bluuebunny/crossref_metadata_2025_split huggingface dataset:
N38 Male patients with Crohn's Disease and perianal fistulae and their experience of sexuality and dialogue with healthcare professionals about their sexuality - a qualitative interview study
Authors: Winther Andersen K , Primdahl J 
Published: January 2024

Abstract

Background
The incidence and prevalence of inflammatory bowel disease (IBD) has increased significantly over the last 30 years. IBD most often debuts in young adulthood and can have an impact on the patient's body image, intimate relationships and sexual function. The aim of this study was to explore how male patients with Crohn's disease and perianal fistulae, experience how their disease affects their sexuality, and how they experience the dialogue with healthcare professionals about sexuality and their related challenges.

Methods
A qualitative study based on a phenomenological hermeneutic approach was applied. Six male participants with Crohn's disease and perianal fistulae were recruited from an outpatient clinic at a regional hospital, Lillebaelt hospital, Vejle and Kolding. Data were collected via semi-structured telephone interviews. The transcribed interviews were analyzed using qualitative content analysis as described by Graneheim and Lundman. The analysis encompassed both a manifest and a latent level.

Results
The analysis led to the development of five themes:
1) The disease and sexuality. Flare-ups in the participants Crohn's disease posed an obstacle to intimacy, negatively affecting their sexlife during flare-ups. The participants used problem-focused and emotional coping strategies to overcome these limitations in their relationships, regarding intimacy and sex.
2) The phases of life - importance for sexuality. Sexuality was affected at different stages in life, independent of the participants' Crohn's disease. The balance with family, relationships, small children and work life, also had an impact on the participants desire for sex and intimacy with their partner and vice versa.
3) The importance of fistulas for sexlife. Acitive fistuala negatively affected the participants' sexuality. Their masculinity was affected by erectile dysfunction, which was a common complication to surgery.
4) Sexuality - an omitted topic in healthcare dialogue. Sexuality was often an omitted topic in the healthcare dialogue, even though the topic was important to the participants.
5) Is sex taboo? Sexuality was a topic the participants considered to be impacted by taboo, which encompassed both the participants and the health care professionals.

Conclusion
In patients with Crohn's disease and fistulae, sexuality must be seen in a bio-psycho-social perspective. Gender roles and coping strategies are important topics to include in the health care professionals dialogue with these patients.
N42 New tool for IBD nurses to support IBD patients
Authors: Toivonen T T I , Perttula K , Oksanen S , Ilus T , Mattila M 
Published: January 2024

Abstract

Background
There are about 58000 Inflammatory Bowel Disease (IBD) patients in Finland. The number has doubled in ten years. Over 5500 IBD patients live in the Pirkanmaa region. Patients are treated in three different hospitals and there are eight trained IBD nurses in adult services. Patients can contact a call back-system at any hour of the day. With growing number of patient contacts there is a need for additional contact channels and ways of support for patients care.

Methods
TaysPolku is an app developed by Buddy HealthCare where IBD patients can see their appointments, upcoming procedures, information packages, medication instructions, videos and questionnaires related to their treatment all in one place. TaysPolku provides automatic reminders and enables them to contact their own care unit directly via message. IBD nurses has been part of creating material for TaysPolku. IBD nurse explains the app and creates TaysPolku for the patient after providing the necessary information. The app is downloaded from app stores, verified by strong authentication. The app works with any face ID or pin number chosen by the patient.

Results
TaysPolku was introduced in June 2021 and the first users were patients receiving intravenous biologicals. IBD nurses informed about the new service during the infusion visits and provided written material. In the next phase, TaysPolku was set up for biological self-injecting patients. Currently, TaysPolku have been created 299 patients at Tampere University Hospital Tays. The utilization rate of the created TaysPolku is high. Messages on TaysPolku has been send/received 3896 times. The messages feature enables the care unit to reach everyone using TaysPolku simultaneously. It is used in all three hospitals and every IBD nurses take care of it. Satisfaction with TaysPolku has been good for both patients and IBD nurses. Patient questionnaire highlighted the benefits, and the answers highlighted the ease of use of the service.
"A well-functioning system "
"Reminds me very much of the lab, questions and treatment days. Easy to useand connect. There could also be a connection to other departments when care is taken in other departments as well"

Conclusion
Different forms of service are needed with the growing number of patients, and a digital app that supports the patient's self-care has been proven to work. Further development is underway to offer a similar service to all IBD patients in the region.
N43 The East Kent experience of switching from intravenous infliximab to subcutaneous, benefits to the patients, the service and financial implications
Authors: Abreu B , Scott G 
Published: January 2024

Abstract

Background
This project started due to two main problematics, Medical Day Unit (MDU) capacity and costs savings. Infliximab is used to treat IBD, and is initially administered by infusion, arranged by MDU. Due to increased need of biologics, MDU capacity decreased and patients waited a minimum of 6 weeks for first treatment, which can cause flares and, consequently, need steroids or attendance to A&E. If patients were able to self-administer treatment, they would not need to attend MDU and those appointments could be used for new patients. Treatment costs savings have positive financial implications to the Trust. Another benefit is that patients have more independence and do not have to attend MDU for their infusions.

Methods
To organize this, we had regular meetings with our Homecare Pharmacy team so we could understand the implications to our service, Homecare availability for the increase of prescriptions and homecare company for stock requirements and availability of a nurse visit.
Once all processes were clear, we visited MDU frequently for face-to-face discussion with patients at their appointment. During these conversations, we demonstrated what supplies the patient will receive and explained with demonstration pens. We noted that patients feel more reassured if they can be familiar with the injections and raise any concerns. During the days we could not attend MDU, we arranged letters for the patients, and had positive feedback as they contacted our helpline showing interest to switch. Another strategy is to discuss this process before starting treatment, so patients can have everything arranged while having their loading doses.

Results
Before organising this, we had 14 patients on infliximab subcutaneous injections. From April 2023 to 16/11/23 we have switched 58.4% of patients. Potential cost saving to the trust includes no VAT payment on homecare products, no nursing time cost, medical devices and disposable cost and MDU cost. From patient feedback it is shown that patients prefer subcutaneous injections as this reduces the time spent in MDU, cost of travel and better symptom control. This is work in progress and we will have further information on successes at the year end.

Conclusion
Our goal was to switch 40% of infliximab by the third quadrimester and have switched 58.4%. This is an ongoing process, patients are started on infliximab regularly so need to ensure they are aware of this option. This project has been very successful for both patients and the Trust. We only switched back 3 patients due to side effects and flares. We will continue with this initiative so we can promote patient independence, decrease waiting times for loading doses and to improve cost savings to the Trust.
N47 Spiritual needs of patients with IBD: preliminary results of a pilot study
Authors: Starnella G , Rosato I , Canova C , Savarino E V , Zingone F , Barberio B , Lorenzon G , Gregori D , Comoretto R I , Martinato M 
Published: January 2024

Abstract

Background
Inflammatory bowel disease (IBD) includes Crohn's Disease (CD) and Ulcerative Colitis (UC), and both lead to manifestations that affect the patient's quality of life (QoL). The issue of chronicitỳ makes the disease difficult to manage and requires a radical change in patients’ habits, leading to a decrease in QoL after diagnosis. The literature emphasises how spiritualitỳ positively influences the psychophysical well-being of chronic patients and consequently their QoL.
This study aims to describe the spiritual needs of patients with IBD to promote holistic care and improve their QoL and aims to explore their eventual association with sociodemographic and clinical variables.

Methods
A cross-sectional study was carried out in the outpatient gastroenterology clinics of a university hospital, administering the validated Spiritual Needs Questionnaire (SpNQ) during outpatient follow-up visits to patients over 18 years of age after informed consent to participate in the study. The SpNQ consist of 27 items divided into four domains: Religious needs, Needs for Inner Peace, Existential needs, and Giving/Generativity Needs. Some clinical and sociodemographic data were also collected.

Results
A total of 103 completed the questionnaire: 53% had CD, 35% UC and 12% had undetermined IBD. 44% were males the median age was 45 years, and half of the sample was more than 10 years from IBD diagnosis. More than 40% were in biologics, 47% had a high educational level, 28% were smokers, and 4% had a stoma. 65% were Christian, 26% had no religion, and the frequency of their participation in religious gatherings varies from never (15%), to rarely (59%) and often (26%).
They cultivate their spirituality mainly by conducting their existence in accordance with values that are fundamental to them (47.7%), staying in contact with nature (30.5%), praying (15.8%), engaging in introspection and self-knowledge (14.7%), volunteering (12.6%), and practising extreme sports (10.5%).
The analyses showed statistically significant differences between sexes regarding the domains "Needs for Inner Peace" and "Religious Needs" (p&lt;0.001) more relevant to women than men, and significant differences between ages regarding the domains "Existential Needs", more relevant to middle age (p=0.037), and "Giving/Generativity Needs", more relevant to middle age and to elderly (p=0.015).

Conclusion
Spiritual needs may play a major role in the care of patients with IBD, and nursing should consider this dimension to improve the holistic care of the patients. Research should be expanded through studies involving a larger sample size and evaluating the IBD outcome by acting on spiritual needs.
N48 Exploring & evaluating the benefits of initiating an IBD Transition clinic
Authors: Scott G 
Published: January 2024

Abstract

Background
Establishing an Inflammatory Bowel Disease (IBD) Transition Clinic can bring about several significant benefits. This includes providing continuity of care, specialised care, education in new treatment, emotional support, collaboration and coordination of care, empowering patients and assisting in adherence to medication and follow up appointments. In the author's history within the Trust there has never been an established IBD Transition clinic. This has led to young adults delayed in transitioning to adult services without any formal handover.

Methods
The IBD Consultant Nurse felt that the young adults were given a second class service and that they were not receiving the care and advice that they needed in the difficult time of being a young adult with a long term condition. They enlisted the help of a paediatric gastroenterologist and worked with the paediatric operations team and a cohort of patients were booked into a three monthly clinic held on a Saturday as this was felt the best day for engaging both patients and family. The paediatric gastroenterologist and IBD Consultant Nurse undertook the clinic jointly.

Results
A number of clinics were undertaken and the IBD Consultant Nurse asked for all patients to be assigned to an adult gastroenterologist after the first appointment. At the joint clinic all medication was discussed and a personalised plan of care was adopted for all patients to allow a smooth transition into adult services. The feedback from patients and family members was extremely favourable and all patients felt that they had been given all of the required information, a personalised care plan and were prepared to be transitioned to adult care. All patients were given a post clinic questionnaire on their satisfaction of the Transition clinic. The clinic was recently stopped as a adult gastroenterologist felt that this should not have been undertaken by a nurse and that they can only be undertaken by doctors. The current waiting time to be reviewed by a gastroenterologist is currently around 65weeks which could lead to a delay in treatment.

Conclusion
Ideally establishing a nurse-led transition clinic requires collaboration among healthcare providers, administrative support, and resources dedicated to its development. Additionally, an emphasis on patient and family involvement in the planning and execution stages can lead to a more patient-centric and successful transition program. This clinic was extremely successful but has had to stop as the gastroenterologists feel that only gastroenterologists can undertake transition clinics and should not be nurse led. Unfortunately this will lead to transition patients having an extended delay into adult services.
ECCO Fellowship Generation of an IBD single-cell multiome ATLAS for deeper understanding of IBD sub-phenotypes
Authors: Pibiri Paola , Anderson Carl 
Published: January 2024

Abstract

Background and Aims
Inflammatory Bowel Disease (IBD) is one of the most prevalent gastrointestinal diseases worldwide (1, 2, 3). Disabling symptoms affect the quality of life of IBD patients, and incurred disability and healthcare costs result in a high socio-economic burden (1, 4, 5). Despite new biologicals and small-molecule drugs, patients deal with high rates of non-response, requiring therapy switching without evidence-based guidance on optimal therapy choices for each specific disease condition.

Methods
In an effort to better understand the disease pathomechanisms underlying IBD, an essential role has been played by single-cell RNA sequencing (scRNAseq). Two scRNAseq studies, one in Crohn’s disease (CD) (Martin e.a., Cell 2019), and one in ulcerative colitis (UC) (Smillie e.a., Cell 2019), characterized the molecular and functional heterogeneity of phenotypically similar IBD cases, and gave us the first clues on the mechanism underlying non-response to anti-TNFa. However, the statistical power of these studies is limited due to their small cohort sizes (6, 7, 8). To acquire further insights into IBD, and to definitively establish the mechanism underlying anti-TNFa non-response without having to generate costly new single-cell experiments, we propose harmonizing smaller IBD scRNAseq studies and performing large-scale meta-analyses. Specifically, our goal is to start with meta-analyzing four IBD scRNAseq datasets (two CD, each ~100 ind, and two UC, each ~30 ind) and to perform a powerful meta-analysis. To easily add more datasets we will create a pipeline for integrating scRNAseq data.

Anticipated Impact
The large meta-analysis will allow us to get more insight into the mechanisms underlying disease subphenotypes, and to get insight into the effect of commonly used IBD therapies (anti-TNFa, thiopurines) on the gut mucosal composition and inflammatory pathways. The datasets and related results will be made publicly available through a single-cell IBD ATLAS web interface, fulfilling the need for an easily queryable large IBD scRNAseq dataset.
ECCO Grant Investigating the role of gut eukaryotic virome in contributing to colorectal cancer carcinogenesis
Authors: Facoetti A , Massimino L , Cagliani S , Spanò S , Nicolò S , Errico C , Parigi T L , Riva M , Anselmo A , Villa C , Palmieri O , Latiano A , Danese S , Ungaro F 
Published: January 2024

Abstract

Background and Aims
Eukaryotic-targeting viruses have recently attracted considerable interest in gastrointestinal diseases such as ulcerative colitis (UC) and colorectal cancer (CRC)1–3, the fourth leading cause of cancer death in the world4. UC and CRC share several factors influencing their etiogenesis, including intestinal dysbiosis2,5–7. Our group has recently published a work pinpointing a gut virome-associated Orthohepadnaviridae protein, namely Hepatitis B protein X (HBx) to correlate with UC pathogenesis and promote intestinal inflammation in mice by disrupting the epithelial barrier and shaping the gut mucosal immune environment, independently of the microbiota3. Moreover, we showed that HBx is able to induce DNA damagerelated processes and active biological processes related to the Wnt pathway3 known to be involved in colorectal carcinogenesis8. Our preliminary results raised the hypothesis that a specific virome-derived protein may fill the gap existing between intestinal inflammation and CRC onset by stimulating pro-inflammatory and/or pro-carcinogenic effects. To verify this hypothesis, we here propose to address the following Aims:
Aim 1. To evaluate the carcinogenic effects and phenotypes induced by HBx in vivo.
Aim 2. To unveil the molecular and cellular dynamics of HBx-induced effects in vitro.

Methods
Aim 1. Two mouse models of carcinogenesis will be used. The first will be the orthotopic model of CRC performed by injecting HBx-overexpressing Caco-2 cells in the rectal mucosa. The second will be performed by continuously challenging mice with the HBx protein directly into the rectal mucosa over 10 weeks. Tumor growth will be monitored over time and tumor samples will be characterized for histology and multidimensional flow cytometry analysis. Distal organs will also be analyzed to evaluate the extent of the metastasization.
Aim 2. 3D models of intestinal mucosa microenvironment will be set up with HBxoverexpressing epithelial cells cocultured with intestinal immune and stromal cells. Then cells will be analyzed by single-cell transcriptomics and RNA pseudotime.

Anticipated Impact
Our study proposes an unconventional understanding of CRC carcinogenesis, investigating whether and how a eukaryotic virome-associated protein promotes CRC and exploring gut virome-dependent cellular and molecular mechanisms during CRC carcinogenesis.
ECCO Grant Dissecting the role of S1PR1 modulator in the mucosal regeneration of Ulcerative Colitis
Authors: Rizzo Giulia , Vetrano Stefania 
Published: January 2024

Abstract

Background and Aims
Ozanimod, a potent sphingosine 1-phosphate (S1P) 1/5 receptor agonist, first approved for the treatment of adults with moderately to severely active UC in the USA and in the EU, has showed promising results in terms of both tolerability and efficacy reducing inflammatory processes and inducing disease remission. The selectivity of Ozanimod for S1PR1 is 27 times that for S1PR5. Therefore, is plausible that the beneficial effects of Ozanimod are mediated by S1PR1, which is constitutively expressed not only by immune cells, but also by epithelial, endothelial, and stromal cells. However, its function on non-immune cells has been neglected. Based on preliminary data demonstrating a faster recovery of mucosal damage in mice with a conditional deletion of S1PR1 in the epithelia and endothelia compartments, our hypothesis is that the inactivation of S1PR1 not only inhibits immune cell trafficking, but also promotes tissue repair. Based on this background, the main objectives will be to exploit the Ozanimod effects during the process of mucosa healing, and to investigate the molecular pathways activated by Ozanimod on epithelial and endothelial cells.

Methods
Pre-clinical validation of Ozanimod, in vivo model of UC in association with conditional knockout mice for S1PR1 on epithelial and endothelial cells, stimulation of primary endothelial cells from UC patients and human induced pluripotent stem cell-derived intestinal organoids (iHOs) will be used to address our aims. Transcriptomics, functional assay, immune characterization, WB validation will be performed.

Anticipated Impact
In short and medium term, we will improve the knowledge on the role of S1PR1 in the processes of mucosal healing and identify the molecular pathways involved in the response to the mucosal damage mediated by the ozanimod in non-immune cells. The results of this study may improve the treatment options for UC patients.
Left ventricular inferior wall congenital diverticula in athletes: a case series and review of the literature
Authors: Di Gioia Giuseppe , Buzzelli Lorenzo , Segreti Andrea 
Published: January 2024

Abstract

Background
Congenital left ventricular diverticula (LVDs) and aneurysms (LVAs) are rare, developmental, cardiac anomalies, which are often asymptomatic. Sometimes they can cause life-threatening complications like arrhythmias, syncope, embolic events, ventricular wall rupture, valvular regurgitation, congestive heart failure, and various symptoms. Diagnosis is usually made after exclusion of acquired causes, from cardiac or non-cardiac disorders. Specific guidelines for LVD/LVA management are not available and treatment options are guided by different case-by-case clinical presentation and possible complications.

Case summary
We present a series of two patients with occasional diagnosis of diverticula of the inferior basal left ventricular wall in the context of cardiological evaluations for competitive sport certificate. Symptoms were present at clinical evaluation only in Patient 1, together with electrocardiogram (ECG) abnormality. We performed transthoracic echocardiography as a first-line examination and secondly, we confirmed the diverticula by cardiac magnetic resonance. A maximal stress test and 24 h ECG Holter were also performed.
In our case, in light of the clinical-instrumental findings, periodic medical and echocardiographic follow-up without therapy was established, together with the resumption of sports activities.

Discussion
Nowadays, no specific recommendations exist in athletes and no studies are available on how regular sport practice can influence natural history of LVD/LVA. The current case series highlights the importance of risk stratification for cardiac events, of a multimodal imaging approach in diagnostic procedure and of a tailored treatment strategy.