Functional connectome fingerprinting and stability in multiple sclerosis

BACKGROUND: Functional connectome fingerprinting can identify individuals based on their functional connectome. Previous studies relied mostly on short intervals between fMRI acquisitions. OBJECTIVE: This cohort study aimed to determine the stability of connectome-based identification and their underlying signatures in patients with multiple sclerosis and healthy individuals with long follow-up intervals. METHODS: We acquired resting-state fMRI in 70 patients with multiple sclerosis and 273 healthy individuals with long follow-up times (up to 4 and 9 years, respectively). Using functional connectome fingerprinting, we examined the stability of the connectome and additionally investigated which regions, connections and networks supported individual identification. Finally, we predicted cognitive and behavioural outcome based on functional connectivity. RESULTS: Multiple sclerosis patients showed connectome stability and identification accuracies similar to healthy individuals, with longer time delays between imaging sessions being associated with accuracies dropping from 89% to 76%. Lesion load, brain atrophy or cognitive impairment did not affect identification accuracies within the range of disease severity studied. Connections from the fronto-parietal and default mode network were consistently most distinctive, i.e., informative of identity. The functional connectivity also allowed the prediction of individual cognitive performances. CONCLUSION: Our results demonstrate that discriminatory signatures in the functional connectome are stable over extended periods of time in multiple sclerosis, resulting in similar identification accuracies and distinctive long-lasting functional connectome fingerprinting signatures in patients and healthy individuals

Helping patients and their doctors to systematically collaborate : Supporting diabetes patients` self-management activities by an online tool.

Background: The word “Empowerment“ has recently become one of the most important buzzwords in healthcare services. A empowered patient is considered to be actively involved in his disease management and eventually becomes a better self-manager. Therefore this concept has become particularly relevant for patients suffering from chronic diseases, since empowerment has the potential to facilitate their disease management which eventually will lead to better health outcomes. Objective: Funded by the European Commission (FP7-ICT-2011-288209) a web based platform (including a mobile application) has been developed, which aims at supporting self-management activities of diabetic patients and their treating physicians at two test sites in Germany and Turkey. The platform semantically integrates multiple information sources, such as electronic and personal health records. Patients are able to register patterns of daily living, record blood glucose levels, design disease management plans and set long- and short-term goals. The project intends to actively involve the treating physician. He/she has the possibility to set recommendations for the patient on the platform and is able to monitor the progress of the patient. The objective of the study at hand is to evaluate whether an online tool that systematically integrates multiple information sources, including physicians` recommendations, will improve patient empowerment and which impact it will have on constructive and destructive self-management activities in diabetic patients. Method: The test-phase of the platform is split into two phases. The first phase has been recently concluded. Aim was to pre-test the platform by evaluating usability, usefulness and acceptance. In a second phase patients will be assigned to an intervention group and a control group. Data will be collected at baseline and 2.5 months after the intervention started. In addition, qualitative interviews will be regularly conducted to collect extra information on usability and usefulness. Patients with type 1 or 2 diabetes and their treating physicians will be recruited from the two test sites. Participants have to have access to internet via computer and/or mobile phone. Outcome measures include amongst others the Problem Areas in Diabetes questionnaire (PAID), the Summary of Diabetes Self-Care Activities and scales evaluating doctor-patient interaction. Based on the theoretical framework, measures on health literacy are also included, given that it is hypothesized that health literacy might be a moderator. In addition, physiological parameters, such as physical activity or blood glucose levels will be collected via the platform. Further, log files and number of logins will serve as independent variables. Results: Primary statistical analysis will include t-test and multiple regression analysis in order to investigate e.g. the relationship between numbers of logins and self-management activities. Conclusions: The interplay between multiple sources, including electronic health records, patients` own registered information and treating physicians` recommendations on one platform will have important implications for general practice. It may not only improve largely self-management activities in diabetic patients but it will also facilitate physician`s work by having all important information readily available on one platform. This may foster a more systematic discussion with the patient on further disease management strategies and potential intervention points

EMPOWER - pathways for supporting the self-management of diabetes patients.

Diabetes is a serious world-wide medical challenge and there is a recognised need for improved diabetes care outcomes. This paper describes results of the EMPOWER project, to foster the self-management of diabetes patients by integration of existing and new services offered to patients after having been diagnosed with diabetes. The Self-Management Pathway described in this paper helps patients in the specification of personalized activities based on medical recommendations and personal goals, as well as self-monitoring of the results. The whole process is supported by innovative ICT services that motivate patients to change their lifestyle and adhere to defined medication and activity plans. We describe the approach and present the findings of the validation phase in Germany and Turkey

Career development for early career academics: Benefits of networking and the role of professional societies

Whilst effective networking is vitally important for early career academics, understanding and establishing useful networks is challenging. This paper provides an overview of the benefits and challenges of networking in the academic field, particularly for early career academics, and reflects on the role of professional societies in facilitating networkin