Abstract Dementia affects over 50 million people worldwide and is projected to triple by 2050. Chronic inflammation and microbial dysbiosis, including periodontal disease, may contribute to neurodegenerative disease development. We reviewed eight population-based studies from Taiwan (matched-cohort, prospective, and retrospective designs) that examined periodontal exposures (tooth loss, chronic periodontitis, and gingivitis) in relation to dementia or cognitive impairment, with multivariable adjustment for confounders. Periodontal disease was consistently associated with increased dementia risk (unadjusted hazard risk [HR] up to 1.79; adjusted HR = 1.16, 95% confidence interval = 1.01–1.32). Tooth loss and absence of denture use also predicted cognitive decline. Among patients with periodontitis, protective factors included statins (HR = 0.78), metformin (HR = 0.53), and influenza vaccination (HR = 0.67). Comorbidities such as diabetes, mental disorders, and stroke further amplify dementia risk. These findings support periodontal disease as a modifiable risk factor for dementia. Integrating periodontal treatment, metabolic and immunomodulatory therapies, and prosthetic rehabilitation may help reduce dementia risk. Randomized trials with standardized oral assessments, biomarkers, and cognitive measures are needed to establish causality and guide preventive strategies.
Abstract The estrogen receptor alpha (ERα) protein, which is encoded by the ESR1 gene, is a key molecular factor that defines breast cancer. ERα activity regulates a complex program of hormonal activation and survival. ERα hypersensitivity, whether due to increased expression, activation, or aberrant activation, has been recognized as a crucial factor in disease progression and therapeutic resistance. The biological properties of ERα support conventional treatments and endocrine therapy inhibition. Moreover, they are pivotal for developing next-generation endocrine therapy strategies, including selective degraders and full antagonists. This article reviews the key roles of ERα in breast cancer and underscores recent developments in treatment strategies and their relevance to cancer. The goal is to improve the practical application of ER-driven breast cancer treatment. To summarize the multifaceted role of the ESR1 gene in breast cancer research, a comprehensive nonsystematic literature review was conducted. PubMed/MEDLINE and Web of Science were the primary electronic databases used. The search was not restricted by time to ensure the inclusion of historical landmarks and recent findings. The core search strategy employed keyword combinations focusing on “ ESR1 ” and “breast cancer,” further refining with terms, including “therapy,” “clinical diagnosis,” and “drug development,” to cover the breadth of the topic. Selection criteria focused on English-language peer-reviewed original and review articles. Case reports, non-peer-reviewed sources, and studies irrelevant to the clinical or therapeutic role of the ESR1 gene in breast cancer were excluded after screening the titles and abstracts.
Abstract Background: Gestational diabetes mellitus (GDM) presents a significant health challenge impacting one in six expectant mothers worldwide. GDM can cause life-threatening complications for both mother and child. As GDM is preventable, recognizing its prevalence and risk factors as early as possible is crucial for averting complications. Objectives: This study aimed to estimate the prevalence of GDM and identify the factors associated with it in the Juan block of the Sonepat District, Haryana. Methods: This facility-based cross-sectional study was conducted in the Juan block, which serves as the rural field practice area for the Department of Community Medicine, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat District, Haryana, India, among pregnant women residing in the study area for at least 6 months. Presuming a 13.9% GDM prevalence, the sample size was calculated using the formula: n = ([ Z 2 × p × q ]/l 2 ). Subsequently, the sample size was determined to be 520 participants. Community Health Center Juan had six Primary Health Centers (PHCs), two of which were randomly selected using the lottery method. Of the participants, 50% (260) were taken from one PHC (called Juan), and the remaining 50% were obtained from PHC Mahra. Data were analyzed using R software. Results: A single test procedure (Diabetes in Pregnancy Study group in India criteria) revealed an 11.9% GDM prevalence rate. The mean age of the participants was 24.17 ± 3.48 years. Factors, including advanced maternal age, low socioeconomic status, multiparity, early childbirth, passive smoking, increased sun exposure, family history of diabetes, prior macrosomia, overweight status, and anemia, were strong independent predictors of GDM. Conclusion: This study revealed that the GDM prevalence was 11.9%.
Abstract Colchicine was initially an anti-inflammatory drug used to treat gout and cardiovascular diseases and alleviate acute pain by inhibiting the immune response. Despite being an old drug, it has found a new purpose because it was recently approved by the US Food and Drug Administration for treating cardiovascular diseases, along with other medications such as statins, even though in Taiwan, it is yet to be used for treating conditions such as myocardial infarction, atherosclerosis, and ischemic stroke. However, it does pose some side effects; therefore, for its use in acute gout attack or cardiovascular events, patients must always comply with the doctor’s instruction to achieve the optimal therapeutic outcome and minimize any unnecessary risks associated with medication safety.
Abstract Background: Currently, Taiwan has entered a super-aged society. Therefore, the number of people suffering from dementia and the social burden are expected to increase. Moreover, effectively reducing the risk factors for dementia and preventing and detecting its occurrence at an early stage will become an important issue. Objectives: This study aimed to explore the factors related to dementia severity in patients. Methods: Data from 183 patients with dementia were obtained from the case management database in 2020 and analyzed using t test, analysis of variance, Pearson product–moment correlation analysis, and multiple regression analysis. Results: The average age of patients was 81.98 years, and most of them were female, 80–89 years old, illiterate, married, and well-off. The average number of comorbidities was 2.24. Most patients with dementia generally met the conditions for dementia in the comprehensive geriatric assessment and severity. Significant differences and correlations were observed between sex and some health habits, medical conditions, medication status, health problems, and comprehensive assessments (independence of activities of daily living, nutritional status, frailty, depression, and cognitive status) in severity (risk factors, borderline personality, memory performance, emotional symptoms, and psychiatric symptoms). Diabetes, hypertension, depressive condition, frailty, painkillers, and communication disorders each had a significant impact on severity. Conclusion: Many factors affect dementia. To prevent this disease, it is necessary to maintain good lifestyle habits, engage in more mentally challenging activities, engage in social interactions, and deal with health problems early.
Abstract Yoga, a form of mind–body training integrating physical postures, breathing techniques, and meditation, has garnered interest as a nonpharmacological intervention to preserve cognitive function in aging populations. This narrative review synthesizes findings from 19 empirical studies, including 2 integrative/systematic reviews, examining the effects of yogabased interventions on cognitive outcomes among older adults at risk for or experiencing cognitive decline, as well as among caregivers of persons with dementia. The included studies comprised predominantly randomized controlled trials (RCTs) evaluating diverse yoga modalities, including Hatha, Kundalini, and mindfulness-based yoga, over intervention periods ranging from 8 to 24 weeks. Across the analyzed trials, yoga consistently improved attention, processing speed, memory, and executive function compared with active or wait-list control interventions. Neuroimaging studies demonstrated enhanced hippocampal connectivity and attenuation of gray matter atrophy. The mechanisms by which yoga confers its benefits may include stress reduction, upregulation of neurotrophic factors, and improved cerebral perfusion. Despite promising results, heterogeneity in study designs, small sample sizes, and short follow-up durations limit the generalizability of our findings. Hence, future large-scale, standardized RCTs with longitudinal follow-up and biomarker assessments are warranted to confirm the role of yoga in mitigating cognitive decline.
Abstract The multiple physiological factors can contribute to the acute illness known as delirium. Treatment is possible for this organic condition of the central nervous system, which can lead to transitory cognitive dysfunction. Clinically, patients with delirium may experience visual hallucinations and emotional agitation in addition to symptoms like disorientation, impaired consciousness, difficulty concentrating, and muddled thinking. Impaired cognitive function due to delirium can often be improved if it is identified and treated quickly. However, if left untreated, it may result in a gravely poor prognosis, including extended hospitalization and a higher mortality rate. The first step is to rule out internal and external factors, such as polypharmacy, sensory deprivation, and emotional distress, as these can contribute to delirium. Identifying and addressing the underlying problem is the main goal of treatment, as the prognosis for delirium is typically favorable when underlying physiological issues are promptly treated.
Robotic-assisted laparoscopic ureterolithotomy (LU) (RALU) has been proposed as an alternative to conventional LU for managing complex ureteral stones. However, direct comparative evidence on clinical outcomes remains limited. This study aimed to directly compare perioperative outcomes and complication profiles between RALU and LU in a single-center cohort. We conducted a retrospective cohort study of 45 patients undergoing ureterolithotomy at a single institution from January 2016 to December 2023. Of these, 27 and 18 patients received RALU and LU, respectively. Patient demographics, stone characteristics, operative parameters, and postoperative outcomes were analyzed. Complications were classified using the Clavien–Dindo Grading System. Both groups had comparable operative times (RALU, 146.7 ± 43.3 min vs. LU, 141.7 ± 60.2 min) and blood loss (24.1 ± 26.8 vs. 24.2 ± 50.0 mL). The RALU group had a shorter mean stenting duration (31.3 ± 11.5 vs. 88.9 ± 216.0 days); however, was not statistically significant. No moderate complications (Clavien grade ≥A2) developed in the RALU group, whereas 11.1% of the patients who received LU experienced such events, including fever and ureteral stricture. Both groups experienced similar rates of abdominal fullness ( n = 3). No patients required blood transfusions. RALU provides a comparable operative profile to LU but offers distinct advantages in terms of reduced stenting duration and lower complication rates. These findings support the clinical feasibility and potential safety benefits of robotic assistance in ureterolithotomy, particularly in settings with available resources and technical expertise.
Abstract Psoriasis is a chronic immune-mediated skin disorder characterized by aberrant T cell activation, keratinocyte hyperproliferation, and persistent inflammation. Although biologic therapies targeting key cytokines, such as interleukin (IL)-17A and IL-23, have improved disease management, issues related to cost, safety, and relapse necessitate the development of alternative or adjunctive treatments. With its long history of treating inflammatory skin diseases, Traditional Chinese Medicine (TCM) offers a valuable source of bioactive compounds with immunomodulatory potential. The present review summarizes representative TCM-derived compounds exhibiting anti-psoriatic activities, focusing on their molecular targets, pharmacological mechanisms, and translational relevance. A comprehensive literature search was conducted in PubMed and Web of Science from 2000 to 2024 using predefined keywords related to psoriasis and TCM. The inclusion criteria were original research and review articles reporting mechanistic or therapeutic evidence. Key phytochemicals—including flavonoids and terpenoids—were found to suppress proinflammatory cytokines, inhibit signal transducer and activator of transcription 3 and nuclear factor kappa B signaling, reduce proinflammatory cytokine expression, and restore T helper 17/regulatory T cell balance in various experimental models. In vitro studies using activated CD4⁺ T cells and keratinocyte cultures have demonstrated their ability to reduce cytokine secretion and downregulate inflammatory gene expression. Despite promising preclinical findings, standardizing herbal extracts, ensuring long-term safety, and overcoming poor bioavailability through improved formulations remain challenging. Future research integrating omics technologies, rational drug design, and controlled clinical studies will be essential to advance these compounds toward clinical use. In conclusion, TCM-derived compounds represent a promising frontier for the development of multifunctional therapies for psoriasis and offer considerable potential for their integration into modern dermatological practice.
Abstract Background: Breast cancer is the most commonly diagnosed cancer and the leading cause of tumor-related death in women. Although the role of the Dynamin 1-like ( DNM1L ) gene in mitochondrial dynamics is well established, its clinical relevance and molecular mechanisms in breast cancer remain unclear. Objectives: This study employed a multi-omics approach to investigate the prognostic significance of DNM1L , its underlying mechanisms, and potential therapeutic strategies. Methods: This was a retrospective, multi-omics bioinformatics study integrating genomic, transcriptomic, and pharmacogenomic datasets to investigate the role of DNM1L in breast cancer. RNA sequencing and clinical data from TCGA-BRCA were analyzed alongside pharmacogenomic profiles from the Q-omics platform. Genetic alterations were examined using cBioPortal, DriverDBv4, and TIMER2.0, while differential expression and prognostic significance were assessed with UALCAN, CAMOIP, KM Plotter, and Q-omics. Tumor microenvironment profiling was conducted using the Tumor-Immune System Interaction Database. Functional validation was performed through CRISPR-based loss-of-function screening in breast cancer cell lines to evaluate gene networks and drug sensitivity, with a focus on the therapeutic potential of combining DNM1L targeting with pazopanib treatment. Results: DNM1L gene alterations were not associated with mutation frequency; however, elevated DNM1L mRNA levels were linked to BRCA1 hypermethylation, a marker of poor prognosis. DNM1L expression positively correlated with copy number variation and was significantly higher in tumor tissues compared to normal tissues. High DNM1L expression was associated with reduced overall survival and an immunosuppressive tumor microenvironment. CRISPR-mediated in vitro screening confirmed the involvement of DNM1L in cell cycle regulation and revealed heightened sensitivity to pazopanib in DNM1L knockout models. Conclusion: DNM1L is a potential prognostic biomarker in breast cancer, with high expression linked to poor survival outcomes. Targeting DNM1L in combination with pazopanib may offer a promising precision medicine strategy.
Abstract Background: Cognitive dysfunction and depressive tendencies often add to the caregiving burden and frustration experienced by family members. Objectives: This study aimed to explore the factors influencing cognitive function and depression among community-dwelling older adults. Identifying and preemptively addressing potential risk factors can facilitate the early detection of dementia and depressive tendencies, enabling early interventions that help mitigate functional decline and related complications while enhancing quality of life for older adults. Methods: Two hundred residents aged 65 years and older, with no prior diagnosis of dementia or depression, were recruited as research participants. Data were collected using the Mini-Mental State Examination (MMSE), the 15-item Geriatric Depression Scale (GDS-15), and questionnaires covering relevant demographic variables. Descriptive and inferential statistical analyses were performed using SPSS version 26.0. Results: The participants had a mean age of 73.69 ± 5.65 years. The mean MMSE score was 26.10 ± 3.68. Most participants were female (152 participants, 76%). Cognitive dysfunction was observed in 41 residents (20.5%), and abnormal GDS-15 results in 17 (8.5%). Univariate analysis suggested that cognitive dysfunction was significantly associated with age ( F = 7.64, P = 0.001) and educational attainment ( F = 24.17, P < 0.001), while depressive tendencies were significantly associated only with community participation ( F = 9.386, P < 0.001). Conclusion: This study found that approximately 20% of community-dwelling older adults exhibited cognitive dysfunction, which was significantly associated with age and educational attainment. Additionally, about 8.5% of community-dwelling older adults demonstrated depressive tendencies, which were mainly associated with community participation. Consequently, policy measures that promote health awareness and encourage active community engagement among older adults are needed to enhance their quality of life.
Multilocular cystic renal neoplasms of low malignant potential (MCRNLMP), which account for <1% of renal neoplasms, predominantly affect middle-aged males and are often asymptomatic and incidentally identified through imaging. This report presents a case involving a 49-year-old man with an incidentally detected Bosniak III cystic renal lesion measuring 5.7 cm in the left kidney. Preoperative imaging evaluation suggested the lesion’s complexity, guiding the decision toward implementing a nephron-sparing surgical approach. The patient, therefore, underwent robot-assisted partial nephrectomy using the Da Vinci surgical system, achieving complete tumor resection with minimal blood loss and no complications. Histopathological and immunohistochemical analyses revealed clear cells lining the thin fibrous septa without significant atypical features, confirming MCRNLMP. Despite the critical role of imaging in lesion characterization, definitive differentiation between MCRNLMP and clear cell renal cell carcinoma remains challenging due to overlapping imaging and histological features. This case highlights the importance of advanced imaging modalities in improving the diagnostic accuracy when computed tomography findings are inconclusive. Given the excellent prognosis associated with MCRNLMP, nephron-sparing surgery remains the gold-standard diagnostic and treatment approach. This report emphasizes the need for a multidisciplinary approach integrating clinical evaluation, advanced imaging, and precise histopathological assessment to optimize outcomes in patients with rare renal conditions.
A 64-year-old man with neurofibromatosis type 1 (NF1) presented with melena and anemia. Initial endoscopy findings were inconclusive. Computed tomography and enteroscopy revealed active bleeding from a duodenal lesion. Laparotomy identified a bleeding duodenal tumor and multiple small bowel tumors. Surgical resection was performed for the bleeding and the largest tumors, whereas other smaller tumors were preserved. Pathological examination confirmed multiple low-risk gastrointestinal stromal tumors (GISTs; spindle cell type, CD117/DOG-1-positive, low mitotic rate). No adjuvant therapy was indicated. This case underscores the importance of considering multifocal small bowel GISTs in patients with NF1 with obscure gastrointestinal bleeding. Early imaging, enteroscopy, and surgical management are crucial for diagnosis and treatment. Surveillance remains essential due to the potential for recurrence.
Renal abscesses in children are rare, while those caused by Salmonella species are particularly uncommon in infants without underlying risk factors. This study aimed to report a case of a previously healthy 1-year- and 2-month-old boy who presented with persistent fever despite negative urinalysis, urine cultures, and stool cultures. Abdominal ultrasonography subsequently revealed a large left renal abscess, and the culture of the drained material confirmed Salmonella enterica serogroup D1 as the causative pathogen. The abscess was successfully managed with percutaneous nephrostomy drainage and antibiotic therapy. Furthermore, the findings of this study emphasize the critical role of imaging—particularly abdominal ultrasonography—in establishing a diagnosis when conventional laboratory investigations fail to identify an infectious source.
Background: As the population ages, the prevalence of chronic disease—and consequently, end-stage renal disease (ESRD)—has increased. Sleep quality is crucial for maintaining kidney function. While previous research has primarily examined the impact of poor sleep on quality of life, fewer studies have explored how reduced quality of life may lead to poor sleep, particularly among patients undergoing hemodialysis. Dialysis duration and clinical factors may further influence this association. Objectives: This study examined the relationship between health-related quality of life and sleep quality in patients undergoing hemodialysis, and whether dialysis duration modifies this association. Methods: This cross-sectional, multicenter study included 239 patients with ESRD who had been undergoing hemodialysis for at least three months. Data were collected using a structured questionnaire. Quality of life was assessed using the Taiwanese version of the World Health Organization Quality of Life questionnaire. Sleep quality was measured using the Chinese version of the Pittsburgh Sleep Quality Index. Results: Among the 239 participants analyzed, better physical health was significantly associated with a lower risk of poor sleep quality, after adjusting for sex, age, dialysis duration, monthly household income, and self-perceived health status (adjusted odds ratios [ORs] = 0.521; 95% confidence interval [CI]: 0.420–0.647; P < 0.001). Psychological health also showed a significant inverse association (adjusted OR = 0.692; 95% CI: 0.597–0.802; P < 0.001). Social relationships and the environmental domain showed a similar association. In stratified analyses by dialysis duration (≤5 years vs. >5 years), better physical health, psychological health, and environmental conditions remained inversely associated with poor sleep quality. However, social relationships were significantly associated with sleep quality only among patients undergoing dialysis for ≤5 years. Conclusion: Health-related quality of life is significantly associated with sleep quality in patients undergoing hemodialysis. Early psychosocial and environmental interventions may improve sleep and overall well-being.
The treatment of hyperlipidemia has been established to reduce the development and progression of atheroma and thereby reduce atherosclerotic cardiovascular disease events. Low-density lipoprotein cholesterol (LDL-C) is the primary target for treatment, and the LDL-C treatment goals should be determined by the overall cardiovascular risk. Guidelines and consensus statements all recommend statins as the first-line medication to reduce LDL-C following appropriate lifestyle modification. Statins are safe and well-tolerated when used in appropriate doses, but muscle symptoms sometimes limit their use. Drug interactions with some statins may result in severe muscle toxicity. If LDL-C targets are not achieved with high-intensity statin treatment, ezetimibe should be added. If that is insufficient to reach the LDL-C target, adding or substituting a proprotein convertase subtilisin/kexin type 9 inhibitor or bempedoic acid should be considered, depending on cost, availability, and patient preference. The combination of two or three medications should be sufficient for the majority of patients with preserved LDL receptor function to reach the LDL-C goal. However, observational studies often find that LDL-C targets are not attained, which may be related to poor adherence to therapy or failure to use appropriate combination therapy. Severe elevation of triglycerides is a risk for acute pancreatitis and should be treated with fibrates and/or omega-3 fatty acids along with a low-fat diet. Milder degrees of hypertriglyceridemia contribute to cardiovascular risk, which can be evaluated by non-high-density lipoprotein cholesterol or apolipoprotein B levels, and these may represent better markers of atherogenic burden than LDL-C. Treatment with icosapent ethyl or a fibrate should be considered if triglycerides remain elevated despite achieving LDL-C targets. Treatments for the very rare conditions of homozygous familial hypercholesterolemia with lomitapide or evinacumab and familial chylomicronemia syndrome with apolipoprotein C3 inhibitors have been developed but may not be readily available everywhere.
Background: Cancer remains the leading cause of death in Taiwan, with oral cancer ranking among the top 3 cancers in men. Oral cancer is characterized by a high recurrence rate, with most cases occurring within 3 years. Approximately 80% of recurrences are local, occurring at the primary site, whereas the remaining 20% involve distant metastases. The 5-year mortality rate remains close to 50%. Objectives: This study aimed to investigate the clinicopathological factors associated with recurrence in patients with oral cancer undergoing surgical treatment. Methods: A single-center retrospective cohort study, which included patients who underwent primary tumor resection between 2015 and 2022, was conducted. The clinicopathological factors associated with local recurrence were analyzed, and the impact of adjuvant therapies and potential metastatic predictors was further explored. Furthermore, the clinicopathological variables were analyzed using Cox proportional hazard models. Results: A total of 513 patients were included in the study, among whom 164 developed local recurrence (32%). In univariate analysis, tumor location, size, depth of invasion (DOI), histological differentiation, cancer stage, surgical margin status, and receipt of adjuvant therapy were significantly associated with recurrence. In multivariate Cox regression, only a DOI of ≥10 mm (hazard ratio [HR] = 1.806, 95% confidence interval [CI]: 1.107–2.945) and cancer stage (HR = 2.557, 95% CI = 1.380–4.736) remained independent predictors. Conclusion: Our findings are consistent with previous studies, highlighting the prognostic importance of DOI and cancer stage. For patients with deep tumor invasion or positive surgical margins, aggressive postoperative treatment should be considered to reduce recurrence risk.
Background: Breast cancer continues to be a leading cause of cancer-related mortality among women worldwide, with resistance to docetaxel posing a major therapeutic challenge. STAMBP, a deubiquitinating enzyme from the JAMM family, plays a key role in maintaining proteostasis through ubiquitin cleavage; however, its involvement in docetaxel resistance and its potential as a prognostic biomarker have not been fully explored. Objectives: This study aimed to investigate the relationship between STAMBP and docetaxel resistance, assess its prognostic relevance in breast cancer, and identify potential therapeutic strategies targeting STAMBP to improve treatment outcomes. Methods: We used the DepMap platform to examine the role of STAMBP in docetaxel resistance through Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) knockout screening across 45 breast cancer cell lines. Gene Set Enrichment Analysis was performed to explore associated pathways. The prognostic value of STAMBP was analyzed using data from TCGA, the Human Protein Atlas, and GEO. Potential therapeutic strategies were identified through integrated analysis of siRNA screens based on the GDSC and PRISM Repurposing datasets. Results: STAMBP expression was positively correlated with docetaxel resistance, and its knockout reduced cell viability in 80% (36/45) of the tested cell lines. STAMBP-associated pathways were primarily involved in cell cycle and DNA repair mechanisms. Clinical analyses revealed that STAMBP was upregulated in tumor tissues and correlated with worse overall and relapse-free survival. Moreover, breast cancer cells with high siRNA efficacy against STAMBP exhibited increased sensitivity to docetaxel compared with those with low efficacy. Conclusion: These findings suggest that STAMBP is a potential contributor to docetaxel resistance and an independent prognostic biomarker in breast cancer. Targeting STAMBP may be a promising strategy to overcome chemoresistance, warranting further investigation into its molecular mechanisms and therapeutic potential.
Whole-genome sequencing (WGS) and whole-exome sequencing (WES) are transformative next-generation sequencing (NGS) technologies that have rapidly revolutionized clinical diagnostics, particularly in cases of rare genetic disorders and oncology. WGS provides comprehensive data by covering the entire genome, including coding and noncoding regions, allowing single-nucleotide variants, small insertions/deletions, structural variants, and copy number variations to be detected. Conversely, WES targets the protein-coding exome, which represents only 1%–2% of the genome yet contains approximately 85% of the pathogenic mutations. This review discusses the technological underpinnings, clinical applications, challenges, and future prospects of WGS and WES. We explored their roles in rare disease diagnosis, personalized cancer therapy guidance, neonatal screening, pharmacogenomics, and reproductive carrier screening. Despite significant advancements, challenges remain in data interpretation, computational requirements, cost-effectiveness, ethical issues, and clinical integration. Advances in long-read sequencing, artificial intelligence–assisted interpretation, multi-omics integration, and supportive policy initiatives that aim to broaden access to precision medicine are warranted.
High-altitude pulmonary edema (HAPE) is a life-threatening altitude illness that usually occurs in insufficiently acclimatized climbers at altitudes above 2500 m. HAPE also accounts for the high-altitude-related mortality among all high-altitude sicknesses. The risk of developing HAPE increases with increasing altitude and faster ascent. Medications, such as acetazolamide, have been recommended as prophylaxis for acute mountain sickness; however, its role in HAPE prevention has not been established.
