Digital Commons Network^™

Evolution Of Selection Techniques In Breeding For Bloat-Safe Alfalfa, B P. Goplen, R E. Howarth, G L. Lees, W Majak, J P. Fay, K J. Cheng

IGC Proceedings (1977-2023)

This report summarizes the Canadian breeding program to develop a bloat-safe alfalfa (Medicago sativa L.). This program has experienced an evolution of selection methods in attempting to identify bloat-safe alfalfa genotypes. In chronological order, the methods involved selection for fraction I (18S) protein, soluble proteins, foam volume, tannins (flavolans), saponins, initial rate of digestion (IRD), sonication, purified enzymes, gas production, and leaching. Although soluble herbage protein is correlated with the occurrence of pasture bloat, we have experienced slow progress in a selection program to reduce soluble-protein concentration in alfalfa. We have found that foam volume is not correlated with …

Value Of White Sweet Lupin In Production Of Protein Fodder And Feeding Of Animals, O Saric, I Ramosevac

IGC Proceedings (1977-2023)

The potential of white sweet lupin (Lupinus albus L.) as a grain or forage feed for livestock was investigated in a series of ex­periments. Grain yield of lupin was greater than or equal to that of soybeans (Glycine max [L.] Merrill) in most evaluations. The quality of lupin seed compared favorably with that of soybean meal and fishmeal. Lupin is capable of producing large amounts of forage in a short period, making it a good prospect for forage production in regions that have a short growing season.

Hedysarum Mongolicum Turcz.: An Important Protein Resource Legume On Dry Sandy Land, Li Min, A W. Hovin

IGC Proceedings (1977-2023)

In searching for plants that can both increase the protein production and improve the sandy-soil conservation of the grassland in the arid, windy regions of North China, so far, from among many native plants, we have identified Hedysarum mongolicum Turcz. as the best species to fulfill our dual purposes. We investigated its distribution, planted its native seeds in the Maowusu desert, and studied it under its native and cultivated growing conditions from 1957 to 1964. Chinese farmers call this perennial subbrush legume of the sweetvetcb genus "Yang Cai," meaning "sheep like to eat." It can thrive in the stable or …

Preliminary Evaluation Of Legume Germ Plasm In The Cerrados Of Brazil, D Thomas, R P. De Andrade

IGC Proceedings (1977-2023)

In 1978 an evaluation program was initiated to select legumes that (1) grow and produce seed on acid soils under aluminum and water stress, (2) persist under grazing, and (3) tolerate pests and diseases. The work is being conducted at the Cerrados Agricultural Research Center, near Brasilia, at lat 15°S and altitude 1,000 to 1, 100 m . Annual rainfall is 1,500 mm, mostly distributed in a 6-month wet season, and mean annual temperature is 21°C. Nine hundred legume accessions from thirteen genera have now been established as spaced plants on the 2 major soil types of the region. The …

Assessing Legacy Collections: Analyzing The Preservation, Recovery, And Interpretive Value Of Archaeobotanical Remains From Site 15le70 (Pine Crest Rockshelter), Lee County, Kentucky, Jennifer Carroll

Graduate Final Projects

This paper uses the archaeobotanical assemblage from Site 15Le70, a multi-excavated and extensively looted rockshelter in eastern Kentucky, while opening new lines of inquiry into gendered labor and practice during the Archaic-Woodland transition. Because legacy collections are often dispersed across institutions and/or research projects, the materials from any single site may be fragmented, as was the case for 15Le70. Such collections can be overlooked, yet this investigation into 15Le70’s archaeobotanical assemblage demonstrates that partial or scattered datasets can yield meaningful results and hold the potential to fill gaps in the archaeological record left by looting.

In this study, a small …

Elevated Plasma Cholesterol Improves Sepsis Outcome By Promoting Hepatic Metabolic Reprogramming, Qian Wang, Jianyao Xue, Ling Guo, Dan Hao, Misa Ito, Rianna Reese, Bin Huang, Congqing Wu, Xiang An Li

Markey Cancer Center Faculty Publications

Background – Sepsis is a life-threatening condition with high mortality and limited therapeutic options. This study investigated the association between plasma cholesterol levels and sepsis survival and explored the mechanisms by which elevated cholesterol confers protection. Methods – We analyzed 2, 787 sepsis patients from the MIMIC-IV database, comparing cholesterol levels between 28-day survivors and non-survivors and assessing mortality risk using multivariable Cox regression. To test causality, C57BL/6J mice were fed either a high-cholesterol diet (HCD) or a regular diet (RD) before cecal ligation and puncture (CLP). Results – Survivors had significantly higher cholesterol than non-survivors (median 135 vs. 126 …

Triacontanol Boosts Soybean Nodulation Via Gmhsp26-Mediated Antioxidant Enhancement, Bingjie Niu, Minglei Cheng, Xudong Lu, Lili Sun, Shuang Lu, Jinke Guo, Hongyan Zhu, Lixiang Wang

Plant and Soil Sciences Faculty Publications

Soybean (Glycine max (L.) Merr.) is a globally crucial food crop and a model plant for studying symbiotic nitrogen fixation in legumes. Triacontanol (TRIA) is a natural plant growth regulator that enhances photosynthetic efficiency, stress tolerance, antioxidant enzyme activities and yield in crops. However, its regulatory role in nodulation and nitrogen fixation in legumes remains unclear. In this study, soybean seedlings inoculated with Bradyrhizobium japonicum strain USDA110 were treated with different concentrations of TRIA (0, 0.33, 0.5, 1 and 2 μg/mL). Then, oxidative stress indicators and comparative transcriptomic analysis were performed to check the oxidative status and screen the candidate …

Evaluating The Feasibility And Preliminary Effectiveness Of A Tailored Diabetes Education Program For Rural Residents, Brittany L. Smalls, Oluwatosin Leshi, Suraksha Khanal, Grejika E. Abram-Erby

Journal of Appalachian Health

Introduction: Diabetes is a top ten Rural Healthy People 2030 priority for health improvement among rural Americans. Socioeconomic, environmental, geographic and political barriers contribute to the type 2 diabetes (T2D) prevalence and its disparate impact in rural communities. However, promoting proper self-care behaviors via self-management education can help people with diabetes better manage their condition.

Purpose: To account for the social environmental factors that affect rural residents, a tailored diabetes education program was developed, and the program’s effectiveness in improving diabetes knowledge and T2D-related health outcomes was assessed.

Methods: Using data collected from Appalachian Kentucky residents enrolled in a six-week, …

The Effects Of Hurricane Helene On Mental Health And Physical Activity, Hunter Smathers, Robyn York, Jarrett Walbolt

Journal of Appalachian Health

Introduction: Hurricane Helene brought widespread damage to Southern Appalachia, disrupting utilities, health care, and recreation. While natural disasters are linked to declines in mental and physical health, few studies have examined their effects on distinct types of physical activity (PA).

Purpose: This study evaluated the effects of Hurricane Helene on perceived stress, depressive symptoms, post-traumatic stress disorder (PTSD) symptomology, and intentional (exercise for health benefits) and incidental (physical labor or transportation) PA. Evacuation status influence was also explored.

Methods: Twenty participants completed assessments four weeks before (BASE), immediately after (0POST), and four weeks after landfall (4POST). Measures included the Perceived …

Patients' Attitudes Towards Deprescribing And Associations With Patient-Related Factors Across Two Hospital Settings, Louise Westberg Strejby Christensen, Iman El Gamah, Amina Osman Ismail Barre, Daniela Claudia Moga, Anissa Aharaz, Olivia Bornæs, Rikke Lundsgaard Nielsen, Aino Leegaard Andersen, Esben Iversen, Kim Peder Dalhoff, Ove Andersen, Helle Gybel Juul-Larsen, Morten Baltzer Houlind

Epidemiology and Environmental Health Faculty Publications

Medication deprescribing is a targeted strategy to reduce inappropriate polypharmacy. Patients in primary care settings have reported high willingness to discontinue medications, but this phenomenon is less well studied in hospital settings. In this explorative post hoc analysis of two previously described clinical trials, we assessed patients' attitudes towards deprescribing in two hospital-based cohorts: acutely admitted older medical patients (≥ 65 years) in the emergency department at Copenhagen University Hospital Hvidovre (October 2018–April 2021) and multimorbid patients (≥ 18 years) referred to an outpatient clinic at Copenhagen University Hospital Amager (March 2019–December 2019). Among 104 and 72 patients in each …

Muscle Atrophy After Acl Reconstruction Involves Molecular Mechanisms Beyond Unloading, Alexander R. Keeble, Gonzalez Velez Sara, Nicholas T. Thomas, Allison M. Owen, Austin V. Stone, Darren L. Johnson, Julián Candia, Luigi Ferrucci, Marco Narici, Esther E. Dupont-Versteegden, Brian Noehren, Martino V. Franchi, Christopher S. Fry

Physiology Faculty Publications

Anterior cruciate ligament reconstruction (ACLR) leads to profound muscle atrophy and weakness that remain resistant to rehabilitation. Although early recovery typically involves a brief period of limb unloading, the degree to which disuse alone accounts for muscle pathology after ACLR remains unclear. Here, we leveraged publicly available RNA-seq datasets of muscle biopsies from vastus lateralis obtained 7 days after ACLR or 10 days after unilateral lower limb suspension (ULLS), each with matched control limbs, to directly compare disuse-driven and ACLR-specific early transcriptional responses. Despite similar periods of reduced loading, substantial transcriptomic divergence was identified using both intersection and interaction bioinformatic …

Mapping The Polar Neuro-Interactome Of Garcinia Mangostana Against The Ad-Pd-Als Nexus, Rahni Hossain, Sirirat Surinkaew, Pradoldej Sompol, Nasmah K. Bastaki, Rifat Jafrin, Nazim Sekeroglu, Jitbanjong Tangpong

Markey Cancer Center Faculty Publications

Background/Objectives: Neurodegenerative diseases like Alzheimer’s, Parkinson’s, and Amyotrophic lateral sclerosis (ALS) share common molecular pathways, including neuroinflammation and oxidative stress, which complicate the effectiveness of single-target treatments. Garcinia mangostana L. (mangosteen) has shown neuroprotective properties, but previous studies focused on lipophilic xanthones, which have poor bioavailability and uncertain blood–brain barrier permeability. Methods: In the current study, polar metabolites from G. mangostana peel aqueous extract (GMPE) were assessed for potential multi-target interactions via UHPLC-QTOF-MS-based metabolomics, systems pharmacology, and molecular docking analysis. Further, in silico ADMET screening and network-based analyses assessed for overlap between GMPE compounds and genes associated with neurodegeneration (AD, …

Role Of Succinate Dehydrogenase In Age-Related Th17 Inflammation, Evelyn Ocegueda, Gabrielle Chase, Michaella Niceforo, Aida Javidan, Lydia Gugliuzza, Jingting Yu, Rachel Y. Kang, Ava Lankowski, Olivia Stefanik, Kailey Leclerc, Yolander Valentine, Micah J. Drummond, Jude T. Deeney, Josephine S. Modica-Napolitano, Elizabeth A. Proctor, Hatice Hasturk, Barbara S. Nikolajczyk, Leena P. Bharath

Markey Cancer Center Faculty Publications

Age-related cellular changes negatively impact CD4⁺ T cell function. Our prior work showed that mitochondrial complex II (succinate dehydrogenase [SDH]) expression was upregulated in T cells from older (O) adults (60–80 years old). T cells from older adults also produced higher amounts of cytokines generally considered proinflammatory, such as Th17 cytokines IL-17A/F and IL-21, and the Th-17-supportive cytokine IL-6, compared to T cells from younger (Y) adults (25–40 years old). The objective of our study is to evaluate whether hyperactivation of SDH is required for the induction of proinflammatory cytokines and the mechanistic link between SDH and Th17 cytokine …

Renin-Angiotensin-Aldosterone System In Preeclampsia: Pathophysiological Insights And Links To Vascular Dementia, Robin C. Finch, Jenny Lutshumba, Elizabeth Mirsky, Esther Ndashaala, Kelsey Bullens, Emma Smith

Pediatrics Faculty Publications

Pre-eclampsia, a condition characterized by new-onset hypertension during pregnancy and one or more indices of organ damage, is a major driver of both short and long-term maternal health outcomes. Individuals with a history of pre-eclampsia are at increased risk for cardiovascular, renal, and other chronic diseases. Recent studies have linked pre-eclampsia history with increased risk of dementia later in life, underscoring the importance of new guidelines emphasizing blood pressure control to reduce the risk of cognitive decline. Unfortunately, neither mechanisms underlying causes of pre-eclampsia nor their links with cognitive function are well understood. Vascular contributions to cognitive impairment and dementia …

Substantial Variation In Larval Honey Bee Nutrition Within And Among Apis Mellifera Colonies, Rebecca R. Westwick, Clare Rittschof

Entomology Faculty Publications

Parents have evolved strategies to reduce the risk of malnutrition in offspring, including the production of specialized nutritional secretions that are tailored to meet the unique needs of developing offspring. Studies in vertebrates, however, show abundant individual variation in nutritional secretions; the causes and consequences of this variation, and the extent to which such patterns can be generalized beyond vertebrates, remain unclear. Here, we investigated natural variation in nutritional secretions in an invertebrate species, the Western honey bee (Apis mellifera L.). This is a unique bee wherein developing larvae subsist entirely on “jellies” (e.g., royal jelly) produced by glands in …

Hyaluronan 35 Prevents Endotoxin-Mediated Dysregulated Skeletal Muscle Proteostasis During Ethanol Exposure, Nicole Welch, Pugazhendhi Kannan, Gangarao Davuluri, Annette Bellar, Amy H. Attaway, Saurabh Mishra, Jasmin A. Cunningham, Avinash Kumar, Ryan Musich, Elif G. Ertugral, Vandana Agrawal, Isaac L. Hsu, Terri J. Harford, Noah L. Weisleder, Vidula T. Vachharajani, Chandrasekhar R. Kothapalli, Carol A. De La Motte, Laura E. Nagy, Srinivasan Dasarathy

Neurology Faculty Publications

Sarcopenia in alcohol-related liver disease (ALD) is of high clinical significance, but there are no effective treatments. Hyaluronan 35 kDa (HA35), a glycosaminoglycan polymer, modulates responses to Toll-like receptor 4 (TLR4), a lipopolysaccharide receptor, to improve hepatic and macrophage function in ALD. We evaluated skeletal muscle responses to HA35 in preclinical models of ALD. Responses to ethanol, lipopolysaccharide (LPS), and HA35 were studied in differentiated murine C2C12/human-induced pluripotent stem cell (hiPSC)-derived myotubes, and wild-type/HA receptor CD44 knockout (CD44^—/—) mouse models of ALD (mALD). Signaling molecules and measures of protein homeostasis (proteostasis) were quantified by immunoblots, mitochondrial oxidative function …

Toward An Emerging Public Health Paradigm, Rod Wallace, Katherine Frels, Maria Itria Ibba, Conrad Lyford, Devin Rose, David Baltensperger, Jan A. Delcour, Steven Greenspan, Alison Lovegrove, Barbara Schneeman, Peter Shewry, Edward Souza, William W. Wilson, Gary W. Yohe, Jim Anderson, George Annor, Jayne Bock, Claudia Carter, Brett Carver, Jianli Chen, Edward C. Deehan, Noah Dewitt, Lisa Diewald, Jason Donovan, Corrine K. Hanson, David Holding, Amir Ibrahim, Mariah Jackson

Animal and Food Sciences Faculty Publications

An emerging paradigm in public health focuses on enhancing nutrition in existing food staples to reduce chronic disease at the population scale, rather than relying on individuals to change their behavior. This paradigm leverages plant and animal breeding, production practices, and processing to enhance nutrition, whereby foods consumed by millions can be improved at low incremental cost. This article supports and operationalizes this paradigm, illustrating the potential to improve diets through a case study that increases the arabinoxylan fiber content of commodity wheat through classical plant breeding (a non-GMO technology). The approach described in this article proposes to link agricultural …

Consumer Perceptions Of Farmers Market Performance: A Comparative Analysis Across States And Age Groups, Azita Varziri, Timothy A. Woods, Shuoli Zhao

Agricultural Economics Faculty Publications

The USDA Agricultural Marketing Service has invested in direct-to-consumer initiatives to expand local food consumption and enhance farmers market opportunities. To evaluate the effectiveness of these efforts, this study employs a sample-selected ordered probit model to analyze consumer perceptions of farmers market performance across four states in the Southeast United States. Specifically, we examine differences in awareness and performance of product quality, diversity, and market infrastructure. Awareness and perceptions vary significantly by age, other demographics, and state. These insights provide market organizers and policymakers with data-driven strategies to tailor marketing efforts and improve engagement across diverse consumer segments.

Elevating Teacher Agency In School Decision-Making Through Trust-Building: Applying Appreciative Inquiry Within A Mixed Methods Action Research Framework, Alison S. Bellamy

University of Kentucky Doctoral Dissertations

This mixed methods action research (MMAR) study examined how Appreciative Inquiry–based professional learning influenced relational trust, teacher voice, and teacher agency in elementary school decision-making within New Hanover County Schools. Grounded in Teacher Agency Theory, Distributed Leadership Theory, and Appreciative Inquiry, the study addressed the gap between teachers’ perceptions of trust and their opportunities to influence school-level decisions. The study was conducted across three mid-quintile elementary schools using a concurrent QUAN–QUAL design. Quantitative data was collected through pre- and post-intervention relational trust surveys. Qualitative data included focus groups, participant reflections, field notes, and collaborative dialogue from two professional learning sessions …

Investigation Of Genx Exposure To Pathways Associated With Colorectal Cancer Risk, Emily J. Ferguson

Theses and Dissertations--Toxicology and Cancer Biology

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants widely detected in drinking water and food sources, resulting in chronic human exposure. Among these compounds, hexafluoropropylene oxide dimer acid (HFPO-DA), commonly known as GenX, has been introduced as a short-chain replacement for legacy PFAS such as perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Although GenX is believed to be a safer alternative, emerging research suggests it can still affect human health.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related death in the United States, highlighting the need to better understand environmental …

Forage News [2026-02], University Of Kentucky

Forage News

No abstract provided.

Forage News [2026-01], University Of Kentucky

Forage News

No abstract provided.

Developing A Community-Driven, Locally Sourced Medically Tailored Meal Model: A Pilot Linking Healthcare, Farmers, And Patients, Julie Brown, Ashton Potter, Leandra Forman, Jairus J. Rossi, Anna Cason, Christa Mayfield, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Background: Food is Medicine (FIM) programs improve health outcomes by integrating nutrition interventions into healthcare delivery, yet gaps remain in community partner capacity and local food system integration. This program aimed to build community capacity to develop a locally sourced, medically tailored meal (MTM) model connecting farmers, healthcare providers, and patients. Methods: Meals were developed by a registered dietitian following American Heart Association (AHA) Heart-Check and MyPlate nutrition standards. Recipes were adapted for freezing, scaled for production, and sourced from 26 central Kentucky farms. Eligible participants with hypertension or type 2 diabetes (T2D) were referred through the Food as Health …

Forage News [2026-03], University Of Kentucky

Forage News

No abstract provided.

Effect Of Environmental Conditions On German Cockroach (Blattella Germanica) Behavior And Survival, Allison Lopina

Theses and Dissertations--Entomology

German cockroaches (Blattella germanica L.) remain one of the most challenging indoor pests to manage, due to resistance to many commonly used insecticides, and necessary contact/interaction with common management tactics. As such, it is critical to fully understand their aggregation, movement, and longevity, such that treatments can be optimally placed to result in maximal efficacy. The first part of this study explored the effects of multiple factors (harborage width, harborage materials, heat, resource-harborage distance) on initial site selection, and how environmental modifications and infestation density impact harborage site switching. The second half of the study aimed to explore the …

Comparing Strength Testing Measures And The Association Of Strength And Body Composition In Young Children, Abigayle R. Spong

Theses and Dissertations--Kinesiology and Health Promotion

Muscle strength is an important component of physical fitness; however, measuring it with isokinetic dynamometry (IKD) is expensive and requires dedicated space. Handheld dynamometry (HHD) provides a practical alternative for field and clinical settings. Thus, the purpose of this study was to compare peak knee flexion and extension torque measured by IKD and HHD in 37 children (ages 5-11 years) and examine relationships with body composition. Participants completed a RAMPing protocol at 90^o knee flexion consisting of two warm-up contractions at 50% and 75% effort followed by three maximal voluntary isometric contractions. Body composition was assessed via DXA scans. …

Review Of Current Research Describing The Influence Of Non-Health Care Drivers Of Health In Rural And Urban Populations, Katie Youngen, Julia Cecil, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Social determinants of health (SDOH) (also called social drivers of health) are the conditions of the environment where people live, learn, work, and play that are known to affect health outcomes.¹ The primary objective of this literature review is to summarize the most recent literature related to the Healthy People 2030 domains of a) economic stability, b) education access and quality, c) neighborhood and built environment, and d) social and community context.² Our particular focus is on non-health care drivers of health. The secondary objective is to identify gaps in literature applied to rural populations.

Increasing Uptake Of Diabetes Self-Management Education And Support (Dsmes) In Rural Kentucky Primary Care Clinics, Mary E. Lacy, Jessica Elliott, Vance Drakeford, Laura Wright, Brent Mckune, Key C. Douthitt, Aaron J. Kruse-Diehr, James W. Keck

Epidemiology and Environmental Health Faculty Publications

Background: Diabetes self-management education and support (DSMES) is an evidence-based intervention that improves outcomes for people with diabetes, but uptake is <10%. We conducted a pilot pragmatic trial to increase DSMES in rural primary care clinics that integrated health information technology with a quality improvement (QI) learning collaborative. Methods: Two healthcare systems from rural Kentucky participated in the study. Within each system, 2 clinics received the intervention and 1 clinic served as a control (N = 6 clinics). Each intervention clinic identified a QI team (5-6 individuals) who participated in a 9-month QI learning collaborative followed by 5 months of follow-up. Our primary outcome was DSMES referrals; secondary outcomes were DSMES attendance and percentage with A1c >9%. Results: The 6 study clinics served 1,803 patients with diabetes; n = 1083 (60.1%) from 4 intervention clinics and n = 720 (39.9%) from 2 control clinics. DSMES referrals significantly increased in the intervention clinics compared to the control clinics (31.7% vs 0.1%, P < .001) and continued to increase throughout 5-month follow-up (40.0% vs 0.1%, P < .001). Conclusions: A structured QI intervention can significantly increase DSMES referral rates in primary care clinics. Findings highlight the potential of systems-level approaches to address persistent gaps in diabetes care delivery in rural settings. Clinical Trial Registry: Using Practice Facilitation and Operationalizing Referral Information Technology to Increase DSMES Utilization (Clinicaltrials.gov registration number no. NCT05472142). Clinicaltrials.gov URL (https://clinicaltrials.gov/study/NCT05472142).

The Association Between Human Papillomavirus Type 16 E6 Seroprevalence And Degrees Of Anal Disease Among Men With Hiv, Krystle A.Lang Kuhs, Christopher Otieno, Staci Sudenga, Tim Waterboer, Weiqun Tong, Dorothy Wiley, Jay H. Bream, Steven Wolinsky, Jeremy Martinson, Gypsyamber D’Souza

Epidemiology and Environmental Health Faculty Publications

Introduction: Human papillomavirus type 16 (HPV16) E6 antibodies may be an early biomarker of anal cancer. We cross-sectionally evaluated when in the course of anal disease, HPV16 antibodies are induced. Methods: A nested case-control study of 846 men who have sex with men (MSM) was conducted within a prospective study of men with and without HIV. Cases of anal HPV16 (N=262), biopsy-confirmed high-grade squamous intraepithelial lesion (HSIL;N=140), and anal cancer (N=21) were individually matched to controls (N=423) on HIV status, study-participation duration, and age. Serum samples closest to diagnosis underwent HPV serologic testing; prediagnostic serial samples were tested for anal …

Association Between Educational Attainment And Discharge Disposition Following Incident Stroke Hospitalization, Ning Li, Erin L. Abner, Silvia Koton, Lena Mathews, Kunihiro Matsushita, Anna Kucharska-Newton

Epidemiology and Environmental Health Faculty Publications

Background – The relationship between educational attainment and discharge disposition after stroke hospitalization remains unclear. This study examined whether educational attainment is associated with discharge disposition after incident stroke and whether stroke severity modifies this association. Methods – The study included Atherosclerosis Risk in Communities (ARIC) participants with an incident stroke hospitalization from 1991 to 2020 who were enrolled in fee-for-service (FFS) Medicare at discharge. Discharge disposition was obtained from hospitalization claims. Educational attainment was categorized as “less than high school” vs. “high school or more.” Multivariable logistic regression models were used to estimate associations between educational attainment and discharge …