Her Life Depends On It: Sport, Physical Activity and the Health and Well-Being of American Girls

This report is a comprehensive compendium of research that points to physical activity and sport as fundamental solutions for many of the serious health and social problems faced by American girls. An appreciable mass of evidence-based knowledge about girls' involvement with sport and physical activity has been generated during the last decade. The amount and quality of this research are uneven and varied. For example, a good deal of research examines the associations between physical activity and risk for coronary heart disease, but studies that focus on risk for Alzheimer's disease are just beginning to issue. Researchers have verified links between high school athletic participation and teen pregnancy prevention, although more longitudinal research is needed to thoroughly confirm the connections. Overall, however, this report shows that the current state of knowledge on the relationship of physical activity to the health and social needs of American girls warrants the serious attention of public health officials, educators and sport leaders

Her Life Depends on it III: Sport, Physical Activity and the Health and Well-being of American Girls and Women

Her Life Depends On It III is the Women's Sports Foundation's comprehensive report that reviews existing and emerging research on the links between participation in sport and physical activity and the health and wellbeing of American girls and women. As with the previous editions in 2004 and 2009, this study also confirms that physical activity and sport provides the critical foundation, in no small part, that allows girls and women to lead healthy, strong, and fulfilled lives. Ten years since its first publication, the updated Her Life Depends On It provides an even more comprehensive review of the ever-expanding body of research that demonstrates how important it is for girls and women to participate in sport and physical activity. The report's contents reflect the review of 1,500 studies, nearly 400 covered since the previous edition

Her Life Depends on it: Sport, Physical Activity and the Health and Well-Being of American Girls

By Don Sabo, Kathleen E. Miller, Merrill J. Melnick, Leslie Heywood.https://digitalcommons.brockport.edu/bookshelf/1166/thumbnail.jp

Persistent Impairment in Cerebral Vasoreactivity in Subacute Phase Following Concussion

Concussion diagnosis is characterized by a lack of objective markers, as there is a paucity of better understanding of the pathophysiology. Cerebral vasoreactivity (CVR), an important factor in cerebral blood flow (CBF) regulation with dynamic changes in metabolism can be assessed utilizing manipulation of arterial carbon dioxide. CVR utilizing transcranial Doppler ultrasonography may be a useful, objective vascular biomarker for physiological recovery. PURPOSE: To determine the link between clinical symptoms and CVR on Day-3, Day-21, and Day-90 following a concussion in comparison to the non-injured controls. METHODS: Twenty-seven male and female collegiate athletes (21 ±1years) sustaining a sports-related concussion were enrolled. Age and sports-matched non-injured controls were also enrolled. For the concussed athletes, data were obtained on Day-3, Day-21, and Day-90 (N= 17) following the head injury. Symptom severity and cognition were assessed using the Sports Concussion Assessment Tool-3rd Edition (SCAT-3). Depression was assessed utilizing the Patient Health Questionnaire (PHQ-9). Continuous middle cerebral artery blood flow velocity (MCAV) was obtained with transcranial Doppler ultrasonography (TCD) while subjects were seated in an upright position. End-tidal CO₂ (PetCO₂) was measured with an infrared CO₂ analyzer attached to a nasal cannula. MCAV was evaluated in response to changes in PetCO₂ for 2-minutes each during normal breathing (normocapnia), inspiring a gas mixture containing 8% CO₂, 21% oxygen (hypercapnia), and hyperventilating (hypocapnia). RESULTS: On Day-3 subsequent to the head injury, concussed athletes displayed higher symptom number (2.5±3 vs. 12.1±7; PCONCLUSION: Elevated symptoms and lower cognitive scores on Day-3 were resolved by Day-21 following a sports-related concussion. On the other hand, CVR remained impaired at 90 days following concussion suggesting persistent physiological impairment beyond symptom resolution, which could accentuate secondary injuries during this phase. Future studies with a large sample size and longer follow-up period are needed to validate the use of CVR as an objective marker

Cerebral Vasoreactivity Is Impaired Beyond Symptom Resolution Following Concussion in Collegiate Athletes

Compromised cerebral blood flow (CBF) regulation is linked to impaired functional outcome following concussion. Cerebral vasoreactivity (CVR), an important mechanism in CBF regulation, is the ability of cerebral blood vessels to alter blood flow during dynamic changes in arterial carbon-dioxide (CO₂). PURPOSE: The purpose of this study was to examine CVR in an ongoing prospective cohort of collegiate athletes during acute (day-3) and sub-acute (day-21) phases following concussion and compare them with non-injured athletes. METHODS: Sixteen male and female collegiate athletes (21±1 years) with sports-related concussion and 16 sports matched non-injured controls (21±1 years) were enrolled in the study. For injured athletes, data was collected during the acute and sub-acute phase following concussion and for the controls data was collected at one time point. Symptom severity and cognition were assessed using the Sports Concussion Assessment Tool-3rd Edition. Continuous middle cerebral artery blood flow velocity (MCAV) was obtained with transcranial Doppler ultrasonography (TCD) while subjects were seated in an upright position. End-tidal CO₂ (PetCo₂) was measured with an infrared CO₂ analyzer attached to a nasal cannula. MCAV was evaluated in response to changes in PetCo₂ for 2-minutes each during normal breathing (normocapnia), inspiring a gas mixture containing 8% CO₂, 21% oxygen (hypercapnia) and, hyperventilating (hypocapnia). CVR was analyzed as the slope of the linear relationship between PetCo₂ and MCAV, which was expressed as the percent change in CBF velocity per mmHg change in PetCo₂. Independent and paired t-tests were used to compare symptom severity, and CVR between acute and sub-acute phase following concussion with the controls. RESULTS: As anticipated, concussed athletes exhibited higher symptom severity (26.3±0.5 versus 5±7 P= 0.0007) and lower cognition (26.5±1.6 versus 28.3±2.4 P=0.03) during acute phase compared to the controls. Although symptoms and cognition were resolved during the sub-acute phase, CVR was lower in the acute phase compared to the non-injured controls (1.7±0.5U versus 2.3±0.3U, P=0.0006) and it continued to be blunted in the sub-acute phase following concussion (1.9±0.5U P=0.04). CONCLUSION: Despite improvements in symptom and cognition, cerebral vasoreactivity appears to be impaired in the sub-acute phase following concussion. Cerebral vasoreactivity utilizing TCD may be a useful vascular biomarker for physiological recovery and aid in accurate return-to play decision-making

Untangling the Links Among Athletic Involvement, Gender, Race, and Adolescent Academic Outcomes

Although previous research has established that high school sports participation may be associated with positive academic outcomes, the parameters of the relationship remain unclear. Using a longitudinal sample of nearly 600 Western New York adolescents, this study examined gender- and race-specific differences in the impact of two dimensions of adolescent athletic involvement (“jock” identity and athlete status) on changes in school grades and school misconduct over a two-year interval. Female and black adolescents who identified themselves as “jocks” reported lower grades than those who did not, whereas female athletes reported higher grades than female nonathletes. Jocks also reported significantly more misconduct (including skipping school, cutting classes, having someone from home called to the school for disciplinary purposes, and being sent to the principal’s office) than nonjocks. Gender moderated the relationship between athlete status and school misconduct; athletic participation had a less salutary effect on misconduct for girls than for boys

Cardiac Vagal Tone Impairment is Associated with Reduced Cerebral Blood Flow in Collegiate Athletes Following Concussion

Reduced cerebral blood flow (CBF) is linked to functional disturbances following concussion. Since cardiac vagal tone (an index of cardiac health) is associated with disturbances in the autonomic nervous system, deficits in CBF are likely associated with cardiac vagal tone impairment post-concussion. PURPOSE: The current study examined cardiac vagal tone and CBF on days 3, 21 and 90 following concussion in comparison to non-injured control athletes. The association between these two variables was also evaluated. METHODS: Concussed male and female collegiate athletes were evaluated day-3 (N=29), day-21 (N=25) and day-90 (N=17) post concussion and matched controls were enrolled (N=29). A 3-lead electrocardiogram was used to assess cardiac vagal tone in the high frequency domain (HF; 0.15-0.4 Hz). Beat-to-beat mean arterial pressure (MAP) was obtained via finger photoplethysmography and transcranial Doppler ultrasonography (TCD) was used to assess middle cerebral blood flow velocity (MCAV). To measure vascular tone, cerebrovascular conductance index (CVCi) was estimated by dividing MCAV with MAP. Symptom severity and cognition were assessed using the Sports Concussion Assessment Tool-3rd Edition (SCAT-3) and executive function was assessed with the Trails test A & B. RESULTS: On day-3, concussed athletes had lower cognition (SAC 28±1vs.26±2,P=0.0005; Trails B 48±8vs.58±15sec,P=0.006) and HF power (52±12vs.36±14,P=0.006) compared to controls. On days 21 and 90, values were comparable to the controls. However, concussed participants were also categorized based on day-3 MCAV (divided at the median), into low and high MCAV groups. On day-3, the group with lower MCAV exhibited lower HF power (29±13vs.42±11.P=0.006) and lower CVCi (0.60±0.13vs.0.88±0.13,PCONCLUSION:Cardiac vagal tone was impaired 3 days following concussion compared to controls. Lower CBF was also associated with higher cerebrovascular tone. Additionally, lower CBF was linked to blunted cardiac vagal tone and functional outcome on day-21. On day-90, CBF recovered with normalization of functional outcome. Future studies with large sample are recommended to validate these findings

Improvement in Heart Rate Variability during Mild Cognitive Task Following Concussion

Cognitive rest is widely recommended following concussion until symptoms resolve. Unlike return-to-play protocols, there is a lack of clear guideline for return-to-learn in student athletes. Heart rate variability (HRV) is an index of cardiac health and reduced HRV is associated with disturbances in the autonomic nervous system (ANS) following concussion. PURPOSE: Therefore, the purpose of our study was to examine ANS modulation utilizing HRV at rest and during mild cognitive task in concussed and non-injured control athletes. METHODS: Nineteen collegiate athletes (20 ± 1 years) with a physician-diagnosed sports-related concussion were enrolled in the study acutely (4 ± 1 days) following a concussion. Nineteen sports matched non-injured controls also participated. Continuous heart rate recording was obtained with a standard three-lead electrocardiogram at rest and during a mild cognitive task while subjects where seated upright. Resting data was collected for 6 minutes. A computer based cognitive test (2-Back) designed to assess sustained attention and executive function was administered for 3 minutes. Average response time and the percentage of correct responses were obtained from the 2-Back trial. HRV was analyzed with power spectral analysis within the low (LF, 0.04-0.15 Hz) and high (HF, 0.15-0.4 Hz) frequency domains. Normalized LF and HF power spectral densities (n.u.) and LF/HF ratio were obtained. Two-way repeated measures ANOVA {group (concussed, control) x condition (rest, 2-Back)} was used to examine the variables. RESULTS: Higher LF (61.1±15 vs. 45±12, P=0.007), lower HF (38.8±15 vs.54.4±12, P=0.008) variability and higher LF/HF ratio (2.2±2 vs. 0.92±0.4, P= 0.005) were observed in the concussed athletes compared to controls at rest indicating exaggeration of the sympathetic nervous system modulation. Conversely, lower LF (44.5±14, P=0.003), higher HF (55.4±14, P= 0.003) and lower LF/HF ratio (0.92±0.5, P=0.003) was observed with 2-Back cognitive tasks as opposed to rest in the concussed group. The control group showed no difference in HRV between rest and 2-back trials. Despite similar response times for the 2-Back cognitive task, the percentage of correct response was lower (79.9±14.2 vs. 89.9±4.6, P=0.008) in the concussed athletes compared to the non-injured athletes. CONCLUSION: Disturbances in ANS exist as early as 4 days following a concussion. Mild cognitive tasks during rehabilitation may be advantageous in improving cognitive function on and off the field and may expedite the return-to-learn phase in student athletes. Further studies in this field are needed to determine if current complete cognitive rest is possibly inhibitory to recovering in concussed athletes, as opposed to mild cognitive task to promote ANS function

Identification of PKD1L1 Gene Variants in Children with the Biliary Atresia Splenic Malformation Syndrome

Biliary atresia (BA) is the most common cause of end‐stage liver disease in children and the primary indication for pediatric liver transplantation, yet underlying etiologies remain unknown. Approximately 10% of infants affected by BA exhibit various laterality defects (heterotaxy) including splenic abnormalities and complex cardiac malformations — a distinctive subgroup commonly referred to as the biliary atresia splenic malformation (BASM) syndrome. We hypothesized that genetic factors linking laterality features with the etiopathogenesis of BA in BASM patients could be identified through whole exome sequencing (WES) of an affected cohort. DNA specimens from 67 BASM subjects, including 58 patient‐parent trios, from the NIDDK‐supported Childhood Liver Disease Research Network (ChiLDReN) underwent WES. Candidate gene variants derived from a pre‐specified set of 2,016 genes associated with ciliary dysgenesis and/or dysfunction or cholestasis were prioritized according to pathogenicity, population frequency, and mode of inheritance. Five BASM subjects harbored rare and potentially deleterious bi‐allelic variants in polycystin 1‐like 1, PKD1L1, a gene associated with ciliary calcium signaling and embryonic laterality determination in fish, mice and humans. Heterozygous PKD1L1 variants were found in 3 additional subjects. Immunohistochemical analysis of liver from the one BASM subject available revealed decreased PKD1L1 expression in bile duct epithelium when compared to normal livers and livers affected by other non‐cholestatic diseases. Conclusion WES identified bi‐allelic and heterozygous PKD1L1 variants of interest in 8 BASM subjects from the ChiLDReN dataset. The dual roles for PKD1L1 in laterality determination and ciliary function suggest that PKD1L1 is a new, biologically plausible, cholangiocyte‐expressed candidate gene for the BASM syndrome