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Cursus: BMW33517
Early Life Events: Diagnostics and Treatment
Cursus informatie
Studiepunten (EC)7,5
Early Life Events: Diagnostics and Treatment

Credit load:                       7.5 ECTS                                                      Course code:     BMW33517
Coordinator:                      Prof. dr. F.E. Hoebeek                                  Period:               3
Examiner:                          Prof. dr. F.E. Hoebeek                                  Time slot:           AD
E-mail address:                               Level:                3
Phone:                               +31 88 7554359

Dr. Gaby Steba (Fertility & Gynaecology), Dr. Marijke Achterberg (Veterinarian Medicine, Dr. Carlijn van den Boomen (Psychology, Social Sciences), Dr. Jeroen Dudink (Neonatology), Dr. Titia Lely (Obstetrics, Gynaecology), Dr. Casper Schoemaker (Patient participation expert), Dr. Cora Nijboer (DDOD), Dr. Caroline de Theije (DDOD), Dr. Olaf Verschuren (Rehabilitation center de Hoogstraat), Dr. Daniël Vijlbrief (Neonatology), Dr. Geeske van Woerden (Neuroscience, Erasmus MC), Dr. Roos de Jonge (Patient participation expert)

Technical support
Karima Amarouchi, Tessa Roelofs, Mirjam Maas, Sebastiaan Corstjens

This course adheres to the general theme ‘the first 1001 days’ of Utrecht University and focusses on the causes, consequences and cures of adverse early life events as seen from the division ‘Woman & Baby’ of the University Medical Center Utrecht. During the course ‘Early Life Events: Diagnostics and Treatment’ students will be trained by lecturers from the departments for Developmental Origins of Disease, Fertility, Gynaecology, Obstetrics, Neonatology, Veterinary Medicine, Psychology, rehabilitation center de Hoogstraat and the Neuroscience department from the Erasmus MC. Students will be provided with a broad overview of the research approaches available to multidisciplinary research teams. The lecturers have a diverse background (medicine, biomedical sciences, psychology, neuroscience, biology and bioelectronics), which ensures that the students will gain insights from all relevant points of view.    

The main topics of this course are the causes, consequences and (experimental) treatment options for children born pre-term or for term-born children with pathology, which are known as ‘adverse early life events’. This course particularly emphasizes the multidisciplinary character of diagnostics and pre-clinical research. In a series of (online) lectures, activating workshops and practicals the students will be provided with insights in the biomedical and clinical topics relevant to improve fertility, intra-uterine growth and neonatal care. The students will work in small groups as a research team and gain knowledge on how translational experiments work.

The course is divided in a theoretical part (first 4 weeks) and a practical part (6 remaining weeks). The first 4 weeks contain 1 week about causes of adverse early life events (focused on fertility, fetal growth restriction and genetics), 1 week about the immediate causes of adverse early life events (focused on neonatal intensive care unit), 1 week about the long-term outcome of adverse early life events (focused on screening for neurodevelopmental disorders, rehabilitation and biomedical research to investigate consequences), and finally 1 week to prepare for a written exam.
The following 6 weeks contain a practical focused on the potential cures for adverse early life events that affect brain functioning. Students will be guided through an in vitro culture experiment in which they can tune proliferation and differentiation conditions for neural stem cell cultures. This technique lies at the basis of what is currently considered one of the most important experimental therapies for early life brain damage – the first-in-human trial is just completed and reported by the UMC Utrecht in Lancet Neurology. In this practical the students will be trained in writing a research report. Additionally, the students will receive instructions how to communicate the biological findings to parents and patients in layman terms.

During this practical, students will operate in small teams of maximum 6 and set up a neural stem cell culture, induce the differentiation of these cells and evaluate specificity of the cells using immunofluorescent stainings and microscopy. The presence of the students in the laboratory is under tight control of the COVID-19 regulations. During the practical the students will work with LabBuddy software and conclude their findings in individual written report and a group presentation that focusses both on a scientist audience as well as on a patient audience.

Upon completion of the course, the students will be able to answer questions alike:
  • what are the most common causes of (extreme) prematurity?
  • What translational models are relevant for improving fertility, gynaecology, obstetrics and neonatology?
  • What diagnostic tools are used to monitor children at the neonatal intensive care unit?
  • What is, and should be, the role of patients and parents in the design of biomedical research?
  • What biological processes provide options to improve the rehabilitation process?

If the COVID-regulations and availability of personnel allow, students will be given the opportunity for guided tours at the neonatal intensive care unit of the Wilhelmina Children’s Hospital and the rehabilitation center ‘De Hoogstraat’.

Number of participants
Maximum of 24 students applies for this course.

Required background knowledge
Previous knowledge of anatomy, physiology and cell biology as provided by the Biomedical Sciences courses ‘Developmental Biology’ (period 1 BC or period 4 AD) and/or ‘Neuroscience’ (period 3 BC) is not mandatory, but may be experienced as helpful. In case either of these courses have not been followed, students are expected to invest extra time in catching up the knowledge.

Learning outcomes
Knowledge and insight:
After completion of this course, the student is able to:
  • explain the ‘Developmental Origins of Health and Disease’ theory;
  • reproduce the biological processes underlying fetal growth retardation and the consequences for later life;
  • explain how genetic predisposition can lead to mental retardation;
  • analyze social play in rodents and understand what the consequences are of social deprivation for later life;
  • review the process necessary to properly run big data research;
  • provide an overview of experimental treatment options for infants born with brain damage;
  • provide an overview of the working mechanisms of Mesenchymal Stem Cell therapy for neonatal brain injury;
  • explain the biological principles underlying neuronal stem cell differentiation;
  • explain how patient participation is optimally utilized to guide future biomedical research on early life events.

The student is able to:
  • culture, stain and image neuronal stem cells and name which type of cells the neural stem cells have been differentiated into;
  • analyze immunohistochemical stainings using ImageJ software;
  • systematically report about the resulting data individually as well as in a group;
  • provide in depth feedback to fellow students on their research report;
  • communicate fundamental research to patient populations.

Teaching forms and contact time
Prior to the lectures the students are expected to gain background knowledge from reading scientific literature and text book chapters. The students are expected to actively participate in seminars. To support a successful neural stem cell experiment, the students will be provided with a limited introductory session to working with biomaterial in sterile flow cabinets via Virtual Reality training (if available) and fluorescent microscopy via the online LabStar tool.
This course will be in Dutch, unless an exchange student is enrolled. The lecture slides and course reader are mostly in English. Examination will be in Dutch, but not for the exchange students.           

The students will be assessed based on their individual performance (written exam and written report on stem cell culture experiment) and on their participation and performance when working in a group (oral presentation). The final grade is weighted from the written exam (40%) in which knowledge and insight are tested. In the written exam, each of the classes will be evaluated with an uneven distribution of points credited for the various questions. The practical course will be evaluated by the group presentation (20%) and the written report (40%). For the written report also the feedback (how it is formulated and how it is dealt with) will be included in the score. The reports in LabBuddy will be checked for completion of all questions and quality of the daily reports (no marks, only pass/no pass).

Required material:
A reader will be provided containing the course material.
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