bluuebunny/crossref_metadata_2025_split huggingface dataset:
P515 A 12-week tailored physical training program including dietary advice in children with Inflammatory Bowel Disease: a randomized crossover trial
Authors: Scheffers L , van den Berg L E , Pijnenburg M W , Utens E M , Dieleman G C , van der Ploeg A T , Helbing W A , Escher J C 
Published: May 2021

Abstract

Background
Inflammatory Bowel Disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. Recently, physical activity has been suggested to improve the quality of life and course of disease in adult IBD patients. The aim of this study was to investigate physical functioning in paediatric IBD patients and to determine the effects of a tailored 12-week lifestyle intervention including a physical training program.

Methods
Figure 1 shows our study design and measurements. The tailored 12-week lifestyle intervention consisted of 3 strenuous physical training sessions a week and dietary advice. Effects on exercise capacity, endurance, physical activity levels, disease activity, quality of life, and fatigue were measured in paediatric IBD patients. Mild disease activity was defined as a PCDAI between 10 - 27.5 or PUCAI between 10 - 34.

Results
Sixteen paediatric IBD patients (median age 15 [9 - 17]) were included, 13 patients successfully completed the training program, 2 patients are still participating. At baseline, most patients had mild disease activity (n=9). Patients had reduced exercise capacity (76.8%±17.7% of predicted PeakVO2 , and reduced physical activity levels as shown by 80.3%±7.4% of measured time being spent in sedentary activity. PCDAI/PUCAI scores decreased significantly over the intervention period (13.8±11.7 vs. 3.65±4.5, P=0.002). Fecal calprotectin also decreased significantly (400 [18–3089] vs. 128 [20–2704], P=0.041). All patients but one had no changes in medical regimens before or during the lifestyle intervention that could have influenced disease activity. After the 12-week lifestyle intervention period, 9 out of 13 patients were in clinical remission. Maximum walked distance increased significantly (503±69 vs. 540±77 meters, P=0.001), although PeakVO2 and percentage of time spent in moderate-to-vigorous activity did not. Patients improved on overall quality of life measured by the Impact III questionnaire (+2.4 points, p=0.017). The Child Health Questionnaire showed a significant improvement on the child-reported physical functioning scale and on 5 parent-reported scales of quality of life. Child-reported fatigue measured by the PedsQol MFS did not improve significantly, parents-reported fatigue did. No changes were found on mentioned outcomes during the control period. After baseline measurements, the COVID-19 lock-down period started, possibly affecting normal daytime activities of the patients during the lifestyle intervention period.

Conclusion
A 12-week tailored physical training program including dietry advice is safe and beneficial for paediatric IBD patients and may contribute to better control of inflammation.
P586 Drug-induced lipid changes in patients with Inflammatory Bowel Disease: a single center, prospective study
Authors: Sleutjes J , de Vries A C , Roeters van Lennep J E , van der Woude C J 
Published: May 2021

Abstract

Background
Drug use in the treatment of inflammatory bowel disease (IBD) might negatively impact lipid levels. In this study, we assessed drug-induced changes in the lipid profile after IBD induction therapy.

Methods
In this single center, prospective study IBD patients aged ≥17 years who started systemic drug therapy (corticosteroids, thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, ustekinumab and tofacitinib) for IBD were included. Exclusion criteria were pregnancy, history of liver transplantation and use of lipid lowering drugs. Data on cardiovascular risk profile, disease activity (HBI, SCCAI, CRP, FCP) and concomitant medication use were collected. To calculate mean lipid changes after induction therapy, nonfasting lipid levels (total cholesterol (TC), HDL-c, LDL-c, triglycerides (TG)) were measured before and 8–10 weeks after start of therapy. Pearson correlation test was performed to assess the association between lipid changes and CRP.

Results
A total of 183 patients (87 males (48%), median age 36 years (IQR 28–48), 128 Crohn’s disease (70%), 46 CU (3%), 9 IBD-U (7%)) were included. (Table 1) Fourty-nine patients were on concomitant steroids at baseline (31%). Relative increases in TC, HDL-c and LDL-c were significant after treatment with corticosteroids and tofacitinib (+9%, +17%, +8% and +19%, +29%, +24%, respectively) and decrease in TG after treatment with corticosteroids, thiopurines, infliximab, adalimumab, ustekinumab and tofacitinib (-9%, -14%, -10%, -8%, -11%, -8%, respectively). (Table 2, Figure 1) A significant inverse relationship was found between CRP and TC (R -.171), HDL-c (R -.202), LDL-c (R -.153) but not with TG.

Conclusion
Serum lipid levels increased most after start of corticosteroids and tofacitinib as compared to other drug therapies. Whether these changes are explained by the control of inflammation or by the mechanism of action of these agents remains undetermined.
P624 A higher prevalence of human papillomavirus in patients with perianal fistulizing Crohn’s disease compared to patients with anorectal fistula without Crohn’s disease
Authors: Rodrigues Boarini L , Sobrado Jr C W , Facanali C B G , Queiroz N S F , Albuquerque I C , Boarini P , Boarini M R , Borba M R , Nahas S C , Cecconello I 
Published: May 2021

Abstract

Background
Perianal fistulizing Crohn’s disease (PFCD) is the main risk factor for anal cancer in patients with inflammatory bowel disease. It is not known whether this occurs due to a higher frequency of human papillomavirus (HPV) in this population or due to the chronic inflammatory condition resulting from perianal fistulas. We aimed to evaluate whether there is a higher prevalence of HPV and high-risk HPV in patients with PFCD compared to the control group, estimate the prevalence of HPV and the subtypes most frequently associated with PFCD.

Methods
We performed a bicentric cross sectional study in which participants were matched by age and sex. A total of 108 patients with surgical indication for perianal fistula, were recruited, 54 patients in PFCD group and 54 patients with anorectal fistula without Crohn’s disease, from December 2018 through November 2020. These patients were subject to histological material collection during exam under anesthesia with biopsy of the fistulous pathway. The sample was sent for HPV detection and genotyping by INNO-LiPA HPV Genotyping Extra II.

Results
The PFCD group showed a statistically higher frequency of HPV in the fistulous path compared to control group (33.3% vs 16.7%, p = 0.046). The isolated analysis of the high-risk subtypes numerically demonstrated double the frequency in PFCD group, however, not statistically significant (18.5% vs 9.3%, p = 0.164). After multiple logistic regressions, patients with PFCD had a chance of HPV 3.42 times higher than patients without Crohn’s disease (OR = 3.42, 95% CI, 1.25–9.40), regardless of other variables. The subtypes most frequently identified in PFCD group were HPV11 (12.72%) and HPV16 (9.09%).

Conclusion
Perianal fistulizing Crohn’s disease is associated with a higher prevalence of HPV compared to patients with anorectal fistula without Crohn’s disease.
P652 Treatment patterns in patients receiving outpatient care for inflammatory bowel disease in Russian Federation
Authors: Uspenskiy Y , Galagudza M , Ivanov S , Fominikh Y , Dreval R , Mayorova O 
Published: May 2021

Abstract

Background
There is a global trend of increasing prevalence of inflammatory bowel disease (IBD) worldwide, Russian Federation including. Meanwhile, treatment options for patients with IBD have expanded significantly in recent years with the advent of novel biotherapeutics. However, insufficient information is available on the treatment patterns of Crohn’s disease (CD) and ulcerative colitis (UC) in large cities. We aimed to study the levels of usage of different therapeutic agents in the patients with IBD receiving outpatient care in St-Petersburg, Russian Federation.

Methods
In a cross-sectional study lasting from January 1, 2019 to December 31, 2019, the data on drug therapy of adult (&gt; 18 years old) patients with IBD were obtained from 42 outpatient clinics of St. Petersburg. The Wilson’s method of 95% confidence interval (CI) determination was used to determine the statistical differences in the levels of usage of different therapeutics. р values ≤ 0.05 were considered significant. The data on continuous variables are presented as “median (25 quartile; 75 quartile)”.

Results
In total, 535 patients were included. Among them, there were 241 and 294 patients with CD and UC, respectively. Mean age of the patients with CD and UC was 40 (29; 59) and 43 (32; 59) years, respectively (p &gt; 0.05). Among the patients with CD, the ileal, colonic, ileocolonic, and other locations were found in 23.4, 37.6, 34.4, and 4.6 %, respectively. In UC patients, we observed proctitis, left-sided colitis and pancolitis in 24.4, 55.2, and 20.4%, respectively. Oral 5-aminosalicylic acid (5-ASA) drugs, topical 5-ASA drugs, oral (both systemic and topical) glucocorticoids, immunosuppressants, and biologicals were used in 89.3 (84.4–92.8), 32.6 (26.7–39.1), 17.5 (13.0–23.1), 16.5 (12.2–22.0), and 7.3% (0.4–11.7) of patients with CD, accordingly. In UC patients, oral 5-ASA, topical 5-ASA, oral (both systemic and topical) glucocorticoids, immunosuppressants, and biologicals were used in 86.2 (81.4–90.0), 63.1 (56.9–68.8), 12.1 (8.6–16.8), 4.4 (2.5–7.7), and 0.8% (0.02–2.7) of cases, accordingly.

Conclusion
Oral 5-ASA is the most commonly used class of drugs in Russian patients with both CD and UC. The use of topical 5-ASA formulations was more common in patients with UC as compared to CD patients, while immunosuppressive drugs were more commonly prescribed to CD vs. UC patients. We found relatively rare use of systemic and topical oral glucocorticoids in the patients with IBD receiving outpatient care. In our cohort, the use of biological agents was minimal, which probably reflects the trend of prescribing biologicals mostly at the specialized clinics.
Pulsed field ablation prevents chronic atrial fibrotic changes and restrictive mechanics after catheter ablation for atrial fibrillation
Authors: Nakatani Yosuke , Sridi-Cheniti Soumaya , Cheniti Ghassen , Ramirez F Daniel , Goujeau Cyril , André Clementine , Nakashima Takashi , Eggert Charles , Schneider Christopher , Viswanathan Raju , Krisai Philipp , Takagi Takamitsu , Kamakura Tsukasa , Vlachos Konstantinos , Derval Nicolas , Duchateau Josselin , Pambrun Thomas , Chauvel Remi , Reddy Vivek Y , Montaudon Michel , Laurent François , Sacher Frederic , Hocini Mélèze , Haïssaguerre Michel , Jaïs Pierre , Cochet Hubert 
Published: May 2021

Abstract

Aims
Pulsed field ablation (PFA), a non-thermal ablative modality, may show different effects on the myocardial tissue compared to thermal ablation. Thus, this study aimed to compare the left atrial (LA) structural and mechanical characteristics after PFA vs. thermal ablation.

Methods and results
Cardiac magnetic resonance was performed pre-ablation, acutely (&lt;3 h), and 3 months post-ablation in 41 patients with paroxysmal atrial fibrillation (AF) undergoing pulmonary vein (PV) isolation with PFA (n = 18) or thermal ablation (n = 23, 16 radiofrequency ablations, 7 cryoablations). Late gadolinium enhancement (LGE), T2-weighted, and cine images were analysed. In the acute stage, LGE volume was 60% larger after PFA vs. thermal ablation (P &lt; 0.001), and oedema on T2 imaging was 20% smaller (P = 0.002). Tissue changes were more homogeneous after PFA than after thermal ablation, with no sign of microvascular damage or intramural haemorrhage. In the chronic stage, the majority of acute LGE had disappeared after PFA, whereas most LGE persisted after thermal ablation. The maximum strain on PV antra, the LA expansion index, and LA active emptying fraction declined acutely after both PFA and thermal ablation but recovered at the chronic stage only with PFA.

Conclusion
Pulsed field ablation induces large acute LGE without microvascular damage or intramural haemorrhage. Most LGE lesions disappear in the chronic stage, suggesting a specific reparative process involving less chronic fibrosis. This process may contribute to a preserved tissue compliance and LA reservoir and booster pump functions.
A programme for early diagnosis of atrial fibrillation: a multi-centre study in primary care
Authors: Cabrera Javier D , Fluxà Guillem , Fuentes Carmen , Hoyo Jordi , Navarro Marta , Sant Elisenda , de la Poza María Amparo , Altés Andrés , Duch Núria , Caubet Montserrat , Vieytes Gerardo , Pérez Ana M , Herrero María Alba , Gracia Pablo , Domínguez Veronica , Mont Lluís , Coll-Vinent Blanca 
Published: May 2021

Abstract

Background
Atrial fibrillation (AF) is a morbid disease whose complications can be prevented if prompt and correctly treated.

Objective
To assess the usefulness of an early AF diagnosis programme in at-risk individuals in primary care centres.

Methods
In an open-label, multi-centre, controlled interventional study, individuals with one or more risk factors for AF but without known AF were enrolled. They were allocated to intervention and control groups in a 1:2 ratio. Participants in the intervention group had three clinical and educational visits (0, 6 and 12 months). In intervention subgroup A, an electrocardiogram (ECG) was performed at each visit and in subgroup B, only if arrhythmia was detected on auscultation. After 2 years, the medical records of all participants were reviewed. Participants diagnosed with AF were followed for two additional years.

Results
Of the total 2231 participants enrolled, 1503 (67.36%) were allocated to the control group and 728 (32.63%) to the intervention groups (355 in subgroup A, 373 subgroup B). The groups showed similar clinical characteristics. New-onset AF was diagnosed in 38 patients. Early detection in subgroup B was similar to subgroup A and superior to control group (3.2% versus 1.2%, hazard ratio 3.149, 95% confidence interval 1.503–6.597, P = 0.002). AF patients in subgroups A and B had similar long-term complications and a tendency for fewer complications than AF patients in the control group.

Conclusions
An intervention programme consisting of health education, systematic auscultation and opportunistic ECG by a primary care provider is a useful method for the early diagnosis of AF.
Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration
Authors: Zocchi Mark S , Robinson Stephanie A , Ash Arlene S , Vimalananda Varsha G , Wolfe Hill L , Hogan Timothy P , Connolly Samantha L , Stewart Maureen T , Am Linda , Netherton Dane , Shimada Stephanie L 
Published: May 2021

Abstract

Objective
The study sought to investigate whether consistent use of the Veterans Health Administration’s My HealtheVet (MHV) online patient portal is associated with improvement in diabetes-related physiological measures among new portal users.

Materials and Methods
We conducted a retrospective cohort study of new portal users with type 2 diabetes that registered for MHV between 2012 and 2016. We used random-effect linear regression models to examine associations between months of portal use in a year (consistency) and annual means of the physiological measures (hemoglobin A1c [HbA1c], low-density lipoproteins [LDLs], and blood pressure [BP]) in the first 3 years of portal use.

Results
For patients with uncontrolled HbA1c, LDL, or BP at baseline, more months of portal use in a year was associated with greater improvement. Compared with 1 month of use, using the portal 12 months in a year was associated with annual declines in HbA1c of -0.41% (95% confidence interval [CI], -0.46% to -0.36%) and in LDL of -6.25 (95% CI, -7.15 to -5.36) mg/dL. Twelve months of portal use was associated with minimal improvements in BP: systolic BP of -1.01 (95% CI, -1.33 to -0.68) mm Hg and diastolic BP of -0.67 (95% CI, -0.85 to -0.49) mm Hg. All associations were smaller or not present for patients in control of these measures at baseline.

Conclusions
We found consistent use of the patient portal among new portal users to be associated with modest improvements in mean HbA1c and LDL for patients at increased risk at baseline. For patients with type 2 diabetes, self-management supported by online patient portals may help control HbA1c, LDL, and BP.
Automated detection of substance use information from electronic health records for a pediatric population
Authors: Ni Yizhao , Bachtel Alycia , Nause Katie , Beal Sarah 
Published: May 2021

Abstract

Objective
Substance use screening in adolescence is unstandardized and often documented in clinical notes, rather than in structured electronic health records (EHRs). The objective of this study was to integrate logic rules with state-of-the-art natural language processing (NLP) and machine learning technologies to detect substance use information from both structured and unstructured EHR data.

Materials and Methods
Pediatric patients (10-20 years of age) with any encounter between July 1, 2012, and October 31, 2017, were included (n = 3890 patients; 19 478 encounters). EHR data were extracted at each encounter, manually reviewed for substance use (alcohol, tobacco, marijuana, opiate, any use), and coded as lifetime use, current use, or family use. Logic rules mapped structured EHR indicators to screening results. A knowledge-based NLP system and a deep learning model detected substance use information from unstructured clinical narratives. System performance was evaluated using positive predictive value, sensitivity, negative predictive value, specificity, and area under the receiver-operating characteristic curve (AUC).

Results
The dataset included 17 235 structured indicators and 27 141 clinical narratives. Manual review of clinical narratives captured 94.0% of positive screening results, while structured EHR data captured 22.0%. Logic rules detected screening results from structured data with 1.0 and 0.99 for sensitivity and specificity, respectively. The knowledge-based system detected substance use information from clinical narratives with 0.86, 0.79, and 0.88 for AUC, sensitivity, and specificity, respectively. The deep learning model further improved detection capacity, achieving 0.88, 0.81, and 0.85 for AUC, sensitivity, and specificity, respectively. Finally, integrating predictions from structured and unstructured data achieved high detection capacity across all cases (0.96, 0.85, and 0.87 for AUC, sensitivity, and specificity, respectively).

Conclusions
It is feasible to detect substance use screening and results among pediatric patients using logic rules, NLP, and machine learning technologies.
Growth performance and carcass quality are not different between pigs fed diets containing cold-fermented low-oil DDGS and pigs fed conventional DDGS, but pelleting improves gain to feed ratio regardless of source of DDGS
Authors: Rodriguez Diego A , Lee Su A , Stein Hans H 
Published: May 2021

Abstract
The objective of this study was to test the hypothesis that growth performance and carcass characteristics of pigs fed diets containing cold-fermented, low oil distillers dried grains with solubles (DDGS) is not different from that of pigs fed diets containing conventional DDGS regardless of the physical form of the diets. A total of 160 barrows and gilts were used. There were 4 diets, 10 pens per diet, and 4 pigs per pen. Pigs were weaned at 21 d of age and fed a common phase 1 diet that did not contain DDGS during the initial 7 d post-weaning. Pigs were then allotted to the four diets that were arranged in a 2 × 2 factorial design with two sources of DDGS (cold-fermented and conventional DDGS) and two diet forms (meal and pellets). Pigs were fed phase 2 diets from day 7 to 21 and phase 3 diets from day 21 to 43 post-weaning. All diets were based on corn and soybean meal, but phase 2 diets also contained 15% DDGS and phase 3 diets contained 30% DDGS. From day 43, pigs were fed grower diets for 38 d, early finisher diets for 38 d, and late finisher diets for 18 d and these diets also contained 30% DDGS. Feed was provided on an ad libitum basis and daily feed allotments were recorded. Pigs were weighed at the beginning of each phase and at the conclusion of the experiment. On the last day of the experiment, the pig in each pen with a body weight that was closest to the pen average was slaughtered and carcass measurements were determined. Combined results for the two nursery phases indicated that feeding meal diets instead of pelleted diets increased (P &lt; 0.001) average daily feed intake and decreased (P &lt; 0.05) gain to feed ratio (G:F). However, no differences between the two sources of DDGS were observed for the overall growth performance of weanling pigs. For the entire growing-finishing period, the source of DDGS did not affect growth performance, but pigs fed meal diets had reduced (P &lt; 0.001) G:F compared with pigs fed the pelleted diets. There were no differences between the two sources of DDGS for carcass characteristics. Back fat was greater (P &lt; 0.05) for pigs fed pelleted diets than for pigs fed meal diets. In conclusion, no differences in growth performance or carcass characteristics between pigs fed cold-fermented DDGS and pigs fed conventional DDGS were observed. However, pigs fed pelleted diets had greater G:F and greater back fat than pigs fed meal diets.
Evolution of splashback boundaries and gaseous outskirts: insights from mergers of self-similar galaxy clusters
Authors: Zhang Congyao , Zhuravleva Irina , Kravtsov Andrey , Churazov Eugene 
Published: May 2021

ABSTRACT
A self-similar spherical collapse model predicts a dark matter (DM) splashback and accretion shock in the outskirts of galaxy clusters while missing a key ingredient of structure formation – processes associated with mergers. To fill this gap, we perform simulations of merging self-similar clusters and investigate their DM and gas evolution in an idealized cosmological context. Our simulations show that the cluster rapidly contracts during the major merger and the splashback radius rsp decreases, approaching the virial radius rvir. While in the self-similar model rsp depends on a smooth mass accretion rate parameter Γs, our simulations show that in the presence of mergers, rsp responds to the changes in the total mass accretion rate Γvir, which accounts for both mergers and smooth accretion. The scatter of the Γvir − rsp/rvir relation indicates a generally low Γs ∼ 1 in clusters in cosmological simulations. In contrast to the DM, the hot gaseous atmospheres significantly expand by the merger-accelerated (MA-) shocks formed when the runaway merger shocks overtake the outer accretion shock. After a major merger, the MA-shock radius is larger than rsp by a factor of up to ∼1.7 for Γs ≲ 1 and is ∼rsp for Γs ≳ 3. This implies that (1) mergers could easily generate the MA-shock-splashback offset measured in cosmological simulations, and (2) the smooth mass accretion rate is small in regions away from filaments where MA-shocks reside. We further discuss the shapes of the DM haloes, various shocks, and contact discontinuities formed at different epochs of the merger, and the ram-pressure stripping in cluster outskirts.