Academic Ceremonies February 2015

“Work-Family Reconciliation and Use of Parental Leave In Luxembourg; Empirical Analysis of Administrative Records”

“Biomarkers in heart failure: towards individualized therapy”This dissertation describes several biomarkers – measurable substances in the blood – that may contribute to the development of improved methods to treat heart failure. Several biomarkers can improve risk assessment for both acute and chronic heart failure. The ability to better assess the risks can help distinguish the ‘sicker’ patients from the ‘less sick’ patients. This, in turn, can help doctors determine which patients require the most intensive care. The dissertation also explores how the biomarker NT-proBNP can contribute to more individualised therapy for heart failure. The results of this study show that this strategy is not only effective in preventing hospitalisations and deaths, it is also a safe and cost-effective method that does not have additional side effects. There are new markers on the horizon that may improve this strategy further.

Key words:

heart failure, biomarkers, treatment

“Engaging with risks; citizens, science and policy in mobile phone mast siting controversies”

In the past, Dutch and Flemish citizens have protested the placement of mobile phone masts. The debate often centred on whether people can get sick from the radiation these masts emit. Following extensive research in six municipalities, Marijke Hermans suggests that focusing on health risks may mask other important concerns, such as lack of involvement and visual pollution. The focus on health may have placed the issue too firmly in the realm of science, with polarisation as a result. Science itself is becoming part of the public arena, but citizens are falling to the wayside. They are not fundamentally against the placement of phone masts, they simply want more input. They also want scientific uncertainties to be taken into account, instead of being swept under the carpet.

Key words:

mobile phone masts, science, policy, unknown risks 

“VNS in children; more than just seizure reduction”

This dissertation aims to gain more insight into the effects of vagus nerve stimulation (VNS) in children with hard-to-treat epilepsy. VNS appears to be both a tolerable and safe form of treatment.
Predictors of a favourable outcome with VNS therapy were missing at the time of this study, but research has revealed that lower baseline plasma levels of interleukin-6 is associated with a greater reduction in seizure frequency with VNS. This therefore appears to be a favourable prognostic factor. The effect of VNS on epileptic seizures could be partly explained by the way VNS influences the degradation of tryptophan, a neurotransmitter involved in mood regulation, among other things. An improvement in mood was especially seen after a prolonged period of therapeutic stimulation, independent of improved seizure control. Finally, VNS was not found to have a negative effect on behaviour or cognition.

Key words:

epilepsy, treatment, VNS

“Intracellular traffic jam: cholesterol accumulation as cause for chronic inflammatory diseases”

 A rise in obesity has brought with it a rise in the incidences of fatty liver disease. Some people go on to develop liver inflammation, or non-alcoholic hepatic steatosis (NASH), which can lead to severe liver failure or liver cancer and is currently untreatable. This dissertation explores the mechanisms that cause liver inflammation. It appears that an accumulation of cholesterol in the lysosomes (waste disposal system) of Kupffer cells is linked to a heightened inflammatory response. An effective method to treat this lysosomal cholesterol accumulation was recently discovered. This study could therefore contribute to the development of specific therapies to prevent fat accumulation in the macrophages and therefore prevent liver inflammation.  

Key words:

hepatitis, steatosis, macrophages

“Annexin A1 and annexin A5 in cardiovascular disease”

This study involves two members of the annexin family of proteins and their relationship to cardiovascular disease. The main findings are the inhibiting effect of annexin A5 on clearing away dead cells and, therefore, the enhancing effect on ‘arteriosclerosis’. Annexin A1 has an anti-inflammatory effect and was successful in the treatment of ‘arteriosclerosis’ as well as the reduction of damage following myocardial infarction. These findings may lead to the development of new drugs.

Key words:

cardiovascular disease, proteins, arteriosclerosis

“Application of omics to immunotoxicology: from Mechanisms of action to alternative testing strategies”

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Key words:

immunotoxicology, testing strategies

“Internal R&D, external R&D, and firm innovation evidence from the pharmaceutical industry”

“Effects of plant sterol and stanol esters on oxyphytosterol concentrations and postprandial metabolism”

Sterols and stanols are components of plants that are added to functional foods, such as enriched margarine, with the aim of lowering ‘bad’ LDL cholesterol. This dissertation investigates whether consuming enriched margarine also affects oxyphytosterol concentrations (oxidised plant sterols) during fasting and after a meal. Oxyphytosterol concentrations may play a role in the development of cardiovascular disease. This dissertation also examines the effects of two types of antioxidants on oxyphytosterol concentrations. Higher oxyphytosterol concentrations were found in diabetics than in non-diabetics and while the ingestion of plant sterols and antioxidants had no effect on these concentrations, the ingestion of plant stanols did generate a reduction of certain oxyphytosterol concentrations. After eating a meal enriched with plant sterols, higher oxyphytosterol concentrations were found in subjects after they consumed a second meal. It is not yet clear whether oxyphytosterol concentrations are derived from food or whether they are formed in the body.

Key words: 

nutrition, plant sterols, plant stanols, oxyphytosterol concentrations 

“Option Markets: Implied information, Equity process and Risk Management”

“Towards proactive care for potentially frail older people in general practice”

Ensuring that the elderly can live independently at home for as long as possible is central to Dutch healthcare policy. This is pursued by [G]OUD, Gezond Oud in Limburg (Healthy Ageing in Limburg). By making preventative home visits to people over the age of 75, general practitioners can identify vulnerability at an early stage and arrange for the right support in terms of healthcare and wellbeing. This dissertation describes the development, the practical feasibility, and the effectiveness of [G]OUD. Despite the enthusiastic response from GP practices and elderly people, this approach has yet to make a demonstrable impact on quality of life or on the self-reliance of elderly people. This can be attributed to, among other things, the high level of care in the Netherlands and the fact that most of the research participants were relatively healthy. As a result, the study did not assess the intended target group: vulnerable elderly people. More attention is needed in order to better align and coordinate elderly care.

Key words:

elderly care, vulnerability, early detection, primary care

“Cellular immunotherapy; from stem cell to lymphocyte”

To reduce the mortality rate in cancer patients who undergo stem cell transplantation, a study was conducted on the development of cellular immunotherapy using immature T-cells to strengthen the immune system after treatment. A clinically applicable system was developed for producing these cells from stem cells. It was found that vitamin C significantly improved production and brought about greater cell yield for therapeutic purposes. It was also found that patients with haematological malignancy (i.e. certain forms of cancer, including leukaemia) had lower vitamin C levels. Administering vitamin C may therefore promote immune recovery.

Key words:

immune system, stem cell transplantation, immunotherapy, vitamin C

“National Parliaments in the Aftermath of the Lisbon Treaty; Adaptation to the ‘New Opportunity Structure’”

This dissertation examines the influence of European integration on national parliaments. The Treaty of Lisbon granted national parliaments new responsibilities in terms of European affairs. This, in turn, changed the relationship between various parliamentary players, namely parliament members, parliamentary committees, and employees of parliamentary administrations. One of the views argued in this dissertation is that parliaments focus primarily on the distribution of tasks between member states and the EU. Much less attention is paid to the content of European legislation, which can have a negative impact on the decision-making process and the national debate surrounding issues of European importance.

Key words:

European integration, national parliament

“Considerations in designing an adult hearing screening programme”

“Urban Water Management Reform: the case of China”

Water scarcity is particularly acute in urban areas in developing countries, where a safe and secure water supply is threatened by rapid economic development and urbanization, population growth, and the deterioration of water environment. In this dissertation, it is argued that the appropriate policy interventions might allow developing countries to achieve economic development with less capita water consumptions, the privatization reform and the participation of multinational corporations in Chinese water sector contributed to the growth of productivity of the whole sector, and environmental campaign and public participation enhance citizens’ environmental awareness which in turn contribute to water conservation.

Key words:

China, water management

“Health technology assessment in osteoporosis: New perspectives from adherence and preference studies”

“Realities and illusions of human migration: a geographical perspective”

“Branch-and-cut algorithms for graph problems”

“Obtaining information from eyewitnesses: Effects of retrieval support in eyewitness interviews”

In many police cases eyewitness statements are the only available evidence. Hence, whether a crime can be solved may critically depend on the statement quality. Seeking to improve the reliability of eyewitness statements, the thesis examined the effectiveness of retrieval support during the interview when the witnessing conditions were suboptimal (e.g., experience of stress during the crime), as well as retrieval support through repeated interviews. Retrieval support refers to techniques that help witnesses get access to their recollections (e.g., asking the witness to picture the incident in his/her mind). The results showed that retrieval support improves recall performance only after some suboptimal conditions. Furthermore, recall performance can be enhanced when witnesses are interviewed several times. Unfortunately, police detectives in the Netherlands are not aware of the latter, as this research has shown. Therefore, interview trainings need to be revised to improve police detectives’ knowledge about human memory.

Key words:

interviewing; eyewitness memory; eyewitness testimony; retrieval support; police

“In vitro culture of human embryos; effects on fetal development and the role of the placenta”

IVF children are at a slight developmental disadvantage compared to children who were conceived naturally. The cause of low birth weight and premature birth remains unknown. The effects in human babies are less pronounced than in animals and, while IVF newborns may appear perfectly normal at birth, they could go on to develop problems later in life. This study shows that culturing human embryos for two to three days in two different culture mediums results in a significant difference in birth weight after nine months. A difference in fetal development was also noted. Changes were found in the placentas of women who had undergone IVF treatment that were not found in women who had conceived naturally. It is therefore important that manufacturers of IVF cultures publish the exact composition of their mediums. Additionally, the safety of IVF warrants further research.

Key words:

IVF, risks, culture medium, placenta

“The Maternal Brain in Pregnancy and Preeclampsia”

“Een arbeidersbuurt onder de rook van ‘De Sphinx’ Het Boschstraatkwartier-Oost te Maastricht. Een sociaal-ruimtelijke geschiedenis, 1829-1904”

In 1834, Petrus Regout laid the foundations for his glass and ceramics empire, which would later become NV De Sphinx. This study explores the socio-spatial effects of the rise of the ceramics industry on the Boschstraatkwartier-Oost, a district in the shadow of the Regout & Co. factories. Seventy-five years after these factories were founded, the socio-demographically diverse district had become an overcrowded slum where slumlords thrived at the expense of the Sphinx employees, popularly known as pottemennekes. Children grew up in appalling conditions and started working in the factories at an early age, even after the ban on child labour was introduced in 1874. In the fifties, sociologists began studying the ‘unsocial families’ living in this disadvantaged area. However, a life-cycle assessment of five generations of families living in the Boschstraatkwartier district revealed far greater variation and subtleties in this community than the sociologists originally assumed.

Key words:

Maastricht, history, De Sphinx

“COPD and comorbidity”

This thesis focuses on the prevalence and impact of simultaneously existing disorders or comorbid conditions in COPD patients. Common comorbid conditions in COPD patients were detected systematically. Electrocardiography showed a high prevalence of heart damage, which is associated with poorer outcome. Other comorbid conditions such as high blood sugar levels, obesity, high blood pressure, osteoporosis, anxiety and depression were found to be common as well. Comorbidity is present in almost all COPD patients and at least four simultaneously occurring comorbid conditions are present in over 50% of the patients. Patterns could be recognised and patients could be divided into five groups based on these comorbid conditions. In conclusion, it was shown that neither separate comorbid conditions nor comorbidity clusters prevent pulmonary rehabilitation from being effective in COPD patients. 

Key words:

COPD, comorbid conditions