bluuebunny/crossref_metadata_2025_split huggingface dataset:
P580 Benchmarking IBD Pharmacy Services to optimise, strengthen and align IBD Expert Pharmacy Practice
Authors: St Clair Jones A , Meade U 
Published: May 2021

Abstract

Background
UK IBD Standards 2019 (ibduk.org) for the first time embed and describe Specialist Pharmacy Services (SPS) as an integral part of the IBD multidisciplinary team (MDT) and enable recognition and commissioning of Expert Pharmacists in IBD (EPharmIBD). The Benchmarking Tool, comprised of the IBD Patient Survey and Service Self-Assessment 2019/2020 provides a benchmark of expert pharmacy practice.

Methods
The Benchmarking Tool developed by IBD UK to drive quality defines A-D descriptors for all IBD standards (A=’excellent, proactive’ to D=’minimal, inadequate’ care). Descriptors for 4 (7%) standards describing SPS were developed through an e-Delphi process by IBD UK with EPharmIBD representation. Royal Pharmaceutical Society standards and SPS feedback were used to define descriptors for leadership, medicines expert role and MDT working. All UK IBD services were asked to complete the self-assessment between Oct 2019 and Jan 2020.

Results
10,222 IBD patients complete the IBD Patient Survey
166 (72%) paediatric and adult IBD services took part across the UK.

MDT Standard
46% (n=81/166) of all IBD Services have pharmacist input to the IBD MDT, but only 13% of all adult services (n = 18/134) met or exceeded the standard for 0.6 WTE EPharmIBD /250,000 population.

Leadership role
76% (n=98/129) of services with IBD leadership team work with a pharmacist of which 48% (n=47/98) work with an EPharmIBD on the annual formulary review. Of these teams 66% (n=31/47) work with an EPharmIBD on annual protocol/policy review, with actions and outcomes, actively develop pharmacy services within IBD.

Medicines expert role
Ward pharmacists in 95% (n=157/166) of IBD Services have access to an advanced generalist pharmacist for advice. Of these services 54% (n=84/157) are supported by an EPharmIBD but in only 41% (n=34/84) of these patients and ward pharmacists have access to an EPharmIBD on admission and during their stay for medication review, optimisation and personalised consultation.

Conclusion
Benchmarking shows a low level of pharmacy IBD expertise in the UK with a minority of services, ward pharmacists and patients having access to an EPharmIBD. Few IBD leadership teams work with an EPharmIBD and a small number of services have adequate EPharmIBDs commissioned.
In contrast where services report meeting the IBD Standards criteria for the number of EPharmIBDs, patients responding to the Patient Survey were more likely to be given appropriate information about potential treatments to help them make informed decisions.
This highlights the high need for advanced competencies and prioritisation of service commissioning in IBD.The pharmacy profession needs to respond urgently to this challenge to ensure high quality pharmaceutical care for IBD patients.
P587 Utility of intestinal ultrasound in Inflammatory Bowel Disease patients on management decisions
Authors: Abraham B , Saleh A , Perry C 
Published: May 2021

Abstract

Background
Intestinal Ultrasound (IUS) has been gaining momentum in the management of patients with inflammatory bowel disease (IBD). Underutilized in the United States(U.S.), we present the impact of IUS in management decisions in a cohort of IBD patients seen at a tertiary center.

Methods
This retrospective study analyzed all IBD patients seen at our institution undergoing IUS as part of routine clinical evaluation. Patient demographics, disease type, clinical activity, laboratory markers, and therapy was obtained. Patients with evidence of inflammation based on IUS characteristics of bowel wall thickening, with additional parameters of mural stratification, mesenteric fat, doppler flow, lymph nodes, dilated bowel, free fluid used as adjunct measures were compared to those without IUS features of activity. Subsequent management plan based on findings were evaluated.

Results
Of 148 patients seen for IUS (median age 41 (range 18–81), 67% female), 108(73%) had Crohn’s disease (CD), 39(26.4%) had ulcerative colitis (UC), 1(0.7%) had IBD-undetermined (IBD-U) with 111(75%) Caucasians, 9.5% Blacks, 8.8% Asians, and 6.8% Hispanics. Median disease duration was 8 years, range (0–43) with 113(94.1%) on biologic/small molecule therapy and 7(5.8%) on mesalamines. No differences in BMI were noted in those with active disease vs. those in remission. However, we noted 29(19.3%) had fatty liver on ultrasound, which correlated highly with high BMI (31 vs. 24) in those with normal liver (p&lt;0.05).
On IUS, 110(66%) of our patients had evidence of disease activity and 56(34%) were in remission. Inflammatory markers ESR and CRP did not correlate to IUS activity. In our UC patients Mayo score correlated to IUS findings but not Harvey Bradshaw Index (HBI) for CD. For those with positive findings on IUS, 29.5% escalated therapy for their IBD, and 13.3% required change in drug mechanism. For those in remission, the majority of patients 43(84.3%) continued their therapy while 3(5.9%) successfully de-escalated therapy.

Conclusion
In our study, IUS was useful in providing management decisions in those with active disease especially as there was a lack of correlation to inflammatory markers and HBI scores.
P657 Acceptability of a COVID-19 vaccine among cohort of Croatian IBD patients treated in tertiary IBD centre
Authors: Tomasic V , Bišćanin A , Ćaćić P , Kralj D , Dorosulić Z , Ogresta D , Hrabar D 
Published: May 2021

Abstract

Background
Several different types of COVID-19 vaccines are currently available in the EU. Although the massive prophylactic vaccination campaign is the best global solution that may bring an end to the pandemic, a certain proportion of the population seems to remain reluctant to it. No specific data for IBD patients is yet available. We aimed to assess prevalence and characteristics of IBD patients with COVID-19 vaccine hesitancy.

Methods
Adult IBD patients treated in our centre were invited to fulfil anonymous online survey from January 17th to February 25th, 2021. Participants’ characteristics were assessed using descriptive statistics. Normal distribution was assessed using Kolmogorov-Smirnov and Shapiro-Wilk tests. Continuous variables were compared with independent t-test and Mann–Whitney test when appropriate. Categorical variables were analyzed using the Chi-square test.

Results
A total of 120 subjects (43.3% female, mean age 34.5±12.3 years, 56.7% Crohn’s disease) completed the survey with a response rate of 96%. Median of disease duration was 8 years (IQR 3–12 years) and 65.8% of participants were on biologics. Overall, only 51.7% were willing to get a COVID-19 vaccine. Mean age of subjects who were inclined to vaccination was higher compared to those who are not (38.1 vs 30.4 years), t(118)=3.43, p=.001. There wasn’t statistically significant difference in median of disease duration between these two groups U=1551, N1=58, N2=62, p=.194, two-tailed. Mean BMI was higher in group of patients who were willing to get vaccinated (25.4 vs 23.2 kg/m2) t(111.67)=2.94, p=.004. There was no difference in vaccine acceptance between IBD patients who identified themselves as a high-risk group and the other which didn’t. Also, acceptability of a COVID-19 vaccine in IBD patients with or without comorbidities didn’t differ significantly (χ 2 (1, N = 120) = .52, p &lt; .47). Connection between biologic use and willingness to vaccination wasn’t observed (χ 2 (1, N = 120) = 2.06, p &lt; .15). Reported reasons for COVID-19 vaccine unacceptability were belief that vaccine can’t be safe because of its rapid development (55%), fear from possible interaction between IBD therapy and vaccine (44%), and fear that vaccine may lead to disease flare (36%).

Conclusion
A high proportion of Croatian IBD patients are unwilling to get vaccinated against COVID-19. Further patient education, motivation strategies and positive vaccination campaign by gastroenterologists are warranted. Those could be the most significant factors in driving the compliance to COVID-19 vaccination and in reducing IBD patient’s hesitancy to get vaccinated.
P661 Radon exposure and inflammatory bowel disease in a radon prone area
Authors: Mauriz Barreiro M V , Ruano-Raviña A , Baston-Rey I , Ferreiro-Iglesias R , Calviño-Suarez C , Barros-Dios J M , Dominguez-Muñoz J E , Barreiro-de Acosta M 
Published: May 2021

Abstract

Background
Inflammatory Bowel Disease (IBD) is a multifactorial pathology with an increasing incidence. There are environmental factors, many unknown, that participate in its development. There is no study having assessed a possible relationship with residential radon exposure, which is very high in the study area. The aim of this study was to analyze if residential radon concentration measured at a municipal level is associated with a higher incidence of IBD and its characteristics (clinical or demographic).

Methods
We performed an ecological study where we included all incident cases of IBD in the area of Santiago de Compostela between January and December 2017 in order to estimate municipal incidence rates. Radon levels at a municipal level were obtained from the Galician Radon Map and correlated with demographic factors and type of IBD. We used the Spearman’s correlation coefficient to test the existence of any association.

Results
96 patients were included, 63 (65.6%) with Ulcerative Colitis, 29 (30.25) with Crohn’s Disease and 4 (4.2%) with indeterminate colitis. Median age was 41 (IQR: 33.5 to 56 years), and 50.0% were women. The incidence rate per 100.000 inhabitants-year in the study area was 21.6 cases. The median radon concentration was 104.9Bq/m3 (IQR: 91.0 to 154.6), without statistically significant differences in function of the location of the house (rural vs. urban) nor the type of edification (flat vs house), p &gt;0.05. There were no statistically significant differences on the type of IBD developed (ulcerative colitis, Crohn’s disease or indeterminate colitis) regarding radon levels either (p&gt;0.05). There were no statistically significant differences (p&gt;0.05) between radon and sex of IBD cases. No correlation between radon levels and age of the individuals was observed (Spearman’s rho = -0.13, p-value 0.2), nor radon levels variation by age groups (p&gt;0.05). There was no correlation between radon concentration and cumulative incidence of IBD at municipal level (Spearman’s rho = 0.13, p-value 0.5), as it is shown in figure 1.

Conclusion
In the area of Santiago de Compostela there is a higher incidence of IBD in comparison with previous studies taking western countries as reference. It is possible that some environmental risk factors, could be responsible of this difference. In this study we have not found any correlation with municipal average radon concentration and incidence of IBD or any of its types.
Humanitarian Intervention and the Law of State Responsibility
Authors: Paddeu Federica I 
Published: May 2021

Abstract
The primary rules of international law do not permit states to resort to force for humanitarian purposes. Some scholars have thus attempted to rely on the secondary rules of state responsibility to find a legal basis for forcible humanitarian intervention. In particular, three claims can be identified: that humanitarian intervention is justified; that the state intervening for humanitarian purposes is excused; and that the consequences arising from the intervention for the state acting for humanitarian purposes ought to be mitigated. All three arguments rely either on the defence of necessity, cast as a justification or as an excuse, or on necessity-like reasoning, as the basis for mitigation. This article takes these three claims and draws out the implications of each both within and beyond the law of responsibility. In so doing, this article shows how each of the three arguments is more problematic and less straightforward than it appears at first and that, ultimately, none can provide an adequate legal basis for humanitarian intervention. The legality of humanitarian intervention must be found in the primary rules regulating the use of force in international relations and not in the secondary rules of state responsibility.
Strong, Non-specific Adhesion Using C-Lectin Heterotrimers in a Molluscan Defensive Secretion
Authors: Smith A M , Huynh P , Griffin S , Baughn M , Monka P 
Published: May 2021

Synopsis
The defensive mucus produced by the slug Arion subfuscus is tough and remarkably sticky. It spreads rapidly and adheres strongly to a wide range of surfaces. The adhesion is equally strong on wettable (glass) and non-wettable (plastic) surfaces. The adhesion appears to depend on a group of proteins that adsorb equally well to a wide range of different natural and artificial surfaces. Prominent among these proteins were those that distinguish the adhesive secretion from the non-adhesive mucus. The adhesive proteins were not washed off by non-ionic detergent. Similarly, the adhesion of the glue as a whole was not affected by this treatment. In contrast, high salt concentrations washed the most abundant adhesive proteins off the surfaces, and correspondingly weakened the glue’s attachment. The most abundant of the adhesive proteins were C-lectins, which appear to form heterotrimers. These and other lectin-like proteins in slug glue have a high proportion of aromatic amino acids at conserved locations, and are relatively small and often basic. The aromatic and cationic side chains may provide a powerful combination promoting and maintaining surface adhesion.
Genetics and animal models of familial pulmonary fibrosis
Authors: Yasutomo Koji 
Published: May 2021

Abstract
Pulmonary fibrosis is caused by the interplay between genetic and environmental factors. Recent studies have revealed various genes associated with idiopathic pulmonary fibrosis, as well as the causative genes for familial pulmonary fibrosis. Although increased death or dysfunction of type 2 alveolar epithelial (AT2) cells has been detected in lung specimens from pulmonary fibrosis patients, it remains unclear whether and how AT2 cell death or dysfunction is responsible for the progression of pulmonary fibrosis. A recent study showed that increased AT2 cell necroptosis is the initial event in pulmonary fibrosis by analyzing patients with familial pulmonary fibrosis and an animal model that harbors the same mutation as patients. The contribution of AT2 cell necroptosis to the pathogenesis of pulmonary fibrosis has not been identified in animal model studies, which validates the effectiveness of genetic analysis of familial diseases to uncover unknown pathogeneses. Thus, further extensive genetic studies of pulmonary fibrosis along with functional studies based on genetic analysis will be crucial not only in elucidating the precise disease process but also, ultimately, in identifying novel treatment strategies for both familial and non-familial pulmonary fibrosis.
Prognostic significance of the controlling nutritional status score in patients with metastatic renal cell carcinoma diagnosed before an era of first-line immune-oncology combination therapies
Authors: Sekiya Ken , Ito Masaya , Takemura Kosuke , Suzuki Hiroaki , Kobayashi Shuichiro , Koga Fumitaka 
Published: May 2021

Abstract

Objective
To explore the prognostic role of the controlling nutritional status score in patients with metastatic renal cell carcinoma.

Methods
We retrospectively analyzed 107 patients with metastatic renal cell carcinoma who received their diagnosis between 2007 and 2018 and were treated with or without a first-line interferon or tyrosine kinase inhibitor at a single cancer center. The controlling nutritional status score was based on values for albumin, lymphocyte count and total cholesterol at the metastatic renal cell carcinoma diagnosis. Association of the controlling nutritional status score and clinical variables, including the Memorial Sloan-Kettering Cancer Center and the International Metastatic Renal Cell Carcinoma Database Consortium risk classifications, with overall survival was examined using the Cox proportional hazard model. Predictive accuracy of the prognostic factors was assessed using Harrell’s concordance index.

Results
First-line interferon and tyrosine kinase inhibitor were given to 48 (45%) and 41 (38%) patients, respectively, and 28 (26%) and 33 (31%) patients underwent cytoreductive nephrectomy and metastasectomy, respectively. During follow-up (median: 36.3 months), 64 patients died. The median controlling nutritional status score was 2 (range: 0–8). A controlling nutritional status score ≥ 2 was significantly associated with shorter overall survival (P &lt; 0.01) independently of the Memorial Sloan-Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium risk classifications. Integration of the controlling nutritional status score into the Memorial Sloan-Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium risk classifications improved concordance index from 0.702 to 0.770 and from 0.698 to 0.749, respectively.

Conclusion
The controlling nutritional status score may serve as a prognostic biomarker objectively reflecting the general physical condition of patients with metastatic renal cell carcinoma treated with or without first-line interferon or tyrosine kinase inhibitor in terms of nutritional and immuno-inflammatory status.
Development of a gas environmental heating specimen holder system using differential pumping
Authors: Hashimoto Ayako , Han Yutain , Akimoto Hajime , Hozumi Ryo , Takeguchi Masaki 
Published: May 2021

Abstract
We developed a gas environmental heating specimen holder system by applying differential pumping effect to a specimen holder for the insitu transmission electron microscopy observation and electron energy loss spectroscopy (EELS) analysis of catalytic materials. In the insitu experiments, using two small orifices and O-rings, the maximum formed gas pressure was ∼20 Pa. Also, using a heater membrane, the maximum obtained heating temperature was ∼1000°C. We could actually observe/analyze the Pt and Ni nanoparticles with an atomic scale using a double-aberration-corrected microscope and an EELS instrument in the reaction gases at high temperatures.
Comparison of Mid-Turbinate and Nasopharyngeal Specimens for Molecular Detection of SARS-CoV-2 Among Symptomatic Outpatients at a Pediatric Drive-Through Testing Site
Authors: Sahni Leila C , Avadhanula Vasanthi , Ortiz Camerin S , Feliz Karen E , John Rebekah E , Brown Cameron A , Lively Joana Y , Rha Brian , Munoz Flor M , Piedra Pedro A , Dunn James J , Boom Julie A 
Published: May 2021

Abstract

Background
Nasopharyngeal (NP) specimen testing by reverse transcriptase polymerase chain reaction (RT-PCR) is the standard of care for detecting SARS-CoV-2. Data comparing the sensitivity and specificity of the NP specimen to the less invasive, mid-turbinate (MT) nasal specimen in children are limited.

Methods
Paired clinical NP and research MT specimens were collected from children &lt;18 years with respiratory symptoms and tested by molecular assays to detect SARS-CoV-2 RNA. Sensitivity, specificity, and agreement (Cohen’s kappa [κ]) were calculated for research MT specimens compared to the clinical NP specimens.

Results
Out of 907 children, 569 (62.7%) had parental consent and child assent when appropriate to participate and provided paired MT and NP specimens a median of 4 days after symptom onset (range 1-14 days). 16.5% (n = 94) of MT specimens were positive for SARS-CoV-2 compared with 20.0% (n = 114) of NP specimens. The sensitivity of research MT compared to clinical NP specimens was 82.5% (95% CI: 74.2%, 88.9%), specificity was 100.0% (95% CI: 99.2%, 100.0%), and overall agreement was 96.1% (κ = 0.87). The sensitivity of MT specimens decreased with time from 100% (95% CI: 59.0%, 100.0%) on day 1 of illness to 82.1% (95% CI: 73.8%, 88.7%) within 14 days of illness onset; sensitivity was generally &gt;90% when specimens were collected within the first week of illness.

Conclusion
MT specimens, particularly those collected within the first week of illness, have moderately reduced sensitivity and equivalent specificity to less-tolerated NP specimens in pediatric outpatients. MT specimen use in children may represent a viable alternative to NP specimen collection.
Effects of dietary live yeast supplementation on growth performance and biomarkers of metabolism and inflammation in heat-stressed and nutrient-restricted pigs
Authors: Mayorga Edith J , Kvidera Sara K , Horst Erin A , Al-Qaisi Mohmmad , McCarthy Carrie S , Abeyta Megan A , Lei Samantha , Elsasser Theodore H , Kahl Stanislaw , Kiros Tadele G , Baumgard Lance H 
Published: May 2021

Abstract
Study objectives were to determine the effects of dietary live yeast (Saccharomyces cerevisiae strain CNCM I-4407; ActisafHR+; 0.25g/kg of feed; Phileo by Lesaffre, Milwaukee, WI) on growth performance and biomarkers of metabolism and inflammation in heat-stressed and nutrient-restricted pigs. Crossbred barrows (n = 96; 79 ± 1 kg body weight [BW]) were blocked by initial BW and randomly assigned to one of six dietary-environmental treatments: 1) thermoneutral (TN) and fed ad libitum the control diet (TNCon), 2) TN and fed ad libitum a yeast containing diet (TNYeast), 3) TN and pair-fed (PF) the control diet (PFCon), 4) TN and PF the yeast containing diet (PFYeast), 5) heat stress (HS) and fed ad libitum the control diet (HSCon), or 6) HS and fed ad libitum the yeast diet (HSYeast). Following 5 d of acclimation to individual pens, pigs were enrolled in two experimental periods (P). During P1 (7 d), pigs were housed in TN conditions (20 °C) and fed their respective dietary treatments ad libitum. During P2 (28 d), HSCon and HSYeast pigs were fed ad libitum and exposed to progressive cyclical HS (28–33 °C) while TN and PF pigs remained in TN conditions and were fed ad libitum or PF to their HSCon and HSYeast counterparts. Pigs exposed to HS had an overall increase in rectal temperature, skin temperature, and respiration rate compared to TN pigs (0.3 °C, 5.5 °C, and 23 breaths per minute, respectively; P &lt; 0.01). During P2, average daily feed intake (ADFI) decreased in HS compared to TN pigs (30%; P &lt; 0.01). Average daily gain and final BW decreased in HS relative to TN pigs (P &lt; 0.01); however, no differences in feed efficiency (G:F) were observed between HS and TN treatments (P &gt; 0.16). A tendency for decreased ADFI and increased G:F was observed in TNYeast relative to TNCon pigs (P &lt; 0.10). Circulating insulin was similar between HS and TN pigs (P &gt; 0.42). Triiodothyronine and thyroxine levels decreased in HS compared to TN treatments (~19% and 20%, respectively; P &lt; 0.05). Plasma tumor necrosis factor-alpha (TNF-α) did not differ across treatments (P &gt; 0.57) but tended to decrease in HSYeast relative to HSCon pigs (P = 0.09). In summary, dietary live yeast did not affect body temperature indices or growth performance and had minimal effects on biomarkers of metabolism; however, it tended to improve G:F under TN conditions and tended to reduce the proinflammatory mediator TNF-α during HS. Further research on the potential role of dietary live yeast in pigs during HS or nutrient restriction scenarios is warranted.