Age, Sex, and Socio-Economic Status Affect the Incidence of Pediatric Spinal Cord Injury: An Eleven-Year National Cohort Study

Few studies focus on pediatric spinal cord injury (SCI) and there is little information regarding the cause, anatomic level, and high risk population of SCI in children. This study aims to investigate the incidence and risk factors of pediatric SCI.A nationwide cohort of 8.7 million children aged<18 years in an 11-year period was analyzed for causes, age at injury, anatomic sites, disability, and familial socio-economic factors. Incidence rates and Cox regression analysis were conducted.<0.05).In the pediatric population, the overall SCI incidence rate is 5.99 per 100,000 person-years, with traumatic cervical SCI accounting for the majority. The incidence rate increases abruptly in male teenagers. Gender, age, and socio-economic status are independent risk factors that should be considered

Initially overseen vertebral body luxation: diagnosed by dynamic fluoroscopy due to delayed dysphagia

This study relates to the case report of a neurologically intact 13-year-old boy with unrecognized traumatic bipedicular vertebral fracture. He was diagnosed complete vertebral body luxation 1 day later by dynamic fluoroscopy, then successfully treated with surgery that resulted in total recovery. The delayed diagnosis highlights the importance of detailed initial clinical and radiology examinations, even when overt symptoms as diagnostic indicators of severe neurological sequelae expected in similar traumatic vertebral fractures are lacking. A 13-year-old boy, who met with a minor bicycle accident, was presented with two small forehead lacerations but without pain or clinical neurological symptoms for radiological examination, which showed no abnormalities. The following day, however, the patient complained about dysphagia and underwent dynamic fluoroscopy for the assessment of deglutition that revealed a total block of contrast medium. Computer tomography (CT) of the cervicothoracic junction showed a bipedicular thoracic vertebral fracture and a hooked vertebral body luxation causing mechanical dysphagia but, surprisingly, without compression of the spinal cord. The patient fully recovered after carefully carried out protracted distension and orthopaedic surgery with vertebral fusion.. One year after surgery, the patient had clinically resumed normal function, and CT showed a sufficient vertebral bony consolidation with anatomical alignment. This case exemplifies the importance of careful initial clinical examination and spinal CT after accidents encompassing an increased risk of spinal fractures, even if neurologically unapparent

Textbook research in mathematics education: development status and directions

This paper presents a survey study aiming to systematically examine, analyse and review relevant research focusing on mathematics textbooks and hence identify future directions in this field of research. The literature surveyed is selected from different data sources, including mainly journal articles, research theses and conference proceedings. The survey revealed that important progress has been made over the last few decades in mathematics textbook research, though the major achievement has been concentrated in the areas of textbook analysis (including textbook comparison), and the use of textbooks in teaching and learning. It is overall no longer true that the textbook research in mathematics is “scattered, inconclusive, and often trivial” as described six decades ago; however, the development of research on mathematics textbooks has been unbalanced in different areas. Following the review and discussion, the paper proposes five needed directions for advancing the research in this field

Myo/Nog Cells: Targets for Preventing the Accumulation of Skeletal Muscle-Like Cells in the Human Lens

Posterior capsule opacification (PCO) is a vision impairing condition that arises in some patients following cataract surgery. The fibrotic form of PCO is caused by myofibroblasts that may emerge in the lens years after surgery. In the chick embryo lens, myofibroblasts are derived from Myo/Nog cells that are identified by their expression of the skeletal muscle specific transcription factor MyoD, the bone morphogenetic protein inhibitor Noggin, and the epitope recognized by the G8 monoclonal antibody. The goal of this study was to test the hypothesis that depletion of Myo/Nog cells will prevent the accumulation of myofibroblasts in human lens tissue. Myo/Nog cells were present in anterior, equatorial and bow regions of the human lens, cornea and ciliary processes. In anterior lens tissue removed by capsulorhexis, Myo/Nog cells had synthesized myofibroblast and skeletal muscle proteins, including vimentin, MyoD and sarcomeric myosin. Alpha smooth muscle actin (α-SMA) was detected in a subpopulation of Myo/Nog cells. Areas of the capsule denuded of epithelial cells were surrounded by Myo/Nog cells. Some of these cell free areas contained a wrinkle in the capsule. Depletion of Myo/Nog cells eliminated cells expressing skeletal muscle proteins in 5-day cultures but did not affect cells immunoreactive for beaded filament proteins that accumulate in differentiating lens epithelial cells. Transforming growth factor-betas 1 and 2 that mediate an epithelial-mesenchymal transition, did not induce the expression of skeletal muscle proteins in lens cells following Myo/Nog cell depletion. This study demonstrates that Myo/Nog cells in anterior lens tissue removed from cataract patients have undergone a partial differentiation to skeletal muscle. Myo/Nog cells appear to be the source of skeletal muscle-like cells in explants of human lens tissue. Targeting Myo/Nog cells with the G8 antibody during cataract surgery may reduce the incidence of PCO