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The Performance Of Marginal Modeling Methods For Rare Events With Application To Opioid Overdose Mortality And Morbidity, Shawn Nigam

Theses and Dissertations--Epidemiology and Biostatistics

Opioid misuse is a nationwide epidemic, with Kentucky having one of the highest opioid overdose-related fatality rates across all US states. These rates have increased significantly over the past decade, with particularly large increases during the COVID-19 pandemic. This dissertation aims to study the behavior of these increases and the methods for the marginal modeling of count outcomes related to opioid overdose.

Opioid overdose-related fatality rates in Kentucky increased significantly during the COVID-19 pandemic. In this chapter, we characterize the changes in opioid overdose fatality rates in Kentucky and identify associations between potential factors and fatality rates. County-level opioid overdose …

A Praxis Towards Social Change Based On Foucault's Conceptualization Of Experience As Relational, Lila Maureen Wakeman

Theses and Dissertations--Philosophy

This project develops a praxis towards social change based on the works of Michel Foucault. It first establishes Foucault’s philosophical assumptions, methods, and political goal of countering “objectivizing” modern Western social forces. It then draws on sources from the three major phases of Foucault’s career to trace his development of a general conceptualization of experience as relational, or as non-exhaustively co-constituted by and through three indispensable kinds of social forces: knowledge, power, and ethics. It then evaluates implications of Foucauldian experience for efforts towards social change to conceptualize a general Foucauldian praxis towards social change. The praxis aims to affect …

Relationality In Rousseau's Philosophy Of Education, Thayne Cameron

Theses and Dissertations--Philosophy

Jean-Jacques Rousseau’s assertion of Emile that “Our true study is that of the human condition” serves as the foundation for this dissertation, which examines the significance of certain kinds of basic experiential relationships in Rousseau’s philosophy of education. By analyzing the relationships between the self and objects, the self and others, and the educator and the learner, this work elucidates how these interactions underpin Rousseau’s pedagogical views and their implications for fostering personal and social virtue.

The dissertation explores the self-object relationship through affectivity, embodiment, and purposeful activity, demonstrating how direct engagement with objects shapes perceptions and behaviors. It then …

Location, Location, Location: Geographic Qualities Of Political Instability And Military Coups, William O'Connell

Theses and Dissertations--Political Science

Previous research has shown that political instability can lead to military coups, especially when it occurs close to the capital. However, other than proximity to the capital, no other geographic qualities of instability and their relationship to coups have been explored. Therefore, this dissertation serves as a detailed analysis of how the location of instability conditions its impact on coups.

To show how the locational qualities of instability influence coup likelihood, I borrow from expected utility models of coups, and explore how instability influences militaries’ disposition and ability to coup differently when it occurs in different areas within a country. …

Recovery Capital In A Justice-Involved Population: An Asset-Based Approach To Recovery And Community Reentry, Evan Joseph Batty

Theses and Dissertations--Sociology

The burden of the opioid epidemic demands further efforts to facilitate recovery, particularly for disadvantaged populations and those recently released from prison. After community reentry, individuals face a period of vulnerability as they adjust to new roles and responsibilities to meet their basic needs. Prison-based substance use disorder treatment (SUD Tx) programs provide support to help prepare individuals with SUD for their release and facilitate successful recovery goals after community reentry. This dissertation has three aims: (1) further the understanding of potential barriers and facilitators of recovery after community reentry, (2) assess how prison-levels of recovery capital influence recovery outcomes …

Variable Selection For High-Dimensional Data With Interaction Effects: Methods, Applications, And Inferences, Leiyue Li

Theses and Dissertations--Statistics

For high-dimensional data where the number of variables greatly exceeds the number of observations, selecting important variables while maintaining the required heredity conditions can be challenging. This dissertation is structured into three interconnected parts. In the first part, we propose a variable selection method by implementing a well-known optimization technique, the Genetic Algorithm. An R package was developed to simplify the implementation and usage of the proposed method. We then propose another variable selection method by extending the study from the Genetic Algorithm to a different but related optimization technique, Simulated Annealing. We consider three different hierarchical structures in both …

Estimation And Testing Of Nonparametric Effects Of Incomplete Multivariate And Repeated Measures Data, Swetalina Maity

Theses and Dissertations--Statistics

In this dissertation, we investigate three distinct but interrelated problems in analyzing repeated measure data with missing values.

The first project is on semiparametric methods for analyzing repeated measures designs with missing values. A closed-form estimator for the parameters and their asymptotic covariance are derived using block partitioning based on the missing data pattern. We also derive the asymptotic distribution of the estimators and construct test statistics to test hypothesis formulated as linear contrasts of the mean vector.

In the second project, we focus on purely nonparametric methods. In this setup, nonparametric treatment effects are defined as functionals of the …

Intentions To Seek Mental Health Services Among Nursing Students In The United States: The Impact Of Adverse Childhood Experiences And Psychological Distress, Zainab Almogheer

Theses and Dissertations--Nursing

Supporting the mental health of university/college students is a crucial issue facing institutions of higher learning in the U.S. A web-based survey encompassing 196 campuses in the U.S. found that rates of diagnosed mental illness among college students has significantly increased in the last decade from 21.7% in 2007 to 35.5% in 2017 (Lipson et al., 2019). Despite the availability of mental health services within universities/colleges, students with mental health problems do not often utilize these services. Recognizing the significance of assessing the mental health of nursing students is paramount, as evident from a study where 35% of 170 participants …

Health Beliefs, Facilitators And Barriers To Engaging In Blood Glucose Screening Of Adults In Saudi Arabia, Fatema Alsada

Theses and Dissertations--Nursing

Diabetes has reached an epidemic level in Saudi Arabia with a prevalence of 19%. Saudi Arabia currently spends more than $7 billion on diabetes-related health care per year. Type 2 diabetes is preceded by a prediabetes state during which preventative measures can prevent or delay diabetes onset. Blood glucose screening is a method of identifying people with prediabetes. Encouraging people to engage in blood glucose screening will identify those who will benefit from diabetes prevention strategies. The purpose of this dissertation was to explore the knowledge, health beliefs, and perceived barriers and facilitators regarding engaging in blood glucose screenings among …

Investigating A New Drug Target In Alzheimer’S Disease: Nox2, Tiffany Adams

Theses and Dissertations--Pharmacy

Introduction: Alzheimer’s disease (AD) is a neurodegenerative disease with neuropathological changes in the blood-brain barrier that offers possible therapeutic targets. Oxidative stress is one driving factor for AD. NADPH oxidase 2 (NOX2) in the capillary endothelium produces reactive oxygen species, leading to oxidative stress-mediated blood-brain barrier dysfunction. We hypothesized that using a specific NOX2 inhibitor, PhoxI2, has the potential to reduce reactive oxygen species and repair amyloid-β (Aβ)-driven blood-brain barrier leakage in an AD mouse model.

Methods: For this study, 5xFAD (Familiar Alzheimer Disease) mice were treated with vehicle or PhoxI2, a NOX2 inhibitor. Techniques utilized were Enzyme-Linked Immunosorbent Assay …

Design Of Kappa Opioid Receptor Agonists For Potential Treatment Of Multiple Sclerosis, Lindsay Kornberger

Theses and Dissertations--Pharmacy

Multiple Sclerosis (MS) is a neurodegenerative disease of the central nervous system characterized by demyelination and neuroinflammation. There is currently no cure for MS. There is a critically unmet need for the development of pharmacotherapies that can induce remyelination promoting both repair and recovery. The kappa opioid receptor (KOR) has been identified as a potential target for the development of remyelinating pharmacotherapies. KOR activation has been shown to promote functional recovery and remyelination preclinically. However, typical KOR agonists like U50,488 have limitations such as sedation and dysphoria limiting their use. This necessitates further development of new KOR agonists that maintain …

Sensitizing Keap1 Loss Non-Small Cell Lung Cancer To Artesunate Anti-Cancer Activity, Keng Hee Peh

Theses and Dissertations--Pharmacy

Lung cancer is the global leading cause of cancer related death. Non-small cell lung cancer (NSCLC) accounts for 80% of lung cancer diagnoses conferring a significant disease burden. However, certain mutations in tumor suppressors such as Kelch-like ECH-associated protein 1 (KEAP1) confers resistance to standard of care therapy in NSCLC. KEAP1 is known to regulate multiple cellular processes such as oxidative stress response and anti-apoptotic pathways. Furthermore, KEAP1 loss of function in NSCLC is associated with poorer clinical outcomes and there are no currently approved therapies for KEAP1 loss NSCLC and represents an unmet clinical need. Artesunate (Art) demonstrated anti-cancer …

Inhibiting Pi3k/Akt To Enhance Brain Uptake Of Anticancer Agents In Glioblastoma, Louis Rodgers

Theses and Dissertations--Pharmacy

Glioblastoma (GBM) is the deadliest and most common malignant CNS tumor. Despite advances in understanding its biology and the development of targeted therapies, effective treatment options remain limited. As a result, patient survival rates are dismal, with a 5-year survival rate of only 6.8% and an overall survival of less than two years. This poor outcome is partly due to our inability to treat GBM cells that infiltrate the whole brain. Focal treatments like surgery and radiotherapy alone are insufficient due to these invasive tumor cells. Therefore, chemotherapy following resection and irradiation of the primary tumor is essential to eliminate …

The Methodology For Integrating Robotic Systems In Undeground Mining Machines, Peter Kolapo

Theses and Dissertations--Mining Engineering

Roof bolting is a critical operation in ensuring the safety and stability of underground mines by securing the roof strata with bolts. The process involves moving and manipulating heavy tools while being vigilant about the safety of the area. During the installation of roof bolts, operators are exposed to hazardous conditions due to challenging working conditions in underground mines, extensive working hours, and demanding shift schedules leading to personnel fatigue and influencing operators to take shortcuts that may increase the risk of injuries and fatal accidents. The successful completion of roof bolting tasks depends heavily on operator judgment and experience …

Autonomous Shuttle Car Docking To A Continuous Miner Using Rgb-Depth Imagery, Sky Rose

Theses and Dissertations--Mining Engineering

A great deal of research is currently being conducted in automating mining equipment to improve worker health and safety and increase mine productivity. Significant progress has been made in some applications, e.g., autonomous haul trucks for surface mining. However, little progress has been made in autonomous face haulage in underground room-and pillar coal mines. Accordingly, this thesis addresses automating the operation of a shuttle car, focusing on positioning the shuttle car under the continuous miner coal-discharge conveyor during cutting and loading operations. The approach uses a stereo depth camera as the sensor, and machine-learning algorithms are used to identify various …

Propagation Of Vibro-Acoustic Energy In Ducts: Measurement, Simulation, And Attenuation Studies, Caoyang Li

Theses and Dissertations--Mechanical and Aerospace Engineering

Vibro-acoustic energy propagates through heating, ventilating, and air conditioning (HVAC) systems through both airborne and structureborne paths. In this research, measurement and simulation studies are performed to better understand this propagation of energy and how to better attenuate the sound before it impacts building occupants.

First, a scaled-down experiment was developed to assist in the validation of numerical simulation models. A small source room was attached to a wooden duct with variable cross-sectional area. The sound power for both untreated and treated ductwork was measured using sound intensity scanning, and the insertion loss is the difference between untreated and treated …

Artificial Intelligence Enabled Machinery Fault Detection And Diagnosis Using Vibro-Acoustic Signals, Srinivasa Rao Ippili

Theses and Dissertations--Mechanical and Aerospace Engineering

In various industries, the early detection of faults in rotating machinery is crucial to prevent system failures and ensure customer satisfaction. Typically, vibration measurement and diagnosis are employed for fault detection, but this process faces challenges in automation due to the complexity of installing and maintaining accelerometers, particularly in end-of-line quality control or pre-installed machinery health assessments. Acoustic signals, as a form of mechanical wave, offer an alternative for monitoring machinery while in operation. Unlike accelerometers, acoustic transducers are non-contact and easy to set up, enabling real-time data collection without interrupting equipment operation. However, utilizing acoustic signals in manufacturing poses …

Measurement And Simulation Of Aeroacoustic Sources Generated By Elementary Muffler Components, Seth Donkin

Theses and Dissertations--Mechanical and Aerospace Engineering

Mufflers and silencers are commonly used to control noise from sources such as internal combustion engines and heating, ventilating, and air conditioning (HVAC) systems. In these applications, flow interacts with muffler components generating aeroacoustic noise sources. In order to measure these sources in a lab setting, specialized flow rigs are designed to isolate aeroacoustic noise sources. Flow sometimes compromises muffler performance. However, muffler performance is sometimes improved because flow can increase the attenuation of some muffler elements such as perforates. To better understand the complicated impact of flow, the University of Kentucky developed a muffler test rig to measure insertion …

Multiscale Fiber Remodeling In The Heart Using A Finite Element Framework, Mohammad Mehri

Theses and Dissertations--Mechanical and Aerospace Engineering

The organization of myofibers and extra cellular matrix within the myocardium plays a significant role in defining cardiac function. When pathological events occur, such as myocardial infarction (MI) or hypertrophic cardiomyopathy (HCM), this organization can become disrupted, leading to alteration in pumping performance. The current study proposes a multiscale finite element (FE) framework to determine realistic fiber distributions in the left ventricle (LV). This is achieved by implementing a stress-based fiber reorientation law, which seeks to align the fibers with local traction vectors, such that contractile force and load bearing capabilities are maximized. By utilizing the total stress (passive and …

A Hyphenated Career: Sustainable Pathways For Dancers, Rebecca A. Ferrell

Theses and Dissertations--Arts Administration

Despite the rich cultural and artistic contributions of dancers, there exists a pressing need to comprehensively address the challenges and complexities surrounding the sustainability of careers in dance due to underemployment, underpayment, data undercounting and physical strain. This dissertation research aims to understand occupational trajectories that build a sustainable career for dancers. Through a historical examination of the professionalization of dance and an investigation of current career opportunities, this study investigates the growing support systems for dancers, the influence of occupational identity, and the workplace environments needed to sustain a dance career.

Occupational identity theory, motivation-hygiene theory, and transaction cost …

Music For The People: Comparing Public Funding Models For Popular Music In Atlanta, Glasgow, And Toronto, Heather Mcdonald

Theses and Dissertations--Arts Administration

This dissertation explores the complex landscape of public funding policies for popular music across three cities: Atlanta, Glasgow, and Toronto. Through comparative case studies and qualitative research methods, this work explores the varying approaches each city takes towards funding popular music, including the social, economic, and political environments in which these funding policies have developed.

Through document reviews and interviews with key stakeholders, the dissertation highlights the differences in how public funding for popular music is approached in Glasgow, Atlanta, and Toronto and the broader context of how these policies were created. Using Multiple Streams Approach, the Five Streams Confluence …

Orchestra Community Engagement: Factors Of Environmental Impact, Travis Newton

Theses and Dissertations--Arts Administration

The symphony orchestra industry in the United States was founded with the goal of serving the elite, but these orchestras are organized as not-for-profit organizations and are currently mandated to benefit the community more broadly. Professional symphony orchestras in the United States are beginning to address this disconnect between their elite-oriented origins and the more modern federal mandate of community-oriented service in a variety of ways, including through community engagement programming. There are a number of items that remain unknown, including the impact that environmental factors have on orchestras’ community-oriented work, and what “community engagement” means to orchestras.

The purpose …

Repolarizing Tumor-Associated Macrophages In Ovarian Cancer: A Novel Immunotherapeutic Approach, David Schweer

Theses and Dissertations--Clinical and Translational Science

Ovarian cancer, recognized for its high lethality and resistance to conventional immunotherapies, mandates innovative strategies to confront its intricate challenges. The tumor microenvironment (TME), orchestrated by tumor-associated macrophages (TAMs), assumes a pivotal role in disease progression, rendering TAMs an appealing therapeutic target. This study endeavors to explore the prospect of repolarizing TAMs from a protumor M2 phenotype to an antitumor M1 state, employing M1 macrophage-derived vesicles (MEVs) as a groundbreaking immunotherapeutic approach.

The primary objective is to investigate the capacity of M1 MEVs to repolarize M2 macrophages in vitro towards an anti-tumor M1-like phenotype. By inducing human macrophages to adopt …

Developing Radiosensitizers To Enhance Radiotherapy In Treating Gastroenteropancreatic Neuroendocrine Tumor, Zeta Chow

Theses and Dissertations--Clinical and Translational Science

Gastroenteropancreatic Neuroendocrine Tumor (GEP-NET) is a heterogeneous group of malignancies arising from multipotent neuroendocrine stem cells in the gastrointestinal tract. The incidence of GEP-NET continues to rise, possibly due to the advancement of imaging and biomarkers available for diagnosis. However, even though the majority of patients are diagnosed with low-grade and localized disease, a significant percentage of patients present with advanced-stage metastatic disease with poor prognosis in months to a few years. These advanced-stage GEP-NET patients can also present with a variety of debilitating symptoms that significantly impact their quality of life. The role of palliative-intent surgery is limited, and …

Evaluation Of The Cellular And Physiologic Impact Of Mitomycin C On Colon Cancer, Hannah Mcdonald

Theses and Dissertations--Clinical and Translational Science

Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) with Mitomycin C (MMC) has more than doubled the overall and disease-free survival in patients with peritoneal metastases (PM) due to colorectal cancer (CRC) over the past two decades. Although MMC is the most used HIPEC drug for PM due to CRC, dosing protocols vary dramatically between and within institutions across the world. Additionally, little is known about the impact of hyperthermia and MMC on intracellular pathways for CRC. The aim of this work is to determine the optimal dosing strategy in the clinical application of MMC and hyperthermia for treatment of …

Advancing Dysphagia Screening: A Comparison Of Patient-Reported Outcome Measures And Bolus-Driven Screenings In Aspiration Prediction, Arica Amie Rusco

Theses and Dissertations--Communication Sciences and Disorders

It is known that dysphagia impacts an individual’s health and quality of life. Due to this, early identification of dysphagia is crucial. There are many different dysphagia screening tools with no consensus. This study aimed to compare the two most frequently used dysphagia screenings, a patient-reported outcome measure (PROM), the EAT-10, and bolus-driven swallow screening, the Yale Swallow Protocol, to determine if one tool is superior in aspiration prediction on a videofluoroscopic swallow study (VFSS). This study also aimed to discover the best cutoff score on the EAT-10 for aspiration prediction. A total of 66 participants were recruited after physician …

The Effects Of Exercise-Based Voice Therapy On Swallowing Outcomes: A Pilot Study Framework, Jenna F. Johnson

Theses and Dissertations--Communication Sciences and Disorders

In a 2019 study analyzing dysphonic patients in relation to coexisting dysphagia, approximately 11.8% of clients receiving treatment for voice disorders reported difficulty swallowing. However, the literature exploring the use of voice exercises to improve swallow function is limited to a small amount of voice treatment approaches, which does not reflect the wide range of evidence-based treatment approaches that may be prescribed for treatment of one’s voice complaints. This project proposes a descriptive study that would identify if completion of prescribed voice therapy exercises has implications on swallowing function in clients with co-occurring voice and swallow impairments. A pilot study …

The Relationship Between Sleep, Physical Activity, And Musculoskeletal Injury, In Us And Saudi College Students, Abdulaziz Hasan Alameer

Theses and Dissertations--Rehabilitation Sciences

According to the National Sleep Foundation, individuals should sleep 7-9 hours every night. Recently, insufficient or poor sleep has been linked to diabetes, cardiovascular illness, stroke, obesity, and Alzheimer's disease. Insufficient sleep for college students can negatively impact academic performance and mental health. In addition, especially for collegiate athletes, there is evidence that insufficient sleep is associated with an increased risk of musculoskeletal injury. However, it is uncertain if the link between sleep and injury varies between populations, types of individuals (athletes vs non-athletes), sports or types of exercise, or training volume. Despite the health risks of inadequate sleep, up …

Using Inertial Measurement Units (Imus) To Assess Fatigue-Related Changes In Running: Applications In Training Load Management, Reiley Thomas Bergin

Theses and Dissertations--Rehabilitation Sciences

The inertial measurement unit (IMU) is the most researched wearable technology in running. Yet, few studies have validated IMU-derived measures against accepted laboratory standards, such as three-dimensional (3D) motion capture and force plates. IMUs have the potential to provide information that can guide training load management decisions; however, no study has explored their capability to assess fatigue-related changes in running across consecutive days of training. Therefore, the purpose of this project was to evaluate the validity and reliability of IMU-derived measures and assess their capability for detecting fatigue-related changes in running in the days following an intensified training bout. The …

The Critical Need For Early Language Access For Deaf And Hard Of Hearing Children, Kinya D. Embry-Wright

Theses and Dissertations--Rehabilitation Sciences

According to the American Speech-Language-Hearing Association (ASHA), speech-language pathologists (SLPs) are referred to as the experts of communication (ASHA, n.d.) utilizing their specialized training, extensive education, and clinical expertise to work with individuals across the lifespan with a variety of different speech and language delays, disorders, and deficits. However, when working with deaf or hard of hearing (DHH) children, there is often precedent given to speech and listening (M. L. Hall et al., 2019). For example, ASHA only recently updated their DHH portal to include American Sign Language (ASL), though they still list it on some webpages as an Augmentative …