Climate change is one of the largest challenges faced by humanity. To combat this research into alternatives to fossil fuels is ongoing. Dihydrogen is considered a good alternative fuel, since its... Show moreClimate change is one of the largest challenges faced by humanity. To combat this research into alternatives to fossil fuels is ongoing. Dihydrogen is considered a good alternative fuel, since its burning only forms water. A promising means of acquiring dihydrogen is photocatalysis, which can be driven by sunlight. This involves water oxidation and proton reduction, both half-reactions require a catalyst and photosensitizer, generally metal complexes. The limited aqueous solubility and stability of these complexes poses a challenge in their application. In this thesis we investigated the use artificial metalloenzymes (ArMs) for the catalysis and photosensitization of both half-reactions. ArMs can improve the aqueous solubility of these catalysts and provide a second coordination sphere that can be used to improve the stability and activity. The ArMs in this thesis were prepared using the axial coordination of a catalyst or photosensitizer to a protein via histidine. We set up an effective screening method for this coordination using semi-native PAGE. We then prepared and characterized one of the first ArMs with photocatalytic water oxidation activity. We prepared eight photosensitizing ArMs, of which two also able to catalyse hydrogen evolution. Two of these ArM systems were entirely earth-abundant metal-based and showed good activity. Show less
In this thesis, we describe the potential of cell mechanical phenotyping for immune cell characterization, diagnosis, drug testing, as well as treatment of disease.
This dissertation examines the educational positions of children of immigrants in the Netherlands from 1980 to 2020. In particular, the influence of migration background and socioeconomic factors... Show moreThis dissertation examines the educational positions of children of immigrants in the Netherlands from 1980 to 2020. In particular, the influence of migration background and socioeconomic factors on educational positions is studied. Findings reveal substantial progress in education for migrant children overall, especially among the second generation, younger cohorts, and girls with a migrant background, indicating promising upward mobility within the education system for many of these children. The family environment impacts educational outcomes, with socioeconomic background playing a crucial role. Higher parental incomes correlate with higher education levels for children in both the short and long term. Additionally, the living environment affects outcomes such as school dropout rates, especially among boys from migrant backgrounds in larger cities. They are more prone to leaving education prematurely than their female or non-migrant peers. Despite institutional barriers and discrimination within the education system, these children demonstrate an upward trend in education, highlighting the need for further research incorporating discrimination as a factor. Show less
Mucosal melanomas (MM) are malignant tumours arising from melanocytes located at the mucosal lining of the head and neck region or the respiratory, gastrointestinal, anorectal, or genital tract.... Show moreMucosal melanomas (MM) are malignant tumours arising from melanocytes located at the mucosal lining of the head and neck region or the respiratory, gastrointestinal, anorectal, or genital tract. Due to the low incidence the disease is still poorly understood and management is mostly based on guidelines of cutaneous melanoma (CM). Survival of patients with MM is poor and regardless of stage is worse than that of CM. This is explained by the advanced stage at diagnosis and high recurrence rates of MM. Moreover, whilst immunotherapeutic agents have revolutionized the therapeutic landscape in CM, in MM, the efficacy is low and survival has not improved since the introduction of these therapies.The MM located at the vulva (VMM) account for 60% of the female genital tract MM and together with the head and neck region are the most common locations of MM. In line with the MM located at all other locations, prognosis is poor. Whilst the majority of the patients is diagnosed with local disease, the aggressive course of disease is demonstrated by the high recurrence rates with short time to recurrence with a median overall survival of 33 months. To improve outcomes in MM, there is a critical need for clinical trials specifically designed for this disease and international collaboration. Show less
This thesis starts with a literature review on the observation of aggression, then describes the development and implementation of an Observation Checklist in 2 Dutch Juvenile Justice Institutions ... Show moreThis thesis starts with a literature review on the observation of aggression, then describes the development and implementation of an Observation Checklist in 2 Dutch Juvenile Justice Institutions (JJI) and concludes with two papers researching the added value of data harvested with this tool, both for risk assessment and cultural sensitive assessment. Show less
The growing number of older patients presenting to Emergency Departments (EDs) requires better risk stratification to guide treatment and dispositiondecisions. Therefore, it is essential to... Show moreThe growing number of older patients presenting to Emergency Departments (EDs) requires better risk stratification to guide treatment and dispositiondecisions. Therefore, it is essential to understand the effect of age on the associations between physiological variables and outcomes. More importantly, most risk tools are not age or sex adjusted and are not based on a statistical approach. An age and sex adjusted risk tool could improve risk stratification in the ED.This thesis is divided into three parts and has four aims, regarding ageadjusted interpretation of physiological variables for risk stratification in ED patients, developing a new age- and sex-adjusted risk tool for the hospital, and describing potential bias if risk tools are used for comparing the quality of care among departments. Show less
There is an increasing number of adults who suffer from cardiovascular diseases (CVD). These patients would benefit from a healthy lifestyle, as this improves the prognosis of CVD. However, even... Show moreThere is an increasing number of adults who suffer from cardiovascular diseases (CVD). These patients would benefit from a healthy lifestyle, as this improves the prognosis of CVD. However, even though improving one’s health and lifestyle is the focus of cardiac rehabilitation, CVD patients need support to also maintain a healthy lifestyle after their rehabilitation has ended. Even though the support of a healthcare professional seems to be an important factor in successful lifestyle change, there are barriers that hinder professionals from providing lifestyle support, such as a lack of time or expertise. Since the involvement of healthcare professionals is also not always possible or desirable, it is important to further investigate possibilities to provide patients with a self-help eHealth intervention. In such self-help eHealth interventions, feedback is automatically provided, making the interference of a healthcare professional no longer needed. However, self-help eHealth interventions can suffer from a low uptake and a low level of adherence. This PhD dissertation therefore focuses on (1) mapping out the needs and wishes of both healthcare professionals and CVD patients with regard to (human-supported and self-help) eHealth lifestyle interventions, and (2) investigating if and how self-help eHealth lifestyle interventions could be optimised. Show less
Molecular materials have been a subject of interest in fundamental research and applications for decades, and have been studied as bulk crystals, (thin) films and as individual molecules, due to... Show moreMolecular materials have been a subject of interest in fundamental research and applications for decades, and have been studied as bulk crystals, (thin) films and as individual molecules, due to the large variety in their properties. This dissertation explores pentacene crystals near the two-dimensional limit, i.e. in films of one to a few monolayers, primarily using an experimental technique called Low Energy Electron Microscopy (LEEM). We utilize the interaction of low-energy electrons with the molecular layers to learn about the properties of the layers, and also employ low-energy electrons as an external stimulus to create controlled changes in the properties of the sample. We study the real-time dynamics of growth of pentacene layers on various substrates. We study beam irradiation damage to molecular layers due to exposure to low-energy electrons, with implications for technological processes such as electron-beam lithography. We study photoemission and secondary electron emission from the molecular layers and highlight the critical role of unoccupied electronic band structure above the vacuum level in these processes. Finally, we present the design of, as well as the first scientific measurements in, a cryogenic sample chamber for LEEM that enables novel experiments addressing questions in surface science and condensed matter physics. Show less
Cognitive processes play an important role in human mate choice. However, far less is known about this topic in non-human animals. In this thesis, I take a comparative approach to sexually... Show moreCognitive processes play an important role in human mate choice. However, far less is known about this topic in non-human animals. In this thesis, I take a comparative approach to sexually selective cognition by studying humans (Homo sapiens) and Bornean orang-utans (Pongo pygmaeus). I start by reviewing the literature on sexually selective cognition. Hereafter, I show that visual, but not auditory or olfactory attractiveness, plays a major role in initial human mate choice. Furthermore, I show that attractiveness has a profound influence on visual attention in humans, and that attentional biases towards attractive conspecifics may be associated with mate choice. I explore the same topic in Bornean orang-utans by presenting them with stimuli of fully developed males or males experiencing arrested development. The results of these studies suggest that orang-utans preferentially attend to fully developed males, but only in the eye-tracking task and not in touchscreen tasks. The last chapter explores vocalisations, and suggests that orang-utan mate preferences might reflect in female vocal behaviour. Altogether, the results of this thesis suggest that humans and orang-utans show cognitive biases towards mate-relevant traits. However, better understanding of the link between such biases and actual mate choice remains of pivotal importance. Show less
Adverse drug reactions on sexual functioning (sADRs) may seriously decrease a person's quality of life. This topic is barely discussed in healthcare practice, partly because of little knowledge... Show moreAdverse drug reactions on sexual functioning (sADRs) may seriously decrease a person's quality of life. This topic is barely discussed in healthcare practice, partly because of little knowledge about the association between drugs and sexual function. Research in this thesis supplements this knowledge with quantitative methods, identifying drugs associated with sADRs and taking the first steps in characterizing the population with these drugs in use. In the second part of the thesis, qualitative methods were used to describe the current practice and the potential role of healthcare providers regarding sADRs in primary care, especially in the community pharmacy. With the acquired knowledge, materials have been developed for primary healthcare providers to discuss and agree on local policy about sADRs in their own region. Initial experiences with these materials showed greater awareness of the subject among the healthcare providers concerned. Show less
The Base Erosion and Profit Shifting (BEPS) Project was initiated by the Organization for Economic Co-operation and Development and G20 in 2013 to address tax avoidance schemes used by... Show moreThe Base Erosion and Profit Shifting (BEPS) Project was initiated by the Organization for Economic Co-operation and Development and G20 in 2013 to address tax avoidance schemes used by multinational enterprises (MNEs). Drawing on interviews with a range of tax policy stakeholders, this book analyses the BEPS Project’s impact on developing countries’ approaches to combatting international tax avoidance, developing novel typologies to categorize policies and conducting case studies in Colombia, India, Nigeria, and Senegal. Contrary to public communication surrounding it, the BEPS Project does not endorse any kind of approach against tax avoidance, but puts an emphasis on finely delineating responses rather than blunt measures to tackle the problem. However, blunter approaches have been used more often by developing countries due to limited administrative resources. Examining countries’ responses, this research uncovers that the BEPS Project has influenced approaches to transfer pricing, albeit with delays and varied enforcement. The study also reveals discrepancies in addressing treaty shopping, showcasing measures beyond BEPS recommendations that countries adopt when revenue losses are high. The findings further show that the interplay between different governmental departments is pivotal in shaping policy responses to tax avoidance. Show less
The aim of this thesis is to develop noise robust electrical properties tomography (EPT) reconstruction methods that are free from tissue transition artifacts to support clinical applications for... Show moreThe aim of this thesis is to develop noise robust electrical properties tomography (EPT) reconstruction methods that are free from tissue transition artifacts to support clinical applications for complex tissue structures such as the brain. In particular the contrast-source inversion approach is pursued. This focus of this thesis is on the reconstruction of the electrical properties from the transmit field of radiofrequency coils most frequently available in magnetic resonance imaging. Show less
Parental socialization refers to the process through which parents transmit values and beliefs to their children. During this process, children learn to understand the world and shape their social... Show moreParental socialization refers to the process through which parents transmit values and beliefs to their children. During this process, children learn to understand the world and shape their social functioning. The impact of parental socialization can vary across different cultures. My research focuses on family interactions within Chinese cultures, emphasizing the importance of cultural nuances when examining the role of parental behaviors in children's social development. The study utilized samples of Chinese children and their parents, employing various research methods, including observations, interviews, and questionnaires. The findings indicated that Chinese mothers' psychological control had a relatively minor negative effect on children's emotion regulation and social anxiety. Additionally, the research revealed racism and colorism among Chinese children, which were associated with mothers' color-evasive socialization behaviors. Chinese mothers did not avoid talking about racial appearance and cultural background, which contrasts with studies in White Western populations where most White mothers showed color evasion. Chinese mothers’ acknowledgement of shared culture predicted children’s positive attitudes towards their own racial ingroup with a darker skin tone. My research underscores the unique features of Chinese culture that play a pivotal role in shaping the nature and consequences of parental socialization on children's social functioning. It highlights that Western theories related to parenting and color-evasive socialization may need adaptation when applied to non-Western cultural contexts. Show less
Metabolomics has the potential to play a pivotal role in understanding disease onset and progression, and ultimately personalized treatments. One of its major challenges is its large-scale... Show moreMetabolomics has the potential to play a pivotal role in understanding disease onset and progression, and ultimately personalized treatments. One of its major challenges is its large-scale implementation, which is necessary to deal with the high variability of the metabolome. In this work we have developed tools for automated sample handling and preparation for metabolomics analysis, and bioanalysis in general. The tools are versatile, suitable for high-throughput, and able to deal with sensitive and biomass-limited samples. Sample transfer through segmented-flow can accommodate a wide range of samples and volumes, and can work seamlessly with many downstream processing or analysis. Two sample preparation tools based on droplets; one universal preconcentration tools using controlled evaporation, and one based on simultaneous extraction and enrichment, also provide a versatile interface and can be used to bridge gaps between processing steps. The working principles of these sample handling and preparation tools are universal and can be adapted for specific applications. Show less
This thesis contributes to the evidence-base of the influence of patient factors, surgical approach and implant design on outcomes after total hip replacement (THA).A systematic review (SR) shows... Show moreThis thesis contributes to the evidence-base of the influence of patient factors, surgical approach and implant design on outcomes after total hip replacement (THA).A systematic review (SR) shows that there is strong evidence for BMI, age, comorbidity, preoperative functioning and mental health as predictors of physical functioning. A predictive model based on data from this thesis emphasizes preoperative functioning, mental health and pain as predictors.To treat hip fractures, the posterolateral (PLA) and direct lateral surgical approach (DLA) are the most commonly used. The PLA may cause more dislocations, but seems to result in less walking problems and abductor insufficiency than the DLA. All investigated surgical approaches for primary THA resulted in a significant improvement in patient reported outcome measures (PROMs). The anterior and posterolateral approaches provided greater improvement in physical function and pain, but clinical differences were small.A multicenter randomized trial comparing two hip stems is described. No significant difference has been demonstrated between the Collum Femoris Preserving (CFP) and Zweymüller stem in physical function at 5 years or implant survival at 12 years, although CFP may be inferior in cup revisions. A SR suggests lower dislocation rates and revisions for dual mobility cups in THA, but high quality evidence is lacking. Therefore, we designed an RCT comparing dual mobility cups with unipolar cups in older patients.In addition to providing insights into the influence of patient, surgical and implant characteristics on outcome after (total) hip arthroplasty, this thesis provides suggestions for the design of future clinical trials. Show less
This research concerns the role of metabolic sensor AMPK, which is activated during low energy levels, and known to suppress the activation of some immune cells. I studied how AMPK regulates the... Show moreThis research concerns the role of metabolic sensor AMPK, which is activated during low energy levels, and known to suppress the activation of some immune cells. I studied how AMPK regulates the function of dendritic cells (DCs), immune cells that are key regulators of the adaptive immune response. Key findings include that drug-induced AMPK activation in DCs results in metabolic rewiring that leads to immunosuppressive DCs. Furthermore, we show that the AMPK signaling axis in DCs is important for protection against obesity-induced inflammation, while AMPK in DCs inhibits the anti-tumor immune response and thereby promoting tumor growth. Therefore, AMPK activation in DCs may be a promising strategy for the generation of therapeutic tolerogenic DCs, while AMPK inhibition may be beneficial for DC-based cancer therapies. Together, these findings contribute to a better understanding of AMPK as regulator of immunity and tolerance in dendritic cells. Show less
Utilizing the polymeric platform of polypept(o)ides, this thesis describes synthesis and investigation of novel triblock copolymers to obtain carrier systems with multiple compartments for... Show moreUtilizing the polymeric platform of polypept(o)ides, this thesis describes synthesis and investigation of novel triblock copolymers to obtain carrier systems with multiple compartments for efficient siRNA delivery. Although the individual microstructure of nanoparticles differs depending on the polymeric building blocks, desired application and cargo, the final nanoparticles always combine a polysarcosine (pSar) shell with a polypeptide core, providing the ability of siRNA complexation by a polycationic segment. In addition, a third block enabled either covalent cross-linking, hydrophobic / π- π-stacking mediated stabilization or co-encapsulation of small hydrophobic drugs. Broadening the structural variety of such polypept(o)ides, a novel synthetic procedure was introduced to access AA'B- and ABC-type miktoarm star polymers.Investigations have been dedicated to the design of novel polymeric structures based on polypept(o)ides, to improve the delivery of siRNA by Polyion Complex Micelles (PICMs), provide access to different polymeric architectures, and to establish novel synthetic methods for the synthesis of these materials. Covering aspects from the synthesis of novel polymeric species up to advanced drug delivery strategies for siRNA in vivo, developments throughout this thesis extent the accessibility of the polypept(o)ide platform for nucleic acid delivery, highlight their potential in nanomedicine and further elaborate delivery strategies for next-generation nanomedical applications. Show less
The thesis assess the robustness of 4D flow MRI for analyzing aortic hemodynamics and valvular flow, as well as exploring the clinical potential of this technique in patients with aortic and... Show moreThe thesis assess the robustness of 4D flow MRI for analyzing aortic hemodynamics and valvular flow, as well as exploring the clinical potential of this technique in patients with aortic and valvular disease. The first part of the thesis evaluates the reproducibility of segmenting the aortic lumen and calculating various hemodynamic parameters, demonstrating that these processes can be performed accurately and consistently. The second part examines the natural course of aortic hemodynamics during aging, concluding that hemodynamic parameters remain relatively stable. Furthermore, different hemodynamic phenotypes are identified in patients with aortic root and ascending aortic dilatation, possibly explaining the presence of dilatation. Show less
The outbreaks of AIDS and COVID-19 showed clearly how infectious viruses can influence people’s lives. Investigating the changes in the host metabolism may provide a paradigm shift to consider... Show moreThe outbreaks of AIDS and COVID-19 showed clearly how infectious viruses can influence people’s lives. Investigating the changes in the host metabolism may provide a paradigm shift to consider immune-metabolic interactions as therapeutic targets. The aim of this thesis is to examine the interplay between the immune system and metabolism during viral infections, such as HIV and coronavirus. These investigations will utilize metabolomic and lipidomic mass spectrometry techniques to gain a comprehensive understanding of the metabolic changes that occur during viral infections. To enhance the coverage of the lipidome, a new method will be developed. Show less