International Migration, Integration and Social Cohesion online publications
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How do substance use and mental health work for me?:Towards personalized communication in the treatment of addiction and common mental health problems with ecological momentary assessment and network models
No full textThis dissertation investigates how data-informed tools could make psychotherapy more personalized and effective, particularly for people with addiction and co-occurring mental health problems. Ecological momentary assessment (EMA), where patients answer questions on their smartphones several times a day for multiple days, is used to generate personalized feedback to help patients and therapists collaboratively understand individual mental health and addiction patterns.Simulations showed that, while EMA data can be used to estimate personalized networks graphing how different factors influence each other in an individual’s life, detecting smaller effects is difficult and false negatives are likely. This suggests that simpler feedback focused on fewer variables may be more reliable.A case study with a person experiencing cannabis addiction and psychosis suggested that EMA-based feedback can support insight and improve communication during interventions. A pilot randomized controlled trial in young adults with cannabis use problems found that while standard therapy decreased cannabis use, adding personalized feedback helped to maintain these improvements over time. Participants valued discussing the personalized feedback with the practitioners, though completing EMA was sometimes demanding.Additionally, a study of over 1200 cannabis users revealed gender differences in how cannabis use problems relate to mental health problems, suggesting that subgroup-based tailoring of interventions may also be beneficial. The dissertation also discusses how EMA could be integrated with cognitive bias modification interventions to further strengthen addiction treatment.Overall, EMA-based personalized feedback and personalized networks show promise for improving therapy outcomes, thus, larger studies are needed to replicate clinical usefulness, clarify underlying mechanisms, and improve methodologies to obtain personalized networks
Endoscopic duodenal ablation for the treatment of type 2 diabetes:New insights and techniques
No full textMetabolic disorders such as type 2 diabetes (T2D) are rising worldwide. Largely due to poor diet and lack of exercise. Growing evidence highlights the duodenum, as a key regulator of glucose metabolism. Patients undergoing gastric bypass surgery often show rapid improvement in blood glucose within days, long before significant weight loss occurs. This suggests that bypassing the duodenum itself plays a major role in metabolic benefits. Based on this insight, new therapies have been developed that affect the duodenal mucosa. Since it is easily accessible via upper gastrointestinal endoscopy. One such approach is duodenal mucosal resurfacing (DMR), an endoscopic ablation technique that removes and regenerates the duodenal mucosa. Clinical studies have shown significant improvements in glucose control, with many patients able to discontinue insulin while maintaining stable blood glucose levels. Another technique is recellularization via electroporation therapy (ReCET), that uses electroporation (pulsed electric fields) to induce similar mucosal renewal in the duodenum. Both techniques have demonstrated durable effects without complications. Beyond glucose regulation, duodenal ablation also improves related metabolic conditions, including fatty liver disease, visceral fat accumulation, and cardiovascular risk factors. Additional research is ongoing to better understand the underlying hormonal and cellular mechanisms.In conclusion, duodenal ablation represents a safe and promising option for the treatment of T2D. Future studies aim to refine these techniques and identify which patient groups will benefit most
Dynamically driven-dissipative phases of matter
No full textThis thesis is a theoretical study of low dimensional non-equilibrium quantum many-body systems undergoing dynamical drive and dissipation. Thus, the models in this thesis host explicit time-dependent parameters while in thermal contact with an environment. The formal description of these models is approximated using a time-dependent Lindblad equation. Multiple methods are employed, such as numerical simulations, by means of exact diagonalization and direct differential equation solving, mean-field approximations, algebraic disentanglement of time-ordered exponents and integrability.Three different dissipative models are investigated: (I) a system of free, translationally invariant fermions with dissipation, (II) driven-dissipative bosons in with a Kerr non-linearity (III) and finally noisy, driven-dissipative spins whose correlation functions are described by a non-Hermitian Richardson-Gaudin Hamiltonian. This thesis reports among others an exact solution for the wave functions of the free fermions in terms of coupled Riccati equations obtained through algebraic disentanglement. Furthermore, time-crystalline phases and chaos are identified in in the bosons.The noisy spins cannot be investigated directly, rather requiring an in-depth study of the formal solution to the time-dependent Richardson-Gaudin Hamiltonian. This study revealed a connection between integrable (hyperbolic) Landau-Zener models and the Richardson-Gaudin Hamiltonian and its solutions. Long-time expressions for specific wavefunctions of the time-dependent Richardson-Gaudin Hamiltonian are found. A time-dependent phase transition can subsequently be observed in the spins’ correlation functions where the transient behavior of the system ultimately reduces to a power law. Furthermore, using exact results for two-point correlation functions a temporal phase transition is identified
Sweet talking:The impact of bacterial glycan diversity on immune sensing
No full textAntibiotic resistance is a growing global health crisis, with mortality rates projected to rise significantly. Opportunistic pathogens Staphylococcus aureus and Streptococcus pyogenes are major contributors to skin and soft tissue infections, yet effective vaccines remain unavailable. This thesis investigates how bacterial surface glycans interact with the human immune system at barrier sites, focusing on Langerhans cells (LCs), immune sentinels in the skin. Understanding local host defenses may indicate why some individuals develop infections while others remain asymptomatic, and inform new therapeutic strategies.In S. aureus, wall teichoic acids (WTAs) are glycopolymers involved in colonization and immune evasion. Analysis of over 25,000 genomes, which revealed diversity in WTA glycosyltransferases (TarS, TarM, TarP), affecting glycan structures and immune detection. Specific glycosylation patterns may exacerbate inflammation in atopic dermatitis by activating LCs and promoting T helper 2 responses. Single-cell and bulk RNA sequencing identified LC subsets enriched in AD skin, with upregulated pathways linked to prostaglandin signaling, IgE receptor expression, and T cell activation.In S. pyogenes, the Group A Carbohydrate (GAC) is a conserved cell wall component essential for virulence. Genetic analysis revealed mutations in the gacA–L gene cluster, that altered cell wall composition and immune clearance. Langerin, a C-type lectin receptor on LCs, bound variably to a collection of S. pyogenes strains, and bacterial genes such as emm and mga were found to affect this binding.Together, these findings highlight the importance of glycan diversity in host–pathogen interactions and provide valuable insights for the development of vaccines and alternative therapies targeting these priority pathogens.</p
Photo-excitation dynamics of color centers in diamond
No full textThe negatively-charged nitrogen-vacancy (NV-) center in diamond is among the most promising candidates for developing quantum technologies in the realm of solid state materials. The projects reported in this thesis tackle the ongoing challenges of understanding the electronic structure and charge state conversion mechanisms in the neutral and the negatively-charged states of the NV center using transient absorption (TA) spectroscopy. The results from such investigations reveal high-energy excited states localized in the conduction band (CB) of NV-. In the neutral state NV0, a series of transitions reminiscent of the Rydberg states, followed by the onset of the hole excitation threshold in NV0, were observed. The population dynamics intrinsically and between these two charge states are also reported, including the electron tunneling mechanism of the NV-+N+→NV0+N0 process. While the observations in the NV center have improved the overall understanding of this system, there exists multiple open questions that cannot be answered due to the necessary existence of substitutional nitrogen in the lattice. To remove this parameter, the vacancy center is also studied. The precursor system to all vacancy-related defects in diamond, including NV, the vacancy center also exhibited very similar features, especially in the neutral state. Many of the charge conversion processes between the neutral and the negatively-charged states persist even with the lack of substitutional nitrogen to mediate charge carriers. The results from the vacancy center paved way towards the understanding not only in the NV center, but also novel vacancy-related defects in diamond as well as silicon carbide (SiC)
Elijah in a Roman coat:Der Nister’s <i>The Family Mashber</i>: a mystical and subversive text
No full textThis book is about the novel The Family Mashber written in the Soviet Union in the time of the Stalinist repression by Der Nister, the pseudonym of Pinkhas (Pini) Kahanovitz. With this socialist-realist historical novel Der Nister, who used to be a symbolist writer, adapted and developed his literary style. Nevertheless, the novel’s ambiguity, mystical motifs and symbolism have puzzled many readers. The leading question of this study is whether Der Nister’s The Family Mashber hides a mystical layer under its realistic surface, intended to be understood by a limited number of readers, and if so, how it is realised, what it implies for our understanding of the text and whether or not it also reflects on the historical reality of Der Nister’s time. The conclusion is that The Family Mashber is a multi-layered text and that Der Nister continued his kabbalistic style under the cover of a socialist-realist novel. The esoteric level of the text undermines the socialist-realist narrative and is therefore subversive. Intertextuality and knowledge of the Jewish (mystical) tradition are the key to unlock this esoteric level. Der Nister also used certain narrative techniques to mislead or manipulate the reader in assuming he changed course as a writer and adapted himself to socialist-realism. In The Family Mashber Der Nister also reflects on his own writership. In this way the novel also reflects on the social and political circumstances of the 1930s in the Soviet Union. Der Nister uses the image of Elijah in a Roman coat as an illustration of his subversive writership in disguise. He compares The Family Mashber to the Zohar, presenting it as innovation of Torah, meant to strengthen Jewish tradition even in times of persecution
Threatened preterm birth and beyond:Clinical management and child follow-up
No full textDespite advances in obstetric care, the optimal management of threatened preterm birth remains to be determined. This thesis contributes to improving the management of threatened preterm birth by evaluating the role of tocolytics and investigating the optimal timing of birth in late preterm prelabour rupture of membranes, considering both short- and long-term child outcomes. Furthermore, this thesis discusses different approaches to long-term follow-up research of children prenatally exposed to obstetric interventions, an area that still receives limited focus. Future studies must further refine the risk assessment of threatened preterm birth, and the evaluation of long-term child outcomes should be standardised in preterm birth studies. Ultimately, by aligning treatment strategies with individual risk profiles, we can improve outcomes not only at birth, but throughout childhood and beyond
Kosovar youth correctional institutions from the prospect of rehabilitation
Get PDFThis dissertation is guided by Self Determination Theory (SDT), and examines how living group climate and academic involvement may create conditions for successful rehabilitation of incarcerated juvenile delinquents in Kosovo, and what is known in international literature about the effectiveness of aftercare programs in reducing criminal recidivism and ensuring sustainable rehabilitation? The dissertation uses a mix of quantitative (e.g., meta-analysis) and qualitative (interviews and case studies) research methods. Findings highlight the importance of supportive environments and attending formal education in meeting the psychological and criminogenic needs of incarcerated juvenile delinquents in Kosovo from the perspective of successful rehabilitation. The meta-analysis revealed that mentoring and multimodal aftercare programs, targeting multiple risk and protective factors for juvenile delinquency, can effectively reduce recidivism and promote successful reintegration into society. Research findings from the four empirical studies that are part of this dissertation provide insights and practical implications for enhancing rehabilitation and reintegration of incarcerated juveniles in Kosovo, and possibly other collectivistic cultures or countries that experience less or more economic strains. The dissertation may also contribute to empirical knowledge on the putative (universal) ‘what works principles’ of successful judicial interventions.There are four studies: 1. Study 1: Validation of the Living Group Climate Instrument (published: Selimi, R., Llullaku, N., van der Helm, G. H. P., (Geert-Jan) Stams, G. J. J. M., & Roest, J. (2024). Living Group Climate in Kosovo and Albania: Internal Structure and Reliability of the Prison Group Climate Instrument (PGCI). Journal of Forensic Psychology Research and Practice, 1–15. https://doi.org/10.1080/24732850.2024.2425635)2. Study 2: Living group climate in youth correctional facilities in Lipjan, Kosovo: A mixed method study.3. Study 3: Academic Motivation of Incarcerated Juveniles from the Perspective of Self-determination Theory: A Multiple Case Study (published: Selimi, R., Llullaku, N., (Peer) Van Der Helm, G. H. P., Stams, G. J., & Roest, J. (2023). Academic Motivation of Incarcerated Juveniles From the Perspective of Self-Determination Theory: A Multiple Case Study in Kosovo Context. International Journal of Offender Therapy and Comparative Criminology, 0(0). https://doi.org/10.1177/0306624X231198805) 4. Study 4: A Three-Level Meta-Analysis of Aftercare Programs for Juvenile and Young Adult Offenders. <br/
Guideline development for the prevention of surgical site infections
Get PDFSurgical site infections (SSI) are a common postoperative complication with significant impact on patient outcomes. This thesis investigates various preventive measures for SSI through seven studies. Two network meta-analyses are conducted on bowel preparation and preoperative skin antiseptics. The thesis also includes meta-analyses on the effectiveness of hemodynamic management during surgery, different wound irrigation solutions, and the use of triclosan-coated sutures in reducing SSI. Additionally, an individual participant data meta-analysis examines the effect of door openings in the operating room on SSI risk. The findings provide evidence-based recommendations to improve clinical practices in SSI prevention
Exploring the therapeutic potential of immune checkpoint modulation in preclinical models of inflammatory diseases
No full textAtherosclerosis, a lipid-driven inflammatory disease of large arteries, is a leading cause of cardiovascular disease. While lipid-lowering therapies are effective, some patients retain a residual inflammatory risk, highlighting the need for alternative anti-inflammatory treatments. This thesis investigates the therapeutic potential of immune checkpoint modulation in preclinical models of inflammatory diseases.The first part examines the role of immune checkpoints in T cell-mediated inflammation. It begins by exploring E3 ubiquitin ligases as intracellular immune checkpoints, focusing on the E3 ubiquitin ligase CBL-B. We demonstrate that CBL-B deletion reduces atherosclerosis in mice while promoting T cell activation and T cell plaque infiltration. Next, we identify a novel binding partner for the immune checkpoint CD40L, RACK1, and reveal its role in Th1 cell stabilization. A systematic review and meta-analysis follow, showing that cancer-targeted immune checkpoint inhibitors can accelerate atherosclerosis. Finally, we explore the hypothesis that statins may enhance the efficacy of these immune checkpoint inhibitors.The second part evaluates CD40-TRAF6-targeted therapy, which has shown promise in atherosclerotic mice. Extending this research, we investigate its effects in atherosclerotic pigs, providing an initial analysis, and in secondary haemophagocytic lymphohistiocytosis (sHLH), an acute hyperinflammatory condition. A literature review highlights the roke of immune checkpoints in sHLH, and a pilot study implicates CD40 in the inflammatory response.Overall, this thesis advances understanding of immune checkpoints and highlights their potential as therapeutic targets in inflammatory diseases