Background
Kagami-Ogata syndrome (KOS, OMIM 608149) is a rare genetic imprinting disorder involving microdeletions and epimutations affecting a maternally inherited locus (14q32.2) in chromosome 14. Neonates commonly present abnormal phenotypic features such as facial dysmorphia, abdominal wall defects, and skeletal abnormalities.  Around 80 cases of KOS were reported in literature, and the incidence rate is estimated at less than 1 in 1,000,000 newborns.

Case Presentation
We describe the clinical case of a preterm newborn found with polyhydramnios who was delivered by C-section at 32 weeks by a 30-year-old African American female (G4 P3 Ab1 LC2) with a history of severe pre-eclampsia and sickle cell trait. Fetal ultrasound revealed an omphalocele, lung mass, and left-axis deviation of the heart. Chest X-ray indicated features associated with respiratory distress syndrome (RDS) and a bell-shaped chest indicating pulmonary hypoplasia. A chromosome microarray was performed to determine the underlying cause of this newborn presentation.

Discussion
Chromosome microarray analysis confirmed homozygosity of chromosome 14, indicating paternal uniparental isodisomy, which supports the diagnosis of KOS. This case demonstrates the classical symptoms including coat hanger deformity, presence of omphalocele, and bell-shaped thorax revealed by imaging. This patient exhibits facial dysmorphism characterized by hirsute forehead, depressed nasal bridge, micrognathia, webbed neck, and small ears. KOS can be mistaken for other diseases like Beckwith-Wiedemann syndrome, trisomy 18, androgenic mosaicism due to phenotypic overlap. That is why when there are symptoms suggestive of BWS like macrosomia, polyhydramnios, and omphalocele are present, with genetic testing not confirming it, KOS should be tested. The management entails supportive measures like mechanical ventilation, tube feeding, and therapy for developmental delay, necessitating a multidisciplinary approach.

Exploring Kagami-Ogata Syndrome: Insights from a Case Report​

Background: Total hip and knee arthroplasty (THA and TKA) are two of the most common joint arthroplasties performed in the United States, with the prevalence of these procedures anticipated to continue increasing with the aging population. Therefore, medical education programs must expose students to the pathology, mechanisms of surgical intervention, and variance in implant materials for THA and TKA. One of the purposes of the WMed Skeletal Teaching and Research (STaR) Series is to target this educational goal, however, considering whether the collection is representative of the surrounding population is imperative when training medical providers to care for local communities. As few formal skeletal collections exist within the United States, research pertaining to representation of orthopedic surgeries is arguably nonexistent. The WMed STaR Series aims to target this gap in research, comparing representation of THA and TKA from the series to community statistics.

Methods: Donors from the WMed STaR Series were thoroughly evaluated for the presence of THAs and TKAs, as well as associated musculoskeletal pathology. The type and material of implant, laterality of intervention, donor medical history, and donor demographics were documented. Preliminary data collected from the series was evaluated in comparison to national statistics, and will plan to be compared to analogous data from orthopedic patients seen at the WMed Health clinic.

Results: The American College of Rheumatology cites about 1.2 million TKA and THA procedures in the U.S. annually with approximately 36.3% being THA and 63.7% being TKA. Upon evaluation of the STaR series, there were six THA (83% with a metal femoral head and a polymer socket, and the remaining 17% with a ceramic femoral head and a polymer socket) and seven TKA (all with metal tibial and femoral components and plastic spacers). This results in a relative frequency of 46.2% THA and 53.8% TKA in the WMed STaR Series, showing that while WMed has a similar proportion of THA and TKA to the national statistic, the STaR Series shows slightly higher prevalence of THA. 

Conclusion: The development of the WMed STaR Series will provide educators with a reference for orthopedic implants available for medical education, and will offer a unique perspective for further understanding of musculoskeletal pathology and mechanism for surgical intervention. Medical education resources that reflect the surrounding populations, such as the WMed STaR series, are imperative to prepare medical trainees to deliver comprehensive care to their communities. 


An Examination of Orthopedic Implants in the WMed Skeletal Teaching and Research Series: Presenting a Resource for Medical Education and Research

Abstract Title
Education, Language, and Cultural Concordance Influence Patient-Physician Communication in Orthopaedics

Background

Disparities in healthcare outcomes are pronounced among racial and ethnic minorities in the United States, particularly in orthopaedics where only 4.7% of faculty are from underrepresented minority (URiM) groups. Previous research highlights that cultural competency and humility in healthcare can reduce these disparities and improve patient satisfaction. However, there is limited data on the impact of patient-physician cultural and language concordance in orthopaedic care.

Methods

A convenience sample of patients and orthopaedic surgeons from an urban tertiary medical center was surveyed between August 2021 and May 2023. A self-administered questionnaire, available in English and Spanish, assessed demographic information, language proficiency, treatment satisfaction, and the importance of cultural and language understanding by clinicians. The cohort included 394 patients, with data analyzed using descriptive statistics, ANOVA, Pearson’s correlation, chi-square tests, and logistic regression.

Results

A total of 394 patients completed the questionnaire, with 35% male and 65% female, and an average age of 54 years. Hispanic patients reported lower English proficiency compared to Caucasian and African-American subjects (p<0.001), and educational attainment significantly influenced patients' ability to communicate with their orthopaedic surgeon (p<0.001). Hispanic and African-American patients placed higher importance on cultural understanding by their orthopaedic surgeons compared to Caucasian patients (p<0.001). Among Hispanic patients, those treated by culturally and linguistically concordant surgeons reported better communication and higher satisfaction levels. Logistic regression showed that Hispanic patients who saw culture and language concordant surgeons valued Spanish-speaking surgeons more (66% vs 45%, p=0.04). 

Conclusion

This study highlights the critical role of educational attainment and patient-physician cultural and language concordance in effective communication within orthopaedic care. The novel finding that Hispanic patients show significantly improved communication and satisfaction when treated by culturally and linguistically concordant surgeons underscores the need for increasing the number of culturally and linguistically proficient orthopaedic surgeons. Addressing these factors can enhance patient outcomes and satisfaction, particularly among Hispanic and African-American populations. Efforts should focus on improving health literacy and cultural humility training for orthopaedic surgeons to bridge the communication gap and reduce disparities in orthopaedic care.


Education, Language, and Cultural Concordance Influence Patient-Physician Communication in Orthopaedics

Background
Pediatric mood and anxiety disorders are common and associated with significant morbidity and mortality, including suicidality. Understanding factors influencing symptom presentation and treatment response will aid in developing targeted therapies and optimizing outcomes. Neurochemical levels serve as proxies for neurobiological processes altered in depressive and anxiety disorders. While the impact of antidepressant treatment on brain metabolism has been studied in adults, there are limited data in pediatric populations. This study aims to evaluate the relationship between neurochemical concentrations and anxiety and depressive symptoms in fluoxetine-treated youth. 
Methods
Adolescents and young adults aged 12-21 years, on steady-state fluoxetine, underwent proton magnetic resonance spectroscopy (1H-MRS) at 3T to measure glutamate (Glu), glutamine (Gln), myo-inositol (mI), choline-containing products (Cho), N-acetyl-aspartate (NAA) and creatine (Cr). Neurochemicals were reported as ratios relative to Cr. Depressive and anxiety symptoms were assessed using the PHQ-9 and PROMIS Anxiety scales, respectively. Participants with PHQ-9 scores ≥ 11 or PROMIS Anxiety t-scores ≥ 60 (moderate anxiety) were considered non-responders. Statistical analyses included Student’s t-test, Cohen’s d, and Spearman’s rho, performed using JMP Pro v17.  
Results
In 46 youth (mean age 16.1 ± 1.9 years, range 12-21, 67% female), NAA was significantly higher in fluoxetine responders compared to non-responders (NAA mean 1.67 ± 0.09 vs 1.57 ± 0.11, p = 0.004, Cohen’s d = 0.94) when stratified by response to fluoxetine. NAA levels did not correlate with anxiety symptom severity (Spearman’s ρ= -0.146, p=0.333). Glx, Glu, Gln, mI, and Cho levels did not differ between responders and non-responders, nor did they correlate with anxiety or depression symptom severity scores. 
Conclusion
In fluoxetine-treated youth, fluoxetine anxiety responders had higher NAA levels compared to non-responders. NAA, a marker of neuronal integrity, is typically lower in certain psychiatric disorders relative to healthy controls, with some evidence suggesting normalization following successful treatment. Baseline levels of NAA were not measured to provide insight on whether the fluoxetine responders had higher NAA levels before starting treatment. Our pilot findings support the need for further research into NAA as a potential biomarker for fluoxetine response. 


Exploring the relationship between antidepressant treatment, neurochemicals in the brain and anxiety/depression symptoms in youth

Abstract Title
No Change in Endocarditis Rates in Patients with Congenital Heart Disease During the COVID-19 Pandemic
Background
Infective endocarditis (IE) is an infection of the endothelial layer of the heart with a yearly incidence of 10/100,000 in the general population, 25%-30% from healthcare related infections. Patients with congenital heart disease (CHD) have an increased risk for IE with a mortality rate of 19.4% at 6.7 years of follow-up. In 2025 there will be an estimated 355,000 adults aged 20-65 years of age with CHD. Poor dental hygiene and lack of preventive dental care are additional risk factors for developing IE.
In March 2020, the ADA Health Policy Institute reported 76% of dental offices were only seeing emergency cases and 19% were completely closed, and importantly for the adult CHD population, Medicaid dental coverage was limited or eliminated in many states.
We sought to investigate if the decreased access to dental care during the COVID-19 pandemic led to an increased burden of IE in the CHD population.
Methods
Retrospective review of a de-identified national administrative database (Vizient Clinical Data Base/Resource Manager) for hospitalized patients 2-80 years old with an ICD-10 code for any severity CHD between 10/1/2018 – 8/30/2022. Using the introduction of the ICD-10 code for COVID-19 (U07.1) in April 2020 to designate pre- and post-COVID time periods, two eras were defined: Era 1 (10/1/2018 – 3/31/2020) and Era 2 (4/1/2020 – 8/30/2022). Comparisons were made between endocarditis rates, demographics, length of stay, complication rates, in-hospital mortality and costs between Eras.
Results
There was a total of 264,126 admissions with CHD during the study period, 7,532 (2.9%) with CHD and IE. There was no difference in endocarditis rates between Eras (p = 0.478). The only differences identified were a slightly older age at admission in Era 2 (45 vs 47 years, p = 0.001) and higher costs in Era 2 ($48,952 vs 53,758, p = 0.017).
Conclusion
In this retrospective review of a large U.S. administrative database, we did not identify a significant change in IE hospitalization rates in CHD patients. While this finding is reassuring, it may not tell the complete picture yet.
IE is a relatively rare condition with an annual incidence of 11/10,000 in the CHD population and can take months for symptoms to develop. Given the relatively short period available for study, there may not have been sufficient time with limited access to dental care to effect oral health enough and increase IE rates. It will be important for future studies to continue to assess this question.

No Change in Endocarditis Rates in Patients with Congenital Heart disease During the COVID-19 Pandemic

Background
The incidence of acute sport injuries in children is on the rise, with 2.6 annual million emergency room visits for sports-related injury. Concurrently, opioid prescribing practices have increased in recent decades, especially in pediatric populations. To help curb opioid usage, a multimodal pain management guideline should be instituted. Further investigation is needed on the precision of regional anesthetic in performing an adductor canal nerve block (ACB) in pediatric knee arthroscopy procedures. Variations in nerve locations within the thigh may impact postoperative pain and opioid usage. We are interested in studying the optimal location of ACB placement to reduce postoperative pain and consequently reduce opioid medication usage after pediatric knee arthroscopy.

Methods
A prospective, double-blinded randomized control trial consisting of 80 pediatric patients (ages 5-17) undergoing knee arthroscopy at St. Christopher’s Hospital for Children, approved by the Institutional Review Board. Enrolled patients are randomized to receive an ultrasound-guided placement of an ACB using 0.2% ropivacaine in one of three locations in the thigh: proximal, middle, distal, or control group with saline. The primary data collected are postoperative pain scores and amount of opioids taken, standardized to morphine milligram equivalents (MME), in the 24 and 48-hour postoperative period. Secondary outcomes included correlational assessment of pre and postoperative anxiety of patients and caregivers, correlation between patient anxiety and pain, and a postoperative dermatome sensation test. Data analysis performed with ANOVA test. Complete results including analysis of primary and secondary outcomes are shown in Tables 1 and 2.

Results
60 patients (mean age 15.5) have completed this actively enrolling study. This includes 14 in the proximal placement group, 15 in the middle placement group, and 16 in the distal placement group, and 15 in the control group. Primary outcomes analysis showed no significant difference in pain scores or opioids taken at 24 and 48-hours postoperatively among groups. Increased anxiety positively correlated with heightened postoperative pain.

Conclusion
ACB placement in proximal, middle, and distal thigh locations provided comparable 24 and 48-hour postoperative analgesia and opioid medication usage in our first 60 patients.

Adductor Canal Regional Anesthetic Placement in Pediatric Patients for Knee Arthroscopy: Defining the Optimal Location and Analysis of Other Trends

Abstract Title: 
Financial Conflicts of Interest of Physicians Followed by Leading Medical Journals on X (Twitter)
Background
Social media platforms like X (Twitter) have become important for disseminating medical research. However, financial conflicts of interest (FCOIs) among physicians on these platforms may influence content. This study aimed to assess FCOIs among physicians followed by top medical journals on X.

Methods
We identified US physicians followed on X by The New England Journal of Medicine, The Lancet, and JAMA. Using the Open Payments database, we analyzed general payments, research payments, and ownership interests received by these physicians from 2014-2021. We also examined payments to editorial board members and analyzed a subset of posts from physicians with FCOIs. We analyzed the posts using named-entity-recognition, topic modeling, and sentiment analysis. 

Results
Of 253 US physicians followed, 54.9% received general payments totaling $19.2 million. Specialists received significantly higher median payments than primary care physicians ($540 vs $0, p=0.0003). Among editorial board members with X accounts followed by their journals, 73.3% received general payments.When compared to general payments, only 9.5% of physicians received research payments. Analysis of physicians’ X activity showed those with FCOIs had significantly more followers than those without (64,490 vs 17,724, p=0.044). Topic modeling of Posts from physicians with FCOIs revealed frequent discussion of industry-related topics. Physicians with declared financial conflicts of interest tend to include academic links in their tweets slightly more often (20.93%) compared to those without FCOI (19.07%). Subspecialities of internal medicine and surgery tended to share more academic sources. Physicians with FCOIs tend to discuss more specific medical topics (e.g medical education, FDA and regulations, vaccines) compared to those without FCOIs, who often have "other" as their most common topic.The average sentiment scores vary between -0.037 and 0.576, with most scores being positive.

Conclusion
A majority of physicians followed by top medical journals on X have FCOIs, with some receiving substantial payments. This raises concerns about potential bias in social media content from these influential voices. Greater transparency is needed regarding FCOIs on social media platforms used for medical information dissemination. Medical journals should consider implementing policies for disclosing FCOIs when interacting with or promoting content from physicians on social media. Physicians should also provide reference to their FCOIs to avoid the appearance of bias and maintain public trust.


Financial Conflicts of Interest Among Physicians Followed by the Leading General Medical Journals on X

The opioid epidemic has adversely affected neonates and children; but the scope and mechanisms of these affects are not well understood. Failure to understand the impact of prenatal opioid exposure on long term adverse health outcomes could lead to gaps in care for this population. The purpose of this study is to investigate the association of prenatal opioid exposure with the development of adverse respiratory health outcomes, both acute and chronic. We propose that prenatal exposure leads to increased odds of development of childhood asthma, respiratory distress, apnea, and bronchiolitis. This is a retrospective cohort study using the PearlDiver Mariner database and a simple match design. Records from preterm and full-term infants exposed to opioids in utero are analyzed separately for the development of adverse health outcomes. Our preliminary results indicate that opioid exposure in utero results in preterm birth. In full-term infant births, opioid exposure leads to increased odds for developing respiratory distress (OR = 7.54), bronchiolitis (OR = 4.12) and apnea (OR = 1.58). Lastly, diagnoses for adverse respiratory outcomes were earlier in full-term opioid exposed infants than in their unexposed controls. The significance of this study is that it will encourage closer monitoring of full-term infants who are exposed to opioids in utero for specific respiratory outcomes and provide conceptual grounding for future mechanistic studies.



Prenatal opioid exposure impacts respiratory outcomes within the first 5 years of life

Abstract Title: Association of invasive bacterial infections and under-vaccinated status in well-appearing pediatric patients presenting to the emergency department with fever. 

Background: Fever accounts for up to 40% of visits to the pediatric emergency department (ED). While fever can be caused by viral or bacterial infections, those developing invasive bacterial infections (IBI) are at increased risk for life-threatening complications. Thus, evaluating a patient’s risk factors—including assessment of vaccination status—for developing IBI is an essential step. For example, invasive illness from Haemophilus influenzae (Hib) was the leading cause of childhood bacterial meningitis prior to the advent of the vaccine, with around 200,000 cases occurring yearly. Over the decade following the vaccine introduction, the prevalence of invasive disease from bacteria, such as Hib, had been almost eradicated. This study aims to determine the association between vaccination status and IBI in well-appearing pediatric patients presenting to the ED with a chief complaint of fever. 

Methods: This is a retrospective cohort study conducted between 2019-2023, at a single, urban tertiary care pediatric emergency department. Patients were included if their age was between 61 days and 18 years old presenting with a chief complaint of fever. Patients were excluded if they received antibiotics within 3 days or underwent surgery within 2 weeks of presentation. IBI was defined as bacteremia, bacterial meningitis, septic arthritis, osteomyelitis, pneumonia, deep neck space infection, mastoiditis, or orbital cellulitis. Prevalence of IBI was described and compared by presence of age group, chronic medical condition, gender, and vaccination status. Logistic regression was used to analyze the association between IBIs and vaccination status. 

Results: 2,623 patients were screened, and 1249 patients were included. Amongst patients who were included, the prevalence of IBI in the study was 11.9%. Of the 80 under-immunized patients, nine (11.25%) developed an IBI. One hundred and forty (12%) of the 1,169 fully immunized patients developed an IBI. The odds ratio is 1.07 (95%CI 0.52-2.20). 

Conclusion: In conclusion, the preliminary data does not show a significant difference in risk of IBI in patients who are under-immunized versus those who are fully immunized. Thus, clinicians should exercise caution using vaccination status alone to determine risk of IBI in well-appearing febrile pediatric patients presenting to the emergency department. However, low rates of IBI and under-vaccinated status as well as herd immunity in our population may indicate sample bias. Our future research aims to increase the sample size to further investigate this concept.

Association of Invasive Bacterial Infections and Under-Vaccinated Status in Well-Appearing Pediatric Patients

Recurrent Mucosal Melanoma: Clinical Complexities and Socioeconomic Barriers
Ishita Gupta Kaushal, Arshdeep Singh, Le Yen Ly Nguyen, Pragti Garg, Raziullah Riaz, Ajaybir Singh Buttar, Chandan Sona Bevara,Youngsang You, Ansa Ali, Onkardeep Kaur, Aparna Malireddi, Ratesh Khillan MD

Background
Mucosal melanoma of the oral cavity (MMO) constitutes less than 1% of all melanomas. The majority of MMO occur in upper alveolus and hard palate (70%) followed by lower alveolus. The etiology, risk factors and pathogenesis for MMO are poorly understood. Patients with MMO can present with bleeding, local discoloration, facial pain, ulceration, with localized swelling being the most common. Due to the diversity of initial symptoms and histological pleomorphism, immunohistochemical staining is crucial to confirm the diagnosis. Mucosal melanoma (MM) has a very poor prognosis and most patients develop incurable metastatic disease, irrespective of surgical excision.
Due to poor prognosis, staging starts from T3 for lesions confined to mucosa and adjacent soft tissue and T4 for moderately advanced and very advanced lesions, as recommended in 8th edition of AJCC. For tumors limited to mucosa, NCCN recommends postoperative radiotherapy within 6 weeks of resection with consideration for systemic therapy.
In this study, we present a unique case of a 64-year-old Hispanic female with multiple recurrences of MMO.

Case presentation
A 64-year-old Hispanic female presented to our clinic with a possible recurrence of malignant melanoma of hard palate. It started as an irregularly shaped discoloration of gums and the hard palate. She underwent 3 surgical resections in her home country. Adjuvant chemo and radiotherapy were recommended, which proved to be financially challenging.
On presentation to our clinic, she had a tender bluish patch approximately 1 cm in diameter with ulcers on hard palate and a soft bluish bumpy left upper gum lesion approximately 1 cm in diameter, which bled on touching. Following the punch biopsies and various radiographic studies, left maxillectomy was done, the pathology report and immunohistochemistry of which confirmed stage ypT3N0 residual malignant melanoma. Again, patient could not undergo adjuvant chemo and radiotherapy due to financial constraints.

Discussion
Due to the condition’s rarity, rapid progression, and hence delayed diagnosis and poor prognosis, it is essential to complete the treatment regimen, which includes surgical resection followed by chemo and radiotherapy. This case shows the inequitable distribution of medical resources in patients with low socioeconomic status. The lack of medical insurance can hinder patient care in basic cancer treatment like surgery and radiotherapy. This issue is of even greater relevance in the treatment of cancer which is rapidly debilitating and fatal. Even in instances of potentially curable cancers, socioeconomic status, lack of available therapies and cultural stereotypes can impede treatment.

Recurrent Mucosal Melanoma: Clinical Complexities and Socioeconomic Barriers

Background
The pathogenesis of allergic asthma is classically understood to involve allergens crosslinking Immunoglobulin E (IgE) bound to mast cells and basophils, leading to the release of inflammatory mediators. However, omalizumab, an anti-IgE antibody, reduces exacerbation rates in only about 40% of adult patients with severe asthma. These findings highlight the need for further research to fully address the role of IgE in allergic diseases like asthma. This study aims to explore which allergen induces Th2-associated airway inflammation through an IgE-dependent mechanism. 

Methods
We used IgE deficient mice (IgE KO) to generate asthma mouse models induced by two highly clinically relevant allergens house dust mite extract (HDM), cockroach extract (CRE) and one classic allergen ovalbumin (OVA). Hematoxylin and Eosin (HE) staining and Alcian Blue-Periodic Acid-Schiff (AB-PAS) staining was performed on lung tissue to evaluate inflammatory responses and mucus production, respectively. The count of inflammatory cells in Bronchial Alveolar Lavage Fluids (BALF) was determined using flow cytometry. Passive Cutaneous Anaphylaxis (PCA) was conducted to quantify IgE involvement in the anaphylactic reaction, and Toluidine Blue (TB) staining of dorsal skin tissue was used to visualize mast cell recruitment.

Results
All mice treated with allergens exhibited significant signs of airway inflammation, as evidenced by the recruitment of inflammatory cells to the lung parenchyma and goblet cell hyperplasia. However, IgE KO mice treated with different allergens demonstrated significantly variable degrees of inflammation compared to the WT control. Of these, HDM-treated IgE KO mice showed an attenuated inflammatory profile with reduced inflammatory cells, particularly eosinophils. These mice had lower serum levels of HDM-specific IgE1 (sIgE1) and IgG1 (sIgG1) and reduced levels of Th2 cytokines IL-4 and IL-5 in BALF. While CRE-treated IgE KO mice also displayed a reduced inflammation compared to WT mice, the only statistically significant difference was found for eosinophils. No significant differences were observed between OVA-treated IgE KO and WT mice. These findings were further supported by our well-established PCA models. Both HDM and CRE-induced PCA model showed significantly less Evan’s blue dye leakage and mast cell recruitment in the ears of IgE KO mice compared to WT mice. No differences were observed for OVA-induced PCA and mast cell recruitment.

Conclusion
The results highlight the variability in IgE pathway dependence among different allergens, emphasizing the need for further research is to delineate the mechanisms and develop more effective therapeutic strategies for allergic diseases.

Allergic Asthma and Anaphylaxis Induced by Different Allergens Show Distinctive IgE Dependence

Background : Every year there are more than 15,000 new spinal cord injuries in the United States.1 Of those, a complete spinal cord transection, characterized by a lesion through both the motor and sensory tracts, is one of the most devastating injuries to patients. During the subacute and chronic phases of injury, glial cells in vertebrae species accumulate at the lesion site to provide a protective barrier through scar formation. Although the glial scar is imperative in protecting against additional tissue loss, it blocks axon regeneration, causing additional loss of function. A powerful model that lacks this glial scar formation is the zebrafish (Danio rerio). It’s genetic commonalities to humans and larval translucency make it one of the more resourceful models when studying new pharmacological therapeutics for spinal cord injury.2 4-Aminopyridine (4-AP) is a therapeutic that is inhibitory to voltage-gated potassium channels (Kv) allowing for increasing action potentials across demyelinated axons.3 It is essential to understand 4-AP’s therapeutic effect on glial cells spinal cord injury patients in the future and the zebrafish model allows a window to discover its role in glial cell proliferation, migration, and remodeling.

Methods: A complete spinal cord injury was performed on an Tg(gfap:EGFP) x Tg(elavl3:mcherry) transgenic zebrafish line five days post fertilization. On one day post injury, continuous dosing of E2 recovery buffer supplemented with either DMSO or 4-AP was given to an equal number of transected zebrafish and uninjured zebrafish. Utilizing the Leica Thunder System, Z stack images at 20x were taken from day of injury until five days post injury to analyze pixel intensity of the glial cell bridging to ensure a complete transection and progress of bridging. Zebrafish were fed one day during the recovery period and multi-well plates were replenished with new recovery buffer each day after imaging.

Results: Continuous dosing of 4-AP one-day post injury increased glial cell proliferation at both the rostral and caudal ends of the lesion site. The 4-AP zebrafish also had narrower injury sites by the fifth day post injury. The DMSO zebrafish showed higher proliferation at the rostral lesion site.

Conclusion: In closing, it was found that continuous dosing of 4-AP one day post injury enhances glial cell bridging, promoting regeneration of the spinal cord in the zebrafish model. Varying the dosing schedules and monitoring locomotion behaviors are needed to advance the knowledge of 4-AP's effects on regeneration after spinal cord injury.

References:

(Spinal Cord Injury Prevalence In The U.S. | Reeve Foundation (christopherreeve.org)).

Effectiveness of zebrafish models in understanding human diseases—A review of models - ScienceDirect)

Neuroprotective Properties of 4-Aminopyridine - PMC (nih.gov) Neuroprotective Properties of 4-Aminopyridine - PMC (nih.gov)

Building bridges, not walls: spinal cord regeneration in zebrafish - PMC (nih.gov)


Underline digital video library

Exploring Kagami-Ogata Syndrome: Insights from a Case Report

An Examination of Orthopedic Implants in the WMed Skeletal Teaching and Research Series: Presenting a Resource for Medical Education and Research

Education, Language, and Cultural Concordance Influence Patient-Physician Communication in Orthopaedics

Exploring the relationship between antidepressant treatment, neurochemicals in the brain and anxiety/depression symptoms in youth

No Change in Endocarditis Rates in Patients with Congenital Heart disease During the COVID-19 Pandemic

Adductor Canal Regional Anesthetic Placement in Pediatric Patients for Knee Arthroscopy: Defining the Optimal Location and Analysis of Other Trends

Financial Conflicts of Interest Among Physicians Followed by the Leading General Medical Journals on X

Prenatal opioid exposure impacts respiratory outcomes within the first 5 years of life

Association of Invasive Bacterial Infections and Under-Vaccinated Status in Well-Appearing Pediatric Patients

Recurrent Mucosal Melanoma: Clinical Complexities and Socioeconomic Barriers

Allergic Asthma and Anaphylaxis Induced by Different Allergens Show Distinctive IgE Dependence

Understanding 4-AP's Capabilites to Enhance Axonal & Glial Spinal Cord Regeneration after Injury Utilizing a Zebrafish Model

Stay up to date with the latest Underline news!

PRESENTATIONS

CONFERENCES

COMPANY

RESOURCES

Underline digital video library

Exploring Kagami-Ogata Syndrome: Insights from a Case Report​

An Examination of Orthopedic Implants in the WMed Skeletal Teaching and Research Series: Presenting a Resource for Medical Education and Research

Education, Language, and Cultural Concordance Influence Patient-Physician Communication in Orthopaedics

Exploring the relationship between antidepressant treatment, neurochemicals in the brain and anxiety/depression symptoms in youth

No Change in Endocarditis Rates in Patients with Congenital Heart disease During the COVID-19 Pandemic

Adductor Canal Regional Anesthetic Placement in Pediatric Patients for Knee Arthroscopy: Defining the Optimal Location and Analysis of Other Trends

Financial Conflicts of Interest Among Physicians Followed by the Leading General Medical Journals on X

Prenatal opioid exposure impacts respiratory outcomes within the first 5 years of life

Association of Invasive Bacterial Infections and Under-Vaccinated Status in Well-Appearing Pediatric Patients

Recurrent Mucosal Melanoma: Clinical Complexities and Socioeconomic Barriers

Allergic Asthma and Anaphylaxis Induced by Different Allergens Show Distinctive IgE Dependence

Understanding 4-AP's Capabilites to Enhance Axonal & Glial Spinal Cord Regeneration after Injury Utilizing a Zebrafish Model

Stay up to date with the latest Underline news!

PRESENTATIONS

CONFERENCES

COMPANY

RESOURCES

Exploring Kagami-Ogata Syndrome: Insights from a Case Report