bluuebunny/crossref_metadata_2025_split huggingface dataset:
P003 Meat Consumption and All-Cause Mortality in 5763 Inflammatory Bowel Disease Patients: A Prospective Cohort Study
Authors: Chen Hui , Fu Tian , Dan Lintao , Chen Xuejie , Sun Yuhao , Chen Jie , Wang Xiaoyan , Hesketh Therese 
Published: December 2021

BACKGROUND:
Meat consumption was found to be associated with the incidence and developmental course of inflammatory bowel diseases (IBD), but its roles in the risk of all-cause mortality in IBD patients remained unknown. The aim of this study (UK Biobank Resource under application number 73595) was to assess the associations between meat consumption and all-cause mortality among IBD patients.

METHODS:
We leveraged data of 5763 IBD patients in the UK Biobank recruited from 2007 to 2010 and followed up to March 13, 2021. Dietary information was collected using a simplified food frequency questionnaire (FFQ) in the touchscreen questionnaire at baseline recruitment. Death events were ascertained from the death registry. Cox proportional hazards models were used to estimate potential associations of each meat consumption with mortality in IBD patients, 0.1-0.9 time per week was seen as the reference, and hazard ratios (HRs) and 95% confidence interval (CIs) were reported. Moreover, we conducted a series of subgroup and sensitivity analyses.

RESULTS:
During an average follow-up of 11.7 years, we documented 590 deaths over 67,095 person-years. Of the 5763 IBD patients with a mean (SD) age of 57.3 (7.9) years, 3028 (52.5%) were female and 2735 (47.5%) were male, 1834 were with Crohn’s diseases (CD) and 3929 were with ulcerative colitis (UC). Consuming processed meat more than 4 times per week (>4 times/week) was associated with an increased risk of mortality in IBD patients (HR 1.53, 95%CI 1.06-2.23, P = 0.025) compared with consumption of less than once per week (0.1-0.9 time/week), while consumptions of fish, unprocessed poultry, or unprocessed red meat were not found to be related to mortality. The association of processed meat with mortality was also observed in CD patients (HR 2.01, 95%CI 1.12-3.62, P = 0.020), but not significantly in UC patients (HR 1.27, 95% CI 0.77-2.09, P = 0.346). In subgroup analyses, we also observed the associations in IBD patients with diseases duration more than 10 years (HR 1.67, 95%CI 1.03-2.69) or patients who had high physical activities (HR 2.21, 95%CI 1.13-4.33), but was not significant in other subgroup analyses, also, the associations manifested robust in sensitivity analyses.

CONCLUSION:
In this study, more frequent consumption of processed meat was found to be associated with the increased risk of mortality in IBD patients, while no such associations were observed in IBD patients who consuming fish, unprocessed poultry meat or unprocessed red meat. Therefore, based on the results above, we recommend a remodified diet with restricting processed meat as well as supplying an additional healthy diet for IBD patients, using alone or in combination with pharmacotherapy.
P004 Steroid-Free Remission in Patients With Ulcerative Colitis Receiving Tofacitinib in Real Clinical Practice
Authors: Knyazev Oleg , Kagramanova Anna , Lishchinskaya Albina , Babayan Anait , Kulakov Dmitriy , Li Irina , Shkurko Tatyana 
Published: December 2021

BACKGROUND:
Tofacitinib is a selective immunosuppressant, the first representative of the inhibitors of the janus kinase family, which has high selectivity against other kinases of the human genome. According to the results of the study, tofacitinib inhibits JAK-1, JAK-2, and in high concentrations – JAK-3 and tyrosine kinase-2. The drug is registered in Russia for the treatment of patients with ulcerative colitis. According to the OCTAVE Sustain study, steroid-free remission in patients with ulcerative colitis receiving tofacitinib at a dose of 10 and 20 mg per day is 27.7% and 27.6%, respectively.

OBJECTIVE:
To identify the frequency of steroid-free remission in patients with ulcerative colitis receiving tofacitinib in real clinical practice.

METHODS:
In the Department of Inflammatory Bowel Diseases of the Moscow Clinical Scientific and Practical Center named after A. S. Loginov, 58 patients with ulcerative colitis (UC) who received tofacitinib were observed. The effectiveness of therapy was evaluated (the value of the Mayo index less than 2, ESR, CRP, hemoglobin, fecal calprotectin (FCP) and the need for the appointment of glucocorticosteroids (GCS). The follow-up period was 12 months from the start of tofacitinib therapy.

RESULTS:
During the follow-up period, out of 58 (100%) UC patients treated with tofacitinib, 9 (15.5%) patients did not respond to therapy. A prolonged induction course at a dose of 20 mg of tofacitinib was required in 14 (24.1%) patients who had previously received anti-TNF-α drugs. All patients at the time of initiation received GCS at an average therapeutic dose of 40 mg. After the induction course, corticosteroids were discontinued in 49 (100%) patients who responded to treatment. All patients achieved remission within 12 months of therapy (Meyo < 2). Repeated administration of corticosteroids for exacerbation or "eluding" of the response to tofacitinib was required in 11 of 49 (22.4%) patients.

CONCLUSION:
Steroid-free remission in patients with ulcerative colitis, receiving tofacitinib for 12 months, in real clinical practice is 77.6%.
P008 A Novel Smartphone Application to Reduce Infusion Suite Wait Times
Authors: Chandra Joan , Siegel Matthew , Bernash Odalie , Siegel Corey 
Published: December 2021

BACKGROUND:
Patients with inflammatory bowel disease (IBD) are often treated with biologic medications that require visits to an infusion suite. Due to the high cost of biologics, they are not mixed and released from the pharmacy until patient arrival. This typically leads to long wait times after patient check in. An investigator-developed novel smartphone application (app) titled Almost There was created to reduce wait times through the use of geofences to notify the infusion suite when patients are nearing their destination (the hospital). Our aim was to perform a pilot study to assess the feasibility of Almost There for patients with IBD coming for infusions at a rural academic medical center.

METHODS:
Adult patients with Crohn’s disease (CD) or ulcerative colitis (UC) currently receiving intravenous biologic therapy were recruited for this pilot study. Patients received instructions on how to download the app onto their smartphone. Patients activated the application prior to leaving their homes and answered standard screening questions to assess for active infections. Using geofences, the app automatically notified the infusion suite when the patient was within 10 miles of the hospital. The infusion suite alerted the pharmacy who immediately proceeded with medication preparation. Patients completed surveys upon arrival to the infusion suite collecting basic demographics and disease information, perceived wait times for that visit and previous visits prior to using the app. The infusion suite staff recorded actual wait times from check in to medication administration.

RESULTS:
The app was trialed successfully for 12 total visits among 9 patients (5 CD, 4 UC). 78% of app users were 25-44 years old and 22% were 45 years and older. 56% of patients were receiving infliximab and 44% were receiving vedolizumab. 11 patients were recruited and 9 patients out of 11 were able to successfully use the app. Reasons for app failure included one user who forgot their phone at home, one with loss of cell service, and one app malfunction. The median actual wait time from when patients arrived at the infusion suite to the start of the infusion was 38-40 minutes. In 67% of visits, there was decreased perceived wait time for patients using the app compared to their prior visits. When using the app, perceived wait times were shorter than actual wait times in 75% percent of patients.

CONCLUSION:
In this pilot feasibility study, the Almost There app led to decreased perceived wait times for IBD patients coming for biologic infusions. The application was not effective for 18% of patients for a variety of reasons. If this or a similar app was improved to allow for more consistent usability it should be studied compared to a control group to evaluate if it leads to decreased wait times for any medical infusion.
P011 Prevalence of Cannabis Use Disorder in Inflammatory Bowel Disease Hospitalizations in the United States and Effect on Length of Stay
Authors: Wang Yize Richard 
Published: December 2021

BACKGROUND:
The prevalence of cannabis use has been increasing in the United States in recent years. We examined the prevalence and predictors of cannabis use disorder among IBD hospitalizations and its effect on length of stay.

METHODS:
Using the 2017 National Inpatient Sample, cannabis use disorder was identified using ICD-10-CM code F12.xxx in adult IBD patients. Other variables of interest included age, sex, race, Crohn’s disease (vs. ulcerative colitis), region, metropolitan status, zip code household income, primary insurance, and length of stay. Multivariate logistic and Poisson regressions were used in statistical analysis.

RESULTS:
Of the 17,857 IBD hospitalizations, 565 (3.1%) had cannabis use disorder. Patients with cannabis use disorder were younger (mean ± standard deviation [years]: 35.1 ± 11.8 vs. 45.6 ± 18.1), less likely female (32.7% vs. 54.1%), more likely African American (24.8% vs. 13.9%), and more likely Crohn’s disease (72.0% vs. 62.2%) (all p < 0.001). There were also significant differences by region, income, and insurance. Multivariate logistic regression confirmed age (odds ratio [95% confidence interval]: 0.964 [0.957, 0.971]), female (0.444 [0.369, 0.531]), African American (1.405 [1.124, 1.750]), and Crohn’s disease (1.363 [1.126, 1.657]) as predictors of cannabis use disorder. There was no association between cannabis use disorder and length of stay, confirmed in multivariate Poisson regression.

CONCLUSION:
Young age, male sex, African American race, and Crohn’s disease were positively associated with cannabis use disorder in IBD hospitalizations. There was no effect of cannabis use disorder on length of stay.
P033 Moving the Needle on Speaker Diversity at AIBD
Authors: Goldowsky Alexander , Singh Roshni , Charabaty Aline , Moss Alan C. 
Published: December 2021

BACKGROUND:
Diversity of invited speakers at academic conferences is a topic of increased focus in recent years. While there have been efforts to improve speaker diversity, an evaluation of this in the IBD field has not been undertaken to date. We aimed to address gaps in knowledge of speaker gender, race, and experience at a major annual IBD conference over time.

METHODS:
AIBD program brochures from 2014 to 2020 were reviewed by two providers to evaluate speaker demographic information including gender, race, topic of discussion, institutional affiliation, and, for those trained in gastroenterology, years post-fellowship. In addition, the proportion of all-male panels was calculated. As a comparator, the proportion of female speakers and all-male panels was then compared to a control conference run by the same CME organization (Personalized Therapies in Thoracic Oncology).

RESULTS:
The percentage of female speakers of any specialty at AIBD increased from 25% in 2016 to 39% in 2020. Female adult gastroenterologist speakers increased from 12% in 2015 to 27% in 2020. The percentage of all gastroenterologists that are female in the US is 19%. All-male panels also decreased from an average of 47% in 2014-2017, to 11% in 2018-2020. As a comparator, 47% of speakers at the control conference were female and there were no all-male panels in 2020. For race, in any given year an average of 13% of speakers were Asian, 5% Hispanic/Latinx, and 1% Black. This remained static over time. The percentage of Asian, Hispanic/Latinx, and Black gastroenterologists in the US is 29%, 5%, and 6%, respectively. Average years of experience of speakers at AIBD appeared relatively static, with a mean of 15 years since fellowship training per speaker.

CONCLUSION:
From 2014-2020, the proportion of female speakers at AIBD has increased to over one third in main programming. There remains room for improvement, particularly in increasing the racial and ethnic diversity of speakers and inviting more gastroenterologists in the early stages of their careers.
P063 Prevalence in the Use of Complementary/Alternative Medicine in Patients With Inflammatory Bowel Disease from Centro Médico Nacional 20 de Noviembre
Authors: Romero Lozania Jose , Goméz Jesús López , Espinosa Tomas Cortes , Trujillo de la Fuente Korely , Amenabar Carlos Paredes , Perez-Cabeza deVaca Rebeca , Christian Navarro Gerrard , Gómez Mayra Ramos 
Published: December 2021

BACKGROUND:
Frequently, existing therapies for inflammatory bowel disease (IBD) do not achieve complete remission of the disease and are commonly associated with adverse effects. Therefore, patients regularly turn to complementary or alternative medicine (CAM). International CAM use in IBD patients ranges from 21% to 60%. There are no reported statistics of CAM use in the Mexican population who suffer IBD. This study´s objective was to determine the prevalence and characterize the use of CAM in our IBD population.

METHODS:
Observational, cross-sectional, retrospective study in patients diagnosed with IBD belonging to our Institution’s IBD center. The results were analyzed with measures of relative frequency, central tendency, and dispersion.

RESULTS:
A total of 52 patients with IBD (78% ulcerative colitis and 22% Crohn's disease) were included, 38.5% were exposed to CAM. A total of 27% used it as an aid in their IBD treatment. The remaining 11.5% used it for other reasons. Patients exposed to CAM for IBD averaged 51 ± 19 years, 64% were female and 71% had at least an undergraduate degree. The most used CAMs were acupuncture (42.8%), herbal (35.7%) and homeopathy (35.7%). Half of the patients used concomitantly two or more modalities, and 91.6% of the patients knew their diagnosis at the time that CAM was being used. The median exposure time to CAM was 4.5 ± 40.7 months. The main reasons for the use of CAM in IBD patients was as a complementary therapy in 58.3%, as the perception of lack of improvement was present in 33.3% of patients. Twenty-five percent of patients used CAM after a healthcare professional recommended it. CAM was used in 83.2% of patients with conventional treatment (Mesalamine: 74.6%, Mesalamine + Azathioprine: 8.3%) and only 16.5% were on biological therapy. A total of 58.3% CAM users perceived improvement in their symptoms. Currently 25% still use some modality of CAM. No statistically significant differences were found in sociodemographic variables and clinical outcomes when comparing the IBD group exposed to CAM vs the unexposed group.

CONCLUSION:
Exposure to CAM for IBD treatment had a prevalence of 27%. The main CAM modalities for IBD patients were acupuncture, herbal, and homeopathy. No relationship was demonstrated between the use of CAM in IBD patients and their clinical outcomes.
P070 Next Generation Wearable Technology for IBD Patients: A Feasibility Study
Authors: DiJoseph Kara , Rosario Michelle , Hajduczok Alex , Tinsley Andrew 
Published: December 2021

BACKGROUND:
Inflammatory Bowel Disease (IBD) prevalence is rising. Quality of life (QOL) in chronic illness is affected by various physical and psychosocial factors. Recent studies in other chronic illnesses have used remote physiologic monitoring (RPM) to help predict changes in disease activity and provide opportunities for patient self-management. It has been proposed that bowel inflammation can lead to suboptimal sleep, circadian rhythm disruption and even additional immune system activation. Heart rate variability (HRV) is a validated metric that has been used to predict outcomes and help manage other disease states. To date, there is limited data on the benefit of RPM in IBD care. We wish to explore the potential benefit of the Whoop Strap (new wearable technology device) as a method of RPM for IBD patients.

METHODS:
We recruited patients with Ulcerative Colitis from our tertiary care IBD center 18 years and older willing to wear the Whoop Strap 3.0 for 12 months with support from the Penn State Hershey Medical Center, 2020 Department of Medicine House Staff Grant; Clinical Trial Identifier is NCT04333810. During this time, participants were encouraged to use the Whoop mobile application to record symptoms. Physiologic metrics of interest included sleep, resting heart rate (RHR), and HRV; each were correlated to IBD related symptoms. Additionally, we performed monthly “check-ins” to collect disease activity (SCCAI), mood (HADS) and stress (PSS4) questionnaire data. Descriptive statistics were utilized along with correlation coefficient testing to explore potential relationships between Whoop metrics, disease activity scores and patient reported outcomes.

RESULTS:
Enrollment is ongoing with 7 participants, one of which was lost to follow up. Of note, 2 patients proactively reached out to communicate concern for an underlying disease flare as they noticed significant change in their Whoop metrics in conjunction with worrying symptoms. Patient 1 subsequently had serologic testing after having increased HRV and elevated RHR several days prior to symptoms; results were consistent with active inflammation exhibiting a rise in C-reactive protein from 0.25 mg/dL in 2020 to 2.82 mg/dL. Fecal calprotectin was also elevated at 566 ug/g. Colonoscopy is scheduled for the near future. Patient 2 also had noticeable HRV and RHR changes alongside significant sleep disturbances, which has prompted additional testing.

CONCLUSION:
Remote physiologic monitoring is a feasible way to give patients ownership of their medical care and involve them in the diagnostic and treatment process of their underlying IBD. As exhibited with our preliminary results, the Whoop device appears easy to use and may empower patients to reach out to providers even before symptoms occur, leading to an expedited evaluation for increased disease activity. Our feasibility study will hopefully lead to larger prospective efforts utilizing wearable technology devices such as the Whoop in IBD patients.
P072 Non-invasive Vagal Nerve Stimulation to Treat Crohn Disease and Ulcerative Colitis in Children and Young Adults: A Proof-of-Concept Clinical Trial
Authors: Sahn Benjamin , Pascuma Kristine , Tracey Kevin , Markowitz James 
Published: December 2021

BACKGROUND:
Current inflammatory bowel disease (IBD) therapies are limited by incomplete efficacy, loss of response, side effects and high costs. Vagal nerve stimulation (VNS) is an investigational Bioelectronic Medicine therapy targeting the nervous system to treat IBD through an ‘inflammatory reflex’ that reduces systemic inflammation. Data in humans with IBD are promising but limited to two small studies using a cervically implanted VNS device in adults with Crohn disease (CD); no data exist to date using a non-invasive VNS modality in IBD. This study aimed to evaluate the efficacy and safety of transcutaneous auricular VNS (ta-VNS) in children and young adults with CD or ulcerative colitis (UC).

METHODS:
IBD patients 10-21 years of age with mild/moderate CD or UC who did not achieve remission with conventional therapy, and a fecal calprotectin (FC) >200 ug/g within 4 weeks of study entry were enrolled. Subjects were randomized to receive either ta-VNS using a transcutaneous electrical nerve stimulator unit targeting the cymba conchae of the external left ear, or sham stimulation of the posterior lower leg, for 5 minutes once daily for a 2-week duration followed by a switch to the alternative stimulation for an additional 2 weeks. At week 4, all subjects were assigned to receive active ta-VNS for 5 minutes twice daily until week 16 so that all received 14 weeks of active ta-VNS by the end of the study. Primary study endpoint was defined as ∆FC ≥50% reduction from baseline to week 16. Secondary endpoints included improvement in weighted Pediatric Crohn Disease Activity Index (wPCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI).

RESULTS:
Twenty-two subjects were enrolled (12 UC, 10 CD; median age 14.4 years [range 10-21] 54.5% male). Median baseline FC was 587 (range 18 – 3828, SD 1074). 5 subjects (4 UC, 1 CD) had FC levels 12.5 at baseline, 3 (50%) achieved clinical remission (wPCDAI ≤ 10) at week 16. In the full UC cohort (n = 12), baseline PUCAI ranged from 0-45. In the 6 with PUCAI > 10 at baseline, 2 (33%) achieved clinical remission at week 16. There were no safety concerns.

CONCLUSION:
Non-invasive ta-VNS reduced FC levels and improved symptoms in a pediatric cohort with mild/moderate IBD. Further research is needed to identify optimal electrical dose and settings to achieve peak anti-inflammatory effect and to identify the mechanistic principles for this therapy.
Un modelo para integrar lenguaje y conocimiento del mundo: aprender a través de la lengua
Authors: Marimón Llorca Carmen 
Published: December 2021

El objetivo de este trabajo es mostrar cómo a través de la práctica de determinadas estrategias discursivas es posible que el/la estudiante de español como lengua extranjera comprenda un texto complejo como una totalidad, se acerque a los significados esenciales y se despierte en él el espíritu crítico. A partir del nuevo diseño de enseñanza/aprendizaje que suponen el MCER y el PCIC por lo que se refiere a la integración de los conceptos de interculturalidad y conocimiento social, se muestra la presencia, en el PCIC, de conceptos propios de la LSF y su desaprovechamiento a la hora de plantear un aprendizaje de la lengua socialmente orientado. La aplicación se realiza sobre el concepto de ciudadanía por lo que se explica en qué consisten los contenidos de la materia Educación para la ciudadanía (por lo que se refiere al Estado español) y se justifica su pertinencia para enseñar competencias lingüísticas e interculturales. Finalmente, se ejemplifica el planteamiento teórico con un análisis de tres fragmentos de libros de texto a partir de las metafunciones de Halliday. Se concluye con una reflexión sobre las posibilidades reales de vincular lengua y sociedad y de, tal y como se propone en el funcionalismo, “aprender a través de la lengua” también una lengua extranjera.
Supply Chain - innovation: past, present, and future
Authors: Seyhan Mehmet , Çiğdem Şemsettin , Yildiz Bülent , Meidute-Kavaliauskiene Ieva 
Published: December 2021

Nowadays, one of the factors that enable businesses to adapt to markets that are constantly renewed and changing due to the ever-increasing flow of information, and perhaps the most important, is innovation. Innovation is a topic that is frequently studied by both markets and academics. However, the increase in the quantity of studies conducted is far from meeting the need in this field. As a result of the shortening of product life cycles in current market conditions, companies are obliged to continuously innovate in order to sustain their existence. Increasing raw material and resource diversification requirement due to the increasing need for innovation made it necessary to examine and understand the supply chain in the context of innovation. The importance of innovation, especially in the case of participation by suppliers in innovation for a competitive advantage, has resulted in many in-depth studies published in research papers in the field. In this study, articles published in the Web of Science database between 1996-2020 and covering the topics of supply chain and innovation were analyzed in order to reveal the patterns of supply chain management and innovation research, identify relative deficiencies and provide some guidelines. For this purpose, a systematic literature review and bibliometric analysis related has been made. It has been possible to determine the effective actors in the field by including the distribution of the concepts in question according to time, countries, universities and journals. In addition, as a result of the keyword analysis, the evolution and open points of the field over time are among the findings of the study.