Digital Commons Network^™

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 …

Adsorptive Gas Sensor Response Forecasting To Enable Breath-By-Breath Analysis, Samuel Bellaire, Samir Ahmed Rawashdeh, Kirby P. Mayer, Jamie L. Sturgill

Physical Therapy Faculty Publications

MOS gas sensors have proven to be useful in electronic noses, which utilize these sensors to detect volatile organic compounds in human breath to detect various lung diseases. Unfortunately, the long settling time of MOS gas sensors is ill-suited to measuring human breath, where complete breathing cycles are often shorter than 5 s. Existing studies circumvent this limitation by collecting gas samples and injecting them into a sealed chamber to react with the sensors. However, it would be convenient if breath-by-breath analysis could be conducted without the need to store breath samples. To accomplish this, we present a novel forecasting …

Exploring The Influence Of Quadriceps Peak Torque And Rate Of Torque Development On Running Mechanics After Anterior Cruciate Ligament Reconstruction, Amit M. Gohil, Gregory S. Hawk, Darren L. Johnson, Christopher S. Fry, Brian W. Noehren

Physical Therapy Faculty Publications

Background: After anterior cruciate ligament reconstruction (ACLR), chronic changes in knee joint biomechanics during higher level tasks, such as running, may negatively impact long-term knee joint health. Among the factors that contribute to these chronic changes, the influence of quadriceps strength on knee joint biomechanics during running is not well understood.   Hypothesis: Higher involved limb quadriceps strength (peak torque and rate of torque development [RTD]) and limb symmetry index (LSI) will be positively associated with greater peak knee flexion angle and peak knee extensor moment during running.   Study Design: Cross-sectional study.   Level of Evidence: Level 3.   Methods: Peak knee extensor …

Prevalence And Incidence Of Heart Failure Phenotypes Among Transgender And Gender-Diverse Adults In The United States, Ian K. Everitt, Emily K. Quinn, Meredith S. Duncan, Chris Grasso, Sari L. Reisner, Guneet K. Jasuja, Tonia Poteat, Ayelet Shapira-Daniels, Howard Cabral, Vin Tangpricha, Michael K. Paasche-Orlow, Emelia J. Benjamin, Monica Mukherjee, Carl G. Streed

Biostatistics Faculty Publications

BACKGROUND: Prevalent and incident heart failure (HF) and its comorbidities have not been characterized in transgender and gender-diverse (TGD) populations. This study determines the prevalence and incidence of HF phenotypes by gender identity. METHODS: A retrospective cohort analysis was performed using deidentified administrative claims from the Optum Labs Data Warehouse (2006-2022). TGD adults and a sample of demographically similar cisgender comparators were identified using a validated algorithm, and gender identity was categorized as cisgender man, cisgender woman, transmasculine, transfeminine, or unclassified TGD. Prevalent and incident HF, including systolic, diastolic, and unclassified phenotypes, were assessed using diagnosis codes. Multivariable logistic and …

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 …

The Influence Of Support From Family, Friends, And Community On Perceived Mental Health Status In Diabetes, Courtney L. Ortz, Meredith S. Duncan, Oluwatosin Leshi, Suraksha Khanal, Brittany Smalls

Biostatistics Faculty Publications

Strong social support is a protective factor in diabetes and mental health management. The purpose of this study was to examine the influence of the type of support on perceived mental health status among people with diabetes. We used data from the 2021 Household Component of the Medical Expenditure Survey (MEPS). Regression models assessed the association between mental well-being (outcome) and expected help from family, friends, and the community (exposure). Support from both friends and family were significantly associated with better mental well-being, adjusting for covariates. Secondary analyses showed that those who reported greater anticipated support from family were more …

A Practitioner’S Guide To Panel Data Quantile Regression, Antonio F. Galvao, Carlos Lamarche

Economics Faculty Publications

Quantile regression for panel data has become a common model of interest for econometricians and statisticians. The theoretical literature has addressed important questions, including identification, estimation, and statistical inference. Although recent advances have enabled practitioners to estimate flexible models under a wide range of assumptions, practical issues have not been fully addressed. In this paper, we offer a guide to empirical practice intended to help applied researchers navigate the challenges of estimation and inference for panel quantile models. We also present a series of practical recommendations and illustrations, emphasizing both “why” and the “how” to help researchers with the implementation …

A Simple Statistical Tool To Correct The Daily Temperature Effect On Dielectric Soil Matric Potential Sensor Readings, Sebastián Bravo Peña, Meindert Commelin, Ole O. Wendroth

Plant and Soil Sciences Faculty Publications

High-resolution time series recorded by soil water dielectric sensors are often affected by other processes. Dielectric soil matric potential sensors, such as the TEROS 21, exhibit temperature sensitivity, resulting in deviations of readings from the true value due to soil temperature fluctuations. However, methods for correcting this effect remain limited. The objective of this study was to create a straightforward, scale-based statistical approach to mitigate the influence of daily temperature oscillations on matric potential dielectric readings. The temperature sensitivity correction function (TSCF) identifies, quantifies, and smooths diurnal fluctuations caused by soil temperature dynamics. We provide a detailed description of the …

Applying Photovoice To Uncover Fundamental Causes Of Health Inequality In Local Health Contexts, Marisa Booty, Madelyne G. Culbertson, Mason Taylor, Dakota Heise, Heather Stone, Katherine Leanne Kommer, Jennifer Gulley, Jeanette Hart, Christina Nentwick, Margaret Mcgladrey

Sociology Faculty Publications

Introduction: Participatory action research methods like Photovoice are uniquely equipped to identify structural determinants of health based on lived experiences of how they influence proximal and distal population health outcomes. This study uses Photovoice data to examine how structural determinants impact community health needs.

Methods: Qualitative thematic analysis used focus group discussion data (25 transcripts) from four Kentucky counties that embedded Photovoice into their local health department community health assessment processes. Coded excerpts were examined for ways in which participants' community health concerns reflected structural issues rather than individual health behaviors.

Results: Participants perceived issues such as houselessness, food insecurity, …

Current And Emerging Therapeutic Strategies For The Treatment Of Duchenne Muscular Dystrophy, Miguel A. Lopez Perez, Noah L. Weisleder

Molecular and Cellular Biochemistry Faculty Publications

Background/Objectives: Duchenne muscular dystrophy (DMD) is a fatal, progressive neuromuscular disorder caused by mutations in the dystrophin gene, leading to the absence of functional dystrophin protein. As the largest gene in the human genome, the DMD locus is highly susceptible to mutations, contributing to a prevalence of approximately 1 in 3800–6300 live male births worldwide. This review aims to provide a comprehensive and critical synthesis of current and emerging therapeutic strategies for DMD.

Methods: We conducted a narrative review of the literature, integrating findings from clinical trials, regulatory approvals, and preclinical studies. We categorized therapeutic approaches into mutation-agnostic and mutation-specific …

Prevalence And Characteristics For Mental Health Disorder Before And After Childhood Cancer Diagnosis—A Statewide Population-Based Study Among Medicaid Beneficiaries, Feitong Lei, Laurie E. Mclouth, Eric B. Durbin, Thomas T. Tucker, John L. Villano, Bin Huang

Internal Medicine Faculty Publications

Introduction: Pediatric cancer patients suffer mental health deficits. Patients who are vulnerable with respect to socioeconomic or other sociodemographic factors may be at heightened risk for worse mental health outcomes during cancer for many reasons including entering treatment with an existing mental health disorder. The purpose of this study was to describe the prevalence and trajectory of mental health before and after a childhood cancer diagnosis in a socio-demographically at-risk sample.

Methods: Data from the Kentucky Cancer Registry was utilized to identify patients aged 19 or under with a first primary childhood cancer diagnosis during 2001–2017. Linking KCR data with …

Behavioral Interventions For Increasing Group Engagement In K-12 Classrooms: A Systematic Review And Meta-Analysis, Lauren M. Lejeune, Mark Devdas Samudre, Hongyang Zhao, Meredith Jeffords, Jason C. Chow

Early Childhood, Special Education, and Counselor Education Faculty Publications

This systematic review and meta-analysis synthesized the body of research on behavioral interventions for improving group engagement. Fifty studies were included (n = 10 group designs; n = 40 single case designs [SCDs]). Most research on interventions to improve group engagement was conducted in elementary and middle school general education settings. Class-Wide Function-Related Intervention Teams (n = 6), the Good Behavior Game (n = 6), Tootling (n = 8), and multicomponent approaches (n = 9) were the most commonly reported intervention types. Antecedent strategies that were most commonly embedded in behavioral interventions to increase group …

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 …

Toward Efficient And Scalable Scientific Data Management Through Quality-Oriented Data Compression, Pu Jiao

Theses and Dissertations--Computer Science

Scientific simulations and instruments now produce data at rates that overwhelm the storage, memory, and network subsystems of modern high-performance computing (HPC) facilities. Error-bounded lossy compression reduces data movement costs while bounding reconstruction error, yet three barriers limit its adoption in mission-critical workflows: existing compressors cannot guarantee the accuracy of domain-specific quantities of interest (QoIs) derived from compressed data; compression-induced artifacts such as posterization, blocking, and interpolation banding erode user confidence in decompressed fields; and significant compressibility in the quantization index arrays of interpolation-based pipelines remains unexploited. This dissertation addresses all three barriers through four contributions, with the artifact barrier …

Advancing Task-Oriented Dialog Systems: Scalability, Generalization, And Evaluation, Adib Mosharrof

Theses and Dissertations--Computer Science

Task-oriented dialog (TOD) systems enable conversational interfaces for complex tasks like flight booking and restaurant reservations. However, deploying TOD systems at scale faces three critical barriers: scalability, generalization, and evaluation. Scalability is primarily restricted by the human-annotation bottleneck, as current systems depend on vast quantities of manually labeled data for every new domain, making deployment prohibitively expensive. Generalization remains a persistent challenge, as systems optimized for known domains often suffer significant performance degradation when encountering new, unseen ones. Existing evaluation metrics measure response quality and fluency, but fail to measure functional task success. As TOD systems are deployed across diverse …

Three Essays On Disparities And Outcomes Among Patients With Diabetes, Aiemere O. Oikeh

Theses and Dissertations--Health Services Research (HSR)

The American Diabetes Association (ADA) recommends that patients with diabetes adopt 7 preventive care measures to improve their health outcomes. The recommendations are to check their blood glucose levels daily, undergo biennial hemoglobin A1c tests, undergo dilated eye exams once every 2 years, engage in regular physical activity, check their feet daily, have annual feet examinations performed by a clinician, and receive diabetes self-management education services (DSMES). Marital status has been found to be associated with positive health outcomes; thus, it is ideal to evaluate if there is an association between marital status and diabetes preventive care. The ADA also …

The Effects Of Systematic Instructional Interventions On Functional Communication, Vocational Independence, And Academic Performance For High School Students With Autism In A Self-Contained Special Education Setting, Sarah O. Shalash

University of Kentucky Master's Theses

This project evaluated the effects of systematic instruction on functional communication, vocational independence, and functional mathematics for three high school students with autism in a self-contained special education classroom using three A–B single-case designs. Interventions included a system of least prompts for AAC requesting and vocational task completion and constant time delay for a functional timer-setting task. Student performance was measured as the percentage of independently completed responses across instructional sessions. Student T demonstrated meaningful improvement in independent AAC requesting and reached 75% independence in the final session. Student B demonstrated emerging improvement in timer-setting performance and reached 60% independence …

Examining Marginalized Sexual Identity Development Through Perry’S Scheme Of Cognitive Development, Miranda Bejda

University of Kentucky Doctoral Dissertations

Existing models of LGBTQ+ sexual identity development are critiqued for their linearity and lack of inclusion for diverse experiences and sexual identities. There is a call for a more robust understanding of the cognitive aspect of sexual identity development. The purpose of this dissertation is to further the understanding of how people think about their sexual identity through the developmental process using Perry’s scheme of cognitive development as a framework. Through semi-structured interviews, I analyze the LGBTQ+ sexual identity development process (Stage 1), how Perry’s scheme applies to LGBTQ+ sexual identity development (Stage 2), and propose a Perry-informed model of …

Adult Tobacco Product Use Patterns Across The Urban–Rural Continuum: The Longitudinal Population Assessment Of Tobacco And Health (Path) Study, 2016–2023, Jing Zhang, Shyanika W. Rose, Ellen J. Hahn, Megan E. Roberts, Bethany Shorey Fennell, Jenny E. Ozga, Seth Himelhoch, Saber Feizy, W. Jay Christian, Amanda Thaxton Wiggins, Melissa Abadi, Delvon T. Mattingly, Mary Kay Rayens

Nursing Faculty Publications

Purpose: To determine the association between adult tobacco/nicotine product use over time and residence location (urban, suburban, town, rural), controlling for demographics.

Methods: Data from Waves 4–7 (2016–2023) of the Population Assessment of Tobacco and Health (PATH) study (N = 18,590 adults) were analyzed using survey-weighted logistic regression to evaluate location and time differences in likelihoods of current, daily, and established use of combustible tobacco, electronic nicotine delivery systems (ENDS), smokeless products, and poly use (≥2 products).

Findings: Compared to those residing in urban locations, suburban residents were less likely to report current (adjusted odds ratio (aOR) …

Abca12 Frameshift Deletion In Domestic Cats With Ichthyosis Fetalis, Jeanna M. Blake, Melissa P. Swan, Kari J. Ekenstedt

Veterinary Science Faculty Publications

Background: Ichthyosis fetalis (IF), also known as harlequin ichthyosis, is a rare and often fatal autosomal recessive congenital skin disorder. It is characterized by thickened, hard skin plaques and deep skin fissures that limit mobility and cause malformations of the eyes, lips and ears. Affected individuals are highly susceptible to life-threatening infections due to the disruption of the skin's protective barrier. To date, IF and its genetic basis have not been described in domestic cats.

Objectives: To characterize the gross clinical, histopathological and genetic features of IF in two stray, random-bred domestic short-hair (DSH) littermates.

Animals: Two deceased female neonatal …

Associations Between Traumatic Life Events And Substance Use Among Black Men Who Are Incarcerated, Jasmine K. Jester, Brittany Miller-Roenigk, Paris B. Wheeler, Danelle Stevens-Watkins

Educational, School, and Counseling Psychology Faculty Publications

The current study examined associations between traumatic life events, current and lifetime importance of mental health and substance use treatment, and crack cocaine use among 201 Black men who were incarcerated and nearing community reentry. Results indicated age, sexual trauma and lifetime importance of drug treatment were significantly associated with an increased likelihood of crack cocaine use. Substance abuse treatment in correctional settings should consider culturally tailored assessment and treatment for history of unaddressed sexual trauma among Black men who are incarcerated and use crack cocaine.

Different Destinations: Clarifying And Addressing Pipeline Problems For Women In Academic Archaeology, Scott R. Hutson, Jaycee Castro, Bruno Athie Teruel

Anthropology Faculty Publications

In STEM fields, women tend to leak out of the pipeline to the professoriate. In archaeology, however, robust databases and chronological control reveal that there is no leakage from earning a PhD to tenure-track positions. Nor is there a leak from assistant professor to associate professor. Nevertheless, men get hired as faculty in PhD programs more often than women. This is important because PhD programs are research-intensive and train future leaders. Furthermore, women PhD students have women as advisers more than often men and report advantages to this arrangement. Yet with fewer women faculty in PhD programs, women mentors are …

Chirp Imaging In Extant Lakes And Reservoirs, Kevin L. Woller, Edward W. Woolery, Eva C. Lyon, Michael M. Mcglue

Earth and Environmental Sciences Faculty Publications

Compressed high-intensity radiated pulse (CHIRP) acoustic reflection data acquired in lakes and other shallow water bodies can provide detailed imaging that is valuable for environmental and engineering geology applications well below the sub-bottom floors. However, it is often unclear to non-specialists which acquisition settings should be considered to achieve optimal imaging quality when beginning a new survey, particularly in an unfamiliar environment. We review fundamental concepts for optimizing signal design using coincident CHIRP lines from two extant glacial lakes in the eastern Sierra Nevada of California: Convict Lake and June Lake. As part of the optimization process, seismic data were …

Evolutionary Transitions In Social Behavior Are Associated With Convergent And Partially Reversible Expansions Of Transcription Factor Binding Sites, Savanna G. Ploessl, Beryl M. Jones

Entomology Faculty Publications

The evolution of sociality involves shifts in physiology and behavior, most notably the emergence of a reproductive division of labor. Within social colonies, these distinct behavioral phenotypes arise from differential regulation of a shared genome. Changes in transcription factor (TF) binding motifs are one potential mechanism underpinning this plasticity, with prior studies suggesting that social species exhibit expansions in TF binding sites. However, it remains unclear whether motif expansions are reversed when sociality is lost. Here we analyze predicted TF motif occurrences across gene promoters in 42 bee species spanning millions of years of evolutionary divergence and multiple independent gains …

Best Practices For Budgeting In Small Non-Profit Organizations: The Arts Commission Of Danville/Boyle County, Esther Rugerio

MPA/MPP/MPFM Capstone Projects

Nonprofit arts organizations face unique financial management challenges due to limited staffing, restricted funding sources, and fluctuating revenue streams. This thesis examines the Arts Commission of Danville/Boyle County located in Danville, KY. It identifies opportunities to strengthen financial oversight, accountability, and long-term sustainability. Using a qualitative research approach and document-based analysis, the study evaluated organizational budgets, governance documents, and nonprofit financial management best practices.

The findings revealed several areas for improvement, including reliance on line-item budgeting, recurring use of carry-forward funds, limited board financial oversight, fiscal sponsorship complexities, and a lack of formal financial policies. Recommendations include adopting a program-informed …

Sustainable Safety Planning On Two-Lane Highways: A Random Forest Approach For Crash Prediction And Resource Allocation, Fahmida Rahman, Cidambi Srinivasan, Xu Zhang, Mei Chen

Civil Engineering Faculty Publications

During the safety planning stage, accurate crash prediction tools are critical for prioritizing countermeasures and allocating resources effectively. Traditional statistical approaches, while long applied in this field, often depend on distributional assumptions that may introduce bias and limit model accuracy. To address these issues, studies have started exploring Machine Learning (ML)-based techniques for crash prediction, particularly for higher functional class roads. However, the application of ML models on two-lane highways remains relatively limited. This study aims to develop an approach to integrate traffic, geometric, and critically, speed-based factors in crash prediction using Random Forest (RF) and SHapley Additive exPlanations (SHAP) …

A Course Correction? The Correlation Between Gfsi-Recognized Certifications And Salmonella In Raw Chicken Products, Kar Ho Lim, Lijiao Hu, Yuqing Zheng, Michael Ollinger

Agricultural Economics Faculty Publications

The Global Food Safety Initiative (GFSI) is a widely recognized entity. Many third-party certifications, such as Safe Quality Food (SQF), Brand Reputation through Compliance Global Standard (BRCGS), and Food Safety System Certification 22000 (FSSC), benchmarked against GFSI standards. This study compares the Salmonella detection rates in raw chicken products from SQF, BRCGS, FSSC-certified establishments to those from uncertified ones. We performed a probit regression and calculated average marginal effects using testing data from the Food Safety Inspection Service. Overall, products from certified establishments are associated with 3.2 % lower positive rate of Salmonella detection. Certification is associated with a greater …

Anuran Occupancy Of Created Wetlands Within Reforested Legacy Surface Mines In Kentucky And West Virginia, Jillian C. Newman, Steve Price, Jacquelyn C. Guzy, Joshua Castle, John J. Cox, Jeffery L. Larkin, Christopher D. Barton

Forestry and Natural Resources Faculty Publications

Restoration of habitat is an important component of wildlife management. Surface coal mining has altered forest cover in the Central Appalachians, and most reclamation activities on previously mined lands result in non-native grasslands or shrub lands. The Forestry Reclamation Approach (FRA), which emphasizes non-native vegetation removal, soil decompaction, planting of native trees and shrubs, and, in some cases, wetland creation represents an alternative to grassland-based reclamation that may promote forest-associated wildlife on legacy surface mines. We used automated recording units to evaluate the response of anurans to created wetlands and the FRA in Kentucky and West Virginia, USA. We used …