Institutional Repository Universiteit Antwerpen
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The role of temporality in virtual reality interventions for depressive Episodes : a scoping review
No full textAbstract: Highlights What are the main findings? The temporal dimension in VR-based interventions for depression is important, yet underrepresented in the literature. Two features are considered essential in supporting the reorganization of the experience of time in depression through VR: generating immersion and scaffolding vivid imagination through visualization. VR has the capacity to generate experiences otherwise inaccessible in real life, such as shifting between perspectives and enabling interaction with abstract constructs, which remains underrated. What are the implications of the main findings? VR-based interventions may benefit from engaging individuals more actively through designing interactive experiences that provide opportunities for action. Drawing on VR's underrated features such as interaction with abstract entities and possibility to switch between first-, second- and third person perspective consist a promising directions for further research. Since all analyzed studies are exploratory, further research using more coherent experimental designs is needed.Highlights What are the main findings? The temporal dimension in VR-based interventions for depression is important, yet underrepresented in the literature. Two features are considered essential in supporting the reorganization of the experience of time in depression through VR: generating immersion and scaffolding vivid imagination through visualization. VR has the capacity to generate experiences otherwise inaccessible in real life, such as shifting between perspectives and enabling interaction with abstract constructs, which remains underrated. What are the implications of the main findings? VR-based interventions may benefit from engaging individuals more actively through designing interactive experiences that provide opportunities for action. Drawing on VR's underrated features such as interaction with abstract entities and possibility to switch between first-, second- and third person perspective consist a promising directions for further research. Since all analyzed studies are exploratory, further research using more coherent experimental designs is needed.Abstract Background/Objectives: People living with depression often experience consistent disruptions in their experience of time, which further contributes to their suffering. We present a scoping review on virtual reality (VR)-based interventions for depression, addressing temporal processing and subjective experiences of time. The paper aims to explore the extent to which therapeutic interventions using VR target the temporal dimension of patients' experiences. Methods: We conducted a scoping review using the PRISMA 2020 standard. The literature search was further extended using Research Rabbit and by examining the reference lists of relevant articles. Seventeen papers were selected for final analysis. Results: Our scoping review indicates that temporality in VR-based therapeutic interventions for depression remains underrepresented. Of the seventeen papers reviewed, only two explicitly deal with this issue, while the rest touch upon it briefly or implicitly. The studies suggest that VR's main advantage in modifying the experience of time in depression is its potential to generate immersion and to scaffold imagination through visualization. The main limitations are methodological: most of the available research is exploratory, reports short-term effects, and utilizes a broad variety of empirical designs and therapeutic approaches
Sea-level rise in a coastal marsh : linking increasing tidal inundation, decreasing soil strength and increasing pond expansion
No full textAbstract: Coastal marsh conversion into ponds, which may be triggered by sea-level rise, is considered an important driver of marsh loss and their valuable ecosystem services. Previous studies have focused on the role of wind waves in driving the expansion of interior marsh ponds, through lateral erosion of marsh edges surrounding the ponds. Here, we propose another mechanism between sea-level rise, increasing marsh inundation, and decreasing marsh soil strength (approximated here as resistance to shear and penetration stress), that further contributes to marsh erosion and pond expansion. Our field measurements in the Blackwater marshes (Maryland, USA), a microtidal marsh system with organic-rich soils, indicate that (1) an increase in tidal inundation time of the marsh surface above a certain threshold (around 50 % of the time) is associated with a substantial loss of strength of the surficial soils; and (2) this decrease in soil strength is strongly related to the amount of belowground vegetation biomass, which is also found to decrease with increasing tidal inundation at pond bottoms, where the soil has a very low strength. Our finding of decreasing marsh soil strength along a spatial gradient of increasing marsh inundation coincides with a gradient of increasing historical marsh loss by pond expansion, suggesting that feedbacks between sea-level rise, increasing marsh inundation and decreasing marsh soil strength combine to amplify marsh erosion and pond expansion
Tunable anisotropic electronic transport in bilayer phosphorene Y-junctions
No full textAbstract: We theoretically investigate the electronic transport properties of three-terminal ballistic junctions based on bilayer phosphorene nanoribbons, subjected to a uniform perpendicular electric field. We exploit the intrinsic anisotropy of phosphorene by considering different edge terminations for the nanoribbons that form such junctions, namely normal armchair, normal zigzag, skewed armchair, and skewed zigzag. Unlike bilayer graphene, the Bernal-stacked bilayer phosphorene, when subjected to an inversion symmetry breaking, such as the application of a perpendicular electric field, exhibits a semiconductor to metal transition, whereas in AB-stacked bilayer graphene, one observes a gap opening and a metal to semiconductor transition instead. Thus, by adopting this electric-field-controlled band gap strategy for bilayer phosphorene, we demonstrate the possibility of modulating the current flowing through bilayer-BP-based Y-junctions, redirecting it to one or both output terminals under specific conditions. The role played on the electron conductance and probability density currents by the different Y-junction constituents is also explored, and such results are interpreted in light of nanoribbons' dispersion relations. In this sense, the proposed system acts as a nanoscale switching device, and its current modulation effect can be used to develop phosphorene-based logic gates with a large on/off current ratio, benefiting from the material's high carrier mobility
Intrinsic and extrinsic circular dichroism in linear arrays of anisotropic chiral nanoparticles
No full textAbstract: Controlling the collective optical properties of chiral plasmonic systems is essential for advancing photonic and chiral sensing technologies. Using template-assisted self-assembly, we engineered one-dimensional chiral plasmonic linear arrays composed of highly anisotropic chiral gold nanoparticle chains in an end-to-end configuration, achieving tunable plasmonic and chiroptical properties. While isolated chiral NPs exhibit intrinsic plasmonic circular dichroism (CD), their periodic arrangement introduces surface lattice resonances, yielding sharp extrinsic CD peaks. Orientation- and angle-dependent CD measurements enable a clear differentiation between intrinsic and extrinsic CD contributions. Notably, at specific angles of incidence, the assembled arrays exhibit a significant enhancement in the chiroptical response, demonstrating the dynamic tunability of their optical activity. The chiroptical properties of the arrays can be transferred to a luminescent dye, thereby yielding circularly polarized emission. These chiral superlattices supporting intrinsic and extrinsic chiroptical properties offer a robust platform for photonic devices, ultrasensitive chiral sensing, and enantioselective applications
Postural control in children with spastic cerebral palsy : the role of brain lesion characteristics
No full textAbstract: BackgroundPostural control is often impaired in children with spastic cerebral palsy (sCP), with inter-individual differences not fully explained by CP topography or functional level. While brain lesion characteristics are known determinants of upper limb function, their predictive value for postural control remains underexplored.MethodsIn this cross-sectional study, 43 children with uni- or bilateral sCP (GMFCS I-III), aged 5-12 years, underwent standardized postural control assessment using the Kids-BESTest-2 (in percent scores). Lesion type was classified using the MRI classification scale (MRICS), and lesion extent and location were retrospectively scored on clinical MRI using the semi-quantitative MRI (sqMRI) scale. Associations between lesion characteristics and postural control domains were analyzed using stepwise regression models.ResultsChildren with predominant white or grey matter lesions performed similarly across all postural control domains. Greater lesion extent was significantly associated with poorer postural control in all domains (beta = -0.8 to -1.8% per sqMRI point increase, p <= 0.02) except 'Sensory Orientation'. Lesions in the frontal lobe, anterior corpus callosum, PLIC, thalamus, and brainstem were the strongest predictors of domain-specific deficits, explaining up to 53% of variance.ConclusionLesion extent and location, rather than type, determine the severity and domain-specificity of postural control deficits in sCP. Lesion-specific MRI scoring may support patient-tailored rehabilitation and prognosis.ImpactThis study demonstrates that semi-quantitative MRI-based scoring of brain lesion extent and location, rather than lesion type, is key to understanding domain-specific postural control deficits in children with spastic cerebral palsy.It provides novel evidence that damage to specific brain regions, including the frontal lobe, anterior corpus callosum, PLIC, thalamus, and brainstem, most strongly predicts impairments in distinct postural control domains.Lesion-specific MRI profiling has clinical value for identifying postural control deficits and guiding individualized rehabilitation in children with spastic cerebral palsy. Further longitudinal and multimodal research is needed to validate these findings and optimize intervention strategies
Undetected rifampicin-resistant tuberculosis associated with rpoB I491F and V170F mutations in Botswana : diagnostic implications
No full textAbstract: Background: Undetected rifampicin resistance is a threat to global tuberculosis (TB) control efforts by delaying effective treatment. In different studies, non-canonical rpoB mutations outside the rifampicin resistance-determining region have been reported at varying prevalences by country. Here, we report cases of rifampicin resistance in Botswana that were missed by the routine molecular diagnostic assays. Methods: Individuals were tested under routine programme conditions, in accordance with national guidelines, at four designated drug-resistant TB clinics from 2017 to 2022. Initial testing at the facilities included GeneXpert MTB/RIF ultra and later phenotypic drug susceptibility testing (pDST), as well as the Hain MTBDRsl line probe assay, at the National Tuberculosis Reference Laboratory. A total of nine isolates were subsequently sequenced on the Illumina NextSeq 20 0 0 instrument. Results: At the point of care, routine molecular tests classified all nine individuals as susceptible to rifampicin. Subsequent culture and phenotypic drug susceptibility testing confirmed rifampicin resistance. Whole-genome sequencing identified non-canonical rpoB mutations outside the rifampicin resistance-determining region I49F and V170F, which are associated with low-level rifampicin resistance. Of the nine isolates sequenced, 4 (44%) harboured the rpoB V170F mutation, while 5 (56%) harboured the rpoB I491F mutation. Conclusions: These results highlight a diagnostic gap within the current algorithms and show the value of sequencing-based approaches for accurately detecting drug resistance. Incorporating sequencing into routine clinical practice could help guide the selection of TB treatment and improve treatment outcomes in patients who do not respond to first-line therapy. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/
Dose-response relationship between obstructive sleep apnoea severity and C-reactive protein levels : data from the European Sleep Apnoea Database
No full textAbstract: Introduction Obstructive sleep apnoea (OSA) characterised by intermittent hypoxia promotes systemic inflammation. This study evaluated the association between OSA severity and circulating C-reactive protein (CRP) levels as marker of systemic inflammation in a pan-European patient cohort. Methods This cross-sectional analysis of the multicentre European Sleep Apnoea Database (ESADA) cohort used inverse probability weighted regression adjustment for multiple covariates within a linear mixed-effects model (LMEM) to test the independent association between OSA severity and CRP levels. Covariates included anthropometrics and comorbidities. Study centre and year of analysis accounted for methodological variability in CRP analysis. Results 18 445 subjects (71% male, median age 53 years (interquartile range 44-62), median apnoea-hypopnoea index (AHI) 22.1 events per h (9-44.9)) were included. CRP (median 3.0 mg L-1 (1.2-5.1)) increased in a dose-response fashion across OSA severity categories (2.0 (1.0-4.0) for AHI <5 events per h; 2.5 (1.0-5.0) for AHI 5-<15 events per h); 2.9 (1.2-5.0) for AHI 15-<30 events per h; and 3.7 mg L-1 (1.8-6.4) for AHI ,30 events per h; p<0.001, respectively). In the final LMEM model, AHI remained an independent predictor of CRP concentration (p<0.001). Other significant predictors of CRP were age and female sex. Obesity (body mass index ,35 kg m-2) had, among other comorbidities, the strongest independent effect on CRP levels with 2.7 mg L-1 (95% CI 2.45-2.90). Conclusions Our results showed a consistent and robust dose-response relationship between OSA severity and systemic inflammation independent of usual confounders. The combination of OSA and obesity amplified the association. Future studies should address whether elevated CRP could serve as a prognostic marker for subsequent cardiovascular events in OSA
Agreement across 10 artificial intelligence models in assessing human epidermal growth factor receptor 2 (HER2) expression in breast cancer whole-slide images
No full textAbstract: Historically, eligibility for receiving human epidermal growth factor receptor 2 (HER2)-targeted therapies was limited to HER2-positive tumors (immunohistochemistry 3+ or in situ hybridization amplified), but recent advances in antibody-drug conjugates have expanded these criteria to include HER2-low and HER2-ultralow expression. This evolving therapeutic landscape underscores the need for precise and reproducible HER2 assessment. Digital and computational pathology tools may help address these needs, but their measurement variability must be evaluated to inform research and clinical use. We evaluated HER2 scoring variability across 10 independently developed computational pathology artificial intelligence models applied to 1124 whole-slide images from 733 patients with breast cancer. Analyses included American Society of Clinical Oncology-College of American Pathologists categorical scores (0, 1+, 2+, and 3+), H-scores, tumor cell staining percentages, and counts of total and stained invasive carcinoma cells. Agreement among models and 3 pathologists was assessed using pairwise overall percent agreement (OPA), Cohen kappa, and hierarchical clustering. Median model pairwise OPA for categorical HER2 scores was 65.1% (kappa, 0.51). Agreement was highest for HER2 3+ vs not 3+ (OPA, 97.3%; kappa, 0.86) and lowest for HER2-low cases, reflecting existing measurement challenges. For HER2 0 (negative) vs not 0 (positive) scoring, the average negative agreement was 65.3%, compared with the average positive agreement of 91.3%, suggesting more agreement in non-HER2 0 scores. H-score and cell count analyses indicated that scoring differences were more related to staining interpretation than tumor cell detection. Pathologists showed numerically higher concordance than models, but interobserver variability persisted. In exploratory analyses, sample type, staining artifacts, and heterogeneous HER2 expression appeared to be associated with discrepancies. Artificial intelligence-based HER2 scoring demonstrated high agreement in identifying HER2 3+ cases. Variability was most pronounced in borderline HER2 categories, particularly in HER2 low, underscoring the need for continued tool refinement for handling low-intensity staining. Standardized training data sets, validation frameworks, and regulatory alignment are important to improve reproducibility. Developing reference standards and benchmarking data sets is critical to evaluate performance, support regulatory decision-making, and ensure real-world applicability. (c) 2025 THE AUTHORS. Published by Elsevier Inc. on behalf of the United States & Canadian Academy of Pathology. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/)
Optimizing COPD care in Belgium : a multidisciplinary expert consensus on cardiopulmonary risk management
No full textAbstract: Introduction: Chronic obstructive pulmonary disease (COPD) represents a major health and economic challenge in Belgium, affecting approximately 800,000 individuals, half of whom remain undiagnosed. Beyond respiratory morbidity, COPD patients face substantial cardiopulmonary (CP) risk-encompassing severe exacerbations and cardiovascular (CV) events-that is often under-recognized and insufficiently addressed due to limited clinical awareness, fragmented care, and the absence of national guidance. Methods: A multidisciplinary Belgian taskforce (general practitioners, pulmonologists, cardiologists, pharmacists, epidemiologists) convened through structured workshops and iterative consensus-building to develop a pragmatic, evidence-informed care pathway. The recommendations focus on COPD patients with at least one moderate or severe exacerbation, who are at heightened CP risk. Results: This consensus introduces an integrated, stepwise framework that positions CP risk as a central component of COPD management after exacerbation and operationalizes it across primary care, hospitalization, and post-exacerbation follow-up. Core elements include systematic and proactive CP risk identification in primary care, standardized diagnostic workups during hospitalization, and multidisciplinary discharge planning. Pharmacological strategies combine eosinophil-guided inhaler therapy with guideline-directed CV treatment, while non-pharmacological measures reinforce smoking cessation, vaccination, physical activity, and pulmonary rehabilitation. Clear referral thresholds between primary care, pulmonology, and cardiology are defined, supported by patient education and digital monitoring tools. Conclusion: This Belgian consensus complements international guidelines by consolidating fragmented recommendations into coherent, actionable algorithms that bridge gaps in routine practice. Its contribution lies in translating emerging evidence into structured, real-world pathways that integrate respiratory and cardiac care. Adoption of this framework may help reduce exacerbations, improve CV outcomes, and support multidisciplinary COPD care in Belgium
MMS Am\ue9ricas : a regional network for malaria molecular surveillance
No full textAbstract: International researchers and public health professionals convened in Panama in August 2025 to discuss current and future malaria molecular surveillance strategies to accelerate elimination in the Americas. A new network, MMS Am & eacute;ricas, will promote sharing of expertise, protocols, and data