Université Libre de Bruxelles

Introduction: Cannabis is the most consumed illicit substance in Europe. Although its sale and use remain generally prohibited, European public policies have evolved in recent years by legalizing cannabis for medical use and considering its legalization for recreational use. However, in the literature there are arguments in favor of a particular relationship between cannabis consumption and the development of psychotic symptoms. Thus, since cannabis consumption tends to increase with legalization, the aim of this review was to investigate the impact of the legalization of cannabis for recreational use on the risk of psychosis in regions of the world already concerned. Method: A systematic review of the literature was carried out in April 2024 in the PubMed-Medline database according to PRISMA criteria. The sequence of keywords used was as follows: (“Cannabis” [Mesh] or cannabis) AND ((“Psychotic Disorders” [Mesh] or Psychotic Disorders) or (“Schizophrenia Spectrum and Other Psychotic Disorders” [Mesh]) or (“Schizophrenia” [Mesh] or Schizophrenia)) AND legal use. The inclusion criteria applied for the selection of articles in this systematic review were: (1) any article investigating the potential impact of the legalization of cannabis for recreational use on the risk of psychosis (any type of psychosis diagnosed according to ICD-9, ICD-10, DSM-4 or DSM-5) by the intermediary of epidemiological (incidence or prevalence) and/or clinical (ambulatory consultations, emergency visits or hospitalizations) criteria, (2) any type of study (cross-sectional, longitudinal, prospective, retrospective, interventional and experimental) with a methodology including a temporal and/or geographic comparison of the risk of psychosis associated with the legalization of cannabis for recreational use with the exception of literature reviews and clinical cases descriptions, (3) absence of limitation for the age of the populations studied and for the date of publication, and (4) articles written in English or French. After evaluation by the two authors of the 160 articles identified, seven studies investigating the impact of the legalization of cannabis for recreational use on the risk of psychosis were included in this systematic literature review. Results: Four of the studies showed no increase in the use of health services for psychosis following the legalization of cannabis for recreational use whereas three other studies highlighted a negative impact of the legalization of cannabis for recreational use on the risk of psychosis. All of these studies were carried out in North America and were characterized by a low level of scientific evidence. Conclusion: Given the complexity of assessing the impact of the legalization of cannabis for recreational use on the risk of psychosis, additional investigations through studies of better scientific quality are essential. However, based on the data already available, there is some evidence that there is a potential negative impact on mental health due to the legalization of cannabis for recreational use. In this context, in the event of legalization of cannabis for recreational use it seems essential to recommend lower risk use of cannabis (limit the frequency of use, delay the age of first consumption, control the THC content of products and promote prevention/education). Finally, in order to enable dynamic evolution of public health strategies the establishment of continued monitoring is essential as cannabis legalization evolves.

We quantify the effects of intensely applied electric fields on the Fe oxidation mechanism. The specimen are pristine Fe single crystals exposing a variety of surface structures identified by field ion microscopy. These crystals are simultaneously exposed to low pressures of pure oxygen gas, on the order of 10⁻⁷ mbar, while applying intense electric fields on their surface of several tens of volts per nanometer. The local composition of the different surface structures is probed directly and in real time using an Environmental Atom Probe and successfully compared with first principles‐based models. We found that rough Fe{244} and Fe{112} facets are more reactive toward oxygen than compact Fe{024} and Fe{011} facets. Results demonstrate that the influence of an electric field on the oxidation kinetics depends on the timescales that are involved as the system evolves toward equilibrium. The initial oxidation kinetics show that strong increases in electric fields facilitate the formation of an oxide. However, as one approaches equilibrium, high field values mitigate this formation. Ultimately, this study elucidates how high externally applied electric fields can be used to dynamically exploit reaction dynamics at the nanoscale towards desired products in a catalytic reaction at mild reaction conditions.

During cell differentiation, identical pluripotent cells undergo a specification process marked by changes in the expression of key genes, regulated by transcription factors that can inhibit the transcription of a competing gene or activate their own transcription. This specification is orchestrated by gene regulatory networks (GRNs), encompassing transcription factors, biochemical reactions, and signalling cascades. Mathematical models for these GRNs have been proposed in various contexts, to replicate observed robustness in differentiation properties. This includes reproducible proportions of differentiated cells with respect to parametric or stochastic noise and the avoidance of transitions between differentiated states. Understanding the GRN components controlling these features is crucial. Our study thoroughly explored an extended version of the Toggle Switch model with auto-activation loops. This model represents cells evolving from common progenitors in one out of two fates (A or B, bistable regime) or, additionally, remaining in their progenitor state (C, tristable regime). Such a differentiation into populations with three distinct cell fates is observed during blastocyst formation in mammals, where inner cell mass cells can remain in that state or differentiate into epiblast cells or primitive endoderm. Systematic analysis revealed that the existence of a stable non-differentiated state significantly impacts the GRN’s robustness against parametric variations and stochastic noise. This state reduces the sensitivity of cell populations to parameters controlling key gene expression asymmetry and prevents cells from making transitions after acquiring a new identity. Stochastic noise enhances robustness by decreasing sensitivity to initial expression levels and helping the system escape from the non-differentiated state to differentiated cell fates, making the differentiation more efficient.

Group A Streptococcus (GAS) M‐related proteins (Mrp) are dimeric α‐helical coiled‐coil cell‐wall‐attached proteins. During infection, Mrp recruit human fibrinogen (Fg) to the bacterial surface, enhancing phagocytosis resistance and promoting growth in human blood. However, Mrp exhibit a high degree of sequence diversity, clustering into four evolutionarily distinct groups. It is currently unknown whether this diversity affects the host–pathogen interactions mediated by Mrp. In this study, nine Mrp sequences from the four major evolutionary groups were selected to examine the effect of sequence diversity on protein–protein interactions with Fg. Negative staining transmission electron microscopy confirmed that Mrp are fibrillar proteins measuring between 45.4 and 47.3 nm in length, and mass photometry confirmed the ability of Mrp to form dimers. Surface plasmon resonance was used to evaluate the affinity of each Mrp for Fg. All Mrp studied bound to Fg via Fragment D (FgD) with nanomolar affinity. Previous studies have linked the acquisition of plasminogen (Plg) by GAS Fg‐binding M proteins to tissue destruction and excessive stimulation of the human inflammatory response during infection. Our findings show that Mrp provide an alternative mechanism for Plg recruitment, as Plg binding by Mrp was significantly enhanced following pre‐incubation with Fg. These data suggest that Mrp play an important role in GAS host–pathogen interactions. However, further studies are necessary to investigate the relevance of these findings in vivo.

Background The suitability of the United States National Academy of Medicine guidelines for gestational weight gain in women with gestational diabetes remains uncertain, raising global concerns. This study aimed to evaluate the association of gestational weight gain with pregnancy and birth outcomes and to determine optimal ranges for gestational weight gain per pre-pregnancy body mass index category in women with gestational diabetes. Methods An epidemiological analysis between 2009–2018 analyzed a large Belgian cohort of singleton pregnancies with gestational diabetes and gestational age 38–40 weeks. Multivariate logistic regression assessed associations between gestational weight gain and relevant pregnancy and birth outcomes, with and without adjustment for confounding variables, including maternal age, origin, education, mode of conception, parity, gestational age at delivery, social deprivation, and year of delivery. Potential optimal weight gain ranges were calculated by minimizing the combined risk of small- and large-for-gestational-age infants (SGA, LGA). Results A total of 13,060 women with gestational diabetes were included. Compared to recommended weight gain, gestational weight gain above guidelines occurred in 26.9% and was associated with an increased risk of gestational hypertension (aOR 1.41, 95% CI 1.20–1.66, p < 0.001), emergency caesarean section (aOR 1.45, 95% CI 1.25–1.69, p < 0.001), LGA infants (aOR 1.84, 95% CI 1.63–2.08, p < 0.001), and macrosomia (aOR 1.78, 95% CI 1.55–2.04, p < 0.001). Weight gain less than recommended (40.2%) was associated with a decreased risk of gestational hypertension (aOR 0.81, 95% CI 0.69–0.96, p = 0.015), LGA infants (aOR 0.58, 95% CI 0.50–0.66, p < 0.001), and macrosomia (aOR 0.57, 95% CI 0.49–0.65, p < 0.001), but at the expense of an increased risk of SGA infants (aOR 1.68, 95% CI 1.45–1.96, p < 0.001) and low birth weight (aOR 2.28, 95% CI 1.57–3.32, p < 0.001). Based on current analysis, the optimal ranges for gestational weight gain would be 9 to 14 kg for women with a normal weight, 1 to 9 kg for women with overweight, and -7 to 1 kg for women with obesity. Conclusions This Belgian study suggests that optimal gestational weight gain for singleton at-term pregnancies complicated by gestational diabetes should be lower than current recommendations, highlighting the need to reevaluate gestational weight gain guidelines in this context.

The forecasting of stainless steel (SS) pitting corrosion remains challenging due to the need to identify nanometer-scale imperfections in surface passive films. Traditional analytical methods are costly, time-consuming, and limited to model systems with adequate signal- to-noise ratios. This study proposes an alternative approach that leverages optical signatures of passive layer properties which, when enhanced with unsupervised machine learning (ML) to extract signals even at noise level, successfully identifies pitting-susceptible zones (PSZ) in-situ on industrial SS 316L substrates. Complementary optical modeling and X-ray Photoelectron Spectroscopy suggest chromium oxide deficiency in surface films over PSZ, consistent with established pitting mechanisms. This proof-of-concept demonstrates that ML-enhanced optical methods can serve as accessible, precise tools for PSZ identification, advancing the development of predictive corrosion monitoring systems.

Study of the sagittal accuracy of the ‘Robotic Surgical Assistant’ (ROSA®), compared to conventional surgery, regarding the application of the tibial slope (TS). Study of the impact of TS on the range of motion (ROM) and patient-reported outcome measures (PROMS). Inclusion of patients who underwent primary Total Knee Arthroplasty (TKA) between 1/1/2021 and 15/4/2024. Divided into robotic-assisted TKA (RA-TKA) and manual TKA (M-TKA). Measurement of pre- and post-operative TS, using the posterior tibial cortex, on profile knee X-rays. 3° TS applied arbitrarily for both groups. ROM was measured pre-operatively and at three, six and 12 months post-operatively. Patient satisfaction assessed via Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS). 266 patients were included in the study. The M-TKA (110) had a post-operative TS of 3.11° (± 2.12°). 81.21% were within 2° of the target and 92.87% within 3°. The RA-TKA (82) had a post-operative TS of -0.11° ± (1.93°). 36.83% were within 2° of the target and 56.63% within 3°. RA-TKA had a KOOS of 64.43 ± 12.87 and OKS of 33.05 ± 6.01. M-TKA had a KOOS of 64.18 ± 13.11 and OKS of 32.31 ± 5.97. Maximum flexion at 12 months was 118.74° ± 8.19° for M-TKA and 121.88° ± 7.43° for RA-TKA (p = 0.002). The application of TS using ROSA® was less precise than the conventional method in achieving post-operative TS values as measured on X-rays. However, there were no clinical differences in ROM or PROMS.

Introduction: The rapid growth of internet and smartphone use in Cameroon has made social media a significant source of health information for young adults, but the cross-cultural impact of this trend is under-researched, necessitating the development of culturally tailored health communication strategies. Methods: The study employed an online survey from October 2023 to June 2024, involving 151 Cameroonian youth aged 18-35. It aimed to identify factors associated with health information-seeking behavior and digital literacy using descriptive statistics and linear regression analyses. Results: This study reveals extensive digital platform usage among Cameroonian youth, with 87.5% actively using WhatsApp and 40.39% spending over five hours daily on social media. Health-related topics frequently sought include infectious diseases (59.4%), sexual and reproductive health (46.1%), and exercise and fitness (39.1%). Additionally, 74.17% of participants shared health-related information on social media. Regression analysis highlights the significant impact of cultural background on health information-seeking behaviour and digital literacy, with cultural factors influencing confidence in evaluating reliable health information (R2=0.2074, P<2.2e-16). Despite 24.5% of participants receiving formal training, 75.5% lacked digital health literacy training, emphasizing the need for targeted interventions. Conclusion: Cultural factors, such as traditional beliefs and religious values, are pivotal in shaping participants’ trust in and interpretation of health information shared on social media. This study emphasizes the need for culturally tailored digital health literacy initiatives to improve the accessibility and reliability of health information.

Nanoparticle technology, particularly gold nanoparticles (AuNPs), is being developed for a wide range of applications, including as a delivery system of peptides or nucleic acids (NA). Their use in precision medicine requires detailed engineering of NP functionalization to optimize their function and minimize off-target toxicity. Two main routes can be found in the literature for the attachment of NA strands to AuNPs: covalent binding via a thiol group or passive adsorption onto a specially adapted coating previously applied to the metallic core. In this latter case, the coating is often a positively charged polymer, as polyethylenimine, which due to its high positive charge can induce cytotoxicity. Here, we investigated an innovative strategy based on the initial coating of the particles using calix[4]arene macrocycles bearing polyethylene glycol chains as an interesting alternative to polyethylenimine for NA adsorption. Because any molecular modification of AuNPs may affect the cytotoxicity and cellular uptake, we compared the behavior of these AuNPs to that of particles obtained via a classical thiol covalent attachment in MCF-7 and GC-1 spg cell lines. We showed a high biocompatibility of both AuNPs-NA internalized in vitro. The difference in subcellular localization of both AuNPs-NA in MCF-7 cells compared to GC-1 spg cells suggests that their subcellular target is cell- and coating-dependent. This finding provides valuable insights for developing alternative NA delivery systems with a high degree of tunability.

This article explores radicalization processes among the Belarusian opposition-in-exile using resource mobilization theory. Drawing on the case of the post-2020 opposition, exiled in the European Union and recognized by the West as a privileged interlocutor and “legitimate representative of the [Belarusian] people,” it identifies the stages of its radicalization in response to repression in Belarus and Russia’s aggression against Ukraine: first a peaceful approach, then emphasis on self-defense, and finally preparation for violent resistance. It explains each stage by the aggregation and maintenance of a “resource threshold.” It counts domestic/exile networks and Western allies as resources crucial for activism among the exiled opposition. The article also argues that different strategies (peaceful versus violent) have been useful for achieving the resource threshold of the Belarusian opposition-in-exile depending on the domestic, host states’, and sponsor states’ political and geopolitical environments.

Background MR‐guided radiotherapy (MRgRT) offers new opportunities but also introduces workflow complexities requiring dedicated optimization. Implementing magnetic resonance linear accelerator (MR‐Linac) technology comes with challenges such as prolonged treatment times and workflow integration issues. Purpose We present here our experience and share practical tips and tricks to streamline MR‐Linac implementation, optimize workflow efficiency, and improve coordination. Methods The first 150 patients treated with a 1.5T MR‐Linac Unity® at our institution were analyzed. Treatments were assessed based on session recordings, difficulties encountered were identified, and solutions documented. Results A total of 726 fractions were delivered, with a mean treatment time of 48 minutes. Key optimizations included standardized operating procedures (SOPs) and structured briefing sheets, leading to reduced delays and improved treatment consistency. Conclusion Strategic workflow standardization and optimized communication tools significantly improved the ability to deliver high‐quality, patient‐centered care by streamlining processes and enhancing coordination among team members. These insights provide practical guidance for centers integrating MR‐Linac technology.

Malabsorption is a complex and multifaceted condition characterised by the defective passage of nutrients into the blood and lymphatic streams. Several congenital or acquired disorders may cause either selective or global malabsorption in both children and adults, such as cystic fibrosis, exocrine pancreatic insufficiency (EPI), coeliac disease (CD) and other enteropathies, lactase deficiency, small intestinal bacterial overgrowth (SIBO), autoimmune atrophic gastritis, Crohn's disease, and gastric or small bowel resections. Early recognition of malabsorption is key for tailoring a proper diagnostic work‐up for identifying the cause of malabsorption. Patient's medical and pharmacological history are essential for identifying risk factors. Several examinations like endoscopy with small intestinal biopsies, non‐invasive functional tests, and radiologic imaging are useful in diagnosing malabsorption. Due to its high prevalence, CD should always be looked for in case of malabsorption with no other obvious explanations and in high‐risk individuals. Nutritional support is key in management of patients with malabsorption; different options are available, including oral supplements, enteral or parenteral nutrition. In patients with short bowel syndrome, teduglutide proved effective in reducing the need for parenteral nutrition, thus improving the quality of life of these patients. Primary care physicians have a central role in early detection of malabsorption and should be involved into multidisciplinary teams for improving the overall management of these patients. In this European consensus, involving 10 scientific societies and several experts, we have dissected all the issues around malabsorption, including the definitions and diagnostic testing (Part 1), high‐risk categories and special populations, nutritional assessment and management, and primary care perspective (Part 2).

Background This study investigates the gut microbiota components associated with metabolic syndrome in patients living with HIV-1 at Bafoussam Regional Hospital, West Cameroon, it focuses on gastrointestinal mucosal barrier disruption and dysbiosis, and their effects on persistent inflammation and metabolic disorders. Methods A pilot study was conducted involving fourteen patients living with HIV-1. The patients were divided into two groups of seven in each group. One group consisted of patients with metabolic syndrome, and the other group included patients without metabolic syndrome. Gut microbiota was characterized using 16 S rRNA gene-targeted sequencing to analyze microbial diversity and composition. Beta diversity and the relative abundance of bacterial taxa were compared between patients with and without metabolic syndrome. Results Patients living with HIV-1 and metabolic syndrome showed significantly altered beta diversity compared to those without metabolic syndrome. A higher relative abundance of Firmicutes and increased proliferation of Proteobacteria were observed in patients with metabolic syndrome. Additionally, a decrease in metabolically beneficial bacteria, such as Bifidobacterium sp., Lactobacillus sp., Akkermansia sp., and Faecalibacterium sp., was noted. Several beneficial bacterial species were associated with participants' metadata, suggesting potential links between gut microbiota and metabolic syndrome. Conclusion This preliminary study highlights that gut microbial balance, rather than the presence of specific bacteria, plays a crucial role in managing metabolic health in patients living with HIV-1. The altered gut microbiota in participants with metabolic syndrome emphasizes the need for further research into the optimal gut microbial structure. Understanding the interaction between gut microbiota changes and the chemical environment in these patients could guide targeted interventions to improve metabolic outcomes.

Background and study aims Colonoscopy is associated with discomfort that requires intravenous sedation (IVS). The aim of this randomized controlled trial (RCT) was to explore the feasibility of virtual reality distraction (VRD) for colonoscopy using two primary endpoints: cecal intubation rate and the rate of rescue with IVS. Patients and methods Patients scheduled for elective colonoscopy with IVS were randomized in a 2:1 ratio in favor of VRD, with rescue IVS by propofol if needed. VRD involved use of a device providing a visual and auditive experience similar to clinical hypnosis. Results Ninety patients were included (VRD:60, IVS: 30). Cecal intubation rate was similar in both groups (92.8% for VRD vs 100% for IVS, P =0.3). The rate of rescue IVS in the VRD group was 63.6%. There was a decrease in median total dose of propofol per patient in the VRD group (1.15 mg/kg for VRD and 4.41 mg/kg for IVS, P <0.001) and in the subgroup of VRD patients who received IVS rescue (3.17 mg/kg for VRD and 4.41 mg/kg for IVS, P =0.003). The median level of pain was higher and the median level of comfort was lower in the VRD group (respectively 3 vs 0, P <0.001 and 7 vs 10, P <0.001). Conclusions This RCT provides preliminary data to better understand the feasibility of VRD for colonoscopy. We have not identified differences in procedure outcomes compared with conventional IVS, but nevertheless, higher pain and lower comfort scores were reported.

The present contribution gives an overview of the photon strength function models developed to compensate for the lack of data for experimentally non-accessible nuclei. Phenomenological and microscopic approaches are presented in light of their respective strengths. Since the microscopic models included in the TALYS code are based on the quasi-particle random phase approximation (QRPA) method, the scope of application of this approach is presented. The QRPA-based strength functions, obtained using effective, covariant or Skyrme or Gogny interactions, reproduce the majority of experimental data with a variable level of precision which is briefly discussed. Some alternatives or updates to the gamma-ray strength functions based on QRPA methods are proposed. Returning to the definition of the photon strength function, particular attention is paid to the differences between the processes of photon absorption and the de-excitation of nuclei. As perspectives, preliminary theoretical results including probabilities of transition between excited states are presented.

Nuclear reaction models, and in particular compound nucleus reactions, require the knowledge of nuclear level densities (NLDs), among other ingredients. For decades, analytical expressions have been used in nuclear reaction codes, due to the freedom they offer to the user to modify their associated parameters in order to fit cross sections. The development of computational resources has opened a new era, roughly 20 years ago, by allowing calculation of NLDs from more microscopic approaches and their use in reaction codes through tables stored in databases. During this 20 year period, several approaches have been developed to improve step by step the physical description of NLDs. We review some of these efforts and show where we are now and what we foresee as future improvements.