bluuebunny/crossref_metadata_2025_split huggingface dataset:
LONGITUDINAL STUDY OF THE IMPACT OF HEALTH CONFIDENCE ON INFLAMMATORY BOWEL DISEASE OUTCOMES AND HEALTHCARE UTILIZATION
Authors: Tse Chung Sang , Melmed Gil , Weng Chien-Hsiang , Shah Samir , Weaver Alandra , Oliver Brant , Elwyn Glyn , Siegel Corey , van Deen Welmoed 
Published: January 2022

Abstract

INTRODUCTION
A growing body of data from the primary care population demonstrates that health confidence (a patient’s belief of their ability and agency to manage their disease and impact the disease course) is an important psychosocial factor associated with chronic disease outcomes (e.g., blood pressure and glycemic control) and emergency department [ED] visits.[1] Health confidence has also been shown to be associated with inflammatory bowel disease (IBD) symptomatic burden, general well-being, and healthcare utilization.[2] We aim to explore factors that influence health confidence and examine its impact on IBD disease outcome and healthcare utilization in a longitudinal, multi-institutional cohort of adults with IBD.

METHODS
We surveyed adults (age &gt;18) with IBD and their GI providers (verified IBD diagnosis phenotype) at 11 GI clinics across the U.S. as part of the Crohn’s and Colitis Foundation’s IBD Qorus Learning Health System. Included patients reported health confidence, disease activity, and healthcare utilization at baseline and on follow-up 6-12 months thereafter between 2018 and 2021. Health confidence was assessed using the validated Wasson’s health confidence Likert scale from 0 (‘not confident at all’) to 10 (‘very confident’).[1] We identified patient characteristics associated with health confidence using the Kruskal-Wallis test. A Fisher’s exact test was used to examine the associations between baseline low vs high health confidence (score &lt;8 vs ≥8) and adverse IBD outcomes. P&lt;.05 was considered statistically significant.

RESULTS
Adults with IBD (n=327; 62% Crohn’s disease, 35% ulcerative colitis; 47% in remission) had a median baseline health confidence score of 8 (IQR 7-10; Table 1). Patients with low health confidence (score &lt;8; n=197, 60%) were more likely to have active IBD (p&lt;.0001), use opioids (p=.0001), and have had an ED visit in the preceding 6 months (p=.04; Table 1). Notably, in the subsequent 6-12 months, patients with low baseline health confidence were more likely to have a CT scan (87% vs 13%, p=.03) and be on opioids (100% vs 0%, p=0.02) (Table 2). A higher proportion of patients with low baseline health confidence used steroids (91% vs 9%), had an ED visit (88% vs 11%), and were hospitalized (91% vs 9%) 6-12 months thereafter, though these differences did not reach statistical significance (Table 2).

CONCLUSION
Symptomatically active disease and ED visits may undermine patients’ confidence to manage their disease, which in turn increases the frequency of subsequent radiographic diagnostic testing. Opioid use was correlated with low health confidence both as a predictor and outcome in this cohort.

REFERENCES
1. Wasson, J. et al. Family practice management 21.5 (2014): 8-12.
2. Tse, C. S., et al. Gastroenterology 160.6 (2021): S-58.
PROMOTING AT-HOME DISEASE MANAGEMENT OF IBD WITH A MULTIDISCIPLINARY DIGITAL THERAPY APP: SHORT-TERM RESULTS
Authors: Pater Roeland , Zentveld Dandyano , Booth Lisa 
Published: January 2022

Abstract

BACKGROUND
Although current concepts of disease management of Crohn’s Disease and ulcerative colitis (IBD) provide evidence of active engagement of patients, such a strategy is difficult to comply with unless multidisciplinary therapy is practiced.
In the past years mobile and/or digital health solutions have proven to be competent tools to promote and retain self management for patients across many disease areas.
The Nori Health mobile application was developed as multi-faceted digital therapy for IBD based on existing evidence in at-home management and treatment with the aim to accommodate multidisciplinary therapy remotely.

OBJECTIVE
The objective of this paper was to report on the retrospective short-term results of a multidisciplinary digital therapy app for the treatment and self-management of IBD; Nori Health.

METHODS
Nori Health is a mobile application that digitalizes multidisciplinary therapy, such as education, behavioral intervention and cognitive behavioral therapy (CBT), and is in the market as a CE class I medical device.
For the current study, the internal data of anonymized Nori Health users was retrospectively analyzed. User data was evaluated for 8 weeks regarding duration of use (Figures 1, 2) and effect on in-app user reported disease management levels, using the short IBD Control questionnaire (IBD-CONTROL).

RESULTS
Data of 273 users were available, of which 29 users completed the IBD-CONTROL questionnaire both prior and after the duration of the analysis period. The gender of the users was 61% female and 39% male.
Disease management levels increased 34% from baseline 50 to 67 for all users at the end of the observation period.

CONCLUSION
This retrospective study showed that in a randomized population of app users, an app digitalizing multidisciplinary interventions for the self-management of IBD improved user-reported disease management levels significantly.
Additional RCTs will be needed to adjust for selection effects, potential bias, and to further improve clinical relevance of these short-term results.
REDEFINING HEALTHCARE: A NOVEL, SCIENCE-BASED, EXPERIENTIAL FRAMEWORK FOR IMPROVING PATIENT OUTCOMES IN INFLAMMATORY BOWEL DISEASE
Authors: Puckett Amanda , Loftus Amy , Kornfeld Andrew 
Published: January 2022

Abstract
IBD affects 3 million individuals in the US alone but the prevalence is expanding globally. The economic burden of IBD in the US is high, with estimates indicating the combined IBD population in the US is expected to incur a lifetime total cost of over $800 billion. Many current IBD treatments lose effectiveness over time and up to 80% of patients with Crohn’s disease and 20% of patients with Ulcerative Colitis require at least one surgical intervention in their lifetime. Scientific evidence suggests diet, lifestyle factors, and mental health are emerging as key contributors to IBD’s pathogenesis but are often outside of the scope of frontline treatment interventions. Further, patient education is associated with improving outcomes but is not addressed by current treatment strategies. New innovative approaches are needed to improve the efficacy of existing treatments, ease the economic and personal burdens of living with IBD, and address the gaps in existing strategies.
The human-centered framework by IBDCoach is a newly developed and strategic patient-driven system, based on immersive science education and represents a reconceptualization of the IBD healthcare experience (Figures 1 and 2). This framework aims to facilitate seamless patient-doctor interaction, improve compliance to prescribed treatment strategies, empower patients to understand their condition and to develop an effective, well-rounded treatment protocol under the close supervision of their healthcare team, and promote successful behavioral change. The IBDCoach framework combines principles of systems-thinking, experiential scientific education, ancestral health, neuroplasticity and behavioral change, and compassion for the unique human experience of chronic illness to fill the gaps in existing IBD treatment strategies. We report on initial successes observed in the first 100 enrollees of this novel framework, the theory behind the program, and the broader implications for redefining the IBD healthcare landscape with creative solutions.
Figure 1. IBDCoach’s three mechanisms of IBD pathogenesis.

Figure 2. IBDCoach’s key framework steps.
REAL-WORLD UTILIZATION OF ADALIMUMAB BIOSIMILAR (ABP 501) IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN EUROPE
Authors: Jin Ran , Nduka Chidozie , Courmier Delphine , Knight Hannah , Meadows Rachael , Piercy James , Radziszewski Waldemar 
Published: January 2022

Abstract

OBJECTIVE
ABP 501 (AMGEVITA®) was the first approved biosimilar to adalimumab reference product (RP) by the European Medicines Agency and has been marketed in the European Union since 2018. Additional real-world data on its efficacy and safety, particularly for treating patients with inflammatory bowel disease (IBD), an indication approved on the basis of extrapolation, has the possibility of addressing barriers to utilization.

METHODS
This was a retrospective analysis of data collected between April and June 2021 from the Adelphi IBD Disease Specific Programme (DSP) covering ulcerative colitis (UC) and Crohn’s disease (CD) in Germany, France, Spain, Italy, and United Kingdom. Gastroenterologists provided data on demographics, clinical characteristics, treatment history, and treatment satisfaction. Patients had the option to complete the short IBD questionnaire (SIBDQ) aimed at measuring the burden of disease, work productivity and activity impairment (WPAI) questionnaire, and to indicate their assessment of treatment satisfaction. Descriptive analyses were conducted; continuous variables were reported as means or medians, categorical variables as number of patients and percentages.

RESULTS
82 physicians reported data on 396 patients (189 UC and 207 CD): 239 initiated ABP 501 as first advanced therapy (AT) (initiators), 157 switched to ABP 501 from RP with no prior use of other AT (switchers) (Table). Median time from IBD diagnosis to initiation of ABP 501 was 13.9 months for initiators with median time on ABP 501 being 7.5 months at the time of data collection. Switchers previously received RP for a median of 14.1 months and had been on ABP 501 for a median time of 7.7 months since switching. The main reasons for switching from RP to ABP 501 were related to the potential to lower healthcare cost. At the time of reporting, more than two-thirds (67% initiators, 83% switchers) had mild disease, more than three-quarters were in clinical remission (74% initiators, 88% switchers), and a majority were in improving or stable disease status (96% initiators, 98% switchers). Mean SIBDQ scores (56 vs. 59) and overall work impairment (4.7% vs. 3.2%) were similar across initiators and switchers, respectively. Physicians and patients (&gt;90% each of initiators and switchers) reported being satisfied with current treatment with ABP 501.

CONCLUSION
ABP 501 was used as initial or continuing adalimumab therapy in the real-world setting to treat patients with IBD. At least three-fourths of patients currently on ABP 501 were in clinical remission, with a higher proportion in the switching group. Both physicians and patients reported very high levels of satisfaction with treatment.
VEDOLIZUMAB FOR REFRACTORY MICROSCOPIC COLITIS: A CASE SERIES
Authors: Dawoud Nabila , Fein Aaron , Elkammar Mahmoud , Eltaher Mohamed , Barrett Terrence , Perry Courtney 
Published: January 2022

Abstract

INTRODUCTION
Microscopic colitis (MC) is a chronic inflammatory disease of the colon that causes non-bloody, watery diarrhea occurs up to 15 times daily in the presence of normal-appearing mucosa in the colon. There are two main subtypes of MC based on histopathologic features, collagenous colitis (CC) and lymphocytic colitis (LC)1. Treatment of each subtype is similar and should be determined by the severity of symptoms. Some patients suffer severe symptoms despite maximum dosage of budesonide, in these cases biologic therapies should be considered. Vedolizumab, a monoclonal antibody that targets α4β7-integrin, is a gut-specific biologic with an exceptional safety profile. Here, we report our experience with vedolizumab for severe, refractory MC.

METHODS
Eleven patients presenting to the University of Kentucky with severe microscopic colitis refractory to maximum budesonide and Imodium therapy were treated with vedolizumab. Vedolizumab was given at standard induction dosing (300mg IV at week 0, 2 and 6, and then every 8 weeks).

RESULTS
Of the eleven patients included in this study, seven reported subjective symptomatic improvement on vedolizumab monotherapy, with four patients attaining less than 3 stools per day. Of the remaining four patients, one continues to do well on vedolizumab and budesonide combination therapy while another developed a rash after vedolizumab induction and treatment was stopped. The third patient was transitioned from vedolizumab to adalimumab and is now well controlled symptomatically and the final patient has not reached symptomatic remission of her disease. Interestingly, of the seven patients who displayed symptomatic improvement with vedolizumab monotherapy, 5/7 patients also showed improvement in albumin levels.

DISCUSSION
Vedolizumab use in refractory microscopic colitis is increasingly recognized as a conceivable therapy for symptomatic improvement and disease remission. Our case series corroborates these findings, as the majority of our patients reported overall improved quality of life. Vedolizumab binds to the α4β7-integrin and prevent adhesion to its ligand, MAdCAM-1, which causes downstream prevention of T-cell adhesion. Although the exact pathophysiology of microscopic colitis remains largely unidentified, it has been postulated that exposure to a luminal antigen may trigger an inflammatory cascade, leading to activation of CD8 T suppressor cells that attack and cause luminal damage to enterocytes2. This hypothesis is supported by vedolizumab’s mechanism of action and proposed efficacy in MC. Due to low volume studies, the data supporting vedolizumab use in refractory microscopic colitis remains limited, and further studies are needed to elucidate the its potential as a first-line therapy. However, based on our experience, we recommend considering vedolizumab for patients suffering from refractory MC.
The Impact of Frequent SARS-CoV-2 Testing on Weekly Case Rates Among Long-Term Care Facilities in Florida
Authors: Allan-Blitz Lao-Tzu , Aboabdo Belal , Turner Isaac , Klausner Jeffrey D. 
Published: January 2022

AbstractSARS-CoV-2 testing frequency may be as important as test performance for disease control. We analyzed 1,292,165 SARS-CoV-2 test results among 361 long-term care facilities across Florida after implementing twice monthly testing (June 2020-April 2021). Our findings demonstrate that an increase in testing frequency reduced weekly case rates.
Regulation of balanced root fungal community of Vanda falcata (Orchidaceae) by partitioning its mycorrhizal fungi and ascomycetous fungi across growth and development
Authors: Pujasatria Galih Chersy , Nishiguchi Ikuo , Miura Chihiro , Yamato Masahide , Kaminaka Hironori 
Published: January 2022

AbstractEpiphytic orchids are commonly found in exposed environments, which plausibly lead to different root fungal community structures from terrestrial orchids. Until recently, no studies have been conducted to show the fungal community structure during the growth of a photosynthetic and epiphytic orchid in its natural growing state. In this study, the Vanda falcata (commonly known as Neofinetia falcata), one of Japan’s ornamental orchids, was used to characterize the fungal community structure at different developmental stages. Amplicon sequencing analysis showed that all development stages contain a similar fungal community: Ascomycota dominates half of the community while one-third of the community is Basidiomycota. Rhizoctonia-like fungi, a term to group the most common basidiomycetous fungi that form orchid mycorrhiza, exist even in a smaller portion (around a quarter) compared to other Basidiomycota members. While ascomycetous fungi exhibit pathogenicity, two Ceratobasidium strains isolated from young and adult plants could initiate seed germination in vitro. It was also found that the colonization of mycorrhizal fungi was concentrated in the lower part of the root where it directly attaches to the phorophyte bark, while ascomycetous fungi were distributed in the velamen but never colonized cortical cells. Additionally, lower root parts attached to the bark have denser exodermal passage cells, and these cells were colonized only by mycorrhizal fungi that further infiltrated the cortical area. Therefore, we propose that physical regulation of fungal entry to partition the ascomycetes and mycorrhizal fungi results in the balanced mycorrhizal symbiosis in this orchid.
Hummingbird blood traits track oxygen availability across space and time
Authors: Williamson Jessie L. , Linck Ethan B. , Bautista Emil , Smiley Ashley , McGuire Jimmy A. , Dudley Robert , Witt Christopher C. 
Published: January 2022

AbstractPredictable trait variation across environmental gradients suggests that adaptive evolution repeatedly finds the same solution to a challenge. Trait-environment associations can reflect long-term, genetic evolution across phylogenies, or short-term, plastic responses of individuals. When phylogenetic and population-level patterns match, it implies consistency between the long timescale of adaptation and the short timescale of acclimatization. Alternatively, genetic adaptation can find solutions that ‘break the rules’ of trait-environment covariation. For example, blood-hemoglobin concentration ([Hb]) increases at high elevations in animals, but genetic adaptations in some populations have been shown to augment tissue oxygenation while curtailing hemoglobin production, altering this predictable [Hb]-elevation association. Here, we tested whether species adaptation to elevation generally alters trait-environment relationships for blood. To do this, we measured blood traits of 1,217 individuals representing 77 species of Andean hummingbirds, across a 4,600 m elevational gradient. We used hierarchical Bayesian modeling to estimate blood trait responses to elevation, environmental temperature, precipitation, individual and species characteristics, and phylogeny. Strikingly, the effects of elevation on [Hb] and hematocrit (Hct) were nearly identical for individuals and species, implying that rules of elevational blood variation are set by physics of gas exchange in the hummingbird respiratory system and are unchanged by species adaptation. However, when we looked at mechanisms of [Hb] adjustment—by changes in red blood cell size or number—we did find a signal of species adaptation: To adjust [Hb], species at low and high elevations, respectively, tended to adjust cell size, whereas species at mid-elevations tended to adjust cell number. Despite scale-independent elevational variation in [Hb] and Hct, the species-specific balance of red blood cell size versus number appears to have been affected by adaptations that distinguish hummingbird species living at moderate versus high elevations.
Urban population structure and dispersal of an Australian mosquito (Aedes notoscriptus) involved in disease transmission
Authors: Paris Véronique , Rane Rahul , Mee Peter , Lynch Stacey , Hoffmann Ary A , Schmidt Thomas L 
Published: January 2022

AbstractDispersal is a critical factor in designing successful pest control measures as it determines the rate of movement across target control areas and influences the risk of human exposure to the species and its pathogens. Here we used a fine scale spatial population genomic approach to investigate the dispersal ecology and population structure ofAedes notoscriptus, an important disease transmitting mosquito, on the Mornington Peninsula near Melbourne, Australia. The species is suspected to be involved in the transmission ofMycobacterium ulcerans, the bacterium that causes Buruli ulcer, in this area. We sampled and rearedAe. notoscriptuseggs at two time points from 170 traps up to 5 km apart and generated genomic data from 240 individuals. We also produced a draft genome assembly from a laboratory colony established from mosquitoes sampled near the study area. We found low genetic structure (Fst) and high coancestry throughout the study region. Using genetic data to identify close kin dyads, we found that mosquitoes had moved distances of >1km within a generation, which is further than previously described for this species. A spatial autocorrelation analysis of genetic distances indicated genetic dissimilarity at >4 km separation, a fourfold higher distance than for a comparable population of the dengue mosquito,Ae. aegypti, from Cairns, Australia. These findings point to high mobility ofAe. notoscriptus, highlighting the challenges of localized intervention strategies targeting this species. Further sampling within the same area at two time points 6 and 12 months after initial sampling showed that egg counts were relatively consistent across time, and that spatial variation in egg counts covaried with spatial variation in Wright’s neighbourhood size (NS). As NS increases linearly with population density, egg counts may be useful for estimating relative density inAe. notoscriptus. The results highlight the importance of acquiring species-specific data when planning control measures.
Temporal trends in legionellosis national notification data and the effect of COVID-19, Switzerland, 2000- 2020
Authors: Fischer Fabienne B. , Mäusezahl Daniel , Wymann Monica N. 
Published: January 2022

AbstractThe notification rate of legionellosis in Switzerland and other European countries has markedly increased over the last 20 years. Here, we investigated the Swiss notification data on legionellosis from 2000-2020 in regards of overall time trend, content and data quality. We further explored the impact of the COVID-19 pandemic on the reported case numbers using an interrupted time series approach. Between 2000 and 2020, 5,980 cases were included in our analysis. The annual crude notification rate for legionellosis cases increased from 1.1/100,000 population (CI: 0.9 - 1.4) in 2000 to 5.6/100,000 population (CI: 5.1 - 6.1) in 2020. In recent years, the summer peaks have been more pronounced and some shifted earlier in the year. The highest notification rate was recorded in 2018 with 6.7/100,000 population (CI: 6.2 - 7.3). The hospitalisation rate for notified cases remained high across all study years (89.9%), while the case fatality rate slightly decreased (from 7.7% to 3.6%). COVID-19 containment measures, such as travel restrictions and/or related behavioural changes, are associated with a temporary decline in cases of 35%. Overall, the quality of the notification data was good. Clinical data were more susceptible to interferences than data from laboratory reporting, which could be observed most clearly in the decline of clinical reports by 4.3 percentage points in 2020. As the case classification for Legionnaires’ disease includes pneumonia symptoms, this decline could lead to an underestimation of Legionnaires’ disease cases, yet the continuous reporting though the diagnostic laboratories suggested a robust surveillance system for legionellosis in Switzerland.