bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1217 The gut microbiota as a determinant in the development of post-surgical recurrence in Crohn`s disease
Authors: Ortiz Sánchez A , Martinez Tirado M P , Rodriguez Nogales A , Moron Romero R , Rodriguez Cabezas M E , Martin Rodriguez M D M 
Published: January 2024

Abstract

Background
Crohn's disease (CD), is a chronic condition with a growing incidence in recent decades. Despite the development of new biologic therapies it is estimated that up to 70% of CD patients will require surgical intervention during their lifetime. However, surgery is not considered curative even in cases where a resection of all macroscopic involvement is performed, and the management of post-surgical recurrence remains a therapeutic challenge.
Bacterial dysbiosis has been postulated as a precipitating factor in CD and may play a significant role in the development of post-surgical recurrence (PSR) of this condition.
We prospectively studied the characteristics of bacterial diversity in patients with CD following ileocecal resection to identify the predictive value of intestinal microbiota in the onset of PSR.

Methods
We collected fecal and healthy and affected intestinal mucosal samples from 12 patients with CD who underwent surgery during the course of their disease. PSR was defined using a Rutgeerts index ≥i2b. The microbiota was assessed using 16S rRNA sequencing, and a correlation analysis was conducted between the intestinal microbiota and clinical variables of the patients.
The study was conducted in accordance with the Helsinki Declaration, and all patients were recruited from among those undergoing scheduled colonoscopy for clinical indications at the Gastroenterology Unit of the University Clinical Hospital San Cecilio in Granada, Spain.

Results
In patients with CD and severe recurrence, mucosa-associated microbiota was characterized by a significant reduction in alpha and beta diversity compared to subjects in clinical remission.
An enrichment of bacteria belonging to the phyla Bacillota and Pseudomonadota was observed, along with a reduction in Bacteroidota in subjects with PSR.
We observed a negative correlation between the presence of E. coli and Shigella in patients in clinical remission and those actively undergoing treatment with biological therapy.

Conclusion
The recolonization of microbiota after ileocecal resection differs between patients with and without recurrence, with Fusobacteria and butyrate-producing bacteria being the most prominent contributors to driving PSR. The reduction in the abundance of short-chain fatty acid-producing bacteria and stimulators of anti-inflammatory cytokines like IL-10 could create a proinflammatory environment conducive to the development of PSR.
These findings may provide valuable insights into the disease prognosis, allowing for the identification of patients at higher risk of recurrence and laying the groundwork for more targeted therapeutic approaches after surgery
P1220 Dysbiosis of the gut microbiota and decreased fecal levels of short-chain fatty acid in patients with Ulcerative Colitis: a hospital-based case-control study
Authors: Yamamura R , Katsurada T 
Published: January 2024

Abstract

Background
Ulcerative Colitis (UC) is a typical intractable disease whose number of patients is increasing worldwide, and studies have suggested that the gut microbiota and its metabolites are closely involved in its pathogenesis and severity. However, to date, no study has comprehensively compared the microbiomes or metabolomes of UC patients and healthy controls after considering important confounding factors such as age, gender, race, and other lifestyle factors. Therefore, we conducted this clinical study to compare the compositions and diversity of the gut microbiota and the fecal metabolites between age-, sex-, and race-matched patients with Ulcerative Colitis (UC) and those without.

Methods
In total, 90 outpatients with UC (UC group) and 90 without a history of gastrointestinal diseases and their family members (without UC group) were recruited.

Results
The UC group had a significantly lower abundance of the genus Bifidobacterium, Faecalibacterium, and Lactobacillus than the without UC group. Furthermore, the UC group had a significantly lower alpha-diversity of the gut microbiota than the without UC group. The UC group had a significantly lower level of fecal SCFAs than the without UC group. These results remained significant after adjusting for sex, age, and smoking status. Furthermore, the expression of a group of genes encoded by the gut bacteria that are involved in the biosynthesis of tetrapyrrole was significantly lower in the UC group than in the without UC group.

Conclusion
Gut microbiota dysbiosis and low SCFA levels, as well as reduced tetrapyrrole biosynthetic capacity by the gut bacteria, may contribute to the development of UC. Moreover, regardless of the severity, duration, and type of UC, the gut microbiota and its metabolites were in a stable state of dysbiosis in patients with UC.
P1224 Predicting response to nutritional therapy in newly diagnosed children with Crohn’s Disease (CD) using multi-omics approach
Authors: Azulay A , Aharoni Frutkoff Y , Shimhlash Y , Borenstein E , Reshef L , Plotkin L , Focht G , Maslov T , Orlanski-Meyer E , Lev-Tzion R , Ledder O , Yogev D , Assa A , Turner D 
Published: January 2024

Abstract

Background
Background. One third of children with Crohn's disease (CD) will fail treatment with exclusive enteral nutrition (EEN) but predictors of response have been hitherto lacking. In this prospective cohort study, we aimed to use multiomic data to predict EEN response in treatment-naïve children with CD.

Methods
Methods. Children commenced on EEN at CD onset were followed through 8 weeks. Stool was collected for microbiome and metabolomics, and serum for metabolomics. Disease indices and clinical data were recorded. Targeted quantitative metabolomics approach was applied to analyze fecal and serum samples using a combination of direct injection mass spectrometry with a reverse-phase LC-MS/MS custom assay. DNA extracted from stool was sequenced and 16S rRNA gene was amplified. Feature selection was first utilized, using Recursive Feature Elimination with Cross-Validation (RFECV). For each omic analysis and the multiomic integration, selected components were fitted into a machine learning random forest (RF) model.

Results
Results. Included were 51 children (aged 14.8±2.7 yrs) treated with EEN, of whom 34 (66%) were responders; 36 (70%) had serum metabolomics, 20 (39%) fecal metabolomics and 31 (61%) microbiome data while 17 (33%) had all components. Clinical data and standard labs did not predict response (Table). The individual omic models ranked several key metabolites and microbes (Figure) and were able to predict EEN response with an accuracy ranging at 0.806-0.850 (Table). Serum 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF), fecal phenylethylamine and fecal alpha-aminobutyric acid were higher in non-responders while serum malic acid and fecal 3-methyladipic acid were higher in responders (Fig. A-B). Moreover, levels of Veillonela and Bifidobacterium species alongside Blautia genus were higher in responders while Lachnospiraceae and Fusicatenibacter genus were higher in non-responders (Fig. C). The final multiomic model which included also clinical data, retained components from serum and fecal metabolomics but none from the microbiome; it predicted EEN response with high accuracy of 0.882 (Table). Higher level of serum 2-hydroxyglutraic acid, 2-hydroxy-2-methylbutyric acid and fecal 3-methyladipic acid were detected in responders. In non-responders there were higher level of serum alpha-aminobutyric acid, valeric acid, isovaleric acid, alpha-aminobutyric acid and kynrenine and alongside with increased fecal kynrenine/tryptophan ratio, both part of the tryptophan metabolism and kynrenine pathway (Fig. D).

Conclusion
Conclusion. In this multi-omic analysis, we generated a,metabolomics-based multiomic model to predict response to EEN, unravelling related biological insights.
P1237 Development of an algorithm to identify the best donor-recipient match for FMT in IBD patients based on immune system/microbiota interactions
Authors: Facciotti F , Amoroso C , Strati F , Caridi B , Perillo F , Noviello D , Vecchi M , Caprioli F 
Published: January 2024

Abstract

Background
IBD are characterized by uncontrolled immune responses, in genetically predisposed individuals, to the dysbiotic microbiota. Its modulation has thus emerged as a potential therapeutic strategy . Fecal microbiota transplantation (FMT) showed encouraging results for the treatment of mild-to-moderate ulcerative colitis (UC) patients. However, currently the success rate of FMT in UC patients is around 30%, and there are no criteria to predict it.
We hypothesized that the immune system-microbiota interaction can dictate which graft will be accepted or rejected. Thus, we generated an algorithm to identify the best donor-recipient match for FMT treatment in IBD patients based on the functional interaction of recipient's immune system with possible donors' microbiota .

Methods
Mucosal and circulating immune cells isolated from 16 active UC patients, potentially eligible for FMT, were exposed to the microbiota of a panel of 8 potential healthy FM donors collected in the FM biobank of the Policlinico Hospital, Milan. The functional profile of recipients' immune cells before and after the in vitro exposure to the possible donors’ microbiota was assessed by cytokine production, gene expression profiling and activatory or inhibitory surface molecules modulation on T cells. Sequencing of the microbiota of each individual FM donor was performed by 16S. These functional data were used to develop an algorithm to identify the best donor-recipient match based on the capability of individual donors’ microbial ecologies to simultaneously reduce the inflammatory functional profile and increase the tolerogenic functional profile of the recipient's immune cells

Results
We demonstrated that mucosal immune cells from UC recipients exhibited a variety of responses upon exposure to the microbiota from distinct healthy donors, which clusters in two different enterotypes. Each UC recipient exhibited specific preferences for one or more FM donor in the reduction of the inflammatory profile of immune cells and concomitantly enhancement of anti-inflammatory cytokines. On te basis of these data we generated an algorithm capable of predicting the most successful functional interaction between donors and recipients.

Conclusion
Our study suggest that specific functional characteristics of both the donor microbiota and the recipient's immune system should be considered when selecting an optimal donor-recipient match for FMT. This study contributes to the development of a screening tool for donor selection in FMT, enabling personalized and effective therapeutic interventions for UC patients
N10 Evaluation of the impact of an IBD nurse in an Inflammatory Bowel Disease Center
Authors: Rachart A , Cluzeau V , Martins C , Hebuterne X , Nicolau A 
Published: January 2024

Abstract

Background
In some European countries, IBD nurse is not a recognized status. IBD nurses are general care nurses who wants to improve their knowledges and get involved in the « Care and Support » of IBD patients. An increasing number of IBD centers are using the services of IBD nurse. The aim of this study was to evaluate prospectively the activity and impact of IBD nurse on the management of IBD patients in an IBD center.

Methods
From March 13th to June 13th, 2023, all patients having interacted with IBD nurse in an expert center, were prospectively recorded. The main points were, the number and characteristics of patients, means and reasons of contact, actions implemented, follow-up and, finally, patient satisfaction assessed using a standardized questionnaire (visual analog scale from 0 to 10).

Results
During three months, 132 patients, 69 women and 63 men (47% Ulcerative Colitis, 52% Crohn's disease and 1% indeterminate colitis), with a median age of 40 years (16 to 87), had contacted the IBD nurse. The means of contact were phone call: n =131 (42%), text messages: n = 25 (8%), e-mail: n = 69 (22%), face-to-face consult: n = 86 (27.5%) and teleconsulting: n = 1 (0.5%).
The reasons for contact were:
Three hundred and twelve contacts had led to 315 actions divided into seven groups:
Over this period, IBD nurse was contacted 22 times by 19 patients for a real or perceived emergency. These situations were managed by a multidisciplinary team, and resulted in reinsurance (68%), referral to others medical specialist (18%) or hospitalization (14%).
Overall satisfaction with the IBD nurse intervention was 10/10 for 78% of patients and 9/10 for 11%. To the question: “do you think that the intervention of the IBD nurse improves disease management?”: 78.5% agreed at 10/10 and 7% at 9/10. To the question: “do you think contact with the IBD nurse improves access to care: 67.5% agreed at 10/10 and 3.5% at 9/10.
The main patients’ advice / reviews to improve care were: to adjust levels of follow-up according to the patient and his/her needs, to strengthen the IBD Nurse coordination team to limited days off, to have explanation sheets and reports of IBD Nurse intervention, to develop more workshops for patients in the Education program.

Conclusion
This pilot study showed the importance of the IBD Nurse activity in an expert center. The patients who benefited from this care were very enthusiastic about it.
N14 The IBD nurse's role in screening for iatrogenic adrenal insufficiency in children with inflammatory bowel disease on discontinuing glucocorticoid therapy
Authors: Chadokufa S N , huggett B 
Published: January 2024

Abstract

Background
With a wide range of medical treatment on offer, ensuring patient safety by monitoring and or preventing side effects is a key part of holistic care.
Glucocorticoids are widely used in inflammatory bowel disease (IBD) treatment to induce remission or treat flares. Iatrogenic adrenal insufficiency (AI), due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis is an established side effect of exogenous glucocorticoids. Symptoms of AI can range from life-threatening adrenal crisis to more subtle chronic symptoms including fatigue, abdominal pain and diarrhoea. The rate of AI in this population is unknown. There is no standard guidance or recommendations to suggest routine screening of paediatric IBD (pIBD) patients. This study aimed to report our experience on set up a monitoring pathway to manage pIBD patients coming off glucocorticoid therapy(GT).

Methods
A database was created to capture all IBD patients under the age of 18 who had received GT for IBD between March 2022 and July 2023. At the time of starting treatment, predicted last day on GT was identified and patients were booked in for testing serum early morning cortisol (Vitros Ortho Clinical Diagnostics immunoassay) and ACTH. After tapering, patients remained on the lowest dose of GT until results review. Evaluation of the adrenal-axis response was then assessed by a protocol piloted by this study – see figure 1. The patients needing treatment for AI were seen in the Nurse led clinic for prescribing, education and training. The training included IM injection training, sick day training and safety netting. To ensure safe evidence based training, the IBD nurse had received training form the endocrine nurse before the pilot.

Results
Following the initial screening, 9 patients were seen in the clinic with AI ( 8 prednisolone and 1 Budesonide). Of these 9,8 (88%) were followed up by the IBD nurse and 1(11%) was followed up by a local paediatrician with an endocrine interest. Treatment with hydrocortisone was commenced and follow up 3 months blood tests organised.
The school was notified of the risk of Adrenal suppression and emergency kits provided. Repeat adrenal axis testing was offered at 3 months (5 of 9) and 6 months (3 of 9). AI was noted in 3 patients and 2 patients at 3 and 6-month respectively. At the 6 month mark, patients were discharged from the clinic if they had returned to a normal adrenal axis or referred to the endocrine team for further follow up. Patients were discussed in a multi-displinary meeting at every point on the pathway and no child suffered an adrenal crisis during the study period.

Conclusion
AI following GT is common in this small pIBD cohort. The IBD nurse can play a critical role in providing safe care for these patients.
N17 Exploration of medication non-adherence in Inflammatory Bowel Disease patients: A systematic review
Authors: King K , Norton C , Chalder T , Czuber-Dochan W 
Published: January 2024

Abstract

Background
Inflammatory bowel disease (IBD) has recognised medications to maintain remission and prevent relapse. Yet between 53–75% of people with IBD do not take medications as prescribed. Identifying and improving medication adherence in IBD is a primary treatment goal to keep symptoms quiescent.
This systematic review aims to identify why people are adherent and non-adherent to IBD medications.

Methods
Studies exploring medication adherence for IBD conducted between 2012-2022, were identified in six electronic databases.
The quality of quantitative and qualitative studies was assessed using a scoring system or the Critical Appraisal Skills Programme, respectively.

Results
39,603 participants were included across 79 studies investigating IBD medication adherence, mainly from single outpatient clinic populations, using cross-sectional surveys.
Most data were quantitative, rated medium quality. Few studies were based around a theory to explain adherence.
Non-adherence was most typically measured using a version of the Morisky Medication Adherence Scale or the study’s own self-report questionnaire, with non-adherence ranging from 4.3%-88.9%.
In multivariable analysis of quantitative data, younger age and female gender were usually associated with non-adherence. The presence of smoking, psychological issues (depression, treatment concerns, anxiety) or lower social status were also significant non-adherence risk factors. Most typically investigated were clinical variables, many being significantly related with non-adherence, including medication type (specifically 5-ASA), route (oral, rectal, subcutaneous, intravenous), high and low disease activity and poor disease/medication knowledge. Significant results were often contradictory between studies, as was the relationship direction with non-adherence.
Forgetting medication was the main reason for non-adherence in qualitative interviews, with side effects, costs, medication concerns and busy lifestyle also variables.
Cohort-specific factors were reported for non-adherence in pregnant women, adolescents and patients during COVID.Conclusion
Adherence to treatment is essential in IBD. Yet a large and confusing literature exists regarding factors underpinning non-adherence.
Clinicians should be aware of those non-modifiable factors, to help identify relevant patients and support their treatment programme.
Potentially modifiable factors including medication regimes, route and patient knowledge, could be targeted to improve adherence in IBD.
Theoretically informed interventions need to be developed. A successful evidence-based intervention supporting medication adherence could help improve quality of life for patients living with IBD, whilst providing patient-centred care and minimising health costs.
N19 Nurses' difficulties in supporting the sexual well-being of patients with inflammatory bowel disease
Authors: Nozawa M , Wakai S , Fourie S , Kawakami A , Tanaka M 
Published: January 2024

Abstract

Background
Sexual well-being is a state of sexual happiness and satisfaction that combines mental stability and physical health as well as builds on mutual caring and intimacy with the partner. Patients with inflammatory bowel disease (IBD) undergo distress as they experience dating, marriage, and childbirth while living with the disease. Previous studies have indicated the importance of support related to sexual well-being but have suggested that it is a difficult topic for discussion. Hence, this study sought to clarify nurses' specific difficulties and barriers in supporting the sexual well-being of patients with IBD.

Methods
Nurses who had considerable experience caring for with patients with IBD were recruited using a snowballing method or opportunistic sampling. Semi-structured interviews were conducted via a video meeting system. Some examples of the interview questions include ‘Please tell us about your experience talking with patients about romantic relationships and sexual concerns and ‘Could you tell us about your difficulties in supporting patients with IBD in relation to their sexual concerns?’ We performed a reflexive thematic analysis.

Results
We interviewed 20 participants (Male: 4, Female: 16) in 13 facilities, 2 of which were focus group interviews. The mean length of experience in IBD nursing was 13 years. Three themes were identified as reflecting the difficulties nurses faced in discussing sexual issues with their patients: ‘The nurses' experience and their relationships with patients’, including gender and age barriers and difficulties in building rapport; ‘Assessment of sexual well-being’, including difficulties in broaching the issue and identifying people who needed support; and ‘Education for patients and nurses in supporting sexual well-being’, including lack of materials for patients and lack of opportunities for nurses to learn. Most participants rarely experienced discussions about sexual topics and did not initiate conversations about sexual well-being on their own.

Conclusion
Due to the sensitive topic of sexual issues, the difficulties described by nurses were influenced by the level of rapport with patients, the lack of training on how to handle the topic, and the lack of resources. Our results suggest the need for further research into approaches to reduce nurses' difficulties, while considering the identified barriers and needs related to the sexual well-being of patients with IBD.
N40 Surveying outcomes of service user experience on the effects of the transition process in paediatric IBD (PIBD) patients in a tertiary PIBD centre
Authors: Buckingham R , Chadokufa S , Lashley C , Huggett B , Sawney T , Kiparissi F , Elzien A 
Published: January 2024

Abstract

Background
Background: We conducted a prospective survey with our PIBD patients and parents seeking outcomes in accordance with our ICN- Improve Care Now participation goals to ‘Improve and optimize the care of children and teens with IBD in underserved and underrepresented populations by addressing healthcare disparities’.

Methods
Methods: We sent out a survey to our PIBD patients focusing on their overall satisfaction with the service we deliver in relation to their transition and transfer pathway. We prospectively sent this to our patient cohort of 280 PIBD patients.

Results
Results: 69/280 patients and parents (25%) responded, of whom 53/69 (77%) completed the entire survey. Of those responders 45/53 (85%) were mothers speaking on the behalf of their children aged 5-12 years (n=20 patients). 4/53 (7%) patients completed the survey themselves, of whom 3 (75%) were aged between 12-18 years. When asked about if they understood what will happen when your child moves form paediatric to adult care, 24/53 (45.61%) of patients said they had not been spoken to about transition in the last 12 months. Additionally, the survey asked if the IBD team had spoken to the patients about any worries and concerns they had regarding their transition over the last 12 months, 25/53 (48.21%) responded that they had not been spoken to about this.

Conclusion
Conclusion: Our survey has highlighted the importance of promoting the transition process throughout the patient’s IBD journey. Just under 50% of patients reported that they had not been spoken to about this process, which highlights the improvements needed. This process can be developed by identifying patients earlier and establishing clear transition pathways that must be followed in order to improve effective patient experiences with transition.