Université Libre de Bruxelles

Acquiring and processing longitudinal beam profiles in the CERN injector complex is essential for maintaining high beam quality for both the Large Hadron Collider and fixed-target experiments. This paper describes a new and common framework across the injector chain to continuously monitor longitudinal profiles, based on digitizers connected to wall current monitors. A new software class has been developed using the Front-End Software Architecture framework to improve real-time monitoring of longitudinal beam quality along the whole beam production cycle. The new implementation supports efficient data acquisition with highly flexible configuration options, including per-profile and per-cycle settings management. This acquisition class reduces data transfer time from the hardware and enables simultaneous beam monitoring and optimization for multiple users across the CERN accelerator complex. Beyond the raw data acquisition layer, real-time processing analyses have been developed on the Unified Controls Acquisition and Processing platform to perform bunch length, bunch-by-bunch intensity, and bunch spacing measurements, and tomographic reconstruction of the longitudinal phase space to provide key longitudinal parameters such as momentum spread and emittance. This new monitoring framework paves the way for preparing and executing the filling of the LHC in an automated manner and for optimizing fixed-target cycles for physics users.

Social anxiety disorder (SAD) frequently co-occurs with major depressive disorder (MDD). We examined the prevalence and clinical correlates of SAD across three heterogeneous MDD cohorts. Secondary analyses were conducted in adult (CO-MED: n=482; GSRD: n=1398) and late-life (IRL-GREY: n=438) patients. SAD was assessed dimensionally (PDSQ) and categorically (MINI; SCID-1). Cohort-specific instruments were used to assess depressive severity (QIDS; MADRS), suicidality (CHRT; MADRS; SIS) and hypomanic symptoms (ASRM; YMRS). In late-life depression, neurocognitive tests were administered. Multivariate models were adjusted for depression and anxiety levels. SAD prevalence varied markedly by samples and diagnostic definitions (CO-MED: 46.7% with PDSQ≥6; 17.0% with PDSQ>12; GSRD: 3.0%; IRL-GREY: 8.7%). Across cohorts, SAD was associated with earlier MDD onset (CO-MED: p<0.001 d=-0.36; GSRD: p=0.014 d=-0.39; IRL-GREY: p=0.002 d=-0.54) and greater anxiety comorbidity (CO-MED: GAD: p<0.001 d=1.24; panic: p<0.001 d=1.29; GSRD: GAD: p<0.001; panic: p<0.001; IRL-GREY: agoraphobia: p<0.001). After controlling for depression and anxiety levels, SAD was linked to higher suicide risk in both adult cohorts (CO-MED: OR 1.04 (1.01-1.08); GSRD: OR 1.29 (1.04-1.64)) and to lower 6-week remission in CO-MED cohort (OR 0.51 (0.29-0.91)). In MDD, SAD has consistent associations with earlier illness onset and anxiety burden, modest associations with suicidality and antidepressant outcomes, and reduced impact in late life.

The authors declare no conflicts of interest.

Postictal deficits are a well-recognized phenomenon, yet their mechanisms and predictors remain poorly understood. Distinguishing postictal deficits from recurring nonconvulsive seizures (NCSz) or nonconvulsive status epilepticus (NCSE), their main differential diagnosis, can be challenging. This study aimed to identify clinical and electrographic features predictive of ongoing or recurrent ictal activity and to explore biomarkers associated with the duration and severity of postictal deficits. We conducted a retrospective case-control study of patients with prolonged (>1 h) postictal deficits at a tertiary medical center between 2017 and 2022. Based on electroencephalographic (EEG) findings, patients were classified as having uncomplicated Todd's palsy or recurring NCSz. Clinical, imaging, and electrographic characteristics were compared between groups, and factors associated with postictal duration were analyzed. Among 112 patients, 86 (77%) had uncomplicated Todd's palsy and 26 (23%) had recurring NCSz. Patients with NCSz were younger (63 vs. 76 years, p = .022) and had longer deficits (2.5 vs. 1.5 days, p = .024). Sporadic epileptiform discharges (73% vs. 22%, p < .001) and rhythmic or periodic discharges on the ictal-interictal continuum (50% vs. 16%, p = .001) were significantly more frequent in the NCSE group, even when limited to short EEGs or the first 30 min of continuous EEG (96% vs. 40%, p < .001). Consequently, 2HELPS2B scores were higher in NCSE patients (2 vs. 1, p = .0065). In the uncomplicated Todd's palsy group, a preceding focal to bilateral tonic-clonic seizure (1.5 vs. 1.0 days, p = .04) and any rhythmic or periodic discharges on EEG (3.0 vs. 1.5 days, p = .003) were associated with longer deficit duration. A notable minority of patients with prolonged postictal deficits have recurring NCSz. In the absence of reliable clinical or imaging predictors, patients with prolonged deficits may benefit from a 30-min EEG followed-when 2HELPS2B score > 1-by extended continuous EEG monitoring.

For many years, research focused on the immune system's role in the development of type 1 diabetes (T1D). However, mounting evidence suggests a critical involvement of intrinsic pancreatic β cell defects, particularly impaired cellular stress responses, in disease pathology. This shift in understanding is supported by the limited effectiveness of immune-targeting therapies, which have so far managed to delay, rather than prevent or cure, T1D. Here, we discuss why the immune system specifically targets β cells, how stress pathways modify the interaction between β cells and immune cells, β cell resilience, and challenges and opportunities in targeting β cell stress in T1D.

Postmortem magnetic resonance imaging (PMMRI) after fetal or perinatal death is now being adopted more widely in clinical settings as a non-invasive alternative or complementary approach to conventional autopsy. However, indications and imaging protocols vary significantly between centers and require standardization. Emerging advanced imaging techniques such as ultra-high-field MRI are very promising in smaller fetuses. In this article, we outline the current indications for PMMRI across different clinical scenarios and review consensus PMMRI protocols, together with a preview of future imaging possibilities enabled by 7-T MRI technology. We hope these recommendations will facilitate the standardization and implementation of perinatal PMMRI in clinical practice.

Introduction Public speaking (PS) is a widespread activity required in many personal and professional settings. This activity is known to elicit anxiety, subsequently affecting oral communication, especially voice and speech parameters. As mastering PS skills requires practice in situations that are as similar as possible to reality, virtual reality (VR) may represent a promising method for research, training and intervention in this domain. However, it is of paramount importance to first validate VR environments in their ability to reproduce authentic anxiety responses and communicative behaviors, which are often overlooked. Methods Therefore, this study examined university students (N = 60) anxiety responses (self-reported and heart rate) as well as voice and fluency adjustments to a PS task performed either in (1) a real meeting room in front of an audience, (2) a virtual meeting room in front of an audience, and (3) the same virtual meeting room without any audience. As this last condition contained no anxious stimulus, it was included to act as a control for the anxiety induced by VR immersion. The main objective of this study was to examine the influence of the real vs. virtual nature of the audience on anxiety, voice and fluency parameters. Results Our results showed that the virtual audience elicited changes in anticipatory anxiety (increased heart rate and self-reported anxiety) compared to the control condition. The participant’s strong feeling of presence and lack of side effects such as cybersickness support the acceptability and usability of the virtual environment. Discussion Our results extend previous data and support the feasibility and relevance of using VR for PS. Additionally, we describe different VR immersion profiles among participants.

The Ministry of Health of the Democratic Republic of Congo set out to revitalise health districts by strengthening the leadership and management capacities of the District Health Management Teams (DHMTs). This capacity strengthening, called technical support, was provided by staff from the reformed Provincial Health Administration (PHA) through supervision and coaching. We aimed to understand how, for whom, and under what conditions such technical support works (or not) in the Tshopo Province. Our study adopted a realist approach and a case study design. We collected data from document reviews, interviews, questionnaires, and routine data from the health information management system. Data analysis followed a two-step process: first, we identified key features of interventions, context, actors, mechanisms, and outcomes through thematic content analysis. Second, we formulated intervention–context–actor–mechanism–outcome (ICAMO) configurations using a retroductive approach. We found that challenging conditions, such as limited resources, hierarchical culture, poor leadership and narrow decision spaces, hinder the capacity building and motivation of PHA staff, resulting in mixed competencies. This adversely affected the quality of their technical support to DHMT members, failing to fully meet the criteria of being personalised and need-driven, problem-solving-centred, reflection-stimulating, comprehensive, and regular. This sub-optimal support undermined the perceived support’s relevance and the perceived credibility of PHA staff among DHMT members, hindering their active participation and learning and resulting in inconsistent management capacities. Consequently, DHMT members experienced low levels of motivation, self-efficacy and perceived autonomy to improve the performance of their health district. Our findings highlight the need for strong political will and leadership to address contextual challenges, a structured training programme to enhance the competencies of PHA staff, and participatory approaches to tailor technical support to the specific needs of DHMTs.