bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1064 Upadacitinib is safe and effective in Ulcerative Colitis patients with prior exposure to Tofacitinib
Authors: Gilmore R , Fernandes R , Hartley I , Arzivian A , Leong R , Andrew B , Vasudevan A , Greeve T , Moore G , Kim S , Lightowler D , Singh A , Mahy G , Mithanthaya A , Venugpal K , Han S , Bryant R , West J , Segal J , Christensen B , Ding N J , An Y K , Begun J 
Published: January 2024

Abstract

Background
Upadacitinib is a novel selective Janus Kinase (JAK) inhibitor which has recently been approved for use in ulcerative colitis. Clinical trials have rigorous criteria and excluded patients with prior exposure to JAK inhibitors. Given limited real-world effectiveness data we examined outcomes of patients treated with upadacitinib for ulcerative colitis in a real-world population, with a focus on prior tofacitinib exposure.

Methods
This retrospective, multi-centre study recruited patients commencing upadacitinib for moderate-to-severe ulcerative colitis from September 2022 until March 2023 from 13 Inflammatory Bowel Disease centres across Australia. Clinical, biochemical, endoscopic and intestinal ultrasound outcomes were recorded at baseline, week 8 and week 16.
The primary outcome was a comparison between clinical remission using PRO2 definitions (STRIDE II guidelines) in those with prior Tofacitinib exposure compared with Tofacitinib-naïve. Secondary endpoints included clinical response, corticosteroid free clinical remission (CFCR), biochemical response and transmural remission assessed by intestinal ultrasound (IUS). Adverse events in both cohorts were also recorded.

Results
152 patients were identified and included (Table 1) – 42 tofacitinib-exposed and 110 tofacitinib-naïve. Complete clinical data was available for all patients at baseline, week 8, and week 16.
For the overall cohort, the rate of clinical remission was 20% (30/152) at baseline, 78% (119/152) at week 8 and 85% (129/152) at week 16. In patients with prior tofacitinib exposure, the rate of clinical remission was 23% (10/42) at baseline, 72% (30/42) at week 8 and 86% (36/42) at week 16. In tofacitinib-naïve patients, the rate of clinical remission was 19% (21/110) at baseline, 78% (86/110) at week 8 and 84% (92/110) at week 16 (Figure 1). There was no statistically significant difference in rate of clinical remission at baseline (p=0.23), week 8 (p=0.13) or week 16 (p=0.67).
There was no statistically significant difference in clinical response, CFCR, biochemical response or transmural remission by IUS between the cohorts.
Adverse events were seen in 40 (26%) patients over the course of 16 weeks follow-up. Most common were acne (12%), rash (4%) and nasopharyngitis (4%). No venous thromboembolism, systemic infection or cardiovascular events were observed. These events were spread evenly among both groups (p=0.37).

Conclusion
This is the largest real-world study to show that upadacitinib is effective and safe for patients with moderate to severe ulcerative colitis and prior tofacitinib exposure.
P1144 Forecasting the Future Prevalence of Inflammatory Bowel Disease in Korea through 2048: An Epidemiologic Study Employing Autoregressive Integrated Moving Average Models
Authors: Kim J , Oh S J , Lee C K 
Published: January 2024

Abstract

Background
The global escalation of Inflammatory Bowel Disease (IBD) has precipitated an increased burden of disease and economic impact, particularly accentuated within the Asian context. The primary objective of this study is to predict the future prevalence trajectory of IBD in Korea and elucidate the pattern of its evolution.

Methods
Data from the Korean National Health Insurance Service (2004–2018) were analyzed using a validated diagnostic algorithm to identify IBD patients. An autoregressive integrated moving average (ARIMA) model, employing 2004–2017 data, predicted future trends based on past values and error correction. The model's accuracy was validated against the actual 2018 patient count. We projected IBD patient numbers and prevalence from 2018 to 2048, using a generalized linear model (GLM) to determine influencing factors.

Results
A consistent annual increase in the number of IBD cases across all age groups was observed from 2004 to 2018, with prevalence peaking in the 20–39 age group. The validation of our prediction model demonstrated an acceptable range of error for IBD prevalence, with a 2.45% error rate and a mean absolute difference of 2.61. The 2018–2048 projections confirm a steady rise in Crohn’s disease (CD), ulcerative colitis (UC), and IBD prevalence across both genders (Figure 1). IBD prevalence is projected to increase from 104.19 per 100,000 in 2018 to 149.59 per 100,000 by 2028, and further to 239.73 per 100,000 by 2048 (95% confidence interval [CI]: 223.73–255.73), marking a 130% increase. By 2048, the prevalence rates for UC and CD were estimated to be 159.40 per 100,000 (95% CI: 137.38–181.42) and 91.11 per 100,000 (95% CI: 0.81–181.41), respectively. The Average Annual Percent Change (AAPC) of IBD is predicted at 4.51%, varying from a 2.77% decrease in those over 60 to a 14.20% increase in the 20–39 age group. Gender-stratified forecasts show a higher AAPC in males (6.17%) compared to females (2.75%) over the next 30 years. The highest AAPC, valued at 19.48, was noted in the male group aged 20–39 years. GLM analysis indicates significant age, gender, and temporal effects on IBD prevalence, with marked gender disparities in specific age groups for both CD and UC. In UC, males aged 20–39 experienced a significantly higher increase in prevalence than females. For CD, males also showed a higher prevalence increase than females in the 20–39 and 40–59 age groups (all interaction p-values &lt; 0.05; Table 1).

Conclusion
This study forecasts a significant increase in Korean IBD prevalence by 2048, especially among males and the 20–39 age group, highlighting the need to focus on these high-risk demographics in future disease management.
N13 Sexual satisfaction and its associated factors among patients with inflammatory bowel disease in Japan
Authors: Wakai S , Tanaka M , Takai M , Sakagami K , Hiroaki I 
Published: January 2024

Abstract

Background
Patients with inflammatory bowel disease (IBD) frequently experience fatigue and depression, which can lead to difficulties in their sexual lives, such as decreased motivation for sexual activity. Despite indications of sexual dysfunction and dissatisfaction, few studies have explored these issues. This study aims to clarify sexual satisfaction among patients with IBD and its related factors and to determine the percentage of respondents who were unwilling to answer the question about sexual satisfaction and their characteristics.

Methods
We consecutively recruited 500 patients from the specialized IBD clinic, of which 492 (206 with Ulcerative colitis and 286 with Crohn’s disease) valid responses were used in the study. To assess sexual satisfaction, we employed a 5-point scale using the "I am satisfied with my sex life" item from the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F). We collected information on patient characteristics (sex, age, occupation, marital status, disease duration, and sleep deprivation status). Additionally, we obtained data from the FACIT-F regarding non-response to sexual satisfaction, emotional well-being (EWB), and the Fatigue subscale (FS). Furthermore, we collected information on disease severity from the medical records, including the partial Mayo Score (pMayo) and Crohn's Disease Activity Index (CDAI).

Results
Out of 492 patients who participated in the study, 319 (64.8%) provided responses, while 173 (35.2%) did not respond to the sexual satisfaction question. The distribution of responses was as follows: “not at all” (11.0%), “a little bit” (9.7%), “somewhat” (24.7%), “quite a bit” (12.2%), “very much” (7.1%). In the bivariate analyses of sexual satisfaction and related factors, four variables showed a significant relationship: age (rs=-0.19, p=0.001), sleep deprivation status (p=0.003), EWB (rs =0.30, &lt;0.001), and FS (rs =0.34, p&lt;0.001). Multiple logistic regression analysis of the factors influencing non-response preferences revealed that female gender (OR=2.41, 95%CI= 1.55-3.75) and older age (OR=1.04, 95%CI=1.02-1.06) were statistically significant.

Conclusion
Chronic conditions, such as depression, fatigue, and sleep deprivation, can affect the sexual satisfaction of patients with IBD, even during periods of remission. A substantial percentage of respondents were unwilling to answer questions regarding sexual satisfaction among Japanese patients with IBD. Hence, healthcare providers should consider offering support for sexual issues, recognizing the discomfort some individuals may feel in discussing such intimate matters.
Radiofrequency venous ablation for symptomatic relief in postural orthostatic tachycardia syndrome: a case series
Authors: McGeoch Catherine L B , Steinberg Rebecca S , Bortfeld Kristina S , Almuwaqqat Zakaria , Rheudasil J Mark , Bhatia Neal K , Cutchins Alexis C 
Published: January 2024

Abstract

Background
Hypovolemic postural orthostatic tachycardia syndrome (POTS) is thought to be caused by dysregulated circulating blood volume. Management is mainly limited to symptom-targeted lifestyle changes. Radiofrequency venous ablation (RFA) represents a minimally invasive method of increasing circulating blood volume. The following case series describes a novel application of RFA to successfully target POTS symptoms in patients demonstrating venous insufficiency. The use of RFA in alleviating POTS symptoms has not previously been reported.

Case summary
We describe four patients with either a well-established historical POTS diagnosis or dysautonomia symptoms refractory to both medical management and lifestyle modifications. They all demonstrated venous reflux on lower extremity venous ultrasound testing. Upon vascular surgery referral, all underwent great and small saphenous vein RFA. They each subsequently reported subjective improvement in their dysautonomia symptoms and quality-of-life. Two with symptom recurrence years later were found to have new-onset pelvic venous congestion and are being evaluated for pelvic venous insufficiency interventions.

Discussion
Lower extremity venous pooling can exacerbate dysautonomia symptoms in POTS patients. Patients refractory to conventional treatment strategies should undergo venous insufficiency workup, and if positive, should be referred for venous pooling intervention evaluation. The success of RFA at treating refractory POTS symptoms in these four patients with lower extremity venous reflux, including no surgical intervention and no adverse effects, are compelling grounds to further explore this therapy and to quantify and standardize symptom improvement assessment in a larger patient population. Future directions include a demonstration of quality-of-life improvement in randomized clinical trials.
Pacemaker implantation in a patient with isolated persistent left superior vena cava using a delivery catheter: a case report
Authors: Kawakami Toshinaru , Yahagi Kazuyuki , Horiuchi Yu , Tanabe Kengo 
Published: January 2024

Abstract

Background
Persistent left superior vena cava (PLSVC) with absent right superior vena cava, also termed ‘isolated PLSVC’, is extremely rare. Permanent pacemaker implantation in patients with isolated PLSVC is often difficult by the usual subclavian approach due to the unique anatomy. With the advent of delivery catheters in recent years, implantation using the same system has been reported.

Case summary
A 47-year-old woman with symptomatic sick sinus syndrome was admitted to our institution for permanent pacemaker implantation. Preprocedural cardiac multidetector computed tomography (MDCT) showed isolated PLSVC. We performed pacemaker implantation successfully via the left subclavian approach, using the C315 delivery catheter system. The leads were stable on chest radiography, and the sensing and capture thresholds were unchanged. After the procedure, we integrated the delivery catheter images with cardiac MDCT using Ziostation, and they were well matched with the fluoroscopic images. At the 1-month follow-up, the patient was free of heart failure symptoms and had decreased levels of N-terminal prohormone of brain natriuretic peptide.

Discussion
The C315 delivery catheter system was considered an option for permanent pacemaker implantation in patients with isolated PLSVC. When performing permanent pacemaker implantation in patients with unusual venous anatomy, integrating the delivery catheter images with cardiac MDCT allows for appropriate preoperative catheter selection.
Bottom-up and top-down controls on Alteromonas macleodii lead to different dissolved organic matter compositions
Authors: Chen Qi , Lønborg Christian , Chen Feng , Zhang Rui , Cai Ruanhong , Li Yunyun , He Chen , Shi Quan , Jiao Nianzhi , Zheng Qiang 
Published: January 2024

Abstract
The effects of both bottom-up (e.g. substrate) and top-down (e.g. viral lysis) controls on the molecular composition of dissolved organic matter have not been investigated. In this study, we investigated the dissolved organic matter composition of the model bacterium Alteromonas macleodii ATCC 27126 growing on different substrates (glucose, laminarin, extracts from a Synechococcus culture, oligotrophic seawater, and eutrophic seawater), and infected with a lytic phage. The ultra-high resolution mass spectrometry analysis showed that when growing on different substrates Alteromonas macleodii preferred to use reduced, saturated nitrogen-containing molecules (i.e. O4 formula species) and released or preserved oxidized, unsaturated sulfur-containing molecules (i.e. O7 formula species). However, when infected with the lytic phage, Alteromonas macleodii produced organic molecules with higher hydrogen saturation, and more nitrogen- or sulfur-containing molecules. Our results demonstrate that bottom-up (i.e. varying substrates) and top-down (i.e. viral lysis) controls leave different molecular fingerprints in the produced dissolved organic matter.
Role of Syndiniales parasites in depth-specific networks and carbon flux in the oligotrophic ocean
Authors: Anderson Sean R , Blanco-Bercial Leocadio , Carlson Craig A , Harvey Elizabeth L 
Published: January 2024

Abstract
Microbial associations that result in phytoplankton mortality are important for carbon transport in the ocean. This includes parasitism, which in microbial food webs is dominated by the marine alveolate group, Syndiniales. Parasites are expected to contribute to carbon recycling via host lysis; however, knowledge on host dynamics and correlation to carbon export remain unclear and limit the inclusion of parasitism in biogeochemical models. We analyzed a 4-year 18S rRNA gene metabarcoding dataset (2016–19), performing network analysis for 12 discrete depths (1–1000 m) to determine Syndiniales–host associations in the seasonally oligotrophic Sargasso Sea. Analogous water column and sediment trap data were included to define environmental drivers of Syndiniales and their correlation with particulate carbon flux (150 m). Syndiniales accounted for 48–74% of network edges, most often associated with Dinophyceae and Arthropoda (mainly copepods) at the surface and Rhizaria (Polycystinea, Acantharea, and RAD-B) in the aphotic zone. Syndiniales were the only eukaryote group to be significantly (and negatively) correlated with particulate carbon flux, indicating their contribution to flux attenuation via remineralization. Examination of Syndiniales amplicons revealed a range of depth patterns, including specific ecological niches and vertical connection among a subset (19%) of the community, the latter implying sinking of parasites (infected hosts or spores) on particles. Our findings elevate the critical role of Syndiniales in marine microbial systems and reveal their potential use as biomarkers for carbon export.
The active free-living bathypelagic microbiome is largely dominated by rare surface taxa
Authors: Sebastián Marta , Giner Caterina R , Balagué Vanessa , Gómez-Letona Markel , Massana Ramon , Logares Ramiro , Duarte Carlos M , Gasol Josep M 
Published: January 2024

AbstractA persistent microbial seed bank is postulated to sustain the marine biosphere, and recent findings show that prokaryotic taxa present in the ocean’s surface dominate prokaryotic communities throughout the water column. Yet, environmental conditions exert a tight control on the activity of prokaryotes, and drastic changes in these conditions are known to occur from the surface to deep waters. The simultaneous characterization of the total (DNA) and active (i.e. with potential for protein synthesis, RNA) free-living communities in 13 stations distributed across the tropical and subtropical global ocean allowed us to assess their change in structure and diversity along the water column. We observed that active communities were surprisingly more similar along the vertical gradient than total communities. Looking at the vertical connectivity of the active vs. the total communities, we found that taxa detected in the surface sometimes accounted for more than 75% of the active microbiome of bathypelagic waters (50% on average). These active taxa were generally rare in the surface, representing a small fraction of all the surface taxa. Our findings show that the drastic vertical change in environmental conditions leads to the inactivation and disappearance of a large proportion of surface taxa, but some surface-rare taxa remain active (or with potential for protein synthesis) and dominate the bathypelagic active microbiome.
Zooming in on the intracellular microbiome composition of bacterivorous Acanthamoeba isolates
Authors: Rayamajhee Binod , Willcox Mark , Sharma Savitri , Mooney Ronnie , Petsoglou Constantinos , Badenoch Paul R , Sherchan Samendra , Henriquez Fiona L , Carnt Nicole 
Published: January 2024

Abstract
Acanthamoeba, a free-living amoeba in water and soil, is an emerging pathogen causing severe eye infection known as Acanthamoeba keratitis. In its natural environment, Acanthamoeba performs a dual function as an environmental heterotrophic predator and host for a range of microorganisms that resist digestion. Our objective was to characterize the intracellular microorganisms of phylogenetically distinct Acanthamoeba spp. isolated in Australia and India through directly sequencing 16S rRNA amplicons from the amoebae. The presence of intracellular bacteria was further confirmed by in situ hybridization and electron microscopy. Among the 51 isolates assessed, 41% harboured intracellular bacteria which were clustered into four major phyla: Pseudomonadota (previously known as Proteobacteria), Bacteroidota (previously known as Bacteroidetes), Actinomycetota (previously known as Actinobacteria), and Bacillota (previously known as Firmicutes). The linear discriminate analysis effect size analysis identified distinct microbial abundance patterns among the sample types; Pseudomonas species was abundant in Australian corneal isolates (P &lt; 0.007), Enterobacteriales showed higher abundance in Indian corneal isolates (P &lt; 0.017), and Bacteroidota was abundant in Australian water isolates (P &lt; 0.019). The bacterial beta diversity of Acanthamoeba isolates from keratitis patients in India and Australia significantly differed (P &lt; 0.05), while alpha diversity did not vary based on the country of origin or source of isolation (P &gt; 0.05). More diverse intracellular bacteria were identified in water isolates as compared with clinical isolates. Confocal and electron microscopy confirmed the bacterial cells undergoing binary fission within the amoebal host, indicating the presence of viable bacteria. This study sheds light on the possibility of a sympatric lifestyle within Acanthamoeba, thereby emphasizing its crucial role as a bunker and carrier of potential human pathogens.
The Postoperative Breast: Imaging Findings and Diagnostic Pitfalls After Breast-Conserving Surgery and Oncoplastic Breast Surgery
Authors: Pittman Sarah M , Rosen Eric L , DeMartini Wendy B , Nguyen Dung H , Poplack Steven P , Ikeda Debra M 
Published: January 2024

Abstract
Breast surgery is the cornerstone of treatment for early breast cancer. Historically, mastectomy and conventional breast-conserving surgery (BCS) were the main surgical techniques for treatment. Now, oncoplastic breast surgery (OBS), introduced in the 1990s, allows for a combination of BCS and reconstructive surgery to excise the cancer while preserving or enhancing the contour of the breast, leading to improved aesthetic results. Although imaging after conventional lumpectomy demonstrates typical postsurgical changes with known evolution patterns over time, OBS procedures show postsurgical changes/fat necrosis in locations other than the lumpectomy site. The purpose of this article is to familiarize radiologists with various types of surgical techniques for removal of breast cancer and to distinguish benign postoperative imaging findings from suspicious findings that warrant further work-up.
Epistemic consequences of unfair tools
Authors: Lassen Ida Marie S , Kristensen-McLachlan Ross Deans , Almasi Mina , Enevoldsen Kenneth , Nielbo Kristoffer L 
Published: January 2024

Abstract
This article examines the epistemic consequences of unfair technologies used in digital humanities (DH). We connect bias analysis informed by the field of algorithmic fairness with perspectives on knowledge production in DH. We examine the fairness of Danish Named Entity Recognition tools through an innovative experimental method involving data augmentation and evaluate the performance disparities based on two metrics of algorithmic fairness: calibration within groups; and balance for the positive class. Our results show that only two of the ten tested models comply with the fairness criteria. From an intersectional perspective, we shed light on how unequal performance across groups can lead to the exclusion and marginalization of certain social groups, leading to voices and experiences being disregarded and silenced. We propose incorporating algorithmic fairness in the selection of tools in DH to help alleviate the risk of perpetuating silence and move towards fairer and more inclusive research.
Controlling bad-actor-artificial intelligence activity at scale across online battlefields
Authors: Johnson Neil F , Sear Richard , Illari Lucia 
Published: January 2024

Abstract
We consider the looming threat of bad actors using artificial intelligence (AI)/Generative Pretrained Transformer to generate harms across social media globally. Guided by our detailed mapping of the online multiplatform battlefield, we offer answers to the key questions of what bad-actor-AI activity will likely dominate, where, when—and what might be done to control it at scale. Applying a dynamical Red Queen analysis from prior studies of cyber and automated algorithm attacks, predicts an escalation to daily bad-actor-AI activity by mid-2024—just ahead of United States and other global elections. We then use an exactly solvable mathematical model of the observed bad-actor community clustering dynamics, to build a Policy Matrix which quantifies the outcomes and trade-offs between two potentially desirable outcomes: containment of future bad-actor-AI activity vs. its complete removal. We also give explicit plug-and-play formulae for associated risk measures.