bluuebunny/crossref_metadata_2025_split huggingface dataset:
N44 Telenursing for patients with inflammatory bowel disease: an interview study of nurses
Authors: Kawakami A , Tanaka M , Sakagami K , Moribe Y , Kunisaki R 
Published: January 2025

Abstract

Background
Telephone nursing services for people with inflammatory bowel disease are widespread internationally. Nurses supporting this patient group require skills to treat and manage a wide range of symptoms. However, nurses who provide telenursing for people with inflammatory bowel disease face a range of challenges, some of which are specific to telenursing for this condition. We aimed to investigate telenursing specifically for people with inflammatory bowel disease. In particular, we sought to identify nurses’ practices and what they considered to be important in telenursing.

Methods
We carried out semi-structured interviews with 20 nurses in Japan with extensive experience providing telenursing for people with inflammatory bowel disease. Participants were selected by convenience sampling. First, nurses were asked about the main topics about which they were consulted by phone, and their responses to each one. The interviewees were asked about their perceptions of what was important, and the specific actions involved in answering the phone. Data were analysed using inductive content analysis. Reporting followed the Standards for Reporting Qualitative Research.

Results
All 10 facilities provided telephone consultations without screens. Nurses had a mean duration of 9.1 years of telenursing experience. We extracted eight categories and 21 sub-categories of practice, as follows. When giving patients information about the availability of telenursing, nurses provide education and information to ensure that telephone consultations will be effective (A). When nurses receive telephone calls from people with inflammatory bowel disease (B), they work to understand the situation (C). When the call is about a patient’s worsening physical condition, nurses evaluate the patient’s physical condition (D), make decisions (E), and recommend a course of action to the caller (F). For consultations and requests about other issues, nurses act as the initial contact but share the responsibility for decision-making with other professionals (G). In some cases, nurses might contact patients (H). Three categories were identified as important elements in telenursing practice: establishing a coordinated system, clarifying the role of telenursing and improving skills.

Conclusion
We identified several issues that were specific to providing telenursing for patients with inflammatory bowel disease. Addressing these issues could improve nursing practice in this field. Better understanding of telenursing practices and perspectives will help nurses to appreciate the basic practice and scope of work involved in telenursing, and may improve patient care.
N53 Managing an ever-increasing inflammatory bowel disease helpline service
Authors: Scott G , Brown A , Roads N , Abreu B , Rai K , Naeck-Boolauky P , Loxley J 
Published: January 2025

Abstract

Background
Inflammatory bowel disease helplines have been initiated by Trusts throughout the country over many years. However many of them are not adequately job planned and have also seen a dramatic rise in calls over the years. Our Trust operates a helpline over 3 acute hospital sites. Previously calls were not accounted for financially and calls not documented in patient notes. Previously all helpline messages were retrieved by one of the clinical nurse specialists which took a considerable amount of nursing time.

Methods
The nurses on each site all undertake a number of clinical shifts per week answering helpline calls. Previously a list of patients was compiled from patient 1 onwards and staff were unable to prioritise any calls. The consultation is then dictated via a speech recognition system and a letter is generated and sent to the general practitioner. . The time that the call takes is also noted, to enable better job planning. All of the helpline calls are audited and trends and number of calls are analysed.

Results
We enlisted the support of our IBD coordinator who reviewed the helpline system and looked for improvements. They took over listening to and retrieving all messages left on the answerphone thus saving nursing time. They also changed the reporting system to a tabulated excel spreadsheet which enabled all calls to be effectively triaged and acted on in a timely manner. All calls are then added to a central spreadsheet which then categorises the calls into flare advice, medicines advice, investigation issues, appointment issues, etc.
It has also enabled better job planning and it has highlighted the increased number of calls that are taken by the nursing team and that they have been safely managed and accounted for. it has also enabled the team to trend the calls that are taken and the reasons why patients phone our helplines.

Conclusion
This project has shown a dramatic increase in activity for the IBD nurses. It has also highlighted the financial activity of the service and the contribution this provides to the gastroenterology department. This project has not only saved nursing time that should be spent with patients but ensured that patients are reviewed timely. This audit has since been utilised by the South East IBD Network. This project could not have been a success without the vision of Adam our IBD coordinator and the hard working IBD nurses of East Kent Hospitals University Foundation Trust.
Microscopic colitis as pre-inflammatory bowel disease model: from early-stage to tissular endpoint fibrosis
Authors: Escudero-Hernández C 
Published: January 2025

Abstract

Background and aims
Inflammatory bowel disease (IBD) cause chronic relapsing-remitting inflammatory flares in the gastrointestinal tract, resulting in abdominal pain, diarrhea, and gut dysmotility in non-destructive collagenous and lymphocytic microscopic colitis. In addition, classic IBDs Crohn´s disease and ulcerative colitis cause bloody diarrhea and extraintestinal symptoms. Non-destructive IBDs seem to restrain an overt immune response that will damage the tissue and impair wound healing. Thus, I will work under the premise that non-destructive IBDs are undeveloped forms of classic IBDs.

Methods
First, I aim to deeply characterize and compare immune cells and their activation levels in all forms of IBD using “immunomics” (spectral/computational cytometry) and validate my previous finding of two subtypes of lymphocytic colitis. To identify the microbiota that adheres to intestinal epithelial cell (IEC) and therefore alter permeability, and induce collagen deposition, I will coculture IEC and fibroblasts in organ-on-a-chip platforms to mimic gut conditions, including microflow shear stress. I will stimulate chips with patient-derived microbiota-containing luminal content or homogenized biopsies and resections from collagenous colitis (characterized by pathogenic collagen position) and intestinal fibrosis (a major, irreversible IBD complication that increases mortality), respectively, and study using different sequencing techniques. Of note, collagenous colitis could resemble early stages of intestinal fibrosis. My third objective aims to test my previous observation that regulatory B-cells in collagenous colitis might be responsible of restricting overt inflammation.

Anticipated impact
I will adapt spectral cytometry panels to characterize the state of mucosal B- and plasma cells. The support of my host, the well-established IBD immunologist Assoc. Prof. David Bernardo at the Institute of Biomedicine and Molecular Genetics (Valladolid, Spain, h-index=33) and me as coordinator of the biobank for the European Microscopic Colitis Group, ensure the feasibility to complete my ambitious research agenda and make a great impact on IBD field to discover disease-specific biomarkers, pathomechanisms, and new druggable targets.
Patterns and mechanisms of visceral and rectal hypersensitivity in patients with ulcerative colitis in remission
Authors: Trikola A 
Published: January 2025

Abstract

Background and aims
Ulcerative colitis (UC) is a chronic inflammatory disorder affecting the colorectum, with a disease course characterized by periods of flare and remission. Despite the progression of medical therapy and although the clinical and laboratory findings of UC improve during remission, chronic abdominal pain and changes in the frequency and the consistency of stool are frequently observed. It has been reported that abdominal pain occurs in 20-50% of IBD patients even when clinical and endoscopic remission is achieved. Previous studies have suggested that this may reflect visceral hypersensitivity in these patients, with lower thresholds for pain sensation.
The aim of this study is to provide a granular classification of symptom patterns and physiological abnormalities in distinct cohorts among patients with UC in remission, and to dissect the underlying mechanisms.

Methods
The aim of this study is to provide a granular classification of symptom patterns and physiological abnormalities in distinct cohorts among patients with UC in remission, and to dissect the underlying mechanisms. The project will build on an ongoing Greek study (for which the applicant is also the lead investigator). Using validated symptom questionnaires and high resolution anorectal manometry, the Greek cohort will identify clusters of symptomatology and associated physiological changes. Then, as part of this proposal, we will use the same questionnaires in a cohort of patients in Cambridge, UK to validate clusters of symptoms observed. We will use biopsies&lt; from these patients to confirm the presence of a pro-nociceptive bowel environment in patients with pain in remission and investigated how this can be targeted with specific drugs.

Anticipated impact
The result will be a more detailed understanding of the patterns of functional symptoms experienced by patients with UC in remission, along with the functional correlates and putative nociceptive mediators. This will provide immediate insight into how to support patients with these symptoms as well as supporting future studies using therapeutic agents to alleviate symptoms in subgroups of patients.
Evaluating protein SUPPLEMENTation in Ulcerative Colitis (SUPPLEMENT-UC)
Authors: Day A S , Davis R H , Bibb L , Edwards S , Forster S C , Gibson P R , Bryant R V 
Published: January 2025

Abstract

Background and aims
A higher dietary protein intake has overall health and body composition benefits but also has the propensity to drive inflammation in ulcerative colitis (UC). This study aims to investigate whether recreational animal-based protein supplementation affects ability to maintain remission in adults with clinically quiescent UC.

Methods
Twenty-four adults with quiescent UC (Simple Clinical Colitis Activity Index (SCCAI) ≤2) on stable therapy will be randomised to a 24-week double blind, parallel, placebo-controlled protein supplement intervention in addition to habitual diet. The primary outcome is maintenance of remission (defined as SCCAI ≤2) at 24 weeks, relapse being defined as an increase in SCCAI ≥2 points and/or escalation of medical therapy. Disease activity will be assessed using clinical, biochemical and sonographic indices. Adherence, tolerability and safety will be measured using pre-defined categories and 100-mm visual analogue scales. Dietary intake and change in body composition will be measured along with biomarkers and metabolites of fermentation in faecal, blood and urine specimens.

Anticipated impact
This trial addresses one of the top three international IBD research priorities - the role of diet to induce/maintain remission in UC. It will be the first ever study to investigate whether animal-based protein supplements influence the ability of adults with quiescent UC to maintain remission, and to explore the mechanistic basis and relationship between dietary substrate, gut microbiota, and disease activity. The trial results are anticipated to inform UC treatment paradigms by demonstrating dietary factors influence disease activity and dietary advice can be readily incorporated into current UC treatment paradigms as a cost neutral, adjunctive therapy to optimise response to existing therapies. The ultimate goal is to optimise therapeutic outcomes and improve quality of life for people with UC.
Caudovirales as a Trigger of Molecular Mimicry in Crohn’s Disease
Authors: Errico C 
Published: January 2025

Abstract

Background and aims
Dysregulation of gut microbiota has been implicated in inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). Recent studies have highlighted the role of gut virome dysbiosis in CD pathogenesis and the expansion of the Caudovirales of bacteriophages in patients, confirmed also in the IBD Transcriptome and Metatranscriptome Meta-Analysis framework. Additionally, preliminary data showed that, among the Caudovirales, the Proteus virus Isfahan species was the most abundant in CD by comparison with the healthy, while no positivity was shown by UC patients. This result prompted us to hypothesize that this viral species might lead to a molecular mimicry mechanism as part of IBD pathogenesis, as previously suggested. Thus, we assessed whether Proteus virus Isfahan encoded proteins could be similar to the human. We analysed the viral sequence and 3D structural homologies by NCBI blast and iPBA in silico tools. Interestingly, two viral encoded proteins, gp16 and gp82, resulted as highly homologous with the human thymidylate synthase and dCMP deaminase, respectively. Based on our preliminary evidence, we aim to demonstrate a possible molecular mimicry mechanism directed by virome proteins and their involvement in CD pathogenesis

Methods
“In vitro” experiments will assess the impact of Proteus virus Isfahan proteins on immune cells and T-cell responses, aiming to elucidate potential mechanisms of viral-induced autoimmunity and tissue damage. Additionally, we will collect mucosal biopsies from CD to test Proteus virus Isfahan positivity and define a cohort of patients harbouring this gut virome species. By multivariate analysis, we will understand whether viral species positivity correlates with clinical characteristics, pointing to virome-based biomarkers as capable of stratify patients a priori.

Anticipated impact
The project's significance is to uncover novel insights into the relationship between viral dysbiosis, molecular mimicry, and CD pathogenesis, offering opportunities for tailored therapies in a defined cohort of patients.
Immunometabolic landscaping in Crohn’s disease creeping fat – Does fat matter?
Authors: Haag L M 
Published: January 2025

Abstract

Background and aims
The study proposed herein aims to explore the complex immunometabolic landscape of Creeping Fat (CF) in Crohn's disease (CD) ileitis, an area that remains largely unexplored. Our hypothesis posits the existence of distinct sub-entities within mesenteric adipose tissue, characterized by unique metabolic states in immune cells, non-immune cells, and adipocytes. The primary objective is to elucidate the immunometabolic environment within ileal CF, leveraging an advanced Imaging Mass Cytometry (IMC)-based methodology.

Methods
Employing a 37-marker IMC panel, we will conduct comprehensive spatial and metabolic profiling of adipose and intestinal tissues from a cohort of 50 patients, including those with CD and ulcerative colitis (UC), and compare these profiles with samples from bariatric surgery patients. This approach enables single-cell level analysis with spatial resolution, uncovering the metabolic states and signatures of various cell types. Previous work in our group has already demonstrated the utility of this technique in revealing significant variations in cell metabolism across different inflammatory states and cell types in CD. Our methodology integrates the study of immune cell clusters, metabolic states, and subtypes with distinct metabolic signatures. By comparing metabolic signatures in adipose tissues with those in inflamed ileal mucosal tissue, we aim to establish an understanding of metabolic processes within CF.

Anticipated impact
Anticipated impact includes the identification of unique immunometabolic signatures in CF, providing new insights into the pathomechanisms of CD. This could lead to novel therapeutic targets focusing on the metabolism of specific cell types within CF. The study holds the potential to reshape our understanding of CD, paving the way for more targeted and effective treatments for this debilitating disease. Given our established expertise, robust methodology, and comprehensive cohort, this research is poised to offer significant contributions to the field of immunometabolism in IBD, enhancing our understanding of CF and its role in CD.
Optimizing Appendectomy in Ulcerative Colitis: Predictive Markers and Mechanistic Insights
Authors: Becker M A J , Wildenberg M E , Buskens C J 
Published: January 2025

Abstract

Background and aims
Two recent studies from our group have demonstrated a beneficial effect of appendectomy in ulcerative colitis (UC): the ACCURE and COSTA trial show a 20% reduced recurrence rate and &gt;20% increase in induction of remission when compared to medical treatment. However, like for all therapeutic interventions in IBD, not all patients respond equally, leaving room for optimisation. Preliminary RNA sequencing results suggested two subtypes of appendices. Clustering within subtype was seen based on inflammatory pathways which was associated with response. This was confirmed by histology, where patients with a more pro-inflammatory profile were more likely to respond.
The aim of the current project is to improve efficacy of appendectomy by better patient selection through predictive markers and to elucidate the biological mechanisms of action of appendectomy in UC.

Methods
We will validate our preliminary data regarding gene signatures predictive for response to appendectomy and extend these results to the coecal base, enabling prediction of response from endoscopic biopsies and thus improving applicability. In addition, we will focus on the mechanisms of action of appendectomy by targeting the two theories: Firstly, using single cell RNA sequencing we will identify the cellular compartment expressing the genesets associated with response and determine the role of host cells. Secondly, using 16S sequencing of the microbiome of appendix and coecum will allow evaluation of the role of the microbiome.
During the ACCURE and COSTA trial, appendiceal samples (n&gt;100) have been stored for future analysis. This enables the direct start of this experimental study and completion within the 1 year timeframe.

Anticipated impact
This project aims to predict response and clarify the mode of action of appendectomy in UC, contributing to patient stratification. As a simple, safe, and low-cost procedure, appendectomy has significant potential for UC treatment in both high- and low/middle-income countries.
Biomarkers of dietary intake in faeces of children with Crohn’s disease and their role in disease recurrence following treatment with exclusive enteral nutrition
Authors: Gerasimidis K , Gkikas K , Rentaki P , Morrison D , Russell R , Rattray N , Havlik J 
Published: January 2025

Abstract

Background and aims
This study aims to profile biomarkers of dietary intake in faeces of children with Crohn’s disease (CD) and explore their role in disease recurrence following induction treatment with exclusive enteral nutrition.

Methods
We will profile and quantify biomarkers of dietary intake in 928 banked faecal samples of 116 children with CD collected during the first 30 days of food reintroduction, following successful treatment with exclusive enteral nutrition (EEN), and in spot samples from 53 matched healthy controls. In faecal samples, a wide range of carbohydrates (e.g. galactose, rhamnose, glucose, xylose), polysaccharides (e.g resistant starch) and oligosaccharides (e.g. β-fructans), total nitrogen, as well as nitrogen-containing compounds (e.g. amino acids, dipeptides) will be measured with a combination of 1H-NMR, UHPLC-MS, anion exchange chromatography, the Kjeldahl AOAC method and proprietary kits.
Faecal biomarkers of dietary intake will be associated with risk of disease recurrence (indicated by the rapid rise in faecal calprotectin) during the first 30 days of food reintroduction, following successful treatment with EEN. Next, this study will explore whether identified biomarkers of dietary intake in faeces relate with patients’ actual dietary intake, and whether the two datasets complement or supersede each other in prediction of disease recurrence. Last, we will identify common dietary biomarkers of disease recurrence between two distinct cohorts of patients; one which returned to unrestricted diet, post-EEN, and another which followed a novel exclusion diet (CD-TREAT) for the management of CD.

Anticipated impact
This study has the potential to address one of the most frequently asked questions from patients to healthcare professionals; “What should I eat to control my disease and prevent disease relapse?” Identification of dietary triggers may lead to the development of food reintroduction protocols following EEN completion; hence offering better long-term disease control and improving the quality of life of patients with CD.
Patient and public involvement and engagement to inform an adaptive platform trial using a multi-arm multi-stage (MAMS) approach in Ulcerative colitis and Crohn’s disease
Authors: Radford S 
Published: January 2025

Abstract

Background and aims
There is an abundance of advanced therapies in use in treating IBD. The growing number of available treatments for IBD raises questions of comparative efficacy, safety, treatment strategies and sequences. While head-to-head blinded controlled trials are the ideal method for comparing the efficacy of different drugs, practical limitations make it challenging to conduct multiple trials encompassing all available treatment options. The aim is to explore and define which clinical, endoscopic, imaging, and biochemical outcomes are ‘critical’ and ‘important’ definitions of interim and definitive outcomes to IBD stakeholders

Methods
A mixed methods approach will be used in 4 work packages; setting up expert study team made up of UK based patient experts and IBD Nurses from around Europe to finalise the design of a Delphi survey, Delphi survey to establish critical and important clinical outcome measures as identified by key stakeholders, exploratory qualitative survey will be used to capture deeper meaning and understanding of some of the contextual factors around the answers given to the Delphi survey and a final consensus meeting for stakeholders to bring together all findings and the key outcome set for a MAMS trial of advanced therapies in IBD will be defined.

Anticipated impact
A definitive list of stakeholder-identified critical and important clinical outcomes for IBD therapy and downstream research design.