Arcadia University

Salamh P., Stoner B., Ruley N., Zhu H., Bateman M., Chester R., Da Baets L., Gibson J., Hollmann L., Kelley M., Lewis J., McClure P., McCreesh K., Mertens M.G., Michener L., et. al.

Perrone M., Mell S.P., Martin J.T., Nho S.J., Simmons S., Malloy P.

Generative deep learning has emerged as a promising data augmentation technique in recent years. This approach becomes particularly valuable in areas such as motion analysis, where it is challenging to collect substantial amounts of data. The objective of the current study is to introduce a data augmentation strategy that relies on a variational autoencoder to generate synthetic data of kinetic and kinematic variables. The kinematic and kinetic variables consist of hip and knee joint angles and moments, respectively, in both sagittal and frontal plane, and ground reaction forces. Statistical parametric mapping (SPM) did not detect significant differences between real and synthetic data for each of the biomechanical variables considered. To further evaluate the effectiveness of this approach, a long-short term model (LSTM) was trained both only on real data (R) and on the combination of real and synthetic data (R&S); the performance of each of these two trained models was then assessed on real test data unseen during training. The principal findings included achieving comparable results in terms of nRMSE when predicting knee joint moments in the frontal (R&S: 9.86% vs R: 10.72%) and sagittal plane (R&S: 9.21% vs R: 9.75%), and hip joint moments in the frontal (R&S: 16.93% vs R: 16.79%) and sagittal plane (R&S: 13.29% vs R: 14.60%). The main novelty of this study lies in introducing an effective data augmentation approach in motion analysis settings.

Wu Z., Sui Z., Peng L., Ghemrawi M., Duncan G., Jones H., O’Brien S.J., Luo S.

Abstract In the fall of 2003, a two-year-old tiger named Ming, weighing some four hundred pounds, was discovered living in an apartment in Harlem, New York. Ming’s rescue by NYPD was witnessed, recalled, and venerated by scores of neighbors. The tiger’s history and ancestry stimulated considerable media interest, investigative sleuthing, and forensic genomic analyses. The Harlem tiger’s subspecies makeup, his relationship to his putative sibling named Cheeky living in Homestead, Florida, and his genetic distinctiveness from wild tigers was assessed by Whole Genome Sequence (WGS) analyses of trace materials from plucked whiskers. Verified Subspecies Ancestry (VSA) of Ming and Cheeky was determined by comparing their WGS to SNP annotation from WGS of 35 voucher (pure subspecies) tiger specimens from six living subspecies. Genome-wide structure analyses based on 3,422,109 SNPs and a subset of 6,724 Ancestry-Informative Markers (AIMS) showed that Ming has an admixed genetic background from five subspecies: Indochinese tiger (Panthera tigris corbetti 35 ~ 40%), Bengal tiger (P. t. tigris 17 ~ 23%), Sumatran tiger (P. t. sumatrae 12 ~ 14%), Amur tiger (P. t. altaica ~ 10%), and Malayan tiger (P. t. jacksoni 1 ~ 10%). Cheeky is confirmed to be a full sibling to Ming and displayed an admixed genetic background with similar subspecies proportions as Ming’s. The forensic assessment of the tigers’ subspecies composition, kinship, and recent history of animal transaction provides an analytical pipeline and promises to assist in tiger conservation effort worldwide through standardized genomic analysis of tigers or tiger products with unknown origin.

Brackney D.E., Lane S.

Background/aim: Addressing the critical global shortage of nurses requires an understanding of how a global pandemic reshaped nurses' motivations and intentions toward education. This study aimed to describe COVID-19's impact on nurses' intent to pursue additional education. Method: This descriptive study, based in North Carolina in the USA, used content analysis with an inductive approach to examine the responses of nurses to one open-ended question in a large quantitative workforce survey: how has COVID-19 influenced your plans for future education? Responses were coded with counts and organised into themes and subthemes. Findings: Primary themes identified from the data included: stressors, appraisals and coping. There were 10 subthemes, which supported primary themes with direct quotes from nurses. The implications of the themes aligns with concepts from the self-determination theory: autonomy, competence and relatedness. Conclusion: Nurse responses to the pandemic can guide organisations and academic institutions in supporting nurses in times of stress and design programmes that align with their goals. Nursing leaders and educators must support nurses' autonomy, competence and relatedness, addressing issues such as burnout, financial strain, work–life balance and evolving professional demands. Academic institutions should adopt flexible, resilience-focused curricula and invest in skilled nurse educators to support the growing need for advanced education and online learning.

Rodda L.N., Candela K.E., Hart A.P., Moffatt E.G., Farley M.C., Pearring S., Scott K.S.

Abstract In postmortem forensic investigation cases where the bladder is voided or dehydrated prior to autopsy, it is possible to wash the bladder with saline and collect the ‘bladder wash’ and any residual urine for toxicological analysis. While not conventional, this study aims to determine the use of bladder washes as alternative specimens in postmortem forensic toxicology. Comprehensive drug and alcohol analysis was performed on blood, urine, vitreous humor and bladder wash samples. Control studies consisted of matched bladder wash and urine samples for comparison. Authentic applicability studies were performed on bladder wash samples in cases where only blood or no urine samples were available. Bladder wash testing via the routine urine methodology were shown to have the appropriate sensitivity and specificity to serve as an alternative specimen. Specificity of the applicability studies was further improved when comparisons were corrected by evaluating individual analytes jointly with their related parent drug or metabolites. Individual and corrected sensitivity and specificity rates of above 99% were typically observed in both comparisons against urine and blood paired samples. Following drug analysis of 31 cases in which only a bladder wash was available, 57 detections from 23 different analytes were detected that otherwise would have not been obtained. This study demonstrates that standardized collection of the easily accessible bladder wash for postmortem toxicological analysis serves forensic toxicologists and pathologists with invaluable information where urine or other biological specimens are not available.

McClintock H.F., Edmonds S.E., Wang E.

Lack of access to reliable transportation is a barrier to utilizing healthcare and other resources related to type 2 diabetes mellitus (T2DM). Little research has evaluated race/ethnicity-based differences in access to reliable transportation among persons with T2DM. To examine whether access to reliable transportation for persons with T2DM differed by race/ethnicity. Analysis was conducted among persons with T2DM using 2022 Behavioral Risk Factor Surveillance System data. The outcome was access to reliable transportation (yes/no) for medical appointments, meetings, work, or getting things needed for daily living in the last year. The independent variable was race/ethnicity (White, Black/African American, Asian, American Indian or Alaskan Native (AI/AN), Hispanic, Native Hawaiian or Other Pacific Islander, or multi-racial). Weighted logistic regression models examined the association between access to reliable transportation and race/ethnicity controlling for covariates. Persons with T2DM (n = 24,964) who identified as Black (adjusted odds ratio (AOR) = 1.42 (95% confidence interval (CI) = 1.10, 1.84), AI/AN (AOR = 2.03 (95% CI = 1.22, 3.36), or multi-racial (AOR = 1.99 (95% CI = 1.18, 3.5) were significantly more likely to indicate they did not have reliable access to transportation in the past year compared to whites. Persons who were females, older, married, had higher income, employed, no mobility issues, no depression, and rated their health status fair to very good were significantly less likely to report transportation issues. Access to reliable transportation may differ by race/ethnicity among persons with T2DM. Initiatives are needed to improve racially/ethnically equitable access to transportation for people with T2DM.

Gruber-Baldini A.L., Fortinsky R.H., Resnick B., Magder L.S., Beamer B.A., Mangione K., Orwig D., Binder E.F., Terrin M., Magaziner J.

Objective Differences in cognitive outcomes for two home-based 16-week interventions after usual rehabilitative care post-hip fracture were examined. Methods Community Ambulation Project randomized controlled trial included 210 hip fracture participants. Interventions: Specific multi-component (PUSH) included strength-, balance-, function-, and endurance-based exercises; non-specific active control (PULSE) included seated range-of-motion exercises and sensory transcutaneous electrical neurostimulation. Cognitive measures: Modified Mini-Mental State Examination, plus Hooper Visual Organization Test and Trails A/B in an ancillary study (CAP-MP, n = 40), assessed pre-randomization and 16 and 40 weeks post-randomization. Results Over 16 weeks, PUSH-assigned participants became faster on Trails A (Δ = −6.3, 95% CI: −16.7, 4.2); those in PULSE became slower (Δ = 9.3, 95% CI: −1.7, 20.3, p = .04). At 40 weeks, PUSH-assigned participants became faster on Trails B (Δ = −21.5, 95% CI: −46.2, 3.3) while those in PULSE became slower (Δ = 15.2, 95% CI: −11.9, 42.3, p = .04). No other significant differences were found. Discussion Results suggest that multi-component exercise interventions like PUSH may prevent/delay decline or improve attention and psychomotor speed in patients with recent hip fracture.

Longacre M.L., Roche L., Kueppers G.C., Buurman B.

Background and Objectives: A public health priority is the increasing number of persons with Parkinson’s disease (PwP), and the need to provide them with support. We sought to synthesize the experiences of relatives or friends—family caregivers—who provide such support. Eligibility Criteria: This study was a scoping literature review modeled by the PRISMA guidelines. The articles for this review fit the following inclusion criteria: (1) studies including the perspective of caregivers of PwP, (2) studies conducted in the United States, and (3) studies conducted between January 2019 to January 2024. Sources of Evidence: Articles were identified by searching the PubMed, EBSCO, and Ovid databases between January 2019 and January 2024. The search terms included the following: (Parkinson’s disease) AND (caregiver OR caregiving OR carer). Results: A total of 31 articles were included. Most of the included articles are descriptive (n = 26), including quantitative (n = 17), qualitative (n = 7), and mixed-methods studies (n = 2). Gender, race, and ethnicity were not consistently reported. Findings across studies demonstrated common roles of caregiving (e.g., assistance with personal care), extensive physical and mental health strains, social isolation, and work and financial strain. Benefit-finding was also evident among caregivers including a goal of securing the PwP dignity and comfort as the disease progressed. The studies of this review provide perspectives on benefits and challenges of caregiving in this context and caregiver resources. Conclusions: Future studies need to improve racial and gender-related diversity and address caregiver strain and health.

Neilson S., Nangeroni L., Ghemrawi M.

This differential extraction protocol details the steps for isolating DNA from sample pads used in lateral flow immunochromatographic (LFI) tests, particularly for cases involving mixed biological samples such as semen and menstrual blood, or other evidence related to sexual assault. This procedure utilizes a differential extraction technique applied to sample pads from immunochromatographic tests, where the sample pads serve as the substrate. The method involves two sequential lysis steps to effectively separate non-sperm and sperm fractions, enabling the targeted isolation of distinct cell types for downstream DNA analysis. The efficiency of this procedure is demonstrated by the results within this paper, which highlights the successful recovery of both male autosomal and Y-STR profiles, even in mixed samples with a high female presence. Overall, this protocol demonstrates the effective recovery of DNA from sample pads, which is beneficial for forensic practitioners dealing with limited sample quantities, underscoring the value of using these pads in forensic analysis.

Garbin A.J., Falvey J.R., Cumbler E., Derlein D., Currier D., Nordon-Craft A., Will R., Olivos M., Forster J.E., Mangione K.K., Stevens-Lapsley J.E.

Abstract Objectives Reduced physical function following hospitalization places older adults at risk of adverse health events. Many older adults receive home health physical therapy to reverse their deconditioning; however, optimal approaches to improve physical function are currently not known. This study aimed to evaluate the effectiveness of a home health care approach comprised of high-intensity exercise, enhanced care transition, and protein supplementation. Methods Eligible participants included adults aged 65 years or older referred to home health care following hospitalization. Two hundred older adults who are medically complex were enrolled and were randomized 1:1 to (1) a high-intensity progressive, multi-component (PMC) intervention or (2) enhanced usual care (UC) comparison group. All participants received 12 visits over 60 days. The primary study outcome was change in the Short Physical Performance Battery (SPPB) from baseline to 60 days. Secondary outcomes included gait speed (usual, fast), modified Physical Performance Test, grip strength, Fatigue Severity Scale, Falls Efficacy Scale-International, physical activity (step count), and adverse events (falls, emergency department visits, hospitalizations). All outcomes were collected at baseline, then 30, 60, 90, and 180 days post baseline. Results There was no difference in 60-day SPPB change between groups with both groups experiencing significant improvements (PMC = 1.53 [95% CI: 1.00–2.05]; enhanced UC = 1.39 [95% CI = 0.89–1.88]). Differences were also not observed in secondary measures or adverse events at any time point. Conclusion An intervention consisting of high-intensity exercise, enhanced care transition, and protein supplementation was not associated with greater functional improvement at 60 days compared to enhanced UC in older adults receiving home health physical therapy. Impact The findings of this study demonstrate that a high-intensity progressive, multi-component intervention results in similar physical functional changes as an enhanced UC intervention in older adults who are medically complex and receiving home health care following hospital-associated deconditioning.

Garbin A.J., Tran M.K., Graber J., Derlein D., Currier D., Altic R., Will R., Cumbler E., Forster J.E., Mangione K.K., Stevens-Lapsley J.E.

Abstract Objective The optimal approach for improving physical function following acute hospitalization is unknown. A recent clinical trial of home health physical therapy compared a high-intensity, progressive, multi-component (PMC) intervention to enhanced usual care (EUC). While both groups improved in physical function, no between-group differences were observed. However, the EUC group received care that differed from real world practice due to standardized treatments and a higher frequency of visits. This study compared a non-randomized true usual care (TUC) group to the EUC and PMC groups. Methods Participants in the parent trial were randomly assigned to the EUC group (n = 100) and PMC group (n = 100) following hospital discharge. A subset of eligible patients (n = 55) were concurrently enrolled in the TUC group. Both the PMC and EUC groups received strength, activities of daily living, and gait training that differed in intensity but were matched in frequency and duration. TUC group care was determined by the home health agency. The primary outcome at 60-days was the Short Physical Performance Battery (SPPB). Results In comparison to the TUC group, the EUC and PMC groups had significantly greater improvements in SPPB score (EUC: +1.04 points [CI = 0.18–1.90]; PMC: +1.12 points [CI = 0.23–2.00]). Conclusion While participants in the EUC and PMC groups experienced greater functional recovery compared to those in the TUC group, it cannot be determined whether these differences are due to the interventions received or confounding factors associated with the addition of a third, non-randomized, study group during the trial period. Impact This study illustrates the importance of design and interpretation of control groups for clinical trials. Further, the differences between the TUC group and the enhanced intervention groups warrant future research exploring whether increasing visits and standardizing care improve function in older adults receiving home health physical therapy after hospital associated deconditioning. Lay summary Participants in the intervention groups received standardized and more therapy than usual care, and experienced greater functional improvements. However, these differences may be due to factors associated with the addition of a non-randomized group during an ongoing clinical trial.

Macalalag A.Z., Kaufmann A., Van Meter B., Ricketts A., Liao E., Ialacci G.

AbstractSocioscientific issues (SSI) are problems involving the deliberate use of scientific topics that require students to engage in dialogue, discussion, and debate. The purpose of this project is to utilize issues that are personally meaningful and engaging to students, require the use of evidence-based reasoning, and provide a context for scientific information. Social justice is the pursuit of equity and fairness in society by ensuring that all individuals have opportunities to challenge and address inequalities and injustices to create a more just and equitable society for all (Killen et al. Human Development 65:257–269, 2021). By connecting science, technology, engineering, and mathematics (STEM) concepts to personally meaningful contexts, SSI can empower students to consider how STEM-based issues reflect moral principles and elements of virtue in their own lives and the world around them (Zeidler et al. Science Education 89:357–377, 2005). We employed a qualitative research design to answer the following questions: (1) In what ways, if any, did teachers help students grow their knowledge and practices on social justice through socioscientific issues? (2) In teachers’ perceptions, what components of SSI did students learn and what are their challenges? (3) In teachers’ perceptions, what are students’ stances on social justice? After completing the first year and second-year professional development programs, grades 6–12 STEM teachers were asked to complete a reflection on classroom artifacts. Teachers were asked to select student artifacts (e.g. assignments, projects, essays, videos, etc.) that they thought exemplified the students’ learning of SSI and stance on social justice. Based on 21 teacher-submitted examples of exemplar student work, we saw the following example pedagogies to engage their students on social justice: (a) making connections to real-world experiences, (b) developing a community project, (c) examining social injustice, and (d) developing an agency to influence/make changes. According to teachers, the most challenging SSI for students was elucidating their own position/solution, closely followed by employing reflective scientific skepticism. Moreover, the students exemplified reflexivity, metacognition, authentic activity, and dialogic conversation. Using SSI in classrooms allows students to tackle real-world problems, blending science and societal concerns. This approach boosts understanding of scientific concepts and their relevance to society. Identifying methods like real-world connections and examining social injustice helps integrate social justice themes into science education through SSI. Overall, SSI promotes interdisciplinary learning, critical thinking, and informed decision-making, enriching science education socially. This study highlights the value of integrating SSI in science education to engage students with social justice.

Longacre M.L., Roche L.

With the onset of the COVID pandemic the use of electronic tools, including telehealth, increased out of necessity. The goal of this scoping review was to identify perceptions of benefits and limitations of the use of telehealth among cancer patients and their family caregivers. Eligibility-Criteria: This study reviewed articles from PubMed, EBSCO, and Google Scholar using search terms related to oncology and telehealth. Charting Methods: 39 articles were included and categorized as benefits or limitations of telehealth. All studies included patient perceptions while only three studies included caregivers. Benefit themes included (1) Convenience, (2) Savings, (3) Access to Care, (4) Work or Career, (5) Caregiver Inclusion and Perspective, and (6) Other. Limitation themes included (1) Disruption to Care Experience or Patient-Provider Relationship, (2) Need for Physical Examination, (3) Communication Challenges, and (4) Technology-Related Issues. Non-Hispanic White patients were the most prominent racial or ethnic group in the studies while six studies included a high percentage of Black patients. Findings suggest that a hybrid approach might be best depending on the care needed while also benefit from cost-savings and convenience when feasible. Future research must consider the caregiver perspective more intentionally in understanding experiences of telehealth given implications for work. Additional research is also needed to develop strategies to address use differences according to demographics or due to technology barriers.

Lee J., Munoz-Cornejo G.

McClintock H.F., Edmonds S., Okronipa H.

Purpose The purpose of this study is to examine whether food insecurity increases risk for depressive symptoms among adults with diabetes. Food insecurity is associated with depression in the general population. However, minimal research has examined this relationship among persons with diabetes. Methods Adults with diabetes were identified from the 2022 National Health Interview Survey. Depressive symptoms were assessed by the 8-item Patient Health Questionnaire. Food insecurity status was measured with the USDA 10-item food insecurity scale. Participants were categorized as food secure, low food security, and very low food security. The association between food insecurity and depressive symptoms was examined using weighted logistic regression, adjusting for potentially influential covariates (age, sex, ethnicity, poverty to income ratio, education, diabetes type, body mass index, region, and general health). Results Among 2595 persons with diabetes, nearly one third (29.8%) reported symptoms of depression. Over one tenth (11.7%) had low or very low food security. Persons who had low or very low food security were more than twice as likely to report depressive symptoms (adjusted odds ratio [AOR] = 2.15, 95% CI, 1.39-3.32; AOR = 3.84, 95% CI, 2.28-6.45, respectively). Persons who were older, had higher income, and better general health were less likely to report depressive symptoms. Conclusions Among adults with diabetes, low or very low food security was associated with increased risk for depressive symptoms. Further research is needed to evaluate the relationship between food insecurity and depressive symptoms among persons with diabetes.