Recent Advances in Covalent Drug Discovery.

In spite of the increasing number of biologics license applications, the development of covalent inhibitors is still a growing field within drug discovery. The successful approval of some covalent protein kinase inhibitors, such as ibrutinib (BTK covalent inhibitor) and dacomitinib (EGFR covalent inhibitor), and the very recent discovery of covalent inhibitors for viral proteases, such as boceprevir, narlaprevir, and nirmatrelvir, represent a new milestone in covalent drug development. Generally, the formation of covalent bonds that target proteins can offer drugs diverse advantages in terms of target selectivity, drug resistance, and administration concentration. The most important factor for covalent inhibitors is the electrophile (warhead), which dictates selectivity, reactivity, and the type of protein binding (i.e., reversible or irreversible) and can be modified/optimized through rational designs. Furthermore, covalent inhibitors are becoming more and more common in proteolysis, targeting chimeras (PROTACs) for degrading proteins, including those that are currently considered to be 'undruggable'. The aim of this review is to highlight the current state of covalent inhibitor development, including a short historical overview and some examples of applications of PROTAC technologies and treatment of the SARS-CoV-2 virus.

Youth Sport Participation Experiences From the Perspective of Hispanic/Latinx Parents and Their Children.

Hispanic/Latinx communities remain an underserved population in terms of health and physical activity opportunities. The rise of sport specialization can jeopardize these opportunities. Understanding the appeal and welcomeness that minoritized populations feel toward sport and sport specialization culture can play an important role in health promotion and breaking down barriers that widen the gap on physical activity levels in Hispanic/Latinx communities. To date, these studies have not qualitatively investigated Hispanic/Latinx youth sport dyads (parent and child) and how sport specialization perceptions have affected their sport participation experiences. We used a qualitative interpretative phenomenological analysis to explore experiences of Hispanic/Latinx high school athletes. We engaged in semistructured interviews with 12 parent-child dyads. The following 3 interrelated themes emerged: (a) expectations of youth sport participation, (b) meeting expectations of youth sport participation, (c) and (mis)alignment of cultures. Dyads describe a negative youth sport experience when both cultures do not align because of the rise in sport specialization and pay-to-play culture. Findings indicate that dyads understand what is necessary to participate in organized sport and do this by methods that are rooted in their Hispanic/Latinx culture.

Vasopressin-induced hyponatremia in an adult normotensive trauma patient: A case report.

BACKGROUND: Arginine vasopressin is a neuropeptide produced in the hypothalamus and released by the posterior pituitary gland. In addition to maintaining plasma osmolarity, under hypovolemic or hypotensive conditions, it helps maintain plasma volume through renal water reabsorption and increases systemic vascular tone. Its synthetic analogues are widely used in the intensive care unit as a continuous infusion, in addition to hospital floors as an intravenous or intranasal dose. A limited number of cases of hyponatremia in patients with septic or hemorrhagic shock have been reported previously with vasopressin. We report for the first time a normotensive patient who developed vasopressin-induced hyponatremia. CASE SUMMARY: A 39-year-old man fell off a forklift and sustained an axial load injury to his cranium. He had no history of previous trauma. Examination was normal except for motor and sensory deficits. The Imagine test showed endplate fracture at C7 and acute traumatic disc at C7 with cortical degeneration. He underwent cervical discectomy and fusion, laminectomy, and posterior instrumented fusion. After intensive care unit admission post-surgery, he developed hyponatremia of 121-124 mEq/L post phenylephrine and vasopressin infusion to maintain blood pressure maintenance. He was evaluated for syndrome of inappropriate secretion of antidiuretic hormone, hypothyroid, adrenal-induced, or diuretic-induced hyponatremia. At the end of extensive evaluation for the underlying cause of hyponatremia, vasopressin was discontinued. He was also put on fluid restriction, given exogenous desmopressin, and a dextrose 5% in water infusion to prevent osmotic demyelination syndrome caused by sodium overcorrection which improved his sodium level to 135 mmol/L. CONCLUSION: The presentation of vasopressin-induced hyponatremia is uncommon in normotensive patients, and the most difficult aspect of this condition is determining the underlying cause of hyponatremia. Our case illustrates that, considering the vast differential diagnosis of hyponatremia in hospitalized patients, both hospitalists and intensivists should be aware of this serious complication of vasopressin therapy.

Combined targeting of soluble latent TGF-ß and a solid tumor-associated antigen with adapter CAR T cells.

Solid tumors consist of malignant and nonmalignant cells that together create the local tumor microenvironment (TME). Additionally, the TME is characterized by the expression of numerous soluble factors such as TGF-ß. TGF-ß plays an important role in the TME by suppressing T cell effector function and promoting tumor invasiveness. Up to now CAR T cells exclusively target tumor-associated antigens (TAA) located on the cell membrane. Thus, strategies to exploit soluble antigens as CAR targets within the TME are needed. This study demonstrates a novel approach using Adapter CAR (AdCAR) T cells for the detection of soluble latent TGF-ß within the TME of a pancreatic tumor model. We show that AdCARs in combination with the respective adapter can be used to sense soluble tumor-derived latent TGF-ß, both in vitro and in vivo. Sensing of the soluble antigen induced cellular activation and effector cytokine production in AdCAR T cells. Moreover, we evaluated AdCAR T cells for the combined targeting of soluble latent TGF-ß and tumor cell killing by targeting CD66c as TAA in vivo. In sum, our study broadens the spectrum of targetable moieties for AdCAR T cells by soluble latent TGF-ß.

VRK1 as a synthetic lethal target in VRK2 promoter-methylated cancers of the nervous system.

Collateral lethality occurs when loss of a gene/protein renders cancer cells dependent on its remaining paralog. Combining genome-scale CRISPR/Cas9 loss-of-function screens with RNA sequencing in over 900 cancer cell lines, we found that cancers of nervous system lineage, including adult and pediatric gliomas and neuroblastomas, required the nuclear kinase vaccinia-related kinase 1 (VRK1) for their survival in vivo. VRK1 dependency was inversely correlated with expression of its paralog VRK2. VRK2 knockout sensitized cells to VRK1 loss, and conversely, VRK2 overexpression increased cell fitness in the setting of VRK1 loss. DNA methylation of the VRK2 promoter was associated with low VRK2 expression in human neuroblastomas and adult and pediatric gliomas. Mechanistically, depletion of VRK1 reduced barrier-to-autointegration factor phosphorylation during mitosis, resulting in DNA damage and apoptosis. Together, these studies identify VRK1 as a synthetic lethal target in VRK2 promoter-methylated adult and pediatric gliomas and neuroblastomas.

Transition to a mesenchymal state in neuroblastoma confers resistance to anti-GD2 antibody via reduced expression of ST8SIA1.

Immunotherapy with anti-GD2 antibodies has advanced the treatment of children with high-risk neuroblastoma, but nearly half of patients relapse, and little is known about mechanisms of resistance to anti-GD2 therapy. Here, we show that reduced GD2 expression was significantly correlated with the mesenchymal cell state in neuroblastoma and that a forced adrenergic-to-mesenchymal transition (AMT) conferred downregulation of GD2 and resistance to anti-GD2 antibody. Mechanistically, low-GD2-expressing cell lines demonstrated significantly reduced expression of the ganglioside synthesis enzyme ST8SIA1 (GD3 synthase), resulting in a bottlenecking of GD2 synthesis. Pharmacologic inhibition of EZH2 resulted in epigenetic rewiring of mesenchymal neuroblastoma cells and re-expression of ST8SIA1, restoring surface expression of GD2 and sensitivity to anti-GD2 antibody. These data identify developmental lineage as a key determinant of sensitivity to anti-GD2 based immunotherapies and credential EZH2 inhibitors for clinical testing in combination with anti-GD2 antibody to enhance outcomes for children with neuroblastoma.

Intake of corn stover botanical parts by growing and finishing beef steers.

Single-pass corn stover harvest is a method whereby combine harvester tailings consisting of cob, stalk, leaf, husk, and tassel fractions are collected and baled without coming into contact with soil. The objective was to feed beef steers diets that included a roughage component consisting of harvested corn residue in chopped form from conventional corn stover bales (CST) or single-pass bales (SPB) to assess intake selectivity of corn stover fractions and estimate net energy values of these corn stovers. Whole plant corn silage served as the control roughage in the control diet (CSIL). Steers (n = 90, 5 pens per treatment) were fed during Grow (84 d) and Finish (66 d) trials. Steers sorted through corn stover during both trials and consumed 52.5% of corn stover offered and 40% of cob offered. Intake of SPB cob was 2.6-fold and 3.3-fold greater than CST cob intake (P < 0.01) in Grow and Finish trials, respectively, indicating that when more cob was available, cattle consumed more. During the Grow trial, stover intake tended (P = 0.07) to be lower for SPB and diet dry matter intake (DMI) was less (P ≤ 0.05) for SPB, which may be due to the elevated cob intake by SPB steers. Across treatments, stover DMI was similar in the Grow (1.10 kg per steer per d) and Finish (1.11 kg per steer per d) trials. The proportion (65%) of Fines (<8 mm) consumed from the Grow diet (40% neutral detergent fiber, aNDF) was greater than the Finish diet (25% aNDF; 18% to 31%) and gleaning of concentrate feeds from orts seemed to be more extensive in the Grow diet. Steers consuming Finish diets containing SPB and CST had DMI that were 17% and 18%, respectively, greater (P ≤ 0.05) than CSIL, an indication of compensatory intake. The physical effectiveness factors for stovers fed in the Grow and Finish diets were 0.85 and 0.95, respectively. Estimates for net energy maintenance and net energy gain (NEg), respectively, using National Research Council methods from 2001 were as follows for consumed stovers: SPB (1.09 and 0.54 Mcal/kg) and CST (0.98 and 0.44 Mcal/kg) in the Grow trial, and SPB (0.96 and 0.42 Mcal/kg) and CST (0.95 and 0.40 Mcal/kg) in the Finish trial. Although SPB and CST differ in botanical fraction composition and net intakes of botanical fractions, their energetic contributions to steer performance were very similar. Steers fed the Finish diet (1.25 Mcal performance-adjusted NEg per kg) selected stover botanical components to achieve a diet composition of 25% aNDF.

Alfalfa biotypes with putative enhanced cell wall digestibility and effects on performance of growing beef steers.

Three alfalfa biotypes were chosen based on the presumption that they would be sources of alfalfa herbage that differed in lignin concentration and therefore cell wall digestibility. The hypothesis was that a lesser lignin concentration would result in greater alfalfa neutral detergent fiber (NDF) digestibility and greater beef steer growth performance. The three alfalfa biotypes were HarvXtra (Forage Genetics International), Hi-Gest 360 (Alforex Seeds), and a control alfalfa, LegenDairy XHD (Winfield Solutions LLC). High-moisture wrapped bales were prepared from second-harvest, d 30 crops. Digestibility of NDF was determined using in vitro incubations and a steer digestibility trial. Alfalfa baleage and trace mineral salt were fed to Angus steers (300 kg initial body weight, 4 pens/treatment) in an 83-day growing-phase trial. Alfalfa acid detergent lignin concentrations were 75.6, 71.8, and 63.0 g/kg dry matter (P = 0.34) for LegenDairy, Hi-Gest and HarvXtra, respectively. Based on in vitro total-tract NDF digestibility coefficients, HarvXtra tended (P ≥ 0.09) to have the highest NDF digestibility. Alfalfa biotype affected in vivo apparent total tract digestibility of NDF (P < 0.001) and there was a trend for an effect on acid detergent fiber digestibility (P = 0.051). Hi-Gest and HarvXtra had similar in vivo apparent NDF digestibilities, which were greater than for LegenDairy (P < 0.05). There was no alfalfa biotype effect on daily alfalfa dry matter intake (DMI; P = 0.51) or average daily gain (P = 0.25) by growing steers. The absence of an effect by the novel alfalfa biotypes on DMI by growing steers suggests that the compositional and digestibility differences of the novel alfalfa biotypes compared to LegenDairy were not sufficient to alleviate the limitation of physical fill (if evident) on DMI. If more disparity in cell wall composition and NDF digestibility were to exist between control and reduced-lignin biotypes, then perhaps an advantage in cattle growth performance for a reduced-lignin alfalfa biotype would be detectable.

Comparing High School Sport Specialization Trends Between Division I and Club Collegiate Athletes.

BACKGROUND: Adolescent athletes report that sports specialization improves their ability to receive a collegiate athletics scholarship, though this is not well-understood. The purpose of this study was to examine self-reported trends in high school specialization and influences for sport participation between Division I (D-I) and college-aged club (club) athletes. HYPOTHESIS: There would be no difference in high school sport specialization or sport participation influences between D-I and club athletes. STUDY DESIGN: Retrospective cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: A survey included specialization classification (low, moderate, and high) for 9th to 12th grade, age that the athlete started organized sport and his or her collegiate sport, and several influential factors for participation in one's primary high school sport (1 = no influence to 5 = extremely influential). Chi-square analyses were used to compare specialization classifications between groups. Nonparametric tests were used to determine significant differences in age-related variables and influential factors between D-I and club athletes. All analysis were also conducted with boys and girls separately. RESULTS: Participants included 266 D-I (girls, 155; 58%) and 180 club (girls, 122; 68%) athletes. Club athletes were more likely to be classified as low specialization at every grade in high school, and this difference was more pronounced between D-I and club female athletes than male athletes. The number of years an athlete was classified as highly specialized in high school was not different between D-I and club athletes. Club athletes were more influenced by playing with friends than D-I athletes and D-I athletes were more influenced by pursuing a collegiate scholarship than club athletes. CONCLUSION: High levels of specialization in high school sport may not be necessary for playing at the collegiate level, though some level of specialization in high school might be necessary. CLINICAL RELEVANCE: Clinicians should advocate for healthy long-term athlete development, which does not support high specialization in high school sports.

High School Sport Specialization and Injury in Collegiate Club-Sport Athletes.

CONTEXT: Sport specialization during adolescence may affect future injury risk. This association has been demonstrated in some professional sport athletes. OBJECTIVE: To determine the association between adolescent sport specialization levels in high school and injuries sustained during collegiate club sports. DESIGN: Cross-sectional study. SETTING: Paper and online surveys. PATIENTS OR OTHER PARTICIPANTS: Collegiate club-sport athletes. MAIN OUTCOME MEASURES(S): An anonymous survey was administered from September 2019 to May 2020. The survey included sport specialization classification via a commonly used 3-point scale (low, moderate, high) for each high school year (9th-12th), high school sports participation, and collegiate club-sport injury history. The number of years (0-4) an individual was highly specialized in high school was calculated. Individuals who participated in the same sport in high school and college were compared with individuals who played a different sport in college than in high school. An injury related to sport club activities was classified as arising from a contact, noncontact, or overuse mechanism required and the individual to seek medical treatment or diagnosis. Injuries were classified into overuse and acute mechanisms for the upper extremity, lower extremity (LE), and head/neck. RESULTS: Single-sport participation and the number of years highly specialized in high school sport were not associated with college club-sport injuries (P > .1). Individuals who played a different collegiate club sport than their high school sport were more likely to report an LE or head/neck acute injury compared with athletes who played the same collegiate and high school sport (LE = 20% versus 8%, χ2 = 7.4, P = .006; head/neck = 16% versus 3%, χ2 = 19.4, P < .001). CONCLUSIONS: Adolescent sport specialization was not associated with reported injuries in collegiate club-sport athletes. Collegiate club-sport athletic trainers should be aware that incoming students exploring a new sport may be at risk for LE and head/neck acute injuries.

Beef production from cull dairy cows: a review from culling to consumption.

Although more than 3 million head of dairy cows enter the food supply chain in the U.S. every year, research on this topic remains limited and scarce. Meat production from dairy cows is a significant component of beef production, accounting for almost 10% of U.S. commercial beef production. Thus, the purpose of this review is to demonstrate the importance of dairy cows as a beef source, and to provide an overview on topics from farm to meat product-culling, marketing, transportation, welfare, body composition and its relationship with lactation particularities, carcass characteristics, meat quality, and traceability. Current scientific evidence has shown that culling a dairy cow at an appropriate time has beneficial effects on cow welfare and, consequently, cow value. During marketing the dairy cow is visually evaluated for health and factors associated with its expected carcass value; thus, marketing a well-conditioned cow will ensure that the animal is fit for transportation and provides high carcass yield. However, limitations such as low body condition score, lameness or mobility problems, and visual defects remain persistent. Even though beef harvest plants accommodate cows in all body composition states, the current carcass grade system does not reflect the mature cow industry needs. Therefore, improvement of the grading system could maximize carcass utilization and increase cow carcass value by recognizing subprimal cuts that could be merchandised as whole muscle cuts. Lastly, implementation of a traceability system would unify information from the farm to harvest assisting the industry in making further advancements.

The effect of life history events on carcass merit and price of cull dairy cows.

Cull dairy cows contribute almost 10% of national beef production in the United States. However, different factors throughout the life of dairy cows affect their weight and overall body condition as well as carcass traits, and consequently affect their market price. Therefore, the objectives of this study were: (1) to assess relationships between price ratio and carcass merit of cull dairy cows sold through several sites of an auction market and (2) to investigate the effect of animal life history events and live weight on sale barn price (BP) and price ratio (as a measure of relative price), as an indicator of carcass merit. Data from 4 dairy operations included 3,602 cull dairy cow records during the period of 2015 to 2019. Life history events data were collected from each dairy operation through Dairy Comp software; live weight and price were obtained periodically from the auction market, and the carcass data were provided by a local packing plant. Cow price in dollars per unit of live weight ($/cwt) and price ratio were the 2 outcome variables used in the analyses. Price ratio was created aiming to remove seasonality effects from BP (BP divided by the national average price for its respective month and year of sale). The association between price ratio and carcass merit traits was investigated using canonical correlation analysis, and the effect of life history events on both BP and price ratio was inferred using a multiple linear regression technique. More than 70% of the cows were culled in the first 3 lactations, with an average live weight of 701.5 kg, carcass weight of 325 kg, and dressing percentage of 46.3%. On average, cull cows were sold at $57.0/cwt during the period considered. The canonical correlation between price ratio and carcass merit traits was 0.76, indicating that price ratio reflected carcass merit of cull cows. Later lactations led to lower BP compared with cows culled during the first 2 lactations. Injury, and leg and feet problems negatively affected BP. Productive variables demonstrated that the greater milk production might lead to lower cow prices. A large variation between farms was also noted. In conclusion, price ratio was a good indicator of carcass merit of cull cows, and life history events significantly affected sale BP and carcass merit of cull cows sold through auction markets.

Hepatogenous Photosensitivity Outbreak after Coccidiosis in Grazing Holstein Steers.

Clinical signs of photosensitivity in cattle can occur sporadically and unpredictably. It is believed that cases of photosensitivity may be underreported, causing inaccurate and inflated reports of mortality. Additionally, because secondary photosensitization in grazing cattle occurs with liver damage or dysfunction, photosensitivity can have many potential or associated causes. This case links a previous occurrence of coccidiosis to an outbreak of photosensitivity in grazing Holstein steers. Grazing management staff first observed clinical signs of photosensitivity 17 days after an outbreak of coccidiosis and subsequent turnout to spring pastures. Clinical signs were observed in 25% of the population. The severity of photosensitivity was variable and ranged from blistered skin on the muzzle to sloughing of unpigmented epidermis and thinly haired regions. Severely affected cattle were removed from pasture, housed under shade, monitored for infection, and recovered without treatment. Mild cases remained on pasture and recovered without treatment. Photosensitivity did not reoccur in the cattle that remained on pasture or in mildly affected cattle returned to pasture. Photosensitivity did not appear to be associated with pasture weeds, a specific forage species, or variable or extreme weather conditions that could have resulted in mycotoxin production. The occurrence appears to have been a result of a previous and concurrent coccidiosis outbreak that caused secondary photosensitization through hepatic lipidosis caused by anorexia and dehydration associated with the severe coccidiosis. Although clinical signs appeared suddenly, cattle recovered quickly and without treatment.

Training Load and Injury Among Middle School-Aged Athletes.

CONTEXT: Young athletes are encouraged to participate in high-intensity sport programs. However, most research on the association between training volume (TV) and injury has been performed on adult or professional athletes. OBJECTIVE: To evaluate the association between acute and chronic TV (hours/week) and reported injury (yes/no) and evaluate the relationship between acute : chronic TV and injury while controlling for sex, age, and prior injury in young athletes. DESIGN: Cohort study. SETTING: Online surveys. PATIENTS OR OTHER PARTICIPANTS: Middle school-aged adolescents. MAIN OUTCOME MEASURE(S): We conducted a baseline survey at the start of the 2017-2018 academic year. The baseline survey solicited information regarding demographics, injury history, and primary sport. Subsequent surveys were delivered electronically at the start of each week. Information obtained with the weekly survey included weekly TV and injuries sustained the previous week. Injuries were reported and classified (eg, acute or gradual onset) by the participants. Weekly TV was aggregated as rolling averages over the prior 2, 3, and 4 weeks. Acute:chronic TV was calculated for each participant for every week as the prior week TV divided by the TV during the prior 2 (1 : 2), 3 (1 : 3), and 4 (1 : 4) weeks of the study period. RESULTS: A total of 244 recruits participated. Higher average TV over the prior 4 weeks (odds ratio [OR] = 0.97; 95% confidence interval [CI] = 0.93, 1.00; P = .05) was associated with fewer reported injuries. Additionally, higher average TV over the prior 2 (OR = 0.96; 95% CI = 0.93, 0.99; P = .04), 3 (OR = 0.95; 95% CI = 0.91, 0.99; P = .02), and 4 (OR = 0.95; 95% CI = 0.91, 0.99; P = .05) weeks was associated with fewer reported acute injuries the following week. Acute:chronic TV and any injury type were not related. CONCLUSIONS: Consistent, higher levels of physical activity may offer protection against acute injury in young athletes.

A Randomized Controlled Trial of Power Posing on Timed Up and Go Test.

BACKGROUND: Integrating psychological principles into physical therapy treatment may enhance patient outcomes. One intervention strategy from psychological perspectives that could be integrated in physical therapy practice is power posing. There is a lack of research on the effects of power posing on functional outcomes commonly used in physical therapy. OBJECTIVE: To determine the effects of power posing on the timed up and go test score. DESIGN: Randomized controlled trial. METHODS: Subjects in the experimental group were instructed to stand with hands on their hips, elbows pointing out and feet approximately 1 foot apart for 20 s. Subjects in the control group were instructed to stand with hands and arms wrapping around the torso and feet together for 20 s. Timed up and go test was administered using an OmniVR Virtual Rehabilitation System before and after the postural intervention. RESULTS: The timed up and go test score changed by -0.17 s (SD 0.65) and -0.20 s (SD 0.43) for the experimental and control groups, respectively (p=0.87). CONCLUSIONS: The timed up and go test scores for both experimental and control groups improved slightly. However, the results did not show significant effects of power posing in the timed up and go test scores.

German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema).

Perianal dermatitis (anal eczema, perianal eczema) is one of the most common proctological conditions. It may occur as a sequela or a presenting symptom of various proctological, dermatological, allergic or pathogen-induced disorders. The three main types of anal eczema are irritant-toxic, atopic and allergic contact dermatitis. Adequate and successful treatment requires a comprehensive diagnostic workup to determine disease etiology and includes treatment/elimination of causative factors as well as nonpharmacological interventions (avoidance of aggravating factors). In addition, adjuvant topical anti-inflammatory and/or specific symptomatic treatment may be required. The present guidelines contain recommendations for the diagnostic and therapeutic management of perianal dermatitis. Target users of these guidelines are clinicians in the fields of dermatology and proctology, as well as all other specialties involved in the management of patients with perianal dermatitis, both in hospital and office-based settings.

Evaluation of adolescent sport specialization and injury mechanism by sex: A secondary analysis.

OBJECTIVES: The purpose of this study was to compare the association of sport specialization with previous overuse and acute injuries between male and female adolescent athletes. DESIGN: Cross-sectional study. METHODS: Questionnaires were completed by adolescent athletes from various sports at sport club summer events in the state of Wisconsin. Adolescent athletes (12-18 years old) who were active in organized sports in the previous year were recruited. The questionnaire contained demographics, sport participation, sport specialization classification, and previous injury history. Sport specialization classification was determined using common methods in sport specialization research. Previous injury was restricted to athletic injuries that occurred in the past year. RESULTS: Two-thousand and eleven participants (age=13.7±1.6 years, females=989) completed the questionnaire. Highly specialized athletes were more likely to report both acute and overuse injuries compared to low specialization athletes. However, this relationship differed by sex, with only moderate and highly specialized females being more likely (Moderate: OR [95%CI]=1.74 [1.18-2.58], p=0.005; High: OR [95%CI]=1.69 [1.14-2.53], p=0.010) to report an overuse injury compared to low specialization females. Highly specialized female athletes were more likely to report an acute injury (High: OR [95%CI]=1.46 [1.06-2.02], p=0.022) compared to low specialization females. Highly specialized male athletes were not associated with overuse or acute injuries. CONCLUSIONS: Highly specialized athletes were more likely to report acute and overuse injuries. However, when this analysis was separated by sex, only highly specialized females were more likely to report a previous overuse or acute injury.

Environmental Conditions, Preseason Fitness Levels, and Game Workload: Analysis of a Female NCAA DI National Championship Soccer Season.

Benjamin, CL, Hosokawa, Y, Curtis, RM, Schaefer, DA, Bergin, RT, Abegg, MR, and Casa, DJ. Environmental conditions, preseason fitness levels, and game workload: Analysis of a female NCAA DI National Championship Soccer Season. J Strength Cond Res 34(4): 988-994, 2020-The purpose of this study was to determine the independent and combined moderating effect of aerobic fitness and environmental conditions on physical workloads during collegiate female soccer matches. Nineteen National Collegiate Athletic Association female soccer athletes were included in this study (mean ± SD: age, 20.6 ± 1.4 years; height, 169 ± 6.1 cm; body mass 64.7 ± 5.3 kg). Maximal oxygen consumption (V[Combining Dot Above]O2max) was estimated from the yo-yo intermittent recovery test before preseason training and wet-bulb globe temperature (WBGT) was recorded onsite for home matches and at the nearest weather station for away matches. Relative distance (TD), relative high-speed running distance (%HSD), and relative high metabolic load (%HML) performance were collected during each match using a global positioning system unit (Viper Pod; STATSports, Chicago, IL). Statistically significant differences were observed in TD between LOW WBGT and MOD WBGT (mean difference [MD] = 7.08 m·min; effect size [ES] = 0.54; p < 0.001), in %HSD between LOW WBGT and MOD WBGT (MD = 1.97%; ES = 0.64; p = 0.01) and between LOW WBGT and HIGH WBGT (MD = 2.71%; ES = 1.01; p < 0.001), and in %HML between LOW WBGT and MOD WBGT (MD = 1.24%; ES = 0.56; p < 0.001) and between LOW WBGT and HIGH WBGT (MD = 1.55%; ES = 0.78; p = 0.01). There was a significant interaction between WBGT and V[Combining Dot Above]O2max for %HSD (p = 0.03). These findings demonstrate that physical performance metrics were affected by increased WBGT. In addition, aerobic fitness seemed to moderate the effect of increasing WBGT on %HSD, meaning maximizing aerobic capacity is important for optimizing running performance in the heat. Coaches and sports medicine staff could alter training time and session length based on environmental conditions as well as potentially use aggressive cooling strategies to mitigate the imposed heat stress and decrements in physical performance.

Parents' Awareness and Perceptions of Sport Specialization and Injury Prevention Recommendations.

OBJECTIVE: To conduct a survey of parents to determine their knowledge of sport volume recommendations and examine their perceptions toward sport specialization. DESIGN: Cross-sectional survey. SETTING: Youth sport athletic tournaments, competitions, and practices. PATIENTS OR OTHER PARTICIPANTS: Parents (n = 1000, 614 women, age: 44.5 ± 6.7 years) of youth athletes completed the survey. Parents had to have a child between 10 and 18 years of age who participated in organized sport in the previous 12 months. INTERVENTIONS: The survey was anonymous and consisted of yes/no and Likert-scale questions and consisted of background of parent and child and perceptions and knowledge of safe sport recommendations. An expert panel validated the survey. MAIN OUTCOME MEASURES: Data were summarized by frequencies, proportions (%), and mean values and SDs, when appropriate. Chi-square analyses were used to determine if parent sex influenced distributions. RESULTS: Over 80% of parents had no knowledge of sport volume recommendations regarding h/wk (84.5%), mo/yr (82.2%), or simultaneous participation in multiple leagues (89.9%). Twenty-four percent of parents considered it appropriate to participate in multiple leagues in the same sport, whereas 60.5% considered it appropriate to participate in multiple leagues of a different sport. Thirty-four percent of parents indicated that they were concerned about the risk of injury in youth sports. Although 55% of parents considered sport specialization a problem in youth sports, only 43.3% thought that year-round sport participation increased the chances of sustaining an overuse injury. Female parents were more likely to be concerned about injury and believe that year-round sport participation results in overuse injury compared with men. CONCLUSIONS: Recommendations associated with youth sport participation are not well known. However, parents are concerned about the risk of injury and consider sport specialization a problem.