Digital Commons Network^™

Assessment Of Cerebrospinal Fluid And Blood-Based Biomarkers In Degenerative Cervical Myelopathy: Systematic Review And Meta-Analysis, Harshit Arora, Hassan Darabi, Cassandra C. Wolsh, Kelsey N. Karnik, John C. Gensel, Francis Farhadi

Neurosurgery Faculty Publications

Study Design: Systematic Review and Meta-Analysis.

Objectives: Degenerative cervical myelopathy (DCM), the leading cause of spinal cord injury globally, may clinically manifest with hand numbness and tingling, loss of hand dexterity and impaired balance and gait. Biomarkers have been identified as disease indicators with recent studies exploring the role of structural and inflammatory biomarkers in diagnostic and treatment outcome prediction. The review aims to identify relevant cerebrospinal fluid (CSF) and blood-based biomarkers associated with DCM diagnosis and prognostication.

Methods: The systematic review was conducted as per PRISMA guidelines. A comprehensive search strategy was devised to identify articles evaluating biomarkers in …

An Evaluation Of Kentucky’S Policy Landscape And Its Impacts On High-Growth Firms In The Commonwealth, Ivanna Patrick, Jordan Arnold, Devin Dunigan

MPA/MPP/MPFM Capstone Projects

There is significant research on high-growth firms (HGFs), though there is little research focusing on such businesses in Kentucky. By comparing Kentucky to two similar states that are economic competitors and in the context of the Kentucky Innovation Act of 2000, we find that Kentucky has a relatively fewer number of HGFs, even compared to itself at the time of the bill’s passage. Ultimately, we determined that there was a focus on high-tech firms in Kentucky that may be detrimental to the growth and success of HGFs in other industries; furthermore, it would serve the state to focus enhanced efforts …

Addressing Municipal Road Aid Funding In Kentucky During The Era Of Electric Vehicles, Jacob Bruce, Tyler Chapman, Blake Girdler

MPA/MPP/MPFM Capstone Projects

The rapid rise of electric vehicles (EVs) poses a growing threat to Kentucky’s Municipal Road Aid Fund, which relies heavily on fuel tax revenues. As EV adoption increases and fuel consumption declines, the existing funding model becomes increasingly unsustainable, jeopardizing road maintenance, infrastructure development, and municipal services across the state. Commissioned by the Kentucky League of Cities, this study investigates viable policy solutions to ensure long-term fiscal stability for municipal road funding in an electrifying transportation landscape. Drawing from comparative analyses of peer and neighboring states, the report evaluates alternative funding mechanisms such as road usage charges, EV-specific registration fees, …

Strategic Alignment Of Lexington Public Library And Art Community, Jonnisa Ferguson, Samantha Metzger-Elder

MPA/MPP/MPFM Capstone Projects

Amidst the evolving economic, political, religious, social, and technological landscape of the United States, one enduring element across communities has been the presence and importance of public libraries. Despite the decreasing number of genuinely public spaces in America, public libraries remain accessible and welcoming to all (Howard, 2019). Modern public libraries unite people and are "rewriting common assumptions of what people think a library does" (Carlson, 2024). Going far beyond books, libraries are serving as a "trusted public common for social innovation and civic engagement," partnering with community organizations to address daily living issues (i.e., food insecurities and professional development), …

Lfucg: Assessing Homeownership Initiatives Through Document Analysis, Matthew D. Hallock, Dakota Hensley, Jordan G. Salem

MPA/MPP/MPFM Capstone Projects

The Lexington, Kentucky Vice Mayor’s Office is exploring ways to expand access to homeownership as a means to facilitate wealth creation for its citizens. This paper outlines literature highlighting the issues surrounding the shortage of housing and past discriminatory policies which negatively affected Lexington. Specific criteria were used to identify cities that resemble Lexington to see what housing programs those cities have implemented and to see what can be reasonably applied to Lexington. Descriptions and themes of the identified programs are provided to provide the Lexington Vice Mayor’s Office with policy options to increase avenues to first-time homeownership.

Ensuring A Future For The Past: Balancing Heritage Tourism And Historic Preservation, Kyra Frew Sexauer

MPA/MPP/MPFM Capstone Projects

Savannah’s historic city plan, Charleston’s colonial architecture, and New Orleans’ Creole and Cajun culture and cuisine all have a commonality: they tangibly and intangibly connect the past to the present. Each city has a distinct and recognizable landscape, shaped by its built environment, history, and culture, which is listed as a National Historic Landmark District (NHLD) – the most prestigious recognition a historic district can receive in the United States. Heritage tourists are drawn to these places by their history, culture, and authenticity. In 2022, a combined 42,320,000 million tourists poured into the streets of Savannah, Charleston, and New Orleans. …

A Comparative Study Of State-Level Fast Programs To Identify Best Practices For Kentucky, Alana Morgan

MPA/MPP/MPFM Capstone Projects

This capstone project examines best practices among state-level innovation programs participating in the U.S. Small Business Administration’s Federal and State Technology (FAST) Partnership Program, with a specific focus on the Kentucky Science and Engineering Foundation (KSEF). As a key player in Kentucky’s innovation ecosystem, KSEF supports small businesses and entrepreneurs in pursuing federal Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) funding. This study evaluates KSEF’s current program effectiveness and identifies strategies from similar states that could strengthen Kentucky’s outcomes in securing federal innovation funding.

Using a qualitative comparative research design, this study analyzes interviews with program …

The Impact Of Medicaid Postpartum Coverage Expansion On Insurance Coverage In California, Akuoma Nwannunu

MPA/MPP/MPFM Capstone Projects

This study examines the impact of California’s 12-month Medicaid postpartum expansion on insurance coverage outcomes among recent mothers using pooled data from the American Community Survey (ACS) microdata from 2018-2019 and 2022-2023. A quasi-experimental difference-in-differences design compared postpartum mothers with non-postpartum mothers to assess whether the policy altered Medicaid enrollment, private coverage, or uninsurance in the first two years after implementation. Findings show that Medicaid coverage increased slightly and uninsurance declined modestly among postpartum mothers, while private coverage remained stable. Across all three outcomes, however, the DID estimates were small and statistically insignificant, which indicates early but limited measurable effects. …

Establishing Performance Criteria For Evaluating Watershed-Scale Sediment And Nutrient Models At Fine Temporal Scales, Aayush Pandit, Sarah Hogan, David Tyler Mahoney, William I. Ford, James F. Fox, Christopher Wellen, Admin Husic

Civil Engineering Faculty Publications

Watershed water quality models are mathematical tools used to simulate processes related to water, sediment, and nutrients. These models provide a framework that can be used to inform decision-making and the allocation of resources for watershed management. Therefore, it is critical to answer the question “when is a model good enough?” Established performance evaluation criteria, or thresholds for what is considered a ‘good’ model, provide common benchmarks against which model performance can be compared. Since the publication of prior meta-analyses on this topic, developments in the last decade necessitate further investigation, such as the advancement in high performance computing, the …

Sex-Specific Roles Of The Adipocyte Mineralocorticoid Receptor In Obesity And Early Life Stress, Meghan B. Turner

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity is a burgeoning health epidemic caused by chronic overnutrition and exacerbated by genetic, environmental and developmental factors. The adipocyte mineralocorticoid receptor (MR), a transcriptionally active nuclear receptor, is speculated to contribute to metabolic dysfunction in the obese state. MR expression is increased in obese adipose tissue, and MR modulates the expression of fat-derived hormones such as leptin and adiponectin. In women, obesity can be exacerbated by early life stress, such as adverse childhood experiences (ACEs). Studies show that women display a positive association between cumulative ACE exposures and increased body mass index. Previously, we demonstrated that maternal separation and …

Nothing Short Of Superheroic: A Quantitative Study Of Lifetime Exposure To Superhero Comic Book Media As A Predictor Of Attitudes Towards Diversity, Equity, And Inclusion, Michael Nguyen

Theses and Dissertations--Educational Leadership Studies

This dissertation examined the relationship between lifetime exposure to superhero comic book media and attitudes toward diversity, equity, and inclusion (DEI). Drawing on theories of identity formation—transitional objects, parasocial relationships, and cultivation theory—it investigated whether engagement with superhero narratives predicted DEI attitudes. Using quantitative methods, data from 499 U.S. adults were collected via Qualtrics. Two instruments were used: the Lifetime Superhero Comic Book Media Exposure Scale (LSES) and the Intolerant Schema Measure (ISM), which assessed prejudice across race, gender, sexuality, class, age, and religion. Multiple linear regression revealed that superhero media exposure significantly predicted ISM scores (B = 0.118, …

Exploring The Collective Efficacy Of Elementary Special Education Teachers And Its Relationship To Distributed Leadership, Emma L. Jones

Theses and Dissertations--Educational Leadership Studies

This study examined the relationship between collective teacher efficacy (CTE) and distributed leadership practices among elementary special education teachers. CTE reflects teachers’ shared belief in their collective ability to improve student outcomes, while distributed leadership emphasizes shared decision-making, collaboration, and shared responsibility across school personnel.

Using a sequential explanatory mixed-methods design, the study combined survey data from the Collective Teacher Belief Scale with follow-up interviews. Survey results from 31 special education teachers indicated moderate to high levels of CTE, with slightly greater confidence in managing student behavior than in delivering instruction. Interviews with teachers across varying CTE levels provided deeper …

Using The Mand-Model Intervention Strategy To Increase Verbal Or Augmentative And Alternative (Aac) Two-Word Utterances For Requesting Items In A Naturalistic Setting, Morgan A. Williams

Theses and Dissertations--Education Sciences

This project examined the effectiveness of the mand-model milieu teaching strategy for increasing two-word verbal or augmentative and alternative communication (AAC) requests in a classroom. Three students participated. All students demonstrated increased mean length of utterance in words (MLUw) when requesting preferred items. For all students, correct two-word requests improved following a model prompt. Two students showed limited independent requesting following only a mand, while one student met criterion for consistent independent requesting. Other observed outcomes included improved communicative confidence, reduced frustration behaviors, and increased AAC acceptance and generalization across settings for one participant. Findings suggest that the mand-model strategy …

Effect Of Walking With An Active Ankle Exoskeleton On The Biomechanical Responses Of The Lumbar Spine, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Sridevi Nagaraja, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Objective: Musculoskeletal injuries pose a health threat to U.S. Service members. In particular, the physical demands of walking and running with load carriage contribute to a high incidence of musculoskeletal injuries of the lower back. Active ankle exoskeleton devices are promising technologies that may help mitigate the impact of load carriage on the incidence of these injuries. However, the safe extended use of these devices requires an understanding of their beneficial or detrimental effects on the lumbar spine. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on lumbar biomechanical responses.

Methods: We collected …

Comparison Of Machine Learning Models For Colon Cancer Survival: Predictive Modeling Approach, Reuben Adatorwovor, Motolani E. Ogunsanya, Bin Huang, Richard Charnigo, Olufunmilola Abraham

Biostatistics Faculty Publications

Background: Colon cancer is a leading cause of cancer-related deaths worldwide, with survival influenced by risk factors, treatment type, and patient characteristics. Traditional statistical models, such as Kaplan-Meier curves, have been widely used to estimate survival probabilities. However, these models often have difficulty handling complex interactions, covariates, and nonlinear relationships between risk factors. Recently, machine learning (ML) techniques have emerged as promising tools for improving survival prediction by handling large covariates and capturing complex patterns.

Objective: This study compares several ML models to accurately estimate colon cancer survival by leveraging data from the Kentucky Cancer Registry. By identifying key risk …

Incident Atherosclerotic Cardiovascular Disease Among Veterans By Gender Identity: A Cohort Study, Carl G. Streed Jr., Meredith S. Duncan, Kory R. Heier, T. Elizabeth Workman, Lauren B. Beach, Guneet K. Jasuja, Hill L. Wolfe, Landon D. Hughes, John R. O’Leary, Melissa Skanderson, Joseph L. Goulet

Biostatistics Faculty Publications

Background: Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD).

Objective: Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes.

Design: Cohort study.

Participants: Over 1 million veterans receiving care in the Veterans Health Administration.

Main Measures: Gender identity was identified via a validated natural language processing (NLP) algorithm. Incident ASCVD (acute myocardial infarction, ischemic stroke, or revascularization after the baseline date) was identified via International Classification of Diseases diagnosis codes among veterans without prevalent ASCVD. We calculated sample statistics stratified by gender identity and used Cox proportional hazard …

Schubert Lieder For Solo Piano: From Liszt Transcriptions To An Original Adaptation, Changpeng Ti

Theses and Dissertations--Music

This document investigates Franz Liszt’s transcriptions of Schubert Lieder. Between 1838 and 1846, Liszt transcribed 56 songs (including standalone works and song cycles) by Franz Schubert into solo piano pieces. This document discusses compositional devices used in Liszt’s transcriptions and their relationship to Schubert’s vocal and piano writing as well as the original poetic text. Following the discussion on Liszt transcriptions, I present my own transcription of Schubert’s Im Frühling, D. 882, as an experiment in adapting vocal and poetic nuances into a solo piano piece inspired by the Liszt transcriptions.

Teacher Perceptions Of A Mindful-Based Social Emotional Group Drumming Curriculum: A Collective Case Study, Kristin Lewis

Theses and Dissertations--Music

Educational researchers have discovered a connection between educator and student well-being. Educators need to cultivate these skills to effectively model social emotional learning (SEL). However, there is a shortage of resources for elementary general music educators that intentionally embed social emotional competencies in tandem with adhering to the National Core Arts Standards.

Therefore, the purpose of this study was to examine elementary music educators’ perceptions of a Mindfulness-Based Social Emotional Learning (MBSEL) group drumming curriculum and its impact on their own and their students’ social emotional competencies (SECs). The research questions were: (1) What are elementary music educators’ perceptions of …

A Performance Pracitce Guide To Selected Cornet/Trumpet Excerpts From Wind Band Marches, Adiel P. Najera

Theses and Dissertations--Music

This dissertation seeks to illuminate a long-overlooked area in music and education. Wind band marches are part of a genre that has perhaps received less scholarly treatment when compared to the trumpet parts of orchestral, jazz, and popular music. This guide aims to fill the gap in information available for cornet/trumpet players in wind band settings.

This treatise will provide knowledge including a brief background information, marches in teaching and performing, insights from interviews with current and retired military trumpeters & current and retired music educators. Additionally, the document features excerpts with detailed performance practice and a list of renowned …

James M. David’S Ghosts Of The Old Year: A Formal Analysis And Instructional Guide, Brian P. Froedge Dr.

Theses and Dissertations--Music

James David’s Ghosts of the Old Year (2016) is a significant work for wind ensemble which was performed at the American Bandmasters Association Convention in 2019 by the Colorado State University Wind Ensemble under the direction of Rebecca Phillips and at the 2019 Texas Music Educators Association Convention by the North Texas Wind Symphony under the direction of Eugene Migliaro Corporon. The piece was recorded by the North Texas Wind Symphony on the album titled noteworthy. Ghosts of the Old Year has also been performed by such prestigious ensembles as the University of Illinois Wind Orchestra, the University of Florida …

Anatomical Literacy And Body Mapping In Flute Performance: Strategies For Addressing And Preventing Upper Extremity Injuries, Lauren E. Wiedemer

Theses and Dissertations--Music

This document investigates the benefits of incorporating the study of anatomy and Body Mapping into flute performance, specifically focusing on addressing and preventing injuries related to the upper extremities. As the physical demands on musicians continue to grow, this research advocates for recognizing flutists as "musical athletes.” It highlights the importance of anatomical literacy and somatic awareness in sustaining performance longevity. The practical applications of Body Mapping are explored in detail and presents strategies for alleviating strain and fostering ease of movement, supported by research and experiential insights. Pedagogical recommendations are offered to integrate these principles into flute instruction, helping …

Hardcore And Metal Music In Music Therapy: A Functional Guide For Music Therapists And Music Therapy Students, Caroline Nc Wood

Theses and Dissertations--Music

Hardcore and metal music have long been misrepresented, stigmatized, and dismissed in music academia, and overlooked in music therapy literature and education. However, these genres hold significant emotional, cultural, and therapeutic value for many listeners, offering unique opportunities for connection, expression, catharsis, and healing. This thesis presents a practical, introductory guide to help music therapists and music therapy students gain an understanding of why, when, and how to effectively and authentically incorporate hardcore and metal music into clinical practice. The project explores the historical development of these genres; sociocultural associations and considerations, including stigmatization, sensationalism, and the juxtaposing sociopolitical dynamics …

A Pedagogical Survey Of Solo Multiple Percussion Literature, Austin Shoupe

Theses and Dissertations--Music

In the study of western classical percussion, there are three or four core instruments through which the necessary skills of the discipline are taught. The three universally accepted core instruments are snare drum, keyboard percussion, and timpani. Multiple Percussion is often considered as a fourth core instrument, given its significant presence in symphonic literature, musical theatre, chamber music, and solo repertoire. However, despite its importance to percussion performance, there are very few published pedagogical materials for multiple percussion. While there are etude books available, there are no comprehensive method books aimed at multiple percussion pedagogy.

To fill this gap in …

A Comparison Of Informal Choral Singing Experiences, Christopher Powell

Theses and Dissertations--Music

A traditional choir relies on the interest and participation of the population in communal singing. However, drawing willing participants into a traditional choir program can often prove challenging to music educators, community choir directors, and leaders of religious music programs. One of the most prevalent informal singing groups in the USA is Sacred Harp. Sacred Harp “singings” have been around since the early years of The Sacred Harp itself. These singings occur regularly in multiple locations across the country and around the world. These events have an open atmosphere and, despite the mostly Christian material, have no expectation of a …

Designing An Undergraduate Opera Workshop Curriculum For Universities, Christopher L. Burchett

Theses and Dissertations--Music

The world of opera is quickly evolving to keep pace with the other arts forms of film, television and Broadway theater. For many years the genre had been reluctant to change with the times and update the skills of their performers. Those days have passed. Today’s operatic performers must be better actors, better movers and more theatrically efficient with their overall skill set in addition to having the secured singing technique that has for so long been the top priority. Universities must take ownership of this training.

Today’s university opera workshop programs must be more than they have been in …

Secondary String Students’ Perceptions Of The Role Of Self-Efficacy In Mitigating Their Musical Performance Anxiety: A Collective Case Study, Mary E. Henton

Theses and Dissertations--Music

Musical Performance Anxiety (MPA) is a multifaceted psychological condition that arises before, during, or after musical performance and presents a significant obstacle for young musicians, particularly secondary string students. Closely linked to the spotlight effect and social anxiety, MPA has worsened among youth following the COVID-19 pandemic due to decreased social interaction, both of which have had adverse effects on students’ mental health. Despite teachers’ awareness of MPA’s prevalence, music education programs often lack instruction in specific coping mechanisms to address it, and many students do not seek support or treatment.

The purpose of this study was to describe the …

Performance Guide To Select Twentieth-Century French Organ Works Based On Te Deum, Margaret Maria Lerose

Theses and Dissertations--Music

The Gregorian chant Te Deum originated over 1500 years ago and was the basis of many vocal and instrumental compositions. Segments of the chant were also used as motives and themes for improvisation. Students at the French organ school studied both improvisation and composition. This study examined three exemplary pieces that resulted from the French organ school traditions: Improvisation sur le Te Deum (1930) by Charles Tournemire, Hymne d’Actions de Grâces, Te Deum (1934) by Jean Langlais, and Paraphrase sur le Te Deum (1946) by Marcel Dupré.

After a brief chapter on the history of the Te Deum chant, biographical …

Professional Experiences Of Disabled Music Therapists: An Adapted Multiple Case Study, August Lily Tuggle

Theses and Dissertations--Music

Literature about disability often focuses on disabled people as recipients of professional services and there is scant literature about disabled professionals. Although music therapists work primarily with disabled individuals, there is little research on or from the perspectives of disabled music therapists. A growing body of qualitative research, grey literature, and media platforms provides perspectives from the disability community regarding music therapy. Disabled individuals both within and outside the profession critique common music therapy attitudes and practices that conflict with the expressed needs of the disability community. However, much of this literature contains the perspectives of one individual or a …

Luis Serrano Alarcón’S Second Symphony For Wind Orchestra Background, Analysis, And Conductor’S Guide, Adam P. Miller

Theses and Dissertations--Music

Luis Serrano Alarcon’s composition, Second Symphony for Wind Orchestra (2017), is a significant work for the wind ensemble. Written as a tribute to the great Romantic composers it was inspired by their symphonies. It is neo-classical in form but contains a neo-Romantic language and a compositional style unique to the Spanish composer.

The purposes of this dissertation are: 1.) to provide biographical details regarding Luis Serrano Alarcon and his musical career; 2.) to place the Second Symphony for Wind Orchestra in perspective within other modern works for wind band and within the composer’s own catalogue; 3.) to elaborate on the …

Expression Of Dementia Biomarkers In Appalachian And Non-Appalachian Elvo Patients During Thrombectomy, Neha Anil, Christopher J. Mclouth, Hunter S. Hazelwood, Elise Dahlke, Jacqueline A. Frank, Nathan Millson, Mais Al-Kawaz, Jordan P. Harp, Will Cranford, Shivani Pahwa, David Dornbos, Justin F. Fraser, Keith R. Pennypacker

Biostatistics Faculty Publications

Background/Context: Vascular Cognitive Impairment and Dementia (VCID) affects 25-30% of stroke patients and includes cognitive impairments caused by vascular injury, such as post-stroke dementia. Rehabilitation has the potential to improve the quality of life for patients at risk of developing dementia. However, there is currently no reliable method to identify those at risk of dementia after a stroke. Several biomarkers, including ADRD (Alzheimer’s disease and related dementias) biomarkers (Ab, tau, NfL, and GFAP) and angiogenic factors (VEGF, Flt-1, Tie-2, PIGF, and FGF) have been associated with the development of dementia. Populations in Appalachia experience a higher incidence of stroke and …