PURPOSE OF REVIEW: A critical evaluation of contemporary literature regarding the role of big data, artificial intelligence, and digital technologies in precision cardio-oncology care and survivorship, emphasizing innovative and groundbreaking endeavors. RECENT FINDINGS: Artificial intelligence (AI) algorithm models can automate the risk assessment process and augment current subjective clinical decision tools. AI, particularly machine learning (ML), can identify medically significant patterns in large data sets. Machine learning in cardio-oncology care has great potential in screening, diagnosis, monitoring, and managing cancer therapy-related cardiovascular complications. To this end, large-scale imaging data and clinical information are being leveraged in training efficient AI algorithms that may lead to effective clinical tools for caring for this vulnerable population. Telemedicine may benefit cardio-oncology patients by enhancing healthcare delivery through lowering costs, improving quality, and personalizing care. Similarly, the utilization of wearable biosensors and mobile health technology for remote monitoring holds the potential to improve cardio-oncology outcomes through early intervention and deeper clinical insight. Investigations are ongoing regarding the application of digital health tools such as telemedicine and remote monitoring devices in enhancing the functional status and recovery of cancer patients, particularly those with limited access to centralized services, by increasing physical activity levels and providing access to rehabilitation services. SUMMARY: In recent years, advances in cancer survival have increased the prevalence of patients experiencing cancer therapy-related cardiovascular complications. Traditional cardio-oncology risk categorization largely relies on basic clinical features and physician assessment, necessitating advancements in machine learning to create objective prediction models using diverse data sources. Healthcare disparities may be perpetuated through AI algorithms in digital health technologies. In turn, this may have a detrimental effect on minority populations by limiting resource allocation. Several AI-powered innovative health tools could be leveraged to bridge the digital divide and improve access to equitable care.

• Keywords
• Artificial Intelligence, Cardio-Oncology, Digital health, Machine Learning,
• Publication type
• Journal Article MeSH

Ribosomal RNA (rRNA) genes are organized in tandem arrays known as ribosomal DNA (rDNA) on multiple chromosomes in Hominidae genomes. We measured copy number and transcriptional activity status of rRNA gene arrays across multiple individual genomes, revealing an identifiable fingerprint of rDNA copy number and activity. In some cases, entire arrays were transcriptionally silent, characterized by high DNA methylation across the rRNA gene, inaccessible chromatin, and the absence of transcription factors and transcripts. Silent arrays showed reduced association with the nucleolus and decreased interchromosomal interactions, consistent with the model that nucleolar organizer function depends on transcriptional activity. Removing rDNA methylation activated silent arrays. Array activity status remained stable through induced pluripotent stem cell reprogramming and differentiation into cerebral and intestinal organoids. Haplotype tracing in two unrelated family trios showed paternal transmission of silent arrays. We propose that the epigenetic state buffers rRNA gene dosage, specifies nucleolar organizer function, and can propagate transgenerationally.

• Keywords
• DNA methylation, Treacle, UBF, apes, epigenetics, humans, nucleolus, rRNA genes, ribosomal DNA,
• Publication type
• Journal Article MeSH

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the management of obesity, demonstrating significant efficacy in inducing weight loss and improving metabolic parameters. However, emerging clinical and paraclinical evidence suggests that these agents may also contribute to an unintended reduction in skeletal muscle mass, potentially exacerbating or precipitating sarcopenic obesity, particularly in older or frail individuals with limited muscular reserves. This review critically examines current data on the effects of GLP-1 RAs on body composition, explores the underlying pathophysiological mechanisms of skeletal muscle wasting, and offers evidence-based strategies for attenuating these potential adverse outcomes. While GLP-1 RAs therapy remains central to obesity management, optimizing its use through early recognition and management of associated risks is essential to preserve muscular health, patient functional status and quality of life.

• Keywords
• GLP-1 receptor agonists, Muscle mass, Obesity, Sarcopenia, Skeletal muscle loss, Weight loss,
• MeSH
• Glucagon-Like Peptide-1 Receptor Agonists * adverse effects   pharmacology   MeSH
• Weight Loss MeSH
• Hypoglycemic Agents adverse effects   pharmacology   MeSH
• Muscle, Skeletal * drug effects   MeSH
• Anti-Obesity Agents adverse effects   pharmacology   MeSH
• Humans MeSH
• Obesity drug therapy   MeSH
• Sarcopenia * chemically induced   MeSH
• Body Composition MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Glucagon-Like Peptide-1 Receptor Agonists * MeSH
• Hypoglycemic Agents MeSH
• Anti-Obesity Agents MeSH

BACKGROUND&AIMS: Obesity and sarcopenia are major health concerns, particularly among older populations. Dietary protein may help preserve muscle mass and function, but high-protein diets, especially from animal sources, may also increase adipose mass. We investigated associations of total, animal, and plant protein intake with body composition trajectories, sarcopenia, and sarcopenic obesity. METHODS: We included 4576 participants (mean age 65.1 years, 56 % women) from the population-based Rotterdam Study. Dietary protein was measured using food-frequency questionnaires at baseline (2004-2009). Body composition was measured every 4-5 years using dual X-ray-absorptiometry. Handgrip strength (HGS) was assessed starting 2006 using a hydraulic dynamometer. Sarcopenia was determined based on low appendicular skeletal muscle and HGS; and sarcopenic obesity risk based on measures of lean mass, HGS and body fat. Analyses used linear mixed models and generalized estimate equation models. RESULTS: Higher total protein intake was associated with increased BMI over time (mean difference [95 %-confidence interval (CI)]: 0.86 kg/m2 [0.01,1.71] per 5E% increase), and increased fat-mass index (1.33 [0.67,1.99]), body-fat-percentage (4.54[2.76,6.31]), and both gynoid and android fat percentage. Higher protein intake was also associated with a higher sarcopenic obesity risk (-0.85[-1.5,-0.2]), but with a lower sarcopenia risk (odds ratio: 0.62 [0.43,0.90]). These associations were mainly driven by animal protein. CONCLUSION: Higher protein intake, particularly from animal food sources, is protective against sarcopenia but also linked to a higher obesity risk. A balanced protein intake advice for older persons should be formulated based on individual needs and health status to prevent sarcopenia, obesity, and sarcopenic obesity.

• Keywords
• Body compositions, Dietary protein intake, Longitudinal cohort study, Sarcopenia, Sarcopenic obesity,
• MeSH
• Diet * MeSH
• Dietary Proteins * administration & dosage   MeSH
• Body Mass Index MeSH
• Muscle, Skeletal MeSH
• Middle Aged MeSH
• Humans MeSH
• Obesity * epidemiology   MeSH
• Prospective Studies MeSH
• Sarcopenia * epidemiology   MeSH
• Aged MeSH
• Hand Strength MeSH
• Body Composition * MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Netherlands epidemiology   MeSH
• Names of Substances
• Dietary Proteins * MeSH

INTRODUCTION: Ultrasonography is a non-invasive and safe method for assessing muscle morphology. Among its parameters, echo intensity (EI), derived from grayscale image analysis, has emerged as a promising indicator of muscle quality and intramuscular fat infiltration. This study aims to validate EI as a marker for evaluating muscle quality in a population of Czech children, through integration with gold-standard assessments of muscle strength and body composition. The primary aim of this study is to assess the reliability and construct validity of quadriceps muscle EI using ultrasound as a proxy measure of morphological muscle quality in children aged 10-14 years. METHODS AND ANALYSIS: Children aged 10-14 years will undergo ultrasound assessment of the quadriceps femoris (QF). EI will be derived from longitudinal scans of each QF head and the cross-sectional area (CSAQF) from panoramic mid-thigh images. Muscle function will be assessed as maximal voluntary contraction (MVC) of isometric knee extension with muscle quality expressed as MVC/CSAQF. A 30 s sit-to-stand test (30STS) will be used as an additional functional measure. EI reliability (intra-rater, inter-rater and test-retest) will be evaluated with intraclass correlation coefficients (ICC), Bland-Altman plots and complementary indices. Exploratory known-groups validity will be tested by comparing EI between weight-status groups. Control variables include dual-energy X-ray absorptiometry (DXA)-derived body composition, skeletal age (as determined by DXA hand scans) and physical activity (assessed using 7-day accelerometry).This study will include 200 children (100 girls and 100 boys) aged 10-14 years using an a priori power analysis based on the primary objective of assessing construct validity through multiple linear regression, assuming an alpha level of 0.05 and 80% power. Participants will be recruited from paediatric outpatients of the Paediatric Obesity Clinic and individuals reached through a recruitment campaign. Inclusion criteria require general good health, while exclusion criteria include a history or symptoms of cardiovascular, pulmonary, metabolic or neurological disease, as well as the use of over-the-counter or prescribed medications. Informed consent and assent will be obtained from all participants.Reliability of ultrasound-derived EI will be assessed for intra-rater, inter-rater and test-retest agreement using ICC coefficients, Bland-Altman plots and complementary indices such as SE of measurement, coefficient of variation and minimal detectable change at 95% CI, following Consensus-based Standards for the selection of health Measurement Instruments guidelines. Construct validity will be examined by modelling associations between EI and functional muscle quality (MVC/CSAQF), with 30STS as an additional functional measure. Known-groups validity will be tested by comparing EI across weight groups, using generalised linear regression models adjusted for skeletal age, body composition and physical activity. All validity analyses will be conducted separately for girls and boys. Ultrasound-derived EI of the QF is expected to show high reliability (ICC≥0.80) and acceptable test-retest reproducibility. Construct validity should be supported by moderate associations with functional muscle quality (MVC/CSAQF), while known-groups validity is expected to reveal higher EI values in children with obesity and/or insufficient physical activity. ETHICS AND DISSEMINATION: The study will be conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Faculty of Physical Education and Sport, Charles University (EK 101/2024). Written parental consent and verbal assent from children will be obtained, with all data handled confidentially and anonymised. Results will be disseminated transparently to participants and their families in line with ethical principles of respect, beneficence and justice. TRIAL REGISTRATION NUMBER: NCT06792279.

• Keywords
• Child, Obesity, Ultrasound,
• MeSH
• Quadriceps Muscle * diagnostic imaging   physiology   MeSH
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Observational Studies as Topic MeSH
• Cross-Sectional Studies MeSH
• Reproducibility of Results MeSH
• Body Composition MeSH
• Muscle Strength * physiology   MeSH
• Ultrasonography methods   MeSH
• Validation Studies as Topic MeSH
• Research Design MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial Protocol MeSH
• Geographicals
• Czech Republic MeSH

Diffuse large B-cell lymphoma (DLBCL) poses a challenge in hematology given its varied symptoms, and the complex interplay between disease and treatment effects on health-related quality of life (HRQoL). The phase 3 POLARIX study (NCT03274492) demonstrated superior progression-free survival (PFS) and a similar safety profile with polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin and prednisone (Pola-R-CHP) vs rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) in patients with previously untreated DLBCL. Here, we evaluate HRQoL through patient-reported outcome (PRO) instruments to fully characterize the patient experience in the POLARIX study. Changes from baseline in HRQoL, lymphoma symptoms, and gastrointestinal (GI) symptoms were assessed, as well as incidence and severity of common symptoms by PROs vs clinician-reported adverse events (AEs). Baseline characteristics of PRO-evaluable patients (N = 874) were consistent. Comparison between PROs and clinician-reported AEs revealed a notable discordance; patients generally reported a higher incidence of symptoms than clinicians, emphasizing the need for patient-centric tools to accurately capture the patient experience. Both treatments exhibited rapid and sustained improvements in HRQoL and lymphoma symptoms, with the most substantial improvements seen in global health status/QoL, lymphoma symptoms, fatigue, role, emotional, and social functioning. GI symptoms (diarrhea, constipation, nausea, and vomiting) were generally similar between treatment arms and returned to baseline levels after treatment completion. These HRQoL data underscore the complementarity of PROs, as an adjunct to clinician-reported AEs, in evaluating the efficacy and tolerability of new treatments, including Pola-R-CHP, which may represent a new benchmark for patient-reported HRQoL in previously untreated DLBCL.

• Publication type
• Journal Article MeSH

BACKGROUND: Postoperative speech impairment (POSI) and cranial nerve deficits (CND) are common complications of pediatric posterior fossa (PF) tumor surgery. Intraoperative MRI (ioMRI) has proven a useful tool in achieving gross total resection. The risk of POSI and CND with ioMRI remains unclear, making it the primary scope of this study. Additionally, we assessed whether POSI was associated with CND. METHODS: We prospectively included pediatric patients undergoing PF tumor surgery in 36 centers across 15 European countries. Neurological status and speech were assessed preoperatively and 1-4 weeks postoperatively. Surgical details, including tumor location and use of ioMRI, were recorded within 72 h of surgery. Postoperative CND were categorized as 0, 1, 2, or ≥ 3 nerves affected; POSI as habitual, reduced speech, or mutism. Proportional odds models estimated odds ratios (OR) for 1) POSI with stepwise adjustment for tumor location and age, and 2) CND with adjustment for preoperative CND and tumor location. Subgroup analyses assessed systematic differences, missing data, center-level effects, and histology adjustment. RESULTS: Of 790 primary PF tumor surgeries, 141 (18%) involved ioMRI. POSI occurred in 183/790 (23%) and postoperative CND in 213/790 (27%). POSI-risk with ioMRI showed non-significant unadjusted OR (95% CI) 0.83 (0.53;1.30); adjusted OR 0.76 (0.43;1.35). Fewer CNDs were observed with ioMRI (unadjusted OR 0.63 (0.40;1.00), adjusted OR 0.58 (0.33;0.94), p = 0.03). POSI-risk was associated with more CNDs (adjusted OR for 1 CND: 2.06 (1.15;3.68); 2 CND: 2.13 (1.02;4.42); ≥ 3 CND: 4.15 (1.98;8.70), p < 0.05). CONCLUSIONS: ioMRI was not associated with increased risk of postoperative complications in this multicenter cohort. The reduction in CND among ioMRI cases may reflect derived effects on surgical decision-making, expertise, case-load and case-mix. Results should be interpreted with caution due to limited intraoperative data. The association between POSI-risk and cumulative CND may indicate extensive brainstem involvement. Our findings highlight the need to further explore how ioMRI-guided strategies affect functional outcomes in pediatric PF tumour surgery. CLINICAL TRIALS ID: NCT02300766 (October 2014).

• Keywords
• Cerebellar mutism syndrome, Cranial Nerve Deficits, Intraoperative Magnetic Resonance Imaging, Pediatric Neurosurgery, Posterior Fossa Tumor, Posterior Fossa syndrome,
• MeSH
• Child MeSH
• Infratentorial Neoplasms * surgery   MeSH
• Infant MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Adolescent MeSH
• Cranial Nerve Diseases * etiology   epidemiology   MeSH
• Neurosurgical Procedures * adverse effects   MeSH
• Postoperative Complications * epidemiology   etiology   MeSH
• Speech Disorders * etiology   epidemiology   MeSH
• Child, Preschool MeSH
• Prospective Studies MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH
• Geographicals
• Europe MeSH

Phe ochromocytomas and paragangliomas (PPGLs) are rare neural crest-derived tumors with malignant potential and a highly variable natural history, where some patients achieve a cure through surgical resection, while others experience an aggressive and protracted disease course characterized by recurrence and metastasis. While currently no definitive curative treatment exists for metastatic PPGLs, ongoing trials and advances in biology of the disease present a beacon of hope. We present a case that illustrates a 15-year treatment journey, illustrating the complexity of metastatic PPGL treatment with different modalities, each with distinct efficacy and toxicity profiles. The choice of treatment is often an art, as much as it is based on evidence, as the clinician must balance among several factors, including tumor-related (pace of progression, tumor burden) and patient-related (functional status, symptoms, general health) ones. Through a stepwise approach, this discussion aims to provide insights into the evolving landscape of metastatic PPGL management.

• Keywords
• Lutathera, catecholamines and metanephrines, chemotherapy, fumarate hydratase, genetics, metastatic disease, neuroendocrine tumors, peptide receptor radionuclide therapy, pheochromocytoma and paraganglioma, tyrosine kinase inhibitor,
• MeSH
• Pheochromocytoma * diagnosis   pathology   secondary   therapy   MeSH
• Humans MeSH
• Neoplasm Metastasis MeSH
• Adrenal Gland Neoplasms * diagnosis   pathology   therapy   MeSH
• Paraganglioma * diagnosis   pathology   secondary   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

The transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS) is characterized by an increasing neurodegenerative component. Identifying biomarkers that distinguish these disease stages is crucial for early diagnosis and treatment optimization. This study aimed to compare serum levels of progranulin, interleukin-6 (IL-6), semaphorin 3A (SEMA3A), and neurofilaments between RRMS and SPMS patients and to investigate their correlation with clinical characteristics, including disability measured by the Expanded Disability Status Scale (EDSS). This observational study included 118 MS patients (63 RRMS and 55 SPMS). Serum biomarker levels were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analyses included group comparisons using non-parametric tests and correlation analyses using Pearson's correlation coefficient with multiple testing corrections. While demographic and clinical parameters significantly differed between groups (p < 0.001), biomarker levels showed no statistically significant differences (p > 0.05). However, in SPMS patients, SEMA3A correlated positively with neurofilaments (r = 0.359, p = 0.007), and progranulin correlated with IL-6 (r = 0.354, p = 0.008). No significant biomarker correlations with EDSS were found. Although absolute biomarker levels did not distinguish RRMS from SPMS, specific biomarker correlations may reflect processes relevant to disease progression and warrant further longitudinal validation.

• Keywords
• functional capacity, immunity, multiple sclerosis, neuroimmunology,
• MeSH
• Biomarkers blood   MeSH
• Multiple Sclerosis, Chronic Progressive * blood   diagnosis   MeSH
• Adult MeSH
• Interleukin-6 blood   MeSH
• Intermediate Filaments * metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Neurofilament Proteins * blood   MeSH
• Prognosis MeSH
• Progranulins blood   MeSH
• Disease Progression MeSH
• Multiple Sclerosis, Relapsing-Remitting * blood   diagnosis   MeSH
• Semaphorin-3A * blood   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Names of Substances
• Biomarkers MeSH
• Interleukin-6 MeSH
• Neurofilament Proteins * MeSH
• Progranulins MeSH
• SEMA3A protein, human MeSH Browser
• Semaphorin-3A * MeSH

Trait-based ecology relies on high-quality, well-documented data to explore how plant traits relate to environmental conditions, community assembly, and ecosystem functioning. However, the reuse and synthesis of trait data across studies remain limited by several constraints: a lack of detailed metadata, heterogeneous protocols, absence of individual-level measurements, and underrepresentation of certain trait types-particularly below-ground traits. Many existing datasets also lack the environmental details necessary to investigate trait-environment relationships at local scales. Here, we present FAIRTraits, a comprehensive dataset that addresses these limitations by compiling 189,452 records of quantitative trait measurements collected between 1997 and 2023 from 1955 populations of 240 vascular plant species in the Northern Mediterranean Basin, a region known both for its exceptional biodiversity and as a climate change hotspot. All data were collected by a single research group using consistent and well-documented field and laboratory protocols, ensuring internal consistency across traits, species, sites, and years. FAIRTraits includes 180 traits measured at the individual or replicate level, with no aggregation. It features an unprecedented diversity of traits spanning all major plant organs-leaves, stems, roots, and reproductive parts. These include widely used traits such as specific leaf area and plant height, but also traits that are rarely reported, especially below-ground traits related to root morphology, as well as mechanical properties, phenology, and microbial associations. In addition to raw measurements, species are annotated with categorical descriptors (e.g., life form, photosynthetic pathway, and successional status), and species-level values taken from a Mediterranean flora, for key traits such as reproductive phenology and maximum height. To support analyses that account for environmental variability, each observation is linked to detailed descriptors of the plot where the individual was sampled, including climate data, soil physicochemical properties, and disturbance regime. Full metadata on sampling protocols and measurement methods are provided for every trait and environmental variable. FAIRTraits was built in compliance with the FAIR principles of data management (Findable, Accessible, Interoperable, and Reusable). Metadata are described using the Ecological Metadata Language (EML); trait definitions are standardized using community-endorsed semantic resources. The data are archived across two interoperable repositories: GBIF (via Darwin Core and trait-specific extensions) for taxon-trait associations and InDoRES for environmental and contextual data. These efforts ensure long-term preservation, data traceability, and seamless integration with plant trait databases such as BROT or TRY, and cross-organism initiatives such as the Open Traits Network or the Encyclopedia of Life. FAIRTraits offers a robust, richly documented, and reusable resource for investigating plant functional strategies, trait-environment relationships, and scaling from individuals to communities and ecosystems. It also provides a concrete example of how trait datasets can meet the highest standards of data quality and interoperability-serving as a model for future community-led initiatives in functional ecology. The FAIRTraits database is released under the CC-BY Attribution 4.0 International license.

• Keywords
• FAIR principles, Mediterranean Biogeographic Region, biodiversity standards, ecosystem properties, environmental conditions, gas exchange, leaf, stem, root and reproductive traits, litter mass loss, phenology, plant functional traits, terminological resources, trait‐based ecology,
• MeSH
• Databases, Factual * MeSH
• Plant Physiological Phenomena * MeSH
• Plants * classification   MeSH
• Publication type
• Journal Article MeSH
• Dataset MeSH
• Geographicals
• Mediterranean Region MeSH