bluuebunny/crossref_metadata_2025_split huggingface dataset:
INFLAMMATORY BOWEL DISEASE (IBD) COMMUNITY PREFERENCES FOR PSYCHOSOCIAL SUPPORT: THE ROLE AND SCOPE OF PEER SUPPORT FOR YOUTH WITH IBD
Authors: Bugwadia Amy , Dunn Ashley , Bensen Rachel , Wren Anava 
Published: January 2024

Abstract

INTRODUCTION
Youth with inflammatory bowel diseases (IBD) experience psychosocial challenges which can negatively impact their body image, self-efficacy, IBD symptoms, and risk of disease recurrence. Peer support programs have high desirability amongst IBD patients and can improve disease management skills, self-efficacy, and mental health generally. Existing peer support programs vary, ranging from one-on-one peer coaching to professionally-led support groups to IBD summer camps. However, there is limited research identifying best practices for peer support in IBD. Community-based participatory research (CBPR) is a framework that centers patient voices in all phases of research, providing an opportunity to equitably represent patient preferences in the development of peer support programs.

METHODS
Our mixed-methods community survey was disseminated across the US to adults eighteen or older with IBD via patient organizations. This survey assessed patient preferences for a peer support program, including structure (e.g., support group, 1:1 mentor, group activities) and program topics (e.g., body image, social life, medical care). Participants ranked these on a 5-point Likert scale (from “Not at all important” to “Extremely important”) and also had an open-ended opportunity to provide other topic suggestions. Given our CBPR approach, we recruited a Patient Advisory Board (PAB), composed of adults diagnosed with IBD in childhood, and conducted one-on-one interviews to assess patient perspectives of the survey results.

RESULTS
Our sample included 77 participants (mean age 29, 39.5% with ulcerative colitis, 60.5% with Crohn’s disease). Participants ranked doing non-IBD activities (e.g., games, meals) as quite a bit important, while IBD activities (e.g., IBD comic book) were ranked moderately important. PAB members emphasized that the strength of a patient-led support program is the shared experience and “normalcy” of having IBD, and that limiting a program to IBD activities wouldn’t allow for spontaneous conversation and trust-building. The average ranking of all topics surveyed fell between “extremely important” to “quite a bit important.” In order of importance, topics included navigating social life and mental health, increasing independence while growing older, planning for the future, communicating with the healthcare team, disclosure to friends, navigating school, body image, medical management, and nutrition. Themes suggested by participants included sexual intimacy, fertility, and advocacy. PAB members emphasized the role of peer support interventions as complementary to medical care, and specifically, how peer mentorship can allow for ‘real world’ examples of navigating life with IBD, outside traditional topics discussed in medical appointments. We will use this mixed-methods data to inform our design of a novel IBD peer support program.
THE COLONIC MUCOSAL MICROBIOME IN IBD-ASSOCIATED ARTHRITIS IS MORE VARIABLE THAN IN IBD ALONE
Authors: Alizadeh Madeline , Wong Uni , Siaton Bernadette , Patil Seema , George Lauren , Raufman Jean-Pierre , Scott William , von Rosenvinge Erik , Ravel Jacques , Cross Raymond 
Published: January 2024

Abstract

BACKGROUND
Inflammatory bowel disease (IBD)-associated arthritis affects over 25% of those with IBD and is associated with several risk factors including disease location. The intestinal microbiome varies throughout the intestinal tract and is thought to play a role in the development of IBD, although the precise mechanism remains unexplored. To better characterize its relationship with IBD-associated arthritis, we analyzed the intestinal microbiome from a subset of subjects in the LOCATION-IBD cohort.

METHODS
Microbiome analysis was performed on 16S rRNA V3V4 amplicon sequencing data generated from mucosal biopsies from the terminal ileum (TI), hepatic flexure (HF), and the distal descending colon (DDC) of participants in the LOCATION-IBD cohort. Alpha diversity was assessed using the Shannon index, while beta diversity between samples from the same participant were assessed using Jenson-Shannon Divergence (JSD). ZicoSeq was used to assess differential abundances in composition between those with vs without IBD-associated arthritis.

RESULTS
In this analysis, we included a subset of samples from participants in the LOCATION-IBD cohort with (n= 68 from 25 participants) and without (n = 86 from 29 participants) joint EIMs and with joint pain of unclear etiology (n= 14 from 5 participants). Overall, samples clustered predominantly based on participant, and similar genera were present across TI, HF, and DDC mucosal samples. Shannon diversity was similar across samples, regardless of the associated arthritis category, though diversity was lower in those with CD compared to those with UC (p-value = 0.0007, Tukey post-hoc p-value = 0.0004) and trended to be higher in sites of inflammation (p-value = 0.0645). JSDs between samples for an individual participant were higher for those with compared to those without IBD-associated arthritis (p-value = 0.038). In those with joint EIMs, Flavonifractor and Fusicatenibacter were significantly lower without accounting for sampling location, whereas other species including Lachnoclostridium (increased) and Fusobacterium (decreased) were noted in the proximal colon.

CONCLUSIONS
To our knowledge, this represents the first assessment of the mucosal microbiome across several intestinal sites in individuals with and without IBD-associated arthritis. Our finding that similar bacteria are found across the terminal ileum, proximal colon, and distal colon, but that less site-to-site concordance is seen in those with IBD-associated arthritis, aligns with previous findings that the involvement of specific colonic segments is associated with IBD-associated arthritis. Further, our finding that the abundances of specific bacteria are altered, frequently in a site-specific manner, identifies potential opportunities for future studies.
CLINICAL OUTCOMES OF INFLAMMATORY BOWEL DISEASE AFTER ORTHOTOPIC HEART TRANSPLANT
Authors: Kurdi Ahmed , Pardi Darrell , Loftus Edward , Kaur Manreet , Farraye Francis , Hashash Jana Al 
Published: January 2024

Abstract

BACKGROUND
Limited data are available on outcomes of patients with pre-existing inflammatory bowel disease (IBD) who undergo orthotopic heart transplantation (OHT) or develop de novo IBD post-OHT. We aimed to assess the incidence and disease outcomes of pre-existing and de novo IBD in OHT patients while evaluating the effect of IBD on OHT outcomes.

METHODS
A retrospective review of records was performed from a tri-site tertiary care system between July 2000 and July 2022. A total of 83 OHT receipients were concomitantly diagnosed with colitis of infectious or inflammatory etiology. Only patients with a diagnosis of IBD were included. Sub-analyses of the outcomes and immunosuppressive regimens of OHT recepients were done relative to those with pre-existing or de novo IBD.

RESULTS
A total of 8 OHT patients with concomitant IBD were identified. The median patient age (IQR) was 54 (23) with OHT and IBD onset at 50 (21.2) and 32.5 (15.7), respectively. Six patients were diagnosed with ulcerative colitis (UC) and 2 were diagnosed with Crohn’s disease. Five of the patients were female. All patients developed IBD within 11.5 (8) years within OHT. Only 1 patient developed de novo IBD 15 years after the first OHT and 7 years prior to a second OHT. OHT immunosuppressive regimens included a combination of tacrolimus (TAC) and prednisone (n=2), TAC and mycophenolate mofetil (MMF) (n=2), TAC, MMF, and sirolimus (n=2), TAC and sirolimus (n=1), and MMF with sirolimus (n=1). Therapy for pre-existing IBD included maintenance of 5-aminosalicylic (5-ASA) (n=3), escalation to vedolizumab (VD) (n=2), and discontinuation of IBD therapy (5-ASA and azathioprine) (n=3). De novo IBD consistent with UC (15 years post-OHT) was managed with 5-ASA (n=1). Six patients (including de novo IBD case) maintained clinical and endoscopic remission of IBD with no flares post-OHT while 2 patients (1 UC and 1 CD) with active disease flares responded clinically and endoscopically to VD escalation from 5-ASA and azathioprine. Among two UC patients with ileal J-pouch pre-OHT, 1 developed refractory pouchitis requiring diverting ileostomy (while on TAC and prednisone) with no pouchitis in the other (maintained on TAC and MMF). Good graft tolerance limited to mild acute cellular rejection episodes was noted in 6 patients, while multiple or no rejection episodes were noted in the remaining two. None of the patients developed CMV or MMF-induced colitis. One patient died due to progressive functional decline unrelated to graft failure or IBD.

DISCUSSION
The clinical course and treatment of IBD preceding OHT or de novo (though rare) is not significantly worsened or altered post-OHT. The majority of patients achieve clinical and endoscopic remission while on heart transplant-related immunosuppression. Biologic therapy escalation to VD resulted in clinical remission with no effect on graft tolerance.

Table 1 Clinical outcomes of OHT patients with concomitant IBD
FROM RESISTANCE TO RESPONSE: 52 WEEKS OF SUBCUTANEOUS INFLIXIMAB IN REFRACTORY CROHN'S DISEASE PATIENTS AFTER THE MULTIPLE TREATMENT FAILURES
Authors: Lukas Milan , Cerna Karin , Duricova Dana , Lukas Martin 
Published: January 2024

Abstract

BACKGROUND
Infliximab (IFX), an anti-TNFα monoclonal antibody, has been utilized since the late 1990s as an effective therapeutic agent for the treatment of Crohn's disease (CD). Since 2020, subcutaneous IFX (IFX-SC) has been available for treating CD. This study aimed to conduct a 52-week observation of IFX-SC treatment in refractory CD patients who had failed on at least two previous lines of biologic therapy patients.

MATERIALS AND METHODS
The study included 32 patients diagnosed with CD who had failed on 2 to 7 previous lines of biological therapy. Observed cohort was monitored at weeks W0, W4, W14, W30, and W52, recording Harvey-Bradshaw Index (HBI) , C-reactive protein (CRP) and fecal calprotectin (FC) concentrations, trough infliximab (TL-IFX) and anti-infliximab (anti-IFX) serum levels. Endoscopic, ultrasonographic and magnetic resonance disease scores (SES-CD, IUS and MaRIA) were determined at baseline and W52.

RESULTS
52-week persistence on IFX-SC treatment was recorded in 18 out of 32 patients (56.3%). A significant decrease of HBI (P &lt;0 .0001), CRP (P =0 .0035), FC (P =0.0012), SES-CD (P =0.013), IUS (P =0.0034) and MaRIA (P =0.0261) was observed. TL IFX increased significantly (.0073), and median TL-IFX levels reached 19.75 μg/mL at W52. During the therapy, 8 out of 16 initially anti-IFX positive individuals seroconverted to negative anti-IFX (50 %); no new sensitization to IFX was recorded in the cohort. None of the patients treated with IFX-SC in W52 needed concomitant immune-modifying treatment. Baseline clinical, laboratory, and imaging markers did not demonstrate any predictive value for IFX-SC treatment failure, except for baseline high levels of anti-IFX (P = &lt;0.0001).

CONCLUSION
In the cohort of refractory CD patients, over half achieved one-year treatment persistence on IFX-SC, displaying a highly favorable trend in all disease activity markers. The IFX-SC treatment appears to be effective and safe; however, further research is needed to identify potential predictors of therapeutic responsiveness.
Acknowledgement: This work was supported by the IBD-COMFORT Foundation
PATIENT PERCEPTIONS OF ENDOSCOPIC TESTING IN THE MANAGEMENT OF INFLAMMATORY BOWEL DISEASE
Authors: Duncan Eric , Sanon Myrlene , Griffo Cindy , Amatelli Doreen , Barthelmes Jennifer , Wirth Daniel , Kachroo Sumesh , Lee Rebecca , Hoops Timothy , Naessens Dominik 
Published: January 2024

Abstract

BACKGROUND
Inflammatory bowel disease (IBD) is associated with significant patient and societal burden. Treatments for IBD have traditionally focused on symptom management. However, clinical guidelines (Selecting Therapeutic Targets in Inflammatory Bowel Disease [STRIDE] II) now recommend treat-to-target approaches. Mucosal healing on endoscopy is becoming a key prognostic parameter in the management of IBD. In light of new guidelines, we aimed to qualitatively assess patient understanding of, and perspectives on, endoscopic measures in the context of disease monitoring and assessing treatment impact.

METHODS
Twenty patients diagnosed with IBD across the United States, United Kingdom, Spain, Italy, and France participated in TeleWebs (web-enabled phone interviews; United Kingdom, Spain, Italy, France) or a 5-day online bulletin board exchange (United States) discussing their condition and experiences. Specific information regarding disease history, conversations with physicians, experiences with endoscopy, and reactions to information shared on endoscopy were captured over a 5-day period. All respondents were recruited from double opt-in volunteer consumer market research panels.

RESULTS
Patients generally link disease remission to the absence of symptoms. Knowledge and perceptions of endoscopic measurements are largely driven by their physician perspectives and explanation to patients. Some patients are aware of healthy mucosa as a key part of remission, while others have no concept of the term. Patients report they find it psychologically reassuring to know that they are “healthy inside”. Due to its value, most patients are willing (5.7 on a 1 to 7 Likert Scale) to undergo endoscopy annually, but would be reluctant to do so more frequently. Table 1 outlines barriers and drivers reported by patients on the adoption of endoscopy.

CONCLUSION
The insight from this study provides understanding of patient perceptions of endoscopy and its place in treating their IBD. This study demonstrates that despite the barriers to the use of endoscopy, patients recognize its clinical relevance for disease management and are willing to periodically undergo a procedure.
RISANKIZUMAB DOSE ESCALATION IN PATIENTS WITH CROHN'S DISEASE
Authors: Nichols Patrick , Kozlicki Miranda , Fann Jessica , Zuckerman Autumn , Dalal Robin 
Published: January 2024

Abstract

BACKGROUND
Patients (pts) who do not achieve optimal response at standard dosing of biologic therapies or lose response over time often benefit from escalated doses of biologic therapies to manage moderate to severe Crohn’s disease (CD). Currently, no data exists on dose escalating risankizumab, an interleukin-23 inhibitor recently approved for the treatment of moderate to severe CD. This cohort study aimed to describe pt characteristics, insurance access, and response to therapy in pts prescribed risankizumab more frequently than the FDA-approved maintenance dosing of 180mg or 360mg every 8 weeks (wks).

METHODS
We conducted a retrospective single-center cohort study of pts with CD who were initiated on an escalated dose of risankizumab between June 2022 and July 2023. Pts must have received at least one escalated dose during the defined time frame for inclusion. Pt and disease characteristics, steps required to secure insurance access, and early treatment outcomes were collected from the electronic health record and reported descriptively.

RESULTS
A total of 211 pts completed three standard risankizumab intravenous induction infusions during the study period. Twelve pts were initiated on an escalated maintenance dosing frequency. All 12 pts received the 360mg dose. Seven pts were escalated to a frequency of every 6 wks (58%) and 5 pts were escalated to every 4 wks (42%). Pts were mostly female (67%) with a median age of 42 years (interquartile range [IQR] 30-52). The median number of previous biologic/small molecule drug failures was 4 (IQR 2-5). Eleven (92%) pts previously required a dose escalated biologic, the median years since diagnosis was 15 (IQR 10-17), and median body mass index was 25 kg/m2 (IQR 22-27). Six pts (50%) previously required surgical intervention. Pts received a median of 3 (IQR 2-3) risankizumab injections on standard dosing before a decision to escalate was made. Reasons for escalated dosing included colonoscopy/imaging/pathology results showing inflammation (n=7) or persistent symptoms (n=5). Five (42%) pts were able to access the escalated dose without an additional authorization, 5 (42%) required a prior authorization that was approved, and 2 (17%) required at least one level of appeal or peer to peer review. Through 10/03/2023, 6 pts had a documented improved response to the escalated dosing (50%), 3 remained stable (25%) and 3 had no change (25%) at a median of 88 days (IQR 72-103) from escalation.

CONCLUSION
This study demonstrated the need for heavily treatment-experienced pts with severe CD to dose escalate risankizumab, often requiring an additional insurance authorization. Most pts improved or remained stable on the escalated dosing, showing promise for risankizumab dose escalation outcomes. More research is needed to assess risankizumab dose escalation long-term outcomes and the role of trough levels.
The effects of torula yeast as a protein source on apparent total tract digestibility, inflammatory markers, and fecal microbiota dysbiosis index in Labrador Retrievers with chronically poor stool quality
Authors: Timlin Claire L , Dickerson Sarah M , Fowler Jason W , Mccracken Fiona B , Skaggs Patrick M , Ekmay Ricardo , Coon Craig N 
Published: January 2024

Abstract
This study examined the effects of varying protein sources on apparent total tract digestibility, inflammatory markers, and fecal microbiota in Labrador Retrievers with historically poor stool quality. Thirty dogs (15 male, 15 female; aged 0.93 to 11.7 yr) with stool quality scores ≤2.5 on a 5-point scale (1 representing liquid stool and 5 representing firm stool) were randomly assigned to 1 of 3 nutritionally complete diets with differing protein sources and similar macronutrient profiles: 1) chicken meal (n = 10); 2) 10% brewer’s yeast (n = 10); or 3) 10% torula yeast (n = 10). Another 10 dogs (five male, five female) with normal stool quality (scores ranging from 3 to 4) received diet 1 and served as negative control (NC). All dogs were fed diet 1 for 7 days, then provided their assigned treatment diets from days 7 to 37. Daily stool scores and weekly body weights were recorded. On days 7, 21, and 36, blood serum was analyzed for c-reactive protein (CRP), and feces for calgranulin C (S100A12), α1-proteinase inhibitor (α1-PI), calprotectin, and microbiota dysbiosis index. Apparent total tract digestibility was assessed using the indicator method with 2 g titanium dioxide administered via oral capsules. Stool scores were greater in NC (P &lt; 0.01) as designed but not affected by treatment × time interaction (P = 0.64). Body weight was greater (P = 0.01) and CRP lower (P &lt; 0.01) in NC dogs. Dry matter and nitrogen-free extract digestibility did not differ among groups (P ≥ 0.14). Negative controls had greater fat digestibility compared to BY (94.64 ± 1.33% vs. 91.65 ± 1.25%; P = 0.02). The overall effect of treatment was significant for protein digestibility (P = 0.03), but there were no differences in individual post hoc comparisons (P ≥ 0.07). Treatment did not affect S100A12 or α1-PI (P ≥ 0.44). Calprotectin decreased at a greater rate over time in TY (P &lt; 0.01). The dysbiosis index score for BY and TY fluctuated less over time (P = 0.01). Blautia (P = 0.03) and Clostridium hiranonis (P = 0.05) abundances were reduced in BY and TY. Dogs with chronically poor stool quality experienced reduced body weights and increased serum CRP, but TY numerically increased protein digestibility, altered the microbiome, and reduced fecal calprotectin. Torula yeast is a suitable alternative protein source in extruded canine diets, but further research is needed to understand the long-term potential for improving the plane of nutrition and modulating gut health.
Sexual Role Functioning, Sexual Satisfaction, and Intimacy After Surviving Burn Injuries: A Scoping Review of Associated Factors, Screening Tools, and Burn Care Staff Preparedness
Authors: Bayuo Jonathan , Wong Arkers Kwan Ching , Wong Frances Kam Yuet , Baffour Prince Kyei , Kuug Anthony Kolsabilik 
Published: January 2024

Abstract
Although concerns regarding intimacy abound among burn survivors, these are often not captured during rehabilitation. Considering that sexuality remains a part of humans suggests a critical need to pay attention to this aspect. To guide further work, this review sought to examine existing studies to ascertain what is known about factors associated with sexual role functioning, sexual satisfaction, and intimacy, the scree ning tools employed, and the preparedness of burn care staff in initiating discussions about these. We employed a scoping review approach with extensive searches in 4 peer-reviewed databases for studies reporting on the phenomenon, published in English from 2010 to date. A total of 17 studies comprising of 13 studies reporting on the burn survivors and 4 reporting on burn care staff were retained. Though we identified both sociodemographic and clinical factors associated with postburn sexual role functioning, sexual satisfaction, and intimacy, the existing evidence appear limited which made it rather difficult to draw definitive conclusions. The sexuality subscale of the Burn-Specific Health Scale-Brief emerged as the commonly used screening/assessment tool. The evidence suggest that burn care staff are generally unprepared to initiate discussions regarding sexual role functioning, sexual satisfaction, and intimacy and often, there is no personnel assigned to this task. There is a great need for studies to strengthen the evidence base regarding the factors associated with postburn sexual role functioning, sexual satisfaction, and intimacy. In addition, it is imperative to build capacity of burn care practitioners with the requisite know-how needed to navigate through sexual issues.
A Case of Local Radiation Injury in the Creation of Lichtenburg Art
Authors: Janes Lindsay A , Iqbal Uswa , Vercruysse Gary A 
Published: January 2024

Abstract
Despite the fact that there may be no immediate outward signs of tissue destruction, the ultimate damage caused by radiation exposure is immediate and may be predicted based on the source, length of exposure, and type of tissue to which the radiation is exposed. Although predictable, difficulty in caring for these patients stems from the multiple sources of radiation to which people may be exposed, the various parts of the body exposed, the dose involved, the rarity of the condition, and a general lack of knowledge on the part of treating physicians. Due to these factors, there is significant variation in treatment recommendations. Additionally, knowledge about how to treat these injuries is limited and often very difficult to access, even among healthcare professionals. This report highlights the first known case of localized radiation injury secondary to the utilization of a linear accelerator to generate Lichtenberg art. In this case, an accident occurred while working with a retired accelerator and led to severe local radiation injury to this patient’s bilateral hands, prompting a series of searches and inquiries as to the next best step in management. From consulting clinicians at the Centers for Disease Control and Prevention (CDC) who are experts in managing radiation injury to the eventual need for digit amputation, this case highlights the profound lack of knowledge and accessible resources for clinicians and patients facing localized radiation injury. This is a noninterventional observation case report without the requirement of ethical approval.