International Migration, Integration and Social Cohesion online publications
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Sequential metamaterials with plasticity
No full textGeometry controls functionality is the dominant paradigm in metamaterial design. This is especially true in mechanics, where many designs exploit a mechanical instability known as buckling. Buckling has primarily been designed by geometry: the aspect ratio of the slender elements making up the metamaterials or the geometric nonlinearities that come from internal rotations, rather than material nonlinearities. Material nonlinearities such as hyperelasticity and viscoelasticity have been used as design tools to create buckling-based metamaterials, yet the use of plasticity—a ubiquitous material nonlinearity displayed by most solids—has so far remained unexplored. In fact, plastic deformations have traditionally been seen as a failure mode and have therefore been carefully avoided. In this thesis, we embrace plasticity instead and discover a delicate balance between plasticity and buckling instability, which we term “yield buckling.” We exploit yield buckling to design metamaterials across a variety of geometric architectures and elastoplastic materials that buckle sequentially in an arbitrarily large sequence of steps. These sequential metamaterials demonstrate superior shock absorption performance, controllable buckling sequences, a tunable number and shape of buckling modes, and multishape self-assembly governed by loading history. Our findings represent a paradigm shift for metamaterial design by embracing plasticity and using it in tandem with geometrical design
Knowing better is doing better?:A comprehensive evaluation of sports-based intervention to prevent juvenile delinquency
Get PDFSportgerichte interventies worden steeds vaker naar voren geschoven als een geschikte strengths-based benadering, maar de effecten van deze interventies blijken vaak bescheiden (e.g., Jugl et al., 2023). Mogelijke verklaringen zijn dat (a) interventies in de praktijk niet altijd worden uitgevoerd zoals bedoeld, (b) coaches moeite kunnen hebben om hun pedagogische taken goed te vervullen, en (c) de doelgroep sterk uiteenloopt in achtergrond en behoeften. Om meer inzichten te verkrijgen in deze verklaringen is in het huidige proefschrift een onderzoek uitgevoerd naar één specifieke gedragsinterventie: ‘Alleen Jij Bepaalt wie je bent’ (AJB; Hartog et al., 2017). In dit proefschrift onderzochten we: (1) de implementatiegetrouwheid van AJB, (2) de mate waarin de sportcoaches een therapeutische alliantie met de jongeren wisten op te bouwen en (3) de effecten van AJB op delinquent gedrag en op risico- en beschermende factoren voor jeugddelinquentie, met bijzondere aandacht voor de heterogeniteit binnen de doelgroep. Het onderzoek combineerde verschillende soorten meetmethoden én verzamelde informatie bij meerdere betrokkenen.Onze bevindingen benadrukken de meerwaarde van het combineren van kwantitatieve en kwalitatieve methoden, vooral bij het evalueren van complexe psychosociale interventies binnen een sterk heterogene doelgroep. De uitgebreide evaluatie van AJB vergrootte ons inzicht in hoe de interventie in de praktijk werd geïmplementeerd, welke bevorderende en belemmerende factoren hierbij een rol speelden, en voor welke jongeren AJB beter lijkt te werken dan voor anderen. Daarnaast bood het onderzoek concrete handvatten voor het verbeteren van de effectiviteit van AJB. Zo slaagden coaches er goed in een veilige en ondersteunende omgeving te creëren, maar werden er ook moeilijkheden gezien in het consequent toepassen van gepersonaliseerde, doelgerichte strategieën die essentieel zijn voor gedragsverandering.<br/
Improving risk stratification in patients with coronary artery disease using artificial intelligence
No full textCoronary artery disease (CAD) affects millions of people worldwide and remains a leading cause of death despite modern treatment options. Effective treatment depends on accurate risk stratification, which classifies patients based on their likelihood of adverse outcomes and helps identify those who may benefit from more intensive care. This thesis investigates how machine learning (ML) can improve risk stratification in CAD, with a focus on transthoracic echocardiography (TTE) and invasive coronary angiography.TTE, commonly used to measure left ventricular function, provides much broader information, including details about heart valve structure and blood flow. Research involving patients with chronic coronary syndrome showed that moderate or severe valvular heart disease, especially tricuspid regurgitation, was independently associated with a higher risk of mortality, regardless of left ventricular function.A machine learning model based on clinical and TTE data accurately predicted five-year mortality in patients with chronic coronary syndrome and performed better than traditional prediction tools. The model also showed strong performance when tested in another hospital.Further work validated ML-based risk scores in patients with acute coronary syndrome treated with percutaneous coronary intervention. The GRACE 3.0 score predicted in-hospital mortality more effectively than the earlier version, while the PRAISE score showed limited added value.Deep learning models developed for invasive coronary angiography achieved expert-level accuracy in identifying coronary arteries and detecting significant stenoses. These models allow for automated, quantitative assessment of disease severity. In conclusion, machine learning shows great promise for improving cardiovascular risk assessment, but additional validation and clinical evaluation are required
Sour Name:Swamps as Fermentors of Afro-Surinamese Voice in Eighteenth-Century Colonial Poetry
No full textIn descriptions of eighteenth-century Suriname, the perspective of Afro-Surinamese people, both free and enslaved, is virtually absent because they hardly left any written sources behind. This article attempts to bring the Afro-Surinamese experience to the fore in Dutch colonial poetry of Jan Jacob Mauricius (1692–1768) and Paul François Roos (1751–1805). It does so, by reading the poetry through the lens of the swamp, an environment that was feared and preferably avoided by the Dutch, and precisely therefore a place of refuge for freedom seeking Afro-Surinamese. Using theoretical concepts such as ‘hybridity,’ ‘opacity,’ ‘ecological personhood,’ and ‘relational sacred,’ next to anthropological studies of Afro-Surinamese oral traditions and objects, the article examines how Maroons engaged with the ecology of the swamp to enhance their chances of survival and challenge the plantation system. It hypothesizes that Mauricius and Roos’s colonial representation of Suriname is destabilized by imaginations of the swamp, creating space in the poetry for an unfolding of Afro-Surinamese agency that involves alliances with the swamp and its inhabitants. Specifically, it examines Dutch and Maroon usage of metamorphosis, featuring representation and ‘Relation’, respectively, to express their different experiences of the swamp as an environment that is either decaying or fermenting. On the whole, this article aims to be a probing of the disciplinary boundaries of Dutch literary studies, and a contribution to the project of decolonizing them.<br/
New insights into the management of ulcerative colitis
Get PDFDit proefschrift onderzoekt de rol van chirurgische interventies, in het bijzonder appendectomie, bij de behandeling van colitis ulcerosa (CU). De studies zijn geplaatst in de context van (geavanceerde) medicamenteuze therapieën en de impact daarvan op colorectale kanker (CRC) bij geopereerde patiënten.In deel I wordt de effectiviteit van biologicals en small molecules samengevat in een systematische review en meta-analyse. Deze therapieën bleken effectief voor zowel inductie (+13.1%) als onderhoud (+21.1%) van remissie en vormen daarmee een referentiekader voor chirurgische interventies.Deel II beschrijft de ACCURE-trial, de eerste gerandomiseerde studie naar laparoscopische appendectomie bij CU-patiënten in remissie. Appendectomie verlaagde het risico op opvlammingen significant (36% versus 56%). Voorspellende factoren voor gunstig effect waren jongere leeftijd en een rookverleden. Histopathologisch werd bij meer dan de helft van de patiënten inflammatie in de appendix vastgesteld, wat geassocieerd leek met een verhoogd risico op opvlammingen.In deel III wordt de effectiviteit van appendectomie onderzocht bij patiënten met actieve CU na falen van biologicals (COSTA-studie). Appendectomie was hierin superieur aan Janus kinase-remmers (32.8% versus 12.2% remissie zonder therapiefalen na 12 maanden). Intestinale echografie en histologische kenmerken waren potentieel waardevol voor patiëntselectie.Deel IV laat zien dat, ondanks het toegenomen gebruik van geavanceerde therapieën, de tijd tot colectomie onveranderd bleef, terwijl vaker incidentele carcinomen werden gevonden met slechtere CRC-gerelateerde overleving.Concluderend toont dit proefschrift dat appendectomie klinisch relevante voordelen kan bieden bij geselecteerde CU-patiënten
Deep learning-based derivation of physiological information from cardiac CT angiography
Get PDFCoronary artery disease (CAD) is a leading cause of death worldwide. It is characterized by the accumulation of atherosclerotic plaque in the coronary arteries. This buildup can lead to stenosis, a narrowing of the arteries, which is functionally significant if it results in myocardial ischemia. The current clinical standard for determining the functional significance of stenosis is given by invasive fractional flow reserve (FFR) measurement. However, this procedure is invasive, costly and burdensome for patients.While coronary CT angiography (CCTA) allows for the visual identification of most functionally significant stenoses, it suffers from low specificity. This causes a significant number of unnecessary invasive FFR measurements, emphasizing the need for improved patient selection schemes.This thesis addresses the non-invasive selection of patients who may require invasive treatment by using machine learning (ML), specifically deep learning, to derive FFR from CCTA. Deep learning enables the automatic extraction of robust features from high-dimensional input data, which facilitates accurate and fast FFR prediction without the need for manual intervention. The ultimate goal of this work is to enable automatic and non-invasive FFR prediction, providing clinicians with a tool that can assist in assessing coronary artery disease and making informed decisions about whether invasive procedures are necessary. To achieve this goal, several steps were taken, including the design of a multi-step deep learning model that localizes and characterized the arteries into supervised and unsupervised features, to balance model interpretability and performance
Poetic understanding and political community:Actualizing plurality through poetry
Get PDFCan poems show us a way to be part of a many-voiced history, to be with, a part of, despite being an outsider? What complex kinds of understanding do we need to sustain solidarities across the dividing lines of race, coloniality, caste, and class, and to create processes of sharing that do not undermine social difference or the particularity of individual experience? And can we look towards poetry, towards the dynamic between poems and readers, to offer us a model for such understanding? Where instituted racial and colonial hierarchies obstruct complex understandings of some ‘others’ as who they are and not what they are, can poetry help us? In this project, I propose an intersubjective pragmatist framework for reading poetry that takes the actualization of a decolonial and anti-identitarian political plurality as the basis of poetry’s politicality. At its core is the concept of ‘poetic understanding’: a transformative quality of understanding that is a necessarily dynamic, contingent, non-hierarchical, and anti-identitarian process of transformation and constitution, where who I am comes to be constituted in my process of understanding, as does who the other is. I develop this framework by bringing together four distinct conceptual fields: I build on Hannah Arendt’s theory of political plurality, Édouard Glissant’s concepts of relation and opacity, John Dewey’s pragmatist theory of aesthetic experience, and Sylvia Wynter’s model of decipherment to examine poetry as a site of intersubjective transformation, where a genuine plurality of relation in interaction, divested of discriminatory and hierarchizing mechanics, can be actualized. In such a conceptualization of poetic understanding, I argue, lies an as-yet-underestimated cornerstone of solidary understanding, and the crux of poetry’s political contribution
The rise and fall of mesodiencephalic dopaminergic neurons:Molecular programming by transcription factors Engrailed 1, Pitx3, and Nkx2.9 during the development of mesodiencephalic neurons
Get PDFThe mid- and hindbrain harbor two essential monoaminergic neuronal populations: the mesodiencephalic dopaminergic (mdDA) neurons in the midbrain and the serotonergic (5HT) neurons in the hindbrain. Both systems innervate multiple regions in the forebrain and are involved in the guidance of our mood, motility and motivation guided behavior. The population of mdDA neurons can be divided in the substantia nigra (SNc) and the ventral tegmental area (VTA). An important difference between these dopaminergic nuclei is revealed during the evolution of Parkinson's Disease (PD). The mdDA neurons of the SNc are progressively lost, whereas the mdDA neurons of the VTA are (mostly) spared. The subsequent loss of dopaminergic signaling in the striatum results in tremors, rigidity and depression in patients suffering from PD.We investigate the origin story of the mdDA neuron in order to understand the mdDA system in the healthy, adult brain as well as in the adult brain during pathological conditions. We examined the molecular pathway of transcription factors Engrailed 1, Pitx3 and Nkx2.9, that are required to code mdDA neurons. Furthermore, we aimed to unravel the molecular coding that define the molecular and functional differences between SN and VTA neurons. Together this work contributes to the general knowledge of the developing mdDA neurons and the sensitivity to programmed cells death that characterizes the SN subset of mdDA neurons
Argonauts of West Africa:Migration, citizenship and kinship dynamics in a changing Europe
Get PDFThis book is about the novel and often experimental ways West African migrants in the Netherlands use kinship in their quest for international mobility, employment and legal residence. In the social sciences, there has been a general tendency to assume that the emergence and growing influence of the state will restrict the societal role of kinship and its entanglement with politics and other domains of social life. This study shows that it is precisely the evermore intensive interventions by the state – notably new measures to control mobility across borders, access to the labor market and citizenship – that trigger new efforts by migrants to mobilize and develop kinship in order to use it for creating footholds in new surroundings. A focus on kinship, a classical anthropological topic, turned out to be surprisingly relevant for understanding migrant struggles to retain agency in the face of mounting external pressures. Yet, this new context can also inspire a critical appraisal of the basic tenets of older approaches to kinship. Close attention to kinship’s dynamics and flexibility is imperative. But even more important is the attention to inequality as a complement to the usual tendency to pair kinship with reciprocity. Instead of seeking a normative answer to what kinship is, this book examines what kinship enables and how it does so. The emphasis on the practices of kinship relativizes its glossy cover of reciprocity and solidarity, shedding light on its dark side, which is often neglected in formal statements by both migrants and kinship scholars