Metal-Organic Framework Stability in Water and Harsh Environments from Data-Driven Models Trained on the Diverse WS24 Data Set.

Metal-organic frameworks (MOFs) are porous materials with applications in gas separations and catalysis, but a lack of water stability often limits their practical use given the ubiquity of water. Consequently, it is useful to predict whether a MOF is water-stable before investing time and resources into synthesis. Existing heuristics for designing water-stable MOFs lack generality and limit the diversity of explored chemistry due to narrowly defined criteria. Machine learning (ML) models offer the promise to improve the generality of predictions but require data. In an improvement on previous efforts, we enlarge the available training data for MOF water stability prediction by over 400%, adding 911 MOFs with water stability labels assigned through semiautomated manuscript analysis to curate the new data set WS24. The additional data are shown to improve ML model performance (test ROC-AUC > 0.8) over diverse chemistry for the prediction of both water stability and stability in harsher acidic conditions. We illustrate how the expanded data set and models can be used with a previously developed activation stability model in combination with genetic algorithms to quickly screen ∼10,000 MOFs from a space of hundreds of thousands for candidates with multivariate stability (upon activation, in water, and in acid). We uncover metal- and geometry-specific design rules for robust MOFs. The data set and ML models developed in this work, which we disseminate through an easy-to-use web interface, are expected to contribute toward the accelerated discovery of novel, water-stable MOFs for applications such as direct air gas capture and water treatment.

The Effects of Dry Needling on Hamstring Range of Motion: A Critically Appraised Topic.

CLINICAL SCENARIO: Hamstring range of motion (ROM) and the influence it has on injury risk is among great discussion in the literature. Hamstring injury may result from hamstring tightness, poor flexibility, or decreased ROM, and many argue that this can be prevented through various intervention strategies. In active populations, risk of further injury, pain, and complications throughout the kinetic chain can occur if minimal hamstring ROM is left untreated. One therapeutic intervention that has been applied to varying parts of the body to help improve function while relieving pain is dry needling (DN). This intervention includes the application of needles to structures to induce responses that might benefit healing and overall stimulation of a neurological response. In this review, the intent is to identify evidence and the effects of DN on hamstring ROM. CLINICAL QUESTION: What are the effects of DN on hamstring ROM? SUMMARY OF KEY FINDINGS: Among total 11 articles, 1 single-blinded randomized controlled trial and 2 double-blinded randomized controlled trials were included in this critically appraised topic. All 3 articles had inconclusive evidence to isolate the application of the DN intervention. There was insufficient evidence to identify if DN independently improved hamstring ROM; however, in combination with interventions such as exercise and stretch plans, there were improvements on ROM. CLINICAL BOTTOM LINE: DN does not significantly increase or decrease the ROM of the hamstrings. When combined with exercise and stretch plans, DN could increase ROM. STRENGTH OF RECOMMENDATION: The grade of B is recommended by the Strength of Recommendation Taxonomy for inconsistent or limited-quality patient-oriented evidence.

Parent decision-making regarding youth sport participation during the COVID-19 pandemic.

PURPOSE: To describe youth sport participation behaviors during the COVID-19 pandemic as reported by parents of youth sport athletes, to examine the association of family demographics with the likelihood of children resuming sports, and to qualitatively report the factors influencing parental decision-making regarding youth sport participation during the COVID-19 pandemic. METHODS: A national sample of parents of youth athletes from across the United States (n=236, age: 39.2±8.1 years, 57.2% female) were recruited to complete an online questionnaire by Qualtrics Online Samples (Qualtrics, Provo, UT) using a combination of actively managed, double-opt-in market research panels. The questionnaire focused on changes in child sport participation and family finances as a result of COVID-19 and included both close-ended and open-ended questions. RESULTS: Most parents (63.1%) reported the time their children spent participating in organized youth sports had decreased because of the COVID-19 pandemic. Three-quarters of parents (75.5%) reported that it was likely that their children would fully resume participating in organized youth sports within the next year. Parents whose financial situation was worsened by COVID-19 were less likely to report that their children would resume sports in the upcoming year. Three domains related to parental decision-making emerged from the open-ended responses: safety, fear, and normalcy. CONCLUSIONS: Understanding the factors influencing changes in youth sport participation during the pandemic can allow systems to implement strategies for safe participation in youth sport and physical activity among children. Encouraging participation in outdoor sports with appropriate safety precautions such as masking, social distancing, and hygiene may reduce fear of participation among parents.

The Effect of Active Release Technique® on Clinician and Patient-Reported Outcomes: A Systematic Review.

CONTEXT: Active Release Technique® (ART®) is a manual therapy used for soft tissue-related issues, commonly used to lengthen structures in a shortened position and to restore motion of soft tissues. OBJECTIVE: The purpose of this systematic review was to collect, appraise, and summarize the available literature, evaluating the effects of ART® on pain, range of motion (ROM), and disability. EVIDENCE ACQUISITION: Electronic databases (PubMed, EBSCOhost, MEDLINE, SPORTDiscus, and CINAHL) were searched from 2000 to November 2020. The search was completed using a combination of key words related to ART®, rehabilitation, and outcomes. Search limits were full-text publications written in English. Inclusion criteria required that studies evaluated outcomes using ART® for rehabilitation, were peer reviewed, and included human participants without catastrophic conditions or injuries. The modified Downs and Black checklist for nonrandomized studies was used to assess methodological quality of identified studies by 2 independent reviewers, average scores were calculated. The level of evidence was assessed using the strength of recommendation taxonomy. EVIDENCE SYNTHESIS: Nine studies were inculded in this review. The average methodological quality of the studies was 12/15 and ranged from 10 to 14, with the most common methodological quality item missed being the blinding of researchers collecting outcomes. Six studies that assessed pain found significant improvements in participants' pain levels. Six studies that assessed ROM found significant improvement in participants' ROM. Two studies that assessed disability found significant improvement in disability. CONCLUSION: Evidence suggests that ART® may be beneficial in improving pain, ROM, and disability. This review found that ART® positively impacted patient outcomes and may be a viable treatment option for clinicians treating musculoskeletal conditions. However, further research is necessary to determine optimal dosage and long-term effects of ART® on these patient outcomes.

The Effectiveness of Dry Needling Combined With Therapeutic Exercises in Treating Tendinopathy Conditions: A Systematic Review.

CONTEXT: Approximately 70,000 Americans miss work annually due to tendinopathies causing pain, disability, and lower quality of life. Various conservative treatments have been demonstrated to improve outcomes in these conditions. Dry needling (DN) and therapeutic exercise are 2 such interventions that have been proposed to be a positive intervention for addressing tendinopathy. OBJECTIVE: To summarize the best available evidence on the use of DN and exercise combined to treat tendinopathy. EVIDENCE ACQUISITION: PubMed, EBSCOHost, and Web of Science were systematically searched from inception to March 2021. Articles were assessed to determine eligibility and evaluated for methodological quality using the PEDro scale. The PRISMA guidelines were used for this review. Inclusion criteria consisted of use of DN in combination with therapeutic exercise, human participants, and active tendinopathy pathology. EVIDENCE SYNTHESIS: Seven studies met the inclusion and exclusion criteria, which averaged 6/11 on the PEDro scale. The level of agreement of evaluators was 94%. Current evidence supports the use of DN combined with therapeutic exercises, especially those including eccentric exercises, can improve pain and function for various tendinopathies. However, limited evidence exists regarding specific therapeutic interventions to be combined with DN. CONCLUSION: There is moderate, level B evidence to suggest the use of DN techniques targeted at the tendon and combined with eccentric therapeutic exercise to improve pain and functional outcomes for tendinopathies.

The Evaluation of Joint Mobilization Dosage on Ankle Range of Motion in Individuals With Decreased Dorsiflexion and a History of Ankle Sprain.

CONTEXT: Mulligan's Mobilization with Movement (MWM) is a common intervention used to address dorsiflexion range of motion (DFROM) impairments. However, the treatment dosage of MWMs varies within the literature. OBJECTIVE: The aim of this study was to examine the effect of serial MWM application on DFROM. DESIGN: Repeated-measures cohort. SETTING: A Midwestern University and the surrounding community. PARTICIPANTS: A total of 18 adults (13 females; age = 29 [12.87] y; DFROM = 30.26° [4.60°]) with decrease dorsiflexion (<40°) participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥18 years old, no lower-extremity injury in the last 6 months, and no history of foot/ankle surgery. INTERVENTION: Participants completed a single data collection session consisting of 10 individual sets of MWMs. MAIN OUTCOME MEASURES: DFROM was taken at baseline and immediately after each intervention set (post 1, post 2, … post 10). DFROM was measured with a digital inclinometer on the anterior aspect of the tibia during the weight-bearing lunge test with the knee straight and knee bent. Analysis of variances examined DFROM changes over time. Post hoc analysis evaluated sequential pairwise comparisons and changes from baseline at each time point. RESULTS: Analysis of variance results indicated a significant time main effect for weight-bearing lunge test with knee bent (P < .001) and a nonsignificant effect for weight-bearing lunge test with knee straight (P < .924). Post hoc analysis indicated improvements in the weight-bearing lunge test with knee bent at each timepoint compared with baseline (P < .005). Post 2 improved compared with post 1 (P = .027). No other pairwise sequential comparisons were significant (P > .417). CONCLUSIONS: MWMs significantly improved acute knee bent DFROM and indicated that after 2 sets of MWMs, no further DFROM improvements were identified. Future research should investigate the lasting effects of DFROM improvements with variable MWM dosages.

The Examination of Repeated Self-Mobilizations With Movement and Joint Mobilizations on Individuals With Chronic Ankle Instability.

CONTEXT: Chronic ankle instability (CAI) is one of the most common chronic conditions in the world, resulting in millions of dollars contributed to the health care system. Joint mobilizations have been shown to effectively improve patient and disease-specific impairments secondary to CAI. The ability for patients to complete an effective manual therapy intervention without the need for continuous visits to a health care provider can alleviate burdens on the health care system and improve patient satisfaction. OBJECTIVE: To examine the effect of clinician-applied Maitland talocrural joint mobilization and self-mobilization (Self-Mob) on dorsiflexion range of motion (DFROM), dynamic balance, strength, and perceived function in those with CAI. DESIGN: Single-blind randomized trial. SETTING: Research laboratory. PARTICIPANTS: A total of 18 participants (7 males and 11 females; age = 20.78 [2.02] y, height = 67.66 [3.83] cm, limb length = 87.74 [5.05] cm) with self-reported CAI participated. INTERVENTIONS: The participants received 6 interventions over a 2-week period. The participants received either Maitland grade III anterior-to-posterior talocrural joint mobilizations or weight-bearing lunge Self-Mob. Each intervention consisted of four 2-minute sets, with a 1-minute rest between sets. MAIN OUTCOME MEASURES: The DFROM (weight-bearing lunge), dynamic balance (Y-Balance Test), isometric strength, Foot and Ankle Ability Measure Quick, Disablement of the Physically Active modified, Fear Avoidance Beliefs Questionnaire, and Tampa Scale of Kinesiophobia-11 were measured preintervention and postintervention. RESULTS: Dynamic balance, isometric strength, and perceived function significantly improved in both groups at postintervention. The DFROM significantly improved in the Self-Mob group. Higher individual responder rates were demonstrated within the Self-Mob group compared with clinician-applied mobilizations. CONCLUSIONS: Clinician-applied mobilizations and Self-Mobs are effective interventions for improving dynamic balance, isometric strength, and perceived function. Application of Self-Mobs can effectively improve DFROM compared with joint mobilization. Self-Mobs may be an effective intervention to incorporate into a home care plan.

Comparison of Myofascial Release Techniques on Pectoralis Minor Length, Glenohumeral Total Arc of Motion, and Skin Temperature: A Pilot Study.

CONTEXT: The pectoralis minor (PM) is an important postural muscle that may benefit from myofascial techniques, such as Graston Technique® (GT) and self-myofascial release (SMR). OBJECTIVE: To examine the effects of GT and SMR on PM length, glenohumeral total arc of motion (TAM), and skin temperature. DESIGN: Cohort. SETTING: Laboratory. PARTICIPANTS: Twenty-six healthy participants (19 females and 7 males; age = 20.9 [2.24] y, height = 170.52 [8.66] cm, and weight = 72.45 [12.32] kg) with PM length restriction participated. INTERVENTIONS: Participants were randomized to the intervention groups (GT = 12 and SMR = 14). GT and SMR interventions were both applied for a total of 5 minutes during each of the 3 treatment sessions. MAIN OUTCOME MEASURES: PM length, TAM, and skin temperature were collected before and after each intervention session (Pre1, Post1, Pre2, Post2, Pre3, and Post3) and at 1-week follow-up (follow-up). Separate intervention by time analyses of variance examined differences for each outcomes measure. Bonferroni post hoc analyses were completed when indicated. Significance was set a priori at P ≤ .05. RESULTS: No significant intervention by time interactions were identified for PM length, TAM, or temperature (P > .05). No significant intervention main effects were identified for PM length (P > .05), TAM (P > .05), or temperature (P > .05) between the GT or SMR technique groups. Overall, time main effects were found for PM length (P = .02) and temperature (P < .001). Post hoc analysis showed a significant increase in PM length for both intervention groups at follow-up (P = .03) compared with Post2. Furthermore, there were significant increases in temperature at Post1 (P < .001), Post2 (P = .01), and Post3 (P < .001) compared with Pre1; Post2 was increased compared with Pre2 (P = .003), Pre3 (P < .001), and follow-up (P = .01); Post3 increased compared with Pre3 (P = .01) and follow-up (P = .01). CONCLUSION: Serial application of GT and SMR to the PM did not result in increases in PM length or TAM. Regardless of intervention, skin temperature increased following each intervention.

Molecularly Mixed Composite Membranes for Advanced Separation Processes.

Porous organic cages (POCs) are individual soluble, porous molecules. When fabricated into mixed-matrix membranes (MMMs), the soluble POC molecules have the potential to exhibit intimate molecular-level mixing with the polymer matrix. POCs have only recently been incorporated into mixed matrix membrane materials, but this process has not yet resulted in significant improvements of membrane performance. Now, vertex-functionalized amorphous scrambled porous organic cages (ASPOCs) have been utilized as membrane performance enhancers and the amorphous ASPOC mixtures are observed to distribute throughout the matrix without any indication of particle formation or agglomeration, creating unique, molecularly mixed composite membranes. Overall, the molecularly mixed composite membrane provide significant increases in both membrane permeability and selectivity, offering new avenues for creation of membranes with unique properties in industrially relevant separations.

Organizational Expectations Regarding Documentation Practices in Athletic Training.

CONTEXT: Although guidance is available, no nationally recognized standard exists for medical documentation in athletic training, leaving individual organizations responsible for setting expectations and enforcing policies. Previous research has examined clinician documentation behaviors; however, the supervisor's role in creating policy and procedures, communicating expectations, and ensuring accountability has not been investigated. OBJECTIVE: To investigate supervisor practices regarding support, hindrance, and enforcement of medical documentation standards at an individual organization level. DESIGN: Mixed-methods study. SETTING: Online surveys and follow-up interviews. PATIENTS OR OTHER PARTICIPANTS: We criterion sampled supervising athletic trainers (n = 1107) in National Collegiate Athletic Association member schools. The survey collected responses from 64 participants (age = 43 ± 11 years; years of experience as a supervisor = 12 ± 10; access rate = 9.6%; completion rate = 66.7%), and 12 (age = 35 ± 6 years; years of experience as a supervisor = 8 ± 5) participated in a follow-up interview. DATA COLLECTION AND ANALYSIS: We used measures of central tendency to summarize survey data and the consensual qualitative research approach with a 3-person data analysis team and multiphase process to create a consensus codebook. We established trustworthiness using multiple-analyst triangulation, member checking, and internal and external auditing. RESULTS: Fewer than half of supervisors reported having formal written organization-level documentation policies (n = 45/93, 48%) and procedures (n = 32/93, 34%) and an expected timeline for completing documentation (n = 24/84, 29%). Participants described a framework relative to orienting new and existing employees, communicating policies and procedures, strategies for holding employees accountable, and identifying purpose. Limitations included lack of time, prioritization of other roles and responsibilities, and assumptions of prior training and record quality. CONCLUSION: Despite a lack of clear policies, procedures, expectations, prioritization, and accountability strategies, supervisors still felt confident in their employees' abilities to create complete and accurate records. This highlights a gap between supervisor and employee perceptions, as practicing athletic trainers have reported uncertainty regarding documentation practices in previous studies. Although supervisors perceive high confidence in their employees, clear organization standards, employer prioritization, and mechanisms for accountability surrounding documentation will result in improved patient care delivery, system outcomes, and legal compliance.

Immunolabeling-compatible PEGASOS tissue clearing for high-resolution whole mouse brain imaging.

Novel brain clearing methods revolutionize imaging by increasing visualization throughout the brain at high resolution. However, combining the standard tool of immunostaining targets of interest with clearing methods has lagged behind. We integrate whole-mount immunostaining with PEGASOS tissue clearing, referred to as iPEGASOS (immunostaining-compatible PEGASOS), to address the challenge of signal quenching during clearing processes. iPEGASOS effectively enhances molecular-genetically targeted fluorescent signals that are otherwise compromised during conventional clearing procedures. Additionally, we demonstrate the utility of iPEGASOS for visualizing neurochemical markers or viral labels to augment visualization that transgenic mouse lines cannot provide. Our study encompasses three distinct applications, each showcasing the versatility and efficacy of this approach. We employ whole-mount immunostaining to enhance molecular signals in transgenic reporter mouse lines to visualize the whole-brain spatial distribution of specific cellular populations. We also significantly improve the visualization of neural circuit connections by enhancing signals from viral tracers injected into the brain. Last, we show immunostaining without genetic markers to selectively label beta-amyloid deposits in a mouse model of Alzheimer's disease, facilitating the comprehensive whole-brain study of pathological features.

Astrocytic CREB in nucleus accumbens promotes susceptibility to chronic stress.

Background: Increasing evidence implicates astrocytes in stress and depression in both rodent models and human Major Depressive Disorder (MDD). Despite this, little is known about the transcriptional responses to stress of astrocytes within the nucleus accumbens (NAc), a key brain reward region, and their influence on behavioral outcomes. Methods: We used whole cell sorting, RNA-sequencing, and bioinformatic analyses to investigate the NAc astrocyte transcriptome in male mice in response to chronic social defeat stress (CSDS). Immunohistochemistry was used to determine stress-induced changes in astrocytic CREB within the NAc. Finally, astrocytic regulation of depression-like behavior was investigated using viral-mediated manipulation of CREB in combination with CSDS. Results: We found a robust transcriptional response in NAc astrocytes to CSDS in stressed mice, with changes seen in both stress-susceptible and stress-resilient animals. Bioinformatic analysis revealed CREB, a transcription factor widely studied in neurons, as one of the top-predicted upstream regulators of the NAc astrocyte transcriptome, with opposite activation states seen in resilient versus susceptible mice. This bioinformatic result was confirmed at the protein level with immunohistochemistry. Viral overexpression of CREB selectively in NAc astrocytes promoted susceptibility to chronic stress. Conclusions: Together, our data demonstrate that the astrocyte transcriptome responds robustly to CSDS and, for the first time, that transcriptional regulation in astrocytes contributes to depressive-like behaviors. A better understanding of transcriptional regulation in astrocytes may reveal unknown molecular mechanisms underlying neuropsychiatric disorders.

Astrocytic CREB in nucleus accumbens promotes susceptibility to chronic stress.

BACKGROUND: Increasing evidence implicates astrocytes in stress and depression in both rodent models and human Major Depressive Disorder (MDD). Despite this, little is known about the transcriptional responses to stress of astrocytes within the nucleus accumbens (NAc), a key brain reward region, and their influence on behavioral outcomes. METHODS: We used whole cell sorting, RNA-sequencing, and bioinformatic analyses to investigate the NAc astrocyte transcriptome in male mice in response to chronic social defeat stress (CSDS). Immunohistochemistry was used to determine stress-induced changes in astrocytic CREB within the NAc. Finally, astrocytic regulation of depression-like behavior was investigated using viral-mediated manipulation of CREB in combination with CSDS. RESULTS: We found a robust transcriptional response in NAc astrocytes to CSDS in stressed mice, with changes seen in both stress-susceptible and stress-resilient animals. Bioinformatic analysis revealed CREB, a transcription factor widely studied in neurons, as one of the top-predicted upstream regulators of the NAc astrocyte transcriptome, with opposite activation states implicated in resilient vs. susceptible mice. This bioinformatic deduction was confirmed at the protein level with immunohistochemistry. Moreover, NAc astrocyte morphological complexity correlated with CREB activation and was reduced selectively in astrocytes of resilient mice. Viral overexpression of CREB selectively in NAc astrocytes promoted susceptibility to chronic stress. CONCLUSIONS: Together, our data demonstrate that the astrocyte transcriptome responds robustly to CSDS and that transcriptional regulation in astrocytes contributes to depressive-like behaviors. A better understanding of transcriptional regulation in astrocytes may reveal unknown molecular mechanisms underlying neuropsychiatric disorders.

Relationship Between Athletic Trainer Access, Socioeconomic Status, and Race and Ethnicity in United States Secondary Schools.

CONTEXT: Extensive research has exposed healthcare disparities regarding socioeconomic status (SES) and race/ethnicity demographics. Previous research has shown significant differences in access to athletic training services (AT access) in the secondary school setting based on SES, but with limited samples. OBJECTIVE: This study investigated differences in AT access based on race/ethnicity and SES on a national scale. DESIGN: Cross-sectional study. SETTING: Database study using secondary analysis. Data were collected from the National Center for Education Statistics (NCES), Athletic Training Location and Services (ATLAS) database, and US Census Bureau. PATIENTS OR OTHER PARTICIPANTS: 10,983 public schools. MAIN OUTCOME MEASURE: Descriptive data was summarized by measures of central tendency. A one-way ANOVA determined differences between school characteristics: median household income (MHI), percent of students eligible for free and reduced lunch (%FRL), percent white students, and percent non-white students based on AT access: Full-time (FT-AT), part-time (PT-AT), and no athletic trainer (no-AT). A Bonferroni pairwise comparison was used for variables with significant main effects. RESULTS: Across all schools included in the study, 43.8% had no-AT (n=4,812), 23.5% had PT-AT access (n=2,581), and 32.7% had FT-AT access (n=3,590). There were significant effects between AT access and MHI (p<.001), %FLR (p<.001), percent white (p<.001), and percent non-white (p<.001). FT-AT schools had a higher SES when compared to PT-AT and no-AT schools. Significant differences existed between AT access groups and race/ethnicity of schools. Schools with FT-AT had a significantly lower percent of non-white students (31.3%) compared to schools with no-AT (46.0%) (p<.001). No significant differences between FT-AT and PT-AT based on race/ethnicity demographics presented (p≥.13). CONCLUSION: Schools with higher SES had greater AT access; whereas, schools with a higher percentage of non-white students were more likely to have no AT access, demonstrating the disparities in healthcare extends to athletic healthcare as well. To increase AT access, future initiatives should address the inequities where larger minority populations and counties of lower SES exist.

Injury risk factors related to sport specialization in high school basketball: a prospective study.

CONTEXT: Research that has examined the association between specialization and injury in basketball has been limited to cross-sectional or retrospective studies. OBJECTIVE: To determine whether specialization is a risk factor for injury among high school basketball athletes. DESIGN: Prospective cohort study. SETTING: Basketball players from 12 high schools participating in the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program (NATION-SP) were recruited prior to the 2022-2023 interscholastic basketball season. PATIENTS OR OTHER PARTICIPANTS: 130 athletes (mean age (SD) = 15.6 (1.3); girls' basketball: n=68 (52.3%)). MAIN OUTCOME MEASURES: Participants completed a questionnaire prior to the start of their school basketball season that had questions regarding participation in various specialized sport behaviors. During the basketball season, the school's athletic trainer reported all athletic exposures (AEs) and injuries (regardless of time loss) for participating athletes into NATION-SP. Injury incidence (IR) and incidence rate ratios (IRR) with 95% confidence intervals [95%CI] were calculated for the specialized sport behaviors previously described. RESULTS: There was no difference in injury risk between highly specialized and low specialized athletes (IRR [95%CI]: 1.9 [0.9, 3.7]). Players who participated in basketball year-round were twice as likely to sustain an injury compared to those who did not play year-round (IRR [95%CI]: 2.1 [1.1, 3.6]). Similarly, players who reported participating in basketball skills camps were at increased risk of injury compared to athletes who did not participate in basketball skill camps (IRR [95%CI]: 2.5 [1.2, 5.7]). CONCLUSION: Injury risk related to sport specialization in basketball may be specific to certain behaviors such as year-round play and participation in skills camps. Validated measures of comprehensive sport activity are needed to better measure specialization in youth sports to better determine injury risk related to sport specialization and develop injury prevention programs for basketball athletes.

Sex-Specific Regulation of Stress Susceptibility by the Astrocytic Gene Htra1.

Major depressive disorder (MDD) is linked to impaired structural and synaptic plasticity in limbic brain regions. Astrocytes, which regulate synapses and are influenced by chronic stress, likely contribute to these changes. We analyzed astrocyte gene profiles in the nucleus accumbens (NAc) of humans with MDD and mice exposed to chronic stress. Htra1 , which encodes an astrocyte-secreted protease targeting the extracellular matrix (ECM), was significantly downregulated in the NAc of males but upregulated in females in both species. Manipulating Htra1 in mouse NAc astrocytes bidirectionally controlled stress susceptibility in a sex-specific manner. Such Htra1 manipulations also altered neuronal signaling and ECM structural integrity in NAc. These findings highlight astroglia and the brain's ECM as key mediators of sex-specific stress vulnerability, offering new approaches for MDD therapies.

The Impact of the Social Determinants of Health on Athletic Trainer Availability in Indiana Secondary Schools.

CONTEXT: The Social Determinants of Health (SDOH) are circumstances individuals are born, work, and live, that influence health outcomes. Previous research has examined one determinant of economic stability and found disparities in socioeconomic status and athletic trainer availability (AT availability). OBJECTIVE: Examine SDOH characteristics of Indiana secondary schools and AT availability. DESIGN: Cross-sectional study. SETTING: Database secondary analysis. PARTICIPANTS: 426 secondary schools. MAIN OUTCOME MEASURES: All data was collected from publically available databases. The independent variable was AT availability, schools were classified as having a full-time AT (full-time AT), a part-time AT only (part-time AT), or no AT (no AT). The SDOH variables were gathered for each school (school and county-level). Data were summarized using measures of central tendencies, one-way ANOVAs, and Kruskal-Wallis tests. RESULTS: School enrollment was larger in schools with greater AT availability (p<.001). The proportion of non-white students was greater in schools with more AT availability (p=0.002). There was greater AT availability in counties with higher graduation rates (p=0.03). Post-hoc comparisons revealed significant differences in graduation rate between part-time AT and no AT schools (p=0.04). Schools with less AT availability were located in counties with a slightly higher percentage of the population uninsured (p=0.02). Schools with greater AT availability were located in counties with a higher ratio of population to primary care physicians (p=0.03). Schools with less AT availability were located in counties with higher population experiencing severe housing problems (p=0.02). There were no significant differences in AT availability based on the three social and community context variables (p>0.05). CONCLUSIONS: We found differences in AT availability and a different SDOH characteristics at the secondary school-level. There was less AT availability where high school graduation rates and population of primary care providers are lower. Strategies should be implemented to improve access to athletic health care in under-resourced communities.

Higher Levels of Income and Education are Associated with More Specialized Sport Participation Behaviors: Results from a Representative Sample of Youth Sport Parents from the United States.

Background: While previous studies have examined the impact of family socioeconomic characteristics on a child's sport specialization behaviors, this research has been limited to affluent communities with limited sociodemographic diversity. Hypothesis/Purpose: The purpose of this study was to examine associations of parent income and education with child sport specialization behaviors among a nationally representative sample of youth sport parents in the United States. Study Design: Cross-sectional. Methods: Parents of youth athletes in the United States (n=236, age: 39.2±8.1 years, 57.2% female) were recruited to complete an online questionnaire by Qualtrics Online Samples (Qualtrics, Provo, UT) using a combination of actively managed, double-opt-in market research panels. The questionnaire used for this study consisted of: 1) parent demographics (including parent age, race/ethnicity, biological sex, gender identity, household income, and educational status), and 2) child sport participation characteristics and sport specialization behaviors. Results: Parents who reported an annual household income of $75,001 or more were more likely than parents making less than $75,000 to report that their child participated on an organized club team (OR [95%CI]: 1.94 [1.15-3.27]), participated on multiple organized teams at the same time (OR [95%CI]: 1.85 [1.10-3.11]), or specialized in a single sport (OR [95%CI]: 2.45 [1.45-4.14]). Parents who reported receiving a Bachelor's degree or higher were more likely than parents who did not to report that their child participated on an organized club team (OR [95%CI]: 3.04 [1.78-5.18]), participated on multiple organized teams at the same time (OR [95%CI]: 2.42 [1.43-4.10]), or specialized in a single sport (OR [95%CI]: 1.94 [1.15-3.26]). Conclusions: Thes results suggest that in the modern youth sport culture, family resources may serve as a major determining factor in the type of experiences available for a youth athlete. Level of Evidence: III.

Differences in Access to Athletic Trainers in Public Secondary Schools Based on Socioeconomic Status.

CONTEXT: Significant health care disparities exist in the United States based on socioeconomic status (SES), but the role SES has in secondary school athletes' access to athletic training services has not been examined on a national scale. OBJECTIVE: To identify differences in access to athletic training services in public secondary schools based on school SES. DESIGN: Cross-sectional study. SETTING: Database secondary analysis. PATIENTS OR OTHER PARTICIPANTS: Data for 3482 public high schools. MAIN OUTCOME MEASURE(S): Data were gathered from the Athletic Training Locations and Services (ATLAS) database, US Census Bureau, and National Center for Education Statistics. We included schools from 5 states with the highest, middle, and lowest poverty percentages (15 states total) and collected county median household income, percentage of students eligible for free or reduced-price lunch, race and ethnicity demographics, and access to athletic training services (full-time athletic trainer [AT], part-time AT only, no AT) for each school. Data were summarized in means, SDs, medians, interquartile ranges (IQRs), frequencies and proportions, 1-way analyses of variance, and Kruskal-Wallis tests. RESULTS: Differences were present in school SES between schools with full-time, part-time-only, and no athletic training services. Schools with greater access to athletic training services had fewer students eligible for free or reduced-price lunch (full time: 41.1% ± 22.3%, part time only: 45.8% ± 24.3%, no AT: 52.9% ± 24.9; P < .001). Similarly, county median household income was higher in schools with increased access to athletic training services (full time median [IQR]: $56 026 [$49 085-$64 557], part time only: $52 719 [$45 355-$62 105], and no AT: $49 584 [$41 094-$57 688]; P < .001). CONCLUSIONS: Disparities in SES were seen in access to athletic training services among a national sample of public secondary schools. Access to ATs positively influences student-athletes' health care across several measures. Pilot programs or government funds have been used previously to fund athletic training services and should be considered to ensure equitable access, regardless of school SES.