTER IN LIGHT OF THE INCREASING BURDEN OF THE DISEASE AMONG YOUNGER PEOPLE AND THE HIGHER FREQUENCY OF MORE AGGRESSIVE FORMS OF THE DISEASE FOR ALL AGES. MOST CHRONIC DISORDERS RESULT FROM THE INFLUENCE OF THE ENVIRONMENT ON THE EXPRESSION OF GENES WITHIN AN INDIVIDUAL. THE ENVIRONMENT AT-LARGE ENCOMPASSES LIFESTYLE (INCLUDING NUTRITION), AND CHEMICAL/PHYSICAL AND SOCIAL EXPOSURES. IN CANCER, THE INTERACTION BETWEEN THE (EPI)GENETIC MAKEUP OF AN INDIVIDUAL AND A MULTIPLICITY OF ENVIRONMENTAL RISK AND PROTECTING FACTORS IS CONSIDERED KEY TO DISEASE ONSET. THUS, LIKE FOR PRECISION THERAPY DEVELOPED FOR PATIENTS, PERSONALIZED OR PRECISION PREVENTION IS ENVISIONED FOR INDIVIDUALS AT RISK. PREVENTION MEANS IDENTIFYING PEOPLE AT HIGHER RISK AND INTERVENING TO REDUCE THE RISK. IT REQUIRES BIOLOGICAL MARKERS OF RISK AND NON-AGGRESSIVE PREVENTIVE ACTIONS FOR THE INDIVIDUAL, BUT IT ALSO INVOLVES ACTING ON THE ENVIRONMENT AND THE COMMUNITY. SOCIAL SCIENTISTS ARE CONSIDERING MICRO (INDIVIDUAL/FAMILY), MESO (COMMUNITY), AND MACRO (COUNTRY POPULATION) LEVELS OF CARE TO ILLUSTRATE THAT PROBLEMS AND SOLUTIONS EXIST ON DIFFERENT SCALES. IDEALLY, THE DESIGN OF INTERVENTIONS IN PREVENTION SHOULD INTEGRATE ALL THESE LEVELS. IN THIS PERSPECTIVE ARTICLE, USING THE EXAMPLE OF BREAST CANCER, WE ARE DISCUSSING CHALLENGES AND POSSIBLE SOLUTIONS FOR A MULTIDISCIPLINARY COMMUNITY OF SCIENTISTS, PRIMARY HEALTH CARE PRACTITIONERS AND CITIZENS TO DEVELOP A HOLISTIC APPROACH OF PRIMARY PREVENTION, KEEPING IN MIND EQUITABLE ACCESS TO CARE. 2022 18 1127 18 COMPOUND COMBINATIONS TARGETING LONGEVITY: CHALLENGES AND PERSPECTIVES. AGING IS ONE OF THE WORLD'S GREATEST CONCERNS, REQUIRING URGENT, EFFECTIVE, LARGE-SCALE INTERVENTIONS TO DECREASE THE NUMBER OF LATE-LIFE CHRONIC DISEASES AND IMPROVE HUMAN HEALTHSPAN. ANTI-AGING DRUG THERAPY IS ONE OF THE MOST PROMISING STRATEGIES TO COMBAT THE EFFECTS OF AGING. HOWEVER, MOST GEROPROTECTIVE COMPOUNDS ARE KNOWN TO SUCCESSFULLY AFFECT ONLY A FEW AGING-RELATED TARGETS. GIVEN THIS, THERE IS A GREAT BIOLOGICAL RATIONALE FOR THE USE OF COMBINATIONS OF ANTI-AGING INTERVENTIONS. IN THIS REVIEW, WE CHARACTERIZE THE VARIOUS TYPES OF COMPOUND COMBINATIONS USED TO MODULATE LIFESPAN, DISCUSS THE EXISTING EVIDENCE ON THEIR ROLE IN LIFE EXTENSION, AND PRESENT SOME KEY POINTS ABOUT CURRENT CHALLENGES AND FUTURE PROSPECTS FOR THE DEVELOPMENT OF COMBINATION DRUG ANTI-AGING THERAPY. 2023 19 3769 29 INTEGRATIVE MEDICINE TO TACKLE THE PROBLEM OF CHRONIC DISEASES. THIS ARTICLE SUMMARIZES IMPORTANT WAYS THAT INTEGRATIVE MEDICINE CAN CONTRIBUTE TO RESOLVING THE GLOBAL HEALTH CRISIS WITH SPECIAL REFERENCE TO THE US. RESEARCH USING MODERN METHODS OF ANALYSIS OF CELLULAR CHANGES AT THE EPIGENETIC LEVEL HAS SHOWN THAT DIET AND LIFESTYLE INTERVENTIONS GREATLY IMPROVE THE STATE OF PATIENTS' HEALTH. ESTIMATES HAVE BEEN GIVEN THAT UP TO 75% OF ALL US HEALTH COSTS CAN BE SAVED BY THESE METHODS, PARTICULARLY IF APPLIED PREVENTATIVELY. IT IS THUS VITAL THAT ACTIVE STEPS ARE TAKEN TO IMPLEMENT SUCH PROGRAMS, TO REDUCE COSTS TO CITIZENS AND SOCIETY ALIKE, AS WELL AS TO GOVERNMENT. 2010 20 3910 28 LIFE COURSE OF ASTHMA. ASTHMA IS A HETEROGENEOUS CHRONIC AIRWAY DISEASE THAT CAN VARY OVER A LIFETIME. ALTHOUGH BROAD CATEGORIES OF ASTHMA BY SEVERITY AND TYPE HAVE BEEN CONSTRUCTED, THERE REMAINS A TREMENDOUS OPPORTUNITY TO DISCOVER AN APPROACH TO MANAGING ASTHMA WITH ADDITIONAL FACTORS IN MIND. MANY IN THE FIELD HAVE SUGGESTED AND ARE PURSUING A NOVEL PARADIGM SHIFT IN HOW ASTHMA MIGHT BE BETTER MANAGED, CONSIDERING THE LIFE COURSE OF EXPOSURES, MANAGEMENT PRIORITIES, AND PREDICTED TRAJECTORY OF LUNG FUNCTION GROWTH. THIS APPROACH WILL REQUIRE A MORE HOLISTIC VIEW OF PRENATAL, POSTNATAL, ADOLESCENCE, HORMONAL AND GENDER ASPECTS, AND THE AGING PROCESS. IN ADDITION, THE ENVIRONMENT, EXTERNALLY AND INTERNALLY, INCLUDING IN ONE'S GENETIC CODE AND EPIGENETIC CHANGES, ARE FACTORS THAT AFFECT HOW ASTHMA PROGRESSES OR BECOMES MORE STABLE IN INDIVIDUALS. THIS CHAPTER FOCUSES ON THE VARIOUS INFLUENCES THAT MAY, TO DIFFERING DEGREES, AFFECT PEOPLE WITH ASTHMA, WHICH CAN DEVELOP AT ANY TIME IN THEIR LIVES. SHIFTING THE PARADIGM OF THOUGHT AND STRATEGIES FOR CARE AND ADVOCATING FOR PUBLIC POLICIES AND HEALTH DELIVERY THAT FOCUS ON THIS PHILOSOPHY IS PARAMOUNT TO ADVANCE ASTHMA CARE FOR ALL. 2023