Radboud University Press is a unique department at Radboud University. We are a Diamond Open Access publisher of high-quality academic peer-reviewed books and journals across a wide range of disciplines for authors and editors affiliated with Radboud University. The ‘Diamond’ label means that we offer open-access publications free of charge for both authors and readers. Meeting the highest academic standards is our primary goal. Empowering our authors to fully retain their copyrights is our main principle.
In zijn oratie “Van Stoornis naar Verschil – Neurodiversiteit voorbij het Medisch Model” (2025) pleit Léon de Bruin voor een verschuiving van het medische model naar een inclusiever perspectief op neurodiversiteit.
Copyright (c) 2026 Léon de Bruin (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
GRote verhalen is een toegankelijke en verhalende oratie waarin Marcel Schaaf de wereld van het onderzoek naar corticosteroïden tot leven brengt. Hij beschrijft zowel het onderzoek naar de gezondheidseffecten van het stresshormoon cortisol als de werking van geneesmiddelen die hiervan zijn afgeleid, zoals prednison. Omdat de oratie op 5 december werd uitgesproken, speelt het Sinterklaasthema hierin een opvallende en verbindende rol. De lezing verweeft persoonlijke onderzoeksverhalen met fundamentele inzichten in de werking van corticosteroïden en hun receptoren. Schaaf laat zien hoe geavanceerde microscopie en de zebravis als diermodel hebben bijgedragen aan nieuwe kennis over de werking van deze stoffen, en hoe deze kennis kan bijdragen aan de ontwikkeling van nieuwe geneesmiddelen. GRote verhalen is een inspirerende combinatie van wetenschap, storytelling en reflectie op de rol van onderzoek en onderwijs, bedoeld voor zowel vakgenoten als een breed geïnteresseerd publiek.
Copyright (c) 2026 Marcel Schaaf (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Flyer Radboud Dissertation Series
Copyright (c) 2022 Radboud University Press https://creativecommons.org/licenses/by-nc-nd/4.0
De gezondheidszorg staat onder druk door personeelstekorten, vergrijzing, technologische en klimaatveranderingen. Om deze complexe uitdagingen aan te pakken, is een andere manier van werken én opleiden nodig. In haar oratie laat Wietske Kuijer zien hoe het verbinden van opleiden en werken gezondheidsprofessionals helpt zich te ontwikkelen tot adaptieve, samenwerkende professionals. Ze bespreekt hoe een sterke basis in initiële opleidingen gelegd kan worden, hoe de beroepspraktijk als krachtige leeromgeving benut kan worden, en hoe onderwijs en praktijk samen kunnen innoveren. Haar onderzoek richt zich op wat werkt en waarom in het leren(d) samenwerken in de beroepspraktijk over grenzen van beroepen en instellingen heen. Met haar onderzoek draagt ze bij aan duurzame verbetering van opleiden en leren voor betere samenwerking en kwaliteit van zorg.
Interprofessional Education and Learning
Copyright (c) 2026 Wietske Kuijer-Siebelink (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Ruim 200.000 mensen ontvingen in 2024 langdurige GGZ zorg. De bijzondere leerstoel richt zich op een betekenisvolle analyse van herstel. Deze analyse gebruikt een koppeling van zorg gegevens met screeningsgegevens en routine uitkomstmetingen. Ernstig psychiatrische patiënten doen beperkt mee aan routine uitkomstmetingen. Daarom is voor deze groep een analysekader ontwikkeld, die zowel voor het individu, een groep, een afdeling of een kliniek, kan worden toegepast. Bij de inauguratie is het kader toegelicht met een klinische casus en vier voorbeelden van onderzoek verricht door de leerstoel bij verschillende door het ministerie van VWS en ZonMW gefinancierde studies. Het kader is toegepast bij onderzoek naar de nazorg van de vuurwerkramp Enschede, bij landelijk onderzoek naar reductie van dwang en drang en bij verschillende projecten die de effectiviteit van herdiagnostiek bij Ernstig psychiatrische patiënten onderzochten. De betekenis van het analysekader voor beleidsevaluatie en wetenschappelijk onderzoek wordt in de inauguratie nader toegelicht.
Copyright (c) 2026 Eric Noorthoorn van der Kruijff (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
As Carl Rogers famously said, “The only kind of learning which significantly influences behaviour is self-discovered, self-appropriated learning.” This sentiment captures the central role of autonomy in learning and education. However, surprisingly little is known about the cognitive and neural mechanisms underlying the benefits of autonomy in memory encoding and learning. My dissertation aims to investigate how the sense of autonomy influences memory encoding, in conjunction with other environmental factors that surround individuals, focusing on both cognitive and neural mechanisms. This thesis presents four empirical projects that systematically investigate the cognitive and neural mechanisms by which autonomy enhances learning and memory. Drawing on an ecological psychology framework, I examined how internal predictive processes, micro-environmental motivators, and socio-cultural factors interact with autonomy to influence learning outcomes. Across different operationalizations of autonomy—binary choices and active exploration—the findings consistently show that: (1) autonomy enhances learning through predictive processing (Chapters 2 and 3); (2) autonomy activates reward-related brain regions more reliably than monetary incentives (Chapter 4); and (3) cultural background influences the effectiveness of external rewards but not of autonomy (Chapter 5). Together, these findings contribute to a more nuanced understanding of motivation in learning and emphasize that autonomy, an intrinsic motivator, has a stable and powerful effect on memory encoding. In practical terms, these results advocate for educational practices that empower students with more autonomy in their learning process, as doing so may foster deeper and longer-lasting learning.
Copyright (c) 2026 Zhaoqi Zhang (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Grote hervormingen in de zorg komen zelden voor. In dit boek nemen de auteurs de belangrijkste zorghervormingen in Nederland onder de loep en laten zij zien dat niet elke hervorming hetzelfde is of het beoogde resultaat heeft. Hervormingen die de toegankelijkheid van zorg verbeteren, blijken vaak succesvoller dan pogingen om de kwaliteit en doelmatigheid te vergroten. De zorg laat zich echter niet vanachter de tekentafel hervormen. Zorghervormingen worden sterk bepaald door hun politieke en maatschappelijke context en moeten worden “bevochten” in een complexe arena met tal van belanghebbende spelers. Hervormingen zijn bedoeld om institutionele veranderingen tot stand te brengen, maar tonen veelal ook een verrassende mate van institutionele continuïteit. Ook in de toekomst zal de roep om zorghervormingen blijven klinken, in het bijzonder met het oog op de houdbaarheid van het stelsel.
Copyright (c) 2026 Hans Maarse, Patrick Jeurissen (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Journal Guide of Radboud University Press
Author Guide of Radboud University Press
Hoe dacht de middeleeuwer over de ideale date?
Dating was een leuk en spannend onderwerp in de middeleeuwen, juist omdat seksualiteit toen eigenlijk primair binnen het huwelijk hoorde te worden beleefd. Er hing bovendien nogal wat af van wat je uitspookte op liefdesgebied, vooral als jongvolwassene. Zaken als de juiste partnerkeuze en het behoud van maagdelijkheid konden met name voor vrouwen en meisjes immers bepalend zijn voor hun verdere leven. Het was dus belangrijk dat de datingfase van de relatie soepel verliep. Maar hoe zag een ideale date er naar middeleeuws idee eigenlijk uit? Met wie beleefde je die en wat stond er te gebeuren? Welke rollen en idealen waren weggelegd voor mannen en vrouwen? En wat kon je doen als het niet ging zoals gehoopt, zoals bij een afwijzing of bij spijt? Aan de hand van het bekende en geliefde Antwerps liedboek (1544) reconstrueert Cécile de Morrée op levendige wijze laatmiddeleeuwse visies op liefde, daten en seks vóór het huwelijk in de Lage Landen. Het liedboek biedt een inkijkje in een samenleving waarin gelijkwaardigheid, wederzijds respect en consent als belangrijke waarden in relaties golden. Hoewel opvattingen over seks en dating zijn veranderd, zijn de vragen die de middeleeuwer zich stelde verrassend actueel gebleven.
Copyright (c) 2026 Cécile de Morrée (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Tracing the Echoes of Childhood Adversity
The impact of childhood adversity is not limited to childhood; rather, it leads to long-lasting consequences for people’s mental health. To develop more effective interventions, it is important to understand how childhood adversity alters the brain and behaviour. To this end, the thesis traced “echoes” of childhood adversity in an emotional memory task. Advantages in remembering negative events over positive ones are commonly observed in people with depression. Results from our study showed that even for individuals who are not currently in a depressive mood, higher levels of childhood adversity were associated with a greater advantage in remembering negative over positive information. This negative bias was also seen in the activity of brain areas closely involved in emotional memory processing. Beyond the memory study, we also traced childhood adversity in resting‐state functional connectivity between brain regions. The results showed that a specific type of childhood adversity, emotional neglect, interacts with acute stress to influence the functional connectivity organization of the striatum, a key region of the reward processing system. These findings provide new insights into brain and cognitive changes related to childhood adversity, contributing to a better understanding of its underlying psychopathology.
Copyright (c) 2026 Xiangshen Liu (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
This dissertation examines how the built environment shapes active travel and, in turn, opportunities for everyday physical activity in increasingly sedentary societies. While planners often assume that changes to the Built Environment cause significant shifts in travel behaviour, much existing evidence is correlational and vulnerable to bias from self-selection, unobserved confounding factors, and limited data. The thesis advances causal understanding of built environment–active travel relationships by asking: (1) how and to what extent does active travel infrastructure influence travel behaviour, and (2) how and to what extent do density, destination accessibility, and land-use diversity affect walking and cycling. Four empirical studies address these questions using quasi-experimental and longitudinal designs. Two natural experiments estimate the effects of large-scale cycling network expansions in São Paulo and the introduction of cycle highways in the Netherlands, applying robust exposure measures derived from routing algorithms and geospatial analysis. A third study investigates how neighbourhood contexts moderated changes in mobility-related physical activity during COVID-19 restrictions. A fourth study uses panel data on residential movers and a random-intercept cross-lagged model to assess how relocation-related built environment changes influence mode use and attitudes. Across studies, results show measurable but heterogeneous increases in cycling and walking, highlighting the importance of context-sensitive, equity-oriented policy design and robust causal methods for transport planning.
Copyright (c) 2026 Francisco Edson Macedo Filho (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
New Challenges in Azole Resistance Selection in Aspergillus fumigatus
Copyright (c) 2026 Yinggai Song (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Head-up tilt sleeping in Parkinson disease and multiple system atrophy
A common non-motor symptom of Parkinson's disease (PD) and multiple system atrophy (MSA) is autonomic failure, causing blood pressure problems such as orthostatic hypotension (OH) and supine hypertension. A retrospective analysis revealed that the main haemodynamic factor behind this co-occurrence is a high total peripheral resistance during supine rest, which fails to increase under orthostatic stress. Treating both blood pressure issues simultaneously is challenging, and a promising non-pharmacological approach is full-body head-up tilt sleeping (HUTS). HUTS may improve OH and reduce nocturnal hypertension, but its effectiveness and optimal angle remain unclear. The Heads-Up study evaluated the efficacy and tolerability of HUTS in people with PD and MSA with both OH and supine hypertension. Participants slept at three progressively steeper angles for two weeks each. While average nighttime blood pressure did not significantly change, HUTS improved overall blood pressure regulation: early-morning supine BP decreased, nocturnal dipping improved, and OH and orthostatic tolerance improved. Higher angles were more effective but less tolerable, highlighting the need for professional guidance. HUTS appears feasible and beneficial for blood pressure regulation, offering a unique treatment option for cardiovascular autonomic failure in PD and MSA.
Copyright (c) 2026 Amber van der Stam (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Challenging Speech Training in Neurological Patients by Interactive Gaming
The majority of patients with neurological impairment like Parkinson's Disease (PD) or stroke are affected by dysarthria. Dysarthria is a motor speech impairment which leads to reduced speech intelligibility. Intensive and prolonged speech training can increase patients' speech intelligibility. Unfortunately, traditional interventions are generally provided only for a short time. eHealth applications may provide a solution. This thesis explored whether it is possible to develop a game that is suitable for providing speech training in elderly patients with dysarthria due to PD or stroke. Two versions of the game called Treasure Hunters, was developed. In both games two players cooperate and interact verbally to reach the goals of the game, while receiving automatic feedback on voice loudness, pitch, and pronunciation. Participants played with the games in several sessions and generally appreciated it, hinting at their potential for speech training in elderly patients. In two within-subjects experiments the games were compared to a period of no training and to training with a non-game computer-based speech training system. The experiments showed that game-based speech training can have positive effects on speech intelligibility. Based on these outcomes, this thesis regards game-based speech training as a promising option in addition to existing types of speech training. What follows is that this thesis recommends to combine the strengths of all types of training to improve or stabilize speech intelligibility in patients with dysarthria.
Copyright (c) 2026 Mario Ganzeboom (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
As workplaces become increasingly international and diverse, intercultural competence, the ability to interact effectively with people from different cultural backgrounds, has become essential. This dissertation examines various learning experiences to understand whether, and how, they develop intercultural competence. First, intercultural competence development in the classroom was investigated by integrating an intercultural learning tool into a regular university course. Second, the intercultural experiences of Ph.D. students and their supervisors, who lived and worked internationally as part of a research consortium, were explored to identify how trigger events contributed to their competence development. Third, the study examined how growing up abroad as a third culture kid influences multicultural personality traits. The dissertation illustrates how people make sense of intercultural experiences and the strategies they use and focuses on the learning processes that underlie the development of intercultural competence. The studied learning experiences lead to different outcomes for different individuals. For competence to develop, an intercultural learning process must transform an experience into meaningful learning. Key factors supporting this process include interaction with culturally diverse others, appropriate exposure to cultural differences, and opportunities for reflection. Critical incidents play an important role across all studies, highlighting their value for both learning and research.
Internationalization of higher education
Copyright (c) 2026 Pauline Vromans (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Very severe challenging behavior in dementia
People with dementia and very severe challenging behavior can be temporarily admitted to highly specialized units when living in a regular long-term care setting is not possible. The aim of this study was to gain more insight into the organization, treatment, and outcome of treatment in these units. Substudy 1 investigated organizational and treatment characteristics using digital questionnaires, interviews, and observation. This was analyzed using thematic and descriptive statistical analysis. Substudy 2 was a concept mapping study in which a visualization was calculated using input from 82 experts on what comprises successful treatment. Substudy 3 was an observational study in which 127 patients were followed from admission to discharge or death: demographics and behavior were described. Mortality was explored using Cox prediction and association models. Substudy 1 showed that specialized departments were pioneering and exhibited strong heterogeneity in terms of organization and treatment. Nevertheless, similarities were found in the role of the nursing staff, intensive multidisciplinary treatment, and attention to sensory stimuli. Concept mapping identified three overarching clusters of successful treatment: 1) well-being, 2) multidisciplinary analysis and treatment, and 3) attitude and skills of those involved. The observational study showed that one-third of participants died during admission. For patients with very severe physical aggression, the risk of death was nine times higher.
Behavioral and psychological symptoms of dementia (BPSD)
Copyright (c) 2026 Gerrie van Voorden (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
This dissertation explores and offers new perspectives on why market-based innovations designed to alleviate poverty often fail to gain traction among consumers at the base of the pyramid (BOP). Focusing on understanding the link between institutional barriers and BOP consumer behavior, it reveals how local rules, norms and practices shape resistance to pro-poor innovations. Drawing on interdisciplinary perspectives from service-dominant logic, transformative service research, and institutional theory, and using qualitative and quantitative evidence from Zambia, the work offers a grounded understanding of how institutional voids can impede the process of institutional change which necessarily goes hand in hand with the adoption of transformative services such as mobile banking and insurance designed for BOP target groups. By developing a conceptual framework that links local (incomplete) sets of institutions to innovation adoption, the book advances theory on market-based poverty alleviation and transformative service innovation. It provides valuable insights for scholars and practitioners seeking to design more inclusive, context-sensitive strategies for sustainable development and institutional transformation in impoverished markets and beyond.
Copyright (c) 2026 Michelle Greene (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Enhancing Cure and Care for Patients with Chronic Venous Disease
Chronic venous disease (CVD) is highly prevalent and leads to symptoms ranging from pain and skin changes to chronic ulcers, severely affecting quality of life and generating substantial healthcare costs. This thesis aimed to determine whether a one-stop clinic and optimised diagnostic and conservative strategies improve outcomes in venous leg ulcers and post-thrombotic syndrome (PTS). A new one-stop clinic model for venous leg ulcers was evaluated using clinical outcomes, patient interviews and cost analyses. Systematic reviews were conducted on the duration of compression therapy after deep vein thrombosis (DVT) and on the effects of exercise following DVT. Additionally, a pilot study assessed the feasibility of treadmill testing to evaluate venous claudication before and after venous stenting. The one-stop clinic improved chance of ulcer healing and was highly valued by patients for its coordinated, specialist-led care. The cost analysis suggested potential reductions in healthcare utilisation. Evidence showed that the duration of compression therapy can be safely individualised when patients are closely monitored. Exercise interventions after DVT improved pain, quality of life and reduced the long-term severity of PTS. Treadmill testing proved feasible for individual assessment, though its generalisability and applicability across wider patient groups have yet to be established. Findings highlight the importance of structured, personalised care pathways and support the integration of exercise therapy and emerging digital tools into future CVD management.
Copyright (c) 2026 Bram Rook (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Cognitive impairment after stroke in young adults
A stroke at a young age can have serious and lasting consequences. Around 10–20% of all strokes occur in young adults between 18 and 50 years old. Many young survivors experience cognitive problems, such as problems with memory, language, or processing speed. This thesis demonstrates that these issues are common, even among individuals who recover well physically. Our findings show that cognitive function after stroke usually not improves over time. Most young adults remain stable after the first few months. We also found that stroke lesions affecting multiple brain regions, including the cerebellum, are associated with cognitive impairment. This may explain why patients with lesions in different locations can all experience cognitive problems. In addition, we found that lower white matter integrity outside the stroke lesion, particularly in the affected hemisphere, may contribute to cognitive impairment. Importantly, major cognitive problems are associated with unemployment. Early recognition and support of young adults with cognitive impairment after stroke can lead to more personalized care for young stroke survivors.
Copyright (c) 2025 Mijntje Schellekens (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
This thesis investigated whether bilingual syntax can be explained as error-based implicit learning. The thesis first introduced the Bilingual Dual-path model (Chapter 2) and then used that model to examine bilingual phenomena in sentence processing and production (Chapters 3 to 6), and in acquisition (Chapters 4 and 5). In Chapter 6, the model was used successfully to predict the outcome of a new online structural priming experiment with human participants. The results presented in the thesis show that an error-based implicit learning mechanism, instantiated in the Bilingual Dual-path model, accounts for experimental findings on cross-language structural priming and ERPs in L2 learning, and that the model can predict new experimental results on how processing code-switches affects cross-language structural priming. Thus, the thesis has furthered our understanding of a range of bilingual phenomena that play a central role in the psycholinguistic investigation of bilingual syntax, by presenting a plausible underlying mechanism that explains them. At the same time, the thesis has provided further validation for that mechanism.
Copyright (c) 2026 Yung Han Khoe (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Shalawat Performance and Cultural Resistance
This study examines how the traditional Islamic ritual of maulid (celebration of Prophet Muhammad's birthday) has been transformed into popular shalawat performances in Surakarta (Solo), Indonesia. The research focuses on how these performances function as forms of cultural resistance against both Salafi criticism of traditional practices and the influence of radical Islamic movements. Drawing on fieldwork conducted between 2017-2018, the study analyses how performers and participants navigate tensions between religious authenticity and contemporary cultural expression, creating what I term "public resilience" - a sustained capacity to preserve religious traditions while countering radical narratives. Using theoretical frameworks from discursive tradition, religious authority, and popular culture, the research examines five shalawat groups in Surakarta, including the influential Habib Syech bin Abdul Qadir Assegaf's Ahbabul Mustofa. This work contributes to our understanding of how traditional religious practices adapt to contemporary challenges while maintaining their spiritual essence and building community resilience against radicalism.
Copyright (c) 2025 Muhammad As’ad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Copyright (c) 2025 Rebecca Verheggen (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
This thesis addresses the critical challenge of adversarial machine learning in deep learning models, focusing on the defense mechanisms against evasion (adversarial) attacks and backdoor attacks. Part I analyzes evasion attacks through the lens of information bottleneck theory, revealing that compressing redundant information in the input space enhances model robustness. This insight leads to the proposal of novel, theoretically grounded adversarial training methods for stronger defense against evasion attacks. Part II shifts to backdoor attacks, exploring the sensitivity of backdoored models to adversarial examples. The research introduces an innovative backdoor trigger inversion method and investigates how adversarial perturbations can influence neuron weights to activate the backdoor functionality directly, bypassing the need for trigger recovery. This highlights the potential of parameter space analysis for effective backdoor detection and mitigation. An additional chapter systematically examines existing backdoor attacks, identifying a vulnerability: the detectability of backdoor-related neurons. To counter this, a novel backdoor attack is proposed, incorporating an adversarial backdoor injection module to ensure multi-space stealthiness (input, feature, and parameter spaces). The thesis concludes by emphasizing the importance of adopting defense mechanisms before deploying machine learning in critical applications to ensure the security and reliability of these systems.
Copyright (c) 2026 Xiaoyun Xu (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Influence of prior experience on spatial orientation and self-motion perception
Many aspects of our perception and behavior are influenced by prior knowledge. We are usually unaware of this influence, but every now and then we notice its effects, for example when you lift a mug you thought was still full of coffee, only to find that it is almost empty. Prior knowledge also affects our spatial perception. For example, when walking to a new destination, the return journey often feels different from the outward one, partly because on the way back we already have prior knowledge about the distance to be covered. This dissertation investigates how prior knowledge influences our vestibular perception of spatial orientation and self-motion. My research involved measuring participants in behavioral experiments and modeling the collected data using mathematical models. I conclude that vestibular perception is affected by prior knowledge about task-relevant stimulus history, accumulated over multiple timescales.
Copyright (c) 2026 Sophie Willemsen (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Precision Utilization of Extracellular Vesicles
Copyright (c) 2025 Peng Wang (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Mechanism behind clinical symptoms in cerebral small vessel disease
Cerebral small vessel disease (SVD) affects the brain’s small vessels and is a major cause of vascular cognitive impairment and dementia. Conventional MRI markers such as white matter hyper-intensities (WMH), lacunes, and micro-bleeds capture only part of the underlying pathology, failing to explain the marked heterogeneity in clinical symptoms among patients. This thesis applies advanced multi-modal neuroimaging, particularly diffusion imaging, to uncover mechanisms linking SVD damage to clinical manifestations. Three major mechanisms are explored: (1) strategic effects, focusing on damage to the thalamus and dopaminergic and cholinergic white-matter pathways; (2) remote effects, reflecting secondary neurodegeneration related to focal lesions like WMH and cortical microinfarcts (CMIs); and (3) waste-clearance dysfunction, involving perivascular pathways, choroid plexus, and deep medullary veins. By integrating these imaging markers with cognitive and clinical data, this work elucidates multi-level pathways through which SVD disrupts brain structure, providing insights for future diagnostic and therapeutic strategies.
Copyright (c) 2025 Hao Li (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Exploring Immune Checkpoints and Cytokine Signaling to Improve NK Cell Effector Function in Ovarian Cancer
The demonstration that ovarian carcinoma (OC) is an immunogenic disease, opens opportunities to explore immunotherapeutic interventions to improve clinical outcome. In this regard, NK cell based immunotherapy could be promising as it has been demonstrated that OC cells are susceptible to killing by cytokine-stimulated NK cells. Here, we evaluated whether percentage, phenotype, function and IL-15 responsiveness of ascites-derived natural killer (NK) cells is related to progression-free survival (PFS) and overall survival (OS) of advanced stage OC patients. Generally, a lower percentage of NK cells within the lymphocyte fraction was seen in OC ascites (mean 17.4 ± 2.7%) versus benign peritoneal fluids (48.1 ± 6.8%; p < 0.0001). Importantly, a higher CD56+ NK cell percentage in ascites was associated with a better PFS (p = 0.01) and OS (p = 0.002) in OC patients. Furthermore, the functionality of ascites-derived NK cells in terms of CD107a/IFN-γ activity was comparable to that of healthy donor peripheral blood NK cells, and stimulation with monomeric IL-15 or IL-15 superagonist ALT-803 potently improved their reactivity towards tumor cells. By showing that a higher NK cell percentage is related to better outcome in OC patients and NK cell functionality can be boosted by IL-15 receptor stimulation, a part of NK cell immunity in OC is further deciphered to exploit NK cell based immunotherapy.
Copyright (c) 2025 Ralph Maas (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Malaria remains a major global health challenge, with Plasmodium falciparum responsible for most morbidity and mortality. This thesis explores strategies to reduce malaria transmission through both drug- and antibody-based interventions. In three phase 2 clinical trials in Mali, we evaluated how different antimalarial regimens influence gametocyte carriage and infectiousness to mosquitoes, demonstrating variable transmission-reducing activity across artemisinin-based and non-artemisinin combination therapies, and highlighting the potential of adding low-dose gametocytocidal drugs such as primaquine or tafenoquine. We further assessed the transmission-blocking vaccine candidate R0.6C and the monoclonal antibody TB31F in first-in-human studies, showing that both are safe and immunogenic, with TB31F providing potent and long-lasting functional activity. A life cycle assessment of a malaria clinical trial quantified its environmental footprint, identifying key contributors and mitigation strategies. Finally, a phase 1 study of the SARS-CoV-2 vaccine candidate ABNCoV2 provided the first clinical evaluation of the modular capsid virus-like particle (cVLP) platform, demonstrating its safety, tolerability, and immunogenicity in humans. Collectively, these studies advance integrated and sustainable strategies to block Plasmodium falciparum transmission and support malaria elimination.
Reducing Plasmodium falciparum transmission
Copyright (c) 2025 Merel Smit (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Housing shortages remain a persistent global challenge shaped by demographic, economic, and institutional dynamics. In Indonesia, housing demand far outpaces supply: around 800,000 new units are needed annually, yet only about 350,000 are produced by the formal sector, leaving millions dependent on informal solutions. This dissertation examines how the structure of housing provision and public policy interact to shape formal housing development in Indonesia’s evolving market economy. Revisiting Turner’s (1972) concept of housing as a verb and extending it through Adams’s (1994) market-process perspective, the study conceptualizes housing as a dynamic governance process shaped by negotiation, contestation, and adaptation among multiple actors. Through four empirical studies, it analyzes: (1) the transformation of Indonesia’s housing provision structure and the rise of financialization; (2) the evolution of affordable housing policy under public–private interplay; (3) the role of land policies and speculative land banking; and (4) the institutional and market factors driving development delays. The dissertation contributes theoretically by repositioning housing provision as an institutionalized process of governance, and empirically by revealing how speculation, inefficiency, and fragmented regulation reproduce housing gaps. It offers practical insights for strengthening policy integration, land governance, and regulatory capacity toward more inclusive and efficient housing delivery.
Copyright (c) 2025 Dian Rahmawati (Author) https://creativecommons.org/licenses/by-nc-nd/4.0