1 734 184 CANCER HEALTHCARE DISPARITIES AMONG AFRICAN AMERICANS IN THE UNITED STATES. A NEED EXISTS TO EXAMINE RACIAL DISPARITIES IN THE HEALTHCARE ARENA AND THE IMPACT ON PATIENTS WITH CANCER. DESPITE ONGOING EFFORTS TO INCREASE EQUITY IN PRIMARY HEALTHCARE ACCESS, RACIAL AND SOCIOECONOMIC DISPARITIES PERSIST, THUS CONTRIBUTING TO DISPROPORTIONATE TREATMENT OUTCOMES AND SURVIVORSHIP AMONG MINORITY AND LOW-INCOME PATIENTS. SUCH DISPARITIES HAVE BEEN REVEALED IN TREATMENT COHORTS OF PATIENTS WITH MULTIPLE FORMS OF CANCER, INCLUDING BREAST, CERVICAL, OVARIAN, ENDOMETRIAL, PROSTATE, LUNG, COLORECTAL, GASTROINTESTINAL, AND HEPATOCELLULAR, AND HAVE BEEN ATTRIBUTED TO A RANGE OF CO-OCCURRING BEHAVIORAL, SOCIAL DETERMINANTS OF HEALTH, UNDERLYING GENETIC FACTORS, AS WELL AS ACCESS TO EDUCATIONAL OPPORTUNITIES THAT LIMIT THE QUALITY OF INFORMED HEALTHCARE. THESE VARIOUS INTERRELATED FACTORS WIDEN CANCER HEALTHCARE DISPARITIES SYNERGISTICALLY THROUGHOUT UNDERSERVED COMMUNITIES, AND THEIR INFLUENCE HAS BEEN AMPLIFIED BY THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMIC. FUNDAMENTALLY, A LACK OF BASIC AND CLINICAL RESEARCH EXISTS THAT FAILS TO ADEQUATELY REFLECT DIVERSITY AND MINORITY INVOLVEMENT IN DRUG DEVELOPMENT. ALTHOUGH OVERCOMING THE OBSTACLES RESPONSIBLE FOR CHRONIC TREATMENT DISPARITIES IS A FORMIDABLE TASK, PROMISING MEANS OF ACHIEVING MORE UNIFORM QUALITY HEALTHCARE ARE BECOMING MORE CLEARLY ELUCIDATED. TO REDUCE DISEASE PROGRESSION, INCREASE OVERALL SURVIVAL, AND IMPROVE THE HEALTH OF VULNERABLE POPULATIONS, IT IS NECESSARY TO IDENTIFY AND FULLY DISCLOSE ENVIRONMENTAL, BIOLOGICAL, AND ANCESTRAL FACTORS THAT IMPACT THE RISK FOR CANCER; HEAL HISTORICAL FRACTURES WITHIN COMMUNITIES; AND INCREASE PARTICIPATION OF RACIAL AND ETHNIC MINORITIES IN SCREENING EFFORTS AND RESEARCH STUDIES. THIS REQUIRES DEVELOPING A SYSTEM OF JUSTICE AND TRUST BASED ON SPECIFIC, SOLUTION-ORIENTED GRASSROOTS COMMUNITY EFFORTS WORKING IN TANDEM WITH MEDICAL AND PHARMACEUTICAL LEADERS. BY FULLY EXPLORING AND PINPOINTING THE UNDERLYING CAUSES OF HEALTHCARE DISPARITIES, IT SHOULD BE POSSIBLE TO DEFINE STRATEGIES AND INTERVENTIONS MOST LIKELY TO TRANSFORM CANCER CARE. THE ULTIMATE GOAL IS UNDERSTANDING INDIVIDUAL, CULTURAL, AND BIOLOGICAL VULNERABILITIES, INCLUDING ENVIRONMENTAL AND EPIGENETIC LIABILITIES, TO OPTIMIZE CANCER PREVENTION, DIAGNOSIS, AND TREATMENT. 2022 2 6282 46 THE POTENTIAL IMPACT OF SOCIAL GENOMICS ON WOUND HEALING. SIGNIFICANCE: HUMAN SKIN WOUNDS CARRY AN IMMENSE EPIDEMIOLOGIC AND FINANCIAL BURDEN, AND THEIR IMPACT WILL CONTINUE TO GROW WITH AN AGING POPULATION AND RISING INCIDENCE OF COMORBID CONDITIONS KNOWN TO AFFECT WOUND HEALING. TO COMPREHENSIVELY ADDRESS THIS GROWING CLINICAL ISSUE, PHYSICIANS SHOULD ALSO BE AWARE OF HOW CONDITIONS OF THE HUMAN SOCIAL ENVIRONMENT MAY AFFECT WOUND HEALING. HERE WE PROVIDE A REVIEW OF THE EMERGING FIELD OF SOCIAL GENOMICS AND ITS POTENTIAL IMPACT ON THE WOUND HEALING. RECENT ADVANCES: MULTIPLE STUDIES USING HUMAN AND ANIMAL MODELS HAVE CORRELATED SOCIAL INFLUENCES AND THEIR CONTRIBUTING EFFECTS TO ACUTE AND CHRONIC STRESS WITH DELAYS IN WOUND HEALING. FURTHERMORE, OBSERVATIONS BETWEEN NONGENETIC FACTORS SUCH AS NUTRITION, SOCIOECONOMIC, AND EDUCATIONAL STATUS HAVE ALSO SHOWN TO HAVE A DIRECT OR INDIRECT IMPACT ON CLINICAL OUTCOMES OF WOUND HEALING. CRITICAL ISSUES: NUTRITION, FINANCIAL BURDEN, SOCIOECONOMIC AND EDUCATION STATUS, AND ACUTE AND CHRONIC STRESS ARE VARIABLES THAT HAVE EITHER DIRECT (EPIGENETIC) OR INDIRECT IMPACT ON WOUND HEALING AND PATIENTS' QUALITY OF LIFE. WOUND CARE IS COSTLY AND REMAINS A CHALLENGE PLACING ECONOMIC BURDEN ON PATIENTS. FURTHERMORE, POOR CLINICAL OUTCOMES AND COMPLICATIONS INCLUDING LOSS OF MOBILITY AND DISABILITY MAY LEAD TO JOB LOSS, FURTHER CONTRIBUTING TO SOCIOECONOMIC RELATED STRESS. THUS, THE ECONOMIC BURDEN AND INADEQUATE WOUND HEALING ARE INTERTWINED, MAKING EACH OTHER WORSE. FUTURE DIRECTIONS: ALTHOUGH SOME EVIDENCE REGARDING THE SPECIFIC CHANGES IN GENETIC PATHWAYS IMPARTED BY CONDITIONS OF THE SOCIAL ENVIRONMENT EXISTS, FURTHER STUDIES ARE WARRANTED TO IDENTIFY POTENTIAL MECHANISMS, INTERVENTIONS, AND PREVENTION APPROACHES. 2020 3 264 35 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 4 548 37 AUTISM SPECTRUM DISORDER AT THE CROSSROAD BETWEEN GENES AND ENVIRONMENT: CONTRIBUTIONS, CONVERGENCES, AND INTERACTIONS IN ASD DEVELOPMENTAL PATHOPHYSIOLOGY. THE COMPLEX PATHOPHYSIOLOGY OF AUTISM SPECTRUM DISORDER ENCOMPASSES INTERACTIONS BETWEEN GENETIC AND ENVIRONMENTAL FACTORS. ON THE ONE HAND, HUNDREDS OF GENES, CONVERGING AT THE FUNCTIONAL LEVEL ON SELECTIVE BIOLOGICAL DOMAINS SUCH AS EPIGENETIC REGULATION AND SYNAPTIC FUNCTION, HAVE BEEN IDENTIFIED TO BE EITHER CAUSATIVE OR RISK FACTORS OF AUTISM. ON THE OTHER HAND, EXPOSURE TO CHEMICALS THAT ARE WIDESPREAD IN THE ENVIRONMENT, SUCH AS ENDOCRINE DISRUPTORS, HAS BEEN ASSOCIATED WITH ADVERSE EFFECTS ON HUMAN HEALTH, INCLUDING NEURODEVELOPMENTAL DISORDERS. INTERESTINGLY, EXPERIMENTAL RESULTS SUGGEST AN OVERLAP IN THE REGULATORY PATHWAYS PERTURBED BY GENETIC MUTATIONS AND ENVIRONMENTAL FACTORS, DEPICTING CONVERGENCES AND COMPLEX INTERPLAYS BETWEEN GENETIC SUSCEPTIBILITY AND TOXIC INSULTS. THE PERVASIVE NATURE OF CHEMICAL EXPOSURE POSES PIVOTAL CHALLENGES FOR NEUROTOXICOLOGICAL STUDIES, REGULATORY AGENCIES, AND POLICY MAKERS. THIS HIGHLIGHTS AN EMERGING NEED OF DEVELOPING NEW INTEGRATIVE MODELS, INCLUDING BIOMONITORING, EPIDEMIOLOGY, EXPERIMENTAL, AND COMPUTATIONAL TOOLS, ABLE TO CAPTURE REAL-LIFE SCENARIOS ENCOMPASSING THE INTERACTION BETWEEN CHRONIC EXPOSURE TO MIXTURE OF SUBSTANCES AND INDIVIDUALS' GENETIC BACKGROUNDS. IN THIS REVIEW, WE ADDRESS THE INTERTWINED ROLES OF GENETIC LESIONS AND ENVIRONMENTAL INSULTS. SPECIFICALLY, WE OUTLINE THE TRANSFORMATIVE POTENTIAL OF STEM CELL MODELS, COUPLED WITH OMICS ANALYTICAL APPROACHES AT INCREASINGLY SINGLE CELL RESOLUTION, AS CONVERGING TOOLS TO EXPERIMENTALLY DISSECT THE PATHOGENIC MECHANISMS UNDERLYING NEURODEVELOPMENTAL DISORDERS, AS WELL AS TO IMPROVE DEVELOPMENTAL NEUROTOXICOLOGY RISK ASSESSMENT. 2020 5 3910 36 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 6 5161 44 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 7 966 44 CHRONIC NEUROLOGICAL DISORDERS: GENETIC AND EPIGENETIC MARKERS FOR MONITORING OF PHARMACOTHERAPY. INTRODUCTION: CHRONIC NEUROLOGICAL DISEASES ARE A MAJOR CAUSE OF MORTALITY AND MORBIDITY IN THE WORLD. WITH INCREASING LIFE EXPECTANCY IN THE DEVELOPING WORLD, THE INCIDENCE AND PREVALENCE OF THESE DISEASES ARE PREDICTED TO RISE EVEN FURTHER. THIS HAS ALSO CONTRIBUTED TO AN INCREASE IN DISABILITY-ADJUSTED LIFE YEARS (DALYS) FOR NONCOMMUNICABLE DISEASES. TREATMENT FOR SUCH DISEASES ALSO POSES A CHALLENGE WITH MULTIPLE GENETIC AND EPIGENETIC FACTORS LEADING TO A VARIED OUTCOME. PERSONALIZATION OF TREATMENT IS ONE WAY THAT TREATMENT OUTCOME/PROGNOSIS OF DISEASE CAN BE IMPROVED, AND PHARMACOGENOMICS PLAYS A SIGNIFICANT ROLE IN THIS CONTEXT. METHODOLOGY: THIS ARTICLE REVIEWED THE EVIDENCE PERTAINING TO THE ASSOCIATION OF GENETIC AND EPIGENETIC MARKERS WITH MAJOR NEUROLOGICAL DISORDERS LIKE MULTIPLE SCLEROSIS (MS), ALZHEIMER'S DISEASE (AD), AND PARKINSON'S DISEASE (PD), WHICH ARE A MAJOR SOURCE OF BURDEN AMONG NEUROLOGICAL DISORDERS. TYPES OF STUDIES INCLUDED ARE PEER-REVIEWED ORIGINAL RESEARCH ARTICLES FROM THE PUBMED DATABASE (1999-2018). RESULTS: THIS STUDY COMPILED DATA REGARDING SPECIFIC GENETIC AND EPIGENETIC MARKERS WITH A SIGNIFICANT CORRELATION BETWEEN THE CLINICAL DIAGNOSIS OF THE DISEASE AND PROGNOSIS OF THERAPY FROM 65 STUDIES. IN A SINGLE PLATFORM, THIS REVIEW HIGHLIGHTS THE CLUES TO SOME VITAL QUESTIONS, SUCH AS WHY INTERFERON BETA (IFN-BETA) THERAPY FAILS TO IMPROVE SYMPTOMS IN ALL MS PATIENTS? WHY CHOLINESTERASE INHIBITORS FAIL TO IMPROVE COGNITIVE IMPAIRMENT IN A SUBSET OF PEOPLE SUFFERING FROM AD? OR WHY SOME INDIVIDUALS ON LEVODOPA (L-DOPA) FOR PD SUFFER FROM SIDE-EFFECTS RANGING FROM DYSKINESIA TO HALLUCINATION WHILE OTHERS DO NOT? CONCLUSION: THIS ARTICLE SUMMARIZES THE GENETIC AND EPIGENETIC FACTORS THAT MAY EITHER REQUIRE MONITORING OR HELP IN DECIDING FUTURE PHARMACOTHERAPY IN A PATIENT SUFFERING FROM MS, AD, AND PD. AS THE HEALTH CARE SYSTEM DEVELOPS AND REACHES NEWER HEIGHTS, WE EXPECT MORE AND MORE OF THESE BIOMARKERS TO BE USED AS PHARMACOTHERAPEUTIC OUTCOME INDICATORS. 2021 8 530 37 ASTHMA. ASTHMA IS THE MOST COMMON INFLAMMATORY DISEASE OF THE LUNGS. THE PREVALENCE OF ASTHMA IS INCREASING IN MANY PARTS OF THE WORLD THAT HAVE ADOPTED ASPECTS OF THE WESTERN LIFESTYLE, AND THE DISEASE POSES A SUBSTANTIAL GLOBAL HEALTH AND ECONOMIC BURDEN. ASTHMA INVOLVES BOTH THE LARGE-CONDUCTING AND THE SMALL-CONDUCTING AIRWAYS, AND IS CHARACTERIZED BY A COMBINATION OF INFLAMMATION AND STRUCTURAL REMODELLING THAT MIGHT BEGIN IN UTERO. DISEASE PROGRESSION OCCURS IN THE CONTEXT OF A DEVELOPMENTAL BACKGROUND IN WHICH THE POSTNATAL ACQUISITION OF ASTHMA IS STRONGLY LINKED WITH ALLERGIC SENSITIZATION. MOST ASTHMA CASES FOLLOW A VARIABLE COURSE, INVOLVING VIRAL-INDUCED WHEEZING AND ALLERGEN SENSITIZATION, THAT IS ASSOCIATED WITH VARIOUS UNDERLYING MECHANISMS (OR ENDOTYPES) THAT CAN DIFFER BETWEEN INDIVIDUALS. EACH SET OF ENDOTYPES, IN TURN, PRODUCES SPECIFIC ASTHMA CHARACTERISTICS THAT EVOLVE ACROSS THE LIFECOURSE OF THE PATIENT. STRONG GENETIC AND ENVIRONMENTAL DRIVERS OF ASTHMA INTERCONNECT THROUGH NOVEL EPIGENETIC MECHANISMS THAT OPERATE PRENATALLY AND THROUGHOUT CHILDHOOD. ASTHMA CAN SPONTANEOUSLY REMIT OR BEGIN DE NOVO IN ADULTHOOD, AND THE FACTORS THAT LEAD TO THE EMERGENCE AND REGRESSION OF ASTHMA, IRRESPECTIVE OF AGE, ARE POORLY UNDERSTOOD. NONETHELESS, THERE IS MOUNTING EVIDENCE THAT SUPPORTS A PRIMARY ROLE FOR STRUCTURAL CHANGES IN THE AIRWAYS WITH ASTHMA ACQUISITION, ON WHICH ALTERED INNATE IMMUNE MECHANISMS AND MICROBIOTA INTERACTIONS ARE SUPERIMPOSED. ON THE BASIS OF THE IDENTIFICATION OF NEW CAUSATIVE PATHWAYS, THE SUBPHENOTYPING OF ASTHMA ACROSS THE LIFECOURSE OF PATIENTS IS PAVING THE WAY FOR MORE-PERSONALIZED AND PRECISE PATHWAY-SPECIFIC APPROACHES FOR THE PREVENTION AND TREATMENT OF ASTHMA, CREATING THE REAL POSSIBILITY OF TOTAL PREVENTION AND CURE FOR THIS CHRONIC INFLAMMATORY DISEASE. 2015 9 3286 45 HIDRADENITIS SUPPURATIVA: DETANGLING PHENOTYPES AND IDENTIFYING COMMON DENOMINATORS. HIDRADENITIS SUPPURATIVA (HS) IS A CHRONIC INFLAMMATORY SKIN DISEASE WITH A SEVERE IMPACT ON PATIENTS' QUALITY OF LIFE THROUGH ITS RECURRENT AND PAINFUL NATURE, AS WELL AS ITS COMORBIDITY BURDEN. THE SHIFT IN THE PATHOGENIC PARADIGM FROM A CONDITION OF THE APOCRINE GLANDS TO AN AUTOINFLAMMATORY DISEASE ASSOCIATED WITH FOLLICULAR DESTRUCTION HAS RENDERED ITS UNDERSTANDING DIFFICULT, AS THERE ARE STILL LARGE GAPS IN PINPOINTING THE UNDERLYING MECHANISMS, WHICH CANNOT CURRENTLY EXPLAIN THE EXISTING CLINICAL VARIATION AND AS A RESULT, TRANSLATE INTO SUBOPTIMAL THERAPY. MULTIFACTORIAL INVOLVEMENT IS HYPOTHESIZED, WITH AN IMPLICATION OF GENETIC MUTATIONS, MICROBIOME DYSBIOSIS, CYTOKINE UPREGULATION, AND ENVIRONMENTAL FACTORS. CLINICAL OBSERVATION IS FUNDAMENTAL FOR DIAGNOSIS, HOWEVER, THE MARKED HETEROGENEITY IN PRESENTATION LEADS TO DELAYS IN DETECTION AND CHALLENGES IN TREATMENT SELECTION, SHOWCASING CLEAR LIMITS IN DEFINING THE LINK BETWEEN GENETIC ASPECTS OF HS, THE ROLE OF EPIGENETIC FACTORS, AND ITS PATHOGENIC PATHWAYS. THERE HAVE BEEN ATTEMPTS TO FORMULATE PHENOTYPES THAT COULD AID IN PROGNOSTICATION AND MANAGEMENT, HOWEVER, CURRENT CLASSIFICATION SCHEMATA SHOW SIGNIFICANT OVERLAP AND NO VALIDATION THROUGH LONGITUDINAL STUDIES. IN THIS CONTEXT, NOMENCLATURE POSES A GREAT CHALLENGE DUE TO THE LACK OF GLOBAL AGREEMENT IN THE DEFINITION OF LESIONS, WHICH SHOULD BE ADDRESSED BY FUTURE RESEARCH TO ENABLE SIMPLIFIED RECOGNITION AND ALLOW FOR MORE PRECISE SEVERITY SCORING. THIS COULD BE COMPLEMENTED BY THE ADDITION OF EXTRA DERMATOLOGIC FINDINGS OR PARACLINICAL ASSESSMENT IN CONSTRUCTING PHENOTYPES. THE DEVELOPMENT OF VALID, PREDICTIVE, AND RELIABLE CLASSIFICATIONS OF HS MAY LEAD TO AN IMPROVEMENT IN COMPREHENDING ITS PATHOPHYSIOLOGY, FAVORING A MORE PERSONALIZED APPROACH IN MANAGEMENT. THIS COULD BE ACHIEVED THROUGH CONSENSUS IN THE CHARACTERIZATION OF CLINICAL FEATURES AND DATA GATHERING, AS WELL AS VALIDATION ATTEMPTS FOR DESCRIBED PHENOTYPES. ULTIMATELY, THE GENOTYPE-ENDOTYPE-PHENOTYPE CORRELATION IN HS REQUIRES TARGETED, SYSTEMATIC INQUIRIES AND SHOULD BE ADDRESSED MORE LARGELY TO BROADEN THE PERSPECTIVE ON THIS DEBILITATING ENTITY. 2023 10 3472 31 IDENTIFICATION AND MANAGEMENT OF PAIN MEDICATION ABUSE AND MISUSE: CURRENT STATE AND FUTURE DIRECTIONS. LONG-TERM OPIOID THERAPY POSES A RISK FOR ABUSE AND MISUSE IN SOME PATIENTS. IDENTIFYING WHICH PATIENTS MAY POTENTIALLY BE AT RISK PRIOR TO INITIATION OF THERAPY, AND IDENTIFYING PATIENTS IN WHOM THESE PROBLEMS DEVELOP DURING THERAPY, ARE SIGNIFICANT CHALLENGES. OUTCOME PREDICTION IS IMPEDED BY THE COMPLEXITY OF THE PROBLEM, WHERE CONSIDERABLE HETEROGENEITY RESULTS FROM PSYCHOLOGICAL AND SOCIOECONOMIC FACTORS, AS WELL AS INTERINDIVIDUAL VARIATION IN BIOLOGICAL PATHWAYS DUE TO GENETIC AND EPIGENETIC FACTORS. SCREENING TOOLS DESIGNED TO DETECT OPIOID MISUSE AND URINE DRUG TESTING ARE BOTH USED CLINICALLY; SCANT EVIDENCE CURRENTLY EXISTS TO ALLOW THE FORMULATION OF AN ALGORITHM FOR JUDICIOUS USE OF THESE TOOLS. MOREOVER, THESE TOOLS MAY NOT BE ADDRESSING THE UNDERLYING ALTERATIONS IN BIOLOGICAL PATHWAYS THAT OCCUR OWING TO THE DEVELOPMENT OF CHRONIC PAIN OR IN RESPONSE TO CHRONIC OPIOID ADMINISTRATION. AN EVIDENCE-BASED ALGORITHMIC APPROACH TO RISK MITIGATION THAT CAN BE APPLIED IN A COST-EFFECTIVE MANNER TO GUIDE THERAPY IS URGENTLY NEEDED. 2012 11 5224 52 PRIORITIZED RESEARCH FOR THE PREVENTION, TREATMENT, AND REVERSAL OF CHRONIC DISEASE: RECOMMENDATIONS FROM THE LIFESTYLE MEDICINE RESEARCH SUMMIT. DECLINING LIFE EXPECTANCY AND INCREASING ALL-CAUSE MORTALITY IN THE UNITED STATES HAVE BEEN ASSOCIATED WITH UNHEALTHY BEHAVIORS, SOCIOECOLOGICAL FACTORS, AND PREVENTABLE DISEASE. A GROWING BODY OF BASIC SCIENCE, CLINICAL RESEARCH, AND POPULATION HEALTH EVIDENCE POINTS TO THE BENEFITS OF HEALTHY BEHAVIORS, ENVIRONMENTS AND POLICIES TO MAINTAIN HEALTH AND PREVENT, TREAT, AND REVERSE THE ROOT CAUSES OF COMMON CHRONIC DISEASES. SIMILARLY, INNOVATIONS IN RESEARCH METHODOLOGIES, STANDARDS OF EVIDENCE, EMERGENCE OF UNIQUE STUDY COHORTS, AND BREAKTHROUGHS IN DATA ANALYTICS AND MODELING CREATE NEW POSSIBILITIES FOR PRODUCING BIOMEDICAL KNOWLEDGE AND CLINICAL TRANSLATION. TO UNDERSTAND THESE ADVANCES AND INFORM FUTURE DIRECTIONS RESEARCH, THE LIFESTYLE MEDICINE RESEARCH SUMMIT WAS CONVENED AT THE UNIVERSITY OF PITTSBURGH ON DECEMBER 4-5, 2019. THE SUMMIT'S GOAL WAS TO REVIEW CURRENT STATUS AND DEFINE RESEARCH PRIORITIES IN THE SIX CORE AREAS OF LIFESTYLE MEDICINE: PLANT-PREDOMINANT NUTRITION, PHYSICAL ACTIVITY, SLEEP, STRESS, ADDICTIVE BEHAVIORS, AND POSITIVE PSYCHOLOGY/SOCIAL CONNECTION. FORTY INVITED SUBJECT MATTER EXPERTS (1) REVIEWED EXISTING KNOWLEDGE AND GAPS RELATING LIFESTYLE BEHAVIORS TO COMMON CHRONIC DISEASES, SUCH AS CARDIOVASCULAR DISEASE, DIABETES, MANY CANCERS, INFLAMMATORY- AND IMMUNE-RELATED DISORDERS AND OTHER CONDITIONS; AND (2) DISCUSSED THE POTENTIAL FOR APPLYING CUTTING-EDGE MOLECULAR, CELLULAR, EPIGENETIC AND EMERGING SCIENCE KNOWLEDGE AND COMPUTATIONAL METHODOLOGIES, RESEARCH DESIGNS, AND STUDY COHORTS TO ACCELERATE CLINICAL APPLICATIONS ACROSS ALL SIX DOMAINS OF LIFESTYLE MEDICINE. NOTABLY, FEDERAL HEALTH AGENCIES, SUCH AS THE DEPARTMENT OF DEFENSE AND VETERANS ADMINISTRATION HAVE BEGUN TO ADOPT "WHOLE-PERSON HEALTH AND PERFORMANCE" MODELS THAT ADDRESS THESE LIFESTYLE AND ENVIRONMENTAL ROOT CAUSES OF CHRONIC DISEASE AND ASSOCIATED MORBIDITY, MORTALITY, AND COST. RECOMMENDATIONS STRONGLY SUPPORT LEVERAGING EMERGING RESEARCH METHODOLOGIES, SYSTEMS BIOLOGY, AND COMPUTATIONAL MODELING IN ORDER TO ACCELERATE EFFECTIVE CLINICAL AND POPULATION SOLUTIONS TO IMPROVE HEALTH AND REDUCE SOCIETAL COSTS. NEW AND ALTERNATIVE HIERARCHIES OF EVIDENCE ARE ALSO BE NEEDED IN ORDER TO ASSESS THE QUALITY OF EVIDENCE AND DEVELOP EVIDENCE-BASED GUIDELINES ON LIFESTYLE MEDICINE. CHILDREN AND UNDERSERVED POPULATIONS WERE IDENTIFIED AS PRIORITIZED GROUPS TO STUDY. THE COVID-19 PANDEMIC, WHICH DISPROPORTIONATELY IMPACTS PEOPLE WITH CHRONIC DISEASES THAT ARE AMENABLE TO EFFECTIVE LIFESTYLE MEDICINE INTERVENTIONS, MAKES THE SUMMIT'S FINDINGS AND RECOMMENDATIONS FOR FUTURE RESEARCH PARTICULARLY TIMELY AND RELEVANT. 2020 12 1859 50 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 13 6295 38 THE PROMISES AND CHALLENGES OF TOXICO-EPIGENOMICS: ENVIRONMENTAL CHEMICALS AND THEIR IMPACTS ON THE EPIGENOME. BACKGROUND: IT HAS BEEN ESTIMATED THAT A SUBSTANTIAL PORTION OF CHRONIC AND NONCOMMUNICABLE DISEASES CAN BE CAUSED OR EXACERBATED BY EXPOSURE TO ENVIRONMENTAL CHEMICALS. MULTIPLE LINES OF EVIDENCE INDICATE THAT EARLY LIFE EXPOSURE TO ENVIRONMENTAL CHEMICALS AT RELATIVELY LOW CONCENTRATIONS COULD HAVE LASTING EFFECTS ON INDIVIDUAL AND POPULATION HEALTH. ALTHOUGH THE POTENTIAL ADVERSE EFFECTS OF ENVIRONMENTAL CHEMICALS ARE KNOWN TO THE SCIENTIFIC COMMUNITY, REGULATORY AGENCIES, AND THE PUBLIC, LITTLE IS KNOWN ABOUT THE MECHANISTIC BASIS BY WHICH THESE CHEMICALS CAN INDUCE LONG-TERM OR TRANSGENERATIONAL EFFECTS. TO ADDRESS THIS QUESTION, EPIGENETIC MECHANISMS HAVE EMERGED AS THE POTENTIAL LINK BETWEEN GENETIC AND ENVIRONMENTAL FACTORS OF HEALTH AND DISEASE. OBJECTIVES: WE PRESENT AN OVERVIEW OF EPIGENETIC REGULATION AND A SUMMARY OF REPORTED EVIDENCE OF ENVIRONMENTAL TOXICANTS AS EPIGENETIC DISRUPTORS. WE ALSO DISCUSS THE ADVANTAGES AND CHALLENGES OF USING EPIGENETIC BIOMARKERS AS AN INDICATOR OF TOXICANT EXPOSURE, USING MEASURES THAT CAN BE TAKEN TO IMPROVE RISK ASSESSMENT, AND OUR PERSPECTIVES ON THE FUTURE ROLE OF EPIGENETICS IN TOXICOLOGY. DISCUSSION: UNTIL RECENTLY, EFFORTS TO APPLY EPIGENOMIC DATA IN TOXICOLOGY AND RISK ASSESSMENT WERE RESTRICTED BY AN INCOMPLETE UNDERSTANDING OF EPIGENOMIC VARIABILITY ACROSS TISSUE TYPES AND POPULATIONS. THIS IS POISED TO CHANGE WITH THE DEVELOPMENT OF NEW TOOLS AND CONCERTED EFFORTS BY RESEARCHERS ACROSS DISCIPLINES THAT HAVE LED TO A BETTER UNDERSTANDING OF EPIGENETIC MECHANISMS AND COMPREHENSIVE MAPS OF EPIGENOMIC VARIATION. WITH THE FOUNDATIONS NOW IN PLACE, WE FORESEE THAT UNPRECEDENTED ADVANCEMENTS WILL TAKE PLACE IN THE FIELD IN THE COMING YEARS. HTTPS://DOI.ORG/10.1289/EHP6104. 2020 14 5163 39 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 15 5025 42 PERSONALIZED MANAGEMENT OF CARDIOVASCULAR DISORDERS. PERSONALIZED MANAGEMENT OF CARDIOVASCULAR DISORDERS (CVD), ALSO REFERRED TO AS PERSONALIZED OR PRECISION CARDIOLOGY IN ACCORDANCE WITH GENERAL PRINCIPLES OF PERSONALIZED MEDICINE, IS SELECTION OF THE BEST TREATMENT FOR AN INDIVIDUAL PATIENT. IT INVOLVES THE INTEGRATION OF VARIOUS "OMICS" TECHNOLOGIES SUCH AS GENOMICS AND PROTEOMICS AS WELL AS OTHER NEW TECHNOLOGIES SUCH AS NANOBIOTECHNOLOGY. MOLECULAR DIAGNOSTICS AND BIOMARKERS ARE IMPORTANT FOR LINKING DIAGNOSIS WITH THERAPY AND MONITORING THERAPY. BECAUSE CVD INVOLVE PERTURBATIONS OF LARGE COMPLEX BIOLOGICAL NETWORKS, A SYSTEMS BIOLOGY APPROACH TO CVD RISK STRATIFICATION MAY BE USED FOR IMPROVING RISK-ESTIMATING ALGORITHMS, AND MODELING OF PERSONALIZED BENEFIT OF TREATMENT MAY BE HELPFUL FOR GUIDING THE CHOICE OF INTERVENTION. BIOINFORMATICS TOOLS ARE HELPFUL IN ANALYZING AND INTEGRATING LARGE AMOUNTS OF DATA FROM VARIOUS SOURCES. PERSONALIZED THERAPY IS CONSIDERED DURING DRUG DEVELOPMENT, INCLUDING METHODS OF TARGETED DRUG DELIVERY AND CLINICAL TRIALS. INDIVIDUALIZED RECOMMENDATIONS CONSIDER MULTIPLE FACTORS - GENETIC AS WELL AS EPIGENETIC - FOR PATIENTS' RISK OF HEART DISEASE. EXAMPLES OF PERSONALIZED TREATMENT ARE THOSE OF CHRONIC MYOCARDIAL ISCHEMIA, HEART FAILURE, AND HYPERTENSION. SIMILAR APPROACHES CAN BE USED FOR THE MANAGEMENT OF ATRIAL FIBRILLATION AND HYPERCHOLESTEROLEMIA, AS WELL AS THE USE OF ANTICOAGULANTS. PERSONALIZED MANAGEMENT INCLUDES PHARMACOTHERAPY, SURGERY, LIFESTYLE MODIFICATIONS, AND COMBINATIONS THEREOF. FURTHER PROGRESS IN UNDERSTANDING THE PATHOMECHANISM OF COMPLEX CARDIOVASCULAR DISEASES AND IDENTIFICATION OF CAUSATIVE FACTORS AT THE INDIVIDUAL PATIENT LEVEL WILL PROVIDE OPPORTUNITIES FOR THE DEVELOPMENT OF PERSONALIZED CARDIOLOGY. APPLICATION OF PRINCIPLES OF PERSONALIZED MEDICINE WILL IMPROVE THE CARE OF THE PATIENTS WITH CVD. 2017 16 4344 33 MINIREVIEW: TRANSLATIONAL ANIMAL MODELS OF HUMAN MENOPAUSE: CHALLENGES AND EMERGING OPPORTUNITIES. INCREASING IMPORTANCE IS PLACED ON THE TRANSLATIONAL VALIDITY OF ANIMAL MODELS OF HUMAN MENOPAUSE TO DISCERN RISK VS. BENEFIT FOR PREDICTION OF OUTCOMES AFTER THERAPEUTIC INTERVENTIONS AND TO DEVELOP NEW THERAPEUTIC STRATEGIES TO PROMOTE HEALTH. BASIC DISCOVERY RESEARCH CONDUCTED OVER MANY DECADES HAS BUILT AN EXTENSIVE BODY OF KNOWLEDGE REGARDING REPRODUCTIVE SENESCENCE ACROSS MAMMALIAN SPECIES UPON WHICH TO ADVANCE ANIMAL MODELS OF HUMAN MENOPAUSE. MODIFICATIONS TO EXISTING ANIMAL MODELS COULD RAPIDLY ADDRESS TRANSLATIONAL GAPS RELEVANT TO CLINICAL ISSUES IN HUMAN MENOPAUSAL HEALTH, WHICH INCLUDE THE IMPACT OF 1) CHRONIC OVARIAN HORMONE DEPRIVATION AND HORMONE THERAPY, 2) CLINICALLY RELEVANT HORMONE THERAPY REGIMENS (CYCLIC VS. CONTINUOUS COMBINED), 3) CLINICALLY RELEVANT HORMONE THERAPY FORMULATIONS, AND 4) WINDOWS OF OPPORTUNITY AND OPTIMAL DURATION OF INTERVENTIONS. MODIFICATIONS IN EXISTING ANIMAL MODELS TO MORE ACCURATELY REPRESENT HUMAN MENOPAUSE AND CLINICAL INTERVENTIONS COULD RAPIDLY PROVIDE PRECLINICAL TRANSLATIONAL DATA TO PREDICT OUTCOMES REGARDING UNRESOLVED CLINICAL ISSUES RELEVANT TO WOMEN'S MENOPAUSAL HEALTH. DEVELOPMENT OF THE NEXT GENERATION OF ANIMAL MODELS OF HUMAN MENOPAUSE COULD LEVERAGE ADVANCES IN IDENTIFYING GENOTYPIC VARIATIONS IN ESTROGEN AND PROGESTERONE RECEPTORS TO DEVELOP PERSONALIZED MENOPAUSAL CARE AND TO PREDICT OUTCOMES OF INTERVENTIONS FOR PROTECTION AGAINST OR VULNERABILITY TO DISEASE. KEY TO THE SUCCESS OF THESE MODELS IS THE CLOSE COUPLING BETWEEN THE TRANSLATIONAL TARGET AND THE RANGE OF PREDICTIVE VALIDITY. PRECLINICAL TRANSLATIONAL ANIMAL MODELS OF HUMAN MENOPAUSE NEED TO KEEP PACE WITH CHANGES IN CLINICAL PRACTICE. WITH FOCUS ON PREDICTIVE VALIDITY AND STRATEGIC USE OF ADVANCES IN GENETIC AND EPIGENETIC SCIENCE, NEW ANIMAL MODELS OF HUMAN MENOPAUSE HAVE THE OPPORTUNITY TO SET NEW DIRECTIONS FOR MENOPAUSAL CLINICAL CARE FOR WOMEN WORLDWIDE. 2012 17 2605 28 EPIGENETICS-A POTENTIAL MEDIATOR BETWEEN AIR POLLUTION AND PRETERM BIRTH. PRETERM BIRTH IS A MAJOR CAUSE OF INFANT MORBIDITY AND MORTALITY AND A POTENTIAL RISK FACTOR FOR ADULT CHRONIC DISEASE. WITH OVER 15 MILLION INFANTS BORN PRETERM WORLDWIDE EACH YEAR, PRETERM BIRTH POSES A GLOBAL HEALTH CONCERN. THERE IS A POSSIBLE ASSOCIATION BETWEEN AIR POLLUTION AND PRETERM BIRTH, THOUGH STUDIES HAVE BEEN INCONSISTENT, LIKELY DUE TO VARIATION IN STUDY DESIGN. HOW AIR POLLUTION INDUCES HEALTH EFFECTS IS UNCERTAIN; HOWEVER, STUDIES HAVE REPEATEDLY DEMONSTRATED THE EFFECTS OF AIR POLLUTION ON EPIGENETIC MODIFICATIONS. MORE RECENT EVIDENCE SUGGESTS THAT EPIGENETICS MAY, IN TURN, BE LINKED TO PRETERM BIRTH. DISCOVERY OF ENVIRONMENTALLY MODIFIABLE EPIGENETIC PROCESSES CONNECTED TO PRETERM BIRTH MAY HELP TO IDENTIFY WOMEN AT RISK OF PRETERM BIRTH, AND ULTIMATELY LEAD TO DEVELOPMENT OF NEW PRETERM BIRTH PREVENTION MEASURES. 2016 18 29 49 A BIOPSYCHOSOCIAL OVERVIEW OF THE OPIOID CRISIS: CONSIDERING NUTRITION AND GASTROINTESTINAL HEALTH. THE OPIOID CRISIS HAS REACHED EPIDEMIC PROPORTIONS IN THE UNITED STATES WITH RISING OVERDOSE DEATH RATES. IDENTIFYING THE UNDERLYING FACTORS THAT CONTRIBUTE TO ADDICTION VULNERABILITY MAY LEAD TO MORE EFFECTIVE PREVENTION STRATEGIES. SUPPLY SIDE ENVIRONMENTAL FACTORS ARE A MAJOR CONTRIBUTING COMPONENT. PSYCHOSOCIAL FACTORS SUCH AS STRESS, TRAUMA, AND ADVERSE CHILDHOOD EXPERIENCES HAVE BEEN LINKED TO EMOTIONAL PAIN LEADING TO SELF-MEDICATION. GENETIC AND EPIGENETIC FACTORS ASSOCIATED WITH BRAIN REWARD PATHWAYS AND IMPULSIVITY ARE KNOWN PREDICTORS OF ADDICTION VULNERABILITY. THIS REVIEW ATTEMPTS TO PRESENT A BIOPSYCHOSOCIAL APPROACH THAT CONNECTS VARIOUS SOCIAL AND BIOLOGICAL THEORIES RELATED TO THE ADDICTION CRISIS. THE EMERGING ROLE OF NUTRITION THERAPY WITH AN EMPHASIS ON GASTROINTESTINAL HEALTH IN THE TREATMENT OF OPIOID USE DISORDER IS PRESENTED. THE BIOPSYCHOSOCIAL MODEL INTEGRATES CONCEPTS FROM SEVERAL DISCIPLINES, EMPHASIZING MULTICAUSALITY RATHER THAN A REDUCTIONIST APPROACH. POTENTIAL SOLUTIONS AT MULTIPLE LEVELS ARE PRESENTED, CONSIDERING INDIVIDUAL AS WELL AS POPULATION HEALTH. THIS SINGLE COHESIVE FRAMEWORK IS BASED ON THE INTERDEPENDENCY OF THE ENTIRE SYSTEM, IDENTIFYING RISK AND PROTECTIVE FACTORS THAT MAY INFLUENCE SUBSTANCE-SEEKING BEHAVIOR. NUTRITION SHOULD BE INCLUDED AS ONE FACET OF A MULTIDISCIPLINARY APPROACH TOWARD IMPROVED RECOVERY OUTCOMES. CROSS-DISCIPLINARY COLLABORATIVE EFFORTS, NEW IDEAS, AND FISCAL RESOURCES WILL BE CRITICAL TO ADDRESS THE EPIDEMIC. 2019 19 3395 45 HOST GENETIC FACTORS PREDISPOSING TO HIV-ASSOCIATED NEUROCOGNITIVE DISORDER. THE SUCCESS OF COMBINATION ANTIRETROVIRAL THERAPY (CART) IN TRANSFORMING THE LIVES OF HIV-INFECTED INDIVIDUALS WITH ACCESS TO THESE DRUGS IS TEMPERED BY THE INCREASING THREAT OF HIV-ASSOCIATED NEUROCOGNITIVE DISORDERS (HAND) TO THEIR OVERALL HEALTH AND QUALITY OF LIFE. INTENSIVE INVESTIGATIONS OVER THE PAST TWO DECADES HAVE UNDERSCORED THE ROLE OF HOST IMMUNE RESPONSES, INFLAMMATION, AND MONOCYTE-DERIVED MACROPHAGES IN HAND, BUT THE PRECISE PATHOGENIC MECHANISMS UNDERLYING HAND REMAIN ONLY PARTIALLY DELINEATED. COMPLICATING RESEARCH EFFORTS AND THERAPEUTIC DRUG DEVELOPMENT ARE THE SHEER COMPLEXITY OF HAND PHENOTYPES, DIAGNOSTIC IMPRECISION, AND THE GROWING INTERSECTION OF CHRONIC IMMUNE ACTIVATION WITH AGING-RELATED COMORBIDITIES. YET, GENETIC STUDIES STILL OFFER A POWERFUL MEANS OF ADVANCING INDIVIDUALIZED CARE FOR HIV-INFECTED INDIVIDUALS AT RISK. THERE IS AN URGENT NEED FOR 1) LONGITUDINAL STUDIES USING CONSISTENT PHENOTYPIC DEFINITIONS OF HAND IN HIV-INFECTED SUBPOPULATIONS AT VERY HIGH RISK OF BEING ADVERSELY IMPACTED, SUCH AS CHILDREN, 2) TISSUE STUDIES THAT CORRELATE NEUROPATHOLOGICAL CHANGES IN MULTIPLE BRAIN REGIONS WITH GENOMIC MARKERS IN AFFECTED INDIVIDUALS AND WITH CHANGES AT THE RNA, EPIGENOMIC, AND/OR PROTEIN LEVELS, AND 3) GENETIC ASSOCIATION STUDIES USING MORE SENSITIVE SUBPHENOTYPES OF HAND. THE NIH BRAIN INITIATIVE AND HUMAN CONNECTOME PROJECT, COUPLED WITH RAPIDLY EVOLVING SYSTEMS BIOLOGY AND MACHINE LEARNING APPROACHES FOR ANALYZING HIGH-THROUGHPUT GENETIC, TRANSCRIPTOMIC AND EPIGENETIC DATA, HOLD PROMISE FOR IDENTIFYING ACTIONABLE BIOLOGICAL PROCESSES AND GENE NETWORKS THAT UNDERLIE HAND. THIS REVIEW SUMMARIZES THE CURRENT STATE OF UNDERSTANDING OF HOST GENETIC FACTORS PREDISPOSING TO HAND IN LIGHT OF PAST CHALLENGES AND SUGGESTS SOME PRIORITIES FOR FUTURE RESEARCH TO ADVANCE THE UNDERSTANDING AND CLINICAL MANAGEMENT OF HAND IN THE CART ERA. 2014 20 5263 38 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