Avulsion and Soft Tissue Injuries of the Ulnar Collateral Ligament in Children and Adolescents.

BACKGROUND: Although pediatric medial epicondylar fractures and apophysitis are well studied, patterns of subapophyseal avulsion and ligamentous injuries of the medial elbow in this population merit investigation to inform optimal treatment strategies. PURPOSE: To describe the occurrence and demographic correlates of ulnar collateral ligament (UCL) avulsion and soft tissue injuries of the pediatric and adolescent elbow. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: An institutional review board-approved review was conducted to identify consecutive patients with medial elbow injuries treated in a tertiary pediatric sports medicine practice between 2016 and 2021. Radiographs were obtained during injury evaluation, and patients with nondisplaced medial epicondylar apophysitis and complete epicondylar fracture were excluded, resulting in 150 patients with soft tissue injuries occurring distal to the medial epicondyle apophysis (subapophyseal) for study. Radiographs were evaluated for bony avulsion of the UCL from either the medial epicondyle proximally or the ulnar sublime tubercle distally. Injuries without radiographic evidence of bony avulsion, but with clinical examination findings consistent with ligamentous injury, were classified as radiographically negative UCL injuries, and magnetic resonance imaging (MRI) was performed to further evaluate these injuries if moderate to severe medial swelling of the elbow or significant concern for medial structural injury was present on examination. These MRI scans were evaluated to classify the UCL injury and assess for periosteal or cartilaginous avulsions. RESULTS: A total of 150 patients (mean age, 12.5 ± 3.4 years; 70 female), 55% (150/274) of the entire medial elbow injury population, had a subapophyseal injury. Of these patients, 62 had a bony avulsion detected on radiograph, and 88 had a radiographically negative injury. In addition to the 62 radiographic avulsions, the 61 MRI scans obtained on those radiographically negative injuries revealed 33 complete UCL disruptions, resulting in 63.3% (95/150) of patients sustaining a complete ligamentous disruption. With the MRI scans, 37 (61%) cases of cartilaginous or periosteal avulsion of the UCL were diagnosed. Overall, 66% of all 150 subapophyseal injuries had a bony, cartilaginous, or periosteal UCL avulsion. Patients with cartilaginous (mean age, 10.3 years) and bony (mean age, 10.6 years) avulsions were younger than those with central ligament injury (mean age, 14.2 years) or periosteal (mean age, 14.2 years) avulsions (P = .005). There was a significant association between the mechanism of injury and the location of UCL tear identified on MRI scans: traumatic falls were associated with distal tears, and throwing injuries were associated with proximal tears (P < .001). CONCLUSION: UCL central ligament and avulsion lesions may be frequently diagnosed after injury to the pediatric medial elbow, the majority of which are complete injuries, and may require MRI for diagnosis. The mechanism of injury may predict the location of ligamentous injury, and osteocartilaginous avulsions are more likely to present at younger ages than injuries to the soft tissue of the UCL or periosteum. The prevalence of these injuries merits further investigation into best protocols of nonoperative treatment or surgical repair techniques and outcomes.

Applications of chromatographic methods in metabolomics: A review.

Chromatography is a robust and reliable separation method that can use various stationary phases to separate complex mixtures commonly seen in metabolomics. This review examines the types of chromatography and stationary phases that have been used in targeted or untargeted metabolomics with methods such as mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy. General considerations for sample pretreatment and separations in metabolomics are considered, along with the various supports and separation formats for chromatography that have been used in such work. The types of liquid chromatography (LC) that have been most extensively used in metabolomics will be examined, such as reversed-phase liquid chromatography and hydrophilic liquid interaction chromatography. In addition, other forms of LC that have been used in more limited applications for metabolomics (e.g., ion-exchange, size-exclusion, and affinity methods) will be discussed to illustrate how these techniques may be utilized for new and future research in this field. Multidimensional LC methods are also discussed, as well as the use of gas chromatography and supercritical fluid chromatography in metabolomics. In addition, the roles of chromatography in NMR- vs. MS-based metabolomics are considered. Applications are given within the field of metabolomics for each type of chromatography, along with potential advantages or limitations of these separation methods.

Switching Lead for Tin in PbHfO3 : Noncubic Structure of SnHfO3.

The removal of lead from commercialized perovskite-oxide-based piezoceramics has been a recent major topic in materials research owing to legislation in many countries. In this regard, Sn(II)-perovskite oxides have garnered keen interest due to their predicted large spontaneous electric polarizations and isoelectronic nature for substitution of Pb(II) cations. However, they have not been considered synthesizable owing to their high metastability. Herein, the perovskite lead hafnate, i.e., PbHfO3 in space group Pbam, is shown to react with SnClF at a low temperature of 300 °C, and resulting in the first complete Sn(II)-for-Pb(II) substitution, i.e. SnHfO3 . During this topotactic transformation, a high purity and crystallinity is conserved with Pbam symmetry, as confirmed by X-ray and electron diffraction, elemental analysis, and 119 Sn Mössbauer spectroscopy. In situ diffraction shows SnHfO3 also possesses reversible phase transformations and is potentially polar between ≈130-200 °C. This so-called 'de-leadification' is thus shown to represent a highly useful strategy to fully remove lead from perovskite-oxide-based piezoceramics and opening the door to new explorations of polar and antipolar Sn(II)-oxide materials.

Mental health disparities and the role of perceived discrimination among Latinx individuals living with Parkinson's disease.

INTRODUCTION: Parkinson's disease (PD) is a neurodegenerative disorder with motor and non-motor symptoms including depression and cognitive impairment. There is underrepresentation of Latinxs in PD research as most of the research consists of non-Latinx white participants. The current study investigates longitudinal differences in health disparities among Latinx and White non-Latinx individuals living with PD. As a second aim, we examined the associations between perceived discrimination in healthcare and outcomes from aim 1. METHODS: The present study consisted of 25,298 individuals with PD who enrolled in the Fox Insight (FI) online study. Participants were followed annually for up to 3 years. Participants completed measures of depressive symptoms, health-related quality of life (HRQOL), cognitive complaints, subjective motor symptom severity, self-reported income, and perceived discrimination in healthcare. Multilevel models examined the longitudinal differences in non-motor and motor outcomes among Latinx (n = 1161) and White non-Latinx individuals (n = 24,137). RESULTS: Latinx participants reported significantly more depressive symptoms and worse HRQOL than non-Latinx individuals. No significant differences were found in cognitive complaints, or motor severity between Latinx and non-Latinx participants. The main effect of perceived discrimination was associated with both depressive symptoms and HRQOL. CONCLUSIONS: The current study provides initial evidence of mental health discrepancies among Latinx individuals living with PD and White non-Latinx counterparts. The combination of underrepresentation in research and possible health disparities among Latinx communities may affect the quality of clinical trials/studies and patient care.

Immunoaffinity Chromatography for Protein Purification and Analysis.

Immunoaffinity chromatography (IAC) is a type of liquid chromatography that uses immobilized antibodies or related binding agents as selective stationary phases for sample separation or analysis. The strong binding and high selectivity of antibodies have made IAC a popular tool for the purification and analysis of many chemicals and biochemicals, including proteins. The basic principles of IAC are described as related to the use of this method for protein purification and analysis. The main factors to consider in this technique are also presented under a discussion of the general strategy to follow during the development of a new IAC method. Protocols, as illustrated using human serum albumin (HSA) as a model protein, are provided for the use of IAC in several formats. This includes both the use of IAC with traditional low-performance supports such as agarose for off-line immunoextraction and supports used in high-performance IAC for on-line immunoextraction. The use of IAC for protein analysis as a flow-based or chromatographic immunoassay is also discussed and described using HSA and a competitive binding assay format as an example. © 2023 Wiley Periodicals LLC. Basic Protocol 1: Off-line immunoextraction by traditional immunoaffinity chromatography Basic Protocol 2: On-line immunoextraction by high-performance immunoaffinity chromatography Basic Protocol 3: Competitive binding chromatographic immunoassay.

Position comparison of sport-related concussions in female youth soccer players.

OBJECTIVES: Youth soccer participation, particularly among females, continues to grow worldwide. With the high incidence of sport-related concussion (SRC) in soccer, it is important to investigate if SRC occurs disproportionally by positions. Our hypothesis was to see no positional differences in SRCs, SRC-related characteristics, and outcomes among in female youth soccer athletes. METHODS: Data were prospectively collected from participants at a single sports medicine institution between August 2015-April 2021. Female participants aged 8-18 diagnosed with SRC sustained during an organized soccer practice, scrimmage, or game were separated into 4 groups based on position: Forward, Midfielder, Defender, and Goalkeeper. Demographics, medical history, injury-related details, and outcomes were reviewed. A chi-square test or Fisher's exact test was used for categorical variables. Continuous variables were compared with Mann-Whitney or Kruskal-Wallis test. RESULTS: Two hundred fourteen participants were included: 52 Forwards, 65 Midfielders, 63 Defenders, and 34 Goalkeepers. There were no significant differences between the groups in age, race, ethnicity, or previous concussion history. Differences in mechanism existed with Goalkeepers most commonly reporting Head to Body Part. Goalkeepers, which make up 1/11 of the total positions on the field, had a significantly higher proportion of SRCs compared to Field Positions. (9.1% vs 15.9%)At 3-month post-enrollment, there were no significant differences in reported symptoms or return-to-play between the different positions. CONCLUSION: In youth female soccer players, goalkeepers sustained a higher proportion of sport-related concussions compared to field players based upon the composition of a soccer team. The mechanism of injury also differed among the different soccer positions. However, no differences in concussion characteristics, outcomes, or RTP were seen across the different soccer positions.

Point-of-Care Ultrasound (POCUS) for Sideline Youth Sports Coverage.

PURPOSE OF REVIEW: The purpose of this review is to discuss the use of point-of-care ultrasound for sideline youth sports coverage. RECENT FINDINGS: Participation in youth sports has been increasing, with trends that athletes are specializing earlier and competing at higher levels at younger ages (NSCH 2019, Fabricant 2013). Point-of-care ultrasound (POCUS) utilizes non-invasive imaging to diagnose and manage various musculoskeletal conditions ranging from traumatic injuries, such as fractures and intramuscular hematomas, to early screening for conditions such as asymptomatic knee lesions. Since it is well-tolerated by children and adolescents and allows for easy accessibility for sideline care, POCUS could provide a strong alternative to other imaging modalities such as x-ray and magnetic resonance imaging (MRI) as both have their limitations. Youth sideline sports coverage could be enhanced with immediate medical attention from ultrasound-trained medical professionals. On the sidelines of a traumatic injury, POCUS expedites patient care with immediate examination of acute injuries. In low resource and hard-to-reach locations such as a rural youth sporting event, it can be key in the triaging of injuries. As a supplement to a physical exam, the risk of a misdiagnosis is reduced, and a long, expensive trip to the hospital for unnecessary imaging studies may be avoided. Ultrasound is a versatile, non-invasive, radiation-free imaging modality that serves as an accessible option for sideline coverage at youth sporting events. Ultrasound is well-tolerated by children and adolescents. It can be used to evaluate, diagnose, and manage a range of musculoskeletal conditions at the sidelines of youth sports.

Phosphate starvation: response mechanisms and solutions.

Phosphorus is essential to plant growth and agricultural crop yields, yet the challenges associated with phosphorus fertilization in agriculture, such as aquatic runoff pollution and poor phosphorus bioavailability, are increasingly difficult to manage. Comprehensively understanding the dynamics of phosphorus uptake and signaling mechanisms will inform the development of strategies to address these issues. This review describes regulatory mechanisms used by specific tissues in the root apical meristem to sense and take up phosphate from the rhizosphere. The major regulatory mechanisms and related hormone crosstalk underpinning phosphate starvation responses, cellular phosphate homeostasis, and plant adaptations to phosphate starvation are also discussed, along with an overview of the major mechanism of plant systemic phosphate starvation responses. Finally, this review discusses recent promising genetic engineering strategies for improving crop phosphorus use and computational approaches that may help further design strategies for improved plant phosphate acquisition. The mechanisms and approaches presented include a wide variety of species including not only Arabidopsis but also crop species such as Oryza sativa (rice), Glycine max (soybean), and Triticum aestivum (wheat) to address both general and species-specific mechanisms and strategies. The aspects of phosphorus deficiency responses and recently employed strategies of improving phosphate acquisition that are detailed in this review may provide insights into the mechanisms or phenotypes that may be targeted in efforts to improve crop phosphorus content and plant growth in low phosphorus soils.

Synergistic associations of depressive symptoms and aging on cognitive decline in early Parkinson's disease.

Objective: Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder. About 40%-50% of PD patients experience depression, making it one of the most common neuropsychiatric disturbances in PD. Cognitive deficits (e.g., difficulties with memory, attention) are an additional common complication in PD. Past studies among healthy aging individuals suggest that depression is a risk factor for cognitive decline, and the risk increases with older age. This study aims to examine the association between depressive symptoms on cognitive decline as a function of age among patients with PD. It is hypothesized that older PD patients with more severe depressive symptoms will be at greater risk of cognitive decline than their younger or less depressed counterparts. Methods: Four hundred and eighty-seven newly diagnosed patients with PD, were assessed for depression and cognition over a five-year period. Participants completed neuropsychological tests that assessed memory, learning, attention, visuospatial functioning, processing speed, and verbal fluency. Multilevel-modeling was used to examine the longitudinal association between cognition, age, and depressive symptoms. Results: Our results indicated a significant three-way interaction (age X occasion X depressive symptoms) predicting language and working memory/attention performance. More specifically, detrimental associations of depressive symptoms on cognitive decline in these domains were more pronounced among older adults. Conclusions: Our findings support that older PD patients with comorbid depressive symptoms experience greater cognitive decline compared to their younger counterparts. Findings suggest that older individuals with PD may be more vulnerable to neurotoxic effects of depression (e.g., neuroinflammation, HPA axis disruption), and better management of depression could potentially reduce cognitive decline and dementia risk.

Age and Sex Comparisons in Pediatric Track and Field Hurdle Injuries Seen in Emergency Departments of the US.

There is limited literature analyzing pediatric hurdle injuries based on sex and age. This study compares hurdle-related injury types, injured body parts, and injury mechanisms by age and sex in pediatrics. Hurdle-related injury data from the National Electronic Injury Surveillance System were used to retrospectively review the injuries of hurdlers 18 years and under. Differences in injured body parts, injury types, and mechanisms were analyzed by age (pre-high school vs. high school) and sex (male vs. female). A total of 749 cases were extracted. Fractures were more common in pre-high schoolers (34.1% vs. 21.5%, p = 0.001), while more sprains were identified in high schoolers (29.6%) than pre-high schoolers (22.8%, p = 0.036). Males suffered more fractures than females (35.1% vs. 24.3%, p = 0.001). Females sustained more joint sprains (29.1% vs. 21.0%, p = 0.012) and contusions/hematomas (12.7% vs. 7.5%, p = 0.020). Ankle injuries were more common in females (24.0%) than males (12.0%, p = 0.001), while wrist injuries were more prevalent in males (11.7% vs. 7.2%, p = 0.034). The most common injury mechanism was apparatus-related, with no differences based on age or sex. Injury types and injured body parts differed depending on age and sex in pediatric hurdle injuries seen in emergency departments. These findings may be helpful for injury prevention and medical care for pediatric hurdlers.

Comparison of pre-high school and high school football quarterback injuries.

OBJECTIVE: To compare the common injuries of pre-high school American football quarterbacks (Pre-HS QBs) and high school American football quarterbacks (HS QBs) within the last 15 years. METHODS: A retrospective chart review was performed at a sports medicine clinic at a tertiary-level pediatric medical center. Pediatric and adolescent American football quarterback patients who sustained sports-related injuries were extracted. Injury status (acute vs. overuse), injured anatomic locations, injury types, and surgical status were compared by Pre-HS QBs (<14 years old) and HS QBs (14-18 years old). RESULTS: A total of 121 injuries were found in 118 male Pre-HS QBs (mean age: 12.4 ± 1.6), while 302 injuries were observed in 256 male HS QBs (mean age: 15.8 ± 1.4). Overall, nearly two-third (2/3) of injuries were acute (64.3%) while a little over one-third (1/3) of injuries were overuse in nature (35.7%), and there were no differences between Pre-HS and HS QBs (58.7% vs. 66.7%, p = 0.114). The top 3 injured anatomic locations for Pre-HS QBs were elbow (20.7%), shoulder (18.2%), and head/neck (14.0%). For HS QBs, the top 3 injured anatomic locations were shoulder (24.5%), knee (17.5%), and head/neck (15.2%). There were significant differences in proportion of elbow (20.7% vs. 10.6%, p = 0.006), hip/trunk/upper leg (10.7% vs. 3.3%, p = 0.002), and knee injuries (9.1% vs. 17.5%, p = 0.028) between Pre-HS and HS QBs. Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their older counterparts (60.3% vs. 46.3%, p = 0.009) while HS QBs experienced significantly more ligamentous injuries than Pre-HS QBs (14.2% vs. 5.8%, p = 0.015). CONCLUSIONS: QB-associated injuries were distinctively different between Pre-HS and HS QBs. Future studies are warranted to investigate relatively high proportions of elbow injuries as well as bony/cartilaginous/labral injuries found in Pre-HS QBs.

Reduced fatigue and leakage of ferroelectric TiN/Hf0.5Zr0.5O2/TiN capacitors by thin alumina interlayers at the top or bottom interface.

Hf0.5Zr0.5O2(HZO) thin films are promising candidates for non-volatile memory and other related applications due to their demonstrated ferroelectricity at the nanoscale and compatibility with Si processing. However, one reason that HZO has not been fully scaled into industrial applications is due to its deleterious wake-up and fatigue behavior which leads to an inconsistent remanent polarization during cycling. In this study, we explore an interfacial engineering strategy in which we insert 1 nm Al2O3interlayers at either the top or bottom HZO/TiN interface of sequentially deposited metal-ferroelectric-metal capacitors. By inserting an interfacial layer while limiting exposure to the ambient environment, we successfully introduce a protective passivating layer of Al2O3that provides excess oxygen to mitigate vacancy formation at the interface. We report that TiN/HZO/TiN capacitors with a 1 nm Al2O3at the top interface demonstrate a higher remanent polarization (2Pr∼ 42µC cm-2) and endurance limit beyond 108cycles at a cycling field amplitude of 3.5 MV cm-1. We use time-of-flight secondary ion mass spectrometry, energy dispersive spectroscopy, and grazing incidence x-ray diffraction to elucidate the origin of enhanced endurance and leakage properties in capacitors with an inserted 1 nm Al2O3layer. We demonstrate that the use of Al2O3as a passivating dielectric, coupled with sequential ALD fabrication, is an effective means of interfacial engineering and enhances the performance of ferroelectric HZO devices.

Intravascular Endothelial Hyperplasia of the Foot.

Intravascular endothelial hyperplasia is a benign soft tissue mass rarely reported in the foot. Advanced imaging and confirming a benign diagnosis are critical for any soft tissue mass. This paper identifies 2 patients that developed intravascular endothelial hyperplasia tumors which required surgical excision. A 17-year-old male patient presented to clinic complaining of a painful bump to the arch of his right foot which he related to an injury 9 months prior. Magnetic resonance imaging of the right foot revealed a mass within the plantar subcutaneous fat that was serpiginous in nature similar to adjacent branching vessels favoring a low-flow vascular malformation. A 38-year-old female with Multiple Sclerosis presented with complaints of persistent symptoms of pain to the 1st interspace, difficult ambulation and neuritis. Ultrasound and MRI observed solid, multilobulated mass, with internal vascular malformation, MRI describing intrinsic involvement along the abductor musculature and flexor tendons. Both lesions were surgically excised and sent for pathology. Pathology report indicated a diagnosis of intravascular papillary endothelial hyperplasia or Masson's tumor in both cases. Pathology diagnosis of intravascular papillary endothelial hyperplasia is generally good with wide resection leading to low recurrence rates. Both patients in the current study have progressed postoperatively with resolution of symptoms and without recurrence.

Subjective cognitive complaints are important in PD-MCI criteria: Associations with CSF markers and cognitive decline.

INTRODUCTION: According to the Movement Disorder Society (MDS), subjective cognitive complaints (SCC) are a diagnostic criterion for PD-mild cognitive impairment (PD-MCI); however, studies often do not incorporate SCC when classifying PD-MCI. This inconsistent use may reflect mixed findings regarding the association between SCC and objective measures of cognitive impairment. Our study aimed to describe the extent that inclusion/exclusion of SCC affects the occurrence of PD-MCI, and if the inclusion of SCC is associated with faster cognitive decline and cerebrospinal fluid markers (CSF) of alpha-synuclein, amyloid beta, total tau, and phophorylated-tau. METHODS: Individuals with PD (N = 358) from the PPMI cohort whom completed measures of neuropsychological performance, subjective cognitive complaints, motor severity, and CSF markers were included. Participants were classified as cognitively normal (CN), PD-MCI with subjective cognitive complaints (PD-MCI + SCC) and PD-MCI without subjective cognitive complaints (PD-MCI -SCC). RESULTS: PD-MCI rates were consistently higher (16.5-19.1%) across the 5 years when SCC was not included in the diagnostic criteria as opposed to when SCC was included (4.4-11.0%). PD-MCI + SCC experienced greater cognitive decline and had significantly higher levels of tau/ab and p-tau/ab relative to both the CN and PD-MCI - SCC groups. CONCLUSIONS: Inconsistent implementation of an SCC requirement in PD-MCI classifications may have important implications in terms of the occurrence of PD-MCI and its prognostic value. Classifying PD-MCI only using neuropsychological cut-off criterion, without regard to SCC, may lead to higher rates of PD-MCI. Inclusions of SCC in PD-MCI criteria in newly diagnosed PD participants may strengthen the ability to detect individuals at risk for future cognitive decline, though it is possible that this decline is related to Alzheimer's disease changes rather than worse PD pathology.

Pediatric hurdle-related acute injuries in track and field presenting to US emergency departments: descriptive epidemiology study.

BACKGROUND: Hurdling is a track event that is unique due to a combination of running and jumping over an apparatus. Since hurdling requires a special skillset with sprinting and jumping, athletes are at risk for various musculoskeletal injuries. However, there has been a paucity of studies describing the epidemiology of pediatric hurdle injuries. PURPOSE: To examine hurdle-related injury types, injured body parts, injury mechanisms, and injury settings in children and adolescents. METHODS: Descriptive epidemiology study. Data from the National Electronic Injury Surveillance System, which represents emergency room visits, was retrospectively reviewed. Injury data involving hurdle injuries was searched during a 10-year period (2008-2017) with hurdlers 18 years old and younger. Injuries were classified based upon injury types, body parts, injury mechanisms, and injury settings. Descriptive statistics were used including mean ± standard deviation, frequency (N), and percentages (%). RESULTS: A total of 749 hurdle-related injuries were found from 333 males (44.5%) and 416 females (55.5%). The top three injury types were fracture (N = 218, 29.1%), joint sprain (N = 191, 25.5%), and contusion/hematoma/bruise (N = 78, 10.4%). The top three injured body parts were ankle (N = 140, 18.7%), knee (N = 120, 16.0%), and wrist (N = 69, 9.2%). The most common injury mechanisms were apparatus-related trips, falls, and landings (N = 594, 79.0%). Finally, injury settings consisted of track and field practices (N = 469, 62.6%), track and field meets (N = 96, 12.8%), and other settings including gym, physical education class, recess, school activities, and camps (N = 49, 6.5%). CONCLUSION: In pediatric hurdle athletes, the most prevalent injury type seen in the emergency room was fracture. Although most hurdle-related injuries occur in the lower extremity, wrist injuries were the third most commonly injured body location. The most common injury mechanism was apparatus-related trip, fall, and landing, and injuries most commonly occurred during track practices. In pediatric hurdle athletes seen in the emergency room, majority of injuries consisted of traumatic fractures and joint sprains at ankle, knee, and wrist, which frequently occurred with apparatus-related trip, fall, and landing mechanisms during track and field practices.

Cumulative Effect of Head Injuries on Nonmotor Outcomes in Parkinson's Disease.

OBJECTIVE: Parkinson's disease (PD) is a neurodegenerative movement disorder that is a result of dopamine depletion in the basal ganglia. Individuals with a PD diagnosis experience motor symptoms (e.g., tremors) and nonmotor symptoms (e.g., cognitive decline). Previous studies suggest that progression of cognitive dysfunction in other neurologic populations can be predicted by cumulative head injuries. The study examined the association between lifelong number of head injuries and nonmotor outcomes (cognitive complaints, depression, and quality of life). METHODS: Participants consisted of 3,483 individuals with PD diagnoses who were enrolled in the Fox Insight study. Participants completed a self-report questionnaire to quantify the number of head injuries experienced throughout life. Participants also completed measures of nonmotor outcomes (cognitive complaints, depression, and quality of life) every 6 months over a 3-year period. RESULTS: Cognitive complaints were more common among those experiencing more head injuries. Further, more severe depression and greater difficulties in quality of life were reported among individuals experiencing a greater number of head injuries. Additional analyses revealed the effect between cognitive complaints and number of head injuries was driven by individuals who experienced five or more head injuries in their lifetime. CONCLUSIONS: Among individuals with PD, a patient report of past head injuries may have prognostic implications for important nonmotor outcomes. Report of multiple head injuries may be particularly concerning.

Circumventing thermodynamics to synthesize highly metastable perovskites: nano eggshells of SnHfO3.

Sn(ii)-based perovskite oxides, being the subject of longstanding theoretical interest for the past two decades, have been synthesized for the first time in the form of nano eggshell particle morphologies. All past reported synthetic attempts have been unsuccessful owing to their metastable nature, i.e., by their thermodynamic instability towards decomposition to their constituent oxides. A new approach was discovered that finally provides an effective solution to surmounting this intractable synthetic barrier and which can be the key to unlocking the door to many other predicted metastable oxides. A low-melting KSn2Cl5 salt was utilized to achieve a soft topotactic exchange of Sn(ii) cations into a Ba-containing perovskite, i.e., BaHfO3 with particle sizes of ∼350 nm, at a low reaction temperature of 200 °C. The resulting particles exhibit nanoshell-over-nanoshell morphologies, i.e., with SnHfO3 forming as ∼20 nm thick shells over the surfaces of the BaHfO3 eggshell particles. Formation of the metastable SnHfO3 is found to be thermodynamically driven by the co-production of the highly stable BaCl2 and KCl side products. Despite this, total energy calculations show that Sn(ii) distorts from the A-site asymmetrically and randomly and the interdiffusion has a negligible impact on the energy of the system (i.e., layered vs. solid solution). Additionally, nano eggshell particle morphologies of BaHfO3 were found to yield highly pure SnHfO3 for the first time, thus circumventing the intrinsic ion-diffusion limits occurring at this low reaction temperature. In summary, these results demonstrate that the metastability of many theoretically predicted Sn(ii)-perovskites can be overcome by leveraging the high cohesive energies of the reactants, the exothermic formation of a stable salt side product, and a shortened diffusion pathway for the Sn(ii) cations.

Role of Oxygen Source on Buried Interfaces in Atomic-Layer-Deposited Ferroelectric Hafnia-Zirconia Thin Films.

Hafnia-zirconia (HfO2-ZrO2) solid solution thin films have emerged as viable candidates for electronic applications due to their compatibility with Si technology and demonstrated ferroelectricity at the nanoscale. The oxygen source in atomic layer deposition (ALD) plays a crucial role in determining the impurity concentration and phase composition of HfO2-ZrO2 within metal-ferroelectric-metal devices, notably at the Hf0.5Zr0.5O2 /TiN interface. The interface characteristics of HZO/TiN are fabricated via sequential no-atmosphere processing (SNAP) with either H2O or O2-plasma to study the influence of oxygen source on buried interfaces. Time-of-flight secondary ion mass spectrometry reveals that HZO films grown via O2-plasma promote the development of an interfacial TiOx layer at the bottom HZO/TiN interface. The presence of the TiOx layer leads to the development of 111-fiber texture in HZO as confirmed by two-dimensional X-ray diffraction (2D-XRD). Structural and chemical differences between HZO films grown via H2O or O2-plasma were found to strongly affect electrical characteristics such as permittivity, leakage current density, endurance, and switching kinetics. While HZO films grown via H2O yielded a higher remanent polarization value of 25 µC/cm2, HZO films grown via O2-plasma exhibited a comparable Pr of 21 µC/cm2 polarization and enhanced field cycling endurance limit by almost 2 orders of magnitude. Our study illustrates how oxygen sources (O2-plasma or H2O) in ALD can be a viable way to engineer the interface and properties in HZO thin films.

Improvement in balance from diagnosis to return-to-play initiation following a sport-related concussion: BESS scores vs center-of-pressure measures.

OBJECTIVE: Accurate assessment of balance recovery throughout treatment of a sport-related concussion is imperative. This study examined differences in balance from diagnosis to return-to-play initiation in adolescent patients post-concussion. Second, this study investigated the extent to which the Balance Error Scoring System (BESS) correlated with center-of-pressure (COP) measures. METHODS: Forty participants performed the BESS while standing on a force platform such that COP data were obtained simultaneously. Spatial and velocity COP-based measures were computed for the double-stance conditions. RESULTS: BESS scores and COP-based measures indicated improved balance performance between visits. Specifically, 62.5/65.0% of participants exhibited improved firm/foam BESS final scores, respectively, and 56.4-71.8% exhibited improved COP-based measures. However, once normative ranges were referenced to identify maintained performance, the percentage of participants who substantially improved differed from initial findings (BESS: 2.5/7.5%, COP: 48.7-69.2%). Additionally, positive correlations between balance measures were primarily found at diagnosis (r=0.33-0.53), while only three correlations were maintained at return-to-play initiation (r=0.34-0.39). CONCLUSIONS: BESS scores successfully identified poor balance performance at diagnosis when symptoms were most pronounced, but failed to accurately depict performance once balance impairment, indicated by COP-based measures, became less apparent. Further work is needed to implement more advanced balance assessments into clinical environments.

Physical inactivity links depressive symptoms and cognitive functioning among individuals with Parkinson's disease.

OBJECTIVE: Parkinson's disease (PD) is a neurodegenerative disorder caused by disruption of dopamine-producing cells. PD is associated with motor symptoms and nonmotor symptoms including depression and cognitive impairment. Past research suggests an association between depression and cognitive impairment in PD. Physical activity may have a therapeutic effect on both depression and cognitive impairment. The present study investigates if physical activity mediates the association between depressive symptoms and cognition in a longitudinal sample of individuals with PD. METHOD: Participants include individuals newly diagnosed with PD (N = 487) enrolled in the Parkinson's Progression Marker Initiative (PPMI). Participants completed an array of neuropsychological tests over the course of 5 years, as well as questionnaires of depression and physical activity. Between-person and within-person effects of depression and cognition mediated through physical activity were analyzed using structural equation modeling. RESULTS: A significant direct effect demonstrated depression was associated with worse global cognitive functioning. Furthermore, there was a significant indirect within-person effect, indicating that physical activity fully mediated the association between depression and cognition. Individuals who became more depressed over time became less physically active and subsequently experienced cognitive decline over the 5-year period. CONCLUSIONS: Findings have implications for prognostic detection and/or the role of physical activity interventions to buffer effects of depression on cognitive impairment among individuals diagnosed with PD. Physical interventions may potentially be implemented among depressed persons to preserve cognitive functioning. Worsened depression early during PD may be a risk factor for inactivity and cognitive diminishment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).