bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1241 Distinct gut microbiota in Crohn's Disease between inflammatory B1 and stricturing B2 phenotype
Authors: Zhang Q , Zhi M 
Published: January 2024

Abstract

Background
The gut microbiome represents a promising avenue to elucidate distinct underlying pathophysiology in Crohn's disease (CD).Our aim was to evaluate the composition of the microbiota in Inflammatory B1 and Stricturing B2 Phenotype.

Methods
We performed 16S ribosomal RNA sequencing on stool samples of 108 patients (64 B1 and 44 B2) included in the Chinese CD cohort and 58 health controls without any inflammatory disorder, in order to explore the structural composition of gut microbiota in different phenotype of CD.

Results
Comparison of gut microbiota between patients with CD and healthy controls, α diversity and β diversity were statistically different. At the genus level, compared with the normal group, the abundance of Blautia, Bifidobacterium, Faecalibacterium, Collinsella, Coprococcus, Gemmiger, Prevotella, Dialister, Roseburia and Clostridium were decreased significantly in the CD group. In contrast, the abundance of Bacteroides, Ruminococcus, Streptococcus, Enterococcus, Dorea, Escherichia, Phascolarctobacterium, Veillonella and Eubacterium increased significantly. Compared with B1 phenotype, Streptococcus, Collinsella, Veillonella, Coprococcus and Gemmiger were significant decreased in B2 phenotype group. However, Ruminococcus, Dorea, Lactobacillus and Dialister were significant increased.

Conclusion
Comparison of gut microbiota between patients with CD and healthy controls, α diversity and β diversity were statistically different. At the genus level, compared with the normal group, the abundance of Blautia, Bifidobacterium, Faecalibacterium, Collinsella, Coprococcus, Gemmiger, Prevotella, Dialister, Roseburia and Clostridium were decreased significantly in the CD group. In contrast, the abundance of Bacteroides, Ruminococcus, Streptococcus, Enterococcus, Dorea, Escherichia, Phascolarctobacterium, Veillonella and Eubacterium increased significantly. Compared with B1 phenotype, Streptococcus, Collinsella, Veillonella, Coprococcus and Gemmiger were significant decreased in B2 phenotype group. However, Ruminococcus, Dorea, Lactobacillus and Dialister were significant increased.
N16 Discontinuation of anti-TNF therapy in patients with inflammatory bowel disease in remission: a qualitative study on shared decision making and patients perspective
Authors: Nabibaks S , Devillers M , de Vries A 
Published: January 2024

Abstract

Background
Anti-tumor necrosis factor (TNF) therapy has been the mainstay for managing patients with moderate to severe inflammatory bowel diseases (IBD). Despite its effectiveness, anti-TNF therapy is associated with several side effects such as infections and infusion reactions, as well as considerable costs. Discontinuation of therapy may be considered in patients in long-term remission. Since prediction of the risk of relapse for an individual patient is difficult, shared decision making (SDM) on this decision is highly essential. The aim of this qualitative study is to explore the considerations of IBD patients in remission concerning the decision on discontinuation of anti-TNF therapy.

Methods
This is an explorative, single center study. Semi-structured interviews were conducted in adult IBD patients in clinical remission, after discontinuation of the anti-TNF therapy as treatment option was discussed by the patient and their treating gastroenterologist. Patients were identified by purposive sampling. Interviews were performed at the outpatient clinic or by telephone. The interviews were recorded, transcribed verbatim and thematically analyzed. Patients were interviewed until saturation was reached.

Results
Twelve patients were interviewed; age 25-79 years, 7 (58%) males, 7 CD and 5 UC. The duration of the anti-TNF treatment varied from 6 to 16 years. Seven patients were on first-line biological therapy, while 5 were on second or third-line biological therapy. With regard to the therapy decision, 5 patients decided to discontinue their anti-TNF treatment and 7 continued. Three main themes were identified in the interviews: patient considerations regarding the decision, patient education and perceived support of the physician. Key factors influencing decisions included the fear of relapse, with personal impact often prioritized over quantifying the risk. The memory of a previous ‘traumatizing period’ discouraged discontinuation. Notably, some patients were unaware of the efficacy of restarting anti-TNF therapy and alternative options in case of treatment failure. The study highlighted patients’ high appreciation for the support provided by gastroenterologists during the shared decision-making process.

Conclusion
Since considerations on discontinuation of anti-TNF therapy are diverse among patients, a thorough exploration of fears and impact of a relapse on the personal life is essential during the shared decision making process. Patient education on the therapeutic options in case of relapse is essential to reach a well-considered decision.
N20 Sexual health in IBD can be brought up with help from tools
Authors: Rasmussen Edelbo R , Faurskov Møller L , Bager P 
Published: January 2024

Abstract

Background
Sexual topics can be tabooed; both for patients with IBD and for the health care professionals (HCPs). Patients with IBD have more sexual problems than the background population. A considerable number of patients with IBD have other autoimmune diseases (Ads), which may exacerbate sexual problems. Based on patient reported data, we aimed to develop communication tools and models for talks about patients' sexual health. Furthermore, we aimed to generate informative patient leaflets for different ADs including one specific for patients with IBD.

Methods
A cross-sectional e-survey on sexual health among patients with IBD, dermatological- and/or rheumatologically diseases (both solely and in combination). Patients were invited consecutively as they tuned up in the out-patient clinics at our university hospital. Participation were anonymous and access were possible by using a QR-code.
The questions were ad hoc designed and focused on 1) disease-related sexual problems, 2) partner-related sexual problems, and 3) the need (and current practise) for talks with HCPs about sexual health. In addition, the participants could add qualitative descriptions. Quantitative data were analysed using descriptive statistics. NVivo™ were used to code the qualitative data. Based on the survey results we developed and implemented communication tools in daily practise.

Results
170 patients scanned the QR-code. 142 responded (61% females, 44% had IBD, 49% had a dermatologically disease, 40% had a rheumatologically disease, 33% had ≥ 2 AD). 51% of participants with only 1 AD reported disease-related sexual problems vs 71% for participants with ≥ 2 ADs. In IBD, the main reasons for impaired sexual health were: pain, fatigue, fistulas, incontinence and mental reasons. 86% responded that they didn't talk to HCPs about sexual issues (38% wish the HCPs to bring up the topic, 34% felt the topic to be a taboo, and 25% found it difficult to address problems).
Based on the findings, specialist nurses with knowledge of all 3 ADs developed communication tools. The tools were tested and evaluated by both patients and reviewed by Clinic for Sexual Health and include: i) communication aid for nurses; ii) action card for nurses; iii) leaflets to patients with IBD.

Conclusion
Disease-related sexual problems are common for patients with IBD and ADs. Even more prevalent for patients with more than one AD. Sexual health is seldom a topic between patients and HCPs. Based on patient reported data, simple tools are developed and implemented.
Figure 1: Typical levels of topics for the HCPs talks with patients about sexual health. HCPs will most often be able to help patients by focusing on the 2 lower levels.
N21 Shared Decision Making: A Qualitative Exploration of Clinical Nurse Specialists in Gastroenterology
Authors: Lukose T , Forry M , Lardner C , O Toole A , Boland K 
Published: January 2024

Abstract

Background
Clinical Nurse Specialists (CNS) participation in the Shared Decision Making (SDM) process and understanding basic concepts and principles related to the decision-making process are critical. (Storms et al. 2015). The core concept role of CNS includes a clinical focus on direct and indirect care of the patients in the specialist area, health educator and trainer, patient advocate, audit and research and consultation (NCNM, 2008). They have many opportunities to participate in the SDM process with patients arising from clinic visits, telephone helpline services and multidisciplinary team meetings. Nurses are progressively deemed influential in shared decision-making; however, studies on the SDM role of the CNS are limited; our study investigates the experiences of CNS in SDM, in the speciality of gastroenterology (GI) in both medical and surgical.

Methods
This study adopted a qualitative descriptive style. The survey was distributed to medical and surgical GI CNS at a tertiary referral hospital. This study aimed to look at three aspects of CNS's SDM experience: the CNS's knowledge about SDM, generating discussion and coordination, and respect for sociocultural factors. Semi-depth interviews were conducted for data collection. There were 11CNS participants from surgical and medical GI specialities, including IBD, hepatology, endoscopy, upper GI, and colorectal nursing. All interviews were recorded and transcribed verbatim and coded.

Results
Six themes emerged from the data collected: perceptions, attitudes, positive change, influential factors, reflection and obstacles. SDM is an unknown concept for the majority of the CNS.CNS self-identified as integral to the speciality and the patient's primary contact.

Conclusion
CNS has little understanding of the SDM concept. SDM is perceived as MDT (Multi-Disciplinary Team) making decisions without patient involvement. Formal education and increased awareness of the SDM process are essential for CNS active participation in individual patients. The procured knowledge of SDM enhances the CNS's confidence in active participation in MDT team meetings and the SDM process. It consequently improves patient experience, knowledge and participation in the SDM process.
N33 Experience of inflammatory bowel disease patients in relation to the practice of anal intercourse
Authors: Navarro Correal E , Marín Sanchez L , Mañosa Círia M , Domènech E 
Published: January 2024

Abstract

Background
Sexual health should be part of the management of people with chronic diseases. Receptive anal intercourse is a relatively common practice, and in Inflammatory Bowel Disease (IBD) it can be clearly compromised by the perianal and rectal involvement that many patients present. Understanding the experience of people with IBD in relation to anal intercourse will provide information to help them live their sexuality in a full and healthy way.

Methods
Observational, descriptive, cross-sectional study. Creation of ad-hoc online questionnaire through the REDCap platform. The study population was people between 18 and 75 years with IBD who have or have had sexual intercourse. The survey was distributed through social networks, advanced practice nurses and patient associations (ACCU). The study was approved by the Ethical Committee for Clinical Research of Hospital Universitari Germans Trias i Pujol, (reference PI-22-255, approval date November 11, 2022)

Results
1111 surveys answered, 766 (68.8%) completed. Mean agewas 41.86 years (SD10.32), 560 (73.3%) were women, and 50% had a university education. Sixty per cent (460) have Crohn's disease and 765 people (75.4%) are on immunosuppressive treatment. 22.4% (171) report perianal disease. 34.8% (266) practice anal sex, of these more than 60% do not use a condom during anal sex. 7.6% clean their bowels, 32.4% dilate their anus beforehand, and 60.5% use lubricants. Injuries, tearing and bleeding are reported after anal sex, with 78.5% of women reporting pain. More than 30% think that anal sex increases the urge to go to the toilet and 22% think that it worsens their IBD.

Conclusion
As nurses results obtained in this study direct us towards two main themes. We have to be aware of focusing on health education for the prevention of sexually transmitted diseases and the prevention of possible complications produced by anal sex.
N35 Inflammatory Bowel Disease (IBD) nurses' knowledge practice and attitudes related to Microscopic Colitis (MC)
Authors: Walsh C 
Published: January 2024

Abstract

Background
Microscopic Colitis (MC) is affiliated with and increasingly recognized as an Inflammatory Bowel Disease (IBD). Crohn's Disease and Ulcerative Colitis (IBD) were first described over a century ago. Microscopic Colitis was first described in 1976 and the last decade has seen increasing awareness and European guidelines developed. There is no education on microscopic colitis for IBD nurses and it is not known of the practice of MC by IBD nurses in Ireland. Furthermore it is not incorporated in the Nurse European Crohn's and Colitis Organisation (N-ECCO) guidelines. The aim was to assess knowledge, practice and attitudes of IBD nurses in relation to MC.

Methods
A quantitative cross sectional survey research methodology was conducted using a 17 point questionnaire. 29 (n=29) IBD nurses from the IBD national association of Ireland (IBDNAI) responded from a total of 52 (55.7%). The inclusion criteria was 1) registered practicing nurse 2) on IBDNAI register 3) willing to participate. Data was recorded and analysed using SPSS software. Descriptive statistics were implemented. Cronbach's Alpha for instrument reliability was 0.789.

Results
The majority were female (90%) between ages 36-55 years (86%). The greater number (41%) had over 11 years of experience, followed by 38% with 1-5 years experience. The highest work location was Clinical Nurse Specialist 65.5% (n=19) and the majority qualified at Post Grad level (27.6%, n=8) or Masters level (34.5%, n=10).
Mean and standard deviation scores for knowledge indicated no significant variation but variation was most significant with treatments for MC. Knowledge and years of experience revealed no significant variation. Less than one year experience (Mean 1.50 SD.707) and greater than 11 years (Mean 1.42 SD.669)
Knowledge scores for symptoms are high (65.5%-90%) but investigations and treatments are average (31%, 38% and 48.3%). In relation to practice the majority of IBD nurses 71% do not receive referrals and 78.5% do not review patients diagnosed with MC at the out-patient department. Attitudes from IBD nurses regarding MC as part of the IBD nurse caseload, 42.8% said no and 57.10% said yes. 67% agreed that MC should be incorporated into the N-ECCO guidelines.

Conclusion
Education on Microscopic Colitis for IBD nurses is required nationally in Ireland which will improve the integration into practice. IBD nurses are best placed to care for patients diagnosed with MC. Recognition for MC to be incorporated into the Nurse European Crohn's and Colitis (N-ECCO) guidelines needs to be considered.
ECCO Grant Risk of cardiovascular disease in patients with inflammatory bowel disease (IBD)
Authors: Sun Jiangwei 
Published: January 2024

Abstract

Background and Aims
Although evidence has suggested an increased risk of venous thromboembolism and arteriosclerotic events in patients with inflammatory bowel disease (IBD), there are still substantial knowledge gaps about the long-term risk of cardiovascular disease (CVD) in patients with IBD and how CVD risks vary by disease histological and clinical activity. The aims of this project are: 1) to investigate the long-term risk (both absolute and relative) of CVD in patients with IBD, and 2) to assess CVD risks for patients in different phases of histological and clinical periods of IBD.

Methods
We will apply epidemiological and statistical methods to tackle the proposed research questions through using data from a comprehensive linkage of a nationwide histopathology cohort, one quality register for IBD, and several nationwide registers in Sweden. Individual informed consent will be waived as the study is register-based.

Anticipated Impact
The project will address several important knowledge gaps and benefit the IBD community in multifaceted ways. Findings from Aim 1 will help us identify patients with IBD at a high risk of developing CVD and enhance the awareness of screening, management, and treatment of cardiovascular risk factors in patients with IBD among healthcare professionals as well as patients and their families. Findings from Aim 2 will contribute towards an improved comprehension of CVD risk in different periods of histological and clinical activity, which can offer novel insights into guiding current therapeutic strategies aiming to mitigate the risk of adverse cardiovascular events in IBD patients. Overall, knowledge from our project can provide valuable evidence for the development of clinical guidelines for CVD management in patients with IBD. Currently, such guidelines remain underdeveloped.
Monopsony, Job Tasks and Labour Market Concentration
Authors: Dodini Samuel , Lovenheim Michael , Salvanes Kjell , Willén Alexander 
Published: January 2024

Abstract
This paper extends the monopsony literature by taking a task-based approach and estimating the causal effect of concentration on labour market outcomes. Using detailed employer–employee data from Norway, we find that our job task-based measure shows lower degrees of concentration than conventional industry- and occupation-based measures. Exploiting mass lay-offs as exogenous shocks to local labour demand, we show that workers who experience mass separations in more concentrated markets have substantially worse subsequent labour market outcomes than workers in less concentrated markets. Our results point to the existence of employer market power that is driven by the concentration of skill demand across firms.
Minimally invasive surgery for clinical T4 non-small-cell lung cancer: national trends and outcomes
Authors: Rodriguez-Quintero Jorge Humberto , Elbahrawy Mostafa M , Montal Anne Michelle , Jindani Rajika , Vimolratana Marc , Kamel Mohamed K , Stiles Brendon M , Chudgar Neel P 
Published: January 2024

Abstract

OBJECTIVES
Recent randomized data support the perioperative benefits of minimally invasive surgery (MIS) for non-small-cell lung cancer (NSCLC). Its utility for cT4 tumours remains understudied. We, therefore, sought to analyse national trends and outcomes of minimally invasive resections for cT4 cancers.

METHODS
Using the 2010–2019 National Cancer Database, we identified patients with cT4N0-1 NSCLC. Patients were stratified by surgical approach. Multivariable logistic analysis was used to identify factors associated with use of a minimally invasive approach. Groups were matched using propensity score analysis to evaluate perioperative and survival end points.

RESULTS
The study identified 3715 patients, among whom 64.1% (n = 2381) underwent open resection and 35.9% (n = 1334) minimally invasive resection [robotic-assisted in 31.5% (n = 420); and video-assisted in 68.5% (n = 914)]. Increased MIS use was noted among patients with higher income [≥$40 227, odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01–1.51] and those treated at academic hospitals (OR 1.25; 95% CI 1.07–1.45). Clinically node-positive patients (OR 0.68; 95% CI 0.55–0.83) and those who underwent neoadjuvant therapy (OR 0.78; 95% CI 0.65–0.93) were less likely to have minimally invasive resection. In matched groups, patients undergoing MIS had a shorter median length of stay (5 vs 6 days, P &lt; 0.001) and no significant differences between 30-day readmissions or 30/90-day mortality. MIS did not compromise overall survival (log-rank P = 0.487).

CONCLUSIONS
Nationally, the use of minimally invasive approaches for patients with cT4N0-1M0 NSCLC has increased substantially. In these patients, MIS is safe and does not compromise perioperative outcomes or survival.
Rhizosphere assembly alters along a chronosequence in the Hallstätter glacier forefield (Dachstein, Austria)
Authors: Wicaksono Wisnu Adi , Mora Maximilian , Bickel Samuel , Berg Christian , Kühn Ingolf , Cernava Tomislav , Berg Gabriele 
Published: January 2024

Abstract
Rhizosphere microbiome assembly is essential for plant health, but the temporal dimension of this process remains unexplored. We used a chronosequence of 150 years of the retreating Hallstätter glacier (Dachstein, Austria) to disentangle this exemplarily for the rhizosphere of three pioneer alpine plants. Time of deglaciation was an important factor shaping the rhizosphere microbiome. Microbiome functions, i.e. nutrient uptake and stress protection, were carried out by ubiquitous and cosmopolitan bacteria. The rhizosphere succession along the chronosequence was characterized by decreasing microbial richness but increasing specificity of the plant-associated bacterial community. Environmental selection is a critical factor in shaping the ecosystem, particularly in terms of plant-driven recruitment from the available edaphic pool. A higher rhizosphere microbial richness during early succession compared to late succession can be explained by the occurrence of cold-acclimated bacteria recruited from the surrounding soils. These taxa might be sensitive to changing habitat conditions that occurred at the later stages. A stronger influence of the plant host on the rhizosphere microbiome assembly was observed with increased time since deglaciation. Overall, this study indicated that well-adapted, ubiquitous microbes potentially support pioneer plants to colonize new ecosystems, while plant-specific microbes may be associated with the long-term establishment of their hosts.
Preoperative Exclusive Enteral Nutrition Is Associated With Reduced Skin and Soft Tissue and Intra-abdominal Infections in Patients With Crohn’s Disease Undergoing Intestinal Surgery: Results from a Meta-Analysis
Authors: Krasnovsky Lev , Weber Andrew T , Gershuni Victoria , Pettke Erica , Lewis James D 
Published: January 2024

Abstract

Background
Malnutrition is an independent risk factor for adverse postoperative outcomes and is common among patients with Crohn’s disease (CD). The objective of this meta-analysis was to precisely quantify the association of preoperative exclusive enteral nutrition (EEN) and total parenteral nutrition (TPN) with surgical outcomes in patients undergoing intestinal surgery for CD.

Methods
PubMed, Embase, and Scopus were queried for comparative studies evaluating the impact of preoperative nutritional support on postoperative outcomes in patients undergoing surgery for CD. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2.

Results
Fourteen studies, all nonrandomized cohort studies, met inclusion criteria for studying EEN. After pooling data from 14 studies (874 EEN treated and 1044 control patients), the relative risk of intra-abdominal septic complications was decreased 2.1-fold in patients receiving preoperative EEN (relative risk 0.47, 95% confidence interval [CI], 0.35-0.63, I2 = 0.0%). After pooling data from 9 studies (638 EEN treated and 819 control patients), the risk of skin and soft tissue infection was decreased 1.6-fold (relative risk 0.63; 95% CI, 0.42-0.94, I2 = 42.7%). No significant differences were identified in duration of surgery, length of bowel resected, or operative blood loss. Among the 9 studies investigating TPN, no significant differences were identified in infectious outcomes.

Conclusions
Preoperative nutritional optimization with EEN was associated with reduced risk of infectious complications in CD patients undergoing intestinal surgery. Preoperative nutritional support with EEN should be considered for optimizing outcomes in CD patients requiring bowel resection surgery.