Due to the reactive medical approach applied to disease management, stroke has reached an epidemic scale worldwide. In 2019, the global stroke prevalence was 101.5 million people, wherefrom 77.2 million (about 76%) suffered from ischemic stroke; 20.7 and 8.4 million suffered from intracerebral and subarachnoid haemorrhage, respectively. Globally in the year 2019 - 3.3, 2.9 and 0.4 million individuals died of ischemic stroke, intracerebral and subarachnoid haemorrhage, respectively. During the last three decades, the absolute number of cases increased substantially. The current prevalence of stroke is 110 million patients worldwide with more than 60% below the age of 70 years. Prognoses by the World Stroke Organisation are pessimistic: globally, it is predicted that 1 in 4 adults over the age of 25 will suffer stroke in their lifetime. Although age is the best known contributing factor, over 16% of all strokes occur in teenagers and young adults aged 15-49 years and the incidence trend in this population is increasing. The corresponding socio-economic burden of stroke, which is the leading cause of disability, is enormous. Global costs of stroke are estimated at 721 billion US dollars, which is 0.66% of the global GDP. Clinically manifested strokes are only the "tip of the iceberg": it is estimated that the total number of stroke patients is about 14 times greater than the currently applied reactive medical approach is capable to identify and manage. Specifically, lacunar stroke (LS), which is characteristic for silent brain infarction, represents up to 30% of all ischemic strokes. Silent LS, which is diagnosed mainly by routine health check-up and autopsy in individuals without stroke history, has a reported prevalence of silent brain infarction up to 55% in the investigated populations. To this end, silent brain infarction is an independent predictor of ischemic stroke. Further, small vessel disease and silent lacunar brain infarction are considered strong contributors to cognitive impairments, dementia, depression and suicide, amongst others in the general population. In sub-populations such as diabetes mellitus type 2, proliferative diabetic retinopathy is an independent predictor of ischemic stroke. According to various statistical sources, cryptogenic strokes account for 15 to 40% of the entire stroke incidence. The question to consider here is, whether a cryptogenic stroke is fully referable to unidentifiable aetiology or rather to underestimated risks. Considering the latter, translational research might be of great clinical utility to realise innovative predictive and preventive approaches, potentially benefiting high risk individuals and society at large. In this position paper, the consortium has combined multi-professional expertise to provide clear statements towards the paradigm change from reactive to predictive, preventive and personalised medicine in stroke management, the crucial elements of which are:Consolidation of multi-disciplinary expertise including family medicine, predictive and in-depth diagnostics followed by the targeted primary and secondary (e.g. treated cancer) prevention of silent brain infarctionApplication of the health risk assessment focused on sub-optimal health conditions to effectively prevent health-to-disease transitionApplication of AI in medicine, machine learning and treatment algorithms tailored to robust biomarker patternsApplication of innovative screening programmes which adequately consider the needs of young populations.

• Keywords
• Blood pressure, Blood–brain barrier breakdown, Body mass index, COVID-19, Cancer, Coagulation, Connective tissue impairments, Diabetes comorbidities, Endothelial dysfunction, Endothelin-1, Flammer Syndrome phenotype, Health policy, Health risk assessment, Health-to-disease transition, Hypoxia-reperfusion, Individualised protection, Ischemic stroke, Lacunar stroke, Mental health, Metastasis, Normal-tension glaucoma, Optic nerve degeneration, Paradigm change, Pre-pregnancy check-up, Predictive preventive personalised medicine (PPPM / 3PM), Primary care, Pro-inflammation, Retinal microvascular abnormalities, Screening, Secondary care, Silent brain infarct, Small vessel disease, Stress, Sub-optimal health, Systemic effects, Thromboembolism, Vascular stiffness, Vasospasm, Young populations,
• Publication type
• Journal Article MeSH

Breast cancer incidence is actually the highest one among all cancers. Overall breast cancer management is associated with challenges considering risk assessment and predictive diagnostics, targeted prevention of metastatic disease, appropriate treatment options, and cost-effectiveness of approaches applied. Accumulated research evidence indicates promising anti-cancer effects of phytochemicals protecting cells against malignant transformation, inhibiting carcinogenesis and metastatic spread, supporting immune system and increasing effectiveness of conventional anti-cancer therapies, among others. Molecular and sub-/cellular mechanisms are highly complex affecting several pathways considered potent targets for advanced diagnostics and cost-effective treatments. Demonstrated anti-cancer affects, therefore, are clinically relevant for improving individual outcomes and might be applicable to the primary (protection against initial cancer development), secondary (protection against potential metastatic disease development), and tertiary (towards cascading complications) care. However, a detailed data analysis is essential to adapt treatment algorithms to individuals' and patients' needs. Consequently, advanced concepts of patient stratification, predictive diagnostics, targeted prevention, and treatments tailored to the individualized patient profile are instrumental for the cost-effective application of natural anti-cancer substances to improve overall breast cancer management benefiting affected individuals and the society at large.

• Keywords
• Breast cancer, COVID-19, Cost-effective disease management, Evidence-based research data, Food, Health risk assessment, Improved individual outcomes, Individualized patient profiling, Modifiable risk factors, Molecular patterns, Phytochemicals, Plants, Predictive Preventive Personalized Medicine (PPPM/3PM), Primary secondary tertiary care, Stroke, Translational research, Treated cancer,
• Publication type
• Journal Article MeSH
• Review MeSH

An increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised "normal" body weight and individually optimal weight. To this end, the basic principle of personalised medicine "one size does not fit all" has to be applied. Contextually, "normal" but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyle parameters-all included into comprehensive individual patient profile. Even if only slightly deviant, both overweight and underweight are acknowledged risk factors for a shifted metabolism which, if being not optimised, may strongly contribute to the development and progression of severe pathologies. Development of innovative screening programmes is essential to promote population health by application of health risks assessment, individualised patient profiling and multi-parametric analysis, further used for cost-effective targeted prevention and treatments tailored to the person. The following healthcare areas are considered to be potentially strongly benefiting from the above proposed measures: suboptimal health conditions, sports medicine, stress overload and associated complications, planned pregnancies, periodontal health and dentistry, sleep medicine, eye health and disorders, inflammatory disorders, healing and pain management, metabolic disorders, cardiovascular disease, cancers, psychiatric and neurologic disorders, stroke of known and unknown aetiology, improved individual and population outcomes under pandemic conditions such as COVID-19. In a long-term way, a significantly improved healthcare economy is one of benefits of the proposed paradigm shift from reactive to Predictive, Preventive and Personalised Medicine (PPPM/3PM). A tight collaboration between all stakeholders including scientific community, healthcare givers, patient organisations, policy-makers and educators is essential for the smooth implementation of 3PM concepts in daily practice.

• Keywords
• Adults, Anorexia athletica, Anthropometrics, Artificial intelligence in medicine, BMI deviation, Big data management, Biomarker panel, Body fluids, Body weight, COVID-19, Cancers, Cardiovascular disease, Communicable, Deficits, Disease development, Elderly, Endothelin-1, Fat, Flammer syndrome, Health economy, Health policy, Healthcare, Hypoxic effects, Immune system, Individualised patient profile, Inflammation, Innovative population Screening Programme, Intentional, Manifestation, Medical imaging, Metabolic pathways, Microbiome, Modelling, Molecular patterns, Multi-level diagnostics, Multi-parametric analysis, Neurodegeneration, Neurology, Non-communicable disorders, Nutrition, Overweight, Pathology, Population health, Predictive preventive personalised medicine (3PM/PPPM), Pregnancy, Progression, ROS, Reproductive dysfunction, Sports medicine, Stroke, Systemic ischemia, Underweight, Unintentional, Vasoconstriction, Weight loss, Well-being, Wound healing, Youth,
• Publication type
• Journal Article MeSH

Multi-factorial mitochondrial damage exhibits a "vicious circle" that leads to a progression of mitochondrial dysfunction and multi-organ adverse effects. Mitochondrial impairments (mitochondriopathies) are associated with severe pathologies including but not restricted to cancers, cardiovascular diseases, and neurodegeneration. However, the type and level of cascading pathologies are highly individual. Consequently, patient stratification, risk assessment, and mitigating measures are instrumental for cost-effective individualized protection. Therefore, the paradigm shift from reactive to predictive, preventive, and personalized medicine (3PM) is unavoidable in advanced healthcare. Flavonoids demonstrate evident antioxidant and scavenging activity are of great therapeutic utility against mitochondrial damage and cascading pathologies. In the context of 3PM, this review focuses on preclinical and clinical research data evaluating the efficacy of flavonoids as a potent protector against mitochondriopathies and associated pathologies.

• Keywords
• anti-oxidant activity, cancer, cardiovascular disease, dysfunction, flavonoids, genoprotection, injury, mitochondrial function, mitochondrial impairment, mitochondriopathy, natural substances, neurodegeneration, patient stratification, phytochemicals, predictive preventive personalized medicine (PPPM/3PM), stress, tumorigenesis,
• MeSH
• Antioxidants pharmacology   therapeutic use   MeSH
• Cytoprotection drug effects   MeSH
• Flavonoids pharmacology   therapeutic use   MeSH
• Precision Medicine methods   MeSH
• Humans MeSH
• Mitochondrial Diseases diagnosis   prevention & control   MeSH
• Mitochondria drug effects   metabolism   MeSH
• Mitophagy drug effects   MeSH
• Oxidative Stress drug effects   MeSH
• Prognosis MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Antioxidants MeSH
• Flavonoids MeSH

Metabolic reprogramming characterized by alterations in nutrient uptake and critical molecular pathways associated with cancer cell metabolism represents a fundamental process of malignant transformation. Melatonin (N-acetyl-5-methoxytryptamine) is a hormone secreted by the pineal gland. Melatonin primarily regulates circadian rhythms but also exerts anti-inflammatory, anti-depressant, antioxidant and anti-tumor activities. Concerning cancer metabolism, melatonin displays significant anticancer effects via the regulation of key components of aerobic glycolysis, gluconeogenesis, the pentose phosphate pathway (PPP) and lipid metabolism. Melatonin treatment affects glucose transporter (GLUT) expression, glucose-6-phosphate dehydrogenase (G6PDH) activity, lactate production and other metabolic contributors. Moreover, melatonin modulates critical players in cancer development, such as HIF-1 and p53. Taken together, melatonin has notable anti-cancer effects at malignancy initiation, progression and metastasing. Further investigations of melatonin impacts relevant for cancer metabolism are expected to create innovative approaches supportive for the effective prevention and targeted therapy of cancers.

• Keywords
• Warburg effect, anti-depressant, anti-inflammatory, anti-tumor, antioxidant, cancer, melatonin, metabolism, mitochondrial dysfunction, predictive preventive personalized medicine (PPPM/3PM),
• Publication type
• Journal Article MeSH
• Review MeSH

Biobanking is entering the new era-era of big data. New technologies, techniques, and knowledge opened the potential of the whole domain of biobanking. Biobanks collect, analyse, store, and share the samples and associated data. Both samples and especially associated data are growing enormously, and new innovative approaches are required to handle samples and to utilize the potential of biobanking data. The data reached the quantity and quality of big data, and the scientists are facing the questions how to use them more efficiently, both retrospectively and prospectively with the aim to discover new preventive methods, optimize treatment, and follow up and to optimize healthcare processes. Biobanking in the era of big data contribute to the development of predictive, preventive, and personalised medicine, for every patient providing the right treatment at the right time. Biobanking in the era of big data contributes to the paradigm shift towards personalising of healthcare.

• Keywords
• Artificial intelligence, Big data, Biobanks, Biomedical research, Cancer, Computation analysis, Diabetes, Economy, Healthcare, Implementation, Information technologies, Innovations, Liquid biopsy, Machine learning, Patient benefits, Personalised treatment algorithms, Population screening, Predictive preventive personalised medicine, Services, Stroke,
• Publication type
• Journal Article MeSH
• Review MeSH

Vaginal dryness (VD) affects both pre- and postmenopausal women at any age. Since the hormonal regulation changes during the climacteric period are considered as being the main course of the VD, affected women prefer not to talk about the problem. However, the problem does exist, and unfortunately if any, relatively minor group in the population possesses the health literacy at sufficient level to understand that VD is a suboptimal health condition which carries a multi-factorial character. Thereby, some of the contributing factors are clearly preventable and, therefore, if treated properly, have a potential to milden the VD. Current chapter demonstrates specific signs and symptoms of Flammer syndrome in women suffering from vaginal dryness, although individualised patient profiles clearly discriminate between pre- and postmenopausal women regarding the subgroup-specific symptoms. Noteworthy, about 20% of the VD patients involved in the study notify a delayed or even impaired wound healing observed for themselves over a couple of years. Optimising modifiable risk factors accompanying FS phenotype at the level of primary prevention is strongly recommended. Individualised patient profiles provide important information for VD mitigating measures tailored to the person. Further, future projects should essentially deal with the complexity of vulvar-vaginal dryness as part of the Sicca syndrome in individuals with FS phenotype, in order to prevent genital female cancers which may occur at any age. In contrast to the human papilloma virus as possible trigger of the disease, the role of the vulvar-vaginal dryness as an important risk factor is strongly underestimated in currently applied diagnostic and treatment approaches.

• Keywords
• Altered sense regulation, Blood pressure, Dehydration, Dyspareunia, Flammer syndrome, Headache, Hormonal regulation, Life quality, Menopause, Microbiome, Pain, Psychological aspects, Sexual intercourse, Sicca, Stress, Vaginal dryness, Vaginal dysfunction, Vasoconstriction, Vulva cancer,
• Publication type
• Journal Article MeSH