Husson University

Gait speed is a key indicator of mobility and health in older adults, with declines often reflecting neuromotor deficits rather than musculoskeletal or cardiopulmonary limitations. This study presents a wearable smartphone-based haptic feedback system that applies feedback to the thighs to increase peak thigh extension (PTE) and, consequently, improve stride length and walking speed. Thirty community-dwelling older adults (79.9 ± 6.5 years) participated in this study. Three treatment conditions were evaluated: (1) tactile feedback due to incorrect response when PTE was below the target (F_IR); (2) tactile feedback due to correct response when the target PTE was met (F_CR); and (3) verbal instructions (I_V) without feedback. Cognitive demand during treatment was assessed using a probe reaction time task. Walking trials comparing baseline with treatment conditions were conducted. We found significant differences for all gait parameters across walking trials ( p < 0.001), but no significant difference among the three treatment conditions. The haptic feedback system significantly increased stride length by 14% and gait speed by 18%. Gains in speed and stride length were achieved using the haptic system during a single session, comparable to following verbal instructions. Although no statistical difference was found across treatments, thigh feedback employed a different mechanism than verbal instructions for attaining greater speed. Adding haptic feedback increased reaction time, but these increases were small (F_IR: 27ms, F_CR: 74ms), indicating minimal cognitive load. The observed gait improvements suggest haptic feedback is a viable option for gait training for older adults.

Interlimb coordination can be used as a metric to study the response of the neuromuscular system to mechanical perturbations and behavioral information. Behavioral information providing haptic feedback on thigh angle has been shown to increase stride length and consequently walking speed, but the effect of such feedback on limb coordination has not been determined. The current work investigates the effects of this feedback on lower-limb coordination and examines if such effects are dependent on the age of the walker. Existing kinematic data were examined from 10 young and 10 older adults during overground walking at self-selected normal and fast speeds and with thigh extension haptic feedback. Using sagittal angles of the lower-limb segments, we quantified changes in the mean of continuous relative phase ( ) and its standard deviation ( ) for thigh-shank and shank-foot segment pairs, over windows of 10% of gait cycle around peak thigh extension, toe-off, and heel strike. We found that the haptic feedback resulted in more in-phase movement (i.e., decreased , Cohen’s : 0.56-1.46), and larger coordination variability (i.e., increased , Cohen’s : 0.60-1.50) of the segment pairs across the three windows. Additionally, the young adults exhibited lower than older adults (Cohen’s =1.02) and higher (Cohen’s =1.02) when the feedback was provided. The results suggest that the haptic feedback elicited distinct adaptations in the neuromuscular system and that this response differed between young and older adults.

Current gait rehabilitation protocols for older adults typically attempt to effect changes in leg movements, while the role of arm movements is often ignored despite evidence of the neurological coupling of the upper and lower extremities. In the present work, we examine the effectiveness of a novel wearable haptic cueing system that targets arm swing to improve various gait parameters in older adults. Twenty participants ($M = 73.4 \pm 6.2$ years) were recruited to analyze their gait during normal and fast walking without haptic cueing. Vibrotactors attached to the arms were then used to give haptic cues that were designed to either increase or decrease arm swing cycle time. The effects of such cueing on gait symmetry and spatiotemporal parameters were then analyzed. The presentation of the haptic cues significantly altered arm swing cycle time resulting in an increase in gait speed of 18.2% when arm cycle time was decreased and a 12.3% decrease in gait speed when arm cycle time was lengthened. The response to haptic cues was immediate, emphasizing the tight coupling of the arm and legs in the production of gait. Spatiotemporal analysis revealed improvements in gait parameters and symmetry metrics, indicating enhanced coordination between limbs when using tactile cues. Subjective evaluations further supported the system’s potential for gait training. The results reveal the significant potential of the haptic cueing system to modulate gait through arm swing manipulation, leveraging interlimb neural coupling. This aligns with the growing need for home-based gait training solutions, particularly for the older population, and presents a novel approach that could be integrated into current gait rehabilitation practices.

Vascular malformations are common vascular lesions in infants and seriously affect their health and quality of life. Vascular sclerotherapy is an effective treatment for vascular malformations. However, current sclerosants have difficulty achieving both high efficiency and low toxicity, and their dosing forms make it difficult to achieve long-term retention in the affected blood vessels. Therefore, exploring a safe and effective sclerosant and its delivery strategy is the key to clinical sclerotherapy. To address the above issues, this study developed sclerosants that could form an in-situ gel based on a dual mechanism of vascular injury and plasmin (PLA) inhibition. By linking the non-ionic surfactant sclerosant polyoxyethylene alkyl ether (PAs) and the PLA inhibitor tranexamic acid (TA) through an ester bond, a cationic surfactant sclerosant polyoxyethylene alkylether tranexamate derivatives (PATDs) were constructed. The cationic charge of PATDs enhanced its cytotoxicity to HUVEC-TIE2-L914F cells, and the ester bond of PATDs could be degraded by esterase in the blood, reducing its systemic toxicity. The degradation product TA inhibited the activation of the PLA-matrix metalloproteinase (MMPs) system induced by vascular injury, thereby promoting the deposition of collagen and the proliferation and differentiation of fibroblasts to promote vascular fibrosis. In addition, an injectable solution (PATDs/GA) was prepared by mixing PATDs with glycerol formaldehyde (GA), and PATDs/GA could form a low-molecular-weight gel automatically in an aqueous solution, which was beneficial to increase its retention in the affected blood vessels and reduce the risk of drug entering non-targeted sites. At the same time, this gel automatically dissolved, reducing the risk of immune rejection caused by long-term retention. This study provided a new and precise approach for the treatment of vascular sclerosis with high efficiency and low toxicity.

College student mental health has been a critical concern for professional counselors. Anxiety and depressive disorders have become increasingly prevalent over the past decade. Utilizing machine learning, a subset of artificial intelligence (AI), we developed predictive models (i.e., eXtreme Gradient Boosting [XGBoost], Random Forest, Decision Tree, and Logistic Regression) to identify US college students at heightened risk of diagnosable anxiety and depressive disorders. The dataset included 61,619 students from 133 US higher education institutions and was partitioned into a 90:10 ratio for training and testing the models. We employed hyperparameter tuning and cross-validation to optimize model performance and examined multiple measures of predictive performance (e.g., area under the receiver operating characteristic curve [AUC], accuracy, sensitivity). Results revealed strong discriminative power in our machine learning predictive models with AUC of 0.74 and 0.77, indicating current financial situation, sense of belonging on campus, disability status, and age as the top predictors of anxiety and depressive disorders. This study provides a practical tool for professional counselors to proactively identify students for anxiety and depressive disorders before these conditions escalate. Application of machine learning in counseling research provides data-driven insights that help enhance the understanding of mental health determinants, guide prevention and intervention strategies, and promote the well-being of diverse student populations through counseling.

The lanthanide series elements are transition metals used as critical components of electronics, as well as rechargeable batteries, fertilizers, antimicrobials, contrast agents for medical imaging, and diesel fuel additives. With the surge in their utilization, lanthanide metals are being found more in our environment. However, little is known about the health effects associated with lanthanide exposure. Epidemiological studies as well as studies performed in rodents exposed to lanthanum (La) suggest neurological damage, learning and memory impairment, and disruption of neurotransmitter signaling, particularly in serotonin and dopamine pathways. Unfortunately, little is known about the neurological effects of heavier lanthanides. As dysfunctions of serotonergic and dopaminergic signaling are implicated in multiple neurological conditions, including Parkinson’s disease, depression, generalized anxiety disorder, and post-traumatic stress disorder, it is of utmost importance to determine the effects of La and other lanthanides on these neurotransmitter systems. We therefore hypothesized that early-life exposure of light [La (III) or cerium (Ce (III))] or heavy [erbium (Er (III)) or ytterbium (Yb (III))] lanthanides in Caenorhabditis elegans could cause dysregulation of serotonergic and dopaminergic signaling upon adulthood. Serotonergic signaling was assessed by measuring pharyngeal pump rate, crawl-to-swim transition, as well as egg-laying behaviors. Dopaminergic signaling was assessed by measuring locomotor rate and egg-laying and swim-to-crawl transition behaviors. Treatment with La (III), Ce (III), Er (III), or Yb (III) caused deficits in serotonergic or dopaminergic signaling in all assays, suggesting both the heavy and light lanthanides disrupt these neurotransmitter systems. Concomitant with dysregulation of neurotransmission, all four lanthanides increased reactive oxygen species (ROS) generation and decreased glutathione and ATP levels. This suggests increased oxidative stress, which is a known modifier of neurotransmission. Altogether, our data suggest that both heavy and light lanthanide series elements disrupt serotonergic and dopaminergic signaling and may affect the development or pharmacological management of related neurological conditions.

The 2014 Medicaid expansion excluded Americans who were 65 years old and older, but they could still be affected via spillover effects. Using Medicare administrative data, we test for spillovers in Medicare spending and Medicaid coverage among low‐income Medicare beneficiaries. We analyze two cohorts: those under 65 in 2014, who could have been induced by the expansion to take up Medicaid before joining Medicare; and those 65 or older in 2014, whose Medicaid eligibility was never affected by the expansion. We only find spillovers for the under‐65 cohort, where Medicare spending fell and Medicaid coverage increased, with no measurable adverse effect on mortality. Combined with a null effect for the over‐65 cohort, these facts suggest Medicare beneficiaries were not crowded out of health care by the expansion. Instead, those under‐65 cohort satisfied “pent‐up” demand via Medicaid, consuming care they would have otherwise obtained later under Medicare.

Artificial intelligence (AI) applications influence human growth and development across the lifespan. This article provides a conceptual model that shows significant AI applications and their influence from prenatal to maturity using Erikson's psychosocial stages as a framework. AI influences development through diverse avenues, encompassing diagnosis, attachment formation, social skill acquisition, relationship dynamics, and caregiver support. The effects of AI interventions can be perceived as advantageous, contentious, and as raising a multitude of ethical considerations. Consequently, we propose avenues for future research endeavors to further investigate the intersection of AI and human growth and development within counseling contexts.

Despite the widely accepted importance of clinician empathy in quality healthcare, no occupational therapy-based pedagogy has consistently demonstrated the ability to improve the level of empathic awareness in students. In an effort to replicate 2020 findings that demonstrated the close reading of literary narratives improves empathic awareness in occupational therapy students ( p < 0.001), the study’s curriculum and methodology were repeated in 2021 and 2022. Results demonstrated that classes taught fully in-person repeated findings ( p < 0.001), while classes taught online (2021) did not ( p > 0.001). Study implications include the potential of an in-person curriculum that emphasizes literary narratives to facilitate empathic awareness in occupational therapy students, and the possible limitations of online instruction to foster greater understanding of client needs.

Heart failure (HF) is a pervasive global health concern, with acute decompensated heart failure (ADHF) contributing significantly to morbidity and mortality. Medications used in patients with HF may exacerbate HF or prolong the QT interval, posing additional risks. The objective is to assess the prevalence and utilization patterns of medications known to cause or exacerbate HF and prolong the QT interval among patients with ADHF. Understanding these patterns is crucial for optimizing patient care and minimizing potential risks. A retrospective chart review was conducted at Huntsville Hospital, Huntsville, USA, covering 602 patients with ADHF over a 40-month period. Inclusion criteria involved age ≥ 18 years, a history of HF, and ADHF admission. The 2016 American Heart Association Scientific Statement was used to identify drugs that may cause or exacerbate HF and those that could prolong the QT interval Among the 602 patients, 57.3% received medications causing or exacerbating HF, notably albuterol (34.9%) and diabetes medications (20.4%), primarily metformin, followed by urologic agents (14.3%), mostly tamsulosin, and nonsteroidal anti-inflammatory drugs (NSAIDs) (6.1%). Moreover, 82.9% were on medications prolonging the QT interval, with loop diuretics, amiodarone, ondansetron, and famotidine most prevalent. Furthermore, 42.1% of the patients received more than two concomitant medications that prolong the QT interval, which can further exacerbate the risk of torsades de pointes. This study underscores the high prevalence of HF-causing or HF-exacerbating medications and QT-prolonging drugs in patients with ADHF. Healthcare professionals must be cognizant of these patterns, advocating for safer prescribing practices to optimize patient outcomes and reduce the burden of HF-related hospitalizations.

Although trends toward earlier ice‐out have been documented globally, the links between ice‐out timing and lake thermal and biogeochemical structure vary spatially. In high‐latitude lakes where ice‐out occurs close to peak intensity of solar radiation, these links remain unclear. Using a long‐term dataset from 13 lakes in West Greenland, we investigated how changing ice‐out and weather conditions affect lake thermal structure and oxygen concentrations. In early ice‐out years, lakes reach higher temperatures across the water column and have deeper epilimnia. Summer hypolimnia are the warmest (~ 11°C) in years when cooler air temperatures follow early ice‐out, allowing full lake turnover. Due to the higher potential for substantive spring mixing in early ice‐out years, a warmer hypolimnion is associated with higher dissolved oxygen concentrations. By affecting variability in spring mixing, the consequences of shifts in ice phenology for lakes at high latitudes differ from expectations based on temperate regions.

This research shows that linguistic differences can influence the diffusion of technology and income between countries. I use a measure of language similarity known as the normalised Levenshtein distance to show that lexical distances closely track bilateral differences in the adoption intensities of key production technologies. This relationship holds for technologies in the transportation, information technology, steel, telecommunications and health sectors. Linguistic differences also result in larger bilateral gaps in per capita income. These results hold among higher but not low‐income nations, likely because language affects technology transfer only once a threshold level of development is surpassed.

Anti-tumor angiogenesis therapy, targeting the suppression of blood vessel growth in tumors, presents a potent approach in the battle against cancer. Traditional therapies have primarily concentrated on single-target techniques, with a specific emphasis on targeting the vascular endothelial growth factor, but have not reached ideal therapeutic efficacy. In response to this issue, our study introduced a novel nanoparticle system known as CS-siRNA/PEITC&L-cRGD NPs. These chitosan-based nanoparticles have been recognized for their excellent biocompatibility and ability to deliver genes. To enhance their targeted delivery capability, they were combined with a cyclic RGD peptide (cRGD). Targeted co-delivery of gene and chemotherapeutic agents was achieved through the use of a negatively charged lipid shell and cRGD, which possesses high affinity for integrin αvβ3 overexpressed in tumor cells and neovasculature. In this multifaceted approach, co-delivery of VEGF siRNA and phenethyl isothiocyanate (PEITC) was employed to target both tumor vascular endothelial cells and tumor cells simultaneously. The co-delivery of VEGF siRNA and PEITC could achieve precise silencing of VEGF, inhibit the accumulation of HIF-1α under hypoxic conditions, and induce apoptosis in tumor cells. In summary, we have successfully developed a nanoparticle delivery platform that utilizes a dual mechanism of action of anti-tumor angiogenesis and pro-tumor apoptosis, which provides a robust and potent strategy for the delivery of anti-cancer therapeutics.

The Pharmaceutics Editorial Office retracts the article, “A Novel Drug Self-Delivery System from Fatty Alcohol Esters of Tranexamic Acid for Venous Malformation Sclerotherapy” [...]

While established measures gauge poverty across diverse aspects of life, a definitive metric for health poverty in Australia remains absent. This study examines health poverty trends, identifying priorities for interventions to improve overall population health. We define health poverty as the state of falling below a specified minimum threshold in any critical health aspect, encompassing physical function, role function, social function, pain, mental health and vitality. Additionally, mortality (i.e., dying within 1 year) is integrated into the health poverty measure. The percentage of the overall adult population grappling with health poverty was 42 percent in 2001, falling to 37 percent in 2009 before ascending to 43 percent in 2018. The level of health poverty was more prevalent among women, older age groups and Indigenous individuals than in men, younger age groups or non‐Indigenous people, respectively. By meticulously monitoring health poverty trends across various dimensions, this study unveils the sociodemographic group susceptible to health poverty and quantifies its impact on overall population well‐being. The investigation highlights poor role functioning and vitality deficiency as pivotal components contributing to health poverty.