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Frequent Snoring Is Associated With Higher Odds Of Depression In Us Adults, Nathan A. Farr, Jayani Jayawardhana, Rachel Hogg-Graham, Daniela C. Moga, Sara N. Pasha, Min Woong Sohn

Epidemiology and Environmental Health Faculty Publications

Background and objective Snoring occurs due to intermittent narrowing of the airway during sleep and may indicate more severe pathology, including obstructive sleep apnea (OSA). Evidence of an independent relationship between snoring and depression is mixed. This study sought to estimate the association between self-reported snoring frequency and depression in a sample of US adults. Methods Data from the National Longitudinal Study of Adolescent to Adult Health), Wave V were analyzed cross-sectionally using inverse probability of treatment weighting (IPTW). Interviews were conducted between March 2016 and November 2018. Marginal potential outcome means and population average treatment effects were estimated for …

Kentucky Transportation Cabinet Secretary’S Office Of Safety ‘Safety Academy’, Gabriel Dadi, Farshid Taherpour, Amanda Casolare

Kentucky Transportation Center Research Report

The Kentucky Transportation Cabinet (KYTC) Safety Academy was developed to provide a structured and practical safety training program that strengthens safety leadership, planning, communication, employee engagement, hazard recognition, and continuous improvement across KYTC operations. The program was refined over the course of multiple discussions with Cabinet representatives to ensure that the content reflected the needs and responsibilities of KYTC personnel. The final Safety Academy consists of six modules: Safety Academy Welcome, Safety Leadership, Safety Planning, Safety Engagement, Hazard Recognition, and Safety Academy Closeout and Evaluation. The modules combine instructional content with discussions, practical examples, group exercises, and KYTC-related scenarios to …

Gender Disparities In Sheltered Status And Systemic Drivers Of Homelessness In Johnson City, Tennessee, Preet Patel, Dr. Opal Frye-Clark

Journal of Appalachian Health

The article examines the homelessness crisis in Johnson City, Tennessee, a mid-sized Appalachian city. First, analysis of Point-in-Time (PIT) counts from 2023 to 2025, conducted in 2025, showed persistently high unsheltered rates (35.88% – 47.17%), with men comprising 60 – 65% of the unhoused population. Men experiencing homelessness also had approximately half the odds of being counted as sheltered compared with women, indicating a gender disparity in sheltered status. Second, an interview with an experienced public health practitioner from the Appalachian Region contextualized these findings by identifying systemic drivers, including the regional housing crisis and policy restrictions, and supporting equitable …

Improving Diabetes Self-Management Through A Partnership Between Clinical Providers And Community Educators In Appalachian Communities, Soghra Jarvandi, Lydia Hoskins, Karen Carver, Andrew May

Journal of Appalachian Health

Introduction: The burden of diabetes is an increasing public health challenge, especially in the Appalachian Region.

Purpose: This study assessed the impact of a community-based diabetes education program on glycemic control.

Methods: Health Extension for Diabetes (HED) is a 4-month diabetes education program offered by Extension educators in collaboration with clinical providers. Participants’ data were collected via phone interviews at baseline and after completing the program. Assessments included self-reported HbA1c, socio-demographics, diabetes knowledge, self-efficacy, and self-management behaviors. Data were analyzed by SAS software using paired analyses.

Results: Of the 105 participants in the program, 87 (83%) completed the post-assessment. Among …

School-Centered Tobacco Retailer Exposure And Neighborhood Opportunity Across Urban And Rural Tennessee, Sima Namin Dr, Jacob Black, Jennifer Ferris, Robert E. Heidel Dr

Journal of Appalachian Health

Introduction: Tobacco retailer availability contributes to youth tobacco use, and retailers are concentrated in socioeconomically disadvantaged communities. However, few studies have examined how school-centered retailer exposure intersects with neighborhood opportunity in a predominantly rural Appalachian state.

Purpose: The purpose of this study is to assess the association between neighborhood opportunity and school-centered tobacco retailer exposure across Tennessee (TN), including differences by rurality and Appalachian status.

Methods: We constructed a tract-level, school-centered youth tobacco exposure index for TN using tobacco retailer locations and public and private K-12 school data. The index incorporated retailer proximity, density, and distance-decay accessibility measures. Child Opportunity …

Deaths Of Despair Among Cancer Survivors In Rural/Urban Appalachia (2000-2022), Jason Semprini, Anders Erickson, Nosa Osazuwa-Peters

Journal of Appalachian Health

Introduction: Rising deaths of despair (premature deaths from suicide, overdose, alcohol, and violence) in adults under age 65 persist across the United States, especially in Appalachia. People diagnosed with cancer may face elevated risks of such deaths due to pain, psychosocial distress, and financial hardship.

Purpose: Deaths of despair trends were compared among adults with cancer across Appalachian and non-Appalachian regions, stratified by sex and rurality.

Methods: Analyzing SEER-21 Incidence-Based Mortality data (2000–2022), deaths caused by suicide, cirrhosis of the liver, or accidents (includes overdose) were identified among adults aged 20–64 years. Annual mortality rates per 100,000 total population were …

Disparities In Access To Medicare-Approved Medical Specialists In Rural Kentucky, Logan Hurm, Jacob A. Welch, James Adkins

Journal of Appalachian Health

Introduction: Approximately 20% of the United States population resides in a rural community; however, only 10% of all healthcare resources and physicians are dedicated to these areas. Appalachia, and Kentucky (KY) in particular, have higher populations living in rural areas which leads to a greater number of individuals affected by medical access disparities. As of 2026, 21% of KY’s population is eligible for Medicare, making access to Medicare-accepting specialty physicians crucial for the state’s population.

Purpose: This research aims to quantify healthcare disparities among rural communities in KY through quantification of the potential distance required to travel to access specialty …

Major League Baseball's Major Labor Boondoggle: Rethinking Salary Arbitration, Matthew W. Givens

Kentucky Law Journal

No abstract provided.

Kentucky's Alford Predicament: The Case For Curbing Qualified Guilty Pleas In The Commonwealth, Ben Whatley

Kentucky Law Journal

No abstract provided.

The Duty To Develop Imperative In Immigration Proceedings, Sabrineh Ardalan, Tiffany J. Lieu

Kentucky Law Journal

No abstract provided.

Deportation After Death By Incarceration: A Right To Redemption, Jennifer Lee Koh, Tin Nguyen

Kentucky Law Journal

No abstract provided.

A Sherbert Colored Lens: Apache Stronghold And The Uphill Battle For The Recognition Of A Substantial Burden For Indigenous Plaintiffs, Emma P. Collins

Kentucky Law Journal

No abstract provided.

Hope In The Holler: How Eminent Domain Can Bring Economic Justice To Central Appalachia, Matthew B. Chaney

Kentucky Law Journal

No abstract provided.

History And Tradition Of Inequality, Advocacy, And Progress, Teri Dobbins Baxter

Kentucky Law Journal

No abstract provided.

States Strip Local Governments Of Authority To Govern Causing Some Rural Communities To Suffer, Terence J. Centner

Kentucky Law Journal

No abstract provided.

Arbitration Clause Expansion, Hossein Fazilatfar

Kentucky Law Journal

No abstract provided.

The New Parens Patriae, Meredith Johnson Harbach

Kentucky Law Journal

No abstract provided.

From Centralized To Decentralized Care: Assessing The Role Of Design In Cardiovascular Unit Performance, Lindsey Fay

Interiors Faculty Publications

This report presents a comprehensive pre- and post-occupancy evaluation of the University of Kentucky HealthCare Cardiovascular Unit, conducted through a collaborative effort between the College of Design, College of Communication and Information, UK HealthCare, and GBBN Architects. The study examines the transition from a centralized to a decentralized care delivery model within a newly constructed hospital environment, with the goal of understanding how spatial design influences healthcare delivery, staff performance, and patient experience.

Using a mixed-methods approach, the research integrates quantitative and qualitative data collection techniques, including behavioral mapping, communication tracking, pedometer data, acoustic measurements, and staff and user feedback. …

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training (Dsmt) To The Fee-For-Service Medicare Population, 2017–2024, Wanying Zhu, Aleksandr Taraskin, Jeffrerey Talbert

Rural & Underserved Health Research Center Publications

Key Report Highlights

• A significant rural DSMT access gap exists. Rural beneficiaries accounted for 20.1% of Medicare beneficiaries with diabetes but only 7.8% of DSMT participants.

• Geographic availability remains limited. Only 16.8% of counties with DSMT utilization were rural.

• Access, not demand, appears to be the primary challenge. Rural counties offering DSMT achieved utilization rates more than twice those observed in urban counties (6.0% vs. 2.5%).

• Expanding rural DSMT capacity may represent a high-impact opportunity to improve diabetes self-management support among underserved Medicare beneficiaries.

Non-Metropolitan Vs. Metropolitan Variations In Alcohol, Illicit Drug, And Prescription Therapeutic Drug Misuse, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

Alcohol Use. The prevalence of past year and past 30-day drinking was lower among non-metropolitan (non-metro) than metropolitan (metro) residents. However, non-metro drinkers engaged in more frequent binge drinking than metro drinkers. Drinking 3-5, 6-19, and 20-30 days over the past 30 days were higher among non-metro than metro residents.

Illicit Drug Use. Hallucinogens were the mostly commonly used illicit drugs among non-metro as well as metro residents. Methamphetamine use was significantly higher among non-metro than metro residents.

Prescription Pain Reliever Use. The misuse of prescription pain killers, primarily prescription opioids, was higher among non-metro than …

High-Deductible Health Plans In Rural And Urban Populations: Outpatient Utilization And Out-Of-Pocket Costs, Aaron P. Smith, Jefferey Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings This policy brief explores rural-urban differences in High-Deductible Health Plan (HDHP) enrollment, subsequent healthcare utilization, and out-of-pocket (OOP) costs. ▪ HDHP enrollment was uncommon. Rural residents were slightly less likely to enroll than urban residents across all demographic groups. ▪ Switching plans influenced utilization. Compared to those who did not change healthcare plans, switching from a Traditional plan to a HDHP was associated with a larger reduction in 2022 outpatient visits for both rural and urban residents. Moving from a HDHP to a Traditional plan was associated with a smaller reduction in 2022 outpatient visits for …

Locus Coeruleus Tdp-43 Pathology In A Community-Based Cohort, Allison M. Neltner, Ryan K. Shahidehpour, Megan E. Hall, Xiaotong Ning, Shuling Fister, Hannah Kang, Sonya Anderson, Gregory A. Jicha, Tiffany L. Lee, Erin L. Abner, David W. Fardo, Peter T. Nelson

Epidemiology and Environmental Health Faculty Publications

The locus coeruleus (LC) is the source of norepinephrinergic innervation in the human brain. Locus coeruleus pathology has been linked to clinical conditions such as cognitive impairment and behavioral and psychiatric symptoms of dementia (BPSD). However, phosphorylated TDP-43 (pTDP-43) pathology in the LC has been understudied, particularly in the contexts of aging and limbic predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC). Here, a convenience sample (n = 134) of autopsied participants from the University of Kentucky Alzheimer’s Disease Research Center community-based cohort was analyzed for LC pTDP-43 and phosphorylated tau (pTau) pathologies. Locus coeruleus pTDP-43 pathology was found in 28/134 …

Cellular Senescence Links Muscle Atrophy And Posttraumatic Osteoarthritis After Acl Injury, Alexander R. Keeble, Allison Owen, Sara Gonzalez-Velez, Nicholas T. Thomas, Camille R. Brightwell, Peyton J. Balawender, Madeline G. O'Daniel, Helena C. Weiss, Haley Noehren, Heather Thompson, Karen Sofia Zuluaga-Osorio, Zane T. Bates, Lauren Gottlieb, Douglas E. Long, Douglas Harrison, Philip Kern, Caitlin E. Conley, Michael A. Samaan, Stephen Duncan, Austin Stone, Darren Johnson, Yuan Wen, Brian Noehren, Cory Dungan, Christopher Fry

Biology Faculty Publications

Traumatic knee injury leads to posttraumatic osteoarthritis (PTOA) and significant skeletal muscle weakness, resulting in chronic disability. The current standard of care frequently fails to prevent musculoskeletal dysfunction, underscoring the need to identify therapeutic mechanisms of PTOA. Using an established preclinical anterior cruciate ligament (ACL) transection model of PTOA and leveraging an innovative SPiDER-senescence-associated β-galactosidase stain to discern senescent cells, we investigated cellular senescence at single-cell resolution and identified anti-inflammatory macrophages as a predominant contributor to the senescent cell burden in both muscle and knee joint after injury. Clearance of senescent cells using the senolytic dasatinib and quercetin (D + …

Neutralization Of Reactive Oxygen Species With Cobinamide Augments Aortic Dissections And Rupture In Bapn-Administered Mice, Alexis Richard, Zhen Zhou, Jose Emiliano Esparza Pinelo, Callie S. Kwartler, Hema Kalyanaraman, Gerry R. Boss, Hong S. Lu, Alan Daugherty, Dianna M. Milewicz

Physiology Faculty Publications

Thoracic aortic aneurysms involving the root and ascending aorta progressively enlarge and can lead to life-threatening acute aortic dissections, collectively termed thoracic aortic disease (TAD). Oxidative stress due to an excess of reactive oxygen species (ROS) has been implicated in TAD pathogenesis by promoting vascular inflammation, extracellular matrix degradation, and smooth muscle cell apoptosis. Cobinamide (Cbi), a potent antioxidant and vitamin B12 analog, has been reported to slow aortic aneurysm growth in TAD mouse models. We evaluated its efficacy in mice administered b-aminopropionitrile (BAPN) to induce TAD, a model in which aneurysms progress to dissections. C57BL/6J mice of both sexes …

Rural And Urban Availability Of Substance Use Treatment Facilities, Aaron P. Smith, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Rural counties have higher per capita numbers of substance use disorder treatment facilities than urban counties on average, but also greater variability and large pockets of unmet need.

• The highest proportions of residents living in counties without any treatment facilities are concentrated in rural areas within the Midwestern and Southern United States.

• Rural and urban treatment facilities offer medications for opioid use disorder (MOUD) at similar rates, with inpatient facilities most likely to provide MOUD, followed by residential and outpatient settings.

Irrigation With Sewage -An Effective Procedure For In­Creasing The Yield Performance Of Grassland As Well As For Protecting Inland Waters Against Pollution, V M. Novikov, N A. Kovaleva, V P. Sayapin, L F. Mikheeva, M I. Demina

IGC Proceedings (1977-2023)

The utilization of sewage for irrigation pur­poses is an effective procedure for increasing the yield performance of grassland as well as for protecting inland waters against pollution. Compared with irrigation only during the growing season, all-season use of sewage is more effective in increasing forage production and reducing both the quantity of sewage diverted into inland waters and the deficit of irrigation water. By way of science-based choice of the irri­gation regime, the perennial forage plant spe­cies, and their kind ofutilization, 8.0-10.0 tons and more of high-quality dry matter can be obtained per hectare, with 6,000-7,000 m3 of sewage being …

Effect Of Nitrogen Fertilization Of Pastures On The Cu, Fe And Zn Content In Fodder And Blood Of Dairy Cows, Kazimerz Rybak

IGC Proceedings (1977-2023)

Results of one of the grazing experiments carried out in the period 1971-1975 are dis­cussed. In the experiment two rates of N fer­tilization were applied: 60 and 120 kg per hectare under each regrowth, i.e. 360-420 and 720-840 kg N/ha per year, respectively. Rates of phosphorus and potassium fertili­zation remained unchanged: 120 kg P2O5 and 160 kg K2O per hectare. High N rates led to an increase of the Cu and Zn contents and an Fe content decrease in plants, and stimulated the Cu and Fe absorption but reduced the Zn absorption by high-yielding cows. A drop of the Cu …

Effect Of High Nitrate Fertilization On The Yield And Biological Value Of Grasses Tested By Common Vole, Slawomir Pronczuk, Janina Gnat, Tadeusz Szuperski

IGC Proceedings (1977-2023)

The effect of different fertilization doses ( 4 x 60, 4 x 120, and 1 x 480 kg N/ha) on the yield of grasses and their basic chemical composition as well as on the growth efficiency and health of animals fed those grasses was studied. Yield of grass during three following years was higher from the fields fertili_zed 4 x 120 and 1 x 480 kg N/ha, when compared to 4 x 60 kg N/ha. No differences were found be­tween 1 x 480 kg N/ha and 4 x 120 kg N/ha. Growth ·efficiency of the common voles which were fed …

Young-Cattle Rearing Along Industrial Lines And Pasturing In The Gdr, H Kleiber, F Morchen, F Lemme

IGC Proceedings (1977-2023)

Young-cattle rearing along ind us trial lines involves a general increase ofrearing standards. When pasturing large herds of young cattle it is difficult to achieve high live weight gain. Factory-like milk production requires not only optimal live weight development of the heifers but also an excellent state of health of the animals' legs. The latter is achieved more easily through pasturing than by way of indoor rear­ing of the youngstock. The intensification of young-cattle rearing includes the intensifica­tion of pasture rearing as well. Young-cattle rearing along industrial lines brings up new problems to be solved by technological re­search workers.

Factors Affecting Green Forage Intake By The Milking Goat, Lionel Huguet, Michel De Simiane, Claude Bernard Broqua

IGC Proceedings (1977-2023)

For the past fifteen years in France goat rearing has developed thanks to a favourable economic background. The specialization of farmers has given rise to new needs in breed­ing techniques and particularly in green forage feeding systems. From 1972 to 1975, trials were carried out to specify the utilization of green forage by milking goats in order to simplify and rationalize their diet. Three factors were studied to estimate their effect on forage intake: removal of hay from the ration, the quantities of green forage offered, and the quantities of concentrates distributed. When the green forage has a good feeding …