Appropriateness of small molecule agents for patients with IBD of childbearing age - a RAND/UCLA appropriateness panel.

Background: Many women of childbearing age with inflammatory bowel disease (IBD) require advanced therapies. While biologics are largely low risk during pregnancy, the novel small molecules tofacitinib, filgotinib, upadacitinib and ozanimod (TFUO) have shown concerning teratogenic effects, and decreased fertility in animal studies. Therefore, their use in women of childbearing age needs careful consideration.

Realization of a gas puff imaging system on the Wendelstein 7-X stellarator.

A system for studying the spatiotemporal dynamics of fluctuations in the boundary of the W7-X plasma using the "Gas-Puff Imaging" (GPI) technique has been designed, constructed, installed, and operated. This GPI system addresses a number of challenges specific to long-pulse superconducting devices, such as W7-X, including the long distance between the plasma and the vacuum vessel wall, the long distance between the plasma and diagnostic ports, the range of last closed flux surface (LCFS) locations for different magnetic configurations in W7-X, and management of heat loads on the system's plasma-facing components. The system features a pair of "converging-diverging" nozzles for partially collimating the gas puffed locally ≈135 mm radially outboard of the plasma boundary, a pop-up turning mirror for viewing the gas puff emission from the side (which also acts as a shutter for the re-entrant vacuum window), and a high-throughput optical system that collects visible emission resulting from the interaction between the puffed gas and the plasma and directs it along a water-cooled re-entrant tube directly onto the 8 × 16 pixel detector array of the fast camera.

Heavy ion beam probe for Wendelstein 7-X measurement capabilities as projected through its design.

A heavy ion beam probe (HIBP) diagnostic is being developed for studies of plasma equilibrium and turbulence in the optimized Wendelstein 7-X (W7-X) stellarator. Operation of W7-X has experimentally demonstrated that its optimized magnetic field results in improved neoclassical particle confinement and, as a result, turbulence is the predominant cause of energy transport. The HIBP will have the unique ability to provide experimental data needed to complement models of both neoclassical and turbulent transport.

First-trimester exposure to tofacitinib in ulcerative colitis: A case report of a healthy newborn and literature review.

Tofacitinib is contraindicated in pregnancy. We present a patient with ulcerative colitis on tofacitinib who had an unplanned pregnancy. Tofacitinib was ceased, switched to vedolizumab, and she gave birth to a healthy newborn at term.

Reproductive Safety Issues of Novel Small Molecules for the Treatment of Inflammatory Bowel Disease: A Systematic Review.

Maintenance of remission during pregnancy is vital for women with inflammatory bowel disease (IBD). The antenatal safety of novel small molecules for IBD is yet to be ascertained. We aimed to describe the current evidence on reproductive data regarding small-molecule drugs.

Planning to conceive within a year is associated with better pregnancy-specific disease-related patient knowledge and better medication adherence in women of childbearing age with inflammatory bowel disease.

Background: Adherence to inflammatory bowel disease (IBD) medication is crucial to maintain remission, especially during pregnancy.

Objective: To examine the influence of family planning and pregnancy-related patient knowledge regarding IBD and pregnancy on adherence.

Design: Cross-sectional survey study.

Australian inflammatory bowel disease consensus statements for preconception, pregnancy and breast feeding.

Objective: Because pregnancy outcomes tend to be worse in women with inflammatory bowel disease (IBD) than in those without, we aimed to update consensus statements that guide the clinical management of pregnancy in patients with IBD.

Design: A multidisciplinary working group was established to formulate these consensus statements. A modified RAND/UCLA appropriateness method was used, consisting of a literature review, online voting, discussion meeting and a second round of voting.

Medication adherence in women with IBD of childbearing age likely associated with disease knowledge.

Background: Medication adherence in inflammatory bowel disease (IBD) is crucial, particularly during pregnancy. Unplanned pregnancies are common; therefore, efforts to maximise adherence should not be restricted to pregnant women.

Objectives: We aimed to assess medication adherence in women with IBD of childbearing age, regardless of their reproduction plans.

Conceptual design of a heavy ion beam probe diagnostic for the Wendelstein 7-X Stellarator.

This article describes the current state of the design of the heavy ion beam probe (HIBP) for Wendelstein 7-X (W7-X). It will be the first HIBP diagnostic on an optimized stellarator and is designed to study electric fields and ion scale turbulence in all W7-X reference magnetic configurations. The use of an existing 2 MV accelerator, located outside of the torus hall, results in the need for a circuitous primary beamline.

Selective internal radiation therapy for hepatocellular carcinoma: A 15-year multicenter Australian cohort study.

Background And Aim: The exact place for selective internal radiation therapy (SIRT) in the therapeutic algorithm for hepatocellular carcinoma (HCC) is debated. There are limited data on its indications, efficacy, and safety in Australia.

Methods: We performed a multicenter retrospective cohort study of patients undergoing SIRT for HCC in all Sydney hospitals between 2005 and 2019.

Managing Inflammatory Bowel Disease in Pregnancy: Health Care Professionals' Involvement, Knowledge, and Decision Making.

Background: The management of pregnant women with inflammatory bowel disease (IBD) is complex. We aimed to assess health care professionals' (HCPs) theoretical and applied knowledge of pregnancy-related IBD issues.

Methods: A cross-sectional international survey was distributed to HCPs providing IBD care between October 2020 and March 2021.

Gastroenterology team members' knowledge and practices with fertility therapy for women with inflammatory bowel disease.

Introduction: Fecundity may be reduced in women with active inflammatory bowel disease (IBD) or prior IBD-related surgery, and these women may require assisted reproductive technology (ART). There are no guidelines for women with IBD to outline referral criteria for ART.

Methods: We performed a prospective, multicentre, international questionnaire of gastroenterologists, gastroenterology trainees, and IBD nurses.

A method to estimate probability of disease and vaccine efficacy from clinical trial immunogenicity data.

Vaccine efficacy is often assessed by counting disease cases in a clinical trial. A new quantitative framework proposed here ("PoDBAY," Probability of Disease Bayesian Analysis), estimates vaccine efficacy (and confidence interval) using immune response biomarker data collected shortly after vaccination. Given a biomarker associated with protection, PoDBAY describes the relationship between biomarker and probability of disease as a sigmoid probability of disease ("PoD") curve.

Assisted Reproductive Technology in Crohn's Disease and Ulcerative Colitis: A Systematic Review and Meta-Analysis.

Introduction: Infertility may occur in women with Crohn's disease (CD) and ulcerative colitis (UC), especially after surgery such as ileal pouch-anal anastomosis (IPAA). Assisted reproductive technology (ART) may be an option, but the safety and efficacy in this setting has been based on small cohorts to date. We performed a systematic review and meta-analysis to address this data gap.

Review of pregnancy in Crohn's disease and ulcerative colitis.

Inflammatory bowel disease (IBD) frequently affects women of childbearing age and can have implications in pregnancy. Most women with IBD have comparable fertility with women in the general population. Fertility is reduced in women with active disease or previous ileal-pouch-anal anastomosis (IPAA) surgery and is temporarily reduced in men taking sulfasalazine.

Palliative medicine referrals for hepatocellular carcinoma: a national survey of gastroenterologists.

Objectives: Palliative care (PC) service involvement for hepatocellular carcinoma (HCC) patients is suboptimal and little is known about the underlying reasons for this. We aimed to study clinicians' experience and attitudes towards PC in HCC.

Methods: A nationwide survey was conducted of consultants/trainees recruited from the Gastroenterological Society of Australia membership directory.

Use of medications during pregnancy and breastfeeding for Crohn's disease and ulcerative colitis.

: The peak age of diagnosis of inflammatory bowel disease (IBD) occurs during childbearing years, therefore management of IBD during pregnancy is a frequent occurrence. Maintenance of disease remission is crucial to optimize pregnancy outcomes, and potential maternal or fetal toxicity from medications must be balanced against the risks of untreated IBD.: This review summarizes the literature on safety and use of medications for IBD during pregnancy and lactation.

Prevalence and Risk Factors for Bilateral Meniscal Tears Identified during Treatment for Cranial Cruciate Ligament Disease Via Tibial Plateau Levelling Osteotomy in Dogs.

Objective:  The aim of this study was to report the prevalence and risk factors of bilateral meniscal tears during a tibial plateau levelling osteotomy (TPLO).

Methods:  Data from 362 dogs that underwent staged or simultaneous TPLO between January 2006 and April 2019 were retrospectively collected. Variables such as breed, sex, weight change and intervals between surgeries were analysed with logistic regression.

Palliative care in hepatocellular carcinoma.

Hepatocellular carcinoma is a common cancer with a poor prognosis, associated with high economic costs and a significant burden of disease. While it is often asymptomatic in the early stages, patients may experience great discomfort from advanced disease, treatment adverse effects, or decompensation of underlying cirrhosis. Palliative care has the potential to markedly improve quality of life, physical, and psychological symptoms in patients with end-stage liver disease, and has been shown to prolong survival in some nonhepatocellular carcinoma malignancies.

Knowledge and Attitudes Towards Pregnancy in Females with Inflammatory Bowel Disease: An International, Multi-centre Study.

Background And Aims: Poor knowledge of inflammatory bowel disease [IBD] in pregnancy underlies unwarranted voluntary childlessness [VC], and risks poorer obstetric outcomes and adverse fetal outcomes. IBD is increasing worldwide but education on IBD issues might be heterogeneous based on cultural differences and variations in models of care.

Methods: Consecutive female IBD subjects aged 18-45 years were prospectively recruited from two dedicated IBD-pregnancy clinics, two multidisciplinary IBD clinics and nine general gastroenterology clinics.