bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0309 Machine learning for predicting Crohn’s disease from routine blood tests years before diagnosis: results from the epi-IIRN
Authors: Lev Zion R , Dolev A , Yuval Bar-Asher S , Ben-Tov A , Ledderman N , Matz E , Dotan I , Turner D , Lerner B 
Published: January 2025

Abstract

Background
Various biomarkers may help predict inflammatory bowel disease (IBD) in advance of diagnosis, but these are mostly not routinely tested and thus are more challenging for screening. In this nationwide study, we used the epi-IIRN validated cohort to explore the utility of routine blood tests as markers for predicting IBD occurrence.

Methods
We used the epi-IIRN cohort to collect results of all blood tests performed up to 15 years before diagnosis, from all IBD patients diagnosed between 2005-2020 and insured by Israeli health maintenance organizations (HMOs); each patient was individually matched to two non-IBD controls. Means were compared using Welch’s t-test with false discovery rate correction to account for multiple comparisons. We then used machine learning to build a model using the 15 most statistically significant blood tests to predict Crohn’s disease.

Results
46,223 individuals were included – 8,630 with Crohn’s disease (CD) (43% males, mean age at diagnosis 38±19 years) and 6,791 with ulcerative colitis (UC) (41% males, mean age at diagnosis 42±10 years) with their 2:1 matched controls. For adults with CD, 29 tests showed differences between cases and controls earlier than 1 year pre-diagnosis, including 3 with consistent differences &gt;10 years pre-diagnosis (white blood cell, neutrophil and platelet counts). In children, 17 blood tests showed consistent differences earlier than 1 year pre-diagnosis. No test showed significant differences between UC cases and controls.
The machine-learning model had an area under the curve (AUC) for predicting future CD 1 year pre-diagnosis of 0.70 in adults and 0.68 in children.

Conclusion
We were able to detect significant changes in routinely collected blood tests long before CD diagnosis and to predict future CD using a machine learning model. This opens the possibility of detecting early signals of future CD in patients undergoing routine blood tests, which may be used for developing screening and prediction models for prevention strategies.
P0310 Intestinal Ultrasound parameters correlate with endoscopic findings in patients with post-operative Crohn’s disease.
Authors: Laoudi E , Chatzinikolaou M L , Kokkotis G , Koutsounas I , Gizis M , Chalakatevaki K , Kitsou V , Bamias G 
Published: January 2025

Abstract

Background
In patients with Crohn’s disease (CD) and ileocecal resection, colonoscopy remains the gold-standard for detecting post-operative recurrence (POR). Intestinal ultrasound (IUS) is non-invasive, patient-friendly, with high accuracy for the detection of bowel inflammation. The aim of the present study was to investigate the correlation between post-operative endoscopic findings and those of IUS in patients with CD.

Methods
We analyzed data from CD patients with ileocecal resection who underwent colonoscopy and IUS for follow up. Post-operative endoscopic recurrence (ER) was defined as Rutgeert’s score (RS)≥i2b. The following IUS parameters were analyzed: bowel wall thickness (BWT), bowel wall stratification (BWS), modified Limberg score for the assessment of bowel wall hyperemia (BWH) and neo-terminal ileum peristalsis. Linear and binary logistic regressions were used to identify associations between RS and IUS parameters. SPSS-23 was used for the statistical analysis with a threshold of P=0.05 for statistical significance.

Results
In total, 44 patients [29 male, median age (SD): 40 (14.7) years] underwent IUS 42 [2-126] months following ileocecal resection. Thirty-eight (86%) patients were on treatment [infliximab 10 (23%), adalimumab 9 (21%), ustekinumab 11 (25%), vedolizumab 4 (9%), ozanimod 1 (2%) azathioprine 1 (2%), methotrexate 1 (2%)] and 7 (16%) patients were on no treatment. Endoscopic recurrence was detected in 52% of patients. Higher RS was associated with increased BWT, absence of peristalsis in the neo-TI and loss of BWS (P=0.007, P=0.001 and P=0.028 respectively). In multivariate analysis a higher RS was independently associated with the absence of peristalsis in the neo-terminal ileum (P=0.019). A tendency for a positive correlation between RS and ΒWT (P = 0.071) was also observed. RS≥i2b was significantly correlated with loss of BWS (P=0.045), absence of peristalsis (P=0.027) and a tendency was observed with BWT(P=0.081). RS≥i3 was significantly correlated with absence of peristalsis in the neo-TI (P= 0.001), BWT&gt;3mm (P= 0.041), while a tendency was observed with modified Limberg score≥2 (P= 0.082).

Conclusion
IUS parameters correlate with RS in patients with post-operative CD. IUS may be a valuable monitoring tool for the assessment of POR in CD. Larger prospective studies are needed to determine cut-off values of sonographic parameters that may accurately predict post-operative recurrence of CD.
P0320 The consistency of ultrasound and colonoscopy of every colonic segment in patients with Ulcerative Colitis
Authors: Zhang Y , Yang H 
Published: January 2025

Abstract

Background
Many studies have indicated the consistency of ultrasound and colonoscopy in patients with ulcerative colitis (UC). However, their relationship in every colonic segment has not been shown.

Methods
The sigmoid, descending, transverse, and ascending colon of 111 UC patients were evaluated by ultrasound and colonoscopy. Regarding ultrasound, four parameters were evaluated: bowel wall thickness, colour Doppler signal, wall layer stratification, and Milan score. For colonoscopy, the Mayo endoscopic score (MES) was used. Their association was assessed if ultrasound and endoscopic evaluations are close in time (defined as within 8 weeks).

Results
One hundred and sixty-six matched pairs of ultrasound and colonoscopy were assessed. The bowel wall thickness and the Milan score were significantly associated with MES regardless of colonic segments. The higher the MES was, the thicker the bowel wall thickness was. A similar trend was also shown for the Milan score. The colour Doppler signal is increasingly abundant with higher MES in the descending, transverse, and ascending colon. Besides, the patients with loss of wall layer stratification in the sigmoid and descending colon had a higher MES.

Conclusion
The bowel wall thickness and Milan score are consistent with the MES for all colonic segments. However, the consistency of the colour Doppler signal and bowel wall stratification is different for four bowel segments. The consistency of the ultrasound colour Doppler signal and MES is good in the descending, transverse, and ascending colon, but not in the sigmoid colon. The consistency of the wall layer stratification and MES is good in the descending and sigmoid colon but not in the transverse and ascending colon.
P0323 Serum leucine-rich α2-glycoprotein (LRG) and Monocyte chemoattractant protein-1 (MCP-1) as Novel Biomarkers for Predicting Vedolizumab Response in Ulcerative Colitis Patients
Authors: Yoshihara T , Shinzaki S , Naka T , Iijima H , Hayashi Y , Inoue T , Tsujii Y , Uema R , Otake-Kasamoto Y , Tani M , Amano T , Tashiro T , Asakura A , Sakakibara Y , Yamada T , Hiyama S , Nishida T , Ishiguro K , Baba Y , Takehara T 
Published: January 2025

Abstract

Background
Close monitoring of disease activity is essential for the therapeutic management of inflammatory bowel disease. A minimally invasive and reliable serum biomarker is desirable, but its reliability and validity have not yet been fully evaluated. The purpose of this study (UMIN000043185) was to investigate the utility of leucine-rich α-2-glycoprotein (LRG) in the management of vedolizumab therapy in patients with ulcerative colitis (UC), and to identify mucosal signatures and surrogate biomarkers by using serum cytokine and mucosal transcriptome analysis.

Methods
Serum LRG, C-reactive protein (CRP), serum Mucosal Vascular Addressin Cell Adhesion Molecule 1(MadCAM1), serum vedolizumab levels, 19 serum cytokines, and fecal calprotectin (fCal) were measured over 54 weeks (week 0, 2, 6, 14, 30, and 54) (n=21). Clinical remission (Mayo score &lt;= 2, all subscore &lt; = 1) and mucosal healing (Mayo endoscopic subscore &lt;= 1) at week 14 were compared between the clinical remission (CR) group (n=11) and non-clinical remission (non-CR) group (n=10), and between the mucosal healing (MH) group (n=14) and non-mucosal healing (non-MH) group (n=7). Differentially expressed gene (DEG) extraction was performed by stratifying data at week 0 and comparing two groups: CR (n=10) and non-CR (n=3), and complete MH (Mayo endoscopic subscore = 0) (n=8) and non-complete MH (n=6) at week 14.

Results
Serum LRG concentrations were significantly lower in CR group compared to the non-CR group at week 0 (19.0 vs. 29.0 ug/mL, p=0.027) and week 6 (13.4 vs. 19.6 ug/mL, p=0.034) and significantly lower in MH group compared to the non-MH group at week 6 (13.7 vs. 21.6 ug/mL, p=0.033). In contrast, there were no significant differences in serum CRP and fecal calprotectin levels at any time point for either CR or MH. Serum MCP-1 levels showed significant differences between CR and non-CR at week 0 (609.0 vs 403.4 pg/mL, p=0.0018), between MH and non-MH at week 0 (587.2 vs 358.9 pg/mL, p&lt;0. 001), week 6 (606.9 vs 451.6 pg/mL, p=0.015). DEGs extracted from colon tissue included LRG1 and LRG-related cytokines, MCP-1, reflecting the effect of vedolizumab treatment.

Conclusion
Both serum LRG (lower in CR/ MH group) and serum MCP-1 (higher in CR/MH group) were suggested to be promising predictive biomarkers of vedolizumab treatment response in patients with UC. Further studies are needed to assess their reliability and validity as indicators of treatment effectiveness.
P0332 Optimization and assessment of colonoscopy preparation in Inflammatory Bowel Disease: a comprehensive single-center analysis with focus on disease-specific factors
Authors: Saidani R , Cherif D , Hassine H , Yacoub H , Debbabi H , Kchir H , Maamouri N 
Published: January 2025

Abstract

Background
Colonoscopy remains a cornerstone in inflammatory bowel disease (IBD) management, yet comprehensive data on preparation quality and tolerability in this specific population remains limited. We aimed to evaluate bowel preparation efficacy, tolerability, and colonoscopy outcomes in IBD patients while analyzing disease-specific influencing factors.

Methods
We conducted a prospective single-center study of 78 IBD patients (45 ulcerative colitis [UC] and 33 Crohn’s disease [CD]) undergoing routine colonoscopy surveillance. All patients received a split-dose 4L polyethylene glycol preparation. We collected comprehensive data including clinical parameters, Boston Bowel Preparation Scale (BBPS) scores, sedation requirements, and procedure tolerability using Visual Analogue Scale (VAS, 0-100mm). Disease activity was assessed using standardized endoscopic scores.

Results
Mean age was 47.2 ± 14.5 years for UC and 43.8 ± 13.9 years for CD patients. Adequate bowel preparation (BBPS ≥6) was achieved in 85.7% (67/78) of patients, with a mean total BBPS score of 6.3 ± 1.4. Female patients showed slightly higher preparation quality scores compared to males (BBPS 6.5 ± 1.3 vs 6.1 ± 1.4, p=0.12), though this difference was not statistically significant. Complete colonoscopy was successfully performed in 93.6% (73/78) of cases. No significant differences in BBPS scores were observed between UC and CD patients (6.4 ± 1.5 vs 6.2 ± 1.3, p=0.62), or between patients with active disease versus those in remission (6.3 ± 1.4 vs 6.2 ± 1.5, p=0.85). Preparation tolerability was rated as good or excellent (VAS ≥70) in 76.9% (60/78) of patients, with similar ratings between genders (females: 77.8%, males: 75.9%, p=0.83). Notably, 32.1% (25/78) of IBD patients required increased sedation compared to standard doses, with a higher proportion in CD patients (42.4%, 14/33) compared to UC patients (24.4%, 11/45, p=0.047), and in female patients (37.2%, 16/43) compared to males (25.7%, 9/35, p=0.038). Disease-related factors including disease duration, location, and previous surgery did not significantly impact preparation quality.

Conclusion
Our study demonstrates that high-quality bowel preparation can be achieved in IBD patients regardless of gender and disease characteristics, with good tolerability rates. However, increased sedation requirements, particularly in CD patients and females, should be anticipated. These findings support the implementation of standardized preparation protocols in IBD patients while emphasizing the need for personalized sedation strategies based on both disease and demographic factors.
P0333 Predictive factors for thiopurine treatment failure in anti-TNF naïve IBD patients: Insights from a tertiary care Hepato-Gastroenterology center experience
Authors: Adamou Mainassra F , Hassini A , Essadi B , Koulali H , Elmqaddem O , Zazour A , Zahi I , Kharrasse G 
Published: January 2025

Abstract

Background
Chronic Inflammatory Bowel Diseases (IBDs) pose a significant challenge due to their chronic nature and the characteristic pattern of relapse and remission. The maintenance’s goal therapy is to prolong remission as much as possible. Immunosuppressants, particularly thiopurines, are widely employed for this purpose. However, Nearly half of patients on these drugs lose remission or fail to maintain it, with the causes still unclear. This study explores patient-related factors linked to thiopurine failure.

Methods
This retrospective study, conducted over five years and two months (January 2018 to March 2023), included IBD patients treated with thiopurines who had not previously received anti-TNF therapy. Patients were followed for 1 to 5 years after starting thiopurines, with treatment failure defined as requiring two or more corticosteroid courses in a year, escalation to anti-TNF therapy, or surgical intervention. Data were collected from medical records and analyzed using SPSS software, employing the chi-square test and multivariate logistic regression to assess relationships

Results
We analyzed 165 patients, including 119 with Crohn’s disease (CD) and 46 with ulcerative colitis (UC), with a median age of 39.05 years and a female predominance (sex ratio 0.81). All patients consumed tea (100%), smoking was present in 15.15%, alcohol consumption in 6%, and NSAID use in 10%.
Among UC patients, 13 failed thiopurine treatment, with 3 requiring colectomy and 10 escalating to anti-TNF therapy, all diagnosed with UC E3. For CD patients, 99 experienced treatment failure, including 15 ileocolectomies, 30 ileocecal resections, and 54 cases requiring anti-TNF therapy.
Hypoalbuminemia (&lt;35 mg/L) at diagnosis was a significant risk factor for thiopurine failure (p=0.05). Non-smoking UC patients (p=0.06) and UC E3 patients with frequent flares (p=0.09) showed a strong, though not statistically significant, trend towards failure. In CD, smoking (p=0.05), NSAID use (p=0.08), and active inflammatory colonic disease with over two flares annually (p=0.04) increased failure risk.
Common factors for both UC and CD included anemia (p=0.001), tea consumption (p=0.003), phytotherapy (p=0.06), and younger age (17–32 years, p=0.09)

Conclusion
Our findings demonstrate that hypoalbuminemia, anemia, and young age at diagnosis pose an increased risk of thiopurine treatment failure. Moreover, some patients characteristics such as smoking, frequency of flares, NSAID use, and phytotherapy may also serve as predictive factors for thiopurine treatment failure. These factors should be regarded as markers of non-response to thiopurines as monotherapy in patients with moderate to severe colonic CD or UC E3.
P0337 Incidentally Diagnosed Inflammatory Bowel Disease: Prevalence and Long-Term Outcomes
Authors: Tubal Bronze S M , Shenoy S , Agrawal M , Colombel J F , Rodríguez-Lago I , Ungaro R C 
Published: January 2025

Abstract

Background
Incidentally diagnosed inflammatory bowel disease (IBD) can be found in asymptomatic individuals undergoing endoscopic examinations performed for various reasons such as colorectal cancer (CRC) screening. We aimed to characterize the prevalence of incidental IBD in individuals undergoing non-diagnostic colonoscopy and describe its clinical characteristics, disease course, and medium to long-term outcomes.

Methods
Retrospective cohort study including all asymptomatic adults who underwent colonoscopy for CRC screening or polyp surveillance between 2009 and 2023. Incidental IBD was considered any case with endoscopic and histologic findings suggestive of IBD. The endoscopic lesions considered were erythema, erosions, loss of vascular pattern, ulcerations, strictures, and pseudopolyps. On the other hand, the microscopic criteria were transmural inflammation, non-caseating granulomas, ulcers, crypt distortion and abscesses, cryptitis, Paneth cell metaplasia, and basal plasmacytosis. Clinical data and disease characteristics were collected. Tests for categorical variables were performed using the Fisher-Freeman-Halton Exact Test, while for quantitative variables the ANOVA and Kruskal-Wallis Test were utilized. Statistical analyses were conducted using R, with significance at p&lt;0.05.

Results
Out of 40,573 colonoscopies, a total of 60 patients with incidental IBD were identified: 40 patients (67%) with Crohn’s disease (CD), 10 (18%) with ulcerative colitis (UC), and 10 (18%) with IBD-unclassified (IBD-U). Most CD patients presented with ileal (L1) involvement (98%) and inflammatory (B1) behavior (98%), while 60% of UC patients exhibited extensive (E3) disease. UC and IBD-U patients had lower hemoglobin values than those with CD (11.67 +/-1.97; 11,73 +/- 1.25; 13.74 +/- 1.93; respectively, p=0.019). Follow-up data was available from 27 patients (45%), after a mean follow-up of 27.9 +/- 34.7 months in CD patients, 20% (N=8) developed new-onset symptoms (diarrhea [n=3, 38%], abdominal pain [n=3, 37.5%], bloating [n=2, 25%], fatigue [n=1, 12.5%], weight loss [n=1, 13%]), while only one patient (10%) with UC reported symptoms (diarrhea and abdominal pain). A total of 5 patients (8%) initiated medical therapy, in most cases after symptom onset. Two patients (3%) with CD received oral corticosteroids, one (2%) with CD received sulfasalazine, and two patients (3%) with UC were started on oral mesalamine. No hospitalizations or surgeries were noted.

Conclusion
In our experience, the prevalence of incidental IBD was 0.2% with two-thirds receiving a diagnosis of ileal CD with inflammatory behavior. A low proportion of patients developed symptomatic disease (5% for CD and 2% for UC) after 2 years of follow-up and generally had milder disease course.
P0340 Endo-Histo Foundational Fusion Model: A Novel Artificial Intelligence Approach for Predicting Histologic Remission and Early Response to Therapy in a Phase 2 Ulcerative Colitis Clinical Trial
Authors: Iacucci M , Santacroce G , Meseguer P , Del Amor R , Diéguez A , Kolawole B B , Chaudhuri U , Zammarchi I , Hayes B , Crotty R , Zardo D , Maeda Y , Puga-Tejada M , Ditonno I , Vadori V , Burke L , Gottlieb K T , Owen C , Eastman W J , Ghosh S , Grisan E , Naranjo V 
Published: January 2025

Abstract

Background
Artificial Intelligence (AI)- enabled endoscopy and histology offer accurate, objective, and rapid assessment of disease activity in Ulcerative Colitis (UC). Emerging multi-source AI models integrating diverse datasets may enhance standardised disease evaluation and outcome prediction. This study aimed to develop a novel AI model fusing endoscopic and histological findings to improve the assessment of disease remission and predict early response to therapy in UC clinical trials.

Methods
A novel multimodal AI fusion algorithm was developed by integrating paired endoscopic videos and histological whole-slide images (WSIs) from the phase 2 clinical trial of Mirikizumab in UC (NCT02589665). The endoscopy branch of the model was trained with 291 white-light videos, using a convolutional neural network to select informative frames and the BioMedCLIP foundational model to extract features. The histology branch utilised the CONCH foundational model and was fine-tuned on 291 WSIs to obtain patch-level features. Features from both modalities were aggregated and fused using multi-head self-attention. The model’s ability to assess histological remission and response to therapy at weeks 12 and 52 was evaluated. Histological remission was defined as Geboes ≤2B.0, while a response to therapy at different time points was based on histological remission or improvement (Geboes &lt;3.1).

Results
The fusion model outperformed single-modality assessments for histological remission, achieving a sensitivity of 89.72% (95% CI: 82.35–94.76), specificity of 89.67% (95% CI: 84.34–93.67), and accuracy of 89.69% (95% CI: 85.61–92.94). It demonstrated remarkable performance in assessing response to therapy at 12 and 52 weeks, with sensitivity of 97.96% (95% CI: 89.15–99.95), specificity of 86.84% (95% CI: 71.91–95.59) and accuracy of 93.10% (95% CI 85.59 – 97.43) for histological remission at week 52. Substantial agreement was observed between the AI fusion model and central readout.

Conclusion
This innovative multimodal fusion AI model enhances the assessment of histological remission and accurately predicts response to therapy. By potentially standardising central readouts and enabling automated disease assessment, this novel tool marks a significant advancement towards precision medicine in clinical trials.