The participating scientists were:
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| | + Annebet Leeuwis | | VUmc Alzheimer Center | | + Astrid Hooghiemstra | | VUmc Alzheimer Center | | + Giulia de Luca | | University of Amsterdam | | + Jelte Elsinga | | University of Groningen | | + Jochem Jansen | | Academic Medical Center Amsterdam
| | + Judith Poldervaart | | Julius Center, UMCU | | + Lisa Law | | MRC Biostatistics Unit | | + Masum Mia | | University Medical Center Groningen |
| |
| | + Nelleke Korteland | | Erasmus University Medical Center | | + Olympia Papchristofi | | MRC Biostatistics Unit | | + Randy Poelman | | University Medical Center Groningen | | + Rosalinde Slot | | VUmc Alzheimer Center | | + Ruoyu Xing | | Erasmus University Medical Center | | + Sahar Mokhles | | Erasmus University Medical Center | | + Sanne van der Weegen | | Maastricht University |
| |
| | + Sonja Simpraga | | Center for Neurogenomics and Cognitive Research, VU |
| Study protocol: the effect of aerobic exercise on cerebral perfusion in patients with vascular cognitive impairment | Accumulating
evidence suggests that physical activity benefits cognition in elderly.
The beneficial effect of exercise on stroke prevention could suggest an
increased perfusion of the brain as underlying mechanism. We aim to
assess whether physical exercise increases cerebral blood flow (CBF) and
to assess the effect on cognition, blood biomarkers, brain and cardiac
structure and quality of life in patients with vascular cognitive
impairment (VCI). In this randomized controlled trial a 14-week,
thrice-weekly, aerobic exercise program is compared to a control group.
Participants are 80 non-demented patients over 50 years, who are
diagnosed with VCI. They undergo the same standardized set of imaging,
neuropsychological and physical assessments. The primary outcome measure
is CBF, measured by Arterial Spin Labeling (ASL)-MRI. The first results
are expected in early 2017. This intervention study is funded by
“CardioVasculair Onderzoek Nederland” (CVON) and is performed on behalf
of the Heart-Brain-Axis study group. | VUmc Alzheimer Center, Annebet Leeuwis | 
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| The Heart-Brain Connection study protocol: The missing link in the pathophysiology of vascular cognitive impairment | On
behalf of the Heart-Brain study group: Heart disease is increasingly
recognized as a contributor to memory problems and dementia. We aim to
assess the association between heart and blood flow abnormalities and
cognitive functioning (e.g. memory functioning), possibly mediated
through altered brain structure and blood flow. In this study 600
patients aged over 50 years, diagnosed with either vascular cognitive
impairment, blockage of the carotid artery, or with heart failure, as
well as 120 healthy controls undergo the same standardized set of tests:
blood testing, blood pressure, ECG, memory testing, and assessment of
daily functioning and depression. Furthermore, heart and brain MRI is
performed. Follow-up is after one and two years. The first results are
expected in early 2019. This multicenter study is funded by
“CardioVasculair Onderzoek Nederland” (CVON), and is a collaboration of
AMC Amsterdam, Erasmus MC, LUMC, Maastricht UMC, UMC Utrecht, and VUmc. | VUmc Alzheimer Center, Astrid Hooghiemstra |
|
Re-scan Confocal Microscopy
| Microscopes
are built to make sharp images of an object with a strong
magnification. For biomedical research, high magnification microscopes
allow observation of the smallest details in cells with the highest
resolution. However, there is a fundamental limit to resolution and,
consequently, to magnification. This phenomenon is described by Abbe’s
Law which tells that it is not possible to see details smaller than half
the wavelength of light (~250 nm).
We have invented a new
super-resolution technique to obtain 40% better resolution than Abbe’s
limit. Our method is simple to use, robust and relatively inexpensive.
This new super-resolution technique, “Re-scan Confocal Microscopy”
(RCM), is based on standard microscopy extended with two optical
scanners forming the heart of the microscope. One scanner “reads the
sample” by directing laser light to the sample. The other scanner, the
re-scanner, “writes the image” on a camera. The trick to obtain super
resolution is that we apply an additional step of magnification by
increasing the amplitude of the second scanner by a factor of two. With
this method, we measure details down to 170 nm, which is a 40%
resolution improvement compared to Abbe’s limit (250 nm). | Dutch Technology Foundation STW, Giulia de Luca | 
|
| Health seeking behaviour and treatment intentions of dengue and fever: a hh survey of children and adults in Venezuela | Dengue
is a viral disease spread by mosquitoes, affecting approximately 400
million persons annually. Early diagnosis and treatment influences the
outcome of dengue illness. We aimed to understand intended patterns of
health seeking behaviour (HSB) in individuals exposed to high dengue
incidence in order to improve early attendance to health centres. We
performed a cross-sectional household survey in Maracay, Venezuela.
Intended HSB of adults and parents/guardians was assessed in 105
individuals using structured questionnaires. Intended pathways to care
differed for suspected dengue compared to fever, and between children
and adults. Moreover, a suspected dengue infection would prompt people
to search medical help earlier than for fever. Considering that people
would show more adequate HSB when they knew they had dengue but the
identification of a dengue infection still is challenging, we conclude
that improving knowledge and awareness of dengue symptoms may enhance
early attendance to medical care. | University of Groningen, Jelte Elsinga | 
|
Alcohol dependence and the relation to impaired processing and handling of negative emotions
| The
ability to manage emotional information is central to our daily
functioning and often impaired addicted patients. The consumption of
alcohol reduces negative emotion and enhances positive emotion; in other
words, alcohol is an emotion regulator. Relying heavily on this
mechanism of ‘self-medication’ is related to more alcohol related
problems. Therefore it is relevant to improve the handling of emotional
information, or emotion regulation. Differences in performance and brain
activity between alcohol dependent patients and healthy controls have
never been tested with an emotion regulation task. Therefore, an emotion
regulation task is administered within a group of alcohol dependent
patients and healthy controls inside an fMRI scanner and participants
receive one session of a new non-invasive neurostimulation technique
(called rTMS) in order to improve emotion regulation and assess the
effect this technique has on brain function. The results indicate that
rTMS improves performance on the emotion regulation task and changes
brain functioning in alcohol dependent patients. | Academic Medical Center Amsterdam, Jochem Jansen | 
|
Evaluating the impact of the HEART risk score in chest pain patients using a stepped wedge design
| Chest
pain remains a diagnostic challenge: it can be a symptom of a heart
attack. Therefore, most chest pain patients are admitted to the hospital
for further testing. However, most of these patients do not have
anything severe and could have been sent home safely without further
testing. How can we identify these patients? The HEART risk score
provides the doctor with a simple, quick and reliable predictor of
cardiac risk. We studied how the use of this HEART score in daily
practice impacts patient outcomes, quality of life and costs. Last year
we included 3,666 patients with chest pain presenting at the Emergency
Department in 9 Dutch hospitals. All hospitals started with a period of
‘normal care’ and during the study switched to ‘HEART score care’:
calculation of the HEART score in each patient to guide doctors’
decision; reassurance and discharge of patients with low scores and
intensive monitoring/intervention in patients with high scores. | Julius Center, UMCU, Judith Poldervaart | 
|
| An Adaptive trial design for better evaluation of the benefits of telehealth | One
of the biggest barriers to widespread implementation of telehealth
technology in healthcare systems is the lack of strong evidence of its
benefits. This lack of evidence is often due to flaws in trial design.
The aim of my work is to investigate alternative options of trial
design, to allow more accurate and efficient evaluation of telehealth.
My project is partly funded by Philips Research Cambridge, who has a
growing number of telehealth projects. One example is their personal
healthcare system for monitoring the symptoms of chronically ill
patients at home. This includes an alert system which automatically
notifies the healthcare team if a patient’s symptom exceeds a specified
cut-off. Recognising the importance of this cut-off, I propose a new
design which aims to adjust the cut-off to an optimal value during the
trial, allowing the monitoring system to be both optimised and evaluated
within a single trial. | MRC Biostatistics Unit, Lisa Law | 
|
| Fetal stem cells show high anti-scarring properties | Fibrosis
(Scarring) is a defective tissue repair process often seen after
long-lasting injury in many organs, such as the lung, kidney and the
skin. So far, no drugs have been developed that can be used to reduce or
prevent fibrosis. In this study, we treated the adult skin
myofibroblasts (are key cells involed in fibrosis) with the fetal and
adult origin of stem cells. We found that the secreted products of fetal
stem cells create more powerful anti-fibrotic environment than adult
stem cells. From these observations, it appears that fetal stem cells
have potential wound healing properties for adult skin, and most likely
also for other organs that are prone to scarring. | University Medical Center Groningen, Masum Mia | 
|
| Shared decision-making in prosthetic heart valve selection | For
heart valve replacement, two options exist: a mechanical and
bioprosthetic valve. Survival in adult patients is comparable with these
two types of valves. Therefore the choice for a valve prosthesis is
driven by valve-related event occurrence. The nature of these events is
completely different for these two types of valves and the decision is
therefore highly preference sensitive. There is broad support for shared
decision-making (SDM) among cardiovascular professionals and heart
valve patients. Unfortunately, there are no tools available to support
SDM. Therefore, we started a project to develop and test a patient
decision aid for prosthetic heart valve selection. Currently we are
testing the decision aid in a multicenter RCT and after that we will
introduce it in cardiovascular practice. We expect this to result in
better informed and more actively involved patients, and a higher
quality of decision-making in the setting of prosthetic heart valve
selection. | Erasmus Medical Center, Nelleke Korteland | 
|
| Enhancement
of an IDEAL framework for the assessment of surgical interventions:
understanding the complexities and constructing the solutions | My
project deals with the assessment of the impact of learning curves and
multiple operators in clinical trials of surgical and complex
interventions. Firstly, it is expected surgeon performance for novel
operations will improve with increasing experience; this learning effect
may complicate the evaluation of the intervention by either delaying
the start of the trial, or by masking its true impact if surgical
performance has not stabilised before evaluation. We constructed a
model estimating the learning rate, the learning period duration and the
final skill level achieved, in order to adjust for learning effects
during assessment. Secondly, complications during assessment caused by
the multidisciplinary nature of surgery are of interest. The extent to
which patients treated by the same medical team are more likely to have
the same outcome is investigated using a series of hierarchical models
considering surgeon principal effects or, the effects of the next most
influential team member, the anaesthetist, as well as adjustment for
patient heterogeneity. | MRC Biostatistics Unit, Olympia Papchristofi |
|
| REGIOTYPE, an adequate regional viral surveillance strategy | MIn
our tertiary referral hospital, we routinely screen patients suspected
for viral infections. A number of viruses are subsequently typed in
order to identify viral strains and to chart outbreaks and transmission
patterns. Additionally, we implemented a rapid regional sequencing
service called REGIOTYPE, by including primary and secondary healthcare
institutions covering the Northern part of the Netherlands. This allows
us to complete our diagnostics with epidemiological data and as clinical
data are included, to collect information which provides insights into
the circulation of viral strains and their relatedness within multiple
institutions. This fast sequencing strategy even provides a predictive
value in the local circulation of different types of viruses and enables
the early application of infection control measures for the
participating healthcare institutions, including those in our own
hospital. | University Medical Center Groningen, Randy Poelman |
|
Subjective Cognitive Impairment Cohort (SCIENCe)- focus on the earliest changes leading to Alzheimer's disease
| The
primary goal of the SCIENCe study is to investigate the first signs of
Alzheimer’s Disease and factors contributing to cognitive decline.
Dementia is a worldwide growing epidemic, with increasing longevity as
important risk factor. The most common cause of dementia is Alzheimer’s
Disease. Already 25 years prior to the diagnosis of Alzheimer’s Disease,
the first Alzheimer changes in the brain are seen. Memory complaints
can be the first sign of Alzheimer’s Disease, but the majority of
patients with memory complaints do not develop Alzheimer’s. The SCIENCe
study investigates patients with memory complaints, without clear
cognitive impairment. Patients are followed for at least five years.
Patients receive extensive neuropsychological assessment, as well as
questionnaires on lifestyle and psychic health, MRI and PET scanning.
Also, blood, DNA and cerebrospinal fluid are analyzed. The major outcome
is cognitive decline. Identifying Alzheimer’s Disease in its earliest
stage will have important consequences for future treatment of this
devastating disease. | VUmc Alzheimer Center, Rosalinde Slot |
|
Increased risk of stroke or heart attack: is blood flow the cause?
| Atherosclerosis
is the build-up of fatty materials called plaques inside the artery
wall. If a plaque ruptures it can cause stroke or heart attack. Previous
research suggested that the frictional force exerted by flowing blood
on the cells lining the artery can influence plaque composition, thus
increasing its risk of rupture. My project investigates the link between
blood flow and the development of rupture-prone plaques. By surgically
manipulating flow through the artery of a mouse, I created a stable and a
rupture-prone plaque in the mouse artery. I imaged these mice several
times during plaque development and then constructed computer models of
blood flow. Next, I will analyze plaque composition using staining
techniques. Ultimately, I want to find the link between blood flow and
rupture-prone plaques. This will provide a better understanding of the
disease process causing stroke or heart attacks and will help the search
for novel treatments. | Erasmus Medical Center, Ruoyu Xing | 
|
Optimal Clinical Decision Making in Patients with Non-Small Cell Lung Cancer
| Lung
cancer remains the most common cause of cancer-specific mortality
worldwide. In these group of patients guidelines strongly guide
decision-making. However, it is important to involve patients in
decision-making to improve quality of life, and to avoid unnecessary
medical interventions and costs. The purpose of this study is to
investigate the role of the patient with early stage
non-small-cell-lung-cancer in decision-making process concerning
treatment selection. This study illustrate that 46% of patients
experienced personal uncertainty (decisional-conflict). Personal
uncertainty is prevalent when patients are uninformed and uncertain
about treatment options. Furthermore, improvement of information
conveyance, and involvement of patients in treatment decision-making is
needed. Involvement of patients will help them to understand their
prognosis and to make informed treatment decisions. This is important
for quality of life of these patients since there is lack of consensus
about the optimal treatment. Better strategies, such as information
portals and decision aids, are needed. | Erasmus Medical Center, Sahar Mokhles |
|
It’s LiFe! project
| In
the It’s LiFe! project a monitoring and feedback tool was developed,
which measures physical activity with an activity monitor and gives
personalized feedback on a smartphone app and a website, to support
users in their self-management to become more active. Besides the direct
feedback in relation to a personal goal, behavior change dialogue
sessions are sent and the practice nurse in the general practice
automatically receives the results and uses these results in the
behavior change consultations. A Self-management Support Program (SSP)
was developed to guide the practice nurse in this coaching role.
Patients
and care givers were intensively involved in the iterative
user-centered development process of the tool and the SSP. After this
the usability of the tool, the validity of the activity monitor and the
feasibility of the combined intervention was tested. Currently we are
investigating the effects of the tool embedded in the SSP, by a
Randomized Controlled Trial in 24 general practices.
| Maastricht University (Caphri), Sanne van der Weegen | 
|
Is EEG biomarker integration the key to personalized medicine?
| Brain
disorders are a major health care burden, mostly due to inaccurate
diagnosis and insufficient treatment options. Hence the urgent need for
biomarkers, as the current ones are not sensitive and specific enough,
because individual biomarkers overlap between healthy subjects and
patients. This is why we propose an integrative EEG biomarker approach
as multiple biomarkers provide complementary neurological information
and better capture the unique phenotype of an individual (patient). Recently,
we showed that EEG biomarker integration significantly improves the
prediction of conversion from mild cognitive impairment to Alzheimer’s
disease compared with a single biomarker based prediction. Here we
provide additional proof of concept on a twin dataset, yielding a set of
heritable biomarkers which can be used as an index, for diagnosis,
prognosis or monitoring. The high heritability of EEG biomarkers also
implies a high test-retest reliability, which is crucial in clinical
measurements, for longitudinal monitoring of treatment effects.
| VU University Amsterdam, Sonja Simpraga | 
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All the entries for 2014 can be found here.
|
Poster presentations
Awards
