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BACKGROUND AND AIMS: A key histopathological feature of inflammatory bowel disease is damage to the mucosa, including breakdown of the epithelial barrier. Human enteroids and colonoids are a critical bench-to-bedside tool for studying the epithelium in inflammatory bowel disease. The goal of the current study was to define transcriptional differences in healthy versus diseased subjects that are sustained in enteroids and colonoids, including from disease-spared tissue. METHODS: Biopsies and matching enteroid or colonoid cultures from pediatric patients with ileal Crohn disease (N = 6) and control subjects (N = 17) were subjected to RNA sequencing followed by bioinformatic and machine learning analyses. Late passage enteroids were exposed to cytokines to assess durable transcriptional differences. RESULTS: We observed substantial overlap of pathways upregulated in Crohn disease in enteroids and ileal biopsies, as well as colonoids and rectal biopsies. KEGG pathways for cytokine-cytokine receptor interaction, chemokine signaling, protein export, and Toll-like receptor signaling were upregulated in both ileal and rectal biopsies, as well as enteroids and colonoids. In vitro cytokine exposure reactivated genes previously increased in biopsies. Machine learning predicted biopsy location (100% accuracy) and donor disease status (83% accuracy). A random forest classifier generated using ileal enteroids identified rectal colonoids from ileal Crohn disease subjects with 80% accuracy. CONCLUSION: We confirmed transcriptional profiles of Crohn disease biopsies are expressed in enteroids and colonoids. Furthermore, transcriptomic data from disease-spared rectal tissue can identify patients with ileal Crohn disease. Our data support the use of patient enteroids and colonoids as critical translational tools for the study of inflammatory bowel disease.
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Colonoscopy is an important diagnostic and therapeutic tool in evaluating and treating gastrointestinal tract pathologies. Adequate visualization of the intestinal lumen is necessary for detection of lesions, and thus bowel preparation is a key component of the process. It is estimated that over 25% percent of pediatric patients have sub-optimal bowel preparations, which can lead to longer procedure times, missed pathology, unsuccessful ileal intubation, and possibly repeat procedure/anesthesia. There is no universal protocol for bowel preparation in pediatrics and there is a wide variability of practices around the world. The purpose of this paper is to review the recent published literature regarding bowel preparations for pediatric colonoscopy with focus on published work in the last decade exploring a number of factors involved in bowel preparation including the role of patient education, types of bowel preparation, and their efficacy and safety.
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AIM: The aim of this study was to compare the driving behaviours of four ethnic groups and to investigate the relationship between violations, errors and lapses of DBQ and accident involvement in Qatar. SUBJECTS AND METHODS: The Driver Behaviour Questionnaire (DBQ) was used to measure the aberrant driving behaviours leading to accidents. Of 2400 drivers approached, 1824 drivers agreed to participate (76%) and completed the driver behaviour questionnaire and background information. RESULTS: The study revealed that the majority of the Qatari (35.9%) and Jordanian drivers (37.5%) were below 30 years of age, whereas Filipino (42.3%) and Indian subcontinent (34.1%) drivers were in the age group of 30-39 years. Qatari drivers (52%) were involved in most accidents, followed by Jordanians (48.3%). The most common type of collision was a head on collision, which was similar in all four ethnic groups. The Qatari drivers scored higher on almost all items of violations, errors and lapses compared to other ethnic groups, while Filipino drivers were lower on all the items. The most common violation was the same in all four ethnic groups "Disregard the speed limits on a motorway". The most common error item observed was "Queing to turn right/left on to a main road". "Forget where you left your car" and "Hit something when reversing" were the two lapses identified in factor analysis. CONCLUSION: The present study identified that Qatari drivers scored higher on most of the items of violations, errors and lapses of DBQ compared to other countries, whereas Filipino drivers scored lower in DBQ items.
