Academic Ceremonies June 2014

“Identifying and modifying behavioral determinants in response to the HIV epidemic in Indonesia”

“Exercise strategies to optimize glycemic control in type 2 diabetes”

“The use of pulsed radiofrequency in the management of chronic lumbosacral radicular pain”

A herniated lumbar disc may cause pain to radiate into the leg. Although it is a common chronic disorder, therapeutic options are scarce. Applying pulses of high-frequency (radiofrequency) current may be considered if conservative management gives no satisfactory results. In order to increase the chance of this therapeutic option being successful we present an overview of current knowledge on the mechanism of radiating pain and the effect of pulsed radiofrequency treatment on this mechanism. The clinical studies showed that this treatment method was successful in a considerable proportion of patients. In addition, several predictive factors for successful treatment of radiating pain were found.

Key words:

Lower back pain, radiating pain, pulsed radiofrequency treatment

“Something to chew on”

“The impact of dietary habits on cardiovascular risk factors and other metabolic parameters of free-living populations: methodological approaches to dietary analyses”

This thesis examined the impact of dietary habits on cardiovascular health of human populations, using different methodological approaches to get more integrated conclusions. The analysis of data from 2 large epidemiological studies conducted in Italy and European region (Moli-sani and IMMIDIET studies) revealed that the higher antioxidant content of human diet might have a role in controlling blood pressure and inflammation progression and in establishing a better omega-3 fatty acids profile and quality of life in these populations. Dietary patterns adherence including natural food sources of folate could assure adequate folate profile especially in women at childbearing age.

Key words:

dietary habits, cardiovascular health

“Quercetin and its methylated metabolites: the chemical basis of activity”

“Left Bundle Branch Block; Controversies in Aortic Valve Interventions and Cardiac Resynchoronization Therapy”

“The sensitivity of radiotherapy to tissue composition and its estimation using novel dual energy CT methods”

“Optimising delays in access to specialist outpatient clinics”

Thursday 12 June 2014, 14.00 hours

“Regulator Preferences and Managers’ Manipulation Choices”

This dissertation investigates underlying motives for differences in regulatory scrutiny across different types of firms operating in different institutional settings. As regulatory behavior also affects managers’ manipulation choices, this dissertation also sheds light on how managers make different manipulation choices depending on the regulatory scrutiny they face. In particular, study 1 and 2 investigate the behavior of regulators in the healthcare industry and hospital managers’ reactions to these behaviors, while study 3 focuses on regulatory preferences of the SEC and managers’ reactions to these preferences. All of these studies contribute towards a better understanding of regulatory behavior and firms’ reactions to such behavior. Overall, the findings of this dissertation suggest that firms can be given regulatory leeway for performance manipulation if their behavior is potentially beneficial for the economy or society as a whole.

Key words:

regulatory behavior, performance manipulation, manipulation choices

“EGFRvIII: molecular insights and therapeutic potential”

“Mijn hart stond van stocht bijna stil! Dichters en hun biografen”

“Hyperostosis cranialis interna”

Hyperostosis cranialis interna is a hereditary bone disease that manifests in the skull and skull base. Symptoms, which result from a narrowing of the nerve channels in the skull base, range from hearing loss, facial paralysis and facial pain. CT and PET scans can illustrate changes in anatomy and bone metabolism in the affected areas. In collaboration with the University of Antwerp, the mutation of the gene in question was discovered. Unravelling the mechanisms behind normal bone metabolism can further our understanding of the pathogenesis of this disease. Hyperostosis cranialis interna is one of dozens of rare bone diseases involving the skull. Intervention usually involves symptomatic treatment through pain relief or surgically exposing the affected cranial nerves.

Key words:

hyperostosis cranialis interna, bone disease, CT scan, PET scan, genetics

“Evaluation of Meal and Deworming Programs for Primary Schools in Rural Senegal”

“New governance  under limited statehood: The case of local government reform in Kosovo”

“Constructing worlds with words; Science and international language in the early twentieth century”

This dissertation examines a remarkable event in twentieth-century history of science: the introduction of an artificial, international language known as Ido. Proponents presented this language as scientifically designed and therefore a neutral and efficient information carrier for conferences and trade. Ido was to transcend national interests but, as De Kloe demonstrates, the new language reflected a world order that served the national and sometimes imperialistic interests of its creators. He also argued that international scientific linguists copied the use of language as a creator of communities from the nationalists, but applied it on an international level.

Key words:

history of science, artificial language, Ido

“ACCESS TO MEDICINES; The interface between Patents and Human Rights. Does one size fit all?”

Patients having no or inadequate access to affordable medicines endangers the full realisation of human rights, particularly the right to health. Three country studies have been conducted, on South Africa, India and Uganda. These aim to provide a concrete insight into whether these countries recognise and acknowledge the interplay between patents and human rights with respect to access to medicines. Secondly these studies examine whether TRIPS agreement  concluded within the framework of the WTO leaves sufficient freedom for (developing) states to adopt a patent system suited to their domestic needs, enabling them to strike a fair balance between access to medicines and patent protection for medicines. In other words: does one size fit all? The thesis illustrates that the normative force of human rights in combination with social movement can provide a powerful tool for prioritising the health needs of the global poor.

Key words:

medicine, access, patents, human rights, Intellectual Property Rights

“Improvement of data quality for Diffusion Kurtosis Imaging and application to clinical neurological research”

Understanding human brain function and dysfunction is one of the major challenges of our century. One of the most popular methods to achieve this goal is in vivo magnetic resonance imaging. In particular, diffusion-weighted imaging has become a standard tool to non-invasively study white matter structure in vivo. This PhD dissertation deals with the development of pre-processing methods to improve image quality and the accuracy of diffusion parameters for a novel technique called diffusion kurtosis imaging (DKI). We proposed a novel method to correct data misalignment due to subject motion, as well as a method to reduce within- and between-subject variability due to the presence of noise. The diagnostic value of DKI was investigated in the case of Parkinson’s disease: kurtosis metrics show more sensitivity to white matter changes than standard diffusion metrics. Significant differences were found in posterior cerebral areas as well as subcortical regions like the putamen, and are therefore promising results.

Key words:

brain, diffusion kurtosis imaging (DKI), white matter, Parkinson’s disease

“Recessions and Depressions: A Marketing Perspective on Central Issues in the Healthcare Sector”

“ENDOTHELIAL CELL FUNCTION FROM A TISSUE ENGINEERING PERSPECTIVE”

Tissue-engineered vascular grafts can be used in cardiovascular patients who require a by-pass. These artificial vessels are created by sowing naturally occurring cells on biodegradable plastic. This dissertation aims to test and optimise tissue-engineered vessels that were too weak and triggered infection. Endothelial cells, the innermost layer of cells in blood vessels, were examined in greater detail in terms of growth and coagulation. The endothelial cells of patients functioned as well as those in our control group and can be considered safe for tissue engineering. This research brings us one step closer to the clinical application of vascular tissue engineering.

Key words:

Endothelial Cells, Vascular Tissue Engineering

“De Grijsaard en de Jongeling”

“Who governs? Authority and authorisation in global affairs”

Friday 20 June 2014, 16.00 hours

“Psychogenic non-epileptic seizures; the identification of neurophysiological correlates”

This PhD dissertation describes research on physiological characteristics of patients with psychogenic non-epileptic seizures (PNES). PNES are attacks that look like epileptic seizures, but that are not caused by epileptiform abnormalities in brain activity. Instead, they have psychogenic causes. This PhD dissertation aimed to explore possible underlying mechanisms.

Magnetic resonance imaging (MRI) techniques were used to look at these patients’ brain networks, to understand how they deal with information and emotion. Their heart rate variability was analysed using electrocardiography (ECG) techniques, to investigate whether the attacks are characterised by elevated stress levels.

Key words:

psychogenic non-epileptic seizures, MRI, ECG

“Nutritional Profile of Young Sudanese Adolescents”

“Guidelines for designing programmes of assessment”

Designing a coherent set of exams within a programme is a complex process subject to high demands and a legion of quality criteria. What it lacks, however, is support for the design process. Exams not only present a measurement problem (e.g. reliability) and an academic problem (e.g. learning outcome), they also present organisational problems (e.g. costs and logistics). A framework and 73 guidelines for designing an exam were developed and tested in practice. The guidelines are not an exact science and their application varies per situation. Exam expertise remains essential to designing high-quality exams.

Key words:

exams, curriculum design, guidelines

“The selective toxicity of acrolein”

“Highly-skilled migration and new destination countries”

This dissertation looks into the effect of government policies on the choice of a destination country for highly-skilled migrants. Highlighting the case of India, which is one of the most important emigration countries, the United States are found to persist as the single most important country in terms of study and career destinations.  In the situation when the motivation for moving abroad is exclusively limited to completion of a short-term project, be it study or work, many of the favourable options introduced in the recent versions of immigration policies to attract highly skilled migrants do not matter to a large extent. The decision to go abroad guided by professional motives and economic factors, override institutional and socio-political factors in migration decisions. Fragmentation of the European labour market and the associated lack of free movement between countries for third-country nationals remain arguably one of the serious challenges of transforming EU Member States into more attractive destination countries.

Key words:

migration, high-skilled migrants, destination countries, Europe

“Essays on Insider Trading”

“Can Remittances influence the Tenure and Quality of Housing in Uganda?”

Policy makers have not progressed on how to improve housing tenure and quality using remittances, because of varied and conflicting conclusions drawn by different authors in literature. This thesis argues that it is possible to create incentives for the targeted use of remittances for advancement of tenure and quality of housing. From a pooled-cross section analysis on sample survey data from the Uganda National Household Survey 2005/2006 (UNHS III) and 2009/2010 (UNHS IV), results show that due to significant positive correlations between remittances and the attributes of housing tenure (own and rent) and housing quality (access to utilities and physical condition of housing), remittances can be conditioned.

Key words:

policy, Uganda, remittances, housing tenure, housing quality

“Pharmacotherapeutic options in sarcoidosis; how can we improve them?”

Sarcoidosis is an immune disease that can occur in virtually any organ in the body. Although it can go away on its own, some patients experience a more serious disease progression that impacts their quality of life. Timely intervention and individual treatment is essential in this latter group. Despite the availability of a wide range of therapeutic options, good agreements are often lacking. This dissertation aims to contribute to the optimisation of pharmacotherapy for sarcoidosis patients. International recommendations for using specific medications have been drafted and a mobile application (app) for doctors has been developed. Furthermore, a start was made on offering ‘tailored therapy’ to sarcoidosis patients. The degree to which patients responded positively to medication (biologicals) was partly determined by genetic predisposition. In the future, medication will likely be prescribed on a much more individual basis using a personal profile.

Key words:

sarcoidosis, pharmacotherapy, treatment

“Flax as a bio-based biomedical textile material”

“Promoting Innovation in Latin America; What Countries Have Learned (and What They Have Not) in Designing and Implementing Innovation and Intellectual Property Policies”

This dissertation analyzes the evolution of innovation policy in Latin America and the rise of intellectual property as a domain of action for innovation policies. The dominance of the conventional approach has led to a detachment between innovation and industrial policies and to an excessive focus on intellectual property “protection” and markets for knowledge, thus jeopardizing the effectiveness of public support.  Nowadays, Latin American countries have more fiscal space, their societies are young and with new aspirations, and the global economy is undergoing major changes. Some windows of opportunities are available, but targeted interventions are needed, because markets are not generating the incentives for structural transformation. The challenge is to factor in the voices for change going beyond the existing elites to change the status-quo and set the basis for a society which should be more innovative and more inclusive in order to be more equal.

Key words:

Latin America, innovation policy, intellectual property

“Short- and long-term cardiometabolic consequences of infant growth: size matters”

“Human Migration: Myths, Hysteria and Facts”

“Towards personalized medicine”

“JAM-A: Junctional Adhesion Molecule-A or Janus Acting Mediator in atherosclerosis”

Presently, atherosclerosis constitutes one of the leading causes for patients suffering morbidity and death from myocardial infarction and stroke around the world.  Atherosclerosis is facilitated by a chronic inflammation of the vessel wall, thus investigating different cell-types of the immune system and their interactions is a valuable goal to find novel diagnostic and therapeutic strategies. Junctional adhesion molecule (JAM)-A plays an important part in crossing of blood borne leukocyte over the innermost cell-layer of the vessels, so called endothelial cells (EC). 
With this study, we investigated the role of JAM-A harbored by leukocytes, platelets or ECs on atherosclerotic lesion formation. We found differing consequences and their mechanisms on lesion formation mediated by JAM-A of different cellular origin.  As most important finding, specific intervention of endothelial JAM-A might present a worthwhile strategy for non-invasive diagnostics and tailor-made therapeutics.

Key words:

atherosclerosis, molecule (JAM)-A, endothelial cells (EC)

“Neuronal correlates of repetitive whiskers stimulation in the Neuregulin 1 mouse model of schizophrenia”

“Dissecting Anatomy Education in the Medical Curriculum”

“Management and leadership education for medical residents; evaluating needs and developing an educational intervention”