P1185 IBD Has No Age: Preliminary results of an international survey among older patients with Inflammatory Bowel Disease (IBD)

Background Future research and health policy can benefit from a better understanding of the characteristics of a globally growing, but often underrepresented, older population with Inflammatory Bowel Disease (IBD). The aim is to evaluate the characteristics of this population, including frailty, comorbidity, and reported therapy goals through a survey. Methods An international, anonymous online survey was conducted among older patients (aged ≥ 60 years) with Crohn’s disease (CD), ulcerative colitis (UC) and IBD-unclassified (IBD-U). The survey was developed by the European Federation of Crohn’s and Ulcerative Colitis Associations (EFCCA), translated in 21 languages and distributed in 46 countries through national IBD associations affiliated with the EFCCA. The survey contained questions about demographic- and IBD characteristics, IBD-therapy and symptoms. Clinical disease activity was assessed by the Harvey-Bradshaw Index (HBI) (>= 4) for CD, and 6-point Mayo score (≥ 1.5) for UC and IBD-U. Self-reported versions of the Geriatric-8 (G8) questionnaire and Charlson Comorbidity Index were included to assess frailty (G8 ≤ 14) and comorbidity, respectively. Respondents were asked to choose three out of the following 12 therapy goals they considered most important: to experience less abdominal pain, decrease inflammation, prevent/postpone IBD surgery, not feel fatigued, stop using corticosteroids, decrease diarrhea/incontinence, maintain or get to their preferred weight, be comfortable with their body image, or to preserve/restore their mobility, social life, good mood or sexual activity. Descriptive analyses were performed using R, version 4.3. Results Out of 2191 respondents, 1785 (81.4%) completed the survey for the variables of interest and were retained for analyses. Respondents were mainly from the Netherlands (47.2%), Norway (9.1%) and Italy (8.4%). Mean age was 67.3 years (Standard Deviation (SD) 5.9), 61% was female, and 58.1% was retired. The most common type of IBD was CD (50.9%). Clinical disease activity was found in 33% of respondents. Therapy with aminosalicylates was most common among patients with UC (58%), biological therapy among patients with CD (44%). Frailty was reported by 39% of respondents and 64% of respondents reported to have one or more comorbidities. Three therapy goals that were most frequently reported were: to not feel fatigued (56.1%), to be of good mood (42.2%) and decrease in diarrhea/incontinence (31.1%). Conclusion Preliminary results from the "IBD Has No Age" survey suggest that it will contribute a wealth of knowledge to the IBD landscape, providing insight in a range of IBD characteristics, frailty, comorbidity and therapy goals in an older population with IBD

Investigating the impact of exopolysaccharides on yogurt network mechanics and syneresis through quantitative microstructural analysis

Exopolysaccharides produced by lactic acid bacteria are widely used to improve the sensory properties of yogurt. The relation between the physical properties of the microbial exopolysaccharides and the structural and rheological properties of the yogurt are incompletely understood to date. To address this knowledge gap, we studied how two distinct exopolysaccharides influence the microstructure, rheological properties, and syneresis of yogurt. The effect of a negatively charged, capsular exopolysaccharide produced by Streptococcus thermophilus and a neutral, non-capsular exopolysaccharide produced by Lactococcus lactis were investigated. Using quantitative microstructural analysis, we examined yogurt samples prepared with either the capsular or the non-capsular exopolysaccharide, and with mixtures of the two. Confocal laser scanning microscopy and stimulated emission depletion microscopy were employed to visualize the microstructures, revealing differences in pore size distribution, protein domain size, and casein interconnectivity that were not apparent through visual inspection alone. Additionally, variations in rheological properties were observed among the different yogurt types. In the yogurt fermented with both bacterial strains, we observed a combined impact of the two exopolysaccharide types on relevant microstructural and rheological properties. The negatively charged capsular exopolysaccharide enhanced casein interconnectivity and gel stiffness, while the neutral non-capsular exopolysaccharide led to thicker protein domains, an abundance of small pores, and a lower loss tangent. These factors collectively hindered syneresis, resulting in improved structural integrity. Our study not only provides valuable insights into the influence of different exopolysaccharides on yogurt properties, but also presents the first demonstration and quantification of the effect of multiple types of exopolysaccharides on casein interconnectivity. These findings offer guidance for the production of yogurts with customized microstructure, rheological properties, and resistance to syneresis.<br/

Reduced order modeling of non-linear monopile dynamics via an AE-LSTM scheme

Non-linear analysis is of increasing importance in wind energy engineering as a result of their exposure in extreme conditions and the ever-increasing size and slenderness of wind turbines. Whilst modern computing capabilities facilitate execution of complex analyses, certain applications which require multiple or real-time analyses remain a challenge, motivating adoption of accelerated computing schemes, such as reduced order modelling (ROM) methods. Soil structure interaction (SSI) simulations fall in this class of problems, with the non-linear restoring force significantly affecting the dynamic behaviour of the turbine. In this work, we propose a ROM approach to the SSI problem using a recently developed ROM methodology. We exploit a data-driven non-linear ROM methodology coupling an autoencoder with long short-term memory (LSTM) neural networks. The ROM is trained to emulate a steel monopile foundation constrained by non-linear soil and subject to forces and moments at the top of the foundation, which represent the equivalent loading of an operating turbine under wind and wave forcing. The ROM well approximates the time domain and frequency domain response of the Full Order Model (FOM) over a range of different wind and wave loading regimes, whilst reducing the computational toll by a factor of 300. We further propose an error metric for capturing isolated failure instances of the ROM

Teaching reading strategies in science and social sciences in secondary education

Teaching and Teacher Learning (ICLON

Control of the tokamak safety factor profile with time-varying constraints using MPC

A controller is designed for the tokamak safety factor profile that takes real-time-varying operational and physics limits into account. This so-called model predictive controller (MPC) employs a prediction model in order to compute optimal control inputs that satisfy the given limits. The use of linearized models around a reference trajectory results in a quadratic programming problem that can easily be solved online. The performance of the controller is analysed in a set of ITER L-mode scenarios simulated with the non-linear plasma transport code RAPTOR. It is shown that the controller can reduce the tracking error due to an overestimation or underestimation of the modelled transport, while making a trade-off between residual error and amount of controller action. It is also shown that the controller can account for a sudden decrease in the available actuator power, while providing warnings ahead of time about expected violations of operational and physics limits. This controller can be extended and implemented in existing tokamaks in the near future.</p

Describing the profile of diagnostic features in autistic adults using an abbreviated version of the Diagnostic Interview for Social and Communication Disorders (DISCO-Abbreviated)

The rate of diagnosis of autism in adults has increased over recent years; however, the profile of behaviours in these individuals is less understood than the profile seen in those diagnosed in childhood. Better understanding of this profile will be essential to identify and remove potential barriers to diagnosis. Using an abbreviated form of the Diagnostic Interview for Social and Communication Disorders, comparisons were drawn between the profile of a sample of able adults diagnosed in adulthood and the profile of a sample of able children. Results revealed both similarities and differences. A relative strength in non-verbal communication highlighted a potential barrier to diagnosis according to DSM-5 criteria for the adult sample, which may also have prevented them from being diagnosed as children

Comorbidity, not patient age, is associated with impaired safety outcomes in vedolizumab- and ustekinumab-treated patients with inflammatory bowel disease-a prospective multicentre cohort study

Background: Few data are available on the effects of age and comorbidity on treatment outcomes of vedolizumab and ustekinumab in inflammatory bowel disease (IBD). Aims: To evaluate the association between age and comorbidity with safety and effectiveness outcomes of vedolizumab and ustekinumab in IBD. Methods: IBD patients initiating vedolizumab or ustekinumab in regular care were enrolled prospectively. Comorbidity prevalence was assessed using the Charlson Comorbidity Index (CCI). Association between age and CCI, both continuously assessed, with safety outcomes (any infection, hospitalisation, adverse events) during treatment, and effectiveness outcomes (clinical response and remission, corticosteroid-free remission, clinical remission combined with biochemical remission) after 52 weeks of treatment were evaluated. Multivariable logistic regression was used to adjust for confounders. Results: We included 203 vedolizumab- and 207 ustekinumab-treated IBD patients, mean age 42.2 (SD 16.0) and 41.6 (SD 14.4). Median treatment duration 54.0 (IQR 19.9-104.0) and 48.4 (IQR 24.4-55.1) weeks, median follow-up time 104.0 (IQR 103.1-104.0) and 52.0 weeks (IQR 49.3-100.4). On vedolizumab, CCI associated independently with any infection (OR 1.387, 95% CI 1.022-1.883, P = 0.036) and hospitalisation (OR 1.586, 95% CI 1.127-2.231, P = 0.008). On ustekinumab, CCI associated independently with hospitalisation (OR 1.621, 95% CI 1.034-2.541, P = 0.035). CCI was not associated with effectiveness, and age was not associated with any outcomes. Conclusions: Comorbidity - but not age - is associated with an increased risk of hospitalisations on either treatment, and with any infection on vedolizumab. This underlines the importance of comorbidity assessment and safety monitoring of IBD patients

Intraduodenal Administration of Intact Pea Protein Effectively Reduces Food Intake in Both Lean and Obese Male Subjects

BACKGROUND: Human duodenal mucosa secretes increased levels of satiety signals upon exposure to intact protein. However, after oral protein ingestion, gastric digestion leaves little intact proteins to enter the duodenum. This study investigated whether bypassing the stomach, through intraduodenal administration, affects hormone release and food-intake to a larger extent than orally administered protein in both lean and obese subjects. METHODS: Ten lean (BMI:23.0±0.7 kg/m²) and ten obese (BMI:33.4±1.4 kg/m²) healthy male subjects were included. All subjects randomly received either pea protein solutions (250 mg/kg bodyweight in 0.4 ml/kg bodyweight of water) or placebo (0.4 ml/kg bodyweight of water), either orally or intraduodenally via a naso-duodenal tube. Appetite-profile, plasma GLP-1, CCK, and PYY concentrations were determined over a 2 h period. After 2 h, subjects received an ad-libitum meal and food-intake was recorded. RESULTS: CCK levels were increased at 10(p<0.02) and 20(p<0.01) minutes after intraduodenal protein administration (IPA), in obese subjects, compared to lean subjects, but also compared to oral protein administration (OPA)(p<0.04). GLP-1 levels increased after IPA in obese subjects after 90(p<0.02) to 120(p<0.01) minutes, compared to OPA. Food-intake was reduced after IPA both in lean and obese subjects (-168.9±40 kcal (p<0.01) and -298.2±44 kcal (p<0.01), respectively), compared to placebo. Also, in obese subjects, food-intake was decreased after IPA (-132.6±42 kcal; p<0.01), compared to OPA. CONCLUSIONS: Prevention of gastric proteolysis through bypassing the stomach effectively reduces food intake, and seems to affect obese subjects to a greater extent than lean subjects. Enteric coating of intact protein supplements may provide an effective dietary strategy in the prevention/treatment of obesity

Langmuir probe electronics upgrade on the tokamak a configuration variable

A detailed description of the Langmuir probe electronics upgrade for TCV (Tokamak a Configuration Variable) is presented. The number of amplifiers and corresponding electronics has been increased from 48 to 120 in order to simultaneously connect all of the 114 Langmuir probes currently mounted in the TCV divertor and main-wall tiles. Another set of 108 amplifiers is ready to be installed in order to connect 80 new probes, built in the frame of the TCV divertor upgrade. Technical details of the amplifier circuitry are discussed as well as improvements over the first generation of amplifiers developed at SPC (formerly CRPP) in 1993/1994 and over the second generation developed in 2012/2013. While the new amplifiers have been operated successfully for over a year, it was found that their silicon power transistors can be damaged during some off-normal plasma events. Possible solutions are discussed. (C) 2019 Author(s)