bluuebunny/crossref_metadata_2025_split huggingface dataset:
A245 A TERTIARY CENTRE REVIEW OF PORTO-SYSTEMIC SHUNTS: AN INCREASINGLY IMPORTANT TOOL IN LIVER DISEASE MANAGEMENT
Authors: Malik S , Hirschfield G , Jaberi A 
Published: March 2023

Abstract

Background
Portal hypertensive complications arising from chronic liver disease are increasingly prevalent. Radiologically placed porto-systemic shunts are used successfully to address complications such as ascites and recurrent variceal bleeding.

Purpose
We sought, with approval from ethics to electronically chart review the UHN experience for TIPSS (transjugular intrahepatic porto-systemic shunt) and DIPS (direct intrahepatic porto-caval shunt) over time.

Method
We employed a search strategy focused on radiologic databases, to identify UHN patients who had received a porto-systemic shunt insertion over three decades between January 1, 1990, to September 14, 2021. A total of 238 UHN patients that had a shunt imaged, re-assessed, or inserted were included in this retrospective electronic chart review. Demographic information was recorded at baseline. Data pertaining to clinical outcomes of portal hypertension such as refractory ascites, recurrent gastrointestinal bleeding and ESLD progression was recorded at baseline, 1 month, 3 months and 6 months post-shunt insertion. HVPG was recorded pre-shunt and post-shunt insertion. Transplant-free survival and post-operative complications was also assessed. Patients were followed until death or liver transplant.

Result(s)
Out of 238 patients confirmed, 219 had a TIPSS insertion and 19 a DIPS insertion. The average age at time of shunt was 55.1 ± 8.4 years. 53.7% (n=128) of patients were male. Indications for portosystemic shunt placement included refractory ascites (n=141), recurrent gastrointestinal bleeding (n=73), hydrothorax (n=10), hepatorenal syndrome (n=8), and portal vein thrombosis (n=4). Etiology of disease was categorized as alcohol-associated liver disease (n=107), non-alcohol associated fatty liver disease (n=36), viral hepatitis (n=27), autoimmune hepatitis (n=38) and vascular liver disease (n=20). Relevant events noted post procedure included hepatic encephalopathy (n=34), hydrothorax (n=17), vascular (including stent) thrombosis (n=17) and renal failure (n=4). 12 months post-shunt insertion 2.5% (n=6) of patients had died or received liver transplant; of these 1.7% (n=4) were transplanted. HPVG fell consistently post-procedure: 15.6 ± 1.5mmHg pre-shunt to 5.9 ± 1.2mmHg post-shunt. There was no observable increase in MELD-Na score in the first month post-shunt. Temporal trends showed that more patients aged 50 to 69, and more female patients, are now receiving shunt insertion than at the initiation of the chart review.

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Conclusion(s)
Portosystemic shunt placement in the form of TIPSS or DIPS insertion is an increasingly common and effective treatment for portal hypertension in patents with advanced liver disease at UHN.

Disclosure of Interest
None Declared
A264 ORAL IRON SUPPLEMENTATION SHAPES THE RECOVERY OF GUT THE MICROBIOTA AND PROMOTES CARCINOGENESIS IN THE APCMIN/+ MOUSE MODEL
Authors: Cuisiniere T , Oliero M , Hajjar R , Calvé A , Fragoso G , Santos M M 
Published: March 2023

Abstract

Background
Colorectal cancer (CRC) induces anemia in a large proportion of patients and is usually treated with oral iron supplementation. Surgery, the main treatment for CRC, is routinely accompanied by prophylactic antibiotics to avoid infection. Moreover, the concomitance of oral iron supplementation and antibiotics treatment is highly prevalent in general population. However, the combined effect of antibiotics and high luminal iron concentration in the gut on the microbiota and intestinal homeostasis remains unknown.

Purpose
This study sought to identify possible deleterious effects of the recovery from antibiotics exposure of the gut microbiota under oral iron supplementation.

Method
In order to assess the effects of luminal iron on the recovery of the gut microbiota, WT mice were subjected to antibiotic treatment with different concentrations of dietary iron. Then, to explore potential deleterious effects of this setup on CRC promotion and progression mediated by the human CRC gut microbiota, CRC model ApcMin/+ mice were subjected to antibiotics prior to gavage with fecal samples from anemic CRC patients, then fed different concentrations of dietary iron. The composition of the gut microbiota and its recovery after these interventions were assessed in stool samples by 16S rRNA. Gut microbiota functions were inferred by using the PICRUSt2, and short chain fatty acid (SCFA) concentration in feces were assessed by liquid-chromatography mass spectrometry. CRC progression and promotion were assessed by tumour counts and immunohistochemistry.

Result(s)
Recovery from antibiotics under high luminal iron concentration shifted the gut microbiota toward a Bacteroidetes phylum-dominant composition. Three bacterial species characterized as CRC initiators were significantly more abundant. Nitrogen, pentose phosphate, cyanoamino acid metabolisms were higher after recovery under oral iron supplementation. Antibiotic exposure induced a long-term increase in SCFAs linked to gut inflammation, propionate and succinate. For mice under high luminal iron concentration, they showed a lack of recovery in baseline levels of butyrate, a SCFA that inhibits cancer cell proliferation in the gut. In addition, an increase in CRC burden and progression were found in ApcMin/+ mice receiving fecal sample from patients and oral iron supplementation.

Conclusion(s)
Gut microbiota recovery from antibiotic exposure under oral iron supplementation is frequent in CRC patients, but is also common in the general population. This study identifies possible deleterious effects of the concomitance of these two disruptive agents of the gut microbiota on the CRC progression.

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Other

Please indicate your source of funding;
NSERC, ICM

Disclosure of Interest
None Declared
A268 RESOLUTION RATES IN OPEN-LABEL VERSUS RANDOMIZED CONTROLLED TRIALS FOR MICROBIOTA RESTORATION FOR RECURRENT CLOSTRIDIOIDES DIFFICILE INFECTION: AN UPDATED META-ANALYSIS
Authors: Tariq R , Pardi D S , Khanna S 
Published: March 2023

Abstract

Background
Microbiota restoration is highly effective to treat recurrent Clostridioides difficile infection (CDI) in observational studies (cure rates &gt;90%) but efficacy in controlled clinical trials appears lower.

Purpose
We performed an updated meta-analysis to assess the efficacy of microbiota restoration for recurrent CDI in open-label registered prospective clinical trials compared to randomized controlled trials (RCTs).

Method
A systematic search of Embase, Web of Science and Scopus was performed up to June 2022 to identify studies of interest. Clinical trials of microbiota restoration for recurrent CDI with clinical resolution with one dose as the primary outcome were included. We calculated both unweighted and weighted pooled resolution rates (UPR and WPR) with 95% confidence intervals (CI).

Result(s)
Eighteen studies (9 RCTs and 9 open-label trials) with 1149 CDI patients were included. Of the patients treated with microbiota restoration, 881 experienced symptom resolution (UPR 77%%; WPR 79%, 95% CI, 72%-85%). There was significant heterogeneity among studies with an I2of 86%. Analysis of trials with a control arm (non-microbiota restoration) revealed CDI resolution in 357 of 496 patients (UPR 72%; WPR 73%, 95% CI 63%-82%) with microbiota restoration. Among the 9 open-label clinical trials, CDI resolution was seen in 524 of 653 patients after initial microbiota restoration (UPR 80%; WPR 84%, 95% CI 74%-92%). Comparison of resolution rates between RCTs and open-label trials revealed a lower cure rate in RCTs compared to open-label trials (WPR 73% vs 84%, p&lt;0.0001).
Analysis of the 10 trials with non-microbiota restoration revealed CDI resolution in 201 of 397 patients with antibiotics (WPR 52%, 95% CI 43%-60%). There was significant heterogeneity among the included studies with an I2of 61%. Comparison of cure rates with microbiota restoration vs antibiotics showed higher cure rate with microbiota restoration (WPR 73%, [95% CI 63%-82%] vs 52% [95% CI, 43%-60%]; p&lt;0.0001). There were no serious adverse events reported.

Conclusion(s)
Microbiota restoration in a randomized controlled setting leads to lower resolution rates compared to open label and observational settings, likely due to stricter definitions and inclusion criteria. Resolution rates in open label studies were similar to observational studies.

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None

Disclosure of Interest
None Declared
A273 INCREASING THE REPRESENTATION OF INDIANS IN MICROBIOME RESEARCH: HOW DOES THEIR GUT MICROBIOME DIFFER?
Authors: D'Aloisio L D , McComb C , Shetty V , Ballal M , Ghosh S , Gibson D L 
Published: March 2023

Abstract

Background
During the 1900s when industrialization was on the rise in western countries, inflammatory bowel disease (IBD) began to present itself and continually increase over the decades. Now, newly industrialized countries such as India are following this same pattern, and with a population reaching over one billion, India is projected to have one of the highest IBD prevalence worldwide. Furthermore, pediatric diagnoses of IBD are more frequently reported in India and in Indian children living in Canada, suggesting this disease may present differently in those of Indian descent. While the etiology of IBD remains unclear, a gut microbiome that is no longer symbiotic with its host is a key player. However, Indians are one of the least represented in microbiome research, therefore we cannot accurately assess the role of their gut microbiome in IBD. To effectively understand the nature of IBD in Indians, we must first define their gut microbiome.

Purpose
Our study characterizes the microbiome of Indians living in India to explore how it differs from Canadians of European descent.

Method
Stool samples from healthy volunteers (ages 18-55) were collected from Indians in India and Euro-Canadians in Kelowna, BC. Microbial DNA was extracted for 16S sequencing on the Illumina MiSeq platform and QIIME2 was used for microbiome analysis.

Result(s)
We will discuss the similarities and differences comparing the gut microbiome of Indians to Euro-Canadians, further highlighting the need for more microbiome research of this demographic.

Conclusion(s)
Our research aims to increase representation of Indians in microbiome research in the hopes of improving our knowledge of the predispositions to IBD, which will aid in the information required to develop effective preventive measures. With elevated risk for IBD in Indians residing in Canada, future studies should also aim to analyze if the gut microbiome in Indians change as they migrate and adopt the westernized lifestyle.

Disclosure of Interest
None Declared
A279 EVIDENCE OF TRANSIENT RECEPTOR POTENTIAL MELASTATIN 3 (TRPM3) CHANNEL SENSITIZATION IN A MOUSE MODEL OF COLITIS
Authors: King J W , Bennett A S W , Wood H , Baker C , Reed D E , Lomax A E 
Published: March 2023

Abstract

Background
Abdominal pain is a primary symptom of inflammatory bowel disease (IBD). Opioids provide relief from IBD-associated pain, but they are addictive and associated with excess mortality in IBD patients. Thus, there is a need to develop novel therapeutics for IBD-associated pain. The mechanosensitive ion channel, transient receptor potential melastatin 3 (TRPM3) is upregulated in sensory neurons innervating inflamed tissue and contributes to pain from inflamed joints and cystitis. However, TRPM3’s role in abdominal pain has not been investigated.

Purpose
To evaluate whether TRPM3 contributes to abdominal pain using a mouse model of colitis.

Method
We used ratiometric Ca2+ imaging and extracellular afferent nerve recording to determine the effects of pharmacological activation or inhibition of TRPM3 on T13-L5 dorsal root ganglia (DRG) neurons and lumbar splanchnic nerves, respectively. Increased intracellular Ca2+ indicates neuronal excitation. Furthermore, the effects of TRPM3 activation in neurons and nerves from healthy mice and mice with dextran sulphate sodium-induced colitis were compared.

Result(s)
The TRPM3 agonists, CIM-0216 (0.1-10µM) and pregnenolone sulphate sodium (PSS; 1-300µM), concentration-dependently increased intracellular Ca2+ concentration in mouse DRG neurons and this was blocked using the TRPM3 inhibitor isosakuranetin (5µM; p&lt;0.0001, Mann-Whitney Test). CIM-0216 (5µM)-induced increases in intracellular Ca2+ were significantly larger in neurons from mice with colitis (326±16% of baseline) compared to neurons from healthy mice (257±13% of baseline; p&lt;0.01, Kruskal-Wallis with Dunn’s Multiple Comparison Test). The percentage of neurons responding to CIM-0216 was significantly increased in mice with colitis compared to healthy mice (79% vs 62%; p&lt;0.001, Fischer’s Exact Test). Similarly, the percentage of neurons responding to PSS from mice with colitis was increased compared to healthy mice; however, this did not reach statistical significance (75% vs 70%, p=0.351, Fischer’s Exact Test). Furthermore, CIM-0216 (20µM)-induced change in the basal firing of lumbar splanchnic nerves was significantly increased in mice with colitis (1.23±0.24Hz) compared to healthy mice (0.60±0.14Hz, p&lt;0.05, unpaired t-test).

Conclusion(s)
TRPM3 activation excited DRG neurons and lumbar splanchnic nerves and these excitatory effects were augmented in mice with colitis.

Disclosure of Interest
None Declared
A287 HOME PARENTERAL NUTRITION FOR INDIVIDUALS WITH SHORT BOWEL SYNDROME SECONDARY TO CROHN’S DISEASE VERSUS OTHER ETIOLOGIES: A PROSPECTIVE COHORT STUDY
Authors: Sasson A N , Noelting J , Schwenger K , Armstrong D , Raman M , Duerksen D , Whittaker S , Lu Y , Jurewitsch B , Gramlich L , Ananthakrishnan A , Allard J 
Published: March 2023

Abstract

Background
Individuals with short bowel syndrome (SBS) have reduced intestinal absorptive capacity and many require home parenteral nutrition (PN) support. One of the common causes of SBS is secondary to intestinal resections in the management of Crohn’s disease (CD). Complication rates and survival in SBS secondary to CD on PN versus other etiologies remains unknown.

Purpose
To determine whether patients with SBS secondary to CD versus SBS secondary to other etiologies on home PN, have increased risk of hospitalizations and complications including central line associated bloodstream infection (CLABSI) and venous thromboembolism and whether there is a difference in overall survival between groups.

Method
This is a multicentre prospective cohort study using the Canadian Home Parenteral Nutrition (HPN) Registry on individuals with defined SBS separated into two cohorts: 1) Patients with SBS secondary to Crohn’s disease vs. 2) Patients with SBS secondary to other aetiologies (trauma, surgical complication, vascular event, volvulus, malignancy). Patient characteristics and clinical factors are presented as mean (standard deviation) for continuous variables and as frequency (percentage) for categorical variables. Comparison between groups (SBS CD vs SBS other) were performed using 2-sample t-test for continuous variables and Chi-square or Fisher exact tests when appropriate for categorical variable. Survival probabilities will be estimated using the Kaplan-Meier method.

Result(s)
The study included a total of 379 patients with short bowel syndrome on home PN. There are 170 (45%) patients with SBS secondary to CD and 209 (55%) patients with SBS from other secondary causes. The average age of those with CD is 52 and 65% female patients. The average age of those with other causes of SBS is 56 with similar percentage of female patients (65%). There were significant differences in baseline medications with higher use of immunosuppressant therapy (39% vs. 7%, p&lt;0.001) in those with CD. There was no significant difference in total number of hospitalizations, hospitalizations related to PN and CLABSI.

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Conclusion(s)
Individuals with SBS secondary to CD do not appear to be at increased risk of central line infections or hospitalizations compared those with SBS from other causes.

Please acknowledge all funding agencies by checking the applicable boxes below
None

Disclosure of Interest
None Declared
Recent Douglas-fir Mortality in the Klamath Mountains Ecoregion of Oregon: Evidence for a Decline Spiral
Authors: Bennett Max , Shaw David C , Lowrey Laura 
Published: March 2023

AbstractRecent increases in Douglas-fir (Psuedotsuga menziesii var. menziesii) mortality in the Klamath Mountains ecoregion raise concerns about the long-term resilience of Douglas-fir in the ecoregion and increased potential for uncharacteristic wildfire. We used data from the USDA Forest Service Aerial Detection Survey and ninety-six field plots to explore the relationships between physiographic and climate variables and Douglas-fir mortality. Our results provide strong evidence for a decline spiral in which Douglas-fir growing on hot, dry sites (predisposing factor) are further stressed by drought (inciting factor) and are then exploited by the flatheaded fir borer (Phaenops drummondi) and other secondary biotic agents (contributing factors), resulting in decline and mortality. At the landscape scale, Douglas-fir mortality increased as average annual precipitation declined and average climatic water deficit increased. We developed a risk score integrating several environmental variables associated with drought and heat stress to predict the likelihood and intensity of mortality at the stand scale.
Optometric Brain Injury Curriculum in Federal Residency Training Programs: A Consensus Report
Authors: Jackson Kevin M , Merezhinskaya Natalya , Mallia Rita K , Barker II Felix M 
Published: March 2023

ABSTRACT

Introduction
Brain injury often impacts the visual system. Diagnosis and treatment of visual system problems related to brain injury is a field with less settled science and more variation in practice than most specialty fields. Most optometric brain injury residency programs are in federal clinics (VA and DoD). A consensus core curriculum has been created that will allow some consistency while facilitating program strengths.

Materials and Methods
Kern’s curriculum development model and a focus group of subject matter experts were used to reach consensus in producing a core curriculum to provide a common framework for brain injury optometric residency programs.

Results
A common high-level curriculum was developed with educational goals through consensus.

Conclusions
In a relatively new subspeciality without a firm foundation of settled science, a common curriculum will help provide a common framework to facilitate clinical and research progress in this field. The process sought out expertise and community building to help improve the adoption of this curriculum. This core curriculum will provide a framework for educating optometric residents in the diagnosis, management, and rehabilitation of patients with visual sequelae because of brain injury. It is intended to ensure that appropriate topics are covered while allowing for flexibility according to each program’s strengths and resources.
A case of Behçet’s-like disease associated with trisomy 8–positive myelodysplastic syndrome carrying MEFV E148Q variant presented with periodic fever
Authors: Ishikawa Yukiko , Sasaki Ryo , Ishiwata Akira , Hatakeyama Shuji , Matsumura Masami , Sato Takeo 
Published: March 2023

ABSTRACT
Behçet’s-like disease, which incompletely fulfils the criteria of Behçet’s disease, is often associated with trisomy 8–positive myelodysplastic syndrome (MDS). We report a case of an 82-year-old man with these conditions carrying the E148Q variant of MEFV gene who presented with periodic fever. The patient presented with joint pain, muscle pain, and episodes of periodic fever every 2 weeks for the past 3 months. On admission, painful erythema and fever were observed. Colonoscopy revealed erosion in the caecum and ascending colon. The patient had bicytopenia, and a bone marrow biopsy showed findings compatible with trisomy 8–positive unclassifiable MDS. Because the patient incompletely fulfilled the criteria for Behçet’s disease, he was diagnosed with Behçet’s-like disease associated with trisomy 8–positive MDS. Positron emission tomography–computed tomography performed during the fever revealed multiple muscle lesions consistent with the sites of pain. To examine the cause of the periodic fever attacks, MEFV gene was analysed, and the results revealed an E148Q variant. Steroids were ineffective against periodic fever attacks. A daily dose of 0.5 mg colchicine was prescribed, but the effect was minimal, probably, because of the insufficient dose due to renal dysfunction. Based on the diagnosis of atypical familial Mediterranean fever, canakinumab was added, which partially mitigated the periodic fever. This case suggests the importance of ruling out MDS when physicians see an elderly patient who present with Behçet’s-like disease. Although the significance of the E148Q variant in the pathogenesis of periodic fever remains controversial, it may act as a disease modifier in accordance with trisomy 8–positive MDS.
Magnetoelectric effect generated through electron transfer from organic radical to metal ion
Authors: Liu Xiaolin , Liu Qiang , Zhao Haixia , Zhuang Guilin , Ren Yanping , Liu Tao , Long Lasheng , Zheng Lansun 
Published: March 2023

Abstract
Magnetoelectric (ME) materials induced by electron transfer are extremely rare. Electron transfer in these materials invariably occurs between the metal ions. In contrast, ME properties induced by electron transfer from an organic radical to a metal ion have never been observed. Here, we report the ME coupling effect in a mononuclear molecule-based compound [(CH3)3NCH2CH2Br][Fe(Cl2An)2(H2O)2] (1) [Cl2An = chloranilate, (CH3)3NCH2CH2Br+ = (2-bromoethyl)trimethylammonium]. Investigation of the mechanism revealed that the ME coupling effect is realized through electron transfer from the Cl2An to the Fe ion. Measurement of the magnetodielectric (MD) coefficient of 1 indicated a positive MD of up to ∼12% at 103.0 Hz and 370 K, which is very different from that of ME materials with conventional electron transfer for which the MD is generally negative. Thus, the current work not only presents a novel ME coupling mechanism, but also opens a new route to the synthesis of ME coupling materials.