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Projeto de investigação
Cancer Long Survivors Artificial Intelligence Follow Up
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Clinical factors influencing long-term survival in a real-life cohort of early stage non-small-cell lung cancer patients in Spain
Publication . Torrente, Maria; Sousa, Pedro A.; Guerreiro, Gracinda R.; Franco, Fabio; Hernández, Roberto; Parejo, Consuelo; Sousa, Alexandre; Campo-Cañaveral, José Luis; Pimentão, João; Provencio, Mariano; DEE - Departamento de Engenharia Electrotécnica e de Computadores; CMA - Centro de Matemática e Aplicações; DM - Departamento de Matemática; Frontiers Media
Background: Current prognosis in oncology is reduced to the tumour stage and performance status, leaving out many other factors that may impact the patient´s management. Prognostic stratification of early stage non-small-cell lung cancer (NSCLC) patients with poor prognosis after surgery is of considerable clinical relevance. The objective of this study was to identify clinical factors associated with long-term overall survival in a real-life cohort of patients with stage I-II NSCLC and develop a prognostic model that identifies features associated with poor prognosis and stratifies patients by risk. Methods: This is a cohort study including 505 patients, diagnosed with stage I-II NSCLC, who underwent curative surgical procedures at a tertiary hospital in Madrid, Spain. Results: Median OS (in months) was 63.7 (95% CI, 58.7-68.7) for the whole cohort, 62.4 in patients submitted to surgery and 65 in patients submitted to surgery and adjuvant treatment. The univariate analysis estimated that a female diagnosed with NSCLC has a 0.967 (95% CI 0.936 - 0.999) probability of survival one year after diagnosis and a 0.784 (95% CI 0.712 - 0.863) five years after diagnosis. For males, these probabilities drop to 0.904 (95% CI 0.875 - 0.934) and 0.613 (95% CI 0.566 - 0.665), respectively. Multivariable analysis shows that sex, age at diagnosis, type of treatment, ECOG-PS, and stage are statistically significant variables (p<0.10). According to the Cox regression model, age over 50, ECOG-PS 1 or 2, and stage ll are risk factors for survival (HR>1) while adjuvant chemotherapy is a good prognostic variable (HR<1). The prognostic model identified a high-risk profile defined by males over 71 years old, former smokers, treated with surgery, ECOG-PS 2. Conclusions: The results of the present study found that, overall, adjuvant chemotherapy was associated with the best long-term OS in patients with resected NSCLC. Age, stage and ECOG-PS were also significant factors to take into account when making decisions regarding adjuvant therapy.
To burn-out or not to burn-out
Publication . Torrente, Maria; Sousa, Pedro A. C.; Sánchez-Ramos, Ana; Pimentão, João; Royuela, Ana; Franco, Fabio; Collazo-Lorduy, Ana; Menasalvas, Ernestina; Provencio, Mariano; DEE - Departamento de Engenharia Electrotécnica e de Computadores; DEE2010-C1 Sistemas Digitais e Percepcionais; BMJ Publishing Group
Objective To assess the prevalence of burn-out syndrome in healthcare workers working on the front line (FL) in Spain during COVID-19. Design Cross-sectional, online survey-based study. Settings Sampling was performed between 21st April and 3rd May 2020. The survey collected demographic data and questions regarding participants' working position since pandemic outbreak. Participants Spanish healthcare workers working on the FL or usual ward were eligible. A total of 674 healthcare professionals answered the survey. Main outcomes and measures Burn-out syndrome was assessed by the Maslach Burnout Inventory-Medical Personnel. Results Of the 643 eligible responding participants, 408 (63.5%) were physicians, 172 (26.8%) were nurses and 63 (9.8%) other technical occupations. 377 (58.6%) worked on the FL. Most participants were women (472 (73.4%)), aged 31-40 years (163 (25.3%)) and worked in tertiary hospitals (>600 beds) (260 (40.4%)). Prevalence of burn-out syndrome was 43.4% (95% CI 39.5% to 47.2%), higher in COVID-19 FL workers (49.6%, p<0.001) than in non-COVID-19 FL workers (34.6%, p<0.001). Women felt more burn-out (60.8%, p=0.016), were more afraid of self-infection (61.9%, p=0.021) and of their performance and quality of care provided to the patients (75.8%, p=0.015) than men. More burn-out were those between 20 and 30 years old (65.2%, p=0.026) and those with more than 15 years of experience (53.7%, p=0.035). Multivariable logistic regression analysis revealed that, working on COVID-19 FL (OR 1.93; 95% CI 1.37 to 2.71, p<0.001), being a woman (OR 1.56; 95% CI 1.06 to 2.29, p=0.022), being under 30 years old (OR 1.75; 95% CI 1.06 to 2.89, p=0.028) and being a physician (OR 1.64; 95% CI 1.11 to 2.41, p=0.011) were associated with high risk of burn-out syndrome. Conclusions This survey study of healthcare professionals reported high rates of burn-out syndrome. Interventions to promote mental well-being in healthcare workers exposed to COVID-19 need to be immediately implemented.
Spanish Non-small Cell Lung Cancer Patients - A Survival Analysis
Publication . Matos, Filipa Mendes de; Sousa, Pedro; Guerreiro, Gracinda
Health is an invaluable asset that prevails in any society throughout human history. As a priceless good,
humans are willing to make all sacrifices to ensure this precious good.
The techniques and technologies used over time, their massification and constant evolution, end up
raising a highly competitive and increasingly sophisticated industry in a constant search directed to the
population's most pressing needs. The digitalization of clinical processes and the immensity data acquired is currently an enormous knowledge capital.
Cancer is the second leading cause of death worldwide, and its increasing number is a concern for world
health organisations that are trying to reverse this trend. In this context, there is an urgent need for
projects and research such as this dissertation that aims to achieve early diagnosis, predict and prevent
disease repercussions, improve quality of life, and increase survivorship rates in cancer patients. This
work focuses explicitly on lung cancer patients. Lung cancer is one of the most typical cancers worldwide, being the most common global cause of cancer death in men and the third most common in
women. Non-small cell lung cancer (NSCLC) accounts for approximately 80% of all lung malignancies.
In addition, the incidence of lung cancer has been gradually increasing over the last 50 years, becoming
a worldwide public health issue.
The dataset analysed is specific for non-small cell lung cancer patients, and all its attributes were reviewed from a clinical perspective.
After understanding the dataset's content and the pre-processing data phase followed a descriptive analysis of each attribute, and the use of the Kaplan-Meier method. Finally, this work proposes the use of
Cox's Multivariate Proportional Hazard Model.
Additionally, this dissertation reviews the applications domain, including the Healthcare industry structure and Information Systems and the technical knowledge necessary to implement Machine Learning
algorithms.
This work was supported by Holos S.A. and engaged with the CLARIFY project (European Union
Horizon 2020- under grant agreement nº 875160).
Chronodisruption and Ambulatory Circadian Monitoring in Cancer Patients: Beyond the Body Clock
Publication . Almaida-Pagan, Pedro F.; Torrente, María; Campos, Manuel; Provencio, Mariano; Madrid, Juan Antonio; Franco, Fabio; Morilla, Beatriz Rodríguez; Cantos, Blanca; Sousa, Pedro A.; Madrid, María José Martínez; Pimentão, João; Rol, María Ángeles; DEE - Departamento de Engenharia Electrotécnica e de Computadores; DEE2010-C1 Sistemas Digitais e Percepcionais; Springer
Purpose of Review: Circadian rhythms impose daily rhythms a remarkable variety of metabolic and physiological functions, such as cell proliferation, inflammation, and DNA damage response. Accumulating epidemiological and genetic evidence indicates that circadian rhythms’ disruption may be linked to cancer. The integration of circadian biology into cancer research may offer new options for increasing cancer treatment effectiveness and would encompass the prevention, diagnosis, and treatment of this disease. Recent Findings: In recent years, there has been a significant development and use of multi-modal sensors to monitor physical activity, sleep, and circadian rhythms, allowing, for the very first time, scaling accurate sleep monitoring to epidemiological research linking sleep patterns to disease, and wellness applications providing new potential applications. Summary: This review highlights the role of circadian clock in tumorigenesis, cancer hallmarks and introduces the state-of-the-art in sleep-monitoring technologies, discussing the eventual application of insights in clinical settings and cancer research.
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Entidade financiadora
European Commission
Programa de financiamento
H2020
Número da atribuição
875160