Patients-centered SurvivorShIp care plan after Cancer treatments based on Big Data and Artificial Intelligence technologies (PERSIST): a multicenter study protocol to evaluate efficacy of digital tools supporting cancer survivors.

BACKGROUND: It is encouraging to see a substantial increase in individuals surviving cancer. Even more so since most of them will have a positive effect on society by returning to work. However, many cancer survivors have unmet needs, especially when it comes to improving their quality of life (QoL). Only few survivors are able to meet all of the recommendations regarding well-being and there is a body of evidence that cancer survivors' needs often remain neglected from health policy and national cancer control plans. This increases the impact of inequalities in cancer care and adds a dangerous component to it. The inequalities affect the individual survivor, their career, along with their relatives and society as a whole. The current study will evaluate the impact of the use of big data analytics and artificial intelligence on the self-efficacy of participants following intervention supported by digital tools. The secondary endpoints include evaluation of the impact of patient trajectories (from retrospective data) and patient gathered health data on prediction and improved intervention against possible secondary disease or negative outcomes (e.g. late toxicities, fatal events). METHODS/DESIGN: The study is designed as a single-case experimental prospective study where each individual serves as its own control group with basal measurements obtained at the recruitment and subsequent measurements performed every 6 months during follow ups. The measurement will involve CASE-cancer, Patient Activation Measure and System Usability Scale. The study will involve 160 survivors (80 survivors of Breast Cancer and 80 survivors of Colorectal Cancer) from four countries, Belgium, Latvia, Slovenia, and Spain. The intervention will be implemented via a digital tool (mHealthApplication), collecting objective biomarkers (vital signs) and subjective biomarkers (PROs) with the support of a (embodied) conversational agent. Additionally, the Clinical Decision Support system (CDSS), including visualization of cohorts and trajectories will enable oncologists to personalize treatment for an efficient care plan and follow-up management. DISCUSSION: We expect that cancer survivors will significantly increase their self-efficacy following the personalized intervention supported by the m-HealthApplication compared to control measurements at recruitment. We expect to observe improvement in healthy habits, disease self-management and self-perceived QoL. Trial registration ISRCTN97617326. https://doi.org/10.1186/ISRCTN97617326 . Original Registration Date: 26/03/2021.

Will Big Data and personalized medicine do the gender dimension justice?

Over the last decade, humans have produced each year as much data as were produced throughout the entire history of humankind. These data, in quantities that exceed current analytical capabilities, have been described as "the new oil," an incomparable source of value. This is true for healthcare, as well. Conducting analyses of large, diverse, medical datasets promises the detection of previously unnoticed clinical correlations and new diagnostic or even therapeutic possibilities. However, using Big Data poses several problems, especially in terms of representing the uniqueness of each patient and expressing the differences between individuals, primarily gender and sex differences. The first two sections of the paper provide a definition of "Big Data" and illustrate the uses of Big Data in medicine. Subsequently, the paper explores the struggle to represent exhaustively the uniqueness of the patient through Big Data is highlighted prior to a deeper investigation of the digital representation of gender in personalized medicine. The final part of the paper put forward a series of recommendations for better approaching the complexity of gender in medical and clinical research involving Big Data for the creation or enhancement of personalized medicine services. Supplementary Information: The online version contains supplementary material available at 10.1007/s00146-021-01234-9.

Polyphenols from Polygala spp. and their antioxidant activity.

Members of Polygalaceae are known to contain a variety of different polyphenolic compounds such as xanthones, flavonoids, and biphenyl derivatives. Here, we report the isolation and structural characterization of two new phenol derivatives, named alpestrin (= 3,3',5'-trimethoxy[1,1'-biphenyl]-4-ol; 10) and alpestriose A (= 6-O-benzoyl-1-O-{6-O-acetyl-3-O-[(4-hydroxy-3,5-dimethoxyphenyl)prop-2-enoyl]-beta-D-fructofuranosyl}-alpha-D-glucopyranoside; 11), and of four known compounds (12-15) from the MeOH extract of Polygala alpestris. The relative in vitro antioxidant activities of these compounds, in comparison with other phenolic substances from Polygala vulgaris, were evaluated by means of the Briggs-Rauscher (BR) oscillating reaction, a method based on the inhibitory effects of antioxidant free-radical scavengers. The experimental antioxidant-activity values (relative to resorcinol as a standard) were compared with those calculated on the basis of the bond-dissociation enthalpies. The structure/activity relationships for the compounds examined are also discussed.