Title Promoter Affiliations Abstract "Systemic sclerosis and occupational silica or solvent exposure: investigating epidemiology, gene-environment interactions and objective markers of exposure to improve occupational epidemiology, risk assessment and prevention." "Ellen De Langhe" "Skeletal Biology and Engineering Research Center" "Systemic sclerosis is a rare autoimmune disease that can develop in genetically predisposed individuals upon exposure to – at present largely unknown- environmental triggers. The best available evidence supports a link between systemic sclerosis and job exposure to silica or solvents. Due to the rarity of the disease many questions remain open: what is the critical threshold of exposure above which disease will develop? Is intensity of exposure the most important factor or rather the duration, or both? By what mechanism do silica or solvents cause systemic sclerosis? What is the specific genetic background that renders an individual susceptible? Europe has acknowledged that it is a top research priority to elucidate the role of the environment in disease development. This is highly relevant as it would allow for true preventive strategies lowering disease incidence and lead to better understanding of disease processes and identification of new therapeutic targets. In this project, we will perform a large epidemiological study to clarify the association between occupational exposure and systemic sclerosis. We will determine genetic backgrounds to evaluate the relation between exposure, genetics and disease characteristics. We will evaluate objective markers of exposure. This will lead to substantial progress in the field and shed light on the link between environmental exposure and human disease." "Systemic sclerosis and occupational silica or solvent exposure: investigating epidemiology, gene-environment interactions and objective markers of exposure to improve occupational epidemiology, risk assessment and prevention" "Ellen De Langhe" "Skeletal Biology and Engineering Research Center" "ystemic sclerosis can develop in genetically predisposed individuals upon exposure to environmental triggers. We will investigate the association between occupational exposure to silica or solvents and systemic sclerosis. We will determine genetic backgrounds to evaluate the relation between exposure, genetics and disease characteristics. We will evaluate objective markers of exposure. This would allow for true preventive strategies and lead to better understanding of disease processes." "Refinement and validation of the sewage epidemiology approach to estimate illicit drug use in the general population." "Adrian Covaci" "Laboratory Experimental Medicine and Pediatrics (LEMP), Toxicological Centre" "In this post-doctoral mandate, I will validate and refine an innovative approach for estimating illicit drug use in the general population based on sewage analysis for human excretion products of these substances (""sewage epidemiology""). In the first objective of this proposal, I will validate the approach by simultaneously executing a drug consumption questionnaire (thegold standard at this moment) and sewage epidemiology for a well-defined population and time period. The data resulting from both approaches will be compared and can serve as a validation of sewage epidemiology. The second objective focuses on refining sewage epidemiology back-calculations, by addressing the issue of estimating the population contributing to a specific sewage system in an objective, dynamic and real-time way. Different approaches for estimating the real amount of people contributing to a specific sewage system will be based on the analysis of specific markers in sewage that result fromhuman activity. The last objective deals with applying sewage epidemiology for new and innovative purposes, such as the exploratory investigation of the use of new and emerging substances and through the execution of uniformed Europe-wide monitoring studies that allow reliable international comparisons on the epidemiology of illicit drug use. It is expected thatthe successful completion of these objectives will have positive implications for international drug policy and public health." "Compulsary admission in Flanders: epidemiology and decision making." "Joris Vandenberghe" "Research Group Psychiatry" "Een gedwongen opname is een controversieel en maatschappelijk relevant thema en vormt steevast voer voor discussies over wanneer dwang al dan niet mag gebruikt worden, over wanneer veiligheid primeert boven vrijheid, en vice versa. Bovendien is GO op het eerste zicht een maatregel die contrasteert met de huidige tendens tot vermaatschappelijking van zorg, waarin vooral nadruk ligt op patiëntemancipatie, autonomie en zelfbeschikking. De afgelopen jaren waren er geregeld berichtgevingen over GO in de media, die telkens voor maatschappelijke beroering zorgden. Het spreekt voor zich dat een GO een grote impact heeft op een persoon en zijn omgeving.Toch is er zowel in de nationale als in de internationale literatuur weinig specifieke informatie te vinden over de epidemiologische aspecten en het besluitvormingsproces van GO. In meerdere Europese landen, inclusief België, lijkt het aantal GO toe te nemen, in sommige neemt het aantal GO eerder af. Data zijn echter vaak niet beschikbaar, weinig betrouwbaar of kennen weinig consistentie tussen regio’s en landen. Ook op lokaal (Belgisch en Vlaams) vlak moeten de bestaande data met enige voorzichtigheid geïnterpreteerd worden omwille van het niet-consistente gebruik van meetinstrumenten en registratiesystemen, waardoor de cijfers niet door de tijd vergelijkbaar zijn.Wat betreft indicatiestelling voor GO heerst er zowel in het klinische als in het juridische veld discussie over in welke mate middelenabusus overeenstemt met de juridische term ‘geestesziekte’. Reden hiervoor is dat de Belgische wetgeving bindend moet getoetst worden aan het Europees Verdrag van de Rechten van de Mens en de Fundamentele Vrijheden (Raad van Europa, 1950), en hierin middelenabusus (‘…verslaafden aan alcohol of verdovende middelen…’) apart van geestesziekte wordt gedefinieerd. In sommige Europese landen is om diezelfde reden middelenabusus zelfs als exclusiecriterium voor GO geformuleerd. Hiertegenover staat dat in 1998-1999 middelenabusus in België in ¼ blijkt voor te komen als hoofddiagnose bij GO7. In geen enkel ander Europees land zijn de incidentiecijfers van GO omwille van middelenabusus zo hoog als in België.Er zijn verschillende grote tekortkomingen met betrekking tot het bestaande onderzoek rond de epidemiologie en het besluitvormingsproces van GO: 1) Het beperkte internationale onderzoek dat voor handen is is vaak gebaseerd op kleine aantallen en puur descriptief. Statistische toetsing met bivariate en multivariate modellen is bijzonder schaars. 2) Bovendien is de generaliseerbaarheid van buitenlands onderzoek naar de Belgische situatie problematisch omdat het juridisch kader van land tot land verschilt. 3) In België vond nooit eerder een voor een grote regio generaliseerbare kritische en statistische data-analyse plaats met betrekking tot GO in het algemeen of GO specifiek bij middelenabusus. Nochtans kunnen vanuit zulk onderzoek zowel klinische als overheidsaanbevelingen voortvloeien die rechtstreeks gericht zijn op een gerichter beleid ten aanzien van GO, waarbij alternatieven maximaal benut kunnen worden.In een eerste deel van deze studie wensen we specifieke epidemiologische aspecten van GO in het algemeen, en specifiek voor middelenabusus, in Vlaanderen te expliciteren. We wensen te onderzoeken of een stijgende temporele trend in incidentie van GO zich verderzet, en we wensen klinische en niet-klinische variabelen te analyseren. In een tweede deel van deze studie wensen we te achterhalen in welke mate besluitvorming tot GO in het algemeen, en specifiek bij middelenabusus, gestoeld is op de wettelijke criteria, en of er ook andere klinische of niet klinische factoren een rol spelen in de beslissing tot GO." "Epidemiology, outcome, and structural differences of tricuspid valve insufficiency; identification of modifiable variables on right heart hemodynamics and evaluation of medical intervention using non-invasive morphological and functional testing." "Werner Budts" "Cardiac Surgery, Cardiology" "Environmental sampling as a tool to monitor enteric virus epidemiology" "Jelle Matthijnssens" "Laboratory of Clinical and Epidemiological Virology (Rega Institute), Laboratory of Clinical Microbiology" "Our knowledge of the epidemiology of enteric viruses widely relies on testing capacity of clinics and clinical characteristics of infections. However, for only a few enteric viruses (e.g., poliovirus) environmental surveillance (soil and wastewater) is being used to track their existence among a population which leads to many important enteric viruses such as norovirus, rotavirus, and astrovirus being overlooked. In our project, we will use longitudinal wastewater samples from the wastewater treatment plant (WWTP) Leuven of the company Aquafin and air samples from UZ Leuven Daycare Center. To identify the virome of the samples, we will utilize The Novel Enrichment Technique of Viromes (NetoVIR) and use our metagenomics pipeline. Additionally, the COVID-19 pandemic and especially the actions taken to prevent SARS-CoV-2 spread (lockdowns, mask-wearing, and social distancing) have also impacted the spread of other pathogens including rotavirus. We believe that this lack of rotavirus circulation in the seasons 2019-2020 and 2020-2021 could result in a larger pool of infants susceptible to rotavirus infections, and hence we hypothesize a strong rebound of the number of rotavirus cases in Belgium in the subsequent years. Taken together, we hypothesize that the epidemiology of enteric viruses is reflected in environmental samples (sewage and air) and such data can be used as an early warning system for epidemics of enteric viruses. Therefore, this PhD project will be conducted in four main work packages, answering the following questions: 1. What are the long-term effects of the COVID-pandemic on rotavirus epidemiology? 2. Can longitudinal sewage sample analyses be used as a proxy for virus epidemiology or even as an early warning system? 3. Can unbiased analyses of air samples be used to study the epidemiology of enteric viruses? 4. What is the relationship between virus detection in environmental samples and epidemiological surveillance data?" "ICP - Incremental funding Master of Epidemiology" "Jean-Pierre Van geertruyden" "Global Health Institute (GHI), Epidemiology and social medicine (ESOC)" "The Master Epidemiology is unique in Flanders. Students gain the knowledge, skills and competences required to design and conduct epidemiological research to address the etiology, prevention, screening, diagnosis, and treatment of disease and to enhance or maintain health of people and populations. Three fields of epidemiology are covered in depth: infectious disease, clinical and environmental epidemiology. During the first year, the focus is on gaining in-depth knowledge in the fields of epidemiology, statistics and research methods. In addition, students become acquainted with the practice of epidemiology by attending seminars and workplace visits. In the second year, students expand their methodological knowledge in the course Advanced Methods in Epidemiology, learn how to convert theory into practice in the course Public Health, Policy and Practice, and focus on their own research for their Master's thesis." "ICP Connect - Master of Epidemiology" "Jean-Pierre Van geertruyden" "Global Health Institute (GHI)" "The Master Epidemiology is unique in Flanders. Students gain the knowledge, skills and competences required to design and conduct epidemiological research to address the etiology, prevention, screening, diagnosis, and treatment of disease and to enhance or maintain health of people and populations. Three fields of epidemiology are covered in depth: infectious disease, clinical and environmental epidemiology. During the first year, the focus is on gaining in-depth knowledge in the fields of epidemiology, statistics and research methods. In addition, students become acquainted with the practice of epidemiology by attending seminars and workplace visits. In the second year, students expand their methodological knowledge in the course Advanced Methods in Epidemiology, learn how to convert theory into practice in the course Public Health, Policy and Practice, and focus on their own research for their Master's thesis." "An Analysis Framework to Evaluate the Epidemiology of Respiratory Pathologies Using Complex Hierarchical Datasets" "Thomas Neyens" "Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Laboratory of Clinical and Epidemiological Virology (Rega Institute), Academic Center for General Practice" "Triple Aim is a framework aimed at the sustainable organization of healthcare. Three equally important objectives are: (i) improving patient experience (e.g. by focusing on Patient Related Outcome Measures and Patient Related Experience Measures), (ii) improving the health of a particular population (e.g. diabetic persons), and (iii) lowering the healthcare cost per capita. In order to monitor the Triple Aim objectives, a database of health data is required. Intego, a Flemish-Belgian general practice-based morbidity registration network, provides one of the most comprehensive databases of health data. This allows us to investigate the effectiveness of primary care interventions by analyzing the evolution of disease incidence, thereby providing a way to monitor the second objective of Triple Aim. The ultimate goal is to turn the Intego network into a general health monitoring system for the improvement of primary care in Flanders. For the monitoring of the first and third objective of Triple Aim, the Intego database needs to be coupled with other databases. Patient engagement platforms (e.g. Helena®, Meplis®,…) provide information about patients’ experiences with primary care, and data about medical costs are collected in the database of IMA (Intermutualistisch Agentschap). The combined use of these databases with the Intego database will create a data-ecosystem that we intend to use as a general health monitoring system for obtaining a sustainable healthcare system in Flanders. However, this ‘Big Data’ evolution of Intego will pose several challenges that need to be solved. This PhD project will focus on the evaluation of the epidemiology of selected pathologies (e.g. respiratory diseases such as COPD, asthma and pneumonia). Due to ICT changes in the electronic health record used for Intego, there are currently two distinct epidemiological datasets available, namely one that contains data until 2015 and the other starting from 2015. A first objective is therefore to merge the older with the recent database to get an insight in the evolution of selected pathologies. One of the objectives is to obtain a better understanding of the pneumococcal vaccination coverage in Flanders. This linking of databases will allow longitudinal analyses of epidemiological data collected over periods of more than five years. Furthermore, we are interested in studying the spatial dynamics of specific epidemiological outcomes (e.g. disease incidence, vaccination coverage, etc.) over the 60 available distinct primary care zones (PCZs) in Flanders, by using and developing geostatistical and data science methodologies. Primary care zones are new structures that will create the basis for effective integrated care and services in the locality. One such PCZ is a geographically defined area consisting of one or more communities and is managed by a care board. The prime responsibility of these primary care zones is to support and improve multidisciplinary and intersectoral collaboration at practice level. The main challenge will be the coupling of patient-specific data from one database with corresponding data from the most recent database. Since 2017, the study of the impact of environmental pollution on health is of interest. More specifically, we are interested in how environmental factors (e.g. fine dust) affect respiratory diseases and their evolution in time. This PhD project will also further investigate this relation between environmental pollution and respiratory health using the Intego database in combination with other databases." "Genetic diversity and molecular epidemiology of hantaviruses" "Piet Maes, Marc Van Ranst" "Laboratory of Clinical and Epidemiological Virology (Rega Institute)" "Hantaviruses are zoonotic pathogens responsible for hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS) after human transmission. Pathogenic hantaviruses primarily have rodents as their reservoir, with humans acting as an accidental dead-end host. The actual hantavirus host range appears to be much broader with hantaviruses detected in shrews, moles, bats, reptiles, and fish. In Western, Northern, and Central Europe, Puumala virus, that has the bank vole as their natural host, is the most prominent causative agent of HFRS. At the moment, no effective antivirals and WHO-prequalified vaccines are available, making identification of local outbreaks and prevention of subsequent infections the most effective response. As zoonotic agents, hantaviruses are strongly influenced by changes in ecological and environmental factors and much effort is invested in identifying these drivers, what could aid in estimating the effective infection risk. Characterization of short-term evolution can help uncover recent virus dynamics and their influencing factors while investigating long-term evolution could provide insights into the evolutionary mechanisms shaping the relationship between hantaviruses and their hosts. This thesis attempts to characterize PUUV dynamics and factors influencing the human infection risk in Belgium. In addition, the genetic diversity and evolutionary history of non-rodent hantaviruses in Belgium are described."