bluuebunny/crossref_metadata_2025_split huggingface dataset:
P291 Longitudinal assessment of Illness Identity in patients with Inflammatory Bowel Disease
Authors: Knödler L L , Atanasova K , Fischer L , Thomann A , Ebert M , Lis S , Reindl W 
Published: January 2024

Abstract

Background
The concept of Illness Identity (IID) describes the way a patient integrates a chronic illness into the self-concept and has been examined in several chronic diseases. We distinguish four IID dimensions: acceptance, enrichment, engulfment and rejection. In patients with Inflammatory Bowel Diseases (IBD) IID engulfment has been shown to be associated with quality of life (QoL) and important psychosocial factors like anxiety and depression.
As IBD often show a relapsing course with varying disease activity and symptom burden, it is unclear whether IID is a stable concept or whether it changes over the disease course.

Methods
In 2018 we started to recruit patients with active Crohn´s Disease or Ulcerative Colitis before the beginning of a new therapy with biologics (t1) and did follow-up examinations 6- 12 months (t2) and 2-3 years (t3) after the baseline examination. Until now we were able to reassess 71 of 83 at t2 and 16 of 83 patients at t3
We assessed IID with the Illness Identity Questionnaire (Oris et al.). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale and QoL was assessed with the IBDQ.
We analysed correlations between these factors at t1, t2 and t3 and calculated linear mixed-effects models to analyse the stability of IID over time. Pearson correlation between changes in IID and changes in disease activity were also examined.

Results
IID engulfment is associated with poorer QoL (r= -0.696, p= 0.003) at t3. Higher anxiety scores are linked to poorer QoL (r= -0.630, p=0.009) and higher depression scores are linked to poorer QoL (r= -0.502, p= 0.048) at t3.
In the linear mixed-effects models of IID dimensions we found no significant changes in IID over time (IID enrichment : mean difference of 1.03, p= 0.297; IID acceptance : mean difference of -0.19, p= 0.824; IID rejection : mean difference of 0.69, p= 0.259; IID engulfment : mean difference of -0.22, p= 0.771. Changes in IID engulfment correlated positively with changes in disease activity (r= 0.626; p = .0095), whereas no significant correlations were found for the other IID dimensions (Fig 1.))

Conclusion
Our preliminary results suggest stability of IID in patients with IBD over a period of up to 3 years. These results confirm our previous findings, demonstrating that especially IID engulfment is linked with a poorer QoL and changes in IID engulfment correlate with changes in disease activity.
P293 Safety and diagnostic yield of wireless video capsule endoscopy in early onset inflammatory bowel disease (EOIBD) in children under the age of 6 years in a tertiary paediatric IBD centre
Authors: Green S , Hammond J , Gaynor E , Kiparissi F 
Published: January 2024

Abstract

Background
Wireless video capsule endoscopy (VCE) is a well-established diagnostic tool used in the evaluation of small bowel disease in paediatric IBD. Patients usually swallow the capsule. Young children are rarely able to swallow the capsule and these therefore need to be placed with the help of an OGD and an ACORN device. 2 capsule systems were used: PillCam and MiroCam. The aim of this study was to look at the safety of capsule insertion in children less than 6 years of age and to also look at the diagnostic yield.

Methods
We conducted a retrospective review of our VCE data base over a 7 year period from April 2016 to August 2023.

Results
We conducted a retrospective review of our VCE data base over a 7 year period from April 2016 to August 2023. 22 patients (14 male) and 27 capsule episodes were included into the study with a an age range at point of capsule insertion between 2 years and 5 months and 5 years and 8 months (median 5 years). All capsules were inserted with an ACORN device. All patients had a histologically proven diagnosis of EOIBD; during this period 4 patients had 2 VCEs and 1 patient 3 VCEs placed. All patient had genetic tests performed, only 1/24 patients had a monogenic mutation confirmed. 15/27 (56%) of all capsules were normal, 8/27 (30%) showed small bowel ulcerations only, 2/27 (7%) showed both small bowel and colonic ulcerations and 5/27 (19%) showed colitis only. We were able to insert the capsule in all 27 capsule episodes without any complications. All studies were complete with the capsule entering the colon and no capsule got stuck.

Conclusion
Wireless video capsule endoscopy in early onset inflammatory bowel disease in children under the age of 6 years is safe with a diagnostic yield of around 50%. This modality should be used in the diagnostic pathway of EOIBD.
P302 Diagnostic Delayed is Associated with a Poor Prognosis in Patients with Crohn's Disease
Authors: Kiliç V , Kivrakoglu F , Ergin M , Kucuk H , Yuksel I 
Published: January 2024

Abstract

Background
The studies show that diagnostic delay, especially in Crohn’s disease (CD), is associated with a higher risk of complications and major surgery. We aimed to investigate timing of the diagnostic delay (DD) and its impact on the CD outcomes.

Methods
We retrospectively evaluated demographic and clinical features of CD patients between June 1993 and October 2023. Diagnostic delay was defined as the time interval from the onset of the first symptoms to the making of the CD diagnosis. The first CD related symptoms were evaluated by a review of the physician’s notes and medical record. Specific symptoms of CD included chronic or recurrent bloody or non-bloody diarrhea, and/or abdominal pain accompanied by noticeable weight loss, general weakness, and fever.

Results
514 patients with CD were included in the study. The median age of disease onset was 34.14 years (16–84 years). Male sex was 299 (58.2%). DD was detected median 13 months (5-47) (14 months in male and 12 months in female). DD was 12 months for diseases with onsets before the age of 40 and 15 months for diseases with onsets after the age of 40. DD was 25 months in isolated ileal involvement, in terminal ileal involvement was 21.5 months, ileo-colonic involvement was 20 months, and colonic location was 10 months. Ileal involvement was found to have a longer duration for DD than colonic involvement. Compared to stenosing behavior (20 months) and penetrating behavior (17 months), DD was shorter in non-stenosing non-penetrating behavior (12 months). DD was longer in perianal disease (18 months) than in those without (12 months). Current smokers had a longer duration of the DD (20 months) compared to non-smokers (11.5 months) and ex-smokers (10 months). The duration of DD (18 months) was longer in CD patients with extraintestinal manifestations than in those without (12 months).
Regarding the biological treatment, CD patients who experienced multiple biologics and resistance had longer DD (24 months) than those who experienced biologic monotherapy and responded (12 months). Compared to patients who had not had surgery (12 months), DD was longer in CD patients who had undergone surgery (15 months).

Conclusion
Our study showed that ileal involvement, stenosing-penetrating behavior, perianal disease, current smoking and existing extraintestinal manifestations were connected with DD. DD was also associated with multiple biologic needed and surgery. DD may have a role a significantly increased risk of bowel damage.
P303 Determining the threshold for moderate-to-severe disability in inflammatory bowel disease using IBD-Disk
Authors: Kallel H , Elleuch N , Dahmeni W , Limam R , Hammami A , Braham A , Ksiaa M , Jaziri H , Ben Slama A 
Published: January 2024

Abstract

Background
The IBD-Disk is a validated 10-question visual scale, which has been shown to measure functional disability associated with inflammatory bowel diseases (IBD). The aim of this study is to assess the correlation between the IBD-Disk, the daily-life burden associated with IBD, and disease activity.

Methods
We conducted a cross-sectional study over 6 months between April and September 2023. IBD patients responded to the IBD-Disk and 2 visual analog scales (VAS): 1) Daily-life IBD burden (scored from 0 to 10, score &gt; 5 indicates high burden) 2) Overall perceived health status (0=poor, 10=good). Means were compared using the Wilcoxon-Mann-Whitney test. The correlation of the overall IBD-Disk with daily-life IBD burden and overall health was analyzed using Spearman's correlation coefficient. The diagnostic performance of IBD-Disk in detecting severe disability was studied using the area under the Receiver Operating Characteristic (ROC) curve.

Results
We included 142 patients, 55.6% male and 72.5% with Crohn's disease. The median age of the series was 38 years [30 - 48]. The mean IBD-Disk total score was 35.7 ± 21.6. Energy, Emotion, and Sleep obtained the highest scores. Mean values for daily-life burden and self-rated overall health status were 4.9 ± 3.1 and 5.9 ± 2.6 respectively. There was a significant difference in means between the overall IBD-Disk score, IBD daily-life burden and overall health status between patients in clinical remission and patients with active disease (Table 1). We observed 43.7% patients (n=62) with a high daily-life burden. The correlation between the overall IBD-Disk score and the VAS of daily-life burden was r=0.787 (p&lt;0.001) and was inversely related to the VAS of overall health status with a coefficient r=-0.632 (p&lt;0.001). At an optimal overall IBD-Disk score cut-off equal to 38/100, the area under the receiver operating characteristic curve (AUROC) for high IBD daily-life burden [VAS&gt;5] was 0.907 (95% confidence interval [CI]: 0.858-0.955; p&lt;0.001) (Figure 1)

Conclusion
Our work has demonstrated excellent item homogeneity in the classical Arabic version of the IBD-Disk, and a good correlation between each item and the remaining total score. However, a prospective measurement of the intra-class correlation coefficient of the classical Arabic version will be necessary to assess its reproducibility over time.
P308 CPa9-HNE: A NEUTROPHIL-DERIVED FRAGMENT OF CALPROTECTIN MEASURED IN SERUM CAN MONITOR ENDOSCOPIC AND CLINICAL DISEASE ACTIVITY IN ULCERATIVE COLITIS
Authors: Sorokina Alexdóttir M , Poulsen A , Pehrsson M , Karsdal M A , Bay-Jensen A C , Seidelin J B , Mortensen J H 
Published: January 2024

Abstract

Background
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) presenting in remitting ulcerations of the colonic mucosa and submucosa. Mucosal healing is therefore an important treatment target. While fecal calprotectin is a common biomarker used to monitor mucosal healing in UC, patient compliance is low due to a preference for serological markers. This study aimed at investigating the association of serum calprotectin [CPa9-HNE], a non-invasive neo-epitope biomarker of neutrophil activity, with both clinical and endoscopic disease activity in UC.

Methods
The cohort included 49 patients with active UC and 50 and healthy controls (HC). Endoscopic and clinical disease activity was assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and the full Mayo score. Serum calprotectin [CPa9-HNE] was measured, reflecting a human neutrophil elastase-derived fragment of calprotectin. Spearman’s rank correlation was applied. Group differences were evaluated using Kruskal-Wallis with Dunn‘s test, bonferroni corrected for MCP. Diagnostic and discriminative capabilities were assessed using receiver operating characteristic (ROC) statistics with are under the curve (AUC).

Results
CPa9-HNE was significantly elevated in patients with UC compared to HC (ng/ml [IQR]: 32.4 [29.0–52.3] vs. 26.0 [22.6–29.0], p&lt;0.0001) and presented acceptable discriminative capabilities (AUC [95% CI]: 0.77 [0.67–0.87], p&lt;0.0001). CPa9-HNE showed a moderate positive correlation to UCEIS and Mayo (ρ=0.42; ρ=0.48, both p&lt;0.01). When patients were stratified according to endoscopic disease activity (UCEIS), CPa9-HNE was significantly elevated in patients with severe disease compared to those with mild disease (ng/ml [IQR]: 55.6 [40.9–66.4] vs. 28.9 [24.6–31.1], p&lt;0.01) and could accurately discriminate between the two groups (fig 1A-B). Similarly, when patients were grouped according to the full Mayo score, CPa9-HNE was significantly elevated in patients with mild vs. severe disease (29.1 [24.3–32.4] vs. 62.9 [55.2–67.5], p&lt;0.01) and moderate vs. severe disease (32.0 [29.2–39.2] vs. 62.9 [55.2–67.5], p&lt;0.01), and could accurately discriminate between the groups (fig 1C-E).

Conclusion
CPa9-HNE was elevated in patients with UC compared with healthy subjects. Furthermore, CPa9-HNE accurately discriminated between patients with mild and severe endoscopic disease based on the UCEIS score, as well as between patients with mild, moderate, and severe clinical disease activity according to the full Mayo score. These findings highlight the potential use of CPa9-HNE as a non-invasive tool to monitor both endoscopic and clinical disease activity in UC, with the potential of guiding treatment decisions and better aligning with patient preferences.
P311 Prevalence and impact of sarcopenia in patients with inflammatory bowel diseases: a prospective cohort study
Authors: Nuzzo A , Adam Hassan F , Dermine S , Mohamed Gouse A , Billiauws L , Bourdillel J , Joly F 
Published: January 2024

Abstract

Background
Sarcopenia is associated with increased morbidity and mortality in IBD. The main objective of this study was to prospectively evaluate sarcopenia by combining morphological and functional criteria in an outpatient IBD population.

Methods
In a prospective cohort study, we included all IBD patients admitted to the Day Hospital (DH) of our department between March 1st and 31st, 2023. Patients with short bowel syndrome were not included. Muscle mass was assessed using a Bodystat®1500MDD dual-frequency impedance meter, and muscle function was assessed by measuring handgrip strength, Carym® digital dynamometer. Pre-sarcopenia was defined by a handgrip measurement &lt; 16 to 26, and myopenia was defined by an appendicular muscle mass index (AMMI) &lt; 5.5 to 7 kg/m2 or a fat-free mass index (FFMI) &lt; 15 to 17 in women or men. Sarcopenia was defined by the association of pre-sarcopenia and myopenia. Patients were followed-up at 6 months to measure a composite criterion of disease activity combining one of the factors: FC &gt; 250µg/g, endoscopic activity, therapeutic change, hospitalization, or IBD-related surgery.

Results
In total, 60 patients were included, median age 37 years (IQR 28-54), 55% women, with CD (52%) or UC (48%) diagnosed 9 years (4-17) ago, mostly in remission (67%, n=40). Patients with CD had ileocolic (48%), ileal (35%), or colonic (16%) involvement. Patients with UC had E1 (7%), E2 (41%), or E3 (52%) involvement. A history of digestive surgery linked to IBD was noted in 30% of cases. The biologics administered were infliximab (61%), vedolizumab (25%), or ustekinumab (14%). The BMI was 24 (21-27) and serum albumin was 41g/l (39-44). The prevalence of sarcopenia, pre-sarcopenia and myopenia was 10%, 11% and 20%, respectively. Sarcopenic patients were significantly older (59 vs. 36 years, p=0.01), with older disease (20 vs. 8 years, p=0.003), and associated joint damage (40% vs. 2%, p=0.002) and tended to involve CD more frequently (80 vs. 49%, p=0.36). There was no significant difference between biologics, BMI or albuminemia in sarcopenic patients, but vitamin D levels tended to be lower (15 vs. 43, p=0.27). Myopenia was significantly associated with a history of surgery (67 vs. 21%, p=0.004), a lower BMI (21 vs. 24, p=0.001) and a more active disease at M6 according to the composite criterion (50 vs. 21%, p=0.04 after adjustment for age, sex, and disease activity at baseline). Myopenia indices were strongly correlated with handgrip values (r=0.7, p&lt;0.001).

Conclusion
In a prospective study of Day Hospital IBD patients, sarcopenia was identified by impedancemetry in 11% and myopenia in 20% of cases, and associated with an increase in morbidity.
P330 Rate of disability at diagnosis in patients with inflammatory bowel diseases: Results from a prospective population-based inception cohort, IBD Prognosis Study
Authors: Attauabi M , Madsen G R , Bendtsen F , Seidelin J , Burisch J 
Published: January 2024

Abstract

Background
Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic, progressive diseases associated with a high level of disability over time. In the current study, we aimed to investigate the occurrence of disability at the time of IBD diagnosis and determine its association with the initial disease presentation.

Methods
Incident adult patients (≥18 years old) with newly diagnosed UC or CD according to the Copenhagen IBD Criteria were included in the IBD Prognosis Study, a prospective, population-based, inception cohort covering a catchment areas of approximately 20% (1.1 million) of the Danish population. Disability was assessed using the validated IBD-Disability Index version 2.1 We defined no, moderate, and severe disability scores as 0-20, 36-50, and 51-100 points.2 A severe disease presentation was defined by the need for glucocorticoids, immunomodulators, biologics, or surgery within three months of disease. Multivariable logistical regression analyses were conducted by adjusting for gender, age, and IBD phenotype.

Results
Out of the original cohort, 208 (67.5%) and 128 (63.1%) patients with incident UC and CD, respectively, responded to the questionnaires. In comparison to non-responders, the former differed only in a higher proportion of female patients and never-smokers with UC, while a higher proportion of current smokers among patients with CD responded.
The mean IBD Disability scores differed significantly between UC (24.2, standard deviation (SD) 18.1) and CD (28.8, SD 18.6, p=0.01), with every fourth and third patient, respectively, experiencing moderate or severe disability (moderate: UC: 9.9%, CD: 22.4%, p=0.002); severe: UC: 12.3%, CD: 11.2%, p=0.77).
Independent factors associated with disability were extensive UC as well as female gender and extra-intestinal manifestations in both UC and CD (Table 1).
In multivariable logistical regression analyses adjusting for age at disease onset, gender, and disease phenotype, severe disability was significantly associated with a severe initial presentation of IBD, including IBD-related hospitalization and initiation of biological therapies (Figure 1).

Conclusion
In this prospective population-based inception cohort of unselected patients with newly diagnosed IBD, we found every third and every fourth patient with UC and CD to experience moderate-to-severe disability at the time of diagnosis, which was independently associated with a severe disease presentation. These findings have implications for patient management and surveillance strategies.

References
1 Peyrin-Biroulet L, et al. Gut. 2012. doi: 10.1136/gutjnl-2011-300049.
2 Gower-Rousseau C et al. Gut. 2017. doi: 10.1136/gutjnl-2015-310151.
P331 Photoplethysmography waveform analysis detects inflammatory status in patients with inflammatory bowel disease
Authors: Chowers Y , Banai-Eran H , Akavia L , Ollech J E , Peleg N , Snir Y , Avni-Biron I , Saidov G , Yanai H , Dotan I 
Published: January 2024

Abstract

Background
Early detection of inflammatory flares and corresponding treatment adjustment were shown to improve inflammatory bowel disease (IBD) patient care. Current episodic inflammatory biomarker testing allows limited monitoring and is associated with suboptimal compliance. We aimed to test the feasibility of monitoring patient inflammatory status by non-invasive photoplethysmography (PPG) waveform analysis.

Methods
Patients hospitalized due to IBD flares and flaring outpatients treated with IV biologics were continuously monitored using a finger-based PPG device. Flares were defined as Harvey Bradshaw index&gt;5, or partial Mayo score&gt; 3, or fecal calprotectin &gt;250mcg/gr, or C-reactive protein (CRP)&gt;1.5X the upper normal limit. We extracted and analyzed features from the raw PPG waveform to predict levels of CRP, erythrocyte sedimentation rate (ESR), and platelet counts during hospitalization. Ambulatory patients were assessed at each scheduled infusion. Models were developed using support vector machines (SVMs). The dataset was partitioned into a training set, comprising 75% of the data, and a validation set, comprising the remaining 25%. Principal component analysis (PCA) on the PPG waveform features was conducted to assess potential distinctions correlating with levels of inflammatory markers.

Results
Monitoring results were available from twenty-six patients (14 Crohn's disease, 12 ulcerative colitis). Analysis of all pooled PPG measurements revealed that the PPG waveform analysis enabled prediction of ESR results with R2 0.91, and root mean square error (RMSE) 5.6; of platelet count with R2 0.87 RMSE 59.1; and CRP with R2 0.69 RMSE 1.55. Analysis of individual patient data demonstrated that PPG features reflected different ESR values along the treatment course as depicted in a representative example in Figure 1. Dynamics of PPG measurements were demonstrated in all monitored patients as compared to partial detection of inflammatory dynamics by conventional biomarkers.

Conclusion
Analysis of PPG waveform features allowed continuous passive monitoring of the inflammatory status in patients with IBD and was sensitive to daily dynamics in a heterogenous patient population. This technology may allow feasible, sensitive and continuous patient inflammatory state monitoring and support optimized IBD patient care.
Figure legend:
PPG signal features reflect the changes in ESR values across treatment days
Each dot represents a single measurement. Colors represent different days. Dot diameter is proportional to ESR values.