ORCID Profile
0000-0001-8186-0237
Current Organisations
KU Leuven
,
University Hospitals Leuven
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Publisher: Elsevier BV
Date: 08-2020
Publisher: Copernicus GmbH
Date: 03-2023
DOI: 10.5194/GMD-2023-7
Abstract: Abstract. The Australian Bureau of Meteorology has developed a national hydrological projections (NHP) service for Australia. With the focus on hydrological change assessment, the NHP service aims at being complementary to climate projections work carried out by many federal and state governments, universities, and other organisations across Australia. The projections comprise an ensemble of application-ready bias-corrected climate model data and derived hydrological projections at daily temporal and 0.05° × 0.05° spatial resolution for the period 1960–2099 and two emission scenarios (RCP 4.5 and RCP 8.5). The spatial resolution of the projections matches that of gridded historical reference data used to perform the bias correction and the Bureau's operational gridded hydrological model. Three bias correction techniques were applied to four CMIP5 global climate models (GCMs) and one to output from a regional climate model forced by the same four GCMs, resulting in a 16-member ensemble of bias-corrected GCM data for each emission scenario. The bias correction was applied to fields of precipitation, minimum and maximum temperature, downwelling shortwave radiation and surface winds. These variables are required inputs to the Bureau's landscape water balance hydrological model (AWRA-L) which was forced using the bias-corrected GCM and RCM data to produce a 16-member ensemble of hydrological output. The hydrological output variables include root-zone soil moisture (moisture in the top 1 m soil layer), potential evapotranspiration and runoff. Here we present an overview of the production of the hydrological projections, including GCM selection, bias correction methods and their evaluation, technical aspects of their implementation and ex les of analysis performed to construct the NHP service. The data are publicly available on the National Computing Infrastructure (0.25914/6130680dc5a51) and a user interface is accessible at awo.bom.gov.au roducts rojection/.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2020
Publisher: Springer Science and Business Media LLC
Date: 15-01-2021
DOI: 10.1038/S41598-021-81035-8
Abstract: Magnetization transfer ratio (MTR) and brain volumetric imaging are (semi-)quantitative MRI markers capturing demyelination, axonal degeneration and/or inflammation. However, factors shaping variation in these traits are largely unknown. In this study, we collected a longitudinal cohort of 33 multiple sclerosis (MS) patients and extended it cross-sectionally to 213. We measured MTR in lesions, normal-appearing white matter (NAWM), normal-appearing grey matter (NAGM) and total brain, grey matter, white matter and lesion volume. We also calculated the polygenic MS risk score. Longitudinally, inter-patient differences at inclusion and intra-patient changes during follow-up together explained 70% of variance in MRI, with inter-patient differences at inclusion being the predominant source of variance. Cross-sectionally, we observed a moderate correlation of MTR between NAGM and NAWM and, less pronounced, with lesions. Age and gender explained about 30% of variance in total brain and grey matter volume. However, they contributed less than 10% to variance in MTR measures. There were no significant associations between MRI traits and the genetic risk score. In conclusion, (semi-)quantitative MRI traits change with ongoing disease activity but this change is modest in comparison to pre-existing inter-patient differences. These traits reflect in idual variation in biological processes, which appear different from those involved in genetic MS susceptibility.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 13-02-2023
DOI: 10.1111/JON.13084
Abstract: Two early basilar artery occlusion (BAO) randomized controlled trials did not establish the superiority of endovascular thrombectomy (EVT) over medical management. While many providers continue to recommend EVT for acute BAO, perceptions of equipoise in randomizing patients with BAO to EVT versus medical management may differ between clinician specialties. We conducted an international survey (January 18, 2022 to March 31, 2022) regarding management strategies in acute BAO prior to the announcement of two trials indicating the superiority of EVT, and compared responses between interventionalists (INTs) and non‐interventionalists (nINTs). Selection practices for routine EVT and perceptions of equipoise regarding randomizing to medical management based on neuroimaging and clinical features were compared between the two groups using descriptive statistics. Among the 1245 respondents (nINTs = 702), INTs more commonly believed that EVT was superior to medical management in acute BAO (98.5% vs. 95.1%, p .01). A similar proportion of INTs and nINTs responded that they would not randomize a patient with BAO to EVT (29.4% vs. 26.7%), or that they would only under specific clinical circumstances ( p = .45). Among respondents who would recommend EVT for BAO, there was no difference in the maximum prestroke disability, minimum stroke severity, or infarct burden on computed tomography between the two groups ( p .05), although nINTs more commonly preferred perfusion imaging (24.2% vs. 19.7%, p = .04). Among respondents who indicated they would randomize to medical management, INTs were more likely to randomize when the National Institutes of Health Stroke Scale was ≥10 (15.9% vs. 6.9%, p .01). Following the publication of two neutral clinical trials in BAO EVT, most stroke providers believed EVT to be superior to medical management in carefully selected patients, with most indicating they would not randomize a BAO patient to medical treatment. There were small differences in preference for advanced neuroimaging for patient selection, although these preferences were unsupported by clinical trial data at the time of the survey.
Publisher: The Journal of Rheumatology
Date: 02-2021
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JOCN.2016.10.018
Abstract: Telestroke services have been shown to increase stroke therapy access in rural areas. The implementation of advanced CT imaging for patient assessment may improve patient selection and detection of stroke mimics in conjunction with telestroke. We implemented a telestroke service supported by multimodal CT imaging in a rural hospital in Australia. Over 21months we conducted an evaluation of service activation, thrombolysis rates and use of multimodal imaging to assess the feasibility of the service. Rates of symptomatic intracranial haemorrhage and 90-day modified Rankin Score were used as safety outcomes. Fifty-eight patients were assessed using telestroke, of which 41 were regarded to be acute ischemic strokes and 17 to be stroke mimics on clinical grounds. Of the 41 acute stroke patients, 22 patients were deemed eligible for thrombolysis. Using multimodal CT imaging, 8 more patients were excluded from treatment because of lack of treatment target. Multimodal imaging failed to be obtained in one patient. For the 14 treated patients, median door-imaging time was 38min. Median door-treatment time was 91min. A 90-day mRS ⩽2 was achieved in 40% of treated patients. We conclude that a telestroke service using advanced CT imaging for therapy decision assistance can be successfully implemented in regional Australia and can be used to guide acute stroke treatment decision-making and improve access to thrombolytic therapy. Efficiency and safety is comparable to established telestroke services.
Publisher: Springer Science and Business Media LLC
Date: 06-07-2018
Publisher: Oxford University Press (OUP)
Date: 18-06-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-03-2021
DOI: 10.1212/WNL.0000000000011885
Abstract: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] −11.7 to −11.3, p 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI −13.8 to −12.7, p 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI −13.7 to −10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2–9.8, p 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.
Publisher: American Society of Neuroradiology (ASNR)
Date: 27-07-2023
DOI: 10.3174/AJNR.A7956
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JSTROKECEREBROVASDIS.2017.03.020
Abstract: Patients with acute ischemic stroke and large vessel occlusion (LVO) may benefit from prehospital identification and transfer to a center offering endovascular therapy. We aimed to assess the accuracy of an existing 8-item stroke scale (National Institutes of Health Stroke Scale-8 [NIHSS-8]) for identification of patients with acute stroke with LVO. We retrospectively calculated NIHSS-8 scores in a population of consecutive patients with presumed acute stroke assessed by emergency medical services (EMS). LVO was identified on admission computed tomography angiography. Accuracy to identify LVO was calculated using receiver operating characteristics analysis. We used weighted Cohen's kappa statistics to assess inter-rater reliability for the NIHSS-8 score between the EMS and the hospital stroke team on a prospectively evaluated subgroup. Of the 551 included patients, 381 had a confirmed ischemic stroke and 136 patients had an LVO. NIHSS scores were significantly higher in patients with LVO (median 18 interquartile range 14-22). The NIHSS-8 score reliably predicted the presence of LVO (area under the receiver operating characteristic curve .82). The optimum NIHSS-8 cutoff of 8 or more had a sensitivity of .81, specificity of .75, and Youden index of .56 for prediction of LVO. The EMS and the stroke team reached substantial agreement (κ = .69). Accuracy of the NIHSS-8 to identify LVO in a population of patients with suspected acute stroke is comparable to existing prehospital stroke scales. The scale can be performed by EMS with reasonable reliability. Further validation in the field is needed to assess accuracy of the scale to identify patients with LVO eligible for endovascular treatment in a prehospital setting.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Massachusetts Medical Society
Date: 11-11-2021
Publisher: Ubiquity Press, Ltd.
Date: 2022
DOI: 10.5334/JBSR.2891
Publisher: Massachusetts Medical Society
Date: 29-06-2023
No related grants have been discovered for Jelle Demeestere.