Research Stijn Verhulst

Abstract

Antwerp has a long tradition of paediatric vaccine clinical trials. The new 'Antwerp Pediatric Clinical Trial Network Chair' aims to enhance current expertise on paediatric clinical trials. The chair also wants to initiate cooperation on paediatric clinical trials with a focus on vaccine research in order to conduct more efficient clinical trials in Antwerp. To achieve this, the Department of Paediatrics at the UZA combined its expertise in paediatric clinical and academic studies with the paediatric expertise at the Antwerp hospitals GZA and ZNA and the expertise on vaccinations at the Faculty of Medicine and Health Sciences, including the Department of Vaccines & the Institute of Infectious Diseases (VAXINFECTIO) at the University of Antwerp. The 'Antwerp Pediatric Clinical Trial Network Chair' aims to create a sustainable collaboration and establish an official network with the following objectives: Establish an inter-institutional collaboration around paediatric clinical trials with an emphasis on vaccine trials and paediatric infection trials; Attract paediatric clinical trials in these areas; Exchange patients and research personnel in the context of optimal conduct of clinical trials. Moreover, the partners also aim to organise joint meetings on future vaccine developments, to anticipate future studies and to jointly discuss and evaluate the process of paediatric vaccine trials.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

This research project will investigate the short- and long-term complications of prematurity and BPD. It will mainly focus on the further characterization of airway inflammation by analysis of VOCs in a translational model both as a predicative factor for the occurrence of BPD and also to gain more insight into the mechanisms that may lead to BPD. One of the goals is therefore to develop a non-invasive parameter on which to evaluate the effect of new treatments.

Researcher(s)

• Promoter: Verhulst Stijn
• Fellow: Ghys Inès

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

This is a quality improvement project in which a platform will be created between the Antwerp departments of pediatrics to jointly improve the care of children and adolescents with asthma. Projects will be performed on better communication with primary care, nursing education, protocols for acute and chronic asthma and transition.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

With this project, we will establish a Respiratory Virus Repository at the University of Antwerp. The collection of respiratory viruses will be available to companies, academic groups, and research institutions.

Researcher(s)

• Promoter: Delputte Peter
• Co-promoter: De Winter Benedicte
• Co-promoter: Van Hoorenbeeck Kim
• Co-promoter: Verhulst Stijn

Research team(s)

• Laboratory for Microbiology, Parasitology and Hygiene (LMPH)

Project type(s)

• Research Project

Abstract

Childhood obesity and obstructive sleep apnea (OSA) are prevalent diseases associated with cardiovascular disease but no combined management. Weight loss might tackle both and OSA could promote weight loss due to more energy expenditure during sleep. However, weight loss takes time which could expose patients longer to OSA morbidity. This SESEM project will focus on hypoxia in the adipose tissue using a unique platform to study OSA in childhood obesity. Effects of intermittent (recurrent breathing pauses in OSA) on the established chronic hypoxia in the adipose tissue are unknown. A translational model of obese mice exposed to intermittent hypoxia and a clinical study on adipose tissue biopsies of adolescents +/- OSA undergoing bariatric surgery will be used to study this effect. In a next step, I will investigate the protective effects of melatonin because of possible anti-inflammatory and cardioprotective effects. Using both the animal model and biopsy study during, I hope to identify protective mechanisms of melatonin in the adipose tissue and its optimal dose modulating the hypoxia-related effects. Finally, via a randomized clinical trial in a standardized weight loss program I will prove that this unique translational platform (mouse model – human adipose tissue biopsies – clinical study) can provide crucial insights in new adjuvant treatments on top of weight loss for the obese child +/- OSA.

Researcher(s)

• Promoter: Verhulst Stijn
• Fellow: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Gaucher disease is one of the most common lysosomal storage diseases. Due to the underlying β-glucocerebrosidase enzyme deficiency, there is an accumulation of glucosylceramide (Gb1) and lyso-glucosylsphingosine (lyso-Gb1), as the breakdown thereof is disrupted. Gb1 and lyso-Gb1 accumulate in the lysosomes of the macrophages, known as Gaucher cells, of various organs (liver, lungs, bones, spleen and sometimes central nervous system) where they can cause a variety of symptoms. The clinical presentation is therefore very diverse, but (hepato)splenomegaly (whether or not in combination with thrombocytopenia) is always present. When clinically suspected, the diagnosis can be made by detecting the enzyme activity. In case of abnormal results, genetic analysis follows for the detection of mutations in the GBA1 gene, which is associated with Gaucher disease. A large proportion of patients develop manifestations of the disease in childhood, but are unfortunately diagnosed too late. With this study we aim to accelerate the diagnostic process by developing an efficient, sensitive and specific screening method based on detection of the biomarker lyso-Gb1 on dried blood (Newborn blood spot cards). Lyso-Gb1 has been shown in previous studies as a sensitive and specific biomarker for Gaucher disease. Liquid Chomatography-Mass Spectrometry (LC-MSMS) will be used for the analysis of the dried blood spots. There is currently 1 other study, the study by I. Motta et al. 2016, which performed a (successful) screening using dried blood. When developing an enzymatic assay on dried blood using the LC-MSMS, we also want to simultaneously look at Niemann-Pick disease type B/ASMD (given the similar clinical presentation). The main goal of this study is the early detection of patients with Gaucher disease so that treatment can also be started on time and any organ damage is prevented/limited. For this purpose, patients between 2 and 18 years old with splenomegaly, and with or without thrombocytopenia, without other known underlying disorders from the pediatric haematological-oncological population (hematology departments of the university hospitals in Belgium / participating hospitals in close collaboration with the 'Belgian Society of Hematology & Oncology") will be recruited. If the patients meet the inclusion/exclusion conditions, they can be included in the screening program if they agree and sign the informed consent. Blood samples (for complete blood count, blood cell morphology, platelet count, enzyme assay of glucocerebrosidase and measurement of lyso-Gb1) and spleen dimensions (measured by MRI or CT) will be collected from all enrolled patients for further data analysis.

Researcher(s)

• Promoter: Verhulst Stijn
• Fellow: Van Baelen Amber

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Particulate matter (PM) and black carbon (BC) exposure pose a major environmental risk factor to our health, since it is estimated to have caused 4.2 million premature deaths in 2016. Although a significant amount of research has been invested in determining health effects related to air pollution on adults, still relatively few research exists on the most vulnerable part of the population, namely children. More specifically, research is missing on acute responses on respiratory functioning (RF) and on neurobehavioral abilities (NBA) of children due to PM and BC pollution. Children's exposure to atmospheric pollution is of special concern because their immune system, lungs and neuropsychological abilities are not fully developed yet when exposure begins, raising the possibility of more severe health outcomes than observed in adults. This project aims at determining the acute impacts of (dynamic) air pollution exposure on healthy children's RF and NBA. To do so, this project will conduct a monitoring campaign at the school and home environment of children of age 9-11, to evaluate PM and BC exposure and its short-term effect on RF and NBA. In extend, the project will combine high-resolution air quality monitoring of PM and BC using mobile sensors, with early RF and NBA responses, in order to monitor students on their way to and from school. With changes in behavior and a shift in transport modes, we then aim to observe possible changes in effects on RF and NBA.

Researcher(s)

• Promoter: Samson Roeland
• Co-promoter: Lamote Kevin
• Co-promoter: Verhulst Stijn
• Fellow: Hendrickx Hanne

Research team(s)

• Environmental Ecology & Applied Microbiology (ENdEMIC)

Project type(s)

• Research Project

Abstract

Lung auscultation, which is the process of listening to breath sounds, is one of the most commonly used examinations to evaluate respiratory health. Over the last decades computational methods have been developed for the analysis of recorded lung sounds. Computer Aided Lung Sound Analysis (CALSA) aims to overcome limitations associated with standard lung auscultation by removing the subjective component of the process and allowing quantification of lung sound characteristics. To date, no accepted standard for data acquisition and analysis has been set and none of the proposed approaches have been successfully implemented in clinical practice. During this project we will develop a simple but robust visual representation for CALSA, which can be easily interpreted by health care professionals. Several clinical studies described in this project aim to validate this analysis and to study the ability of CALSA to measure the severity of RSV-bronchiolitis and the effects of respiratory therapy. Digital auscultation has the potential to be a sensitive, objective and non-invasive tool by providing regional information associated with local changes in the airways.

Researcher(s)

• Promoter: Verhulst Stijn
• Co-promoter: Delputte Peter
• Co-promoter: Steckel Jan
• Fellow: Stas Toon

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Lung auscultation, which is the process of listening to breath sounds, is one of the most commonly used examinations to evaluate respiratory health. Over the last decades computational methods have been developed for the analysis of recorded lung sounds. Computer Aided Lung Sound Analysis (CALSA) aims to overcomel imitations associated with standard lung auscultation by removing the subjective component of the process and allowing quantification of lung sound characteristics. To date, no accepted standard for data acquisition and analysis has been set and none of the proposed approaches have been successfully implemented in clinical practice. During this project we will cooperate with the Faculty of Applied Engineering to develop a simple but robust visual representation for CALSA, which can be easily interpreted by health care professionals. Several clinical studies described in this project aim to validate this analysis and to study the ability of CALSA to measure effects of respiratory therapy. The latter could be of great interest to evaluate different airway clearance techniques. More particularly, there is a lack of adequate outcome measures appropriate for assessing airway clearance, which has been a barrier for the development of evidence based guidelines. Digital auscultation has the potential to be a sensitive, objective and non-invasive tool by providing regional information associated with local changes in the airways.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

In hospitals where there is a significant workload, performing auscultations can be a timeconsuming process, which also exposes the medical personnel to potentially contagious diseases. Current systems that allow remote auscultations are often not fit for use with large amounts of patients, long-term use, or are limited in terms of functionality. The major drawback in current remote auscultation systems is the relatively bulky acoustic coupler which makes part of the stethoscope assembly. This physical dimension reduces the applicability for long-term monitoring, because of the discomfort for the patient and the inherent risk of decubitus wounds. In this project, we will investigate the construction of thinner stethoscopes, increasing patient comfort

Researcher(s)

• Promoter: Steckel Jan
• Co-promoter: Daems Walter
• Co-promoter: Jorens Philippe
• Co-promoter: Verhulst Stijn

Research team(s)

• Co-Design of Cyber-Physical Systems (Cosys-Lab)

Project type(s)

• Research Project

Abstract

Obesity is a prevalent problem, present in 7% of Belgian children between 2 and 17 years old. Studies have shown that if obese children reach a normal BMI by adulthood, there is no increased cardiovascular risk compared to adults with a normal BMI without a history of obesity. Therefore, weight management during childhood is the most effective form of prevention for subsequent cardiovascular problems. However, due to the frequent weight gain after weight loss and the conflicting hypotheses about its effect on cardiovascular co-morbidities, it is necessary to investigate the influence of these variations in weight.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Particulate matter (PM) and black carbon (BC) exposure is a major environmental risk factor to our health since it is estimated to have caused 4.2 million premature deaths in 2016. Although a significant amount of research has been invested in determining health effects related to air pollution on adults, still relatively few research exists on the most vulnerable part of the population, namely children. More specifically, research is missing on acute responses on respiratory functioning (RF) and on neurobehavioral abilities (NBA) of children due to PM and BC pollution. Children's exposure to atmospheric pollution is of special concern because their immune system, lungs and neuropsychological abilities are not fully developed yet when exposure begins, raising the possibility of more severe health outcomes than observed in adults. This project aims at determining the acute impacts of (dynamic) air pollution exposure on children's RF and NBA. To do so, this project will conduct a monitoring campaign at the school and home environment of children of age 9-11, to evaluate the exposure to PM and BC and its short-term effect on RF and NBA. In extent, the project will combine high-resolution air quality monitoring of PM and BC using mobile sensors, with early RFand NBA responses, in order to monitor students on their way to and from school. With changes in behavior and a shift in transport modes, we then aim to observe possible changes in effects on RF and NBA.

Researcher(s)

• Promoter: Samson Roeland
• Co-promoter: Lamote Kevin
• Co-promoter: Verhulst Stijn
• Fellow: Hendrickx Hanne

Research team(s)

• Environmental Ecology & Applied Microbiology (ENdEMIC)

Project type(s)

• Research Project

Abstract

Overweight and obesity in children and adolescents are prevalent, have several long lasting medical and psychosocial comorbidities and post a serious burden on society. Tackling weight problems at an early age in a sustainable way is therefore of utmost importance. Earlier studies of the UGhent and the UZA research groups, showed that in the short term a multidisciplinary obesity treatment (MOT) focusing on behavioral lifestyle approach, has a positive impact on weight and comorbidities. However, existing therapies have only limited success, specifically at long-term. One explanation for these modest results relates to poor executive functions (EFs, e.g., attention, inhibition) in overweight and obesity. EFs are needed for self-control and resisting temptation. The UGhent group investigates since 2011, as the first group worldwide, the potential of EF-training strengthening selfcontrol capacities in obese youth and proved that a computerized EF-training on top of an evidence-based MOT enhances EFs of obese youth, and increases their capability to maintain weight loss until 8 weeks after treatment. This proof-ofconcept for the present project is strengthened by recent international studies showing that training individuals to control responses to high-calorie foods via computerized tasks results in weight loss. We aim to show now that adding computerized EF-training to evidence-based MOT further improves weight maintenance until 6-month after MOT and ameliorates medical and psychosocial comorbidities. We will test this in a multicenter longitudinal, prospective randomized RCT. During the regular MOT, 200 obese youngsters (8-18 years) will be randomized on a 1/1 base to either a 6 week EF-training or an active control condition, followed by 8 weekly (training or control) booster sessions. The effects of the EF-training will be measured immediately after the MOT, at 2 month and 6 month. We expect significant effect of EF-training on 1) weight loss maintenance up to 6-months after MOT, 2) EF and 3) comorbidities and related to health benefits. The project partner's extensive professional network and close collaboration with the different partners from the advisory board (BASO, VVK and Eetexpert.be vzw) allows for the broad dissemination of the project results to different target groups. The EF-training (and manual) will be presented to different MOT centers. A train-the-trainer program will be developed. Press releases, communications to the general public and appropriate stakeholders (e.g., health authorities, medical societies and youth health organizations) and scientific presentations and publications will report on the project's activities and results.

Researcher(s)

• Promoter: Verhulst Stijn
• Fellow: Vermeiren Eline

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

This application relates to the purchase of new basic infrastructure, more specific a FlexiVent system from Emka Technologies. FlexiVent is a platform for standard respiratory research that can be used across many pulmonary applications and which has major advantages compared to the classical, non-invasive, unrestrained plethysmography because it is accurate, reproducible and proven. FlexiVent is much more capable of detecting pulmonary abnormalities via changes in functional residual capacity, total lung capacity, vital capacity, and compliance of the respiratory system. Furthermore, analysis of pulmonary functions via FlexiVent allows distinction between respiratory diseases in mice by clinically relevant variables and is therefore generally accepted as the standard in the functional evaluation of infectious and non-infectious pathological, respiratory disease models.

Researcher(s)

• Promoter: Cos Paul
• Co-promoter: Delputte Peter
• Co-promoter: Verhulst Stijn

Research team(s)

• Laboratory for Microbiology, Parasitology and Hygiene (LMPH)

Project type(s)

• Research Project

Abstract

Respiratory Syncytial Virus (RSV) is worldwide the leading cause of serious airway infections. It's so common that most children will be infected by age 2. In adults and older children, RSV symptoms are mostly mild and typically mimic a common cold, but younger children can develop very severe disease. Preventive and therapeutic options are limited and currently it is not clear why some children develop severe disease while others do not. We therefore aim to investigate host- and virus-related factors that influence disease severity. To reach this objective, we will isolate RSV from children with respiratory disease, characterize the isolates and objectify differences between them. Next, we will investigate the effect of different virus isolates on the immunological response induced by a human respiratory epithelial cell line, since epithelial cells are the primary target cells and are implicated in the pathogenic reaction upon RSV infection. Lastly we want to evaluate whether the same clinical isolate induces a different immunological response in respiratory epithelial cells isolated from different patients. We will thus not only gain fundamental insights in the causes of RSV induced disease, but we will finally also correlate the virus- and host-related risk factors identified in the lab with clinical symptoms observed in patients. With this project we aim to identify patients prone to severe disease in an early stage, thus improving therapeutic options and disease outcome.

Researcher(s)

• Promoter: Verhulst Stijn
• Co-promoter: Delputte Peter
• Co-promoter: Smet Annemieke
• Fellow: Stobbelaar Kim

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

- Premature neonates are extremely vulnerable to external insults. - Bisphenol A and phthalates (DEHP) are plasticizers, used in soft plastics to increase their elasticity and extend their lifetime. - Leaching of plasticizers from indwelling medical devices used in the neonatal intensive care unit (NICU) might expose neonates to these chemicals at levels far exceeding tolerable daily dose recommendations. - Although awareness of these plasticizers is growing, they are still used in many medical devices in NICU. They are prohibited in the production of toys intended for children under 3 years of age, but legislation about their use in medical devices isn't strict or clear. - The studied plasticizers have toxic effects on neuronal and pulmonary cells, as proven in in vitro and in vivo (animal and human) models. - This project aims to explore the utility of plasticizer levels in an emerging non-invasive matrix (hair) as a diagnostic tool for cumulative and past exposure in the neonatal intensive care unit. - The possibility that this matrix can detect past exposure in this vulnerable population is a novel approach and is expected to provide fresh insights into the detection of past exposure to chemicals. - Based on these pathophysiological effects, we hypothesize that exposure to these plasticizers during the NICU stay contributes to the long-lasting impaired (neurocognitive and lung) development that is frequently observed in neonates after discharge from NICU.

Researcher(s)

• Promoter: Jorens Philippe
• Co-promoter: Covaci Adrian
• Co-promoter: Mulder Antonius
• Co-promoter: Verhulst Stijn
• Fellow: Panneel Lucas

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Lung auscultation, which is the process of listening to breath sounds, is one of the most commonly used examinations to evaluate respiratory health. Over the last decades computational methods have been developed for the analysis of recorded lung sounds. Computer Aided Lung Sound Analysis (CALSA) aims to overcomel imitations associated with standard lung auscultation by removing the subjective component of the process and allowing quantification of lung sound characteristics. To date, no accepted standard for data acquisition and analysis has been set and none of the proposed approaches have been successfully implemented in clinical practice. During this project we will cooperate with the Faculty of Applied Engineering to develop a simple but robust visual representation for CALSA, which can be easily interpreted by health care professionals. Several clinical studies described in this project aim to validate this analysis and to study the ability of CALSA to measure effects of respiratory therapy. The latter could be of great interest to evaluate different airway clearance techniques. More particularly, there is a lack of adequate outcome measures appropriate for assessing airway clearance, which has been a barrier for the development of evidence based guidelines. Digital auscultation has the potential to be a sensitive, objective and non-invasive tool by providing regional information associated with local changes in the airways.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Respiratory Syncytial Virus (RSV) is worldwide the leading cause of serious infections of the lower airways, and nearly all children are infected with RSV by the age of two. RSV is responsible for different clinical presentations, ranging from mild to very severe disease. Limited preventive and therapeutic options are available, and furthermore, it is not clear why some infected individuals develop severe disease while others do not. We therefore aim to investigate host- and virus-related factors that may influence disease severity. To reach this objective, we will divide our research project in four different goals. Firstly, we will isolate RSV from patients and investigate which of two commonly used virus collection methods is best to obtain viable RSV isolates. Secondly, we will investigate the effect of different virus isolates on human respiratory epithelial cells, since these are not only the primary target cells, but also implicated in the pathogenic immune response upon RSV infection. Thirdly, we want to evaluate whether respiratory epithelial cells from different patients, react differently upon infection with the same virus, which may explain differences in disease severity observed in patients. We will thus not only gain fundamental insights in the causes of RSV induced diseases, but we will finally also correlate risk factors identified in the laboratory with clinical symptoms in patients, supporting the translational character of this research project.

Researcher(s)

• Promoter: Verhulst Stijn
• Co-promoter: Delputte Peter
• Fellow: Stobbelaar Kim

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Obstructive sleep apnea (OSA) is characterized by intermittent collapse of the upper airway during sleep resulting in an abnormal sleep pattern and drops in oxygen concentration. It affects up to 50% of children with specific risk factors including obesity and Down syndrome. It results in neurocognitive impairment but can also augment for instance the obesity-related cardiovascular morbidity. Therefore, a correct treatment is mandatory. Adenotonsillectomy, the classical first line treatment, has a success percentage of only 50% or less. This implies that 50% of these children with OSA are at risk of being exposed to unnecessary surgery. The aim of this research project is to identify markers that could predict the outcome of this surgery in children with OSA. In a first study, we will identify markers that correlate with the severity of OSA in these children. More classical markers include for instance body mass index, neck circumference, tonsil size, etc. We will also use a more innovative approach with parameters obtained from CT-scanning and functional imaging methods to describe more detailed physical characteristics of the airway. Second, we will identify markers that predict the success of treatment. Finally, we will introduce an individualized approach by selecting a treatment a priori based on the airway characteristics of a specific patient. We will also use virtual surgery to determine if a specific child will benefit from surgery

Researcher(s)

• Promoter: De Winter Benedicte
• Fellow: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

This research project will investigate the long-term respiratory complications of premature birth and BPD. It will focus on classical techniques including lung function but will mainly investigate the long-term morbidity using new techniques such as functional respiratory imaging. The correlation between long-term pulmonary morbidity and airway inflammation at birth will also be assessed. This project is supported by the Josephine Neiman Foundation.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Overweight and obesity in children and adolescents are prevalent, have several long lasting medical and psychosocial comorbidities and post a serious burden on society. Tackling weight problems at an early age in a sustainable way is therefore of utmost importance. Earlier studies of the UGhent and the UZA research groups, showed that in the short term a multidisciplinary obesity treatment (MOT) focusing on behavioral lifestyle approach, has a positive impact on weight and comorbidities. However, existing therapies have only limited success, specifically at long-term. One explanation for these modest results relates to poor executive functions (EFs, e.g., attention, inhibition) in overweight and obesity. EFs are needed for self-control and resisting temptation. The UGhent group investigates since 2011, as the first group worldwide, the potential of EF-training strengthening self-control capacities in obese youth and proved that a computerized EF-training on top of an evidence-based MOT enhances EFs of obese youth, and increases their capability to maintain weight loss until 8 weeks after treatment. This proof-of-concept for the present project is strengthened by recent international studies showing that training individuals to control responses to high-calorie foods via computerized tasks results in weight loss. We aim to show now that adding computerized EF-training to evidence-based MOT further improves weight maintenance until 6-month after MOT and ameliorates medical and psychosocial comorbidities. We will test this in a multicenter longitudinal, prospective randomized RCT. During the regular MOT, 200 obese youngsters (8-18 years) will be randomized on a 1/1 base to either a 6 week EF-training or an active control condition, followed by 8 weekly (training or control) booster sessions. The effects of the EF-training will be measured immediately after the MOT, at 2 month and 6 month. We expect significant effect of EF-training on 1) weight loss maintenance up to 6-months after MOT, 2) EF and 3) comorbidities and related to health benefits. The project partner's extensive professional network and close collaboration with the different partners from the advisory board (BASO, VVK and Eetexpert.be vzw) allows for the broad dissemination of the project results to different target groups. The EF-training (and manual) will be presented to different MOT centers. A train-the-trainer program will be developed. Press releases, communications to the general public and appropriate stakeholders (e.g., health authorities, medical societies and youth health organizations) and scientific presentations and publications will report on the project's activities and results.

Researcher(s)

• Promoter: De Winter Benedicte
• Co-promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Overweight and obesity in children and adolescents are prevalent, have several long lasting medical and psychosocial comorbidities and post a serious burden on society. Tackling weight problems at an early age in a sustainable way is therefore of utmost importance. Earlier studies of the UGhent and the UZA research groups, showed that in the short term a multidisciplinary obesity treatment (MOT) focusing on behavioral lifestyle approach, has a positive impact on weight and comorbidities. However, existing therapies have only limited success, specifically at long-term. One explanation for these modest results relates to poor executive functions (EFs, e.g., attention, inhibition) in overweight and obesity. EFs are needed for self-control and resisting temptation. The UGhent group investigates since 2011, as the first group worldwide, the potential of EF-training strengthening selfcontrol capacities in obese youth and proved that a computerized EF-training on top of an evidence-based MOT enhances EFs of obese youth, and increases their capability to maintain weight loss until 8 weeks after treatment. This proof-ofconcept for the present project is strengthened by recent international studies showing that training individuals to control responses to high-calorie foods via computerized tasks results in weight loss. We aim to show now that adding computerized EF-training to evidence-based MOT further improves weight maintenance until 6-month after MOT and ameliorates medical and psychosocial comorbidities. We will test this in a multicenter longitudinal, prospective randomized RCT. During the regular MOT, 200 obese youngsters (8-18 years) will be randomized on a 1/1 base to either a 6 week EF-training or an active control condition, followed by 8 weekly (training or control) booster sessions. The effects of the EF-training will be measured immediately after the MOT, at 2 month and 6 month. We expect significant effect of EF-training on 1) weight loss maintenance up to 6-months after MOT, 2) EF and 3) comorbidities and related to health benefits. The project partner's extensive professional network and close collaboration with the different partners from the advisory board (BASO, VVK and Eetexpert.be vzw) allows for the broad dissemination of the project results to different target groups. The EF-training (and manual) will be presented to different MOT centers. A train-the-trainer program will be developed. Press releases, communications to the general public and appropriate stakeholders (e.g., health authorities, medical societies and youth health organizations) and scientific presentations and publications will report on the project's activities and results.

Researcher(s)

• Promoter: Verhulst Stijn
• Fellow: Van Eyck Annelies

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Many respiratory diseases require a physiotherapeutic treatment whit a focus on clearance of excessive mucus from the airways. Although patients report a subjective benefit, there is little objective evidence regarding the effect of airway clearance techniques. This contradiction exists due to a lack of good outcome measures that are specifically related to the interventions employed. Electronic auscultation coupled with computerized lung sound analysis (CALSA) has the potential to improve the clinical evaluation of pulmonary disorders in both clinical and research settings. In other words, CALSA could be a valid instrument for the evaluation of physiotherapeutic treatments. In this project, we want to validate CALSA and recorded lung sounds in patients with cystic fibrosis and neuromuscular diseases by comparing it with CT-based functional respiratory imaging. In the second part, we want to evaluate the effect of airway clearance techniques by using changes in CALSA and comparing it with classic outcome measures.

Researcher(s)

• Promoter: Ides Kris
• Co-promoter: Verhulst Stijn
• Co-promoter: Vissers Dirk

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

This project concerns patients with hemophilia. - The patients will have 4x/year a contact with the hemophilia treatment centre by means of a consultation (with doctor and/or dedicated nurse and/or psychologist). - Use of interdisciplinary (12x/year) & multidisciplinary (4x/year) meetings at several specific time points for discussing the transition within a systematic follow-up protocol (together with the consultations/ultrasound imaging/PK studies). - Systematic assessment of hemophilic arthropathy through the validated ultrasound scales (HEAD US scoring system). The six joints (2x elbow, 2x knee, 2x ankle) will be examined (1 a 2x/year) in a systematic way according to the developed ultrasound-protocol specific for the assessment of arthropathic changes in hemophiliac joints (HEAD US scoring system). - Systematic assessment of PK-studies through the WAPPS-HEMO web service (1 a 2x/year)

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

Obstructive sleep apnea (OSA) is characterized by intermittent collapse of the upper airway during sleep resulting in an abnormal sleep pattern and drops in oxygen concentration. It affects up to 50% of obese children and can be considered as one of obesity's most important complications. It results in neurocognitive impairment but can also augment the obesity-related cardiovascular morbidity. Therefore, a correct treatment is mandatory. Adenotonsillectomy, the classical first line treatment, has a success percentage of only 50%. This implies that 50% of obese children with OSA are at risk of being exposed to unnecessary surgery. The aim of this research project is to identify markers that could predict the outcome of this surgery in obese children with OSA. In a first study, we will identify markers that correlate with the severity of OSA in these children. More classical markers include for instance body mass index, neck circumference, tonsil size, etc. We will also use a more innovative approach with parameters obtained from ultra low dose CT-scanning and functional imaging methods (computational fluid dynamics) to describe more detailed physical characteristics of the airway (volume, cross sectional area, resistance). Second, we will identify markers that predict the success of treatment. Finally, we will apply virtual surgery on these images to determine if a specific child will benefit from surgery.

Researcher(s)

• Promoter: Verhulst Stijn
• Co-promoter: De Backer Wilfried
• Fellow: Lauwers Eline
• Fellow: Slaats Maria

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand UZA. UA provides UZA research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project

Abstract

The aim of this research project is to identify markers that could predict the outcome of this surgery in obese children with OSA. In a first study, we will identify markers that correlate with the severity of OSA in these children. More classical markers include for instance body mass index, neck circumference, tonsil size, etc. We will also use a more innovative approach with parameters obtained from CT-scanning and functional imaging methods to describe more detailed physical characteristics of the airway. Second, we will identify markers that predict the success of treatment. Finally, we will introduce an individualized approach by selecting a treatment a priori based on the airway characteristics of a specific patient. We will also use virtual surgery to determine if a specific child will benefit from surgery.

Researcher(s)

• Promoter: De Winter Benedicte
• Fellow: Verhulst Stijn

Research team(s)

• Laboratory Experimental Medicine and Pediatrics (LEMP)

Project type(s)

• Research Project