Digital Commons Network^™

Regulation Of Human Dna Mismatch Repair, Breanna Knicely

Theses and Dissertations--Toxicology and Cancer Biology

The DNA mismatch repair (MMR) pathway identifies and corrects misincorporations that arise during DNA replication. MMR is a pathway that is critical for maintaining genomic stability. Mutations within the MMR pathway, both germline and somatic, lead to the development of cancer. There are a variety of mechanisms that regulate the MMR pathway including protein-protein interactions, DNA damage response, and post-translational modifications. In this study, we aim to dive deeper into each of these mechanisms to obtain novel information regarding the mechanisms and regulation of human DNA MMR. In this study we generated hExo1 constructs mutating Exo1’s interactions with MSH2 and …

The Paradox Of Survival: Gendered Food Insecurity, Labor Inequalities, And Coping Strategies During The 2023/4 Drought In Eastern Ethiopia, Meron E. Lemma

Theses and Dissertations--Geography

In drought-prone regions of Eastern Ethiopia, recurring droughts profoundly reshape everyday life in ways that deepen existing gendered inequalities. Drawing on fieldwork conducted in Fedis district, including semi-structured interviews with women, project implementers, and government officials, as well as group discussions with community members, this study explores how women experience, navigate, and resist the gendered impacts of drought. By attending to the sociopolitical dynamics of drought and the development interventions that accompany it, I analyze how these forces restructure labor, land, food systems, and authority in ways that reproduce and exacerbate existing inequalities. Women’s coping strategies, ranging from begging and …

A Geopolitical Economy Analysis Of China And India’S Approaches To Transnational Data Governance, Yujia He, Ka Zeng

Patterson School of Diplomacy and International Commerce Faculty Publications

Recent literature on the behavior of rising powers in digital trade and data governance highlights their discourses of data sovereignty and desire to preserve domestic policy autonomy. This article contributes to the literature by employing a political economy lens that shifts the focus from the nation-state/inter-state framework towards the dynamics of state–capital relations, allowing for a more historical and contextual understanding of the geopolitics of data governance in emerging economies. Using China and India—two of the largest emerging economies—as comparative cases, and drawing on secondary data from government documents and other sources, the article argues that the interplay between the …

Igc Oral Presentation Summary: Xxv Igc Congress, S. Ray Smith, Echo Elizabeth Gotsick, J. R. Weinert-Nelson, Alayna Jacobs, Christopher D. Teutsch, Will Fleming, D. R. Woodfield, James L. Klotz, Jeff Lehmkuhler, Greg S. Halich, Brittany Davis, Brittany Hendrix, Krista Lea

IGC Proceedings (1977-2023)

This paper will give an overview of the XXV International Grassland Congress thematic, keynote, and plenary sessions. The theme of the XXV IGC Congress meeting was “Grasslands for Soil, Animal, and Human Health.” We had many people attending, presenting, and participating in all these sessions. Within a month after the conclusion of the Congress, the proceeding’s papers presented at the meeting will be available on the IGC app. By the end of 2023 all papers will be available for download through any search engine at internationalgrasslands.org.

Ioto: Never Open A Stiff Lid Again, Gabriel Portugal

Libraries Award for Undergraduate Scholarship

Background: From baby food to pickles, food jars are a common find in American homes. Unfortunately,  the task of opening a stiff jar lid can be very difficult for consumers with lower grip strength, parkinsons,  or arthritis. While there are a variety of products on the market to help make this easier, there exist few jar  openers that can be used by these consumers. Objective: This project aimed to research and develop  (R&D) an improved hands-free jar opener that is accessible for consumers with the most advanced  cases of limited arm strength. Methods: R&D followed a Design Thinking approach with …

Body Mass Index, Sleep, And Food Insecurity Predict Prevalence Of Anxiety And Depression In College Students, Makenzie Barr-Porter, Amelia Sullivan, Jade Mcnamara

Dietetics and Human Nutrition Faculty Publications

This study aimed to assess the relationship between mental health, health behaviors, and food security in young adults in a university environment. Young adults (N = 536) at two United States universities completed a survey assessing health behaviors and characteristics. Logistic regression determined the odds of anxiety and/or depression based on gender identity, body mass index (BMI), food security status (FSS), and sleep restfulness. Over one-third of students were food insecure (36.7%), and almost all reported anxiety (57%) and/or depression (39.1%). Students who identified as female, reported very low FSS, poor sleep, and had higher BMI were at greater odds …

A Program Evaluation Case Study, Madelyne G. Culbertson

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

This case study presents a program evaluation of a physical activity intervention implemented in Bourbon County, Kentucky, guided by the Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health.

A Case Study In Program Evaluation, Alexis Strottman

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

This paper presents a comprehensive evaluation plan for the Bourbon County Physical Activity Improvement Program, as prompted in the University of Kentucky's 2025 MPH-Health Management and Policy Capstone Case Study. The case study outlines a program developed in response to high obesity and inactivity rates in Bourbon County, Kentucky. Utilizing the CDC's 6-step program evaluation framework, the plan outlines engagement of a diverse group of stakeholders to assess the program's effectiveness in increasing physical activity among residents. The evaluation focuses on both process and outcome measures, examining the implementation of exercise facilities, community events, and an app designed to track …

A Case Study In Program Evaluation: Evaluation Of A Program Designed To Increase Activity Levels In Bourbon County Residents, Brooke M. Woodburn

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

This paper provides recommendations to eliminate possible barriers in a program developed to reduce inactive levels across Bourbon County.

Increasing Hpv Vaccination Adherence In Floyd County, Ky: Give Teens Vaccines, Taylor M. Stumbo

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

Cervical cancer remains a pressing public health issue, particularly in underserved and rural areas where access to preventive care is limited. This capstone addresses the urgent need to increase human papillomavirus (HPV) vaccination adherence in Floyd County, Kentucky—part of the central Appalachian region that experiences disproportionately high cervical cancer incidence and mortality. Despite the proven effectiveness of HPV vaccines in preventing the virus strains most responsible for cervical cancer, uptake in this region remains below national targets due to socioeconomic barriers, limited healthcare access, and lack of awareness. Give Teens Vaccines is a two component intervention leveraging existing healthcare systems …

A Case Study In Program Evaluation Evaluation Of A Physical Inactivity Program In Bourbon County, Kentucky, Carine N. Malekera

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

This paper evaluates a physical activity program by the Bourbon County Health Department aimed at increasing physical activity among local residents. Using the CDC’s Framework for Program Evaluation, the study includes both process and outcome evaluations to assess program implementation and impact on health outcomes. Key findings indicate success in urban areas but challenges in rural regions due to limited access to resources. Recommendations include improving access to exercise opportunities in rural areas and offering virtual classes. This evaluation emphasizes the importance of continuous assessment for effective public health interventions.

A Case Study In Program Evaluation, Kaitlyn E. Lee

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

This capstone project evaluates a fictious online MRSA education program developed by the Lexington-Fayette County Health Department and Fayette County Public Schools after a suspected outbreak among student athletes. Using the CDC’s 6-Step Framework for Program Evaluation, the project focuses on how stakeholders were engaged, how the program was described and mapped, how the evaluation questions were developed, what evidence was collected, and how conclusions were formed. The goal of the evaluation is to understand whether the program’s structure, delivery, and implementation support clear infection-control education for the different school personnel who use it. This project emphasizes the overall evaluation …

Identifying Adverse Childhood Experiences And Mental Health Needs Among A Small Sample Of Pregnant Women Who Use Cannabis, Aubrey Jones, Lisa M. Blair, Julie A. Kurzer, Kathy Rademacher, Letitia Ducas, Cynthia Cockerham, Kristin Ashford

Social Work Faculty Publications

Introduction: As the legalization of cannabis becomes more widespread use has steadily increased. Approximately 5 percent of pregnant individuals self-report use during pregnancy.

Methods: This study uses a mixed methods approach to examine adverse childhood experiences, mental health needs, and cannabis use among a small sample (N =59) of women. Cumulative ACE scores of four or more were considerably high within this sample compared to the US average.

Results: Results of a binary logistic regression indicate an association between ACEs and Cannabis use (OR 1.27, 95% CI (1.002- 1.616) when controlling for maternal age and anxiety. Qualitative results identified two …

The Role Of Self-Efficacy In Rehabilitation And Recovery From Ankle Sprains, Bridget M. Walsh

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are among the most common musculoskeletal injuries in the United States. Approximately 2 million ankle sprains occur annually, with an estimated 46% of affected individuals experiencing residual symptoms and developing chronic ankle instability (CAI). In addition to physical impairments, individuals with CAI may exhibit lower physical and psychological health-related quality of life (HRQL). HRQL integrates the physical, psychological, and social domains of a person’s health and is influenced by their experiences, expectations, and perceptions.

Injury-related fear is a common psychological impairment in individuals with CAI and has been associated with decreased physical function, reduced physical activity, and greater …

Investigating Non-Functional Overreaching In Special Operations Tactical Training, Jeremy Alan Ross

Theses and Dissertations--Rehabilitation Sciences

Special Operations Forces (SOF) tactical training requires high levels of physical performance and psychological resilience. This training is often characterized by extreme temperatures and environments, extremely high levels of physical activity and large caloric deficits. As such, SOF personnel follow intense strength and conditioning (S&C) programs to enhance a wide range of athletic abilities. Such programs rely on a balance between training stress and recovery to allow for gradual improvement in physical ability over time, however it is unknown how to quantify tactical training stress in the context of a training program. This dissertation explores evidence related to how this …

Renewal Of Cocaine Seeking Using Social And Nonsocial Contextual Stimuli, Bree A. Humburg, Michael T. Bardo

Psychology Faculty Publications

Rationale Various nonsocial cues have been used as stimuli to examine the contextual control of drug seeking behavior, but little is known about the role of social stimuli.

Objectives This study determined if renewal of cocaine seeking is differentially controlled using a context consisting of either a social peer and/or house light illumination.

Methods In Experiment 1, male and female rats trained to self-administer cocaine in the presence of a same-sex social peer and house light illumination (context A). Following self-administration, rats were randomly assigned to either an AAA (control) or ABA (renewal) group for extinction. For AAA rats, extinction …

Residual Next-Day Effects Of Alprazolam On Psychomotor Performance And Simulated Driving In Healthy Normal Adults, Stevie C. Roszkowski, Shanna Babalonis, Marion A. Coe, Paul Nuzzo, Michelle R. Lofwall, Laura C. Fanucchi, Sharon L. Walsh

Center on Drug and Alcohol Research Faculty Publications

The prevalence of drugged driving has increased in the United States. Some drugged driving may be unintentional as prescription medications used as sleeping aids, like zolpidem, cause impairment after the predicted duration of therapeutic action has elapsed. The aim of this study was to determine if nighttime administration of alprazolam, a drug commonly prescribed off-label as a sleeping aid, impacts driving performance the following day. Participants were healthy adults (n = 15) who completed a double-blind, double-dummy, within-subjects inpatient study examining the effects of nighttime administration of alprazolam (0.5, 1, and 2 mg), zolpidem (10 mg), and placebo on driving …

Analysis Of Tar And Oil Derived From Pyrolysis And Copyrolysis Of Waste Plastics And Biomass, Anitha Shankaralinge Gowda, Dimitrios Karadimas, Jeffrey Seay

Chemical and Materials Engineering Faculty Publications

Pyrolysis has been proposed as a potential technology for managing the growing volume of plastic waste generated worldwide. Co-pyrolysis of plastic waste with biomass is a promising technology for generating fuel and chemical products. However, this process generates tar as a waste product. The chemical properties of this tar have yet to be thoroughly analyzed. This study presents the results of gas chromatography–mass spectrometry (GC–MS), Fourier-transform infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA) of oil and tar obtained from the pyrolysis of pure plastics including high-density polyethylene (HDPE), low-density polyethylene (LDPE), polyethylene (PE), polystyrene (PS), and plastic-biomass mixtures. GC–MS analysis …

A Qualitative Study Of End-Stage Liver Disease And Liver Transplant Referral Practices Among Primary Care Providers In Nonurban America, Vashisht Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R. Garcia, Natalie D. Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta

Surgery Faculty Publications

Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider’s (PCP’s) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).

Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.

Findings: …

Cardiac Injury Regulates Neuroinflammation Through Extracellular Vesicle–Mediated Heart-Brain Crosstalk, Qingxuan Li, Ramzi H. Hamdalla, Neha Dhyani, Lijun Sun, Lie Gao, Tara L. Rudebush, Irving H. Zucker, Changhai Tian

Toxicology and Cancer Biology Faculty Publications

Cognitive impairment is common in heart failure patients, contributing to morbidity and mortality. This impairment may be linked to neuroinflammation in heart failure. However, the primacy of the heart-brain axis remains to be completely understood. Here, we elucidate the potential effects of myocardial injury on pathways and inflammatory mediators responsible for cognitive impairment using a rodent myocardial injury model. The results demonstrate direct extracellular vesicle (EV)-mediated heart-brain crosstalk and the glial uptake of cardiac EVs. In addition, brain inflammation was also elicited following myocardial injury. Moreover, cardiac EVs promote brain microglial cell activation in vitro, potentially mediated by EV-enriched micro-RNAs …

A Community Effort To Develop Common Data Elements For Pre-Clinical Spinal Cord Injury Research., Britt A. Fedor, Abel Torres-Espin, Romana Vavrek, Maryann E. Martone, John L. Bixby, John C. Gensel, Vance Lemmon, Jeffrey S. Grethe, J. Russel Huie, Adam R. Ferguson, Karim Fouad, The Preclinical Sci Common Data Elements (Cde) Workshop Participants

Spinal Cord and Brain Injury Research Center Faculty Publications

For nearly 350 years, the process of disseminating scientific knowledge has remained largely unchanged. Scientists conduct experiments, analyze the data, and publish their findings in the form of scientific articles. Since the turn of the century, this process has been challenged by numerous open science and data sharing efforts to enhance transparency, reproducibility, and replicability of scientific research. Big data approaches, together with machine learning and artificial intelligence, are frequently used to gain insight into the ever-growing complexity of biological systems and biomedical research. To utilize these approaches and harness the continuously increasing computational power requires data to be both …

Cross-Species Comparisons Between Pigs And Mice Reveal Conserved Sex-Specific Intraspinal Inflammatory Responses After Spinal Cord Injury, Reena Kumari, Gabrielle V. Hammers, Robert H. Hammons, Andrew N. Stewart, Steven M. Maclean, Tracy Niedzielko, Lonnie E. Schneider, Candace L. Floyd, John C. Gensel

Spinal Cord and Brain Injury Research Center Faculty Publications

Objective Therapeutic translation is challenging in spinal cord injury (SCI) and large animal models with high clinical relevance may accelerate therapeutic development. Pigs have important anatomical and physiological similarities to humans. Intraspinal inflammation mediates SCI pathophysiology. The purpose of this study was to evaluate the effect of sex on inflammation and outcomes in a pig thoracic contusion/compression SCI model.

Methods Adult (gonad-intact) male and female Yucatan miniature swine were subjected to either SCI or sham (laminectomy-only) injury.

Results SCI caused locomotor dysfunction (measured with the Porcine Thoracic Injury Behavior Score) with some recovery over 6 weeks and limited tissue sparing …

Cytosolic Phospholipase A2 In Infiltrating Monocyte Derived Macrophages Does Not Impair Recovery After Spinal Cord Injury In Female Mice, Ethan Glaser, Timothy J. Kopper, William M. Bailey, Hassan K. Kashif, Reena Kumari, Andrew N. Stewart, John C. Gensel

Spinal Cord and Brain Injury Research Center Faculty Publications

Spinal cord injury (SCI) leads to permanent motor and sensory loss that is exacerbated by intraspinal inflammation and persists months to years after injury. After SCI, monocyte-derived macrophages (MDMs) infiltrate the lesion to aid in myelin-rich debris clearance. During debris clearance, MDMs adopt a proinflammatory phenotype that exacerbates neurodegeneration and hinders recovery. The underlying cause of the lipid-mediated MDM phenotype shift is unclear. Our previous work suggests that cytosolic phospholipase A2 (cPLA2) plays a role in the proinflammatory potentiating effect of myelin on macrophages in vitro. Cytosolic phospholipase A2 (cPLA2) frees arachidonic acid from phospholipids, generating eicosanoids that play an …

Exploring The Links Among Brain Iron Accumulation, Cognitive Performance, And Dietary Intake In Older Adults: A Longitudinal Mri Study, Valentinos Zachariou, Colleen A. Pappas, Christopher E. Bauer, Elayna R. Seago, Brian T. Gold

Neurology Faculty Publications

This study evaluated longitudinal brain iron accumulation in older adults, its association with cognition, and the role of specific nutrients in mitigating iron accumulation. MRI-based, quantitative susceptibility mapping estimates of brain iron concentration were acquired from seventy-two healthy older adults (47 women, ages 60–86) at a baseline timepoint (TP1) and a follow-up timepoint (TP2) 2.5–3.0 years later. Dietary intake was evaluated at baseline using a validated questionnaire. Cognitive performance was assessed at TP2 using the uniform data set (Version 3) neuropsychological tests of episodic memory (MEM) and executive function (EF). Voxel-wise, linear mixed-effects models, adjusted for longitudinal gray matter volume …

A Longitudinal Study Of The Association Between The Teachable Moment Heuristic And Smoking Of Head And Neck Cancer Patients, Tia Borger, Matthew W. Southward, Jessica Maras, Abigayle Feather, Jessica L. Burris

Psychiatry Faculty Publications

Background: The Teachable Moment Heuristic (TMH) posits that change in its three components (ie, affective response, risk perception, and social role/self-concept) could increase motivation and confidence for health promotion, such as smoking cessation. For patients with cancer, smoking cessation can extend survival, while persistent smoking causes numerous problems (eg, cancer recurrence).

Purpose: This intensive longitudinal study with cancer patients aimed to evaluate the link between TMH constructs and smoking outcomes.

Methods: Participants included 42 newly diagnosed head/neck cancer patients who reported smoking in the past month. Participants completed a baseline questionnaire before a 30-day daily assessment. Single-item measures were used …

Barriers To Adherence To Standard Of Care In Appalachia: A Qualitative Assessment In Gastrointestinal Cancers, Brittany Levy, Jennifer T. Castle, Roshmita Bardhan, Mark Dignan, Avinash S. Bhakta

Internal Medicine Faculty Publications

Purpose: Appalachian Kentucky, a 32-county region in the eastern part of the state, has elevated colon cancer mortality rates. While recommended as the standard of care, access to adjuvant chemotherapy treatment is limited in this region due to scarce health services and significant social and geographical barriers. The purpose of this investigation was to improve understanding of barriers that cancer patients residing in rural areas not served directly by tertiary medical systems must overcome in completing adjuvant therapy.

Methods: Participants were recruited from two medical centers: A tertiary care NCI designated Cancer Center and a regional hospital. Participants underwent a …

Circulating Molecular Drivers Of Bone Remodeling In Pancreatitis, Rachel L. Hill, Dhiraj Yadav, Phil A. Hart, David C. Whitcomb, Kristen J. Mcquerry, Kelsey N. Karnik, Kimberly M. Stello, Darwin L. Conwell, Madhumathi Rao

Internal Medicine Faculty Publications

INTRODUCTION: 

Pancreatitis-associated osteopathy is a clinically significant but mechanistically underexplored complication of pancreatic disease. We aimed to characterize stage-specific alterations in bone remodeling biomarkers across the spectrum of disease: recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP).

METHODS: 

In a cross-sectional analysis of North American Pancreatitis Study 2 participants, we measured serum mechanistic (sclerostin, dickkopf-1, receptor activator of nuclear factor κβ ligand, and osteoprotegerin), hormonal (fibroblast growth factor 23, insulin, and leptin), and modulatory (osteopontin, oncostatin, and osteoactivin) markers in controls (n = 30), RAP (n = 40), and CP (n = 40) using a multiplex assay. Group differences were …

Digital Health Interventions For Colorectal Cancer Screening Uptake: A Scoping Review, Sujin Kim, Andrew J. Whipkey, Jihye Bae, Avinash S. Bhakta

Internal Medicine Faculty Publications

Digital health interventions (DHIs) are increasingly employed to improve colorectal cancer (CRC) screening uptake, yet comprehensive syntheses of their effectiveness across diverse contexts remain scarce. This scoping review examines how individual, contextual, technological, and timing-related factors shape CRC screening outcomes in DHI-based trials. Following PRISMA-ScR guidelines, we conducted a systematic search of PubMed, Google Scholar, and ClinicalTrials.gov from March 1 to April 20, 2024, identifying 4,523 records through databases and an additional 2,039 through backward citation tracking. After deduplication and screening, 51 studies were included and charted using the PICOT (Population, Intervention, Comparison, Outcome, and Timing) framework. Included studies spanned …

Early-Onset Bevacizumab-Associated Knee Osteonecrosis In A Young Adult With Astrocytoma, Chandra L. Kakarala, Nicole A. Lisek, Clyde Coleman, John L. Villano, Katherine L. Copely, Patricia A. Santos

Internal Medicine Faculty Publications

We describe a rare case of knee osteonecrosis in a 22-year-old man with astrocytoma and neurofibromatosis type 1 after short-term treatment with bevacizumab and corticosteroids. Magnetic resonance imaging (MRI) identified infarctions and osteonecrosis of the distal femur and proximal tibia. Osteonecrosis associated with bevacizumab is typically limited to the jaw; this case highlights the potential for earlier, extra-jaw involvement. Clinicians should maintain a high index of suspicion for osteonecrosis in patients on vascular endothelial growth factor inhibitors, especially with concurrent steroid use, and consider prompt MRI in the evaluation of unexplained joint pain.

Adverse Childhood Experiences, Depression And Subjective Cognitive Decline By Gender: A Moderated Mediation Analysis, Monique J. Brown, Darlingtina K. Esiaka, Jaya Viswanathan

Behavioral Science Faculty Publications

Studies assessing depression as a mediating factor between adverse childhood experiences (ACEs) and subjective cognitive decline (SCD) are lacking. Therefore, the aims of this study were to: (1) determine the mediating role of depression in the association between ACEs and SCD; and (2) assess the moderating role of gender. Data were obtained from the 2023 Behavioral Risk Factor Surveillance Study (BRFSS) survey (N = 38,600). Crude and adjusted path analyses were used to determine the mediating role of depression between ACEs and SCD. Adjusted analyses controlled for sociodemographic confounders. ACEs were positively associated with depression (B = 0.129, p …