bluuebunny/crossref_metadata_2025 huggingface dataset:
Organic Hydroponic Farming Incorporated with Recycles Water
Authors: Jerusha S , Anand A V , Adarsh J , Chandra Kumar K R , Vishnu Saravana Bharathi
Published: May 2021

Recent The cultivation of flora by way putting the root in liquid nutrient solution is referred to as Hydroponic. Agriculture is the backbone of the growing us of like India, agriculture is disturbed with the aid of number of issues like manures, pesticides, small and fragmented land holdings, chemical used for plant growth etc. Hydroponics can be a higher idea to unravel these difficulties and moreover with the aid of using hydroponics we can go organic. Hydroponics is the quickest developing zone of agriculture and it is the technique of creating vegetation life in liquid with delivered vitamins on the other hand besides soil. The whole manner can be finished in room terrace, balcony and additionally in closed environment. Since it can be extended vertically, it has a acquire that many numbers of plants can be planted in a limited space. The plant boom is monitored weekly as soon as for the yield purpose. Since the drift of the used and smooth water for the watering the plant is automatic, few integral parameters like water level indicator, pH sensor, Automatic water dropper and DC motor. These parameters are controlled by Arduino board. Hence the plant is grown by way of capability of Eco-friendly method.
Improved Air Quality Testing Using Kalman Filter Based on IoT Data Fusion for Smart Cities
Authors: Vadivelu R , Santhakumar G , Boopana V P , Dharani S. , Bharathi S Dhivya , Balasubramaniam D
Published: May 2021

Monitoring the amount of gases in air in smart cities provides immature gas emissions, polluting concentrations and filtering are examined in this paper. Air contamination is a worry in numerous metropolitan territories and is a critical reason for respiratory issues for some individuals. Monitoring the quality of air aids in the prevention of emission of gases and also the reduction of disease caused by pollution. A System has been developed to measure the values of CO2, NH3, and CH4 gases and therefore the parameters are sent via the ESP8266 Wi-Fi module through which we can monitor the concentration of the gases by tracking the IP address via IoT and also implemented a Kalman filter which purify the polluted air.
IoT Based Industrial Waste Water Monitoring and Recycling
Authors: Kalirajan K , Nambiar M Vignesh , Vinodhini K , Ramya E
Published: May 2021

In this rapidly urbanising country, environmental safety management has recently become the most challenging challenge. Waste water management is a way to treat waste that is reasonably reused and does not belong to the trash. Reducing and recycling is one of the most efficient ways to handle waste. Waste water treatment firms have been dealing with a slew of issues for decades based on how to prevent waste being managed Separating wastes that are discarded in the water, such as paints and battery wastes, is difficult, because they need a special method to classify and recycle. To address these issues, we turned to the Internet of Things (IoT) for a waste managing system. It is simple to detect polluted mixed in water using IoT, which can be indicated to the consumer and recycled.. In this way they can be made harmless and is again used. This concept’s utility is illustrated in the article.
5G Antipodal Reconfigurable Base Station Antenna for Modern automobile tracking applications
Authors: Kumar S Satheesh , Rithanesh V D , Sharan K , Sidharth T
Published: May 2021

This paper presents antipodal dipole antenna which is also a base station antenna which is highly suitable for tracking an automobile especially cars/trucks. This antenna contains 4 planes, including the reflector plane, brick on which two poles are present. The Gain of the antenna is around 6.9 to 7.1 dB based on the width of the dipole of the antenna. The directivity remains the same in all width of the dipoles and the S11 parameters values changes as of the width of the dipole. Comparatively the antenna has a good gain and S11 values in frequency 6.5 GHz at the dipole width of 4mm. This antenna finds its way in medical fields to improve the communication inside the automotive vehicles. The proposed antenna is a reconfigurable antenna, which has good gain at multiple frequencies. The reconfigurable is made possible using Metamaterials. The Antipodal structure of the antenna is due to presence of multiple planar types in the antipodal structure of the antenna. Even if the frequency not properly received by the antenna, the reflector plane reflects the frequency towards the one plane at the back of the brick, so the gain is maintained at a desired level.
Smart Traffic Assistance System for Ambulance Vehicles using Internet of Things
Authors: Bharathi K. Maignana , Siddharth S. Suman , Uthirasamy R
Published: May 2021

The traffic lights also referred to as traffic signals are used to provide assistance in controlling city traffics and streamlining the present traffic situations. The traffic lights are used since 1868. They are employed by traffic sergeant to avoid congestion and to concern about the right flow of traffic in cities. As years passed, these lights are evolved with automatic controls, pedestrian supporters and so on. There are several standards followed in implementation and design. The intelligent traffic light controller is designed to develop a traffic signal based on avoidance of traffic congestion and also innovative control to clear the traffic for emergency vehicle. The ambulance would have a transmitter within it, which would transmit a signal to the receiver side, this will enable green signal in the corresponding pole. The light of the signal is controlled by automatic timers which are built in by discrete components. Arduino boards are used to control the automatic timers. This module helps to save the lives of many people as well as to avoid congestion.
Quality Control and Communication in Smart Grid Using IED & PLCC
Authors: Ovaiz Mohammed , Katta Pradeep , Senthil Kumar R , Jaya Prakash K , Santhosh S , Sathish Kumar K
Published: May 2021

In the era of growing power demand and power networks, continuous supply of power and data exchanges is inevitable nurturing the implementation of smart grid technology. The smart grid is a self-healing technology which promises the electricity consumers to be an active participant. However, Intelligent Electronic Device (IED) supports the SG as the backbone for operation imparting the functionalities such as protection and monitoring the power networks. But the limitations of the common IED are its finite allocation of functions without modifying its hardware. Moreover, these IEDs confront the communication problems during natural calamities and other network failures as it adopts the cellular communication topology. The limitations mentioned above can be overcome by adopting the flexible IEDs integrated with signal conditioning, filtering and discretization functions along with the implementation of Power Line Carrier communication. The flexible IED and the PLCC extends the scalability of the most reliable and highly efficient smart grid architecture.
Energy Management Optimization in a Hybrid Energy Storage System for Electrical Vehicle Transportation
Authors: Sijini Aarim C , Nivetha K , Ganesan S , Imran M S , Vignesh E
Published: May 2021

The various application such as hybrid electric vehicles, operating devices based on renewable energy, devices used for storage of energy make use hybrid energy storage system. The main purpose of hybrid energy storage system is to provide stable power and supply power to the particular application. The proposed idea in this paper is suitable for different application which are having high voltage gain or high output dc-link voltage, low-power and multi-output applications. This paper have an idea to design and control the power flow of a hybrid energy storage system. This make use of soft switching modulated dc – dc converter in the secondary side. This paper implement extended zero voltage switching range. In this paper Energy Management Optimization in a Hybrid Energy Storage System for Electrical Vehicle Transportation is simulated using Simulink model
Simulation and Measurement of Conducted Emission in DC-DC convertor
Authors: Uma Maheswari Y. , Amudha A. , Kumar L. Ashok , Nagasaravanan K. , Sundaram Mohana , Dhayaneswaran Y.
Published: May 2021

In recent days testing of a product with the EMI standard using test set up is a mandatory as most of the product has the electronic circuitries which possess the high-speed signals. This paper discusses about the conducted emission and the implementation of filters for mitigating the conducted electromagnetic emissions. A DC-DC Buck converter which can be used in vehicle electronics was simulated using the software tool with and without filter and the results were analyzed for mitigating the conducted electromagnetic emission.
Smart voting using Fingerprint, Face and OTP Technology with Blockchain
Authors: Katta Pradeep , Mohammed Ovaiz A , Prabaakaran K , Divya M , Jayashree G , Keerthika D
Published: May 2021

As we all know India is a largest democratic country, the best form of our government is one which allows the citizen to cast the vote and elect the leader of their choice. The future of our country and fate of citizens all lies in a single vote. Traditionally we used ballot papers to vote and the votes are counted manually, which consume excess of time. Then ballot papers are replaced by electronic voting machine as it consumes large time to count the votes and due to the error involved in the manual counting process. The electronic voting machine gives quick publication of result which is accurate. The one that are temporarily out of their voting stations will have difficulties in casting their votes. The online voting should be adopted, as the current process is not flexible for voter’s convenience, online voting will increase the number of voter’s participation in the election. The proposed system will give trust and confidence to voters that the proposed voting system will provide protection to votes and as well as who cast their votes. In our proposed system, we have altered level of safety in voting process which provides reliable and secure voting. They are iris recognition, finger print and OTP. Next the voting portal is accessed and vote is encrypted by the blockchain end to end encryption.
Inductive Load power factor Correction using Capacitor Bank
Authors: Shanmugapriya M , Sijini Aarim C , Srinivas V T , Karthick M , Pavan S
Published: May 2021

At this time, efficient power generation is critical because power leakage is a global problem. The power factor of a machine tests its power efficiency and is a significant factor in improving supply quality. A low power factor caused by high lot of utilises of inductive load is often ignored in the majority of control systems. A power factor correction unit will enable the system’s power factor to be restored to near unity for cost-effective operation. Reduced power system losses, enhanced load carrying capabilities, improved voltages, and other benefits of power factor correction are only a few of the benefits. The aim of this program is to develop an Power Factor Correction Unit which can monitor a system’s energy consumption and increase its power factor. For accurate power measurement, an open source energy monitoring library was used in the design. The energy monitor unit measures the reactive strength absorbed by a load network and uses capacitor bank to compensate for the lagging power factor.
Certain Investigation on IOT Based Smart Pill Carafe in Health Care
Authors: Vignesh  , Gopalan S Harihara , Arokia Mary Celsia J , Indumathy N , Harida A
Published: May 2021

During recent years, many technologies has been evolved for health care. It helps in quick recovery of patients in healthcare. As the population is increasing, the need of health prevention is also increasing day by day. In order to improve the patient health and to treat dehydration a bottle of saline is fed to the patient. Whenever a saline is fed to the patients, the care taker/nurse has to continuously monitor the patient. Assessing and managing of saline, good care for the patients are the most important thing in health care. The responsibility for monitoring the Glucose bottle levelis done bycare taker/nurse. The saline bottle should be checked and changed periodically. But, due to their busy schedule the nurse/caretaker may forget to change. In order to overcome this critical situation a system is designed to monitor the glucose bottle smartly is proposed using GSM( Global System for Mobile Communication). When the intravenous fluid level is below certain limit the IR sensor output voltage level changes based on the principle. The message output is compared continuously using comparator with a threshold value. When the liquid level reaches to its threshold value, the alert will be given through the LCD display. It will also provide intimation to the mobile phone with the help of GSM.
Mobile Application in Rental Batteries for Electronic Vehicles
Authors: Supriya M , Sangeetha V S , Subhasini A , Vaishnav M
Published: May 2021

People nowadays are more or less familiar with buying and selling batteries. But have not really experienced batteries renting or service systems online. Here we are going to develop an application for the users to get benefits of lending, renting, selling and buying a battery through an application. Also, this application make use of people to rent batteries for various reasons including Electronic Vehicles (EV). This Application contains list of Batteries that are available for the customer, and also acts as a one stop solution for all battery related problems. The Customer has another advantage that they can easily find service centers for batteries nearby. Especially in India, the production rate and Consumers of Electronic Vehicles are fairly increasing each and every day. This Application will create a better impact amongst people and will be a Boon factor for customers.
Arduino based firefighting Robot
Authors: Kirubakaran S , Rithanyaa S P , Thanavarsheni S P , Vigneshkumar E
Published: May 2021

A fire fighter’s work entails detecting and extinguishing fires. In this rapidly evolving technological age, the world is gradually moving toward automated systems. Firefighters, on the other hand, are often in danger of losing their lives. The majority of the deaths were caused by toxic gases found in the firefighting environment. As a result, in order to resolve these issues, our system was developed.
Medicine Lending Machine for Elderly Patients
Authors: Suresh C , Sri Krishna P , Shalini D , Rakeshraj J , Rajeshkumar N.
Published: May 2021

In this fast moving life style almost everything around us are getting automated. This in turn greatly reduces the time taken for a work and also increases efficiency. An automatic medicine lending machine is one that helps the patients and uneducated people to keep track on their medical pills in a timely manner. This machine contains containers that contain loaded pills that can be dispensed in timely manner. Major components in this machine are stepper motor, large storage space and inventory monitoring system. All these are monitored by a program fed microcontroller. This machine also contains the alarm system which reminds the patient to take pills at correct time. This machine also has a data storage system which stores the exact date and time that the patient took the medicine from the medical box. From the above concept we can conclude that, this medicine lending machine is feasible for elderly patients to take the medicines by alerting them at the right time.
Power Theft Recognition and data security in Smart Meter Reading of a Smart Grid
Authors: Vineeth V V , Ambrish V , Haricharann D V , Harshini V , Abilash C
Published: May 2021

Smart meter is an important component of smart grid environment has enormous features like precise measurement and possibility of two way communication among the entities involved in grid. Nevertheless, it has distinctive features like intricate structure, resource constriction and confidential sensitive data. These features make a meter structure more susceptible for attack and error. Power theft is identified as a major threat in meter infrastructure. Several literature has found to study this issue in detail because it poses a great threat to the overall grid architecture. This paper investigates the major thefts and threats in such an environment and identifies the essential safety prerequisites to be maintained by a smart meter. A risk model is identified using attack characteristics to figure out major risks. Different class of power theft detection mechanisms are analysed and reviewed to precisely define and understand the attack vulnerability in smart meters.
Anti-Theft Fuel Level Detector with Vehicle Tracking
Authors: Udhaya Kumar A , Vishnukanth S , Deepak kumar A , Nandalal V , Sathishkumar N
Published: May 2021

The appearance, deployment, as well as the evaluation of a computing device for the Fleet Management Solution including trucks that transport fuel are presented in this article. The key aim is to build a framework that can track the backlog instantaneously. The approach are imagined any road tankers that transport petrol transport End customers, such as service stations, get petrol in oil warehouses. However, as code, this technique is reliant on hardware. Shipment electronics, Diy on-board, Wireless communications, and Gp modules are all included. make up the hardware version 0.5. whereas LabView is used for data functions in PC code 0.5. This approach proposes the use of an Automatic Electronic System (AES) to replace manual fuel monitoring. This system tests fuel volume and sends the details to the owner’s cell phone as well as the owner’s device through the GSM network. It also offers a tool for identifying stealing or fraud incidents in the event of gasoline robbery or discharge. Furthermore, the device will monitor the activities every carrier transporting energy in order to determine the location of any incidents Which should have occurred.. Thanks to inadequate and easy-to-acquire electronic elements, this approach allows for automated backlog tracking and tracking at a lower cost. GSM, GPS, AES, and ARDUNIO are some of the terminology used in this article.
Fake News Detection on Social Media Using Machine Learning
Authors: Santhosh Kumar A , Kalpana P , Sharan Athithya K , Sri Ajay Sundar V
Published: May 2021

The project examines the techniques behind detecting “fake news”, i.e. misleading news stories from trustworthy sources. The invention of the World Wide Web and the wide embracing of social media networks (such as Facebook, Twitter) opened the way for information sharing that has never before been seen in human history. The use of social media sites is becoming more independent as a forum for information creation and sharing than ever before. Some of the users are confusing and impractical. It’s no easy task to design a system that automatically highlights an article as dishonest or even misleading. You can tell if an email is reliable even if you are not an expert. And an authority in a particular area needs to go through the process of finding out the facts before reaching a judgement of what is true or not. Reviews suggest the use of the classifier algorithm to plump-up the detection of news stories via machine learning. But these models don’t represent the basic quality of language, such as word order and importance of words. It is very likely that two articles would have the same word count, but would have total differences in their content. The information technology group (information science) wasting in response to the matter. Fiercely each combatting the fake news may be a classical text classification effort that offers a simple proposal. There is a good deal of evidence that may be used for constructing a model of false news or real news. One suggestion is a kind of a Naive Bayes grouping, where articles that are deceptive, speculative, imaginative, or fresh or without researched supporting information may be considered one thing, while those that are measured as fully supported true information may be considered the other.
Co-mutation modules capture the evolution and transmission patterns of SARS-CoV-2
Authors: Qin Luyao , Ding Xiao , Li Yongjie , Chen Qingfeng , Meng Jing , Jiang Taijiao
Published: May 2021

The rapid spread and huge impact of the COVID-19 pandemic caused by the emerging SARS-CoV-2 have driven large efforts for sequencing and analyzing the viral genomes. Mutation analyses have revealed that the virus keeps mutating and shows a certain degree of genetic diversity, which could result in the alteration of its infectivity and pathogenicity. Therefore, appropriate delineation of SARS-CoV-2 genetic variants enables us to understand its evolution and transmission patterns. By focusing on the nucleotides that co-substituted, we first identified 42 co-mutation modules that consist of at least two co-substituted nucleotides during the SARS-CoV-2 evolution. Then based on these co-mutation modules, we classified the SARS-CoV-2 population into 43 groups and further identified the phylogenetic relationships among groups based on the number of inconsistent co-mutation modules, which were validated with phylogenetic trees. Intuitively, we tracked tempo-spatial patterns of the 43 groups, of which 11 groups were geographic-specific. Different epidemic periods showed specific co-circulating groups, where the dominant groups existed and had multiple sub-groups of parallel evolution. Our work enables us to capture the evolution and transmission patterns of SARS-CoV-2, which can contribute to guiding the prevention and control of the COVID-19 pandemic. An interactive website for grouping SARS-CoV-2 genomes and visualizing the spatio-temporal distribution of groups is available at https://www.jianglab.tech/cmm-grouping/.
DOP08 Serum proteomics predict endoscopic remission in patients with Crohn’s Disease
Authors: Alsoud D , Sudhakar P , Sabino J , Ferrante M , Verstockt B , Vermeire S
Published: May 2021

Background

Recent progress in deciphering the complex pathogenesis of Crohn’s disease (CD) has yielded several effective biologicals. However, ambitious therapeutic goals remain unfulfilled as almost 30% of patients are primary non-responders to a particular biological. This underscores the need for easy-to-implement biomarkers that predict (non-)remission. We aimed to identify serum protein biomarkers that predict endoscopic remission in CD patients.

Methods

Serum samples from 169 consecutive CD patients with active endoscopic disease (presence of ulcerations) before starting a biological [infliximab (IFX), adalimumab (ADA), vedolizumab (VDZ) or ustekinumab (UST)] to which they were naïve were collected. Patients were prospectively followed with endoscopic re-assessment after 6–12 months. There were 102 patients (Table 1) with endoscopic remission (SES ≤ 2 or disappearance of all ulcers), whereas 67 showed no improvement. Two independent and complementary proteomic platforms were used: 644 proteins belonging to predesigned assays were quantified using Proximity Extension Assay (PEA) technology (Olink Proteomics AB, Sweden). Second, wide protein discovery mass spectrometry (MS)-based technic (Caprion, Canada) was used and quantified another 985 proteins. A multivariate modelling framework was then applied on a randomly selected training sub-cohort (85%). Predictive performance of identified panels was assessed on the remaining test sub-cohort (15%). We sought to implement the same framework on the drug-specific subgroups; however, train/test splitting was not possible in IFX or ADA subgroups due to very few observations in the non-remission arms which diminishes the possibility for reliable predictive modelling.

Results

Applying the modelling framework on training sets from the general cohort, VDZ subgroup and UST subgroup, proteomic panels were selected and consisted of 26, 6 and 8 proteins, respectively, and showed high performance in the test sets (Table 2). VDZ and UST panels shared only 2 proteins each with the general panel, and had no predictive power (accuracy ≤ 0.5) when used to predict other subgroups, making them specific to their respective drugs. Selected proteins are involved among others in pro-inflammatory, extracellular matrix modelling, coagulation and cellular-vascular interaction pathways (Table 3).

Conclusion

Applying a multivariate machine learning algorithm on a wide pool of serum proteomics analysed through two discovery technics, we were able to identify 3 proteomic panels that can predict endoscopic (non)remission in patients with CD. Exact implication of these proteins in intestinal inflammation and a validation in an independent cohort is being further investigated.
DOP90 Physician global assessment of IBD Activity is associated with COVID-19 severity in patients aged less than 50 years
Authors: Ricciuto A , Lamb C , Benchimol E I , Walker G , Kennedy N , Kuenzig M E , Kaplan G , Griffiths A M , Reinisch W , Sebastian S
Published: May 2021

Background

SECURE-IBD is an international database that monitors COVID-19 outcomes in IBD patients. We examined the influence of IBD activity (reflected by Physician Global Assessment (PGA)) on COVID-19 severity, while exploring the modifying effect of age.

Methods

We analyzed 3,028 cases reported to SECURE-IBD from March 13-November 17, 2020. PGA was categorized as remission/mild (reference) vs moderate vs severe. Outcomes used as surrogates of severe SARS-CoV2 infection were hospitalization and a composite of ICU/ventilation/death. Using generalized estimating equations (GEE) to account for clustering by country, we determined the unadjusted association between disease activity and COVID-19 outcomes, overall and by age decade. We included the following covariates in multivariable GEE models a priori: time of COVID-19 diagnosis, age, sex, comorbidities (0, 1, ≥2), IBD type, systemic corticosteroids (CS), anti-TNF monotherapy, anti-TNF plus immune modulator, immune modulator monotherapy, and mesalamine. We included additional covariates (country GDP, race, BMI, anti-integrins and ustekinumab) if they changed the estimate by ≥10%. We also built models stratified by age; the age cut-off for stratification was determined using Joinpoint regression (selecting the age at which outcome rates significantly changed).

Results

COVID-19 was more severe in patients with more active IBD: hospitalization rates 19% (remission/mild), 26% (moderate) and 45% (severe); ICU/ventilation/death rates 5% (remission/mild), 6% (moderate) and 12% (severe) (p<0.05, Figure 1). In unadjusted analyses, higher PGA was associated with an increased risk of hospitalization (moderate: OR 1.53, 95% CI 1.24–1.88; severe: OR 3.30, 95% CI 2.44–4.46) and ICU/ventilation/death (moderate: OR 1.44, 95% CI 1.10–1.87; severe: OR 2.58, 95% CI 1.71–3.90). As per Figure 2, the magnitude of association between severe PGA (vs remission/mild) and adverse outcomes was greatest in patients ≤50 years. Joinpoint regression also supported a significant change in the rate of ICU/ventilation/death at 50 years. In multivariable analyses (Figure 3), PGA remained significantly associated with hospitalization, but not ICU/ventilation/death. However, in multivariable analyses stratified by age, PGA was consistently associated with both hospitalization and ICU/ventilation/death in patients ≤50, but not >50 years.

Conclusion

Our data suggest an association between IBD activity, as assessed by PGA, and severe COVID-19 outcome with an increased risk in younger patients. Adequate IBD treatment despite the pandemic is needed to avert poor outcome to symptomatic SARS-CoV2 infections.
N18 Multidisciplinary team importance in the view of the patients with Inflammatory Bowel Disease in Brazil
Authors: Herrerias G , Ribeiro J R , Beraldo R F , Hossne R S , Baima J P , Sassaki L Y
Published: May 2021

Background

Inflammatory Bowel Disease (IBD) is characterized by intestinal chronic inflammation that comprehend Crohn’s disease (CD) and ulcerative colitis (UC). Continuous care is essential. Constant contact with the multidisciplinary team (MDT) and its quality of care interferes with treatment adherence and patients’ quality of life (QoL). MDT must be composed by at least gastroenterologists, coloproctologists, nutritionists, nurses and psychologists. The study evaluated the importance of MDT in the patients view.

Methods

A cross-sectional, descriptive study was developed, including 94 patients from a Brazilian IBD reference center. Clinical data and the MDT relevance were evaluated. MDT importance was assessed through a questionnaire developed for the research with the answers: nothing important, unimportant, important and very important for each professional. The patients listed professionals in order of importance. QoL was assessed by IBDQ. Treatment adherence and disease knowledge were assessed by Morisky and CCKNOW questionnaires respectively.

Results

A total of 54 patients with CD and 40 with UC were included, 59.57% female and 53.19% with comorbidities. Previous hospitalization was reported by 54.26% and 36.17% were submitted by previous surgery. The majority referred previous consultation with a gastroenterologist (95.74%) and less than half with nutritionist (47.87%), IBD nurse (43.62%), psychologist (43.62%) and coloproctologist (23.40%). Gastroenterologist was considered important or very important by all patients, coloproctologist by 97.15%, IBD nurse 94.36%, endoscopist nurse 86.16%, stomatherapist 78.19%, nutritionist 88.46% and psychologist 80.55%. Regarding the order of importance, patients reported the gastroenterologist (87.50%) as the most important, followed by the coloproctologist (16.67%) and IBD nurse (14.10%). Patients with CD had more appointments with IBD nurse compared to UC patients (p = 0.007). QoL was considered excellent or good (64.51%). Drug adherence was low in 58.89% of patients. Knowledge about the disease was considered low (2.65 ± 1.65 points), being higher in patients with CD (p = 0.04).

Conclusion

Although the service has MDT, not all patients had the opportunity to visit all professionals. The lack of contact with the entire team, especially with the nurse, can reflect on low medication adherence and disease knowledge, impacting on disease control and QoL. Holistic patient care is recommended, emphasizing the importance of all professionals in the MDT for all patients with IBD.
P006 Host-genetics, dysbiosis, and clinical history explains fecal metabolic alterations in patients with Inflammatory Bowel Disease
Authors: Vich Vila A , Hu S , Andreu-Sánchez S , Collij V , Jansen D , Ruigrok R , Abu-Ali G , Parkinson J , Al Garawi A , Schneider J , Kurilshikov A , Björk J , Gacesa R , Fu J , Zhernakova A , Weersma R K
Published: May 2021

Background

The pathogenesis of inflammatory bowel diseases is characterized by gastrointestinal dysbiosis. Small molecules -or metabolites- present in feces can improve our understanding of host and microbes’ interactions. By exploring the relationship between host genetics, gut microbiota, and fecal metabolites composition from 500 patients with IBD and 255 population controls, we aimed to identify potential new biomarkers for the disease and to reveal host-microbiota interactions while considering factors like life-style and clinical history.

Methods

In short, we used shotgun sequencing to profile the microbiota composition, and an untargeted metabolomics platform (Metabolon INC., USA) was used to identify the levels of 1684 fecal metabolites. Whole exome sequencing and GSA Illumina chip were used to characterize host’s genetics. Multi-omics penalized regressions were used to explore the relationship between metabolite levels and the use of 44 types of medication, 144 long-term dietary patterns, and multiple patient characteristics. Random forest models were used to determine the discriminative power of metabolites.

Results

The levels of 597 fecal metabolites were altered in Crohn’s disease and 209 in patients with ulcerative colitis compared to population controls. Disease heterogeneity was reflected in the fecal metabolite profile; for example, disease location had a large impact on fecal bile-acid profile. Interestingly, metabolomics data could discriminate IBD samples from non-IBD samples (Random Forest AUC= 0.81). Genetic polymorphisms in the NAT2 gene were associated with the levels of multiple coffee metabolites. In both cohorts, IBD and non-IBD individuals, the increase in the abundance of several pathobionts was related to changes in the tryptophan, fatty-acids, and bilirubin metabolism. For example, the increase in abundance of R.gnavus was correlated with higher tryptamine levels, and the presence of bacterial starch degradation enzymes with increased concentrations of butyrate (FDR<0.05). In fact, microbial composition and bacterial enzyme abundance could predict more than 40% of the variation in the levels of 80 metabolites.

Conclusion

Patients with IBD present a different fecal metabolite profile that can be used to distinguish IBD from non-IBD individuals. Metabolite patterns are strongly related to microbial composition, diet, and patient’s clinical characteristics. Overall, these results can help to understand the disease’s complexity considering host-microbiota interaction and point to new therapeutical directions.
P007 Identification and characterisation of intestine-derived circulating resident memory T cells (ex-Trm) in health and Inflammatory Bowel Disease
Authors: Rodger B , Hoti I , Gordon H , Lindsay J , Stagg A
Published: May 2021

Background

Tissue resident memory T cells (Trm) persist in peripheral tissues where they protect against pathogens but can also contribute to inflammatory disease. Recent work shows that Trm can re-enter the circulation and give rise to new effector T cell and Trm populations in secondary tissue sites. Such ‘ex -Trm’ derived from the skin co-express the residency marker CD103 with cutaneous leukocyte antigen (CLA), a marker associated with skin tropism. Many T cells in the human intestine are Trm but it is unknown whether these cells re-enter the circulation; the existence of gut-derived ex-Trm would have important implications for IBD treatment targeting the recruitment of circulating gut-homing cells. Here, we identify a population of blood cells that co-express CD103 and the gut-homing integrin a4b7 and determine how they are changed in IBD.

Methods

Peripheral blood mononuclear cells (PBMCs) were isolated from healthy volunteers and patients with active IBD (Crohn’s disease or ulcerative colitis). Cell surface staining and multi-colour flow cytometry were used to identify CD4+ and CD8+ subsets of antigen experienced (CD45RA-) conventional T cells (abTCR+) and determine expression of markers associated with tissue tropism and residency.

Results

Staining with antibodies to CD103 and b7 integrin were used to define CD103b7+a4b7+ putative gut ex-Trm based on the excess per cell expression of b7 resulting from its contribution to both integrins. A separate CD103b7+a4b7- population defined by 1:1 expression of CD103 and b7 contained CLA+ skin ex-Trm. Gut ex-Trm comprised 0.3% total circulating CD8+ T cells (range 0.02–1.4%), and 1.2% CD4+ T cells (range 0.3–3%). Gut and skin ex-Trm were phenotypically similar; both expressed the residency associated markers CD101 and CD9 but lacked expression of CD69. Gut ex-Trm were phenotypically distinct from both traditional CD103-a4b7+ gut tropic CD45RA- antigen-experienced T cells and naïve T cells; significantly more gut ex-Trm expressed CD101 and CD9 and fewer expressed CD27. The proportion of gut ex-Trm did not differ between heath and IBD. However, the ratio of gut:skin ex Trm was significantly reduced in active Crohn’s disease but not ulcerative colitis indicating a selective reduction in the population derived from the intestine.

Conclusion

A putative population of gut-derived ex-Trm can be identified in the blood of healthy controls and IBD patients. This population has a distinctive phenotype similar to that of previously described skin-derived ex-Trm. Circulating ex-Trm could link discreet areas of intestinal inflammation in Crohn’s disease and there is a selective loss of the gut ex-Trm population from the blood of these patients. The role of ex-Trm in IBD merits further study.
P011 Serum adhesion G protein coupled receptor levels are associated with disease activity in pediatric patients with Crohn’s disease
Authors: Werner L , Weiss B , Shamir R , Shouval D
Published: May 2021

Background

Despite increasing number of therapies available for patients with Crohn’s disease (CD), response rates are generally not high. Therefore, there is a great need to identify novel targets in patients with active disease.

Methods

Serum samples were obtained from pediatric patients with CD at the time of diagnosis and following induction therapy with exclusive enteral nutrition (EEN) or anti-TNFa therapy, and from control subjects, defined as having normal colonoscopy without past or present history of inflammatory bowel diseases or other immune-mediated disorder. Associated clinical and laboratory data from these subjects was also collected. Serums were subjected to Olink technology (metabolism panel), based on proximity extension assay, enabling analysis of 92 proteins in each sample. Analysis was performed on a Normalized Protein eXpression (NPX) file comparing effect of different factors on the overall biomarker expression by supervised, multivariate, principal component analysis and verification by univariate ANOVA with Benjamini-Hochberg and post-hoc Tukey analysis.

Results

Eighty-eight serum samples were collected: 30 from control subjects and 58 from 32 patients with CD. The median age of patients in the control and CD groups was 13.9 years (IQR 11.1–16.6) and 14.6 years (IQR 12.2–16.9), respectively (P=0.32). Twenty-four patients were treated with anti-TNFa agents and 8 with EEN. The median pediatric Crohn’s Disease Activity Index decreased from 35 (22.5–42.5) to 5 (0–12.5, P<0.001) following induction therapy. We identified 34 proteins that significantly differed between patients and controls. Moreover, within patients with CD, 8/34 of these proteins were differentially expressed in patients with active or non-active disease. Among these, adhesion G-protein coupled receptors E2 (ADGRE2) and G2 (ADGRG2), important for macrophage differentiation, were significantly lower among CD patients vs. controls. When stratifying according to disease activity, low levels of both markers were identified in CD patients with active disease (either patients that were treatment-naïve or those with primary non-response to anti-TNFa therapy) or with increased CRP levels. Principal component analysis showed that a combination of ADGRE2 and ADGRG2 showed good separation between control subjects and treatment naïve patients with active CD.

Conclusion

Serum levels of ADGRE2 and ADGRG2 are differentially regulated in patients with active CD, and should further be validated in additional Cohorts. The expression patterns and function of these receptors on different immune cells should be defined in future studies.
P019 Differential effects of first-line IFX and conventional treatment on inflammatory serum proteins of paediatric moderate- to-severe Crohn’s disease patients
Authors: Jongsma M , Costes L M M , Tindemans I , Cozijnsen M A , Raatgeep R H C , van Pieterson M , Li Y , Escher J C , de Ridder L , Samsom J N
Published: May 2021

Background

Recently, we established that First-line infliximab (FL-IFX) was superior to conventional treatment (CONV) in achieving and maintaining clinical remission in newly diagnosed paediatric patients with moderate-to-severe Crohn’s disease (CD) (PMID: 33384335). Selection of patients eligible for FL-IFX can be corroborated by combining clinical criteria with immunological biomarkers relating to the patients’ underlying immunopathology. Therefore, we investigated differential effects of FL-IFX and CONV induction treatment on serum inflammatory protein concentrations and assessed whether stratification of CD patients according to baseline serum profiles of IFX-modulated proteins relates to maintaining remission at week 52.

Methods

In the TISKIDS randomised controlled trial, newly diagnosed therapy-naïve CD patients with a weighted paediatric CD activity index (wPCDAI) >40 were included. FL-IFX consisted of 5 IFX infusions (5 mg/kg) combined with azathioprine (AZA) maintenance treatment. CONV treatment consisted of induction therapy with Exclusive Enteral Nutrition or oral prednisolone combined with AZA maintenance. Serum samples of 48 FL-IFX and 43 CONV patients, collected at time of diagnosis and after 10–14 weeks of induction treatment, were available. Concentrations of 92 inflammatory proteins were determined with Olink Proteomics® proximity extension technology. Hierarchical clustering was performed to stratify patients according to their serum immune profiles. Clinical disease remission was defined as wPCDAI<12.5.

Results

At baseline, prior to therapy, clinical disease characteristics and serum inflammatory protein concentrations did not significantly differ between FL-IFX and CONV treated patients. After 10–14 weeks, FL-IFX reduced 28 proteins and enhanced 2 proteins while CONV treatment reduced 13 proteins and enhanced 1 protein. Eighteen proteins were differentially regulated by FL-IFX only.

Hierarchical clustering of patients based on their baseline profiles of the 30 IFX-modulated proteins revealed 2 patient clusters. The CD-hi cluster had an increased abundance of 24/30 proteins amongst which Oncostatin-M, TNFSF14, HGF and TGF-alpha and higher clinical inflammatory parameters compared to the CD-lo cluster.

Crucially, both baseline inflammatory protein profile and type of induction therapy significantly determined whether patients reached clinical disease remission without treatment escalation at week 52; with CD-hi patients having the lowest change.

Conclusion

FL-IFX achieves stronger reduction and modulates more proteins than CONV treatment. Stratification of patients according to profiles of IFX-modulated proteins discerns patients with a lower chance of reaching clinical remission without treatment escalation at week 52.
P026 Microbial Diversity is affected by Cognitive Behavioral and Mindfulness-Based Stress Reduction and accompanied by an Inflammatory Response in Patients with Crohn’s Disease
Authors: Ilan K , Motro Y , Nemirovsky A , Lerner L , Schwartz D , Goren G , Sergienko R , Greenberg D , Slonim-Nevo V , Sarid O , Friger M , Regev S , Odes S , Moran-Gilad J , Monsonego A
Published: May 2021

Background

Crohn’s disease (CD) is associated with psychological stress and alteration of gut microbiota as compared to healthy individuals. Previous work has reported imbalances in CD patients across four major bacterial phyla including Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria. We aimed to determine the effect on gut microbiota of a 3-month period of Cognitive Behavioral and Mindfulness-Based Stress Reduction (COBMINDEX), a psychological intervention shown to improve the wellbeing and inflammatory state of CD patients.

Methods

Microbial analysis of stool samples, circulating inflammatory markers and a wide range of psychological parameters related to stress, well-being and daily activities were measured and compared among 25 CD patients before (T1) and after (T2) COBMINDEX, and 25 matched CD wait-list controls at the corresponding time-points T1 and T2. Stool DNA extracts were subjected to 16S amplicon sequencing (Illumina) and analysed for taxonomical abundance, alpha and beta diversity using the QIIME2 pipeline and correlated with inflammatory and clinical parameters.

Results

Microbial alpha diversity among all CD patients at T1 significantly correlated to the 3 key cytokines: IL-10 (p=0.04, correlation=0.48), INFg (p=0.02, correlation=0.53), and INFa (p=0.02, correlation=0.51). At T2, while beta diversity was significantly increased in the COBMINDEX group (p=0.03), it was significantly decreased (p=0.0001) among the wait-list controls (Figure 1). Furthermore, compared with the wait-list controls, changes in inflammatory and clinical markers such as INFg, TNFa, IL-6, calprotectin and CRP, occurring following COBMINDEX, were accompanied by changes in the 4 main phyla including Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria (Figure 2). Lastly, changes in a variety of unique taxa, not previously implicated in CD, were also associated with changes in inflammatory and clinical markers such as INFg, TNFa, IL-6, calprotectin and CRP in the COBMINDEX but not in wait-list controls (Figure 2).

Conclusion

Our results show that microbial diversity is connected to the inflammatory profile of CD patients, and is significantly altered by COBMINDEX. Moreover, changes in the 4 main phyla that are known to be different among CD patients are linked to changes in various inflammatory markers, demonstrating the microbial-inflammatory relationship among CD patients. Lastly, we found that changes in the abundancies of 7 taxa, hitherto untied to CD in the literature, correlate with inflammatory markers, hinting at new microbial targets in CD.
P044 Transcriptome analysis identifies dysregulated pathways and targets for therapy in patients undergoing surgical resection for Crohn’s disease
Authors: Akiror S , Acharjee A , Jeffery L , Shivaji U N , Zardo D , Gkoutos G , Ghosh S , Iacucci M
Published: May 2021

Background

In Crohn’s disease, intestinal strictures develop in 40% of patients often requiring repeated surgeries. Current treatments have limited efficacy. Therefore, better understanding of dysregulated molecular pathways is needed to identify targets for therapy. The aim of this study was to identify novel pathways involved in stricture pathogenesis.

Methods

Patients undergoing resection for CD-related strictures were recruited (IRAS ID-248494). RNA was extracted from proximal, strictured and distal segments of resected ileal/ileo.cecal segments. cDNA libraries were prepared for 9 patients using QIAseq UPX 3’ Transcriptome reagents and sequenced. Normalised expressions were obtained through the CLC-Genomics Workbench (Qiagen). Differentially expressed genes (adj.P.Val<0.05) were determined using the Limma package and PCA and PLS-DA modelling performed. Pathway-related genes were enriched using EnrichR. Area under the curve (AUC) analysis was done by the Random Forest method and qPCR used for gene validation.

Results

Strictured, proximal and distal tissues had unique transcriptomes; stricture segment clustered separately from proximal and distal segments, which were very similar by comparison. 64 genes were commonly up-regulated and 17 down-regulated in stricture compared to either control segments. Pathway enrichment on these 81 genes identified 30 targets. 3 of 5 down-regulated genes, associated with the epithelial barrier (KLF5, KRKT20, DSK) whilst most up-regulated genes related to extracellular matrix and tissue remodelling (COL1A1, CTSK, HYAL2, GREM-1, SERPINE1), inflammation (PECAM1, CCL2, EDNRB, LY96, CTSK), adipogenesis (IGF-1, NDN, HADHA) and cellular stress.

Based on statistical significance and biological relevance LY96, AKAP11, SRM, GREM1, EHD2, SERPINE1, HDAC1 and FGF2 were further studied for association with stricture. A combined AUC score of 0.979 (95%CI 0.902–1) confirmed strong association and was supported by qPCR validation with additional patients. (AUC=0.81, (0.56–0.95)).

Conclusion

Loss of epithelial integrity, increased inflammation, tissue remodelling and adiposity characterise the stricture and may be modulated by existing anti-fibrotic drugs not tested in Crohn’s disease as well as new drug development.