bluuebunny/crossref_metadata_2025_split huggingface dataset:
P041 DEVELOPMENT OF PROMIS PEDIATRIC PATIENT-REPORTED OUTCOME SHORT FORMS FOR FATIGUE AND PAIN INTERFERENCE IN CHILDREN WITH CROHN’S DISEASE
Authors: Schuchard Julia , Kappelman Michael , Grossman Andrew , Clegg Jennifer , Forrest Christopher 
Published: January 2020

Abstract

Introduction
There is a need for reliable, valid patient-reported outcome (PRO) measures to assess the health and quality of life in pediatric Crohn’s disease (PCD). The development of PROs for this population may be facilitated by using Patient-Reported Outcomes Measurement Information System (PROMIS) item banks, which were developed using rigorous psychometric methods. We aimed to develop disease-specific PROMIS short forms by conducting qualitative research to identify the items that are most relevant to children with PCD.

Methods
Participants in an initial card sorting study included 42 children with CD (ages 8–17), 70 parents of children with CD, and 26 clinicians with expertise in CD. Using an online program, participants rated the importance of PROMIS items for pediatric CD patients. This exercise indicated that children, parents, and clinicians endorse Fatigue and Pain Interference items as important for PCD. In a separate study, trained research coordinators conducted one-on-one semi-structured interviews with 37 children with CD to further explore their experiences with fatigue and pain. Research coordinators also conducted one-on-one cognitive interviews with 14 children with CD. Each participant completed a questionnaire and then was interviewed about the reasoning for their answers. All interviews were transcribed and coded for meaning units, defined as conceptually distinct statements in the words of the participant.

Results
In semi-structured interviews, highly reported facets of fatigue and its impact included feelings of tiredness, friendships, and sports/exercise. Highly reported facets of pain and its impact included feelings of hurt, friendships, family, attention, and sports/exercise. Participants’ responses revealed the same breadth and types of lived experiences of fatigue and pain as children from the development samples drawn from the general population. Ratings of children’s reasoning and logic in cognitive interviews showed strong understanding of PROMIS items. Final item selection for the PCD-specific PROMIS short forms involved consideration of the concepts that participants identified as important, item understandability, psychometric evaluation of precision and coverage, and balance across different facets of each domain.

Conclusions
Results support the content validity and comprehensibility of PROMIS Pediatric Fatigue and Pain Interference measures in PCD. This work contributed to the development of 8-item short forms that are tailored to assess the lived experiences of fatigue and pain interference in PCD.
P042 FATIGUE AND DISEASE ACTIVITY: A SECONDARY REVIEW OF PATIENT MEDICAL RECORDS
Authors: Kamp Kendra , Clark-Snustad Kindra , Lee Scott D 
Published: January 2020

Abstract

Introduction
Fatigue is often the most prevalent symptom in inflammatory bowel disease (IBD). Previous research has highlighted that patients with active clinical disease activity have greater levels of fatigue compared to those with inactive clinical disease activity. Endoscopic assessment of inflammation is considered the best measure of disease activity; yet, clinical disease activity does not necessarily correlate with endoscopic inflammation. Therefore, there is a need to examine the relationship between endoscopic inflammation and fatigue.

Methods
A retrospective chart review was conducted of adult patients at an academic medical center. Participants were included in the review if they had a diagnosis of ulcerative colitis or Crohn’s disease, a clinic visit between 2018–2019 with completed Short Inflammatory Bowel Disease Questionnaire and clinical disease activity measures (Harvey Bradshaw Index [HBI] or Simple Clinical Colitis Activity Index [SCCAI]), and had a scored endoscopic disease activity score (Mayo Score of Ulcerative Colitis or the Simple Endoscopic Score for Crohn’s Disease) within 6 months of the clinic visit. Fatigue (range 1–7) was reversed scored; a higher number indicated increased fatigue. Descriptive statistics were calculated using STATA 14.

Results
Individuals (N=43) had a mean age of 37.4 (SD=12.3) and 54% were female. Disease location was 9% ileal, 53% ileocolonic, and 37% colonic; 54% were in endoscopic remission. The mean fatigue score was 4.2 (SD=1.7). There was no difference in fatigue between individuals in endoscopic remission (M=4.2, SD=1.6) compared to individuals with active endoscopic disease (M=4.2, SD=1.9; p=0.97). Fatigue was correlated with clinical disease activity measures including the HBI (r=0.61) and the SCCAI (r=0.58). Increased levels of fatigue were associated with abnormal c-reactive protein (p&lt;0.01), erythrocyte sedimentation rate (p&lt;0.01), and albumin (p=0.04) but not hematocrit (p=0.71) or hemoglobin (p=0.60).

Conclusions
The majority of the sample reported fatigue; however, fatigue did not correlate with endoscopic disease activity despite previous research suggesting that clinical disease activity correlates with fatigue. Further confounding our understanding of disease activity’s association with fatigue is the fact that clinical disease activity and biochemical abnormalities (CRP, ESR, albumin) did correlate with fatigue. Additional research is clearly needed to characterize the cause of fatigue among individuals with IBD.
P050 SUBSTANCE USE OCCURS FREQUENTLY IN PATIENTS WITH CROHN’S DISEASE
Authors: Chen Po-Hung , Miller Steven , Brant Steven , Hutfless Susan 
Published: January 2020

Abstract

Background
Crohn’s disease (CD) is an inflammatory disease of the gut with multiple psychosocial comorbidities, including lost wages, stress on loved ones, and psychiatric illnesses, all of which are associated with substance use disorders. While approximately 7.5% of individuals aged 12 or older in the United States have a substance use disorder, we know little about this issue among patients with CD. Using a nationally representative dataset, we examined the burden of alcohol, tobacco, and illicit drug use among patients with CD in the United States.

Methods
We queried the national Medicaid claims data from 2010 through 2014 using ICD-9-CM codes for CD and use of alcohol, tobacco, opioids, cocaine, amphetamine, and cannabis. We defined CD as having two or more CD diagnostic codes; all included individuals must have at least one continuous year of Medicaid eligibility. The primary outcomes of interest were the total and the substance-specific prevalence of use in patients with CD.

Results
During our five-year study period, there were 51,091 individuals with CD. Among them, 7.4% had at least one code to suggest substance use, and 1.3% had codes for two or more substance types. Non-users were 65% female, 39-years old at the first CD diagnosis, and had 1.7 years of median follow-up after the said diagnosis. Users were 62% female, 40-years old at the first CD diagnosis, and had 1.8 years of median follow-up after diagnosis. The frequencies of substance use codes by CD patients were tobacco (3.9%), opioids (2.2%), alcohol (1.6%), cannabis (0.4%), cocaine (0.3%) and psychostimulants (0.3%).

Conclusion
At least 1 in 13 patients with CD in the US Medicaid cohort noted substance use from 2010 through 2014. Our finding was comparable to the reported prevalence of substance use disorders in the general US population.
P054 WHAT ARE THEY WORRIED ABOUT?: FINDINGS FROM THE IBD DISTRESS SCALE
Authors: Beard Jacklyn Stellway , Beeson Erynn , MacKay Heather , Paternostro Jennifer , Bassett Mikelle , Lin Henry , Harris Michael 
Published: January 2020

Abstract

Introduction
It is intuitive to expect youth with IBD will have higher rates of depression and anxiety than their otherwise healthy peers, and most research bears this notion. However, existing literature of emotional distress has not consistently addressed the differentiation between general depression and anxiety and normative emotional experiences of IBD. Assessment measures often used for youth with IBD align with the DSM criteria; based on symptoms, without considering etiology or context (e.g., chronic disease). The IBD Distress Scale (IDS) was designed to identify distress/worry in response to extraordinary circumstances of having IBD.

Methods
The IDS is a 27-item measure of distress related to IBD symptoms, treatment, and disease burden. The youth self-report was completed by 108 patients ages 12–19, and 101 parents. The IDS measure was administered with general measures of depression (Patient Health Questionnaire, PHQ8) and anxiety (General Anxiety Disorder, GAD7) to youth with IBD attending their routine gastroenterology appointment. Item responses were classified as “not a problem,” “moderate problem,” or “serious problem.” For some analyses, “not a problem” and “moderate problem” were collapsed. Correlations and frequencies were conducted to compare youth and parent responses.

Results
Results identified top “serious problems” rated by youth and parents, separately. The highest rated problem for youth was worries about not being able to eat what others are eating, with 18% reporting this as a serious problem. The second most highly rated “serious problem” by youth was fear of not having bathroom access (15%). For parents, the highest rated “serious problem” was fear of surgery (24%). Parents also rated worrying about next flare, and feeling there’s no way to avoid a flare, as “serious problems,” both with 16% frequency. Pearson correlations for the top problems identified as “serious” by youth and parents revealed significant agreement for socially-oriented worries; e.g., anxiety about patient not being able to eat what others are eating (r=.33).

Conclusion
The CCF states IBD treatment goals are five-fold: achieve remission; control inflammation; maintain remission; prevent and manage complications; maximize quality of life. Based on research with other diseases, integrating the IDS into current IBD treatment protocols is a logical step for identifying target areas for treatment. Thematically, results revealed youth and parents worry about future-oriented (e.g., worrying about next flare) and socially-oriented issues (e.g., possibility of not having access to a bathroom). The identified themes enlighten current treatment and provide guidance for improved interventions. Future directions should include development and implementation of appropriate interventions specific to the identified serious problems for IBD distress.
P085 DOSE ESCALATION (Q4) OF USTEKINUMAB SHOULD BE CONSIDERED FOR CROHN’S DISEASE PATIENTS WHO FAIL STANDARD DOSING
Authors: Yadav Abhijeet , Haider Reza , Akanbi Olalekan , Kudaravalli Praneeth , Tripathi Nishant , Hashim Mahmoud , Abdelsalam Mohammed , Tawfik Soliman Hussein Mohamed Sabry , Elkheshen Ahmed , Patel Vihang , Ali Saad Emhmed , Perry Courtney , Flomenhoft Deborah , Barrett Terrence , Lamb Latoya , Ingram Karen , Mayne Casie , Stufflebeam Amy 
Published: January 2020

Abstract

Background
Ustekinumab, a monoclonal antibody of interleukin-12 and interleukin-23, was approved for the treatment of moderate to severe Crohn’s disease (CD) in 2016. Ustekinumab is approved in CD for a weight-based IV induction dose followed by every 8 weeks of subcutaneous dosing. Response rates by 6 weeks range from 34% (anti-TNF failures) to 56% in bio-naïve patients. The remainder includes patients who partially-respond (PR) or do not respond (NR). Response by week 16 is 55% (anti-TNF failures) and 73% in bio-naïve patients suggestive of a ‘delayed response’ in some. Experience with anti-TNF drugs demonstrates that a subset of patients respond to dose escalation, which prompts the notion of a potential delayed response phenomenon with Ustekinumab.

Aim
Determine the efficacy of dose escalation from standard Q8 dosing to Q4 dosing of Ustekinumab in CD patients, who had PR or NR to standard Q8 dosing.

Methods
A Retrospective observation study of 143 adult patients with CD, on Ustekinumab standard Q8 dosing over a 2 year and 9-month period was conducted. Data was extracted pertaining to demographics, disease, and treatment-related variables (biomarkers, steroid use, interval surgery, ER visits). Patients were further subcategorized as responders, partial responders(PR), and non-responders(NR), based on changes in fecal calprotectin, albumin, CRP, and Physician Global Assessment Disease Severity (1=mild, 2=moderate, 3=severe). Q8 non-responders (NR) and partial responders (PR) were dose-escalated to Q4, and outcome variables were collected. Biomarkers, steroid utilization, interval surgery, and ER visits, and PGA were compared in Q8 partial responder(PR) and non-responders (NR) from the date of starting Ustekinmuab on Q8 dosing to the date of escalation to Q4 dosing, versus the date of escalation Q4 dosing to the end of patient follow up.

Results
30% (n=8) of patients were Q8NR, and 70% (n=19) were Q8PR). In the PR group, biomarkers decreased by up to 21% when these patients were switched to Q4 dosing. 100% of patients saw clinical improvement or remained at mild disease on Q4 dosing. In the NR group, biomarkers decreased by up to 91%. 100% of patients saw clinical improvement or remained at mild disease while on Q4 dosing. In both groups, 50% of patients taking steroids on Q8 dosing were no longer taking steroids or were at a reduced dose at the end of Q4 dosing follow-up. 40% of patients on immunomodulators on Q8 dosing were no longer taking immunomodulators at the end of Q4 dosing follow-up.

Conclusions
Constitutional imaginations of the state: Afterword to the Foreword by Ran Hirschl and Ayelet Shachar
Authors: Finck Michèle 
Published: January 2020

Abstract
This Afterword does not seek to contest Ran Hirschl and Ayelet Shachar’s account of spatial statism. It rather argues that although public power remains in many ways untouched by the ever-changing world states are embedded in, counternarratives can also be identified. Looking toward urban spaces as well as the regulation of data and online spaces, I illustrate that a complementary story of state power can also be told. The challenge is to make sense of the fact that state power is both changing and not changing at the same time.
On the Nonnegativity of Stringy Hodge Numbers
Authors: Olano Sebastián 
Published: January 2020

Abstract
We study the nonnegativity of stringy Hodge numbers of a projective variety with Gorenstein canonical singularities, which was conjectured by Batyrev. We prove that the $(p,1)$-stringy Hodge numbers are nonnegative, and for three-folds we obtain new results about the stringy Hodge diamond, which hold even when the stringy $E$-function is not a polynomial. We also use the Decomposition Theorem and mixed Hodge theory to prove Batyrev’s conjecture for a class of four-folds.
CPlantBox, a whole-plant modelling framework for the simulation of water- and carbon-related processes
Authors: Zhou Xiao-Ran , Schnepf Andrea , Vanderborght Jan , Leitner Daniel , Lacointe André , Vereecken Harry , Lobet Guillaume 
Published: January 2020

Abstract
The interaction between carbon and flows within the vasculature is at the centre of most growth and developmental processes. Understanding how these fluxes influence each other, and how they respond to heterogeneous environmental conditions, is important to answer diverse questions in agricultural and natural ecosystem sciences. However, due to the high complexity of the plant–environment system, specific tools are needed to perform such quantitative analyses. Here, we present CPlantBox, a whole-plant modelling framework based on the root system model CRootBox. CPlantBox is capable of simulating the growth and development of a variety of plant architectures (root and shoot). In addition, the flexibility of CPlantBox enables its coupling with external modelling tools. Here, we connected the model to an existing mechanistic model of water and carbon flows in the plant, PiafMunch. The usefulness of the CPlantBox modelling framework is exemplified in five case studies. Firstly, we illustrate the range of plant structures that can be simulated using CPlantBox. In the second example, we simulated diurnal carbon and water flows, which corroborates published experimental data. In the third case study, we simulated impacts of heterogeneous environment on carbon and water flows. Finally, we showed that our modelling framework can be used to fit phloem pressure and flow speed to (published) experimental data. The CPlantBox modelling framework is open source, highly accessible and flexible. Its aim is to provide a quantitative framework for the understanding of plant–environment interaction.
Cattle adapted to tropical and subtropical environments: social, nutritional, and carcass quality considerations
Authors: Cooke Reinaldo F , Daigle Courtney L , Moriel Philipe , Smith Stephen B , Tedeschi Luis O , Vendramini João M B 
Published: January 2020

AbstractBeef production needs to increase from 60 million to 130 million tons by 2050 to feed a growing world population, and 70% of this production increase is expected from beef industries located in subtropical and tropical regions of the world. Bos indicus-influenced cattle predominate in these regions but are often managed using practices developed for Bos taurus breeds reared in temperate climates. Hence, a fundamental step to meet the increasing global demand for beef is to develop specific management for B. indicus-influenced cattle in tropical or subtropical environments. Bos taurus and B. indicus are different subspecies, and diverge in social and biological functions due to selection pressure caused by complex evolutionary and domestication processes. Bos indicus cattle display different social responses compared with B. taurus counterparts, which must be taken into account by management planning as these traits directly impact cattle performance and welfare. In tropical and subtropical regions, warm-season perennial C4 grasses are the dominant forages, and their availability has a significant influence on the productivity of beef cattle systems. The resilience of C4 grasses under adverse conditions is one of their most important characteristics, even though these forages have reduced nutritive value compared with forages from temperate climates. Accordingly, nutritional planning in tropical and subtropical conditions must include management to optimize the quantity and quality of C4 forages. Nutritional requirements of cattle raised within these conditions also require special attention, including inherent metabolic compromises to cope with environmental constraints and altered energy requirements due to body composition and heat tolerance. Nutritional interventions to enhance beef production need to be specifically tailored and validated in B. indicus-influenced cattle. As an example, supplementation programs during gestation or early life to elicit fetal programming or metabolic imprinting effects, respectively, yield discrepant outcomes between subspecies. Bos indicus-influenced cattle produce carcasses with less marbling than B. taurus cattle, despite recent genetic and management advances. This outcome is mostly related to reduced intramuscular adipocyte volume in B. indicus breeds, suggesting a lesser need for energy stored intramuscularly as a mechanism to improve thermotolerance in tropical and subtropical climates.
Cattle adapted to tropical and subtropical environments: genetic and reproductive considerations
Authors: Cooke Reinaldo F , Cardoso Rodolfo C , Cerri Ronaldo L A , Lamb G Cliff , Pohler Ky G , Riley David G , Vasconcelos José L M 
Published: January 2020

AbstractEfforts to understand biological functions and develop management schemes specific to Bos indicus-influenced cattle raised in tropical and subtropical environments are critical to meet the increasing global demand for protein. In the United States, B. indicus breeds are mostly used to generate B. indicus × B. taurus crosses with increased thermal and parasite tolerance, while retaining some productive characteristics of B. taurus cattle. Although crossbreeding represents a proven strategy to improve cattle adaptation almost immediately, research has also attempted to identify B. taurus genetics that can withstand subtropical and tropical climates. Reduced milk production and delayed reproductive maturation appear to be related with tropical adaptation of B. taurus breeds, as a means to conserve energy under stressful conditions and limited nutrition. Moreover, longevity may be the ultimate adaptation response to unfavorable environments, and retention of bulls and heifers from proven cows is the recommended strategy to improve longevity in B. indicus-influenced herds. Besides selection for longevity, other aspects should be considered when planning reproductive management in tropical and subtropical regions. Bos indicus and B. taurus breeds have multiple differences pertaining to reproductive function, including age at puberty, ovarian dynamics, and pregnancy development. Nutritional strategies such as the stair-step regimen, and use of exogenous progesterone (P4) inserts are options to hasten puberty attainment of late-maturing B. indicus-influenced heifers. Yet, limited pharmacological alternatives are available for reproductive management of B. indicus-influenced females in the United States, which rely on GnRH-based protocols not specifically designed to the reproductive function of B. indicus breeds. In contrast, hormonal protocols based on exogenous P4, estradiol esters, and equine chorionic gonadotropin are available for use in B. indicus females in South America. These include protocols tailored to prepubertal heifers, anestrous cows, and cycling nulliparous or parous females, which often yield pregnancy rates of 50% to fixed-time artificial insemination. The global dairy industry also faces similar challenges in increasing demand and production as the beef industry. Selection of cows capable of sustaining optimal milk yield, reproductive success, and health status in hot and humid conditions is essential for optimal dairy production in subtropical and tropical regions.