{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:19:54Z","timestamp":1790659194207,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Bubbles often mask the mucosa during capsule endoscopy (CE). Clinical scores assessing the cleanliness and the amount of bubbles in the small bowel (SB) are poorly reproducible unlike machine learning (ML) solutions. We aimed to measure the amount of bubbles with ML algorithms in SB CE recordings, and compare two polyethylene glycol (PEG)-based preparations, with and without simethicone, in patients with obscure gastro-intestinal bleeding (OGIB). Patients &amp; Methods: All consecutive outpatients with OGIB from a tertiary care center received a PEG-based preparation, without or with simethicone, in two different periods. The primary outcome was a difference in the proportions (%) of frames with abundant bubbles (&gt;10%) along the full-length video sequences between the two periods. SB CE recordings were analyzed by a validated computed algorithm based on a grey-level of co-occurrence matrix (GLCM), to assess the abundance of bubbles in each frame. Results: In total, 105 third generation SB CE recordings were analyzed (48 without simethicone and 57 with simethicone-added preparations). A significant association was shown between the use of a simethicone-added preparation and a lower abundance of bubbles along the SB (p = 0.04). A significantly lower proportion of \u201cabundant in bubbles\u201d frames was observed in the fourth quartile (30.5% vs. 20.6%, p = 0.02). There was no significant impact of the use of simethicone in terms of diagnostic yield, SB transit time and completion rate. Conclusion: An accurate and reproducible computed algorithm demonstrated significant decrease in the abundance of bubbles along SB CE recordings, with a marked effect in the last quartile, in patients for whom simethicone had been added in PEG-based preparations, compared to those without simethicone.<\/jats:p>","DOI":"10.3390\/jcm11102822","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T08:34:29Z","timestamp":1652776469000},"page":"2822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation by a Machine Learning System of Two Preparations for Small Bowel Capsule Endoscopy: The BUBS (Burst Unpleasant Bubbles with Simethicone) Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7501-8438","authenticated-orcid":false,"given":"Charles","family":"Houdeville","sequence":"first","affiliation":[{"name":"Sorbonne University, Center for Digestive Endoscopy, Saint-Antoine Hospital, APHP, 75012 Paris, France"},{"name":"\u00c9quipes Traitement de l\u2019Information et Syst\u00e8mes, ETIS UMR 8051, CY Paris Cergy University, ENSEA, CNRS, 95000 Cergy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Leenhardt","sequence":"additional","affiliation":[{"name":"Sorbonne University, Center for Digestive Endoscopy, Saint-Antoine Hospital, APHP, 75012 Paris, France"},{"name":"\u00c9quipes Traitement de l\u2019Information et Syst\u00e8mes, ETIS UMR 8051, CY Paris Cergy University, ENSEA, CNRS, 95000 Cergy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Souchaud","sequence":"additional","affiliation":[{"name":"\u00c9quipes Traitement de l\u2019Information et Syst\u00e8mes, ETIS UMR 8051, CY Paris Cergy University, ENSEA, CNRS, 95000 Cergy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Velut","sequence":"additional","affiliation":[{"name":"Sorbonne University, Center for Digestive Endoscopy, Saint-Antoine Hospital, APHP, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Carbonell","sequence":"additional","affiliation":[{"name":"Sorbonne University, Hepatology Department, Saint Antoine Hospital, APHP, Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Nion-Larmurier","sequence":"additional","affiliation":[{"name":"Sorbonne University, Hepatology, Gastroenterology and Saint Antoine IBD NeTwork, Saint-Antoine Hospital, APHP, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Nuzzo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, IBD and Intestinal Failure, Intestinal Stroke Center, Structure d\u2019Urgences Vasculaires Intestinales (SURVI), Beaujon Hospital, APHP, 92110 Clichy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3029-4412","authenticated-orcid":false,"given":"Aymeric","family":"Histace","sequence":"additional","affiliation":[{"name":"\u00c9quipes Traitement de l\u2019Information et Syst\u00e8mes, ETIS UMR 8051, CY Paris Cergy University, ENSEA, CNRS, 95000 Cergy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Marteau","sequence":"additional","affiliation":[{"name":"Sorbonne University, Department of Hepato-Gastroenterology, Tenon Hospital, APHP, 75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Dray","sequence":"additional","affiliation":[{"name":"Sorbonne University, Center for Digestive Endoscopy, Saint-Antoine Hospital, APHP, 75012 Paris, France"},{"name":"\u00c9quipes Traitement de l\u2019Information et Syst\u00e8mes, ETIS UMR 8051, CY Paris Cergy University, ENSEA, CNRS, 95000 Cergy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1055\/s-0034-1391855","article-title":"Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"47","author":"Pennazio","year":"2015","journal-title":"Endoscopy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1080\/17474124.2017.1359540","article-title":"Systematic review and meta-analysis: Is bowel preparation still necessary in small bowel capsule endoscopy?","volume":"11","author":"Yung","year":"2017","journal-title":"Expert Rev. 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