VU Research Portal
Not a member yet
199953 research outputs found
Sort by
The impact of video-based intervention for improving attitudes towards autism in Chinese higher education: A pre-post study
No full textThis study assessed whether a brief video-based intervention could improve attitudes toward autism among Chinese university students and staff. A total of 1158 participants—including undergraduates, graduate students, and staff—completed the 17-item Autism and Neurodiversity Attitudes Scale (ANAS) before and after watching a 6-minute autism-awareness video. Paired-sample t-tests assessed pre-post differences. Exploratory factor analysis (EFA) examined whether the intervention altered the underlying attitudinal structure. To predict individual responsiveness, four machine learning models were trained using pre-intervention responses and demographics; TabPFN achieved the highest accuracy (73.4 %). The study revealed significant positive changes in attitudes towards autism following the educational video intervention (t = -13.30, p < 0.001, Cohen's d = 0.39). We identified three stable dimensions of autism perception: support for normalization, acceptance as natural variation, and empathy. SHapley Additive exPlanations analysis identified that pre-intervention responses to deficit-based items and pity-based attitudes are the strongest predictors of attitudinal change, while demographic variables had negligible influence. Higher baseline endorsement of normalization and pathologizing attitudes were associated with reduced responsiveness to the intervention, highlighting the role of entrenched beliefs in moderating intervention effectiveness. While a brief video intervention can enhance attitudes toward autism, its ability to transform deep-seated beliefs remains limited
Canopy height mapping in the Western Himalayas, Pakistan:A deep learning approach using GEDI and Sentinel-2 fusion
No full textThe western Himalayas in Pakistan, characterized by a diverse range of conifer species at higher elevations, represent a critical biodiversity hotspot and habitat for numerous species. Accurate spatial assessments of canopy height are essential for improving estimates of aboveground biomass, carbon sequestration, and associated forest ecosystem services in this region. In this study, we estimated canopy heights in the western Himalayas in Pakistan using a U-Net CNN approach, fusing data from the Global Ecosystem Dynamics Investigation Mission (GEDI) with multi-band Sentinel-2 (S2) imagery. We produced a canopy height map at a 10 m resolution for 2020. To ensure accurate measurements across various canopy height groups, we implemented a stratified training approach that optimized the representation of GEDI data throughout the training, validation, and testing phases. We trained multiple models using varying thresholds and assigned different weights to taller trees to improve accuracy between different canopy height groups in the study region. Our best model achieved a Root Mean Square Error (RMSE) of 7.52 m and a Mean Absolute Error (MAE) of 5.71 m in the test set, significantly outperforming existing global canopy height models in this topographically complex region. We further validate our predictions against field inventory plots, achieving a coefficient of determination (R2) of 0.49 for plots containing at least 15 trees. The resulting tree canopy height map, designated as the Western Himalaya Canopy Height Map (WHiCH Map), is publicly available.</p
Dietary patterns in children:Associations with ethnicity, socioeconomic position, BMI and body composition
Full text linkIn the Netherlands and many other high-income countries, the prevalence of childhood overweight and obesity is unequally distributed among ethnicity and socioeconomic position (SEP). This thesis focuses on the question which dietary patterns can be derived in 5-year old children and how these dietary patterns are associated with ethnicity, socio-economic determinants, longitudinal BMI and measures of body composition. In Chapter 2 we describe the four dietary patterns that were derived using the data-driven Principal Component Analyses (PCA) method: a snacking (high intakes of savoury and sweet snacks, fruit drinks, refined breakfast products and low intakes of whole-grain breakfast products), full-fat (high intakes of full-fat spreads, full-fat cheese, pasta dishes and low intakes of low-fat spreads and low-fat cheese), meat (high intakes of low- and high-fat meat, sauces, potatoes and refined grain products for warm meals) and healthy (high intakes on the food groups water and tea, vegetables, fish, fruits and whole grain product for warm meals) dietary pattern. Children of non-Dutch origin scored high on the snacking and healthy pattern, children of Turkish origin scored high on the full-fat pattern and children of African Surinamese origin high on the meat pattern. Children of lower educated mothers scored above all high on the snacking pattern. In Chapter 3, we observed that also other indicators of SEP, that is a lower level of paternal education, lower level of household finance and lower neighbourhood socioeconomic status (SES) were associated with higher snacking pattern scores. Yet, a lower maternal education level conferred the highest risk. A lower level of household finance was an additional risk factor for higher snacking pattern scores within the group of middle-high educated mothers. We observed that Children of Dutch origin and higher educated mothers were more often normal weight at age 5, and they developed more often normal weight at age 10 if they were underweight or overweight at age 5, compared to children of non-Dutch origin and lower and middle high educated mothers (Chapter 4). Overall, higher scores on the PCA-derived healthy dietary pattern were unexpectedly positively associated with weight development in most groups, regardless of ethnic origin and maternal education level, whereas higher scores on the PCA-derived full-fat pattern were negatively associated with weight development. In Chapter 5, we applied an a priori diet quality score, which reflects the extent to which the intake within 10 food groups complies with the age-specific Dutch food-based dietary guidelines for children aged 4 to 8 years. We observed an average score of 4.8 (± 1.1) out of a possible 10 points, indicating that in our cohort, about half of the age-specific dietary guidelines were met. Only the intake of whole-grains met the recommendation. We observed that children with higher diet quality scores had more often a higher educated mother, a lower weight, lower BMI and a lower Fat Mass Index (FMI) at age 12 years. In Chapter 6 we choose to further study which dietary patterns were relevant for BMI and measures of body composition at age 5 stratified by maternal educational level. We applied the hybrid Reduced Rank Regression (RRR) method and derived dietary patterns that explained the maximum of variation in BMI, FMI and body fat-free mass (FFMI) at age 5. Pattern 1 was characterised by high intakes of low-fat and healthy food items in all maternal education level groups, and explained the maximum of variation in BMI and FMI, in our cohort at age 5. Higher scores on pattern 1, were associated with higher BMI and a higher odds of being overweight/obese at age 10, and higher FMI at age 12 in all maternal education level groups
Expanding the Role of Critical Care Ultrasound:Advancing Implementation and Exploring New Applications of Lung Ultrasound
Full text linkThe overarching aim of this thesis was to contribute to the ongoing refinement and implementation of critical care ultrasound, in particular lung ultrasound. Critical care ultrasound is widely accepted and increasingly used, but effective implementation is hampered by inconsistencies in training, competency definitions, and organizational support. Many skills currently labelled as ‘basic’ are not easily mastered, exposing a gap between expert-defined frameworks and the realities of education and clinical practice. Classification of skills as basic or advanced should consider not only technical ease but also the frequency with which relevant pathologies are encountered. This distinction is well-established in cardiac ultrasound but remains poorly defined in other domains, contributing to lack of standardization in curricula and certification. A global survey confirmed large variability in use and experience: some applications, like lung ultrasound or vascular access, are frequently used, while others, such as advanced cardiac or neurocritical ultrasound, are not fully implemented. Barriers include lack of training, formal certification, and institutional infrastructure, with use often dependent on motivated individuals. Effective implementation requires addressing both facilitators and barriers while communicating the benefits for clinicians and patients. Standardization of and access to training remain limited. Short, targeted training can achieve competency in lung ultrasound image interpretation, even in those without prior experience. Competency can be defined across four domains: indication, acquisition, interpretation, and clinical decision-making. Digital channels can partially address all domains, increasing accessibility and scalability worldwide while focusing in-person training on acquisition techniques. Acquisition training remains a challenge, particularly in resource-limited settings, and future research should evaluate practical approaches to overcome this. A holistic strategy integrating individual training with system-level support is necessary, including institutional initiatives such as dedicated image archiving and supervision systems to enhance training and implementation. Coordinated efforts across departments and professional societies are essential to create an environment where critical care ultrasound use becomes standard, effective, and sustainable. This thesis also explores the evolving role of lung ultrasound in critically ill patients and its potential impact on patient outcomes. Lung ultrasound can guide the setting and titration of positive end-expiratory pressure in mechanically ventilated patients, identifying lung conditions and assessing the response to interventions to support tailored ventilation strategies. Parenchymal changes, particularly in posterior lung regions, frequently occur even in patients without primary lung disease, likely due to immobility and gravitational forces, though the clinical relevance of these changes remains uncertain. Anterior lung ultrasound reliably predicts gas-exchange improvement in prone COVID-19 patients, emphasizing how lung morphology influences the response to ventilation strategies and supporting phenotypic approaches to personalizing mechanical ventilation. Correlations between lung ultrasound and systemic biomarkers in COVID-19 are partial: while some serum biomarkers show weak to moderate correlation with ultrasound scores, many do not, reflecting fundamentally different biological signals. Lung ultrasound primarily captures structural and aeration changes, whereas systemic biomarkers reflect broader inflammatory dysregulation. Local biomarkers from the alveolar space may better correspond to ultrasonographic findings, providing a more precise assessment of pulmonary involvement. Lung ultrasound-guided management may also improve patient-centred outcomes, as demonstrated by the CONFIDENCE study, a randomized trial investigating ultrasound-guided deresuscitation in invasively ventilated patients, bridging diagnostic validation and clinical outcomes. This thesis underscores the importance of continued research into the impact of critical care ultrasound, and in particular lung ultrasound, on patient outcomes. However, it is important to recognize that many interventions with clear and robust evidence still face slow or limited implementation. Therefore, combining scientific research with frameworks for effective implementation is essential for adopting critical care practices that can drive meaningful changes in daily clinical practice
Hippocampal interneuron alterations in mouse models of familial and sporadic Alzheimer's disease
Full text linkAlzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized not only by amyloid beta (Aβ) plaques and tau tangles, but also by early disturbances in neuronal network activity. Increasing evidence from human and experimental studies indicates that inhibitory interneurons, which maintain the balance between excitation and inhibition in cortical and hippocampal circuits, are particularly vulnerable in AD. In addition, synaptic alterations are widely reported and have been linked to cognitive decline. This thesis builds on these observations and provides new insights into the mechanisms that shape the early development and progression of AD, highlighting age-dependent disturbances in hippocampal circuits in familial and sporadic forms of the disease at the molecular, cellular, and network levels. Using the APP/PS1 mouse model of familial AD, we performed electrophysiological recordings to assess the intrinsic firing properties of hippocampal interneurons across disease progression (Chapter 2). We found that somatostatin (SST) interneurons are hyperexcitable both at early and later ages, whereas parvalbumin (PV) interneurons showed a biphasic trajectory, with hyperexcitability at 4 months of age and hypoexcitability at 6 months of age. Notably, this work revealed a potential therapeutic window: early inhibition of SST interneurons not only restored their own excitability but also restored PV interneuron excitability at both early and later ages, suggesting that SST hyperexcitability may be an upstream driver of inhibitory imbalance. Our proteomic analysis in APOE4-targeted replacement (TR) and APOE3-TR mice (Chapter 3) provides novel insights into changes in the proteomic composition of hippocampal synaptosomes induced by APOE4, the greatest genetic risk factor for sporadic AD, highlighting age-dependent shifts in synaptic and mitochondrial protein expression that occur independently of Aβ pathology. At 3 months of age, changes were characterized by an upregulation of synaptic and mitochondrial proteins. At 6 months of age, however, synaptic proteins were primarily downregulated and mitochondrial proteins at the synapse were no longer enriched, suggesting an early, transient, and possibly compensatory response in protein expression driven by APOE4-induced stress. Additionally, our cell type enrichment analysis consistently points to the involvement of GABAergic interneurons in these proteomic alterations, providing a basis for future research into their potential role as modulators of APOE4-related synaptic changes. In addition to our mechanistic and molecular studies in AD models, we also show that commonly used surgical techniques can affect animal welfare in such models by introducing physiological changes that may influence experimental outcomes, and highlight automated monitoring of locomotor activity as a valuable and objective method for assessing post-surgical welfare (Chapter 4). Together, this work shows the multifaceted nature of AD pathology and provides new insights into the role of interneuron dysfunction as an early and potentially tractable contributor to disease progression in both familial and sporadic AD. Rather than focusing exclusively on hallmark pathologies such as Aβ plaques and tau tangles, our findings highlight the importance of addressing neuronal network dysfunction as a key contributor to disease pathology, as well as molecular alterations that may even occur independently of Aβ, particularly during the early stages of the disease. These findings open potential new avenues for therapeutic strategies aimed at restoring E/I balance and synaptic function, with the goal of preserving cognitive function
TiBaLLi: Internet Inclusion Through Artificial Intelligence
No full textIn recent years, Artificial Intelligence has aided in the development of many solutions around the world in numerous fields and it has become imperative to ask how advanced AI methods like Machine Learning and Natural Language Processing can be reconstructed so as to make the Internet more inclusive practically, for communities in low-resource environments in the Global South. This paper outlines the project in Ghana, which utilizes a Participatory Action Research approach to build a local voice-based Automatic Speech Recognition system to provide domain-focused web-based information to local communities in Dagbani (a local Ghanaian language). We look at the methodology, and how it utilized insights from community engagement to build an inclusive system. We also look at what broader implications of this design process for the Web and AI in the context of decolonization of the Internet.</p
Understanding underutilization of oral health care in high-income countries: a scoping review
No full textAimUnderutilization of oral healthcare can exacerbate health disparities by allowing preventable oral health problems to go untreated. This scoping review provides an overview of underutilization of oral healthcare, aiming to provide insight into populations at risk for underutilization and which individual and systemic barriers contribute.Subject and MethodsSearches were conducted in PubMed and Embase, focusing on studies published between 2018–2025 in high-income countries and populations aged 0–65 years. Studies addressing underutilization of oral healthcare were considered for inclusion.ResultsSeventy-nine studies were included. Populations at risk for underutilization included individuals with chronic illnesses, rural residents, migrants, children, pregnant women and ethnic minorities. Individual barriers included financial constraints, low health literacy, dental anxiety, and competing health priorities, while systemic barriers to utilization of oral healthcare involved high treatment costs, lack of insurance, limited provider availability, and discrimination. Overarching determinants of underutilization commonly included low income, lack of education, and rural residence.ConclusionsUnderutilization of oral healthcare is rarely driven by a single individual or systemic factor but instead results from a combination of multiple barriers. Financial constraints, low health literacy, and dental anxiety often intersect with systemic challenges such as lack of insurance and provider shortages. Addressing underutilization requires targeted, multi-level interventions that consider both individual and structural determinants to improve access to oral healthcare
The Impact of Usher Syndrome on Families:A Closer Look at Their Support Needs
No full textLiving with Usher syndrome is not only complex for people with this syndrome, but also affects family members. Usher syndrome is an inherited progressive disorder that leads to deafblindness. Due to genetic testing, Usher syndrome can now be diagnosed before the child’s first year of life. Receiving the diagnosis can bring up many feelings for parents, including insecurity, and raise questions about when and how to inform the child of the diagnosis. The progressive sensory loss in Usher syndrome also requires ongoing adaptations, such as in communication strategies. People with Usher syndrome and their family members often need support in learning to cope with these adaptations. This chapter discusses the support needs of families with a child with Usher syndrome and families with a parent with Usher syndrome. It also discusses what expertise and skills professionals should have when supporting families with a child or parent with Usher syndrome.</p
An accountability evaluation model for systems-of-information systems
No full textContext: The evolution of business processes has driven the integration of systems-of-systems (SoS) across various domains, leveraging technologies such as cloud computing, e-commerce platforms, and smart environments. Systems-of-information systems (SoIS), a business-focused SoS, integrate heterogeneous and independent systems to achieve business goals. The integration necessitates robust accountability, as contemporary approaches often fail to clarify responsibility, processes, and outcomes among systems. Motivation: Research on accountability within the context of SoIS is limited. Most studies focus on domain-specific solutions or isolated factors, lacking a unified perspective. Notably, there is a significant absence of conceptual models for understanding and evaluating accountability in SoIS, impeding the advancement of research in this field. Objective: This article aims to advance in the understanding of accountability evaluation in SoIS. We present a conceptual model defined by systematically examining the literature. Method: We conducted an empirical study by surveying 21 industry professionals and researchers regarding the correctness and consistency of our model, adjusting it according to their feedback. Results: The conceptual model includes 15 core constructs, their relationships, and a glossary. Conclusions: The conceptual model can expand the body of knowledge of SoIS and serve as a basis for novel solutions to address SoIS accountability evaluation.</p