Nationwide emergency department visits for pediatric traumatic spinal cord injury in the United States, 2016–2020

IntroductionTraumatic spinal cord injury (tSCI) is a debilitating neurological condition resulting in lifelong disability for many individuals. The primary objectives of our study were to describe national trends in incident emergency department (ED) visits for tSCI among children (less than 21 years) in the United States, and to determine the proportion of visits that resulted in immediate hospitalization each year, including stratified by age and sex. Secondary objectives were to examine associations between select characteristics and hospitalization following tSCI, as well as to assess sports-related tSCIs over time, including by individual sport and geographic region.MethodsWe used the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample to identify ED visits among children between January 2016 and December 2020 for incident tSCI. Diagnosis codes were used to identify tSCI and sports-related injury etiologies. Census Bureau data were used to approximate annual rates of pediatric ED visits for tSCI per 100,000 children. Unconditional logistic regression modeling assessed whether select factors were associated with hospital admission.ResultsWe found that the annual ED visit rate for tSCI remained relatively stable between 2016 and 2020, with approximately 2,200 new all-cause pediatric ED visits for tSCI annually. Roughly 70% of ED visits for tSCI resulted in hospitalization; most ED visits for tSCI were by older children (15–20 years) and males, who were also more often admitted to the hospital. Notable secondary findings included: (a) compared with older children (15–20 years), younger children (10–14 years) were less likely to be hospitalized immediately following an ED visit for tSCI; (b) patient sex and race were not associated with hospital admission; and (c) American tackle football was the leading cause of sports-related ED visits for tSCI among children. Our findings also suggest that the proportion of sports-related tSCI ED visits may have increased in recent years.DiscussionFuture research should further examine trends in the underlying etiologies of pediatric tSCI, while assessing the effectiveness of new and existing interventions aimed at tSCI prevention

Axo-glial interactions between midbrain dopamine neurons and oligodendrocyte lineage cells in the anterior corpus callosum

Oligodendrocyte progenitor cells (OPCs) receive synaptic innervation from glutamatergic and GABAergic axons and can be dynamically regulated by neural activity, resulting in activity-dependent changes in patterns of axon myelination. However, it remains unclear to what extent other types of neurons may innervate OPCs. Here, we provide evidence implicating midbrain dopamine neurons in the innervation of oligodendrocyte lineage cells in the anterior corpus callosum and nearby white matter tracts of male and female adult mice. Dopaminergic axon terminals were identified in the corpus callosum of DAT-Cre mice after injection of an eYFP reporter virus into the midbrain. Furthermore, fast-scan cyclic voltammetry revealed monoaminergic transients in the anterior corpus callosum, consistent with the anatomical findings. Using RNAscope, we further demonstrate that ~ 40% of Olig2 + /Pdfgra + cells and ~ 20% of Olig2 + /Pdgfra- cells in the anterior corpus callosum express Drd1 and Drd2 transcripts. These results suggest that oligodendrocyte lineage cells may respond to dopamine released from midbrain dopamine axons, which could affect myelination. Together, this work broadens our understanding of neuron-glia interactions with important implications for myelin plasticity by identifying midbrain dopamine axons as a potential regulator of corpus callosal oligodendrocyte lineage cells

Small-Group Learning in an Upper-Level University Biology Class Enhances Academic Performance and Student Attitudes Toward Group Work

To improve science learning, science educators' teaching tools need to address two major criteria: teaching practice should mirror our current understanding of the learning process; and science teaching should reflect scientific practice. We designed a small-group learning (SGL) model for a fourth year university neurobiology course using these criteria and studied student achievement and attitude in five course sections encompassing the transition from individual work-based to SGL course design. All students completed daily quizzes/assignments involving analysis of scientific data and the development of scientific models. Students in individual work-based (Individualistic) sections usually worked independently on these assignments, whereas SGL students completed assignments in permanent groups of six. SGL students had significantly higher final exam grades than Individualistic students. The transition to the SGL model was marked by a notable increase in 10th percentile exam grade (Individualistic: 47.5%; Initial SGL: 60%; Refined SGL: 65%), suggesting SGL enhanced achievement among the least prepared students. We also studied student achievement on paired quizzes: quizzes were first completed individually and submitted, and then completed as a group and submitted. The group quiz grade was higher than the individual quiz grade of the highest achiever in each group over the term. All students – even term high achievers –could benefit from the SGL environment. Additionally, entrance and exit surveys demonstrated student attitudes toward SGL were more positive at the end of the Refined SGL course. We assert that SGL is uniquely-positioned to promote effective learning in the science classroom

Secondary complications of spinal cord injury : risk, inter-relationships, and effects on neurological outcomes

Background: Although there have been major advances in acute care following spinal cord injury (SCI), individuals surviving the acute period experience a reduced life expectancy. Historically, acute respiratory and renal dysfunction were the most prevalent complications, and remain important contributors to mortality. However, all-cause cardiovascular disease (CVD) has now emerged as the leading cause of mortality in chronic SCI. Although it has been long speculated that individuals with SCI may be at a higher risk of complications such as CVD, quantitative data are currently limited. Furthermore, the inter-relationships among secondary complications are currently unknown, as is the relationship with changes in neurological function. Objectives: to examine the risk of secondary complications among individuals with SCI; to examine the relationships among secondary complications in individuals with SCI; to examine the relationship among secondary complications and neurological outcomes. Methods: Data were compiled from the Canadian Community Health Survey, the SCI Community Health Survey, the European Multi-Centre Study on Spinal Cord Injury dataset, and the Simon Fraser University SCI dataset. Several methods were employed for analysis of these data, including: multivariable logistic and linear regression, mixed effects models, and unbiased recursive partitioning. Results: Findings identified elevated odds of heart disease, stroke, Type 2 diabetes, chronic respiratory conditions, and chronic pain among individuals with SCI when compared with non-SCI individuals. Complex correlations were also identified among secondary complications following SCI. These include positive associations between neuropathic pain and CVD, and between blood pressure fluctuations and CVD. Lastly, secondary complications (specifically neuropathic pain) following SCI were positively correlated with neurological decline in chronic phases of injury, and neurological motor recovery in acute phases. These relationships may be partly related through treatments for the secondary complications rather than the secondary complications themselves. Implications: These novel findings update current knowledge of secondary complications among individuals with SCI. These data are useful in guiding the prospective collection of data elements within SCI-specific registries, as well as the design/analysis of studies (i.e., issues of confounding in multivariable analyses). These epidemiological data will also be useful for refined, hypothesis-driven physiological studies exploring precise biological mechanisms.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat

Spinal Cord Injury and Migraine Headache: A Population-Based Study

Migraine headaches are a common neurological condition, negatively impacting health and quality of life. Among potential risk factors for migraine headache, risk of migraine headaches was elevated in individuals with spinal cord injury (SCI). The association between migraines and SCI is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord. The primary objective of this study was to further examine the association between SCI and migraine headache, controlling for potential confounding variables. A secondary objective was to determine the impact of migraine headaches on self-perceived health. Data from a sample of 61,047 participants were obtained from the cross-sectional Canadian Community Health Survey. Multivariable logistic regression was used to explore the association between SCI and migraine headache using probability weights and adjusting for confounders. The multivariable age- and sex-adjusted model revealed a strong association between SCI and migraine headache, with an adjusted odds ratio for migraine of 4.82 (95% confidence interval [3.02, 7.67]) among those with SCI compared to those without SCI. Further, individuals who experienced both SCI and migraine tended to report poorer perceived general health compared with the other groups (i.e., SCI and no migraine). In conclusion, this study established a strong association between SCI and migraine headache. Further research is needed to explore the possible mechanisms underlying this relationship. Improvements in clinical practice to minimize this issue could result in significant improvements in quality of life