bluuebunny/crossref_metadata_2025_split huggingface dataset:
P923 The pre-treatment gut microbiome at adult IBD inception: Initial signals from the Birmingham inception cohort
Authors: Rimmer P , Cheesbrough J , Iqbal A , Sharma N , Iqbal T , Quraishi N 
Published: January 2023

Abstract

Background
Gut microbiome disruption and ‘dysbiosis’ is an established characteristic of IBD. The lack of treatment naïve and prospective longitudinal microbiome data makes it challenging to separate the influence of potential confounders. We present our preliminary microbiota analysis from a treatment naïve cohort of IBD patients seen in our rapid-access integrated clinical and research IBD inception clinic.

Methods
Stool collected in DNA Genotek OM-200 kits is brought to the first face to face pre-diagnosis outpatient review, alongside faecal calprotectin (FCAL). Metadata is collected prospectively with repeat samples collected longitudinally. Healthy controls were recruited separately. Stool microbial DNA was extracted with subsequent 16S rRNA PCR and sequencing. Diversity analysis and taxonomic classifications were performed in line with the QIIME2 workflow. Taxa with linear discriminant analysis (LDA) &gt;2 at a P&lt;0.05 were considered significant on LDA effect size (LEfSe) analysis. Correlation was evaluated with Kendall’s Tau coefficient.

Results
Across sites, our clinics have seen 609 patients, with 256 enrolled in active research. We have banked 200 pre-treatment OM-200 stool samples from this cohort, with a further 45 samples from follow up visits. Of the first 49 samples sequenced, 31 were diagnosed with IBD (UC=18; CD=13). An independent cohort of 18 healthy controls were used for comparison. Median FCAL in the IBD cohort was 915ug/g (IQR 1499ug/g). Microbial composition in the IBD patients as assessed by Bray-Curtis distance matrix was significantly different compared to healthy controls (P&lt;0.001). Alpha diversity (Shannon diversity index) was significantly lower in the IBD cohort when compared to healthy controls (P=0.01, Figure 1).

These differences in alpha and beta diversity were also observed with IBD subtypes (P&lt;0.01). Patients with IBD had significantly lower relative abundance of multiple taxa belonging to the families Clostridiaceae, Lachnospiraceae, and Coriobacteriaceae and genus Ruminococcus, Butyricicoccus, Bifidobacterium, Blautia and Dorea, as displayed in Figure 2. The genuses Fusobacterium, Peptostreptococcus and Subdoligranulum positively correlated with FCAL levels whilst the genus Lachnobacterium negatively correlated (both P&lt;0.05).

Conclusion
We present our preliminary index analysis of microbiome data in a unique treatment naïve IBD cohort. Our ongoing prospective longitudinal collection of clinical, microbial, immunological and metabolomic datasets will facilitate understanding of potential baseline prognostic indicators, predictive biomarkers for treatment response and relationship with disease activity. A further large batch of samples are submitted for sequencing and additional insights will follow.
P925 Deep functional assessment of the colonic mucosa-associated microbiota in Crohn’s disease and health identifies pro- and anti- inflammatory secretomes and associated bacterial consortia. The ENIGMA study
Authors: Teh J J , Kang S , Zhang J , Hu J , Hamilton A L , Wilson-O’Brien A , Trakman G L , Lin W , Ching J , Sung J J Y , Yu J , Ng S C , Kamm M A , Morrison M 
Published: January 2023

Abstract

Background
Gut microbial dysbiosis and dysregulated host immune responses are key factors implicated in Crohn’s disease pathogenesis. However, the nexus between the mucosa-associated microbiota (MAM) and epithelial cell immune response(s) remains poorly understood. Here, we used in vitro cultures of LS174T human epithelial cells to examine the inflammatory tenor of the secretomes from colonic MAM recovered from healthy and Crohn’s disease subjects in Hong Kong (where Crohn’s disease incidence is low but increasing) and Australia (globally high incidence).

Methods
Biopsies from healthy (21 HKG, 20 AUS) and Crohn’s disease (30 HKG, 29 AUS) subjects were collected from the right colon and the MAM propagated from tissue using a habitat simulating medium. After 24h of growth, cultures were centrifuged, and the supernatant (secretome) fraction filter sterilised. For the immune assays, the LS174T cell line was transfected with recombinant lentivirus to provide an NF-κB:luc (luciferase) reporter gene fusion (Cellomics Technology, MD, USA) and aliquots used to inoculate 96-well microtiter plates and cultured for 24 h under standard conditions. Cultures were then challenged for 4 hours with 0.1 vol of a MAM secretome. Luc-bioluminescence was measured as a marker of NF-κB transcriptional activity from the individual wells and normalised to the reporter gene response from cells challenged with sterile, uninoculated bacterial medium.

Results
Across the 100 MAM secretomes tested, the median score for NF-ĸB activation was 104.4% relative to the medium control, suggesting most of the secretomes possessed a net neutral effect, with the 1st and 4th quartiles deemed stimulatory (&gt;126% baseline activity) and suppressive (&lt;92% baseline activity), respectively. There was no significant relationship found between a secretome’s inflammatory score and its corresponding α-diversity metric, nor was there any distinct clustering of the secretomes according to country of origin and/or case-control groups. However, the relative abundances of Roseburia spp. and Clostridium innocuum were significantly enriched in those consortia producing immunostimulatory secretomes. In contrast, the relative abundances of Erysipelatoclostridium ramosum, Ruminococcus gnavus, Parabacteroides distasonis, Blautia sp. CAG257 and Bacteroides xylanisolvens were enriched, and that of Coprococcus comes depleted, in those microbial consortia producing immunosuppressive secretomes.

Conclusion
Specific bacterial taxa drive the functional signature of the colonic MAM secretome in an immunostimulatory or suppressive direction.
The ENIGMA study is supported by a grant from the Leona M. and Harry B. Helmsley Charitable Trust
N01 Using Item Response Theory to improve the efficiency of the Crohn and Colitis Knowledge score for patients with Inflammatory Bowel Disease
Authors: Comoretto R , Azzolina D , Monaco E , Martinato M 
Published: January 2023

Abstract

Background
Patient knowledge varies widely in inflammatory bowel disease (IBD), but knowledge of the disease and its management is essential for patients with chronic disorders and can improve health-related quality of life, coping ability, self-care skills, and adherence and can positively impact several outcomes including disease activity and direct and indirect costs. To assess patients’ knowledge is available the Crohn’s and Colitis Knowledge Score (CCKNOW), but can be biased by subjects’ abilities, attitudes, or other latent traits not considered in its validation process. The purpose of this study was to reassess the index developed for measuring IBD patients’ knowledge using the Item Response Theory (IRT).

Methods
IBD patients with a recent (&lt;18 months) diagnosis, stable therapy, and no previous IBD-related surgery have been asked to answer the 30 items described in the validation of the CCKNOW questionnaire. Measures of between-item relationships (scalability) and unidimensionality (single major trait) were estimated prior to applying a 2-PL logistic IRT model across all 30 items. To evaluate a questionnaire with improved item information, low discriminatory items were removed by order of discrimination value, with the lowest discriminating item&lt;1.7 removed before the 2-PL model was re-estimated with the remaining items. The process was then repeated twice to remove poorly discriminating and inefficient scaling items. The difficulty parameters have also been estimated in the 2-PL logistic IRT model. Cronbach’s alpha (α) was used as a guide to measuring whole-scale reliability.

Results
49 patients (17 females, 21 Crohn’s Disease) were enrolled, with a median (IQR) age of 37 (29-47) years, a median disease duration of 334 (212-426) days and a median number of outpatients visit performed of 1 (1-3). Only 6 subjects involved in the study were graduated; the median level of health-related quality of life (S-IBDQ) was 47,7 (30,3-60,9). About 50% of subjects in both groups were in disease remission. Based on discrimination ability, item number 4, 10, 11, 22, 29, and 30 could be excluded because demonstrated a discrimination ability below 1.7. The Cronbach’s alpha for the 24 items questionnaire indicates a suitable internal consistency (α = 0.84). Based on difficulty parameters, the most difficult items were the 25th and 14th, and the easiest were the 19th and 21st.

Conclusion
This is the first study systematically to interrogate a commonly used index for patients’ IBD knowledge, using robust psychometric and statistical methodologies. IRT is a valid and robust psychometric methodology, which may be used to analyse patient questionnaires. The revised CCKNOW questionnaire provides optimum trait information.
N14 The satisfaction of IBD patients’ nursing care in biological therapy. Observational study
Authors: Napolitano D , Cocchieri A , Orgiana N , Fanali C , Poscia A , Schiavoni E , Bernabei T , Amatucci V , Turchini L , Durini E , Strazzeri M , Laterza L , Lopetuso L R , Mora V , Papa A , Pugliese D , Gasbarrini A , Scaldaferri F 
Published: January 2023

Abstract

Background
Inflammatory Bowel Disease (IBD) management requires a multidisciplinary team, in which nurses have a pivotal role. Although patient care is the main focus of all clinical actions, satisfaction with healthcare professionals is an aspect of growing importance that has been related to positive clinical outcomes. In this setting, evaluating the satisfaction of the nursing provided could be a pivotal component for the satisfaction of the patient, particularly in the IBD unit, where patients in intravenous (iv) biological therapy spend a major amount of time compared to non-complicated acute hospitalization. The aim of the study is to measure the overall quality of nursing care perceived by IBD patients receiving biological therapy. Furthermore, the opinion of loyal and non-loyal patients was measured at the IBD center as a secondary objective

Methods
Cross-sectional observational study to assess nursing satisfaction through the Newcastel Satisfaction Nursing Scale (NSNS). The instrument consists of two separate scales: the Scale of Nursing Care Experiences ("A") and the Scale of Nursing Satisfaction ("B"). The patient who is followed by the center, at the time of administering the questionnaire, for a period of more than 12 months, will be considered in the arm long follow-up while all patients treated at the center for a period ranging from 0 to 12 months, in those short follow-up. The study protocol was approved by the Ethics Committee.

Results
Two hundred and thirty-four in biological therapy, questionnaires were administered, of these, with an excellent response rate, 200 (86.2%). The result was an overall level of satisfaction compared to the first scale "A", equal to 88.4%, while for the second scale "B" the total result was 90.7%. By analyzing the satisfaction of nursing care received, differentiating the patient between short and long follow-up, the results seem to confirm how the patient in the long follow-up positively affects satisfaction, significantly in the first scale "A" 90.5% vs 82.9% p = 0.0002 and in the second scale "B" 92.5% vs 86% p = 0.0001. The lowest average satisfaction scores were recorded in the doctor-nurse ratio and in the communicative aspects, while the highest scores are related to the empathic components and professional competence of nursing.

Conclusion
In conclusion, the level of satisfaction of patients in biological therapy is high and this seems to increase significantly with time and with patient loyalty to the center (Fig. 1). Further research projects could aim to fill gaps in knowledge and validate scales of assessment of nursing skills in the field of IBD, including by structuring studies with a control cohort.
N24 At Home Calprotectin a United Kingdom Patient Perspectives and Tertiary Center Experience
Authors: Avery P , Adio J , Cornford R , Younge L 
Published: January 2023

Abstract

Background
Home faecal calprotectin tests (HFCT) have been available for some years with slow uptake to use in the UK. During the Sars-Cov-2 pandemic use increased as it allowed a measure of disease activity when lab testing in some areas ceased. In a United Kingdom tertiary referral IBD unit, CalproSmart was introduced in 2020. We analysed completion rates of HFCT and the barriers and enablers patients experienced in its use.

Methods
Data from the CalproSmart portal was analysed. Total patients registered was compared against the number that had completed a test. Age, sex and return rates per annum as well as local or out of area patients were included.
All patients who enrolled to receive a HFCT were sent an anonymous online questionnaire using MS Forms. Descriptive statistics were used to analysis the results with a thematic analysis of free form text answers.

Results
A total of N=304 patients were enrolled on the CalproSmart portal over a three-year period from October 2020 until July 2021. HFCT was completed by 118 (39%) of these patients. Completion was highest in 2020 78% of patients who enrolled on the system completed a HFCT. There was a slight trend towards females being more likely to complete at 23% versus 16% of males. There was no sign of age as a determinant to completion. Of the 118 patients who completed the HFCT 84 (71%) were out of local area patients and 34 (29%) local patients.
There were 54 (17%) questionnaires returned. All but 4 (7%) respondents had attempted or completed the HFCT. When asked why they wanted to try a HFCT 39 (72%) patients indicated not having to go to hospital/GP as their primary reason with getting an instant result 29 (54%) and seeing your own result 27 (50%) coming in next. 13 (24%) cited more disease control as a reason to try the test. People found the test mostly easy to use but when comparing overall happiness with the HFCT kits 9 people reported they were somewhat unhappy or unhappy. People were either happy or unhappy with the HFC test usability is a theme that is generated as a barrier and a facilitator for some (see figure 1). When asked which they would prefer to do in future CalproSmart at home or bring your sample to either your GP or hospital n=45 (83%) preferred HFCT.
Figure 1 Q 12 Overall how happy were you with CalproSmart home calprotectin kit? Free text answer comparison

Conclusion
During the pandemic HFCT were popular and out of area patients were more likely to complete the kits. Despite the low return rates those that chose to complete HFCT were in most of cases happy to continue HFCT. With, attention to patient selection and enhanced training on the HFCT there is a case for the continued use in services that have altered significantly since the pandemic.
N27 Living well with IBD; An online survey from the UK
Authors: Radford S , Sawyer R 
Published: January 2023

Abstract

Background
Chronic disease, such as inflammatory bowel disease (IBD), is a major cause of health problems in the U.K. Finding ways to best serve chronically ill patients is amongst the most important challenges facing the health care system. In order to better understand how to best support patients with IBD we need to understand what is important to them. The aim of this survey was to investigate the opinions and experiences of people living with IBD in relation to what they think are the most important factors of living with IBD and what it meant to live well with IBD.

Methods
An online survey, using Microsoft forms was created. Participants of any age or gender who were living with IBD were invited to take part via invitations and advertisements through social media (Twitter). There were three questions asked with free text responses to enable us to gather in depth data relating to personal experiences.

Results
45 responses were collected anonymously via the online survey. Symptom burden was reported by 42 participants to be the most impactful aspect of living with IBD, impacting on work, education, social and leisure activities as well as sex and intimacy. Whilst 26 participants reported that ‘living well’ with IBD was to achieve complete symptom resolution, more participants spoke about having manageable symptoms without fluctuation. Achieving a ‘normal’ level of daily activity was important to participants.

Conclusion
This survey found that most patients focus on symptom resolution or better symptoms management when considering living well with IBD. Patients report that the most impactful aspect of IBD is managing symptoms alongside other daily tasks such as work, education, social and leisure activities. Further exploration in order to better understand the magnitude of symptom resolution that would be acceptable or preferable for people living with IBD is warranted.
The plateauing of cognitive ability among top earners
Authors: Keuschnigg Marc , van de Rijt Arnout , Bol Thijs 
Published: January 2023

Abstract
Are the best-paying jobs with the highest prestige done by individuals of great intelligence? Past studies find job success to increase with cognitive ability, but do not examine how, conversely, ability varies with job success. Stratification theories suggest that social background and cumulative advantage dominate cognitive ability as determinants of high occupational success. This leads us to hypothesize that among the relatively successful, average ability is concave in income and prestige. We draw on Swedish register data containing measures of cognitive ability and labour-market success for 59,000 men who took a compulsory military conscription test. Strikingly, we find that the relationship between ability and wage is strong overall, yet above €60,000 per year ability plateaus at a modest level of +1 standard deviation. The top 1 per cent even score slightly worse on cognitive ability than those in the income strata right below them. We observe a similar but less pronounced plateauing of ability at high occupational prestige.
Gender, Personality, and Cognitive Resilience Against Early-Life Disadvantage
Authors: Saenz Joseph L , Milani Sadaf Arefi , Mejía-Arango Silvia 
Published: January 2023

Abstract

Objectives
Early-life disadvantage (ELD) relates to lower late-life cognition. However, personality factors, including having an internal locus of control (LOC) or a conscientious personality, relate to resilience and effective stress coping. We explore whether personality factors convey resilience against the negative effects of ELD on cognition, by gender, in Mexico.

Methods
Using the 2015 Mexican Health and Aging Study, we estimated expected cognition using multiple ELD markers to identify a subsample in the lowest quartile of expected cognition given ELD (n = 2,086). In this subsample, we estimated cross-sectional associations between personality and having above-median observed cognitive ability (n = 522) using logistic regression.

Results
Among those in the lowest quartile of expected cognition, a more internal LOC (β = 0.32 [men] and β = 0.44 [women]) and conscientious personality (β = 0.39 [men] and β = 0.17 [women]) were significantly associated with having above-median cognitive ability in models adjusted for demographic confounders. Larger benefits of conscientiousness were observed for men than women. Associations between personality and having above-median cognitive ability remained statistically significant after further adjustment for health, stress, and cognitive stimulation variables, regardless of gender.

Discussion
Personality factors may convey resilience among individuals who experienced ELD, potentially breaking the link between ELD and worse late-life cognition. Structural factors and gender roles may affect how much women benefit from personality factors.
School lunchboxes as an opportunity for health and environmental considerations: a scoping review
Authors: Lalchandani Neha Kishan , Poirier Brianna , Crabb Shona , Miller Caroline , Hume Clare 
Published: January 2023

SummaryVery little research has focussed on children’s school lunchboxes from both a health and environment standpoint. This scoping review explores studies that considered children’s lunchbox food consumption trends at school and the environmental impacts of lunchbox contents. We conducted a scoping review of peer-reviewed literature with a focus on lunchboxes of children in preschool or primary school settings that contained food packed from home, through the lens of food and nutrition in combination with environmental outcomes—particularly food and/or packaging waste. The review included 10 studies, with articles from Australia, USA, Spain, New Zealand and the UK. Half of them were intervention studies aiming to shift knowledge levels and attitudes of teachers, parents and children with regard to reducing packaged food choices and food waste, and improving dietary habits. Acknowledging the complexity of lunchbox packing and consumption practices, this review recommends the consideration of socio-ecological influences on children’s health and sustainability behaviour, and mobilizing their pro-environmental agency.
Mixed method evaluation of a clinic waiting room–based health education program in the Dominican Republic
Authors: Cohen S , Halpern M , Stonbraker S 
Published: January 2023

Abstract
Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room–based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees’ change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P &lt; 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room–based education talks improve knowledge and provide suggestions for similar interventions.