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Severe asthma affects a minority of patients with asthma; however, it substantially impacts morbidity, health-care use, and systemic corticosteroid-related harm. Despite the increasing use of biological treatments, achievement of severe asthma remission remains elusive. Notably, real-world data on the disease burden and remission potential of severe asthma in Europe remain limited. We aimed to close this knowledge gap, offering insights with global relevance. Using data from 13 455 adults with severe asthma enrolled in the European Severe Heterogeneous Asthma Registry, Patient-centred Clinical Research Collaboration (SHARP CRC), this cross-sectional observational study evaluated the burden of severe asthma and remission-related clinical domains (exacerbations, asthma control, airflow limitation, and maintenance oral corticosteroid use) across Europe and examined their relationship with disease duration, biological therapy, and type 2 biomarkers (blood eosinophils, fractional exhaled nitric oxide [FeNO], and total IgE). Patients with severe asthma had been enrolled in national registries according to local principles and guidelines and in accordance with the European Respiratory Society/American Thoracic Society guidelines; 3% (430 of 13 885) of patients were excluded due to no consent for the international study and/or missing medication data. Patients were predominantly female (59%; 7999 of 13 453), with adult-onset asthma (82%; 8751 of 10 711), and a median disease duration of 23 years (95% CI 20-26 years). 59% (4148 of 7006) of patients had FEV1/FVC of 0·7 or less, 62% (4680 of 7568) had FEV1 lower than 80% predicted, and 89% (3519 of 3968) had at least one active disease domain. Despite 79% (10 632 of 13 453) receiving biological therapy, more than 66% (2621 of 3968) still had at least two active domains. Elevation of type 2 biomarkers persisted (89% [2806 of 3153] with at least one elevated biomarker) despite widespread biological and maintenance oral corticosteroid treatment. A subset of biologic-naive patients (35%; 1069 of 3018) exhibited a rapid accumulation of disease burden within less than 10 years, suggesting a potentially accelerated progression trajectory. This pan-European analysis of severe asthma revealed significant clinical heterogeneity and a substantial disease burden despite advanced therapies, highlighting the enduring nature of type 2 inflammation, the potential inadequacy of current remission strategies with available therapeutic approaches, and the necessity for early identification of high-risk patients. SHARP Clinical Research Collaboration and consortium partners: European Respiratory Society, GlaxoSmithKline Research and Development, Chiesi Farmaceutici Società per Azioni, Novartis Pharma Aktiengesellschaft, Sanofi-Genzyme Corporation, and Teva Branded Pharmaceutical Products R&D.
Benralizumab, an eosinophil-depleting anti-IL-5 receptor α antibody, has demonstrated efficacy in severe eosinophilic asthma and eosinophilic granulomatosis with polyangiitis and shown promising results in hypereosinophilic syndrome (HES). NATRON was a randomized, double-blind placebo-controlled phase 3 study evaluating the efficacy and safety of benralizumab in FIP1L1::PDGFRA-negative HES. The primary endpoint was time to first HES flare. In total, 133 patients (median (range) age 51 (14-87) years, 62% female) were randomized (1:1) to receive benralizumab 30 mg every 4 weeks or placebo for 24 weeks, in addition to background therapy. Benralizumab significantly reduced the risk of first flare versus placebo (hazard ratio 0.35, 95% CI 0.18 to 0.69, P = 0.0024). Adverse events occurred in 64.2% and 66.7% of benralizumab- and placebo-treated patients, respectively. Benralizumab's safety was consistent with its known profile. These results demonstrate the efficacy and safety of add-on benralizumab in the treatment of HES. ClinicalTrials.gov identifier: NCT04191304 .
The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines produced their first edition in 1999, with subsequent revisions in 2008, 2010, 2016 and 2019. A new iteration of ARIA-ARIA 2024-2025-in collaboration with EAACI is currently being developed, focusing on the management of allergic rhinitis. ARIA 2024-2025 follows the GRADE framework and is endorsed by the European Academy of Allergy and Clinical Immunology (EAACI). A set of approaches has been used to develop guideline questions, including surveying key opinion leaders and using artificial intelligence (AI)-based tools to analyse web searches on allergic rhinitis and to generate questions. Each prioritised guideline question is assessed through an Evidence-to-Decision (EtD) framework. EtDs support the systematic and transparent formulation of recommendations, comprising 12 criteria for which the best available evidence should be sought. In the context of ARIA-EAACI 2024-2025, such evidence is derived not only from randomised controlled trials but also-among others-from patient-generated data sources that better reflect the affected individuals' perspectives. Moreover, ARIA-EAACI 2024-2025 incorporates evidence on planetary health. Developed guideline recommendations will support the creation of digitalised decision algorithms and care pathways. This paper describes the methodology used to develop the person-centred, digitally enabled and AI-assisted ARIA-EAACI 2024-2025. Among others, it describes (i) the development and prioritisation of guideline questions, (ii) sources of evidence for EtDs and (iii) the development of digitalised decision algorithms and care pathways.
Having appropriate and meaningful diagnostic procedures is crucial in the approach to patients with chronic spontaneous urticaria (CSU), so we wanted to investigate relationships between CSU patients' common serum factors and clinical CSU features, and their temporal trends during antihistamine treatment. In this exploratory hypothesis-based study, we assessed disease severity and quality of life (QoL) in, initially, 41 CSU patients using UAS7, daily UAS, UCT, DLQI, and CU-Q2oL. Concurrently, we measured serum complete blood count (CBC), total IgE, thyroid antibodies and hormones, ANA, D-dimer, vitamin D, and the inflammatory molecules CRP, ESR and IL-6. We compared initial (T1) and follow-up findings (T2) (after 3 months of antihistamine therapy). Basophil concentration was the only examined serum factor useful in assessing current CSU severity/daily UAS (sensitivity 78.6%; specificity 63%; p = 0.028). Basopenia was more frequent in patients with moderate/severe CSU than in those with mild disease or remission, as measured by daily UAS (79% vs. 37%; p = 0.020). T4 values showed a significant dependence on CSU duration (r = -0.328; p = 0.036). ESR was the only examined serum factor significantly associated with weekly CSU severity (UAS7) (p = 0.038). Antihistamine treatment significantly reduced CSU activity (recorded by daily UAS and UAS7) and improved QoL (DLQI) (p = 0.006) and disease control/UCT (p = 0.005). After three months of treatment, only the CRP value correlated with CSU control/UCT (p = 0.014). We encourage the use of diagnostics employing basophil counts and clinical indices UAS7, daily UAS, UCT and DLQI for insight into a patient's CSU clinical condition. Serum factor values did not change during the 3-month treatment period, so it is not useful to measure them repeatedly. Although this study involved a small cohort and has many limitations, these promising results highlight the need for replication with a greater number of CSU patients.
This paper presents a participatory method for conducing a collaborative and culturally appropriate dialogue process between gene drive researchers and Indigenous Peoples and local communities. Coordinated by the Outreach Network for Gene Drive Research and representatives of the International Indigenous Forum on Biodiversity (IIFB), this dialogue aimed to build trust and facilitate mutual understanding and create a safe space for sharing traditional knowledge, rather than to reach decisions on the research or implementation of gene drive technology. Over a three-year period, the dialogue evolved through multiple formats, recognising the specific needs to establish a meaningful and culturally appropriate dialogue between these two groups, while ensuring that Indigenous Peoples and local communities could share their traditional knowledge, traditions and innovations in a safe and trusted environment. The method integrates key engagement principles - such as good faith, reciprocity, inclusivity, and respect for Indigenous Peoples and local communities' knowledge systems - and describes how they were operationalised in practice. It provides a concrete example of applied engagement methodology in the context of gene drive and explores how these principles have influenced the dialogue's format and the journey of both groups throughout this process, while also sharing some of the challenges they encountered. This is not a theoretical review, but a joint account from practitioners from diverse backgrounds and interests, on how engagement methods can be implemented in real-world settings. The approach offers practical insights for designing sustained and scalable engagement strategies between scientists and Indigenous Peoples on complex and emerging science topics.
Multiple studies have shown that symptom-based subtypes of obstructive sleep apnea (OSA) exist and are generalizable to clinical and population-based samples of different race/ethnic and regional backgrounds. However, there have not been studies evaluating the generalizability within a clinical sample of Chinese ancestry. Thus, the aim of the current study was to investigate the generalizability of symptom-based subtypes within clinical patients from China. This is a cross-sectional, multi-center study of patients with OSA from international sleep centers participating in the Sleep Apnea Global Interdisciplinary Consortium (SAGIC). Two Chinese cohorts were collected: 666 patients from Peking University People's Hospital (PKUPH) and 503 patients from other China sites (Peking University International Hospital, Taiwan, and Shanghai). In addition, 694 White patients were included from 7 sites across 5 countries (Iceland, Germany [Berlin], Australia [Sydney, Perth], Brazil, and the United States [Ohio State University and University of Pennsylvania]). Symptom-based subtypes were determined using a latent class analysis (LCA) of 18 self-reported symptom variables and 3 comorbidities. A total of 1,863 patients were included in the LCA. The previously described 5 symptom subtype (disturbed sleep, minimal symptoms, excessively sleepy, moderately sleepy, and upper airway symptoms dominant) were optimal in the PKUPH site, other China sites, and White patients from SAGIC. Chinese patients had higher prevalence of the minimal symptoms subtype (P < .001) compared to White patients. Among the five subtypes, the excessively sleepy subtype exhibited the highest AHI, and ODI. : Based on the included symptoms and comorbidities, five subtypes provided the optimal groupings across both Chinese and White patients in SAGIC. Chinese patients were more likely to present with fewer symptoms. These data further enhance understanding of the generalizability of OSA symptom subtypes across ethnically diverse backgrounds, and pave the way for precision management of OSA in the future.
Rapid urbanisation in India has intensified stress on urban water systems, where inadequate sewage treatment, intermittent distribution, and fragmented governance compromise drinking-water quality across diverse city typologies. These weaknesses disproportionately affect informal settlements, increasing exposure to microbial contamination and chronic toxicants such as nitrate, fluoride, arsenic, and industrial pollutants. Beyond acute infections, growing evidence suggests that urban aquatic environments function as amplification reservoirs for antimicrobial resistance. This perspective synthesises evidence across water, sanitation, environmental surveillance, and health systems to examine how infrastructure gaps and weak integration with public health monitoring sustain preventable disease burdens. It reframes urban water quality as a public health function rather than solely a municipal service, highlighting the limits of infrastructure-centric metrics. Pragmatic interventions, including continuous pressurised supply, strengthened sewage and effluent control, integrated water-quality and disease surveillance, and explicit linkage to AMR containments, should be prioritised, with success measured through reductions in morbidity and resistance.
Background: Innovative training strategies aimed at improving physiological efficiency are of growing interest in kinesiology and sports performance. Elevation training masks (ETMs) offer a practical means of inducing hypoxia-like stress. However, evidence of their effectiveness in recreationally active populations remains limited. This pilot study examined the efficiency of a five-week progressive ETM protocol combined with high-intensity interval training (HIIT) in eliciting physiological, hematological, and body-composition adaptations relevant to endurance performance. Methods: Nine recreationally active men completed a five-week intervention consisting of three treadmill-based sessions per week: one weekly incremental Conconi test and two structured aerobic-anaerobic HIIT sessions performed with an ETM. Mask resistance was progressively increased to simulate altitudes of approximately 900-3600 m. Hematological variables (erythrocytes, hemoglobin, hematocrit, erythrocyte indices, leukocytes, and platelets), body composition, maximal heart rate (HRmax), and peripheral oxygen saturation (SpO2) were assessed pre- and post intervention. Data were analyzed using paired-sample t-tests and repeated-measures ANOVA, with effect sizes reported (Cohen's d, ω2). Results: A significant main effect of time on SpO2 was observed (F(1, 8) = 130.61, p < 0.001, ω2 = 0.69), along with a significant effect of training week (F(4, 32) = 17.41, p < 0.001, ω2 = 0.43), and a significant Time × Week interaction (F(4, 32) = 15.20, p < 0.001, ω2 = 0.42), indicating progressively greater post-exercise oxygen desaturation with increasing simulated altitude. Significant post-intervention increases were found in erythrocyte count, hemoglobin concentration, and hematocrit (p ≤ 0.009, d = 1.15-1.55), alongside increases in mean corpuscular volume and mean corpuscular hemoglobin. Platelet count increased significantly (p = 0.001, d = 1.68), while leukocyte values remained unchanged (p > 0.05). Body mass index (p = 0.049, d = 0.77) and body fat percentage (p = 0.012, d = 1.08) decreased following the intervention. HRmax tended to be lower at higher simulated altitudes. Conclusions: A five-week progressive ETM-HIIT protocol efficiently induced hematological and body-composition adaptations associated with improved oxygen transport and metabolic efficiency in recreationally active men. These findings support ETM-based training as an accessible strategy for enhancing physiological efficiency in endurance-oriented kinesiology practice, warranting confirmation in larger randomized controlled studies.
Limited data are available on long-term outcomes after percutaneous coronary intervention (PCI) of coronary drug-eluting stent (DES) in-stent restenosis (ISR) depending on clinical presentation with acute coronary syndrome (ACS) or chronic coronary syndrome (CCS). Thus, the aim of this observational, retrospective study was to address this lack of evidence. Between January 2007 and February 2021, a total of 3,511 patients with 5,497 ISR lesions were treated at 2 large-volume centers in Munich, Germany, of which 1,029 (29.3%) were treated for ACS. Endpoints of interest were the rates of cardiac death, myocardial infarction (MI), repeat revascularization, and stent thrombosis (ST). Survival was analyzed using the Kaplan-Meier method. Differences between the groups were tested with the log-rank test. Conventional multivariable analysis with adjustment for relevant variables was performed. After ten years, the rates of cardiac death were 42.5% in patients with ACS and 33.3% in patients with CCS (HR 1.63 [95% CI, 1.41-1.88], p < 0.001). 17.4% of ACS patients and 9.5% of CCS patients experienced MI (HR 2.04 [95% CI, 1.65-2.50], p < 0.001). The rates of ST were 3.6% in patients with ACS and 1.2% in patients with CCS (HR 3.18 [95% CI, 1.92-5.24], p < 0.001). The rates of repeat revascularization of target lesion, target vessel and non-target vessel did not differ significantly between both groups in the long-term. In the long-term, the rates of cardiac death, MI and ST after PCI of DES-ISR are significantly higher in ACS patients than in CCS patients.
The incidence of oropharyngeal cancer (OPC) is increasing. Thus, there is a need for biomarkers that can identify high-risk patients and support personalised treatment. This study investigated the prognostic significance of circulating microRNAs (miRNAs) for progression-free survival (PFS) and overall survival (OS) in patients with OPC undergoing radiotherapy (RT). The expression of 20 circulating miRNAs was analysed in serum samples collected both before and after RT as a possible prognostic marker in patients treated for OPC. We analysed 80 patients with OPC treated with curative-intent RT. The median PFS was 42.9 months (95%CI: 25.6 - not reached), and the median OS was 63.7 months (95%CI: 33.9 - not reached). In univariate analysis, higher pre-treatment levels of miR-21-5p (HR: 2.12, 95%CI: 1.34-3.36) and miR-148a-3p (HR: 1.38, 95%CI: 1.03-1.85), as well as lower post-treatment levels of miR-345-5p (HR: 0.61, 95%CI: 0.41-0.90), were associated with worse survival. These associations remained significant in multivariable analysis adjusted for clinical factors. A combined risk model based on pre-RT miR-21-5p and post-RT miR-345-5p identified a high-risk group with significantly shorter PFS (HR: 3.01, 95%CI: 1.27-7.14) and OS (HR: 3.19, 95%CI: 1.25-8.15) compared with the low-risk group. High pre-RT hsa-miR-21-5p and low post-RT hsa-miR-345-5p were both independently associated with inferior PFS and OS. These results support the clinical relevance of integrating dynamic miRNA profiling into risk-stratification frameworks and may potentially inform more personalised strategies for post-RT monitoring in OPC patients.
Tezepelumab is a human monoclonal antibody that blocks the activity of thymic stromal lymphopoietin and is approved for adolescents and adults with severe asthma. This analysis assessed pharmacokinetics (PK), pharmacodynamics and safety of tezepelumab up to 85 days postdose in adolescents and children. The adolescent PK study (NCT02512900), in adolescents aged 12-17 years with mild-to-moderate asthma, and TRAILHEAD (NCT04673630), in children aged 5-11 years with mild, moderate or severe asthma, were both open-label, single-dose, Phase 1 studies. In the adolescent PK study, 21 adolescents (median age: 14 years) received a single 140-mg subcutaneous tezepelumab dose. The mean maximum concentration (Cmax; 24.0 [SD: 6.6] μg/mL) was observed at a median time of 6 (range: 1-20) days postdose, with a mean terminal half-life of 25.3 (SD: 4.7) days. The mean area under the concentration-time curve (AUC0-infinity) was 952 (SD: 289) μg*day/mL. In TRAILHEAD, 18 children (median age: 8 years) received a single 70-mg subcutaneous tezepelumab dose. The Cmax (27.1 μg/mL [SD: 11.9]) was observed at a median time of 3.5 (range: 2-10) days postdose, with a mean terminal half-life of 25.7 (SD: 5.9) days. The mean AUC0-infinity was 974 (SD: 320) μg*day/mL. Changes from baseline in blood eosinophil count, fractional exhaled nitric oxide and serum immunoglobulin E (IgE) reflected expected pharmacodynamic effects of tezepelumab. No new safety signals were identified. These results were consistent with previous studies of tezepelumab in other groups, supporting development of tezepelumab for asthma in the paediatric population.
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Sentinel lymph node biopsy is the gold standard for axillary staging in early breast cancer. The conventional dual-tracer technique using technetium-99m (Tc-99m) and blue dye is highly effective but limited by radiation exposure and logistical complexity. Indocyanine green (ICG) fluorescence imaging offers a radiation-free, real-time alternative. This study aimed to assess the diagnostic performance and clinical feasibility of ICG-guided SLNB compared with the standard Tc-99m-nanocolloid method. This prospective, open label, single center paired diagnostic comparison trial was conducted at the Department of Surgery, University of Debrecen Clinical Centre, Hungary. Eligible patients had biopsy-confirmed ductal carcinoma in situ or clinically node-negative invasive breast cancer (T1-T3) undergoing breast-conserving surgery or mastectomy. Periareolar injections of 99mTc-nanocolloid and 5 mg ICG were performed according to standardized international SLNB protocols. Lymphatic mapping was achieved with gamma-radiation detecting and near-infrared fluorescence imaging. Sentinel node detection rate, number of retrieved nodes, metastatic involvement, and adverse events were recorded and analyzed. A total of 106 patients were included. ICG fluorescence achieved a sentinel node detection rate of 90,6%, compared with 97,1% for Tc-99m. A median of 2,1 lymph nodes were excised per patient. 21.7% received neoadjuvant systemic therapy and 63.2% had breast conserving surgery. The overall per-patient sentinel lymph node (SLN) detection rate was 90.6% with indocyanine green (ICG), 97.1% with technetium-99m (Tc-99m), and 98.1% with the combined technique. On a per-node basis (n = 221), detection rates were 88.2%, 83.7%, and 100%, respectively. Among patients with positive SLNs (n = 34), metastatic node detection was 94.1% using ICG, 79.4% with Tc-99m, and 100% with the combined approach. In both upfront surgery and neoadjuvant subgroups, no statistically significant differences were observed between detection methods (p > 0.05); however, interpretation of neoadjuvant results was limited by the small sample size. No ICG-related complications or adverse events were reported. ICG fluorescence-guided SLNB alone is a safe, effective, and radiation-free alternative to conventional radioisotope mapping. Its high detection accuracy, simplicity, and real-time visualization support its integration into standard breast cancer surgery protocols. Further multicenter studies are warranted to validate long-term oncological outcomes.
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Adrenomedullin (ADM) is a peptide hormone with a broad spectrum of actions on vascular smooth muscle, endothelial cells, and immune cells. These ADM cellular targets are prominent constituents of the uterine-placental interface that undergo structural and functional transformation during pregnancy. To explore the biology of ADM at the uterine-placental interface, we examined ADM expression using in situ hybridization and generated and characterized an ADM mutant rat model using CRISPR-Cas9-mediated genome editing. At midgestation, Adm was prominently expressed in trophoblast giant cells. Adm expression shifted to the mesometrial uterus as gestation progressed. A germline Adm mutant model was generated. Adm heterozygous males and females were fertile; however, Adm heterozygous intercrosses did not generate live Adm null rats. Adm null fetal-placental sites were viable until gestation day (gd) 15.5. Viable null fetuses were not identified after gd 15.5. Fetal and placental growth restriction were evident on gd 13.5. On gd 15.5 some Adm null placentas exhibited prominent hemorrhagic regions, whereas both hemorrhage and edema were evident in gd 15.5 Adm null fetuses. Our results indicate that ADM serves as a regulator of placental and fetal development.
High-intensity 5 km running offers an ideal framework to analyze the organism's multidimensional responses. Since previous research primarily analyzed isolated aspects of fatigue, this study aimed to examine the integrated acute neuromuscular, metabolic, and perceptual responses to a 5 km run. Twenty-one recreational male runners participated. Pre- and post-race assessments included body composition, blood lactate, m. rectus femoris ultrasound thickness, quadriceps maximal voluntary isometric contraction (MVIC), heart rate, perceived exertion (Borg CR10), and 5 km finish time. Statistical analysis was performed in the Jamovi software, utilizing descriptive statistics, the Shapiro-Wilk test of normality, the Wilcoxon signed-rank test with effect size calculation, and Spearman's correlation coefficient, at a significance level of p < 0.05. Post-race measurements revealed a significant decrease in quadriceps MVIC (pre: 305 ± 99 N vs. post: 259 ± 88 N; p = 0.002) and an increase in blood lactate (pre: 0.8 ± 0.4 vs. post: 6.9 ± 1.4 mmol/L; p < 0.001), alongside high average heart rates (165 ± 16 bpm). However, ultrasound-assessed muscle architecture remained unchanged. The 5 km run induced pronounced neuromuscular and metabolic fatigue. Unchanged muscle architecture suggests that acute strength decline is primarily mediated by metabolic and neural mechanisms, rather than immediate structural-morphological factors. These findings highlight the value of an integrated assessment approach for understanding acute fatigue responses following high-intensity 5 km running and may contribute to more precise training-load prescription and recovery monitoring in recreational runners.
Stroke is a significant cause of morbidity and mortality. There are racial, ethnic, and sex-based disparities in treatment and outcomes for patients with stroke. This study determined the association between race, ethnicity, and sex and prehospital stroke identification and discharge disposition. This was a multi-center, retrospective analysis of adult acute stroke patients presenting via Emergency Medical Services (EMS) between 01/01/2020 and 12/31/2022 who met criteria for inclusion into the local Get with the Guidelines - Stroke registry. Multivariable logistic regression modeled the association between sex, race, and ethnicity and EMS impression, adjusting for age, demographics, stroke severity, presentation with classic stroke symptoms, and EMS agency type (urban, suburban, or rural). Multivariable regression modeled discharge disposition, controlling for receiving hospital stroke certification, cardiovascular risk factors, acute intervention, and the above covariates. A total of 3,749 (83.5%) patients were identified with suspected stroke by EMS. After adjusting for covariates, males had greater odds of identification as a stroke compared to females (adjusted odds ration [aOR] 1.26, 95% CI 1.08-1.47); non-White patients had similar odds of identification as a stroke patient compared to White patients (aOR 1.00, 95% CI 0.55-1.82). Males also had higher odds of dying in hospital or being discharged to hospice compared to females (aOR 1.43, 95% CI 1.08-1.88). Male patients were more likely recognized as stroke by prehospital clinicians but had greater odds of a poor discharge disposition. Additional research into causes of these disparities in prehospital stroke identification may improve prehospital patient care and change ultimate outcomes.
To investigate the role of social determinants of health (SDoH) in neurocognitive functioning among children with acute lymphoblastic leukemia (ALL), central nervous system (CNS) tumors, and sickle cell disease (SCD). Fifty-eight child-caregiver dyads participated. SDoH included components of socioeconomic status (SES; family income, caregiver education, and insurance type), race/ethnicity, caregiver marital status, and neighborhood-level deprivation. Neurocognitive functioning was measured using the NIH Toolbox Cognition Battery (NIHTB-CB) Fluid Cognition subtests. There were no differences in SDoH between the three diagnosis groups other than expected differences in race/ethnicity (χ2 (4, n = 51) = 46.1, p < 0.001). Bivariate analyses found a significant association between family income and working memory (r = 0.31, p < 0.05), processing speed (r = 0.29, p < 0.05), and fluid cognition composite scores (r = 0.29, p < 0.05). No other SDoH were associated with neurocognitive functioning. Family income remained significantly associated with performance on working memory (β = 0.35, p < 0.05), processing speed (β = 0.33, p < 0.05), and fluid cognition composite scores (β = 0.29, p < 0.05) after controlling for diagnosis, age, and sex. Lower family income emerged as an important element of SES associated with poorer neurocognitive functioning in children treated for cancer and blood disorders. Further research is needed to determine how family income alters neurocognitive functioning, whether by altering the timing of emergence or the magnitude of deficits. Future studies should investigate mechanisms linking low income to neurocognitive performance to inform interventions to bolster neurocognitive development.
Precision nutrition aims to tailor dietary guidance to individual biology, yet current methods struggle to integrate complex molecular and multiomic data into clinical care. Emerging quantum-driven technologies encompassing quantum computing, quantum chemistry, and quantum-enhanced sensors link detailed molecular modeling with real-time metabolic forecasting. Quantum chemical simulations and machine learning model nutrient-protein interactions at the atomic level, whereas quantum algorithms and echo-state networks have been applied to create digital metabolic avatars that predict weight and metabolic trajectories from daily diet and activity data. Quantum computing enables rapid integration of genomic, metabolomic, and microbiome datasets and supports optimization of personalized diet plans. Advances in computational molecular modeling now allow prediction of molecular structures and properties relevant to food components, and prototype quantum metabolic twins have demonstrated the capacity to forecast weight trends from incomplete real-world data. The clinical implications include proactive dietary interventions, noninvasive nutrient deficiency screening, and improved prediction of disease risk from metabolic profiles, all of which can enhance patient outcomes and clinical decision-making. This perspective synthesizes recent advances and delineates research directions at the intersection of quantum science, medical diagnostics, metabolism, and clinical nutrition, with implications for clinicians, physicians, dietitians, and clinical decision support in patient care.