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See detailGouverner la maternité au Bénin. Les difficiles conditions d'application des politiques sanitaires dans le territoire de la Pendjari
Sambiéni, N'Koué Emmanuel ULg

Doctoral thesis (2012)

La Zone Sanitaire de Tanguiéta, partie intégrante du système de santé au Bénin, expérimente, depuis la décentralisation de ce système, la gestion autonome de l’offre de soins de santé moderne dans toutes ... [more ▼]

La Zone Sanitaire de Tanguiéta, partie intégrante du système de santé au Bénin, expérimente, depuis la décentralisation de ce système, la gestion autonome de l’offre de soins de santé moderne dans toutes ses dimensions. Elle est particulièrement ingénieuse dans la production d’initiatives de soins au profit des mères engagées dans l’enfantement, avec le soutien de l’Etat et des partenaires du secteur de la santé. Cet engagement est justifié officiellement par la situation critique des indicateurs de Santé Maternelle traduisant une morbidité et une mortalité élevées. La ZST est tout d’abord un espace socioculturel d’une particularité remarquable, comparée au reste du pays, du fait même de sa position géographique, de son identité culturelle pendjarienne et de son histoire sociopolitique. C’est de son identité socioculturelle et sociopolitique qu’elle revendique son autonomie technico-administrative dans la fourniture des soins de santé. La curiosité intellectuelle de cette recherche socioanthropologique est de comprendre comment la demande et les soins aux femmes qui « veulent donner la vie » sont véritablement « structurés » et « gouvernés » dans cet espace socioculturel et médical. « Habitus maternel » et « gouvernementalité» sont utilisés à la fois comme concepts et comme postures méthodologiques et épistémologiques afin de décrypter et d’analyser « l’ordre » et « le progrès » dans ces logiques et pratiques obstétricales. Suivant une méthodologie essentiellement qualitative, la recherche a duré quatre ans, avec une longue présence sur le terrain, consistant en des observations dans les maternités et dans les familles ainsi que des entretiens avec les différents acteurs participant aux soins. Cette recherche nous apprend que dans l’ordre traditionnel, l’enfantement a été historiquement et socialement géré par des institutions laissant une place assez faible à l’expression de l’individu, qu’il soit le père ou la mère de l’enfant en construction bio-sociale. A l’heure actuelle, les maternités modernes ont toujours du mal à prendre le pas sur ces institutions dans le contrôle des soins avant, pendant et après l’accouchement. Malheureusement, affaiblies par les différentes influences sociales, ces institutions apparaissent socialement et techniquement incapables de contenir et de régler le mal de la grossesse et de l’accouchement. La maternité, tant dans son état traditionnel que moderne, demeure encore morbide et mortelle. L’Etat et ses institutions d’encadrement et d’offre de soins maternels, peu connectés aux réalités socioculturelles, s’avèrent constamment dépendants des agences des Nations Unies et des autres partenaires privés, producteurs de stratégies le plus souvent d’ordre idéologique et militant. La Stratégie Nationale de Réduction de la Mortalité Maternelle et Néonatale et l’Initiative Femme pour Femme, respectivement élaborées au Ministère de la Santé et au niveau de la Zone Sanitaire, révèlent le rendez-vous manqué dans la rencontre programmée entre usagers des maternités et offre de soins dans la planification sanitaire. La maternité, avec ses multiples acteurs en négociation permanente sans consensus, est conflictuelle et souvent détournée de sa mission. Elle empile régulièrement des stratégies tout en chassant constamment ses premiers bénéficiaires et en mettant les enjeux sanitaires en arrière-plan. Pour une « Maternité Sans Risques » dans les espaces traditionnel et moderne, il faudra chercher et comprendre comment, dans la nébuleuse des institutions qui les gèrent dans ces deux registres, les femmes peuvent renforcer leurs positions légitimes dans la négociation pour l’orientation des soins obstétricaux essentiels et d’urgence. Il conviendra enfin d’étudier les conditions pour une lecture effective du risque obstétrical dans l’environnement social des femmes. [less ▲]

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See detailHow to optimally load a set of containers into an aircraft
Schyns, Michael ULg; Limbourg, Sabine ULg; Laporte, Gilbert

E-print/Working paper (2012)

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See detailValidation of Analytical Methods
Rozet, Eric ULg; Hubert, Philippe ULg

Scientific conference (2012, January 10)

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See detailMachine learning-based feature ranking: Statistical interpretation and gene network inference
Huynh-Thu, Vân Anh ULg

Doctoral thesis (2012)

Machine learning techniques, and in particular supervised learning methods, are nowadays widely used in bioinformatics. Two prominent applications that we target specifically in this thesis are biomarker ... [more ▼]

Machine learning techniques, and in particular supervised learning methods, are nowadays widely used in bioinformatics. Two prominent applications that we target specifically in this thesis are biomarker discovery and regulatory network inference. These two problems are commonly addressed through the use of feature ranking methods that order the input features of a supervised learning problem from the most to the less relevant for predicting the output. This thesis presents, on the one hand, methodological contributions around machine learning-based feature ranking techniques and on the other hand, more applicative contributions on gene regulatory network inference. Our methodological contributions focus on the problem of selecting truly relevant features from machine learning-based feature rankings. Unlike the p-values returned by univariate tests, relevance scores derived from machine learning techniques to rank the features are usually not statistically interpretable. This lack of interpretability makes the identification of the truly relevant features among the top-ranked ones a very difficult task and hence prevents the wide adoption of these methods by practitioners. Our first contribution in this field concerns a procedure, based on permutation tests, that estimates for each subset of top-ranked features the probability for that subset to contain at least one irrelevant feature (called CER for "conditional error rate"). As a second contribution, we performed a large-scale evaluation of several, existing or novel, procedures, including our CER method, that all replace the original relevance scores with measures that can be interpreted in a statistical way. These procedures, which were assessed on several artificial and real datasets, differ greatly in terms of computing times and the tradeoff they achieve in terms of false positives and false negatives. Our experiments also clearly highlight that using model performance as a criterion for feature selection is often counter-productive. The problem of gene regulatory network inference can be formulated as several feature selection problems, each one aiming at discovering the regulators of one target gene. Within this family of methods, we developed the GENIE3 algorithm that exploits feature rankings derived from tree-based ensemble methods to infer gene networks from steady-state gene expression data. In a second step, we derived two extensions of GENIE3 that aim to infer regulatory networks from other types of data. The first extension exploits expression data provided by time course experiments, while the second extension is related to genetical genomics datasets, which contain expression data together with information about genetic markers. GENIE3 was best performer in the DREAM4 In Silico Multifactorial challenge in 2009 and in the DREAM5 Network Inference challenge in 2010, and its extensions perform very well compared to other methods on several artificial datasets. [less ▲]

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See detailLe travailleur migrant
Pieret, Denis ULg

Conference given outside the academic context (2012)

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See detailPlasmon-Enhanced Sub-Wavelength Laser Ablation: Plasmonic Nanojets
Valev, V.K.; Denkova, D.; Zheng, X. et al

in Advanced Materials (2012), 24

Plasmonic hotspots are regions on the surface of metal nanostructures where light causes very strong oscillation of the electrons. Because electron oscillations constitute an electric current and because ... [more ▼]

Plasmonic hotspots are regions on the surface of metal nanostructures where light causes very strong oscillation of the electrons. Because electron oscillations constitute an electric current and because electric currents heat up the material the same way an electric stove heats up in the kitchen, the plasmonic hotspots are extremely hot. So hot that they can melt the gold in a spot much smaller than the wavelength of light. We were successfully able to demonstrate that this tiny little pool of molten gold can give rise to the smallest nanojets ever observed. [less ▲]

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See detailResearch on crude protein and digestibility of Arnica montana L. using conventional NIR spectrometry and hyperspectral imaging NIR
Dale, Laura ULg; Fernandez, Juan Antonio; Vermeulen, Philippe et al

in Journal of Food, Agriculture & Environment (2012), 10(1), 391-396

Arnica montana L. (AM) is considered a medicinal plant, used as hay in feed ration. The aim of this study is to assess the prediction of protein content and in vitro organic matter digestibility value in ... [more ▼]

Arnica montana L. (AM) is considered a medicinal plant, used as hay in feed ration. The aim of this study is to assess the prediction of protein content and in vitro organic matter digestibility value in grass mixtures containing Arnica montana L., and in a second step to check if these values have a positive or negative influence in the mixtures. Crude protein has been selected because it is one of the most important quality parameters of forages as nutritional element used in animal feeding. The protein is required on a daily basis for maintenance, lactation, growth and reproduction, but is important for agriculture too, because a high content of protein makes it an important source of feed. The digestibility is also important, because it refers to the extent to which a feedstuff is absorbed in the animal body as it passes through an animal’s digestive tract. In this study, the Weende system (the Kjeldahl method) for the protein content, together with the enzymatic technique for digestibility, was applied and used in combination with non-destructive methods, like those based on the Near Infrared Spectroscopy (NIRS) or the Near Infrared Hyperspectral Imaging. Based on NIR imaging system data, the PLS-DA was used to discriminate between the classes with AM and classes without AM, as well as to build a model that could be used to predict the composition of mixtures. More than 99% correct prediction for AM was obtained. The crude protein content of the hay determined by classical method decrease from the type of meadow Agrostis capillaris L. - Festuca rubra L. (15.22%) until to the pure sample of Arnica montana L. (11.19%); however, the digestibility was highest in the pure sample of Arnica montana L. (84.13%) and lowest in samples from the type of meadow Agrostis capillaris L. - Festuca rubra L. (57.18%) or in samples with the participation of Arnica montana L. This study should lead to a more important point, which is to verify whether the medicinal properties of Arnica montana L. can be transferred or not to milk production through the dairy cow feed. [less ▲]

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See detailA convenient route for the dispersion of carbon nanotubes in polymers: Application to the preparation of electromagnetic interference (EMI) absorbers
Thomassin, Jean-Michel ULg; Vuluga, Daniela; Alexandre, Michaël ULg et al

in Polymer (2012), 53(1), 169-174

A new dispersion technique has been implemented which consists in the polymerization of a monomer in the presence of CNTs in a bad solvent of the polymer. During its formation, the polymer precipitates ... [more ▼]

A new dispersion technique has been implemented which consists in the polymerization of a monomer in the presence of CNTs in a bad solvent of the polymer. During its formation, the polymer precipitates and entraps all the CNTs. Thanks to the establishment of a suitable CNTs dispersion, this method promotes much higher electrical conductivity in the resulting nanocomposite than more conventional techniques, i.e. melt-mixing and co-precipitation. Moreover, the quantity of solvent required is much lower than in the co-precipitation method that makes this process industrially viable. One potential application of these nanocomposites has been demonstrated by the preparation of foams using the supercritical CO2 technology that present very high electromagnetic interference (EMI) absorbing properties since more than 90% of the incoming power being absorbed in the foam. [less ▲]

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See detailLower-Order Effects Adjustment in Quantitative Traits Model-Based Multifactor Dimensionality Reduction
Mahachie John, Jestinah ULg; Cattaert, Tom ULg; Van Lishout, François ULg et al

in PLoS ONE (2012)

Identifying gene-gene interactions or gene-environment interactions in studies of human complex diseases remains a big challenge in genetic epidemiology. An additional challenge, often forgotten, is to ... [more ▼]

Identifying gene-gene interactions or gene-environment interactions in studies of human complex diseases remains a big challenge in genetic epidemiology. An additional challenge, often forgotten, is to account for important lower-order genetic effects. These may hamper the identification of genuine epistasis. If lower-order genetic effects contribute to the genetic variance of a trait, identified statistical interactions may simply be due to a signal boost of these effects. In this study, we restrict attention to quantitative traits and bi-allelic SNPs as genetic markers. Moreover, our interaction study focuses on 2- way SNP-SNP interactions. Via simulations, we assess the performance of different corrective measures for lower-order genetic effects in Model-Based Multifactor Dimensionality Reduction epistasis detection, using additive and co-dominant coding schemes. Performance is evaluated in terms of power and familywise error rate. Our simulations indicate that empirical power estimates are reduced with correction of lower-order effects, likewise familywise error rates. Easy-to-use automatic SNP selection procedures, SNP selection based on ‘‘top’’ findings, or SNP selection based on p-value criterion for interesting main effects result in reduced power but also almost zero false positive rates. Always accounting for main effects in the SNP-SNP pair under investigation during Model-Based Multifactor Dimensionality Reduction analysis adequately controls false positive epistasis findings. This is particularly true when adopting a co-dominant corrective coding scheme. In conclusion, automatic search procedures to identify lower-order effects to correct for during epistasis screening should be avoided. The same is true for procedures that adjust for lower-order effects prior to Model-Based Multifactor Dimensionality Reduction and involve using residuals as the new trait. We advocate using ‘‘on-the-fly’’ lower-order effects adjusting when screening for SNP-SNP interactions using Model-Based Multifactor Dimensionality Reduction analysis. [less ▲]

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See detailL’État burkinabè, le “droit à l'éducation” et les enfants au travail
Wouango, Joséphine ULg

Conference (2012, January 05)

« L’enseignement de base est obligatoire pour tous les enfants de six ans à seize ans », ainsi stipule l’article 4 de la Loi d’Orientation de l’Éducation au Burkina Faso. Dans cette communication, nous ... [more ▼]

« L’enseignement de base est obligatoire pour tous les enfants de six ans à seize ans », ainsi stipule l’article 4 de la Loi d’Orientation de l’Éducation au Burkina Faso. Dans cette communication, nous partirons d’une expérience d’offre et de demande scolaire dans une zone rurale du centre-est du Burkina Faso. Nous verrons comment l’école, de par son fonctionnement interne et sa structuration, a transformé l’engouement en désaffection. Cette expérience rurale n’est pas isolée. Elle nous permet ensuite d’interroger le système scolaire burkinabè contemporain : ses curricula, son fonctionnement interne, sa sélection et sa finalité. Enfin, nous examinerons dans quelle mesure cette école-là peut être une alternative au “travail des enfants”, dont l’élimination semble être une priorité politique depuis une quinzaine d’années. La présente communication s’inspire d’une recherche doctorale en cours. [less ▲]

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See detailFlux avalanches triggered by AC magnetic fields in superconducting thin films
Motta, M; Colauto, F; Johansen, TH et al

in Physica C (2012), 479

Flux avalanches are known to occur as a consequence of thermomagnetic instabilities. Some of their fingerprints are jumps in magnetization curves, or a paramagnetic reentrance in AC susceptibility ... [more ▼]

Flux avalanches are known to occur as a consequence of thermomagnetic instabilities. Some of their fingerprints are jumps in magnetization curves, or a paramagnetic reentrance in AC susceptibility measurements. In this work we have studied flux avalanches triggered by an AC field cycle by means of AC susceptibility and residual magnetization after an applied AC field measured as a function of an AC excitation field (h). These measurements allow comparing both results with magneto-optical imaging carried out in similar conditions. The results show a correspondence for the onset of the avalanche activity, as well as between the residual magnetic moment and the mean gray value calculated from the magneto-optical images in the remanent state. [less ▲]

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See detailHow the DNA damage response determines the fate of HTLV-1 Tax-expressing cells
Boxus, Mathieu ULg; Willems, Luc ULg

in Retrovirology (2012), 9(2),

How the Human T lymphotropic virus type 1 (HTLV-1) Tax protein stimulates proliferation while triggering cell cycle arrest and senescence remains puzzling. There is also a debate about the ability of Tax ... [more ▼]

How the Human T lymphotropic virus type 1 (HTLV-1) Tax protein stimulates proliferation while triggering cell cycle arrest and senescence remains puzzling. There is also a debate about the ability of Tax to activate or inhibit the DNA damage response. Here, we comment on these different activities and propose a conceptual rationale for the apparently conflicting observations. [less ▲]

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See detailInteraction of HTLV-1 Tax with minichromosome maintenance proteins accelerates the replication timing program
Boxus, Mathieu ULg; Twizere, Jean-Claude ULg; Legros, Sébastien et al

in Blood (2012), 119

The Tax oncoprotein encoded by the Human T-cell leukemia virus type 1 (HTLV-1) plays a pivotal role in viral persistence and pathogenesis. HTLV-1 infected cells proliferate faster than normal lymphocytes ... [more ▼]

The Tax oncoprotein encoded by the Human T-cell leukemia virus type 1 (HTLV-1) plays a pivotal role in viral persistence and pathogenesis. HTLV-1 infected cells proliferate faster than normal lymphocytes, expand through mitotic division and accumulate genomic lesions. Here, we show that Tax associates with the minichromosome maintenance MCM2-7 helicase complex and localizes to origins of replication. Tax modulates the spatiotemporal program of origin activation and fires supplementary origins at the onset of S phase. Thereby, Tax increases the DNA replication rate, accelerates S phase progression but also generates a replicative stress characterized by the presence of genomic lesions. Mechanistically, Tax favors p300 recruitment and histone hyperacetylation at late replication domains advancing their replication timing in early S phase. [less ▲]

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See detailProblématisation et conceptualisation de la notion de médiation à travers ses usages
Servais, Christine ULg

Scientific conference (2012, January 05)

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See detailDMFSGD: A Decentralized Matrix Factorization Algorithm for Network Distance Prediction
Liao, Yongjun ULg; Du, Wei; Geurts, Pierre ULg et al

Report (2012)

The knowledge of end-to-end network distances is essential to many Internet applications. As active probing of all pairwise distances is infeasible in large-scale networks, a natural idea is to measure a ... [more ▼]

The knowledge of end-to-end network distances is essential to many Internet applications. As active probing of all pairwise distances is infeasible in large-scale networks, a natural idea is to measure a few pairs and to predict the other ones without actually measuring them. This paper formulates the distance prediction problem as matrix completion where unknown entries of an incomplete matrix of pairwise distances are to be predicted. The problem is solvable because strong correlations among network distances exist and cause the constructed distance matrix to be low rank. The new formulation circumvents the well-known drawbacks of existing approaches based on Euclidean embedding. A new algorithm, so-called Decentralized Matrix Factorization by Stochastic Gradient Descent (DMFSGD), is proposed to solve the network distance prediction problem. By letting network nodes exchange messages with each other, the algorithm is fully decentralized and only requires each node to collect and to process local measurements, with neither explicit matrix constructions nor special nodes such as landmarks and central servers. In addition, we compared comprehensively matrix factorization and Euclidean embedding to demonstrate the suitability of the former on network distance prediction. We further studied the incorporation of a robust loss function and of non-negativity constraints. Extensive experiments on various publicly-available datasets of network delays show not only the scalability and the accuracy of our approach but also its usability in real Internet applications. [less ▲]

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See detailExtent of paleofires and past human settlements in the current rainforest patchwork of the Northern Republic of Congo
Gillet, Jean-François ULg; Doucet, Jean-Louis ULg

Poster (2012, January 04)

Objectives The origins of the patchwork of lowland semi-deciduous forests in the Northern Republic of Congo were apprehended. The aim of this study was to show that dense forests suffered fewer ... [more ▼]

Objectives The origins of the patchwork of lowland semi-deciduous forests in the Northern Republic of Congo were apprehended. The aim of this study was to show that dense forests suffered fewer disturbances than the open canopy forest types. Old disturbances associated with fires and human settlements seem to have had and still have today a substantial impact on the physiognomy and the composition of the forest types. Understanding past forest dynamics is a major component to predict the effects of both present climate change and human activities. Method Fifteen locations were studied along a 400-km-long SW-NE gradient in the NW of the Congo Basin through the ERA-net BiodivERsA CoForChange project. An anthraco-archaeological study was carried out in association with floristic inventories of three strata. Two main geology substrates were considered: the Mesozoic sandstones and Quaternary alluvial deposits. The abundance of charcoal fragments and human artifacts were evaluated by a network of 1-m-deep boring augers (n =208) and a 1.5-m-deep reference soil pit (n =15) in each site. A rating system was used to quantify the abundance of charcoal, charred Elaeis guineensis seeds and other artifacts (ceramic and metallurgic slag). Estimations were based on 20-cm-depth intervals (augers) or on pedological layers (pits). Twelve radiocarbon dating were performed in the major disturbed layers of each vegetation type studied. Results Two main groups of vegetation were highlighted according to the relative openness of the woody stand, the importance of the woody regeneration, and the development of the herbaceous cover. The two dense forests sampled were preferentially found in the northern part: the dense forest with Manilkara mabokeensis and Haumania dankelmaniana, and the Gilbertiodendron dewevrei forest on dry land. Most parts of the understorey exhibited the woody regeneration. The southern part presented more openness including the largest areas of open canopy vegetation types. Three forest types were identified: the Macaranga barteri pioneer forest, the open canopy vegetation type with Aframomum and Marantaceae, and the sparse forest with Megaphrinium macrostchyum and/or Haumania liebrestisiana. The understorey was a dense thicket of giant herbs belonging to the families Marantaceae and Zingiberaceae, causing a very scarce woody regeneration. Regardless the auger depth, charcoals were more profuse in the soils of the southern open canopy vegetation types (2-Way ANOVA, F=5.46, p=0.02). As in pit layers, charred oil palm nuts were more plentiful in the soils of these vegetation types (Mann-Whitney test, p<0.05). Of the five sites containing artifacts, only one recent potsherd dated 466-302 BP was located in dense forest but near a main river. The oldest signs of ceramic and metallurgical activities dated 2160-1407 BP were found in the current open canopy vegetation types. Within the latter, two expansion phases of the oil palm tree E. guineensis were observed: between 2146-1055 BP and 558-347 BP. Conversely, the oldest palaeofire was discovered in the M. mabokeensis dense forest and dated at 5467-5285 BP. Conclusions The dense forests contained less evidence of ancient fires and human settlements. They currently include evergreen and shade-tolerant tree species such as G. dewevrei and M. mabokeensis. The more sustained and repeated fires in the open canopy vegetation types were often associated with ancient human occupation. Today, the light-demanding giant herbaceous species such as Aframomum sp. and M. macrostchyum proliferate in the understorey below a simplified woody component of pioneer species such as M. barteri. The largest expansion phases of the oil palm tree E. guineensis in the southern part would be linked to ancient human occupation associated with larger canopy openings and fire events. The water availability, more evenly distributed near the heavily-irrigated Congo Basin, would also be a discriminating factor. [less ▲]

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See detailDynamique associative et réduction de la pauvreté rurale: une étude comparative de villages inégalement couverts par des Organisations Non Gouvernementales dans la province du Bandundu et dans l’hinterland de Kinshasa.
Nganda Afumba, Jean Pierre ULg

Doctoral thesis (2012)

Comme bon nombre de pays en développement, la République Démocratique du Congo observe, depuis le début des années 90, un développement sans précédent du mouvement associatif, particulièrement des ... [more ▼]

Comme bon nombre de pays en développement, la République Démocratique du Congo observe, depuis le début des années 90, un développement sans précédent du mouvement associatif, particulièrement des organisations non gouvernementales de développement. Dans un environnement où les pouvoirs publics sont quasi inexistants, ces dernières sont considérées par certains comme des instruments efficaces de réduction de la pauvreté, et par d’autres comme des opportunistes évoluant aux dépens de la misère des gens. La présente recherche se propose de faire une étude comparative entre, d’une part, des ménages de deux villages de l’hinterland de Kinshasa largement couverts par des ONG, et d’autre part, des ménages de deux autres villages dans le Bandundu ne bénéficiant d’aucune intervention d’ONG. Cette étude a pour but la compréhension, l’analyse et l’appréciation empirique de la pertinence de la stratégie de développement et de réduction de la pauvreté rurale orientée vers la promotion des organisations associatives du type ONG, et in fine suggère un outil susceptible d’améliorer les interventions visant la réduction de la pauvreté rurale. [less ▲]

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See detailPain perception in disorders of consciousness: Neuroscience, clinical care, and ethics in dialogue
Demertzi, Athina ULg; Racine, Eric; Bruno, Marie-Aurélie ULg et al

in Neuroethics (2012)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we ... [more ▼]

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. [less ▲]

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