bluuebunny/crossref_metadata_2025_split huggingface dataset:
N13 Low compliance with remote monitoring of patient-reported outcomes via digital application in patients with inflammatory bowel disease
Authors: Haj Natour O , Ben Horin S , Lipkin M , Galper A , kopylov U 
Published: January 2023

Abstract

Background
Remote management through online web-based services can reduce healthcare utilization and improve the quality of life and treatment adherence of IBD patients compared to standard care.However, the actual compliance and durability of remote follow-up protocols in IBD have not been well studied.

Aim
To describe the compliance with mobile-app patient-reported outcomes (PRO) questionnaires in a long-term monitoring program for IBD patients

Methods
Retrospective cohort study that included patients with Crohn’s Disease (CD) or ulcerative colitis (UC) treated at a tertiary center. Patients received questionnaires via the specialized smartphone app Datos Health™.The follow-up program included the following questionnaires: IBD-control,Patient-Reported Outcomes Measurement Information System (PROMIS-10), Short IBD Questionnaire (S-IBDQ), and Patient Reported Outcome-2 (PRO 2).

Results
402 IBD patients were enrolled in the program; 299 (74.4%) had CD and 103 UC (25.6%). 187 of the study patients (46.5%) male, 16(0.04%) were naive to biological therapy, 189 (47%) received their first biological therapy. Median age as 35.68 (interquartile ratio (IQR)- 35.68-43.31) and mean disease duration 9.8 years (7-14).
SIBDQ was sent for 515 (398-577) days,20 (15-23) questionnaires were sent, response rate was 23%. After 30 days -62(15.4%) of patients were still responding, 100 days- 36(9%), 1 year- 40(11.3%).
PROMIS-10 was sent for a median of 482(365-574) days; 17(13-20) questionnaires were sent, response rate was 13%. After 30 days -27(6.7%) of patients were still responding, after 100 days- 21(5.2%) and after 1 year- 34 (8.5%).
IBD-control was sent for a median of 515(397-584) days; 21(15-23) questionnaires were sent ,response rate was 22%. After 30 days -63 (15.7%) of patients were still responding, after 100 days- 37 (9.2%) and after 1 year- 40 (10%).
PRO 2 was sent for a median of 361(144-447) days;107(47-140) questionnaires were sent, response rate-11% After 30 days-47(11.7%), after 100 days -23(5.7%) and after 1 year -36(9%) were still responding
Figure 1: The response rate of filled questionnaires over time
SIBDQ; Short IBD Questionnaire. PRO-2; Patient-Reported Outcomes 2. Promis-global 10; Patient-Reported Outcomes Measurement Information System . IBD-control.

Conclusion
Long-term follow-up of IBD patients with remote PRO is associated with low compliance and high withdrawal rates.Future design of such programs should accommodate patients' needs, incorporatE rapid rule-based feedback and devise a smart adaptive frequency strategy to avoid alert fatigue and increase compliance.
N15 Influence of abundant nurse staffing on patient-reported outcomes among patients with inflammatory bowel disease in clinical remission
Authors: Tanaka M , Kawakami A , Sakagami K , Terai T , Ito H 
Published: January 2023

Abstract

Background
There is evidence that a higher number of nurses is associated with better patient outcomes in acute care settings, but little is known in outpatient settings. Patients with inflammatory bowel disease (IBD) are largely treated in outpatient settings and sometimes face difficulties due to their disease or treatment. Through the experience of living with their disease and managing it well, their self-efficacy related to IBD management would improve. Health professionals play important roles in empowering patients and supporting them to be able to manage their disease conditions well. The aim of this study is to explore the impact of adequate support with abundant nurse staffing on self-efficacy and difficulties of life among patients with IBD in clinical remission.

Methods
This is a cross-sectional questionnaire survey, using secondary analysis of a previously reported larger study. Data of a total of 499 patients with IBD in clinical remission, 318 from a specialized IBD clinic (UC: 83, CD: 235) and 181 online (UC: 109, CD: 72), was used for this study. The clinic has 10 full-time staffs (2 physicians, 7 nurses, 1 pharmacist) and 3 part-time staffs (2 doctors, 1 counselor) for approximately 30 outpatients visiting the clinic per day. This number shows the clinic is considerably abundant in nurse staffing compared to the Japanese standard of 1 nurse per 30 outpatients set by the Medical Care Law. The IBD-Self-Efficacy Scale (IBD-SES) and difficulty of life scale (DLS) were used as disease specific patient reported outcome measures. Multiple regression analysis was conducted in order to assess the extent of influence by the difference of facility after adjusting potential effects of confounders.

Results
All multi regression models included following confounders; age, sex, disease, job status, use of biologic, and disease duration. In IBD-SES, the subscales except for the subscale “managing medical care” showed significantly higher self-efficacy scores in patients who were recruited from the specialized clinic than those from online. As for DLS, all subscales and the total score showed significantly lower difficulty scores in patients who were recruited from the clinic.

Conclusion
Our results suggest that abundant nurse staffing influences favorably on self-efficacy and difficulties of life among patients with IBD in clinical remission.
N16 Exploring the factors that influence adjustment to and acceptance of an intestinal stoma for IBD: preliminary findings
Authors: Essex R , Burch J , Kemp K , Duncan J , Monks C , Dibley L ,   PRESTO PPI team
Published: January 2023

Abstract

Background
Adjusting to a stoma can be difficult. During development of a new Patient-Reported Outcome Measure, peoples’ perceptions of factors influencing acceptance of a stoma were explored.

Methods
Participants aged 18 years+ (confirmed IBD diagnosis, current or prior stoma) were recruited via Crohn’s & Colitis UK. Semi-structured interviews (online/phone January–April 2022) were audio-recorded, transcribed professionally, and analysed thematically.

Results
Of 29 participants, 16 (55%) were female, 13 (45% male, or non-binary); mean age 53 years (range 22-77 years); with Crohn’s disease (n=11), ulcerative colitis (n=15) and IBD-unclassified (n=3). Mean time from diagnosis to first stoma: 9.3 years; 27 (93%) had a permanent stoma. Four early themes emerged:
Diagnosis and treatment: Clinical history before stoma surgery affected peoples’ responses afterwards. Delayed diagnosis, medication, and a declining health trajectory led to ‘no other option’ making it easier to consent to and accept stoma-forming surgery. Relief and control came once practical stoma care was mastered. Those who reported delayed diagnosis and/or not being believed about being seriously unwell, carried that experience forward with them.
Challenges of living with a stoma: No-one was ‘pleased’ that they had a stoma, but all (bar one) felt that life was better with, than without one. The stoma was harder to accept when not preceded by extended illness, or when temporary. Challenges included poor facilities for managing the stoma away from home and finding the right appliance to suit. The time needed per day to care for the stoma was burdensome. It took about two years to reach acceptance after stoma surgery.
Personality and coping: Participants viewed their stoma in the same way they addressed other challenges: there was no choice but to ‘get on with it’. Problem-solving skills had often been learnt in childhood. Recalling the stark health contrast between life without and with a stoma was helpful in accepting the stoma as part of their identity.
Social impacts and influences: Family, intimate partner, and social support were crucial. There is inadequate support for ostomates’ family members, especially children. Partners were accepting of the stoma, but women worried about body image and remaining attractive. People described anticipated and perceived stigma; whilst concerned that the stoma might be ‘obvious’ to others, they also endured negative comments because it was invisible.

Conclusion
Adjustment to living well with a stoma is influenced by personality, coping style, and social support, informed by prior personal, social and clinical experiences. Public ignorance about stomas and others' stigmatising attitudes often cause the most distress.
N17 Azathioprine - Is it really a dirty drug? IBD nurse's experience at Our Lady of Lourdes Hospital
Authors: Anderson E , McMahon S 
Published: January 2023

Abstract

Background
Azathioprine is commonly used in the treatment of inflammatory bowel disease (IBD) either as monotherapy or in combination with anti-TNF agents. Azathioprine has numerous side-effects (SA) including leukopenia, pancreatitis and drug-induced liver injury (DILI). At our centre, dedicated IBD nurses play a central role in educating patients regarding potential SA and the importance of blood test monitoring. Suboptimal compliance with regard to blood test monitoring is a significant issue, particularly given that some SE are likely to be asymptomatic, and only apparent on blood tests; eg. neutropenia, leukopenia, DILI. Our aim was to capture real world data regarding the true burden of SE experienced by IBD patients taking azathioprine.

Methods
We conducted a single-centre study within a dedicated gastroenterology unit served by two full-time dedicated specialist IBD nurses. Our unit serves over 1000 IBD patients. Currently approximately 22% of our patient cohort are taking azathiopriine. A prospectively maintained excel database was initiated in 2014 by the IBD nurses in order to capture data regarding SE experienced by IBD patients taking azathioprine. Data was recorded by the IBD nurses each time a patient experienced a SE secondary to azathioprine. The nature of the SE was recorded. Of note, checking of TPMT levels prior to initiation of azathioprine is standard practice in our centre.

Results
During the eight year study period (2014-2022), 91 patients were recorded as having experienced SE to azathioprine. The most common SE (n=43%) was a general intolerance to the drug which included short periods of nausea or flu-like symptoms; followed by muscle/joint pain (n=17%); pancreatitis (n=14%); abnormal lfts (n=12%); hair loss (n=10%); low wcc (n=4%).

Conclusion
Our prospectively collected real-world data shows that SE from azathioprine are common amongst IBD patients. This emphasises the importance of patient counselling prior to initiation of this drug. Whilst leukopenia is a particular concern amongst IBD services who prescribe azathioprine, our data show that this accounts for a very small percentage of SE that our patients experience while taking azathioprine.
N18 Exploring the experiences of UK-dwelling Bangladeshi native language-speaking patients with Inflammatory Bowel Disease: preliminary findings from a qualitative study
Authors: Ahmed S , Singh H , Newton P , Ojo O , Dibley L 
Published: January 2023

Abstract

Background
Native language-speaking patients with IBD may be underserved by an Anglo-centric delivery of healthcare in multicultural communities. We explored experiences of IBD Bangladeshi patients living in the UK whose preferred languages were Bengali or Sylheti.

Methods
Bangladeshi patients aged 18 years+, with confirmed diagnosis of Crohn’s disease, or ulcerative colitis, who fully or mostly spoke Bengali or Sylheti, were recruited from IBD infusion clinics. Semi-structured individual phone interviews with a bilingual researcher (captured February-May 2021) were audio-recorded, translated and transcribed professionally, and analysed thematically.

Results
The eight participants were aged 34-52 years; 4 (50%) females; with Crohn’s disease (n=3), ulcerative colitis (n=5). They spoke no English (n=2), Standard Bengali (n=8), and/or Sylheti (n=6); they could read Bengali and some English (n=5), Bengali only (n=2), or neither (n=1). Four early themes emerged:
The impact of socioeconomic factors: Health inequalities pervaded participants’ experiences. They lived in a deprived London borough in multiple occupancy and/or multi-generational households, often with just one toilet. Those on low incomes had limited access to health-maintaining resources such as diet and medications.
The importance of understanding and being understood in their native language: Issues with translation of health information and interpretation in health settings were reported. Participants struggled to explain their experiences of and concerns about IBD to clinicians; having a clinician who understood their position enabled needs and concerns to be better addressed.
Understanding the condition and its chronic nature: Few participants had a good lay understanding of IBD and did not comprehend why it was only ‘being managed rather than cured’ by clinicians. Some distrusted Western medicine, believing that treatment would be better, and curative, in their native country. Family, friends, and the wider Bangladeshi community did not understand IBD and its effects.
Day-to-day self-management experienced as a burden: Self-management tasks impinged on day-to-day activities, disrupting cultural and religious pursuits. Toileting, food practices and medication management all impacted negatively on personal and family social relationships and events, and on the ability to work.

Conclusion
Wider socioeconomic factors preceded and affected participant’s resources and ability to self-manage their condition. Language barriers fostered poor understanding of IBD and its chronic nature. Improved translation and interpretation assistance, alongside community-based initiatives to ameliorate health inequalities and improve access to health resources, would benefit this community.
N23 Burnout among European IBD specialists – a survey supported by ECCO
Authors: Sánta A , Volosin M , Farkas K , Keresztes C , Rafael B , Molnár T 
Published: January 2023

Abstract

Background
The aim of the study was to measure the level of burnout and the factors influencing it, as well as to analyse the personal and professional risk factors among European IBD professionals.

Methods
102 respondents (56.9% male, average age 48 (SD:10.6)) completed the questionnaire, which consisted of four different psychological constructs (burnout, depression, somatization and well-being), as well as sociodemographic, health-related and work-related factors.

Results
In our study, 47.1% of IBD professionals showed burnout. For all three factors of burnout combined, 17.6% of participants scored at least in the moderate range. The highest rate of burnout factors was depersonalization (medium 48%; high 47.1%). 33.3% of the respondents reported decreased personal performance and 5.9% showed moderate emotional exhaustion. Depression, somatization and well-being correlated with emotional exhaustion and depersonalization, but only depression correlated with personal accomplishment. Emotional exhaustion correlated with age, physical activity and time spent in health care as an IBD specialists. Regression analysis showed that depression is the most important factor explaining both personal accomplishment (β=0.4599; p=0.006) and depersonalization (β=0.5692; p&lt;.001). Among the work factors, endoscopic access and dedicated IBD outpatient unit had a negative effect on burnout. The opportunity to participate in multidisciplinary meetings was proved to be a clear anti-burnout factor.

Conclusion
The pilot study tends to draw the attention to the importance of burnout among IBD professionals in Europe, particularly in relation to depersonalization. Further studies may help uncover the role of underlying factors and provide a basis for international support and prevention programs.
N28 Satisfaction with telemedicine programs in inflammatory bowel disease: a natiowise multicenter study
Authors: Cano Sanz N , Serrano Redondo M , Jurado Monroy R M , Suárez Álvarez P , García Prada M , Latras Cortés I , Sierra Ausín M 
Published: January 2023

Abstract

Background
The novelty of using telemedicine systems with inflammatory bowel disease (IBD) patients represents a new point of view of care delivery. However, different factors such as the acceptance and access to telematic means, the digital literacy of the population and health professionals, as well as other objective and subjective factors in their use must be weighed in order to implement this type of programs. Thus, we propose a multicenter study in different IBD units of Spanish centers with availability of telemedicine programs for clinical follow-up and/or determination of fecal calprotectin at home.

Methods
Cross-sectional observational study. IBD monographic units around national territory with available telemedicine programs were contacted. They were requested to answer to specific questionnaires by professionals (10 questions) and by patients (18 questions), all of them compound by closed-ended questions with a 5-item Likert scale and short answer questions. The closed-ended questions underwent quantitative analysis, while the short answer questions underwent qualitative analysis using the SWOT method.

Results
To abstract date, 18 IBD units joined to the study, including 21 health professionals and 44 patients. The mean score for the closed-ended questions was 26.45 ± 7.32 out of 40 points for health professionals (6.6/10) and 52.67 ± 23.54 out of 72 points for patients (7.3/10). The SWOT analysis identified as weaknesses: lack of integration with the computer system of the centers; threats: low perceived usefulness, flaws in the design of the application; and strengths: free telematic system and fecal calprotectin collection kits, reduction of visits to the healthcare center, simple collection method and analysis of fecal calprotectin at home.

Conclusion
The development of telemedicine systems in IBD units in our country is still limited. Users, patients and professionals, perceive some problems in its use that lead to its underuse and abandonment. Implementing improvement measures represents an opportunity to increase their acceptance and to incorporate this kind of programs into daily practice.
Severing the Belt and Road: Overseas Chinese Networks and COVID-19 Travel Restrictions
Authors: Kim Sung Eun , Shin Adrian J , Yang Yujeong 
Published: January 2023

AbstractIn response to the COVID-19 pandemic, governments around the world have imposed a wide variety of entry restrictions on international travel. Historical cases illustrate that public health concerns based on entrenched prejudices toward immigrant communities have led to restrictive measures against migration from foreign countries. Using our new dataset, COVID-19 Travel Restrictions and Categories, we examine whether Chinese migrant networks around the world have driven government decisions to bar the entry of Chinese nationals and travelers from China in the early months of the COVID-19 pandemic. Our survival analysis of China-specific travel restrictions from January to March 2020 shows that not all Chinese migrant networks were important determinants. We find that entry bans on travel from China emerged more quickly in countries where a large number of temporary Chinese migrants work in clustered sites of Chinese contracted projects.
Foreign Policy Alignment and Russia's Energy Weapon
Authors: Stoelzel Chadwick Christina M , Long Andrew G 
Published: January 2023

AbstractScholars of international relations disagree whether trade in natural gas between Europe and Russia provides the latter with a source of foreign policy power. Because a reduction in trade of natural gas is costly for importers, the potential economic power of Russia's energy weapon could alter strategic calculations about diplomatic conflict with Russia. Consequently, we hypothesize that increases in dependence on Russian natural gas will lead to more foreign policy convergence with Russia. Using a panel of European states from 1995 to 2013 and a time series of Germany from 1979 to 2013, we find support for our argument that greater dependence on Russian natural gas correlates with more similarity in voting patterns at the United Nations General Assembly. Our research suggests that Russian natural gas imports to Europe shape broader political alignments, adding to the growing body of research on the potential ramifications of Russia's energy weapon.
Assessing Healthy Aging Score and Its Association With All-Cause Mortality: Findings From the China Health and Retirement Longitudinal Study
Authors: Zeng Zihang , Li Xuerui , Yang Wenzhe , Wang Jiao , Zhu Yun , Qi Xiuying , Xu Weili 
Published: January 2023

AbstractBackground and ObjectivesTo construct a comprehensive healthy aging score (HAS) and explore its association with all-cause mortality and its potential interactions with other demographics on mortality.Research Design and MethodsThis study included 5,409 participants aged ≥60 years from the China Health and Retirement Longitudinal Study. An HAS was constructed based on three dimensions of healthy aging including intrinsic capacity (IC), environmental support (ES), and chronic disease (CD), which were assessed at baseline, and categorized by tertiles (poor, moderate, and high). Participants were followed up biennially for all-cause mortality through the death registration or family interview from 2011 to 2018. Data were analyzed using Cox regression, Laplace regression, and receiver-operating characteristic analysis.ResultsDuring 7 years of follow-up, 877 (16.21%) participants died. An HAS was constructed based on the cognition, mobility, and instrumental activity of daily living in the IC dimension; housing in the ES dimension; and hypertension, diabetes, chronic lung disease, stroke, and cancer in the CD dimension, which was associated with death. HAS seems a good predictor of all-cause mortality, with an area under the curve of 0.749. The hazard ratios and 95% confidence intervals for all-cause mortality related to moderate and poor HAS (vs high HAS) were 1.26 (1.01–1.56) and 2.38 (1.94–2.91), respectively. The median survival time was 2.46 years shorter in participants with poor HAS than those with high HAS. There were significant additive interactions of HAS with age, sex, and marital status on death.Discussion and ImplicationsPoor HAS may increase mortality and shorten survival, especially among older, male, and single adults.
Gravity degree–depth relationship using point mass spherical harmonics
Authors: Goossens Sander , Smith David E 
Published: January 2023

SUMMARYRelationships between the degree of a spherical harmonic model of the gravitational field of a body and the depth of a source expressed as a density contrast can be used to study the structure of features. Here, we show that the gravitational acceleration per spherical harmonic degree of a constant density source has an extremum that depends on the depth of the source. Using the spherical harmonics expansion for a point mass source, we use this to derive a degree–depth relationship. Our relationship resembles an earlier one derived by Bowin, with substantial differences at the lower degrees. We also find that a recent relationship derived by Deng et al. overestimates the source depth. The relationship that we derive relates spherical harmonic degree n to depth d for a planet of radius R according to $d = (1-e^{\frac{-1}{n+1}})R$, which simplifies to d = R/(n + 1) for high degrees. We support our new relationship with synthetic models of a density contrast in a planet. We also show how the differences between our relationship and that of Bowin affect band-filtered gravity, for example when inspecting the upper 100 km of the Moon. Using point masses in our modelling results in an approximate relationship where in reality sources can be deeper than estimated, since any source contributes to all spherical harmonic degrees. The use of the contribution per individual degree however provides an intuitive relationship between spherical harmonic degree and depth that can be used to place relative bounds on source depths or to determine the bounds on spherical harmonic expansions when band-filtering gravity field models.