Vrije Universiteit Brussel

This paper explores how the epistemic emotions of curiosity, awe, and wonder can motivate us to expand our understanding. Curiosity drives us to fill a local gap in our knowledge. Awe is a mixture of fear and fascination for something so vast and mysterious that it challenges our understanding, thus inciting cognitive accommodation. Wonder is intermediate between curiosity and awe. Awe is commonly understood as a religious emotion, a reverence for the “numinous”—a transcendent reality out of bounds for ordinary humans. Awe has also been conceived as a scientific emotion, a desire to explore an infinite realm of potentiality. The latter defines “raw transcendence”, a willingness to go beyond any boundary imposed by tradition or authority. Newtonian science ignores such emotions, proposing a purely rational, reductionist picture of the world as a clockwork mechanism. However, the new scientific worldview sees the universe as evolving while producing endless novelty. The scientific investigation of this potential can benefit from practices that promote awe and wonder. These include experiencing landscapes, artistic beauty, complex patterns, and mathematical infinity. Awe and wonder thus can help us to realize the Enlightenment's promise of unbounded progress in our understanding of the universe.

Do antitrust investigations by the European Commission have a significant impact on the market value of affected companies? This paper examines the effects of 700 antitrust observations regarding dawn raids, Commission decisions and appeals to the General Court or the Court of Justice on the stock prices of the companies involved using an event study methodology. A dawn raid creates an abnormal return of − 1.72% and a Commission decision generates a long-lasting drop of 2.23%. An appeal has no effect if litigated in front of the General Court and a short-lived dip of 1.38% in case of a judgment by the Court of Justice. Longer cartel participation leads to a more substantial negative abnormal return. An important observation is that firms that were granted immunity from the fine do not record any notable effects in stock price, despite the relatively low explanatory power of the monetary value of the fine in the overall market capitalisation decline. We suggest that this could be explained by the signalling effect of the fine to the market, in that sense being more important than initially expected.

A release from parasites is assumed to be a major factor to the success of invasive species. However, strong evidence for a lower parasite load in invasive species is sparse on a larger geographical scale. To test this hypothesis, we analysed the monogenean gill parasite communities of invasive and native Nile tilapia across the African continent. We find significantly lower parasite loads in invasive populations, but no difference in parasite richness between invasive and native populations. Additionally, significant differences in parasite load and richness within the native range were found. We analysed the parasite community composition with a permanova and found strong variation in parasite communities both among native and invasive Nile tilapia. About 16% of this variation could be explained by two significant explanatory variables: introduction status of the host (4%) and ichthyofaunal province (12%), meaning both introduction status and geographical location influence parasite community composition. Furthermore, significant indicator parasite species were found for introduction status, river basin and ichthyofaunal province. Overall, we illustrate the potential value of ectoparasites to inform about the native environment and introduction history of fish. Possibly, this type of forensic parasitology, easily performed on museum specimens, could be useful to help resolve enigmatic invasions.

Few ecosystems are more sensitive to hydrological change than seasonally-flooded wetlands. Here, we investigate how changes in hydrological regimes caused by the construction of two dams have contributed to large changes in the structure and dynamics of the Kafue Flats, an internationally-important, partially-protected wetland ecosystem in Zambia. We use historical (1970) and contemporary (2013) data to describe changes in hydrology due to dam operations, and to compare the areal extent, distribution, and composition of the major wetland and dryland habitats in the pre- and post-dam periods. To understand the seasonal dynamics of the ecosystem and how these dynamics influence the seasonal movement and use of the ecosystem by the dominant grazing herbivore, the endangered Kafue lechwe, we combine data on annual hydrological variation with spatially- and/or temporally-explicit quantitative estimates of: (1) grass biomass and nutrient stocks, (2) distribution of lechwe across habitats, and (3) lechwe nutritional status. The operation of the dams has reduced hydrological variation, causing a loss of more than 50% of seasonally-flooded grasslands and probably promoting woody encroachment in some habitats. Our results demonstrate that Kafue lechwe is highly dependent on these seasonally-flooded grasslands during the dry season, when their nutritional status is otherwise critically low. In combination, we hypothesize that changes in the flooding regime driven by dam construction precipitated ecosystem-level changes that—together with other factors—may have contributed to a rapid historic, as well as ongoing decline in the lechwe population. Our study highlights potential consequences of the spatio-temporal homogenization of a previously highly variable ecosystem.

Background The use of local anesthetics (LA) in individuals with Brugada syndrome (BrS) remains a subject of debate due to the lack of large‐scale studies confirming their potential risks. This study primarily aimed to evaluate the incidence of new malignant arrhythmias or defibrillation events in patients diagnosed with BrS during the perioperative period, following the administration of local anesthetics, and within 30 days postoperatively. The secondary objective was to analyze the occurrence of adverse effects during hospitalization, as well as 30‐day readmission and mortality rates. Methods A retrospective cohort study was performed on patients with BrS who underwent locoregional anesthesia between January 1, 1996, and September 30, 2020. Anesthetic records and electronic medical records were thoroughly reviewed for up to 30 days following each administration of local anesthetics. Results A total of 47 procedures involving patients with BrS who underwent locoregional anesthesia were analyzed. The patients were categorized into three groups: 27 in the peripheral nerve block (PNB) group, 13 in the epidural anesthesia group, and 9 in the spinal anesthesia group. One patient in the PNB group experienced intraoperative ventricular fibrillation following the administration of ajmaline. No other adverse events were observed. Conclusion In this retrospective study, our findings do not indicate an increased arrhythmogenic risk or a higher incidence of adverse events associated with the administration of local anesthetics in patients with BrS. However, the available data are insufficient to confirm the safety of local anesthetic use in this population. Enhanced vigilance is recommended when administering local anesthetics to individuals with BrS. Prospective studies are necessary to further evaluate and establish the safety profile of local anesthetics in this patient group.

Background Continuous veno-venous hemodiafiltration (CVVHDF) is used in critically ill patients, but its impact on O₂ and CO₂ removal, as well as the accuracy of resting energy expenditure (REE) measurement using indirect calorimetry (IC) remains unclear. This study aims to evaluate the effects of CVVHDF on O₂ and CO₂ removal and the accuracy of REE measurement using IC in patients undergoing continuous renal replacement therapy. Design Prospective, observational, single-center study. Methodology Patients with sepsis undergoing CVVHDF had CO₂ flow (QCO₂) and O₂ flow (QO₂) measured at multiple sampling points before and after the filter. REE was calculated using the Weir equation based on V̇CO₂ and V̇O₂ measured by IC, using true V̇CO₂ accounting for the CRRT balance, and estimated using the Harris-Benedict equation. The respiratory quotient (RQ), the ratio of V̇CO₂ to V̇O₂, was evaluated by comparing measured and true values. Results The mean QCO₂ levels measured upstream of the filter were 76.26 ± 17.33 ml/min and significantly decreased to 62.12 ± 13.64 ml/min downstream of the filter (p < 0.0001). The mean QO₂ levels remained relatively unchanged. The mean true REE was 1774.28 ± 438.20 kcal/day, significantly different from both the measured REE of 1758.59 ± 434.06 kcal/day (p = 0.0029) and the estimated REE of 1619.36 ± 295.46 kcal/day (p = 0.0475). The mean measured RQ value was 0.693 ± 0.118, while the mean true RQ value was 0.731 ± 0.121, with a significant difference (p < 0.0001). Conclusions CVVHDF may significantly alter QCO₂ levels without affecting QO₂, influencing the REE and RQ results measured by IC. However, the impact on REE is not clinically significant, and the REE value obtained via IC is closer to the true REE than that estimated using the Harris-Benedict equation. Further studies are recommended to confirm these findings.

Purpose This survey aimed to assess the public’s knowledge and opinions on oocyte donation (OD) among a large, unselected cohort of young Belgian women, and to explore aspects that could be enhanced to promote future OD programs. Methods We conducted a quantitative, epidemiological, cross-sectional web-based survey from February 2023 to April 2023. A private questionnaire was distributed to young women (21–30 years) living in Belgium via a digital link. The survey covered socio-demographic characteristics, knowledge about the OD procedure, compensation, personal attitudes, motivations and perceptions about anonymity assurance. Results A total of 390 women responded to the online questionnaire, with a drop-out rate of 10%. The survey revealed a good level of knowledge about the procedural aspects of OD, which did not influence willingness to donate. Only 19% of respondents were willing to donate, while 39.1% hesitated, particularly regarding private OD. No significant association was found between personal values and willingness to donate. Altruism emerged as the main motivation for gamete donation. Attitudes towards anonymity varied, with childless and older individuals more reluctant to reveal their identity. Conclusions Our study confirms that a small portion of the population is willing to donate oocytes, while a considerable proportion (39%) is hesitating. These findings highlight the urgent need for global education programs to raise awareness and address concerns that may prevent women from participating in OD programs.

Background: Educational programs for health-care providers increasingly implement culturally sensitive care. Clear methods for educating students in cultural awareness are still lacking. Research indicates that simply increasing knowledge on ethnicity, culture, or migration does not improve culturally sensitive behavior and can foster stereotypes. To overcome barriers like othering, a form of micro-racism, enhanced critical self-awareness is essential for health-care providers. Aim: A 4h module on culturally sensitive care was designed, implemented, and evaluated, with the aim of increasing nursing students’ self-awareness about othering, racism, and exclusion in health care. Methods: This article describes (1) the content of the module, led by the Johari Window model and the needs and insights from nursing students and health-care providers, (2) implementation of the module, and (3) subsequent evaluation among 34 participants. Results: The survey findings were categorized into six themes: Understanding Differences and Prejudices, Applying Knowledge in the Context of Nursing Practice, Acquiring Insights through Interpersonal Engagement, Strengths of the Sessions, Weaknesses and Areas for Improvement, and Overall Impressions. The participants evaluated the module positively, identifying success factors (e.g., enhanced self-reported awareness of their own positionality) and working points (e.g., imbalance in interaction among students and time constraints). Conclusion: The study describes the design, implementation, and evaluation of a module that successfully increases nursing students’ self-reported cultural competence and self-awareness, enhancing understanding of health-care inequalities and fostering open communication for more inclusive care.

In this paper, we introduce multi-objective deep centralized multi-agent actor-critic (MO-DCMAC), a multi-objective reinforcement learning method for infrastructural maintenance optimization, an area traditionally dominated by single-objective reinforcement learning (RL) approaches. Previous single-objective RL methods combine multiple objectives, such as probability of collapse and cost, into a singular reward signal through reward-shaping. In contrast, MO-DCMAC can optimize a policy for multiple objectives directly, even when the utility function is nonlinear. We evaluated MO-DCMAC using two utility functions, which use probability of collapse and cost as input. The first utility function is the threshold utility, in which MO-DCMAC should minimize cost so that the probability of collapse is never above the threshold. The second is based on the failure mode, effects, and criticality analysis methodology used by asset managers to assess maintenance plans. We evaluated MO-DCMAC, with both utility functions, in multiple maintenance environments, including ones based on a case study of the historical quay walls of Amsterdam. The performance of MO-DCMAC was compared against multiple rule-based policies based on heuristics currently used for constructing maintenance plans. Our results demonstrate that MO-DCMAC outperforms traditional rule-based policies across various environments and utility functions.

Purpose: (1) To evaluate the effectiveness of personalised psychologically-informed physiotherapy in people with neck pain; (2) To explore the mediating role of changes in illness perceptions. Method: In this replicated single-case study, 14 patients with non-specific neck pain at risk for chronicity received a personalised intervention addressing unhelpful illness perceptions and dysfunctional movement behaviour, according to principles of cognitive functional therapy. Outcomes included the mediating role of illness perceptions on overall effect, function, pain intensity and self-efficacy. Linear mixed models were used to analyse the data. Results: Repeated measurements (14-20 per patient), including a 3-months follow-up, showed a gradual improvement during and/or after psychologically-informed physiotherapy for overall effect, function, pain and to a lesser extent self-efficacy. Changes in each of the illness perception dimensions showed a mediation effect on overall effect, function and pain. When combining the dimensions "consequences," "personal control," "identity," "concern" and "emotional response," changes in illness perceptions explained approximately 35% of the improvement in overall effect. Conclusion: Addressing unhelpful illness perceptions appears valuable in the management of patients with chronic or recurrent non-specific neck pain. Intervention effects extended beyond the treatment period, indicating that patients' improved understanding of their health condition continued to have a positive impact.

INTRODUCTION Recruitment of participants for intervention studies is challenging. We evaluated the effectiveness and efficiency of a participant recruitment campaign through an online registry for the FINGER‐NL study, a multi‐domain lifestyle intervention trial targeting cognitively healthy individuals aged 60–79 with dementia prevention potential. Additionally, we explored which recruitment strategy successfully reached individuals from underrepresented groups in research. METHODS The campaign entailed seven recruitment strategies referring to The Dutch Brain Research Registry (DBRR): (1) Facebook advertisements, (2) appearance on national television, (3) newspaper articles, (4) researcher outreach, (5) patient organizations, (6) search engines, and (7) other. For each strategy, we describe the number of individuals (a) registered, (b) potentially eligible, and (c) included in FINGER‐NL. Subsequently, the efficiency, defined by the eligibility ratio (eligible/registered), and effectiveness, defined by the inclusion ratio (included/registered) were calculated. Associations between recruitment strategies and sociodemographic factors of underrepresented groups were tested with binomial logistic regressions. RESULTS The campaign resulted in 13,795 new DBRR registrants, of which n = 3475 were eligible (eligibility ratio = 0.25) and n = 1008 were included (inclusion ratio = 0.07). The Facebook advertisements and television appearance resulted in the highest numbers of registrants (n = 4678 and n = 2182) which translated to the highest number of inclusions (n = 288 and n = 262). The appearance on national television (eligibility ratio = 0.35), newspaper articles (0.26), and Facebook campaigns (0.26) were the most efficient strategies. The national television appearance (inclusion ratio = 0.13) was the most effective strategy. The Facebook campaign and appearance on national television performed relatively better in recruiting individuals from underrepresented groups. DISCUSSION A multipronged recruitment campaign via a national online recruitment registry is efficient and effective in recruiting and prescreening an adequate number of individuals aged 60–79 years with prevention potential for a multi‐site intervention trial within a limited time frame of 15 months. Social media advertisements and television are preferred strategies to recruit individuals from underrepresented groups. Highlights An online brain research registry recruited eligible participants successfully. Mass media recruitment strategies are efficient for reaching large numbers. Direct recruitment through researchers and patient organizations seems more effective. Online registries offer automated prescreening and alternatives for screen‐failures. Tailored strategies are needed to reach underrepresented groups to improve diversity.

Background The quantification of neurofilament light chain (NfL) in blood and cerebrospinal fluid (CSF) has proved useful in many contexts, for the diagnosis and prognosis of various neurological disorders. There is, however, a diversity of practices between centers, essentially linked to the context of use (COU), analytical methods, consideration of comorbidities, determination of cut‐points or use of interpretation scales. Finally, for the same biochemical profile, the interpretation and reporting of results may differ from one center to another, raising the question of test commutability. To date, no consensus has been reached between the different laboratories involved to define the most appropriate conclusions/comments based on COU and cut‐points. This work is an essential step towards consensual harmonization of the clinical use of NfL after CSF and/or blood analysis in various neurological contexts, as advocated by the Alzheimer's Association "Biofluid Based Biomarkers PIA" working group. Method This international project involves 58 clinical laboratories in 16 countries, specializing in the biochemical diagnosis of neurological disorders. By means of a questionnaire, we obtained a description of the COU, pre‐analytical and analytical (biological fluid and method used to quantify NfL) protocols of all the centers involved. Results Of the centers, 42% quantified NfL in CSF, 29% in serum and 28% in plasma, and 1% in dried blood spot. The COUs were as follows: Frontotemporal dementia (FTD, 17%), Alzheimer's disease (AD, 16%), multiple sclerosis (MS, 16%), amyotrophic lateral sclerosis (ALS, 11%), psychiatric syndrome (PS, 10%), Creutzfeldt‐Jakob disease (CJD, 8%), Parkinson's disease (PD, 8%), peripheral neuropathy (PN, 7%) and traumatic brain injury (TBI, 7%). Most centers define pathological cut‐points based on published literature and take age into account (50%). Conclusion Our initial results highlight the state of the art in terms of the clinical use of NfL analysis in CSF and blood in the context of different neurological diseases. We have now defined a coordinator for each COU subgroup and are organizing consensus meetings to harmonize the use and reporting of NfL measurements for the identified clinical applications. The results of these next steps will be presented.

Background The COVID‐19 pandemic disrupted global health systems, impacting cancer care and potentially increasing cancer mortality, especially among socioeconomically disadvantaged individuals. We aimed to assess changes in cancer mortality from March 1 to December 31, 2020 relative to the same period in 2019, and to examine potential shifts in cancer mortality's social disparities during the same time frame. Methods We used nationwide individually linked cancer mortality data from the Belgian National Register, the Census 2011, and the tax register. Analyses were stratified by age group (45–59 years, 60–74 years, 75+ years) and sex across all cancer types, including breast, colorectal, lung, pancreatic, and prostate. Direct age‐standardized mortality rates were calculated in 2019 and 2020 to calculate absolute and relative changes in cancer mortality by social indicators. Relative inequalities in cancer mortality by social groups were calculated for both time frames using Poisson regression. Sensitivity analysis considered any mention of specified cancer groups on the Belgian death certificate. Results For both overall and site‐specific cancers, our study found decreases in cancer mortality during the pandemic's early stages, particularly among individuals aged 75 and older. These changes did not significantly alter established socioeconomic patterns in cancer mortality. Conclusions Reductions in reported cancer deaths in 2020 may reflect COVID‐19 prioritization in cause‐of‐death coding and its role as a competing risk, rather than true declines. Persistent educational disparities emphasize the need for continued policy and healthcare collaboration, with future research focused on the pandemic's long‐term effects on cancer mortality and social inequalities.

The enterobacterial common antigen (ECA) is conserved in Gram-negative bacteria of the Enterobacterales order although its function is debated. ECA biogenesis depends on the Wzx/Wzy-dependent strategy whereby the newly synthesized lipid-linked repeat units, lipid III, are transferred across the inner membrane by the lipid III flippase WzxE. WzxE is part of the Wzx family and required in many glycan assembly systems, but an understanding of its molecular mechanism is hindered due to a lack of structural evidence. Here, we present the first X-ray structures of WzxE from Escherichia coli in complex with nanobodies. Both inward- and outward-facing conformations highlight two pairs of arginine residues that move in a reciprocal fashion, enabling flipping. One of the arginine pairs coordinated to a glutamate residue is essential for activity along with the C-terminal arginine rich tail located close to the entrance of the lumen. This work helps understand the translocation mechanism of the Wzx flippase family.

Bumblebees, as social species and efficient pollinators, have attracted the attention of researchers and governments all over the world. However, a comprehensive overview of the bumblebee research field is lacking. This study delves into a bibliometric analysis of the recent 25 years of research with bumblebees from 1999 to 2024. Drawing data from 4119 publications in the Web of Science (WoS) database, it showed a steady increase in number of publications in the recent two decades. Countries in North America, Europe and China formed the three main forces. The hotspots and frontiers were related to decline and health of bumblebees, including combined effects related to climate change, agrochemicals, habitat loss and fragmentation, parasites and disease, and monotonous diets and competition. Additionally, based on co‐cited references cluster analysis, it was concluded that climate change and pesticides will still be the focus research fields in the future. Overall, this paper serves as an exhaustive resource for individuals and governments working intrigued by bumblebee.

In this study, a robust adaptive control strategy using a ${{\mathcal {L}}}$1 theory is applied to fulfil the motion control of a four-wheel electric vehicle. The dynamic model includes longitudinal velocity, lateral velocity, and yaw rate. To develop the proposed control strategy, the vehicle dynamics are decomposed into linear and nonlinear components. The linear part is controlled by fine-tuned state feedback, with its steady-state error addressed by a feedforward control block. The nonlinear part is addressed based on nonlinear adaptive laws and ${{\mathcal {L}}}$1 theory to mitigate adverse effects on the linear dynamics, unwanted parameter changes, and external disturbances. An essential component of the proposed approach is the incorporation of a reference model that dictates the desired system responses. A projection algorithm is used to instantly estimate the nonlinear part of the vehicle dynamics. The performance of the closed-loop system is thoroughly evaluated over a range of vehicle manoeuvres, assessing factors such as steady-state accuracy, transient response, and power consumption. In addition, the effectiveness of the proposed method is compared with conventional model reference adaptive control and a recent robust control approach, particularly in terms of robustness to uncertainties inherent in the nonlinear aspects of vehicle dynamics.

A bstract We generalize recent results in two-dimensional Jackiw-Teitelboim gravity to study factorization of the Hilbert space of eternal black holes in quantum gravity with a negative cosmological constant in any dimension. We approach the problem by computing the trace of two-sided observables as a sum over a recently constructed family of semiclassically well-controlled black hole microstates. These microstates, which contain heavy matter shells behind the horizon and form an overcomplete basis of the Hilbert space, exist in any theory of gravity with general relativity as its low energy limit. Using this representation of the microstates, we show that the trace of operators dual to functions of the Hamiltonians of the left and right holographic CFTs factorizes into a product over left and right factors to leading order in the semiclassical limit. Under certain conditions this implies factorization of the Hilbert space.

Background Heterogeneity of treatment effects (HTEs) can occur because of either differential treatment compliance or differential treatment effectiveness. This distinction is important, as it has action implications, but it is unclear how to distinguish these two possibilities statistically in precision treatment analysis given that compliance is not observed until after randomization. We review available statistical methods and illustrate a recommended method in secondary analysis in a trial focused on HTE. Methods The trial randomized n = 880 anxious and/or depressed university students to guided internet‐delivered cognitive behavioral therapy (i‐CBT) or treatment‐as‐usual (TAU) and evaluated joint remission. Previously reported analyses documented superiority of i‐CBT but significant HTE. In the reanalysis reported here, we used baseline (i.e., pre‐randomization) covariates to predict compliance among participants randomized to guided i‐CBT, generated a cross‐validated within‐person expected compliance score based on this model in both intervention groups, and then used this expected composite score as a predictor in an expanded HTE analysis. Results The significant intervention effect was limited to participants with high expected compliance. Residual HTE was nonsignificant. Conclusions Future psychotherapy HTE trials should routinely develop and include expected compliance composite scores to distinguish the effects of differential treatment compliance from the effects of differential treatment effectiveness.