Digital Commons Network^™

A Framework For Characterizing The Peripheral Immune Isonome Using Long-Read Single-Cell Rna Sequencing And Its Relevance To Neurological Disease, Patricia Hayes Doyle

Theses and Dissertations--Neuroscience

Long-read single-cell RNA sequencing provides an opportunity to understand human health and disease at isoform resolution, revealing cellular diversity and disease mechanisms difficult to resolve with bulk or short-read methodologies.

Using a modified PIPseq workflow and computational pipeline adapted for Oxford Nanopore (ONT) sequencing, we profiled isoform usage across immune cells, integrating marker expression and isoform discovery, generating the largest long-read single-cell dataset of human immune cells from a single individual to date. We identified non-canonical protein-coding variants of GZMB and CD3G enriched in unexpected cell types. We also discovered novel transcripts from CMC1 and LYAR with cell-type-specific signatures that …

Environmental Predictors Of Human Lyme Disease Incidence Across Appalachian Counties In Kentucky, Virginia, And West Virginia, 2000-2019, Karlie D. Rennison

Theses and Dissertations--Epidemiology and Biostatistics

This ecological study examined county-level environmental, landscape, and host-related predictors of Lyme disease incidence across Kentucky, Virginia, and West Virginia from 2000-2019. Lyme disease is an emerging public health concern in the Appalachian region, where geographic expansion and shifting ecological conditions may influence disease risk.

Lyme disease case rates (per 10,000 population) were analyzed in relation to climate variables, land cover metrics, host density measures, and rurality using publicly available data sources. Descriptive and regression analyses were conducted to evaluate associations between candidate predictors and disease incidence.

Substantial geographic variation in Lyme disease incidence was observed, with higher case rates …

Essays In Consumer Credit Markets, Sarah Najafzadeh Khoei

Theses and Dissertations--Finance and Quantitative Methods

This dissertation studies how technology, market structure, and contract design shape outcomes in consumer credit markets, with a particular focus on auto lending and leasing. In the first chapter, I investigate the performance of automated underwriting systems relative to human underwriters in the auto loan market. While prior studies document the advantages of automated underwriting, I show that its performance deteriorates under conditions of heightened data uncertainty. Exploiting the COVID-19 pandemic as an exogenous shock and using a combination of difference-in-differences and regression discontinuity designs, I find that automated underwriting performs significantly worse than human underwriting during this period, particularly …

Beyond The Veil: Critical Black Kantianism And The Ethics Of Structural (In)Visibility, Paradise A. Stanford

Theses and Dissertations--Philosophy

This dissertation develops what I call Critical Black Kantianism, a reconstructive approach to Kantian moral philosophy that centers race, recognition, and the structural conditions under which moral agency is formed. While Kantian ethics typically presumes idealized agents operating within just social contexts, this project argues that such abstraction obscures how racial domination actively shapes autonomy, dignity, and self-consciousness. Drawing on W.E.B. Du Bois’ account of double consciousness, Black feminist thought, and contemporary theories of recognition, I show that moral agency is not merely exercised within social environments but is constituted through them—often under conditions of misrecognition that fracture autonomy.

Against …

Linking S‑Pillar Empirical Criteria With Boundary And Finite Element Models For Underground Stone Pillar Analysis, Benjamin Diddle

Theses and Dissertations--Mining Engineering

The objective of this thesis is to strengthen the relationship between empirically based stone pillar design methods and two numerical modeling techniques by calibrating boundary element and finite element models to the S‑Pillar empirical criteria and observed pillar behavior in underground stone mines. The first component of the research investigates the displacement‑discontinuity boundary element method implemented in LaModel, quantifying the influence of the lamination thickness and element size on stone pillar safety factor predictions. Results showed that optimal thickness depends on overburden modulus, while larger element sizes introduce significant SF differences from S-Pillar values once the grid size exceeds 5 …

Process-Guided Learning Via Data-Driven Modeling And Controller Synthesis, Benton Clark

Theses and Dissertations--Mechanical and Aerospace Engineering

This work introduces process-guided learning, a framework in which process characteristics and learning algorithms are combined in the modeling process of engineering applications with the aim of uniting traditional and data-driven modeling and control techniques. Traditional engineering methods using simplified analytic models fail to capture the increasing complexities of engineering problems with sufficient accuracy to achieve modern requirements. More advanced modeling and control techniques using high-fidelity models often produce a computational burden that is infeasible for real-time solutions. Data-driven modeling offers a simple and flexible algorithm for producing real-time capable, high-fidelity models, but naive implementations lack the physical constraints of …

Human Resource Policy And Practice In The American Regional Theatre: The Intersection Of The Actors’ Equity Association And The League Of Resident Theatres, Kathleen Holland

Theses and Dissertations--Arts Administration

Human resource management plays a critical yet understudied role in the American regional theatre, an industry characterized by project-based labor, mixed union and nonunion workforces, and deeply ingrained cultural norms that prioritize artistic production over worker well-being. This dissertation examines how institutional human resource policies intersect with the Actors’ Equity Association (AEA) collective bargaining agreement and the League of Resident Theatres (LORT), and the implications of these intersections for human resource practice in regional theatre organizations. While entertainment-industry unions predate the formalization of contemporary human resource management, little scholarship has examined how union agreements may shape or substitute for organizational …

Improving Evaluation Practices Of Community Arts Extension Agents: A Mixed-Methods Study Leveraging Theory Of Change And Open Systems Theory, Melissa G. Bond

Theses and Dissertations--Arts Administration

This dissertation examines how a structured evaluation training and subject-based evaluation tool can strengthen evaluation practices among Community Arts Extension professionals in Kentucky. Community Arts programs often support outcomes such as belonging, connection, skill development, and cultural engagement, yet those outcomes can be difficult to document within standardized public reporting systems. Guided by Theory of Change and Open Systems Theory, this mixed-methods study combines an environmental scan of FY2020–FY2025 Community Arts indicator records and agent-authored Success Stories with three survey waves administered before training, immediately after training, and approximately 60 days later.

Findings show that routine reporting captured substantial activity …

Expanding The Role Of Muscle Stem Cell Fusion In Muscle Under Hypertrophic Stimulus, Jensen Goh Zhong Sheng

Theses and Dissertations--Physiology

Muscle stem cells (MuSCs) are a unique stem cell population that can activate in response to both injury and growth stimuli. Studies on muscle regeneration have shown MuSC activation follows a uniform progression through proliferation, differentiation, and fusion. Therefore, to determine whether MuSC replication is a prerequisite for differentiation under hypertrophic stimulus, I used a lineage-tracking mouse model (Pax7^rtTA; TRE-H2B-GFP) to label MuSC nuclei and simultaneously tracked DNA synthesis via EdU incorporation. This dual-labeling approach allowed us to not only distinguish MuSC-derived nuclei but also demarcate which MuSC had proliferated prior to fusion. I then employed a mechanical …

The Association Between Learned Helplessness And Future Outlook And The Mediating Effects Of Parental Support, Engagement, And Closeness, Allison N. Loosle

Theses and Dissertations--Family Sciences

The present study examined the direct and indirect associations between learned helplessness and future outlook among emerging adults, with parental support, engagement, and closeness as potential mediating factors. Using data from 375 participants drawn from G3, Wave 4 of the Youth Development Study, two path analytic models were tested: one including a composite measure of learned helplessness and one examining its components (contingency, cognition, and behavior) individually. Results indicated that higher levels of learned helplessness were associated with a less positive future outlook. When separated, the cognition and behavior components were negatively associated with future outlook, whereas contingency was not …

The Impact Of Technology On The New Product Development Process For Intimate Apparel, Cassie M. Lambert

Theses and Dissertations--Retailing and Tourism Management

The purpose of this research was to provide a better understanding of how 3D CAD Software impacts the New Product Development Process of Intimate Apparel.  As a category, Intimate Apparel falls behind other categories in adopting new technology.  Interviews were conducted with industry professionals to explore their adoption and use of 3D CAD Software.  Two case studies were also conducted to compare the adoption strategies of a small and a large company.  Data coding of the interviews and case studies revealed similar relationships and common themes across all participants.  Findings show that the strategic implementation of 3D CAD Software reduces …

Environmental Detection And Quantification Of Equid Alphaherpesviruses In Equine Facilities Using Air Sampling, Emma E. Hyde

Theses and Dissertations--Veterinary Science

Equid alphaherpesvirus 1 and 4 (EHV-1/-4) circulate at equestrian facilities, contributing to outbreaks. Due to the complexities of the pathogen, including the limited predictability of reactivation from latency and the effects associated with secondary sites of viral replication, abortion, and neurologic disease, EHV infections are of utmost concern to the equine industry. Recent studies have highlighted the prevalence of the viruses in stabling areas at competitions, though little is known about this phenomenon in other high-traffic equine environments. This thesis presents two studies using air sampling surveillance methods to further explore the viral detection in other equine environments (veterinary facility …

Using Camera-Based Unmarked Spatial Capture-Recapture Modeling To Estimate Reintroduced Elk (Cervus Canadensis) Population Parameters And Distribution In Southeastern Kentucky, Claire Marie Muia

Theses and Dissertations--Forestry and Natural Resources

Estimation of population parameters is important for wildlife management decisions. Elk reintroduced to southeastern Kentucky experienced early irruptive population growth and are currently monitored using a statewide harvest-based statistical population reconstruction model (SPR) across the Kentucky Elk Restoration Zone (KERZ). Because the SPR model is spatially coarse and difficult to scale to the smaller management units comprising the KERZ, we conducted a spatially explicit capture-recapture study using a clustered camera-trapping array deployed for 10 weeks from June–August 2024 to estimate elk population parameters within Management Unit 4. Due to a lack of resights of GPS-marked elk, population parameters were estimated …

Between The Rails: Experiential Education And Its Impact On Compliance And Consistency In Racetrack Surface Management, Heather Mackenzie

Theses and Dissertations--Community & Leadership Development

Recent regulatory requirements within the Thoroughbred racing industry have increased expectations for consistent collection and reporting of racetrack surface data. Despite clear standards, implementation in daily operations remains inconsistent, highlighting a gap between regulation, knowledge, and practice. This study examined the impact of an experiential education curriculum on racetrack personnel’s self-efficacy and reporting consistency.

Using a quantitative design, data were collected through pre- and post-surveys measuring self-efficacy and records of the number of days surface data were entered. Descriptive statistics, paired-samples t-tests, and effect size analyses were used. Results showed a statistically significant increase in self-efficacy (p < .001) with large effect sizes, indicating meaningful gains in confidence and comfortability. Reporting consistency did not show a statistically significant change (p = .885).

Overall, experiential education …

Understanding Knowledge And Perceptions Of The Beef Industry On A Land-Grant University Campus, Allison E. Reaves

Theses and Dissertations--Community & Leadership Development

A well-researched phenomenon in the agricultural industry is the effects of constant innovation coupled with an increasing divide between producer and consumer. This issue has been presented as especially prevalent within animal agriculture and the beef industry, a predominant concern considering Kentucky’s agricultural commodities. This study (n = 31) utilized a mixed-methods approach to understand the knowledge, perceptions, and behavior of beef consumers on a land-grant university campus. Methodologies included Python’s DeepFace emotion recognition, semi-structured interviews, and the JMALI agricultural literacy assessment. Findings revealed participants to be below expected agricultural literacy levels of high school graduates (M=11), with no …

From Floodplain To Floodplain: Analyzing Stream And Riparian Restoration Methodologies And Impacts, Noah P. Lane

Theses and Dissertations--Biosystems and Agricultural Engineering

Stream restoration is a relatively new scientific field. Currently, there is not a definitive methodology for performing restorations that all professionals in industry and academia can agree upon. This has allowed for multiple ideologies to be developed and altered that vary by geographic location and the professional using them. In addition to the methodologies used, the publicly available design guidance published by state government organizations also varies by regulatory authority, method of analysis, ecoregion, and restoration objectives. In some cases, design guidance is replicated from a different geographical area and may not satisfy local needs or existing site conditions. Since …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Sepsis In Sight: Immersive Vr Simulation For Pediatric Training, Kelsey Wagler

DNP Projects

Abstract

Objectives: This project aimed to decrease the time required to administer antibiotics and fluid boluses to pediatric patients with sepsis by implementing a virtual reality (VR) simulation program. The initiative sought to enhance bedside nurses’ and pediatric residents’ knowledge, clinical reasoning, and confidence in sepsis assessment, early recognition, and evidence-based management. A secondary objective was to evaluate the effectiveness of VR simulation as an educational strategy for nurses in a high-acuity pediatric setting.

Design: This quality improvement project used a quasi-experimental design that incorporated a VR simulation intervention followed by a structured debriefing and targeted education session. Participants completed …

Stronger Together: Exploring The Impact Of Peer Support Meetings On Stress And Burnout In Ambulatory Nurse Managers, Sara Wellman

DNP Projects

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. …

Rural Oral Health Access Coordination Program Proposal, Anna Luu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Oral health disparities remain a major public health issue in the United States, particularly in rural Kentucky, with barriers such as limited access to preventive dental services, transportation, and insurance coverage contributing to delayed treatment and worsening oral health outcomes. In response, the proposed Rural Oral Health Access Coordination Program aims to improve care access by strengthening referral systems, integrating oral health screenings into public health settings, and enhancing care coordination for high-risk populations. The program intends to focus on the Kentucky River District Health Department Region, connecting individuals to existing services rather than providing direct clinical care. Expected outcomes …

Perry County Perinatal Access Navigator Program (Pc-Pamp) A Public Health Program Proposal To Improve Timely Prenatal Care Access In Perry County, Kentucky, Amber E. Mcguire-Chun

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Delayed initiation of prenatal care remains a significant public health concern in rural Appalachian communities, including Perry County, Kentucky, where structural barriers such as limited provider availability, transportation challenges, and fragmented referral systems contribute to inadequate access to timely care. This capstone project proposes the Perry County Prenatal Access Navigator Program (PC-PANP), a community-based patient navigation model designed to improve initiation of prenatal care in the first trimester. The program is led by the local health department and leverages partnerships with healthcare providers, the University of Kentucky College of Public Health, WIC, Extension services, and community organizations to support early …

Unexpected Longevity In Myasthenia Gravis, Bhupendra O. Khatri, Scott Schutten, Sergey Tarima

Biostatistics Faculty Publications

Background: This study compares age at death in patients with myasthenia gravis (MG) and multiple sclerosis (MS) with the general U.S. population and examines age at death patterns during a period preceding modern high-efficacy therapies. Objective: To compare age at death among individuals with MG and MS with the general population and assess differences in age at death between MG and MS. Design: Retrospective population-based study using death certificate data from four U.S. states (Florida, Wisconsin, Texas, and New York) for 2000, 2005, 2010, and 2015. Methods: Individuals with MG or MS listed on death certificates were identified. Age at …

Catwalk Xt Enables Sensitive Detection Of Locomotor Deficits After C2 Hemisection And Integrates Readily Into Ongoing Experimental Workflows In Adult Female Rats, Aaron L. Silverstein, Christopher M. Calulot, Christopher J. Mclouth, John C. Gensel, Warren J. Alilain

Biostatistics Faculty Publications

Over half of all spinal cord injuries (SCIs) in the United States occur at the cervical level and often cause both life-threatening breathing dysfunction and profound locomotor deficits. Although the C2 hemisection (C2Hx) model is vital for study of breathing dysfunction after experimental SCI, post-C2Hx locomotor deficits have only been assessed by metrics such as the Martínez Scale and ladder tests, which require time-intensive scoring by human observers. However, the CatWalk XT Gait Analysis system (Noldus Information Technology) delivers automated, quantitative assessment of interlimb coordination, gait cycle, and paw function, providing robust locomotor data in a time-efficient and practical manner. …

Integration Of Community-Engaged Research Technology And Methods To Guide Tobacco Regulatory Science In Rural Communities, Melissa H. Abadi, Stephen R. Shamblen, Mary Kay Rayens, Kirsten T. Thompson, Amy Wildman, Kathy Rademacher, William Wieczorek, Raphael Nishimura, Shyanika W. Rose, Mikhail N. Koffarnus, Seth Himelhoch, Ellen J. Hahn

Biostatistics Faculty Publications

Objective – This study aims to build a rural Appalachian cohort to examine how US Food and Drug Administration (FDA) Center for Tobacco Products (CTP) regulatory policies influence tobacco and nicotine product use across levels of rurality. Methods – The AppalTRUST (Appalachian Tobacco Regulatory Science Team) Cohort integrates four inter-connected Community-engaged Research + Technology (CEnRT) elements to support recruitment and retention: (1) building trust and cultural relevance; (2) addressing barriers to participation in research; (3) focusing on ethics and confidentiality; and (4) fostering ongoing and consistent collaboration between the scientific and field teams. The study uses a dual sampling design …

Rethinking Team Science Metrics Through Collaborative Guideposts, Kristen J. Mcquerry, Kelsey Karnik, Megan E. Hall, Caitline Phan, Yana Feygin, Emily Slade

Biostatistics Faculty Publications

Introduction – The increasing reliance on interdisciplinary and transdisciplinary teams has reshaped how science is conducted, yet evaluating the success of such teams remains a persistent challenge. Traditional metrics, such as publication counts, impact factors, and citation indices, fail to capture the full scope of team contributions, particularly in contexts where success may be defined by community engagement, mentorship, or long-term collaboration. Methods – In this Perspective, we introduce Collaborative Guideposts, a framework designed to align success metrics with a team’s organizing priorities. We illustrate this approach through two contrasting team models from a biostatistical collaboration center: Team A, a …

Facilitators Of And Barriers To Implementation Of A Tablet-Based Digital Health Program For Colorectal Cancer Screening In Primary Care: Qualitative Pragmatic Implementation Study, Mark Cromo, Aliza Randazzo, David P. Miller, Kristie Foley, Ajay Dharod, Anna C. Snavely, Elena Wright, Holly Brower, Mark Dignan

Internal Medicine Faculty Publications

Background: Colorectal cancer (CRC) incidence and mortality rates continue to be elevated even though effective screening methods are widely available. To increase CRC screening in primary care practices, our team developed a tablet-based digital health program (mPATH) designed to identify patients needing CRC screening, provide education, and empower patients to request a screening test via the program.

Objective: This study aimed to qualitatively assess facilitators of and barriers to implementing and maintaining mPATH in primary care clinics.

Methods: In a pragmatic implementation trial, clinics were randomized to receive only in-person training and technological support via phone or email (low touch) …

Adipose Tissue-Derived Small Extracellular Vesicles In Plasma Reveal Molecular Circuitries Underlying Glucose Intolerance, Shalini Mishra, Yixin Su, Ashish Kumar, Sangeeta Singh, Brian S. Finlin, Fang-Chi Hsu, Jingyun Lee, Cristina M. Furdui, Philip A. Kern, Swapan K. Das, Gagan Deep

Internal Medicine Faculty Publications

Objective: Glucose tolerance (GT) is a major effector for adipose tissue (AT) remodeling in obesity, yet its molecular mechanisms remain incompletely defined. We hypothesized that the biophysical and molecular profiles of AT-derived small extracellular vesicles (sEV^AT) change in response to glucose availability and differ by GT status.

Methods: sEV^AT were isolated from plasma of individuals with normal GT (NGT) and impaired GT (IGT) (n = 5/group) at fasting (0 h) and 1 h post glucose challenge during oral glucose tolerance test (OGTT). sEV^AT were characterized for size, concentration, surface expression of insulin receptor-α (INSRα), proteome, …

Discrimination Distress And Current Combustible And Non-Combustible Tobacco Product Use Among Us Youth, 2023, Meman Diaby, Osayande Agbonlahor, Maggie K. Richardson, Joy L. Hart, Shyanika W. Rose, Delvon T. Mattingly

Markey Cancer Center Faculty Publications

Introduction: Discrimination is the unfair treatment of people based on their identity. Youth who experience discrimination may cope with associated distress by using tobacco products, with amplified health consequences depending on the type of product.

Methods: We used data from the 2023 National Youth Tobacco Survey (n = 22 069) and derived an overall continuous measure from the 15-item Adolescent Discrimination Distress Index, as well as three continuous discrimination distress sub-indices: educational, institutional, and peer (range for each: 0–5). We defined current tobacco use as two outcomes: any past 30-day use of combustible (cigarettes, cigars, hookah, roll- your-own, pipe, bidis) …

Cultus: Eco-Phenomenology In The Work Of John Steinbeck, Robinson Jeffers, And Jack London, Carter D. Johnson

Theses and Dissertations--English

In the face of increasingly dire environmental crises, proposed solutions have gravitated toward imperatives for faster, cleaner, and more efficient technologies and resources. While practical solutions are necessary, they are entirely insufficient to deal with an underlying issue driving environmental degradation: unbridled instrumental reason. In this dissertation, I suggest a theoretical posture, cultus, which attempts to balance the necessity of instrumental action with the guiding counterweight of receptivity. Furthermore, I argue that such personal receptivity is uniquely fostered in aesthetic experiences, attuning the individual to the non-identical and renewing a relationship of care.

I examine the life and work of …