In recent years there is mounting evidence that type 2 diabetes (T2D) is associated with cognitive impairment and dementia, which can be considered as a “new” long-term diabetic co-morbid complication with dramatic consequences for patients and their families and a significant impact for healthcare systems. At present there are no reported phenotypic indicators or reliable tests to identify T2D patients at risk of developing dementia. Since the retina is ontogenically a brain-derived tissue, we propose that the evaluation of retinal parameters related to either neurodegeneration or microvascular disease will be robust and valuable biomarkers to identify those T2D patients at higher risk of developing cognitive impairment and dementia. On this basis the overarching aims of the project are: 1) To investigate the common mechanisms involved in the pathogenesis of DR and cognitive impairment in the T2D. 2) To use the retina as a tool to identifying individuals with T2D at a higher risk of developing cognitive decline or dementia. Our multidisciplinary consortium (RECOGNISED) consist of top research leaders in the field belonging to 15 prestigious institutions as well as EATRIS, IDF-Europe and Alzheimer Europe and 3 SMEs. RECOGNISED will apply innovative approaches to identify the molecular mechanisms involved in the high prevalence of cognitive impairment and dementia in T2D population and will use this knowledge to characterize clinical phenotypes (personalized medicine) based on retinal functional and structural characteristics and serum biomarkers in order to stratify the risk and severity of cognitive decline. Previously collected data from registries, cohorts and biobanks will be appropriately exploited and robust new data will be generated that will guide clinical recommendations and open up new therapeutic strategies. Ultimately, RECOGNISED project will help to reduce the huge societal and economic burden associated with diabetes-related cognitive impairment.

Cross-border collaboration can tackle the challenges in accessing relevant health data essential for international collaboration between scientists and clinicians, researchers, and health industry. Privacy concerns and regulations on personal data have made the sharing of health data increasingly complex and time-consuming for data controllers, thus severely limiting the access of SMEs, researchers, and innovators to health data. Further complications in cross-border collaboration arise from differences in interpreting the EU GDPR, national regulations, and heterogenous and changing data permit processes at hospital sites. The PHEMS project will provide European children’s hospitals with a decentralized and open health data ecosystem concept consisting of technical components and governance frameworks. The objective is to facilitate access to health data, advance federated health data analysis and build services for the on-demand generation of shareable, synthetized, and anonymized datasets. To achieve this, the project will focus on bridging the gaps in data access and use, especially in the integration of ethical, legal, and technical requirements, including the responsibilities of data controllers and the rights of data subjects. This will allow health data controllers to engage in collaboration without losing control on compliance with respect to GDPR, national legislation or internal policies of their organization. The techniques and tools for generating algorithmically anonymized and synthetic datasets will undergo robust validation processes through three clinical use cases conducted by the European Children’s Hospitals Organisation (ECHO) community. The goal is to assess the usage of custom-generated synthetic data with real-life questions. Data users, such as researchers, SMEs, innovators and the pharmaceutical and MedTech industry, will be engaged through community building, hackathons, and interaction with relevant European large-scale initiatives.

Liver cirrhosis is a very common and severe chronic disease, responsible for high morbidity, impaired quality of life, major healthcare costs, and poor survival, causing an estimated 170,000 deaths per year in Europe. Liver cirrhosis is preceded by a long period of slowly developing, asymptomatic, liver fibrosis; most commonly caused by non-alcoholic fatty liver disease (NAFLD, related to obesity and type 2 diabetes), alcohol, and hepatitis B or C virus infection. There is no treatment available to reverse advanced liver cirrhosis. However, if fibrosis could be detected early, all of the major causes are still amenable to prevention and treatment. Early diagnosis of liver fibrosis in the general population is therefore crucial for the estimated 10 million Europeans with undetected liver fibrosis. The LiverScreen project aims to develop a targeted screening methodology to identify persons with asymptomatic liver fibrosis and cirrhosis among the general population. This methodology involves: 1) identification of groups from the general population at high risk of having chronic liver disease, 2) screening their liver stiffness with the innovative transient elastography (TE) technology (until now only validated in patients with known liver disease) for diagnosis, and 3) determining the right follow-up screening regime. Within the LiverScreen project 8 European countries will collaborate and perform research in over 34,000 subjects to develop the screening methodology and demonstrate its accuracy, clinical value, cost-effectiveness, acceptability, and potential to be implemented by healthcare systems throughout Europe. Using the LiverScreen program, diagnosis at an early stage can stop liver disease progression and have a subsequent long-term impact on liver disease morbidity and mortality and the associated societal burdens in terms of economic costs and health inequity. The estimated cost reduction ranges from €850 to €4,000 per quality-adjusted life-year gained.