Publications by authors named "East J"

Background: Long-standing Inflammatory bowel disease (IBD) increases the risk of colonic neoplasia, necessitating effective screening strategies. This network meta-analysis (NMA) compared the efficacy and safety between different endoscopic modalities in the high-definition (HD) era.

Methods: We searched CENTRAL, ClinicalTrials.

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Introduction: The evolving landscape of inflammatory bowel disease (IBD) necessitates refining colonoscopic surveillance guidelines. This study outlines methodology adopted by the British Society of Gastroenterology (BSG) Guideline Development Group (GDG) for updating IBD colorectal surveillance guidelines.

Methods And Analysis: The 'Grading of Recommendations, Assessment, Development and Evaluation' (GRADE) approach, as outlined in the GRADE handbook, was employed.

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  • The study focuses on the need for an objective method to evaluate and compare different computer-aided detection (CADe) algorithms used in colorectal cancer screening, as their performance varies and no standard exists.
  • A modified Delphi approach was employed, where 25 experts generated and prioritized scoring criteria over eight months, ultimately identifying six key metrics, including sensitivity and adenoma detection rate.
  • The resulting criteria aim to guide the development and improvement of CADe software, with future research suggested to validate these metrics on benchmark video datasets.
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  • Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have a significant risk of developing colorectal cancer, and there's no consensus on the best surveillance methods.
  • A study analyzed 91 patients with PSC and IBD over ten years to evaluate how effective chromoendoscopy and high-definition endoscopy were in detecting neoplastic lesions during regular check-ups.
  • Results showed that chromoendoscopy greatly increased the detection rate of neoplasia (by 5.58 times), while high-definition endoscopy also improved detection, but its significance diminished when factoring in chromoendoscopy.
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  • Patients with inflammatory bowel disease (IBD) face an increased risk of colorectal cancer (CRC), which is heightened for those with low-grade dysplasia (LGD).
  • A study involving 122 patients revealed that the burden of somatic copy number alterations (CNAs) in LGD lesions can significantly predict future cancer development, outperforming traditional clinical risk factors.
  • The research suggests that measuring CNAs in LGD lesions is a cost-effective method for assessing CRC risk, allowing for better management of high-risk patients while reducing unnecessary treatments for those at low risk.
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  • This study investigates the role of inversions—structural variants that involve the rearrangement of DNA—in genetic diseases, using data from 33,924 families involved in the 100,000 Genomes Project.
  • Researchers identified 47 ultra-rare rearrangements, including de novo inversions, in genes linked to disease, with analyses correlating genetic findings to clinical outcomes in some cases, including a specific diagnosis for three family members.
  • The findings suggest that while inversions are less common in genetic diseases compared to other structural variants, they can significantly contribute to the etiology in approximately 1 in 750 families with rare conditions.
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Background: Faecal immunochemical testing (FIT) is recommended by the National Institute for Health and Care Excellence to triage symptomatic primary care patients who have unexplained symptoms but do not meet the criteria for a suspected lower gastrointestinal cancer pathway. During the COVID-19 pandemic, FIT was used to triage patients referred with urgent 2-week wait (2ww) cancer referrals instead of a direct-to-test strategy. FIT-negative patients were assessed and safety netted in a FIT negative clinic.

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  • The study focuses on periprosthetic fractures (PPFs) around the knee, examining patient demographics, fracture types, and treatment methods to assess their effect on in-hospital mortality.
  • A total of 420 patients from a larger database were analyzed, revealing a 6.4% mortality rate; key risk factors included higher ASA grades, peripheral vascular disease, rheumatic disease, and fractures associated with loose implants.
  • Management type did not significantly affect mortality, but surgical interventions led to longer hospital stays and increased likelihood of further surgeries compared to non-operative treatments.
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  • Accurate polyp size estimation is important for clinical decisions, and a new laser-based virtual scale endoscope (VSE) aims to improve measurement accuracy during colonoscopy compared to traditional visual assessment (VA) methods.
  • In a study with 10 expert endoscopists reviewing video sequences of 90 polyps, VSE showed a relative accuracy of 75.1%, outperforming VA at 65.0% and snare-based estimation at 62.0%.
  • The VSE significantly reduced errors in classifying smaller polyps as larger and vice versa, indicating it is more effective than VA or snare methods for accurate size estimation.
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Polyps are well-known cancer precursors identified by colonoscopy. However, variability in their size, appearance, and location makes the detection of polyps challenging. Moreover, colonoscopy surveillance and removal of polyps are highly operator-dependent procedures and occur in a highly complex organ topology.

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Future climate change can cause more days with poor air quality. This could trigger more alerts telling people to stay inside to protect themselves, with potential consequences for health and health equity. Here, we study the change in US air quality alerts over this century due to fine particulate matter (PM), who they may affect, and how they may respond.

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Opioid-induced respiratory depression (OIRD) is the primary cause of death associated with opioids and individuals with obesity are particularly susceptible due to comorbid obstructive sleep apnea (OSA). Repeated exposure to opioids, as in the case of pain management, results in diminished therapeutic effect and/or the need for higher doses to maintain the same effect. With limited means to address the negative impact of repeated exposure it is critical to develop drugs that prevent deaths induced by opioids without reducing beneficial analgesia.

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  • The naked mole rat (NMR) is the longest-living rodent and offers insights into how evolution influences adult stem cell activity as lifespan increases.
  • NMRs exhibit an increased number of intestinal Lgr5 stem cells, which divide more slowly than those in short-lived mice, yet have a similar turnover rate as human LGR5 cells.
  • Instead of entering a resting state, these NMR stem cells slow their division by extending the arrest phase in their cell cycle and possess a higher ratio of differentiated cells that enhance intestinal protection and responsiveness to chemical changes.
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Background And Aims: Inflammatory bowel disease [IBD] is associated with high rates of post-colonoscopy colorectal cancer [PCCRC], but further in-depth qualitative analyses are required to determine whether they result from inadequate surveillance or aggressive IBD cancer evolution.

Methods: All IBD patients who had a colorectal cancer [CRC] diagnosed between January 2015 and July 2019 and a recent [<4 years] surveillance colonoscopy at one of four English hospital trusts underwent root cause analyses as recommended by the World Endoscopy Organisation to identify plausible PCCRC causative factors.

Results: In total, 61% [n = 22/36] of the included IBD CRCs were PCCRCs.

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Introduction: Periprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip.

Methods: Using a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period.

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Background: Lynch syndrome is a hereditary cancer disease resulting in an increased risk of colorectal cancer. Herein, findings are reported from an emergency clinical service implemented during the COVID-19 pandemic utilizing faecal immunochemical testing ('FIT') in Lynch syndrome patients to prioritize colonoscopy while endoscopy services were limited.

Methods: An emergency service protocol was designed to improve colonoscopic surveillance access throughout the COVID-19 pandemic in England for people with Lynch syndrome when services were extremely restricted (1 March 2020 to 31 March 2021) and promoted by the English National Health Service.

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Background And Aims: Endoscopic assessment of disease activity is integral for evaluating treatment response in patients with Crohn's disease (CD). We aimed to define appropriate items for evaluating endoscopic activity and conventions for consistent endoscopic scoring rules in CD.

Methods: A 2-round modified RAND/University of California at Los Angeles Appropriateness Method study was conducted.

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Inflammatory bowel disease encompasses Crohn's disease and ulcerative colitis and is characterized by uncontrolled, relapsing, and remitting course of inflammation in the gastrointestinal tract. Artificial intelligence represents a new era within the field of gastroenterology, and the amount of research surrounding artificial intelligence in patients with inflammatory bowel disease is on the rise. As clinical trial outcomes and treatment targets evolve in inflammatory bowel disease, artificial intelligence may prove as a valuable tool for providing accurate, consistent, and reproducible evaluations of endoscopic appearance and histologic activity, thereby optimizing the diagnosis process and identifying disease severity.

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Screening for colorectal cancer (CRC) is effective in reducing CRC related mortality. Current screening methods include endoscopy based and biomarker based approaches. This guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society of Digestive Endoscopy (APSDE), developed in response to the increasing use of, and accumulating supportive evidence for the role of, non-invasive biomarkers for the diagnosis of CRC and its precursor lesions.

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Artificial intelligence shows promise for clinical research in inflammatory bowel disease endoscopy. Accurate assessment of endoscopic activity is important in clinical practice and inflammatory bowel disease clinical trials. Emerging artificial intelligence technologies can increase efficiency and accuracy of assessing the baseline endoscopic appearance in patients with inflammatory bowel disease and the impact that therapeutic interventions may have on mucosal healing in both of these contexts.

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