bluuebunny/crossref_metadata_2025_split huggingface dataset:
P550 Short term effects of a combined lifestyle intervention in patients with Inflammatory Bowel Disease
Authors: Lamers C R , de Roos N M , Heerink H H , van de Worp - Kalter L A , Witteman B J M 
Published: May 2021

Abstract

Background
Diet and physical activity might help to improve quality of life and maintain remission in patients with inflammatory bowel disease (IBD). In other conditions, interventions in which diet and physical activity are combined seem to be more effective than separate interventions. Therefore, we assessed the effect of a combined lifestyle intervention on the impact of disease on daily life, clinical disease activity, fatigue and quality of life in patients with Crohn’s disease (CD) or ulcerative colitis (UC).

Methods
A single arm intervention study was performed in IBD patients in remission or with mildly active disease. Participants received personal advice to improve their diet and level of physical activity by a dietician and a physiotherapist in one face-to-face and one telephone consult. These advices were supported by guidelines based on the Dutch dietary and physical activity guidelines, a recipe app and a booklet with physical activity exercises. IBD disability index (IBD-DI) to assess impact of disease on daily life, clinical disease activity questionnaires (P-HBI or P-SCCAI), IBD fatigue (IBD-F) patient self-assessment scale and IBD quality of life questionnaire (IBDQ) were completed. The Eetscore Food Frequency Questionnaire (Eetscore FFQ) and Short Questionnaire to Assess Health-enhancing physical activity (SQUASH) were used to assess diet and physical activity. Changes from baseline to 5 weeks after start were investigated by paired samples t-tests or Wilcoxon signed rank tests.

Results
We included 29 participants. At time of this preliminary analysis, 25 participants completed baseline and 5-week assessments (11 males, 11 CD, median age 36 years [IQR 29–53], median BMI 25 kg/m2 [IQR 24–28]). After 5 weeks, diet quality had significantly improved (p&lt;0.001), but level of physical activity had not (p=0.509). Impact of disease on daily life (IBD-DI) decreased with 2.5 points (95%CI -5.5-0.4; p=0.09). Disease activity did not change significantly. There was a significant decrease in fatigue (median IBD-F 20 [IQR 8–29] to 15 [IQR 3–24; p=0.03]) and a significant increase in quality of life (median IBDQ 194 [IQR 179–206] to 196 [IQR 186–209; p=0.03]).

Conclusion
These preliminary results suggest that a combined lifestyle intervention is effective to reduce fatigue and to increase quality of life in patients with IBD, at least in the short term. Impact of disease on daily life and clinical disease activity did not improve significantly. Participants reported their level of physical activity to be restricted due to COVID-19 measures, which could explain the lack of effect on this outcome. This study is still ongoing and we expect follow-up data up till 1 year after start.
P552 Assessing adherence to objective disease monitoring and outcomes with adalimumab in a real-world IBD cohort
Authors: Xiao Y , Al Khoury A , Golovics P , Kohen R , Afif W , Wild G , Friedman G , Galiatsatos P , Hilzenrat N , Szilagyi A , Wyse J , Cohen A , Bitton A , Bessissow T , Lakatos P L 
Published: May 2021

Abstract

Background
Data suggests that tight objective monitoring may improve clinical outcomes in IBD.

Methods
The aim of this study is to assess the adherence to serial tight objective monitoring(clinical and biomarkers) and its effect on clinical outcomes. We retrospectively reviewed the chart of 428 consecutive IBD patients started on adalimumab between January 1,2015–January 1,2019 [338 Crohn’s disease(CD), 90 ulcerative colitis(UC)]. Clinical symptoms (assessed by Harvey-Bradshaw-Index, partial Mayo score), C-Reactive Protein(CRP), and fecal calprotectin(FCAL) assessments were captured at treatment initiation and at 3, 6, 9, and 12 months. Dose optimization and drug sustainability curves were plotted by Kaplan-Meier method

Results
Clinical evaluation was available in nearly all patients at 3(CD-UC:95-94%), 6(90-83%), 9(86-85%) and 12(96-89%) months. CRP was also available in nearly all patients but testing frequency decreased in CD patients over time. Compliance to serial FCAL testing was low. Clinical remission at one-year was higher in patients adherent to early assessment visit at 3 months (p=0.001 for CD and UC). Adherence to early follow-up resulted in earlier dose optimisation in CD and UC patients (pLogrank=0.026 for UC & p=0.09 for CD). Overall drug sustainability did not differ.

Conclusion
Clinical and CRP, but not FCAL, were frequently assessed in patients starting adalimumab. Adherence to early objective combined follow-up visits resulted in earlier dose optimization, improved one-year clinical outcomes but did not change drug sustainability.
P575 Nutrition and Inflammatory Bowel Disease – a nationwide survey of patients, gastroenterologists and dietitians
Authors: McCarthy N , Schultz M , Wall C 
Published: May 2021

Abstract

Background
Literature indicates that Inflammatory Bowel Disease (IBD) patients (pts), who are at high risk of malnutrition, often adjust their diet following diagnosis and wish to receive specialised nutrition advice from their healthcare team. Dietitians (DTs) are health professionals (HPs) with specialist nutrition expertise. Our aim was to assess nutrition advice provided by different HPs.

Methods
Electronic surveys were disseminated to New Zealand IBD pts, DTs and gastroenterologists (GIs) asking about experience of, and practice providing, IBD nutrition advice. DTs and GIs were asked which nutrition interventions they recommend. DTs responded separately for Crohn’s disease (CD) and Ulcerative Colitis (UC) while GIs responded about IBD pts as a group.

Results
Surveys were completed by 407 pts, 79 DTs and 40 GIs.
Almost all (97%) GIs report their IBD pts ask about nutrition and 95% said they provide nutrition advice. DTs and GIs commonly recommended specific diets: modified fibre, high protein/energy and low fermentable carbohydrate diets, with occasional use of some other diet regimes (Table 1).
Half of the pts (52%) had seen a DT for advice and 31% had received nutrition advice from other HPs, commonly their GI, general practitioner or IBD nurse. Some patients (13%) received nutrition advice from other practitioners: nutritionist, naturopath, other medical doctors, counsellor, cannabis practitioner, integrated health professional, osteopath and herbalist.
Patients frequently received general nutrition advice and specific diet advice including various strict exclusion diets and herbal, probiotic and vitamin/mineral supplements from DTs and non-DT HPs (Table 1). No DTs or GIs recommended low carb, high fat, sugar free or ketogenic diets in IBD, which were recommended to pts by other HPs.

Conclusion
Pts with IBD often ask for nutrition advice but only half had seen a DT. The advice given by HPs (medical and non-medical) varies and it appears that this high-risk group of pts is not always offered advice with evidence of scientific benefit in pts with IBD. Pts would benefit from greater access to DTs with IBD expertise.
P597 Cycling Anti-TNF Therapy in Inflammatory Bowel Disease: Effectiveness and Durability of Switching from adalimumab to infliximab
Authors: Steinberg J , Andersen M , Krugliak Cleveland N , Traboulsi C , Rodriguez T , Cohen R , Dalal S , Micic D , Pekow J , Atsushi S , Rubin D 
Published: May 2021

Abstract

Background
Anti-TNF therapy remains the cornerstone of moderate to severe inflammatory bowel disease (IBD) treatment. There are few data regarding switching from subcutaneous (SubQ) to intravenous (IV) agents. We evaluated the clinical utility of cycling adalimumab (ADA) for infliximab (IFX) in IBD patients (pts) treated at a tertiary center.

Methods
This is a retrospective observational study where we evaluated pts with IBD who cycled from ADA to IFX from 2010 to 2018. Pts were followed for 1 year following IFX initiation. We reviewed baseline demographic and clinical data. Primary outcomes included changes in CRP and clinical disease activity indices which were statistically analyzed using Wilcoxon Signed Rank Test.

Results
24 pts with Crohn’s disease (CD) and 11 with ulcerative colitis (UC) were included. Median age at time of IFX initiation in the overall cohort was 33 years with median disease duration of 10 years. Most pts in the UC cohort had pancolitis (63.6%), while the CD cohort mostly had ileocolonic disease (79.2%). Prior to IFX initiation, median baseline CRP was 8 (IQR 15), with median HBI of 3.5 (IQR 5), and SCCAI of 3.5 (IQR 4) in the CD and UC cohorts, respectively. Additional baseline demographics are in Table 1. Following median 12 months on ADA therapy in the overall cohort, 16 pts (45.7%) discontinued ADA due to primary or secondary loss of response, 8 pts (22.8%) due to anti-drug antibody formation, and 11 pts (31.4%) due to adverse events or unclear causes. At the time of starting IFX therapy, 17 pts (48.6%) were using steroids, while 24 pts (68.6%) were on immunomodulatory therapy. In the overall cohort, after cycling to IFX, median CRP was lower at 8 weeks (4; IQR 9), 26 weeks (3; IQR 11), and 52 weeks (5; IQR 10) as compared to baseline; only the 8 week CRP reached statistical significance (P=0.0447, 0.0662, and 0.0876, respectively). In the CD cohort, median CRP was significantly lower at 8 weeks (7; IQR 6; P=0.0314) and 52 weeks (5; IQR 7; P=.0410) as compared to baseline (12.5; IQR 14). Although signals of median HBI and SCCAI scores trended lower after 8 weeks, 26 weeks, and 52 weeks of IFX therapy, these did not reach statistical significance. A total of 15 pts (43.0%) stopped IFX prior to one year. Subgroup analysis of 5 pts who developed anti-ADA antibodies demonstrated statistically significant reduction of median CRP (10; IQR 22.5; P=.043) after 52 weeks of IFX therapy. Additional results are detailed in Table 2.

Conclusion
Cycling anti-TNF therapy from ADA to IFX offers clinical utility in preserving mechanistic benefit of TNF-α blockade in IBD pts leading to improvement of CRP, particularly in CD pts and those who developed immunogenicity to ADA.
P602 Vedolizumab subcutaneous influencing disease course in Constant-care app solution
Authors: Nørgaard J , Malte R , Charlotte P L , Mette B , Eva F , Petra W , Dorit A , Lotte S , Johan B , Pia M 
Published: May 2021

Abstract

Background
The Constant-care app solution (CC) has been shown to empower patients with mild-moderate Ulcerative Colitis (UC) in 5-ASA treatment and improve disease specific quality of life (1). Here we present preliminary data on our study to investigate the effects of CC on quality of life in patients with moderate-severe UC or Crohns Disease (CD) treated with s.c.vedolizumab, launched in June 2020 in Denmark.

Methods
The study is an ongoing non-interventional, observational study. Patients are homemonitored via CC for 24 months. CC shows data on patient’s disease status, grouping them into three: green (remission), yellow (worsening), red (severe disease). Patients were recruited from the outpatient clinic at the Department of Gastroenterology, North Zealand University Hospital, Greater Copenhagen. Simple Clinical Colitis Index (SCCAI), Harvey-Bradshaw Index (HB-I), Fecal calprotectin (FC) and short QoL (0–70) are measured every two months or during a flare up between fixed screenings. Serious adverse events (SAE) and adverse events (AE) are monitored.

Results
19 patients out of 40 have been included, 8 with CD and 11 with UC. None experienced SAEs. Five experienced AEs, of which four discontinued treatment. One patient experienced treatment failure during this study.
Of the 15 patients, two are in complete remission, (Q2 respectively Q3). Five of the remaining patients have not entered more than two data entries in CC (data not shown).All patients sustained remission based on FC, except for two data points for two individual patients. Good QoL ≥ 50 was almost unchanged for 6 patients.

Conclusion
IBD CC has proven a usefull tool for surveillance and maintenance of remission in IBD patients treated with s.c. vedolizumab. S.c. vedolizumab has in this patientgroup, shown to provide sustainable QoL, sustained remission, and to have few AEs.
1) Elkjaer M, Shuhaibar M, Burisch J, Bailey Y, Scherfig H, Laugesen B, et al. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided ‘Constant-care’ approach. Gut. 2010;59(12):1652–61.
P637 Incidence rate and clinical outcome of severe COVID-19 in Inflammatory Bowel Disease patients in a population-based setting
Authors: Rezazadeh Ardabili A , Creemers R H , Jonkers D M A E , Romberg-Camps M J L , Pierik M J , van Bodegraven A A 
Published: May 2021

Abstract

Background
The broad use of immunosuppressants and biologicals in Inflammatory Bowel Disease (IBD) patients increases the susceptibility to severe infections, and possibly COVID-19. Recently, in a Swedish population-based study it was suggested that IBD patients are at an increased risk of hospitalization for COVID-19, although course of COVID-19 did not differ from controls. Data on the outcome of COVID-19 in IBD patients from heavily affected regions remain, however, limited. South-Limburg has the second highest COVID-19 mortality rate in the Netherlands. We aimed to determine the incidence rate and outcome of severe COVID-19 in IBD patients in a population-based setting in South-Limburg.

Methods
We identified all IBD patients who presented at the emergency department (ED) of the only two hospitals covering the whole South-Limburg region with COVID-19 associated symptoms between February 27 and November 1, 2020. Confirmed COVID-19 diagnosis was defined by a combination of COVID-19 associated symptoms and either a positive SARS-CoV-2 PCR or a CT-CORADS score ≥4. As primary outcome, the incidence rate of severe COVID-19 (i.e. confirmed COVID-19 diagnosis requiring hospitalization, and/or resulting in ICU admission or death) was determined. Baseline characteristics and data on COVID-19 course were collected. At present, the total IBD population in South-Limburg is set at 4980 patients.

Results
During a follow-up of 3384 person-years, a total of 61 IBD patients (1.22%) presented with COVID-19 associated symptoms at one of the two hospital’s ED. Of these, 18 IBD patients (0.36%; 11 UC, 7 CD) fulfilled the criteria for severe COVID-19, corresponding to an incidence rate of 5.3 per 1000 person-years. Furthermore, 12/18 patients were using immunosuppressive medication for their IBD. Mean age at time of admission was 64.5 years (SD: 10.8) and 55.6% were male. All hospitalized patients had at least one comorbidity (with ≥ 1 comorbidity in 13/18 patients (72.2%)), cardiovascular disease being most prevalent (12/18). Mean BMI at time of admission was 27.3 (SD: 4.2). Thirteen patients (72.2%) required oxygen support and three patients (16.7%) ICU admission (of which two needed mechanical ventilation), translating to an incidence rate of 0.9 per 1000 patient-years for ICU admission. Median length of hospitalization was 11 days (IQR: 5.3–18.3). No IBD patients died due to severe COVID-19.

Conclusion
The incidence rate of severe COVID-19 among IBD patients in a population-based setting in a heavily affected region was 5.3 per 1000 person-years. Despite frequent use of immunosuppressive medication and high region-specific mortality rates, clinical outcomes of severe COVID-19 were comparable to the general population and in line with recent literature.
P647 Awareness, knowledge and use of mesenchymal stem cells – a global survey among gastroenterologists and colorectal surgeons
Authors: Williams P , Klersy C , Karki C , Bennett D , Rodríguez A M , Ciccocioppo R 
Published: May 2021

Abstract

Background
This study aimed to understand awareness, knowledge, and perception of mesenchymal stem cells (MSCs) among physicians, with particular focus on the complex perianal fistula (CPF) in Crohn’s disease (CD) indication.

Methods
A cross-sectional, web-based survey of currently practicing and registered gastroenterologists (GIs) and colorectal surgeons (CRs) across 15 countries in North America, Europe and Asia Pacific was undertaken. Descriptive analyses of data on awareness, knowledge, and perception of MSCs, willingness to use them in clinical practice and potential concerns were conducted overall and by medical specialty. Missing responses were allowed, thus denominators differed among questions (N values reported throughout). Multivariable logistic regression was used to examine factors associated with moderate/strong awareness of MSCs.

Results
Of 146 physicians, 115 (79%) were aware of MSCs (63% strong/moderate; 37% limited awareness), including 101 GIs (88%) and 14 CRs (12%). Of these, 21 physicians (19%, N=112) had treated ≥1 patient with MSCs.
Among the aware physicians, the majority were moderately/largely interested in MSCs (87%, N=113), were willing to use them for patients with CD and CPF (82%, N=108) and believed MSCs address an unmet need for these patients (93%, N=101). However, there was a marked heterogeneity as to the assumed definition and mechanism of action (MoA) of MSCs (Figure 1). By specialty group, more CRs (50%) than GIs (31%) defined correctly MSCs as an immunomodulatory therapy.

The majority of the physicians aware of MSCs stated that they have limited/no knowledge of this therapy (64%), its efficacy (51%), safety (53%) and MoA (65%) in patients with CPF in CD (N=105 for all questions). Many physicians (46%; N=107) also expressed concerns about using MSCs in these patients.
In physicians with concerns, long-term efficacy, long-term safety, and cost were the most frequently reported concerns, both overall (Figure 2) and by each specialty group (data not shown).

The multivariable logistic regression showed that attendance at discussions or presentations on MSCs in the past 2 years (p&lt;0.0001) and seeing more patients with CD per year (p=0.0002) were associated with increased awareness of the therapy.

Conclusion
In this study, the majority of physicians demonstrated interest and willingness to use MSCs in clinical practice. However, the survey showed a perceived lack of knowledge of what MSCs are and how they work in patients with CPF in CD. This may explain physicians’ concerns about using MSCs in this indication. Increased communication and education regarding MSCs are required to alleviate physicians’ concerns and increase the uptake of this therapy in routine practice.
Sponsor: Takeda Pharmaceuticals USA, Inc.
P690 Changes of intestinal microbiota in patients with inflammatory bowel diseases
Authors: Baryshnikova N , Uspenskiy Y , Suvorova M , Lyudyno V , Suvorov A 
Published: May 2021

Abstract

Background
Normal microbiota is one of the main topic controling normal function of human organism. Microbiota changes and dysbiosis are the important factors in the pathogenesis of different digestive diseases, including inflammatory bowel diseases (IBD). The aim: estimation the intestinal microbiota changes in patients with IBD.

Methods
We investigated fecal samples to determine features of intestinal microbiota in 17 patients with IBD in acute phase of diseases: 10 patients with ulcerative colitis and 7 patient with Crohn’s disease, four patients received therapy with immunodiological agents. For feces analysis we used real-time polymerase chain reaction with fluorescent detection. Statistical processing was performed using the SPSS8.0 software package.

Results
100% of patients showed some changes in gut microbiota. These disorders were different in patients but no any significant changes in ulcerative colitis and Crohn’s disease patients. We saw the most frequent and significant changes:
1. decrease of Lactobacillus spp. level was determined in 59% of those examined
2. increase of Bifidobacterium spp. level was determined in 47% of patients
3. changing of the ratio of Bacteroides spp./Faecalibacterium prausnitzii towards increase of Bacteroides - in 24% of patients
4. frequency of occurrence of C. difficile was 24% of patients
5. frequency of occurrence of Candida spp. was in 35% of patients.
In a number of patients, increased growth of opportunistic bacteria was detected: Proteus vulgaris/mirabilis - 24%, Citrobacter spp. - 29%, Enterobacter spp. - 12%.
Microboal indirect microbial markers of colon oncopathology Fusobacterium nucleatum was identified in 18% and Parvimonas micra - in 24%. F. nucleatum and P. micra have higher frequency in patient who received immimmunodiological agents.

Conclusion
Patients with IBD show a downward trend in Lactobacillus spp. and increasing Bifidobacterium spp., whereby lacto-containing probiotics may be recommended for such patients and Bifidobacteria-containing probiotic may be not recommended. There is also a relatively high incidence of F. nucleatum and P. micra in IBD patients, which dictates the need for dispensary surveillance of these patients not only for the purpose of controlling the onset and maintenance of remission, but also for the purpose of early detection of colorectal cancer and IBD-associated malignancies.
Benchmarking and scalability of machine-learning methods for photometric redshift estimation
Authors: Henghes Ben , Pettitt Connor , Thiyagalingam Jeyan , Hey Tony , Lahav Ofer 
Published: May 2021

ABSTRACT
Obtaining accurate photometric redshift (photo-z) estimations is an important aspect of cosmology, remaining a prerequisite of many analyses. In creating novel methods to produce photo-z estimations, there has been a shift towards using machine-learning techniques. However, there has not been as much of a focus on how well different machine-learning methods scale or perform with the ever-increasing amounts of data being produced. Here, we introduce a benchmark designed to analyse the performance and scalability of different supervised machine-learning methods for photo-z estimation. Making use of the Sloan Digital Sky Survey (SDSS – DR12) data set, we analysed a variety of the most used machine-learning algorithms. By scaling the number of galaxies used to train and test the algorithms up to one million, we obtained several metrics demonstrating the algorithms’ performance and scalability for this task. Furthermore, by introducing a new optimization method, time-considered optimization, we were able to demonstrate how a small concession of error can allow for a great improvement in efficiency. From the algorithms tested, we found that the Random Forest performed best with a mean squared error, MSE = 0.0042; however, as other algorithms such as Boosted Decision Trees and k-Nearest Neighbours performed very similarly, we used our benchmarks to demonstrate how different algorithms could be superior in different scenarios. We believe that benchmarks like this will become essential with upcoming surveys, such as the Vera C. Rubin Observatory’s Legacy Survey of Space and Time (LSST), which will capture billions of galaxies requiring photometric redshifts.