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A Systems Medicine Approach: Translating Emerging Science into Individualized Wellness.

ABSTRACT: In today's aging society, more people are living with lifestyle-related noncommunicable diseases (NCDs) such as cardiovascular disease, type 2 diabetes, obesity, and cancer. Numerous opinion-leader organizations recommend lifestyle medicine as the first-line approach in NCD prevention and treatment. However, there is a strong need for a personalized approach as "one-size-fits-all" public health recommendations have been insufficient in addressing the interindividual differences in the diverse populations. Advancement in systems biology and the "omics" technologies has allowed comprehensive analysis of how complex biological systems are impacted upon external perturbations (e.g., nutrition and exercise), and therefore is gradually pushing personalized lifestyle medicine toward reality. Clinicians and healthcare practitioners have a unique opportunity in advocating lifestyle medicine because patients see them as a reliable source of advice. However, there are still numerous technical and logistic challenges to overcome before personal "big data" can be translated into actionable and clinically relevant solutions. Clinicians are also facing various issues prior to bringing personalized lifestyle medicine to their practice. Nevertheless, emerging ground-breaking research projects have given us a glimpse of how systems thinking and computational methods may lead to personalized health advice. It is important that all stakeholders work together to create the needed paradigm shift in healthcare before the rising epidemic of NCDs overwhelm the society, the economy, and the dated health system.

SUBMITTER: Bland JS

PROVIDER: S-EPMC5661085 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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A Systems Medicine Approach: Translating Emerging Science into Individualized Wellness.

Bland J S JS Minich D M DM Eck B M BM

Advances in medicine 20171015

In today's aging society, more people are living with lifestyle-related noncommunicable diseases (NCDs) such as cardiovascular disease, type 2 diabetes, obesity, and cancer. Numerous opinion-leader organizations recommend lifestyle medicine as the first-line approach in NCD prevention and treatment. However, there is a strong need for a personalized approach as "one-size-fits-all" public health recommendations have been insufficient in addressing the interindividual differences in the diverse po ...[more]

PMID: 29164177

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Project description:The investigation includes findings from our clinical trial, monitoring individualized response to pneumococcal vaccination, where we have carried out integrative profiling on peripheral blood mononuclear cells (PBMCs) and saliva pre and post vaccination in a single individual. This is to our knowledge the most extensive saliva-centered omics dataset on an individual, covering 100 timepoints over the course of one year. The time span covers a healthy period as well as comprehensive monitoring of innate and adaptive immune responses following pneumococcal vaccination. Protein and RNA from saliva and PBMCs were produced at each timepoint (100 timepoints for saliva, 25 for PBMCs), and mass spectrometry proteomics and RNA-sequencing were carried out for all samples in non-targeted comprehensive profiling. Specifically, a single individual (male, 38) was profiled over multiple timepoints during healthy periods, as well as post treatment with pneumococcal vaccine (PPSV23). Initially pre-immunization samples, including a 24 hour period with hourly sampling (samples P1052515H07-P1052615H08), were collected to provide a comparative baseline. A subsequent 24-hour time course was performed, with again hourly samples taken pre and post vaccination (P1060715H07-P1060815H06). The PPSV23 pneumococcal vaccine was admistered inbetween timepoints at approximately 10.30am, prior to datapoint P1060715H11. Following the vaccination, and after the 24 hour monitoring, daily samples were taken for about a month (up to sample P1070715H08), to capture innate and adaptive responses in saliva. Two more weekly samples followed, with then monthly sample till the end of the investigation. Concurrently, weekly or monthly PBMC samples were taken. Omics sample analysis includes: RNA-sequencing of total RNA in saliva and PBMCs. small RNA sequencing in saliva. Proteomics in saliva and PBMCs. small RNA from extracellular vesicles in saliva. Note on sample naming: The sample identifier/name P1MMDDYYHhh corresponds to: patient index:P1, date MMDDYY and hour hh preceded by H using 24hour enumeration. Overall the study produced 100 timepoints for saliva in the span of a year, as well as 30 PBMC samples.

Project description:Due to the ubiquitous nature of disruptive extreme events, functionality of the critical infrastructure systems (CIS) is constantly at risk. In case of a disruption, in order to minimize the negative impact to the society, service networks operating on the CIS should be restored as quickly as possible. In this paper, we introduce a novel network science inspired measure to quantify the criticality of components within a disrupted service network and develop a restoration heuristic (Cent-Restore) that prioritizes restoration efforts based on this measure. As an illustrative case study, we consider a road network blocked by debris in the aftermath of a natural disaster. The debris obstructs the flow of relief aid and search-and-rescue teams between critical facilities and disaster sites, debilitating the emergency service network. In this context, the problem is defined as finding a schedule to clear the roads with the limited resources. First, we develop a mixed-integer programming model for the problem. Then we validate the efficiency and accuracy of the Cent-Restore heuristic on randomly generated instances by comparing it to the model. Furthermore, we use Cent-Restore to recommend real-time restoration plans for disrupted road networks of Boston and Manhattan and analyze the performance of the plans over time through resilience curves. We compare Cent-Restore to the current restoration guidelines proposed by FEMA and other strategies that prioritize the restoration efforts based on different measures. As a result we confirm the importance of including specific post-disruption attributes of the networks to create effective restoration strategies. Moreover, we explore the relationship between a service network's resilience and its topological and operational characteristics under different disruption scenarios. The methods and insights provided in this work can be extended to other disrupted large-scale critical infrastructure systems in which the ultimate goal is to enable the functions of the overlaying service networks.

Dataset Information

A Systems Medicine Approach: Translating Emerging Science into Individualized Wellness.

Publications

A Systems Medicine Approach: Translating Emerging Science into Individualized Wellness.

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