Digital Commons Network^™

Successfully Climbing The "Stairs": Surmounting Failed Translation Of Experimental Ischemic Stroke Treatments, Michael Kahle, Gregory J. Bix

Sanders-Brown Center on Aging Faculty Publications

The Stroke Therapy Academic Industry Roundtable (STAIR) provided initial (in 1999) and updated (in 2009) recommendations with the goal of improving preclinical stroke therapy assessment and to increase the translational potential of experimental stroke treatments. It is important for preclinical stroke researchers to frequently consider and revisit these concepts, especially since promising experimental stroke treatments continue to fail in human clinical trials. Therefore, this paper will focus on considerations for several key aspects of preclinical stroke studies including the selection and execution of the animal stroke model, drug/experimental treatment administration, and outcome measures to improve experimental validity and translation potential. …

Elevated Cardiovascular Risk Among Adults With Obstructive And Restrictive Airway Functioning In The United States: A Cross-Sectional Study Of The National Health And Nutrition Examination Survey From 2007 - 2010, Earl S. Ford, Ann G. Wheaton, David M. Mannino, Latitia Presley-Cantrell, Chaoyang Li, Janet B. Croft

David M. Mannino

Background

Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States.

Methods

We used data from adults aged 20–79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test. The severity of obstructive impairment was defined by adapting the Global Initiative for Chronic Obstructive Lung Disease criteria.

Results

Among 7249 participants, 80.9% had …

Elevated Cardiovascular Risk Among Adults With Obstructive And Restrictive Airway Functioning In The United States: A Cross-Sectional Study Of The National Health And Nutrition Examination Survey From 2007-2010, Earl S. Ford, Anne G. Wheaton, David M. Mannino, Letitia Presley-Cantrell, Chaoyang Li, Janet B. Croft

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States.

METHODS: We used data from adults aged 20-79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test. The severity of obstructive impairment was defined by adapting the Global Initiative for Chronic Obstructive Lung Disease criteria.

RESULTS: Among 7249 participants, 80.9% had …

Treatment Of Klebsiella Pneumoniae Carbapenemase (Kpc) Infections: A Review Of Published Case Series And Case Reports, Grace C. Lee, David S. Burgess

Pharmacy Practice and Science Faculty Publications

The emergence of Klebsiella pneumoniae carbapenemases (KPCs) producing bacteria has become a significant global public health challenge while the optimal treatment remains undefined. We performed a systematic review of published studies and reports of treatment outcomes of KPC infections using MEDLINE (2001-2011). Articles or cases were excluded if one of the following was fulfilled: no individual patient data provided, no treatment regimen specified, no treatment outcome specified, report of colonization, or greater than three antibiotics were used to treat the KPC infection. Data extracted included patient demographics, site of infection, organism, KPC subtype, antimicrobial therapy directed at KPC-infection, and treatment …

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Depletion Of Endothelial Or Smooth Muscle Cell-Specific Angiotensin Ii Type 1a Receptors Does Not Influence Aortic Aneurysms Or Atherosclerosis In Ldl Receptor Deficient Mice, Debra L. Rateri, Jessica J. Moorleghen, Victoria Knight, Anju Balakrishnan, Deborah A. Howatt, Lisa A. Cassis, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Whole body genetic deletion of AT1a receptors in mice uniformly reduces hypercholesterolemia and angiotensin II-(AngII) induced atherosclerosis and abdominal aortic aneurysms (AAAs). However, the role of AT1a receptor stimulation of principal cell types resident in the arterial wall remains undefined. Therefore, the aim of this study was to determine whether deletion of AT1a receptors in either endothelial cells or smooth muscle cells influences the development of atherosclerosis and AAAs.

METHODOLOGY/PRINCIPAL FINDINGS: AT1a receptor floxed mice were developed in an LDL receptor -/- background. To generate endothelial or smooth muscle cell specific deficiency, AT1a receptor floxed mice were bred with …

Transforming The Healthcare Response To Intimate Partner Violence And Taking Best Practices To Scale, Michele R. Decker, Shannon Frattaroli, Brigid Mccaw, Ann L. Coker, Elizabeth Miller, Phyllis Sharps, Wendy G. Lane, Mahua Mandal, Kelli Hirsch, Donna M. Strobino, Wendy L. Bennett, Jacquelyn Campbell, Andrea Gielen

CRVAW Faculty Journal Articles

BACKGROUND: Intimate partner violence (IPV) is prevalent among adolescent and adult women, with significant physical, sexual, and mental health consequences. In 2011, the Institute of Medicine's Clinical Preventive Services for Women consensus report recommended universal screening for violence as a component of women's preventive services; this policy has been adopted by the Health Resources and Services Administration (HRSA). These policy developments require that effective clinic-based interventions be identified, easily implemented, and taken to scale.

METHODS: To foster dialogue about implementing effective interventions, we convened a symposium entitled "Responding to Violence Against Women: Emerging Evidence, Implementation Science, and Innovative Interventions," on …

Drug Overdose Morbidity And Mortality In Kentucky, 2000-2010: An Examination Of Statewide Data, Including The Rising Impact Of Prescription Drug Overdose On Fatality Rates, And The Parallel Rise In Associated Medical Costs, Terry Bunn, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

From Foreword:

Kentucky has seen an explosion in fatal poisonings, particularly prescription drug related fatalities, in the last decade. In 2009, Kentucky had the 5^th highest drug overdose rate in the US, increased from the 6^th highest drug overdose fatality rate determined in 2008 (CDC WONDER). Kentucky also had the 5^th highest nonmedical use of opioid pain relievers, and 11^th highest for opioid pain reliever sales in the nation (CDC, MMWR Report November 4, 2011). These drug overdose mortality statistics are extremely startling and only begin to reveal the devastating mental, emotional, and economic toll and …

Practice Effects In A Longitudinal, Multi-Center Alzheimer's Disease Prevention Clinical Trial, Erin L. Abner, Brandon C. Dennis, Melissa J. Mathews, Marta S. Mendiondo, Allison Caban-Holt, Richard J. Kryscio, Frederick A. Schmitt, John J. Crowley

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Practice effects are a known threat to reliability and validity in clinical trials. Few studies have investigated the potential influence of practice on repeated screening measures in longitudinal clinical trials with a focus on dementia prevention. The current study investigates whether practice effects exist on a screening measure commonly used in aging research, the Memory Impairment Screen (MIS).

METHODS: The PREADViSE trial is a clinical intervention study evaluating the efficacy of vitamin E and selenium for Alzheimer's disease prevention. Participants are screened annually for incident dementia with the MIS. Participants with baseline and three consecutive follow-ups who made less …

Inla Promotes Dissemination Of Listeria Monocytogenes To The Mesenteric Lymph Nodes During Food Borne Infection Of Mice, Elsa N. Bou Ghanem, Grant S. Jones, Tanya Myers-Morales, Pooja D. Patil, Achmad N. Hidayatullah, Sarah E. F. D'Orazio

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Intestinal Listeria monocytogenes infection is not efficient in mice and this has been attributed to a low affinity interaction between the bacterial surface protein InlA and E-cadherin on murine intestinal epithelial cells. Previous studies using either transgenic mice expressing human E-cadherin or mouse-adapted L. monocytogenes expressing a modified InlA protein (InlA(m)) with high affinity for murine E-cadherin showed increased efficiency of intragastric infection. However, the large inocula used in these studies disseminated to the spleen and liver rapidly, resulting in a lethal systemic infection that made it difficult to define the natural course of intestinal infection. We describe here a …

Association Of Intimate Partner Violence And Childhood Sexual Abuse With Cancer-Related Well-Being In Women, Ann L. Coker, Diane R. Follingstad, Lisandra S. Garcia, Corrine M. Williams, Timothy N. Crawford, Heather M. Bush

Obstetrics and Gynecology Faculty Publications

BACKGROUND: Limited evidence suggests that intimate partner violence (IPV) may be associated with poorer cancer outcomes. We hypothesized that timing and type of IPV as well as childhood sexual abuse (CSA) may negatively affect depression, perceived stress, and cancer-related well-being.

METHODS: This was a cross-sectional study of women diagnosed with either breast, cervical, or colorectal cancer in the prior 12 months included in the Kentucky Cancer Registry. Consenting women were interviewed by phone (n=553). Multivariate analysis of covariance (MANCOVA) was used to determine the association between IPV (37% lifetime prevalence) and type, timing, and the range of correlated cancer-related well-being …

Load-Relaxation Properties Of The Human Trunk In Response To Prolonged Flexion: Measuring And Modeling The Effect Of Flexion Angle, Nima Toosizadeh, Maury A. Nussbaum, Babak Bazrgari, Michael L. Madigan

Biomedical Engineering Faculty Publications

Experimental studies suggest that prolonged trunk flexion reduces passive support of the spine. To understand alterations of the synergy between active and passive tissues following such loadings, several studies have assessed the time-dependent behavior of passive tissues including those within spinal motion segments and muscles. Yet, there remain limitations regarding load-relaxation of the lumbar spine in response to flexion exposures and the influence of different flexion angles. Ten healthy participants were exposed for 16 min to each of five magnitudes of lumbar flexion specified relative to individual flexion-relaxation angles (i.e., 30, 40, 60, 80, and 100%), during which lumbar flexion …

Smoking On The Margins: An Equity Analysis Of The Outcomes Of An Outdoor Smoke-Free Policy, Chizimuzo T.C. Okoli, Ann Pederson

Nursing Presentations

• Purpose: To analyze the health and health equity impact of the newly implemented smoke-free policy for Vancouver’s parks and beaches

• CIHR Operating Grant: Population Health Intervention Research – designed to study an intervention in action not controlled by the investigators

• End date of funding, March 31, 2013 (with potential 12-month extension)

Multigenerational Families And Food Insecurity, James P. Ziliak, Craig Gundersen

University of Kentucky Center for Poverty Research Discussion Paper Series

The prevalence of multigenerational families is on the rise in the United States, as is food insecurity. We estimate the effect of resident grandchildren on the risk of and transitions in food insecurity using repeated cross sections and longitudinally linked two-year panels of the Current Population Survey from 2001-2010. We find that rates of food insecurity in families with a grandchild present are at least twice as high in a typical year compared to families without a resident grandchild, and the extent of very low food security increased substantially faster among these households over the past decade. The rise in …

Suicides And Suicide Attempts In Kentucky, 2001–2011, Kayla Pope, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

From Executive Summary:

1. There were 605 suicides among Kentucky residents in the year 2010, up 7% from the 567 recorded in the year 2009.

2. The Kentucky resident age-adjusted suicide rate increased from 12.8 per 100,000 population in 2009 to 13.5 per 100,000 population in 2010, a 5.5% increase.

3. Firearms were the primary means of completed suicide from 2001-2010.

4. Kentucky residents aged 45-54 were the age group that completed suicide most frequently in 2010.

5. The age-adjusted rate for Kentucky self-harm-related hospitalizations increased 7.6% from 2010-2011 (52.5 hospitalizations per 100,000 population in 2010 to 56.5 hospitalizations in …

Racism And Illicit Drug Use Among African American Women: The Protective Effects Of Ethnic Identity, Affirmation, And Behavior, Danelle Stevens-Watkins, Brea Perry, Kathi L. Harp, Carrie B. Oser

Sociology Faculty Publications

Though recent evidence indicates that rates of illicit drug use among African American women are now higher than the national average, little is known about the etiology of substance use in this population. In addition, the effects of racism and other cultural factors are understudied and may be unique amongst African American women. This cross-sectional study explores risk and protective factors for drug use among 204 African American women. More specifically, associations between racism experiences and drug use are investigated in the context of potential moderating influences (i.e., psychosocial resources, social safety net variables, and cultural identity and practices). Findings …

Noninvasive Optical Characterization Of Muscle Blood Flow, Oxygenation, And Metabolism In Women With Fibromyalgia, Yu Shang, Katelyn Gurley, Brock Symons, Douglas Long, Ratchakrit Srikuea, Leslie J. Crofford, Charlotte A. Peterson, Guoqiang Yu

Biomedical Engineering Faculty Publications

INTRODUCTION: Women with fibromyalgia (FM) have symptoms of increased muscular fatigue and reduced exercise tolerance, which may be associated with alterations in muscle microcirculation and oxygen metabolism. This study used near-infrared diffuse optical spectroscopies to noninvasively evaluate muscle blood flow, blood oxygenation and oxygen metabolism during leg fatiguing exercise and during arm arterial cuff occlusion in post-menopausal women with and without FM.

METHODS: Fourteen women with FM and twenty-three well-matched healthy controls participated in this study. For the fatiguing exercise protocol, the subject was instructed to perform 6 sets of 12 isometric contractions of knee extensor muscles with intensity steadily …

Forage News [2012-11], Department Of Plant And Soil Sciences, University Of Kentucky

Forage News

• Kentucky Grazing Conference
• KFGC Presents Awards
• Alfalfa Intensive Training Seminar
• Kentuckian Featured at National Hay Convention
• AFGC Conference in Covington
• Kentucky's 2012 National Forage Spokesman to speak at Farm Bureau Forage Commodity Conference
• Dr. Peter Ballerstedt to Speak at Forages at KCA During the KCA Convention
• Neutral Detergent Fiber Digestibility (NDFD): A Good Predictor of Forage Quality
• Where Does Nitrogen Fertilizer Come From?
• The Cost of Pasture vs. Hay

Cultural Models Of Bodily Images Of Women Teachers, Christine A. Mallozzi

Gender and Women's Studies Faculty Publications

Cultural models are simplified images and storylines that encapsulated what is regarded as typical for a social group. Cultural models of teachers include body images of dress, adornment, and comportment, and are useful in examining society’s standards and values. Two participants, Erin and Gabbie (pseudonyms), shared stories about their tattoos, which in the U.S. have historically been seen as a mode of resistance. These tattoos that reflected the teachers’ personal lives were regarded in light of the cultural model of the U.S. teacher, a typically conservatively dressed and coiffed female. According to discourse analysis of the participants’ stories, each teacher’s …

Gene Expression Analysis Of A Murine Model With Pulmonary Vascular Remodeling Compared To End-Stage Ipah Lungs, Kayoko Shimodaira, Yoichiro Okubo, Eri Ochiai, Haruo Nakayama, Harutaka Katano, Megumi Wakayama, Minoru Shinozaki, Takao Ishiwatari, Daisuke Sasai, Naobumi Tochigi, Tetsuo Nemoto, Tsutomu Saji, Katsuhiko Kamei, Kazutoshi Shibuya

Microbiology, Immunology, and Molecular Genetics Faculty Publications

BACKGROUND: Idiopathic pulmonary arterial hypertension (IPAH) continues to be one of the most serious intractable diseases that might start with activation of several triggers representing the genetic susceptibility of a patient. To elucidate what essentially contributes to the onset and progression of IPAH, we investigated factors playing an important role in IPAH by searching discrepant or controversial expression patterns between our murine model and those previously published for human IPAH. We employed the mouse model, which induced muscularization of pulmonary artery leading to hypertension by repeated intratracheal injection of Stachybotrys chartarum, a member of nonpathogenic and ubiquitous fungus in our …

The Long-Term Impact Of Physical And Emotional Trauma: The Station Nightclub Fire, Jeffrey C. Schneider, Nhi-Ha T. Trinh, Elizabeth Selleck, Felipe Fregni, Sara S. Salles, Colleen M. Ryan, Joel Stein

Physical Medicine and Rehabilitation Faculty Publications

BACKGROUND: Survivors of physical and emotional trauma experience enduring occupational, psychological and quality of life impairments. Examining survivors from a large fire provides a unique opportunity to distinguish the impact of physical and emotional trauma on long-term outcomes. The objective is to detail the multi-dimensional long-term effects of a large fire on its survivor population and assess differences in outcomes between survivors with and without physical injury.

METHODS AND FINDINGS: This is a survey-based cross-sectional study of survivors of The Station fire on February 20, 2003. The relationships between functional outcomes and physical injury were evaluated with multivariate regression models …

The Effect Of Safety Net Programs On Food Insecurity, Lucie Schmidt, Lara Shore-Sheppard, Tara Watson

University of Kentucky Center for Poverty Research Discussion Paper Series

Does the safety net reduce food insecurity in families? In this paper we investigate how the structure of benefits for five major safety net programs – TANF, SSI, EITC, SNAP, and Medicaid – affects low food security in families and very low food security among children. We build a calculator for the years 2001-2009 to impute eligibility and benefits for these programs in each state, taking into account cross-program eligibility rules. To identify a causal effect of the safety net, we instrument for imputed eligibility and benefits using simulated eligibility and benefits for a nationally representative sample. Focusing on non-immigrant, …

Characterization Of Secretory Sphingomyelinase Activity, Lipoprotein Sphingolipid Content And Ldl Aggregation In Ldlr-/- Mice Fed On A High-Fat Diet, Gergana M. Deevska, Manjula Sunkara, Andrew J. Morris, Mariana N. Nikolova‑Karakashian

Physiology Faculty Publications

The propensity of LDLs (low-density lipoproteins) for aggregation and/or oxidation has been linked to their sphingolipid content, specifically the levels of SM (sphingomyelin) and ceramide. To investigate this association in vivo, ldlr (LDL receptor)-null mice (ldlr-/-) were fed on a modified (atherogenic) diet containing saturated fats and cholesterol. The diet led to significantly elevated SM content in all serum lipoproteins. In contrast, ceramide increased only in the LDL particles. MS-based analyses of the lipid acyl chain composition revealed a marked elevation in C16:0 fatty acid in SM and ceramide, consistent with the prevalence of palmitic acid in the modified diet. …

Role Of International Medical Graduates In Kentucky Medicine: Implications For Workforce Planning And Medical Education, Amanda L. Faulkner, Emery A. Wilson, Elmer T. Whitler, Linda M. Asher

Center of Excellence in Rural Health Faculty Publications

An argument for International Medical Graduates (IMGs) as part of a state’s physician workforce is that they “fill the gap” created by the shortage of United States Medical Graduates (USMGs) required to meet the demand for physician services, especially primary care physicians in rural areas.

The purpose of this study is to examine the overall impact of IMGs on Kentucky’s physician workforce and determine whether they overcome the shortage of USMGs. Information from the Kentucky Board of Medical Licensure (KBML) was used to examine the distribution and practice patterns of IMGs and USMGs. IMGs are similar to USMGs in terms …

Family Structure, Work Patterns And Time Allocations: Potential Mechanisms Of Food Insecurity Among Children, Kelly Balistreri

University of Kentucky Center for Poverty Research Discussion Paper Series

Over 469 thousand households in the U.S. experienced very low food security among children, a severe condition characterized by reductions in food intake due to an inability to afford enough food. But food insecurity is not simply about economic resources. There exists a paradox in which some poor households with children are food secure while some non-poor households with children are food insecure. This study moves beyond a singular focus on income and considers how the family context may protect or generate risk of food insecurity for children. The goals of the proposed project were to: 1) to provide a …

Two Can Live As Cheaply As One...But Three’S A Crowd, Christopher Bollinger, Cheti Nicoletti, Stephen Pudney

University of Kentucky Center for Poverty Research Discussion Paper Series

To measure poverty, incomes must be equivalized across households with different structures. In this paper, we use a very flexible ordered response model to analyze the relationship between income, demographic structure and subjective assessments of financial wellbeing drawn from the 1991-2008 British Household Panel Survey. Our results suggest the existence of large scale economies within marital/cohabiting couples, but substantial diseconomies from the addition of children or further adults. This pattern contrasts sharply with commonly-used equivalence scales, and is consistent with explanations in terms of the capital requirements associated with additions to the core couple.

A Profile Of Kentucky Medicaid Mental Health Diagnoses, 2000‐2010, Michael T. Childress

CBER Research Report

Good policy is dependent upon good data. This is especially true in health policy. Here we provide data on the number of Kentucky Medicaid beneficiaries who have received a mental or behavioral health diagnosis from 2000 to 2010. A Profile of Kentucky Medicaid Mental Health Diagnoses, 2000‐2010 provides information on the total number of individuals who have been diagnosed with a mental health disorder as well as a year‐by‐year count of the 15 broad categories used to classify these diagnoses. Presented for children (age 18 and younger) and adults (19 and older), these data are organized at the state, regional, …

Is Earnings Nonresponse Ignorable?, Christopher R. Bollinger, Barry T. Hirsch

University of Kentucky Center for Poverty Research Discussion Paper Series

Earnings nonresponse in the Current Population Survey is roughly 30% in the monthly surveys and 20% in the March survey. If nonresponse is ignorable, unbiased estimates can be achieved by omitting nonrespondents. Little is known about whether CPS nonresponse is ignorable. Using sample frame measures to identify selection, we find clear-cut evidence among men but limited evidence among women for negative selection into response. Wage equation slope coefficients are affected little by selection but because of intercept shifts, wages for men and to a lesser extent women are understated, as are gender gaps. Selection is least severe among household heads.

Sarcopenia, Obesity, And Natural Killer Cell Immune Senescence In Aging: Altered Cytokine Levels As A Common Mechanism, Charles T. Lutz, Lebris S. Quinn

Pathology and Laboratory Medicine Faculty Publications

Human aging is characterized by both physical and physiological frailty. A key feature of frailty, sarcopenia is the age-associated decline in skeletal muscle mass, strength, and endurance that characterize even the healthy elderly. Increases in adiposity, particularly in visceral adipose tissue, are almost universal in aging individuals and can contribute to sarcopenia and insulin resistance by increasing levels of inflammatory cytokines known collectively as adipokines. Aging also is associated with declines in adaptive and innate immunity, known as immune senescence, which are risk factors for cancer and all-cause mortality. The cytokine interleukin-15 (IL-15) is highly expressed in skeletal muscle tissue …

The Child And Adult Care Food Program And Food Insecurity, Colleen Heflin, Irma Arteaga, Sara Gable

University of Kentucky Center for Poverty Research Discussion Paper Series

High rates of food insecurity are a significant problem in the United States. It is currently estimated that more than 48.8 million people live in food insecure households, meaning that at some time during the previous year, they were unable to acquire or were uncertain of having enough food to meet basic needs due to inadequate household resources (Coleman-Jensen, Nord, Andrews, & Carlson, 2011). Rates of food insecurity are substantially higher among those in households with incomes below the poverty line (40.2%) and in households with children headed by a single woman (35.1%). Levels of food insecurity increased across U.S. …