Digital Commons Network^™

Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff

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

Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …

A Case Study In Program Evaluation, Sierra L. Williams

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

The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.

Program Evaluation Case Study, Grace Mullikin

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

Program evaluation case study utilizing Center for Disease Control and Prevention's Case Evaluation Framework.

The Health Literacy Practices Of Rehabilitation Providers Of Perioperative Orthopedic Education, Allen Keener

Theses and Dissertations--Rehabilitation Sciences

Health literacy is the ability to utilize information to make decisions about one’s health or the health of others. It is estimated that a large percentage of the population has inadequate health literacy, yet healthcare professionals, including rehabilitation providers often do not have procedures in place for assessing and addressing the health literacy of their patients. Related to orthopedic patients, a large portion of the interventions are educational in nature. Therefore, it is important that the health literacy of orthopedic patients be considered when addressing their needs perioperatively. There is little currently published related to health literacy among rehabilitation providers …

An Uncultivated Skillset: Emotional Intelligence In Healthcare Profession Students, Molly Taylor

Theses and Dissertations--Rehabilitation Sciences

Burnout and social isolation have become critical threats to optimal health and well-being, with detrimental effects specifically impacting healthcare profession (HCP) students and providers. The US Surgeon General has labelled burnout a crisis in the health workforce and named loneliness an epidemic with profound consequences for mortality and collective longevity. HCP students are heavily and disproportionately affected by stress and burnout compared to their peers, resulting in negative consequences on academic performance, mental health, empathy, and compassion satisfaction. Emotional Intelligence (EI) is a learnable skillset shown to protect against burnout and enhance relational skills, well-being, personal and professional satisfaction, and …

Equestrian Activities And Health Outcomes: A Multidimensional Analysis Of Physical Activity, Injury Patterns, And Occupational Concerns, Michaela Keener

Theses and Dissertations--Rehabilitation Sciences

Over 6 million participate in equestrian activities each year. However, research focusing on the benefits and risks around equestrian activities is limited to epidemiological research and small sample sizes. Equestrian participation ranges from recreational to occupational, and little research has evaluated how the risks of participation change based on the level of participation. Special consideration needs to be given to the occupational equestrians as equestrian participation is their livelihood. The first two aims of this study were to evaluate the physical activity engagement, perceptions of equestrian as a sport, acute injury history, and chronic pain frequency of equestrians across all …

The Effect Of Adding Perceptual-Cognitive Load To Assessments And Intervention Strategies In Healthy Adults, Ke'la H. Porter

Theses and Dissertations--Rehabilitation Sciences

In collegiate athletes, approximately one in four injuries require more than seven days before the athlete can return to full participation. Additionally, there are significant long-term consequences associated with these injuries, such as pain and osteoarthritis. Despite the role that the sensorimotor system and cognitive function play in athletic competition, the interaction between these systems in relation to sport-related injury is commonly overlooked. The sensorimotor system integrates and processes sensory, motor, and central mechanisms to produce a motor response. Further, cognition constructs, such as visual attention or processing speed, allow athletes to navigate the chaotic sporting environment. When there are …

Physical And Psychosocial Factors Related To Firefighter Musculoskeletal Disorders, Jennifer Ellen Tinsley Kubala

Theses and Dissertations--Rehabilitation Sciences

Career firefighters must perform physically and psychologically challenging duties in unpredictable and dangerous conditions. Previous investigations have found that firefighters suffer nearly 4 times the recorded musculoskeletal disorders (MSD) and workplace injuries compared to private and public sector workers, and take approximately 1.5 days longer to return to normal work. Thus, the burden of firefighter MSD experiences has been a growing area of exploration. The few investigations that have concurrently examined physical and psychosocial consequences experienced by firefighters have found a positive relationship between increased occupational stress reports and MSD experiences. However, these investigations, as well as those that individually …

The Role Of Social Determinants Of Health On Patient Recovery After Critical Illness, Lindsey E. Fresenko

Theses and Dissertations--Rehabilitation Sciences

Patients who survive critical illness have a prolonged recovery which impacts their quality of life and outcomes. The sudden life changes from being critically ill may create or exacerbate social factors or needs also known as social determinants of health. Patients’ SDOH are defined as the environments in which we live, work and play that impact health outcomes. Patients’ SDOH impact their life in early recovery from changes in previous roles to their need for increased financial, physical and emotional support. During this early recovery, patients are often recommended to participate in rehabilitation to improve their physical function. Although, accessing …

Key To Success: A Comprehensive Examination Of Support Personnel In School-Based Speech-Language Telepractice, Hannah Douglass

Theses and Dissertations--Rehabilitation Sciences

In the school setting, the telepractice team primarily consists of the clinician and a support person known as a telefacilitator. Though telepractice is an accepted method for delivering school-based speech-language therapy, many barriers to the integration of telepractice as routine care persist. A major barrier is clinicians' acceptance of telehealth. However, there has been limited investigation of factors that influence clinician acceptance. Another barrier is related to support personnel. Telefacilitators have been shown to be an integral part of the telepractice program. Yet there are significant gaps in knowledge regarding the roles and responsibilities, staffing and management, and barriers/facilitators to …

A Mixed Methods Exploration Of Occupational Therapy Pratice And Multiple Sclerosis Specialization, Dana Alghadban

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to increase the body of research of how occupational therapists can address multiple sclerosis rehabilitation through occupational therapy services. Multiple sclerosis is a neurodegenerative disease that creates challenges for individuals to engage in meaningful occupations and significantly affects many areas of their lives. Occupational therapists play a role in the rehabilitation process for people with multiple sclerosis by providing occupation-focused interventions that may improve the health and well-being of clients living with the disease. As a result of the unpredictability of symptoms experienced by this population, individualized approaches to addressing participation and occupational performance …

Reinventing Integrated Photonic Devices And Circuits For High Performance Communication And Computing Applications, Venkata Sai Praneeth Karempudi

Theses and Dissertations--Electrical and Computer Engineering

The long-standing technological pillars for computing systems evolution, namely Moore's law and Von Neumann architecture, are breaking down under the pressure of meeting the capacity and energy efficiency demands of computing and communication architectures that are designed to process modern data-centric applications related to Artificial Intelligence (AI), Big Data, and Internet-of-Things (IoT). In response, both industry and academia have turned to 'more-than-Moore' technologies for realizing hardware architectures for communication and computing. Fortunately, Silicon Photonics (SiPh) has emerged as one highly promising ‘more-than-Moore’ technology. Recent progress has enabled SiPh-based interconnects to outperform traditional electrical interconnects, offering advantages like high bandwidth density, …

Design And Control Of Axial Flux Permanent Magnet Coreless Machines With Special Windings, Yaser Chulaee

Theses and Dissertations--Electrical and Computer Engineering

Permanent magnet synchronous machines (PMSMs), particularly those of the axial flux type, are being researched and developed for various applications such as HVAC systems, aviation propulsion, and electric vehicles. The coreless (air-cored) stator axial flux permanent magnet (AFPM) machine topology offers notable advantages over conventional designs by eliminating magnetic cores and their associated losses. These advantages include potentially higher efficiency, zero cogging torque, and reduced audible noise and vibration. Eliminating the magnetic core also allows for more effective cooling systems, as coolants can be in direct contact with the stator windings, potentially improving power density and specific torque.

The absence …

Get It In Writing: How To Make Medications For Opioid Use Disorder Available During Incarceration, Margaret J. Mcgladrey, Jordan Kelsch, Michelle R. Lofwall, Laura C. Fanucchi, Sharon L. Walsh, Carrie B. Oser

Center on Drug and Alcohol Research Faculty Publications

In a case example from the Kentucky HEALing Communities Study, extensive resources were deployed to address structural barriers and facilitate the provision of medication for opioid use disorder (OUD) in an urban county jail. However, implementation was unsuccessful, and this case example emphasizes the importance of including evidence-based medication for OUD (MOUD) treatment in the scope of work of jails’ contracted medical providers. The privatization of correctional health care services allows local governments with opioid abatement funds to incorporate requirements into medical provider contracts to screen all people entering jails for OUD and to offer MOUD at intake, throughout incarceration, …

The Development Of A Recovery Coaching Training Curriculum To Facilitate Linkage To And Increase Retention On Medications For Opioid Use Disorder, Trevor Moffitt, Amanda Fallin-Bennett, Laura Fanucchi, Sharon L. Walsh, Christopher Cook, Devin Oller, Anna Ross, Molly Gallivan, John Lauckner, Jeremy Byard, Phoebe Wheeler-Crum, Michelle R. Lofwall

Center on Drug and Alcohol Research Faculty Publications

Introduction: Medication treatment for opioid use disorder (MOUD) decreases opioid overdose risk and is the standard of care for persons with opioid use disorder (OUD). Recovery coach (RC)-led programs and associated training curriculums to improve outcomes around MOUD are limited. We describe our comprehensive training curriculum including instruction and pedagogy for novel RC-led MOUD linkage and retention programs and report on its feasibility.

Methods–pedagogy and training development: The Kentucky HEALing (Helping to End Addiction Long-termSM) Communities Study (HCS) created the Linkage and Retention RC Programs with a local recovery community organization, Voices of Hope-Lexington. RCs worked to reduce participant barriers …

A Brief Report On Juvenile Amyotrophic Lateral Sclerosis Cases In The United States National Als Registry: 2010– 2018, Jaime Raymond, Jasmine Berry, Edward J. Kasarskis, Theodore Larson, D. Kevin Horton, Paul Mehta

Neurology Faculty Publications

Juvenile ALS (jALS) is a rare form of ALS, defined as symptom onset before age 25. This report describes the demographic characteristics of confirmed and likely jALS cases in a large cohort of ALS patients ascertained in the National ALS Registry (Registry) from 2010 to 2018. Patients in the Registry must be at least 18 years of age. Of the 44 identified patients, 37.8% were diagnosed at age 24, were more likely to be nonwhite (54.5%), male (79.5%), and live in the Midwest or Northeast regions (54.5%) of the US. Some 68.9% of the jALS cases were received from federal …

Design And Optimization Of High-Efficiency Coreless Pcb Stator Axial Flux Pm Machines With Minimal Eddy And Circulating Current Losses, Yaser Chulaee, Greg Heins, Ali Mohammadi, Mark Thiele, Dan M. Ionel, Ben Robinson

Electrical and Computer Engineering Graduate Research

This paper proposes a systematic multi-step design procedure for highly efficient printed circuit board (PCB) stator coreless axial flux permanent magnet (AFPM) machines with minimal eddy and circulating current losses. The process begins with initial sizing, providing specific coefficients based on experience with multiple design projects. It continues with the optimization of the machine envelope design using an evolutionary algorithm and computationally efficient 3D finite element analysis (FEA) models. The subsequent step focuses on the detailed design of a PCB stator, aiming to minimize eddy and circulating current losses. Several open circuit loss mitigation techniques are proposed based on analytical …

Design Optimization Of A Direct-Drive Wind Generator With A Reluctance Rotor And A Flux Intensifying Stator Using Different Pm Types, Ali Mohammadi, Oluwaseun A. Badewa, Yaser Chulaee, Donovin D. Lewis, Somasundaram Essakiappan, Madhav Manjrekar

Electrical and Computer Engineering Graduate Research

This paper presents a large-scale multi-objective design optimization for a direct-drive wind turbine generator concept that is based upon an experimentally validated computational model for a small-scale prototype motor of the same type. By integrating an outer reluctance-type rotor and a segmented stator with toroidally wound single-coil modules containing spoke-type PMs, the design optimization aims to minimize losses, active mass, and torque ripple while adhering to a power factor constraint. The AC windings and PMs are positioned in the stator and this concept enhances flux concentration, enabling the use of more affordable high energy non-rare-earth (special type) magnets. The exterior …

Large-Scale Design Optimization Of An Axial-Flux Vernier Machine With Dual Stator And Spoke Pm Rotor For Ev In-Wheel Traction, Ali Mohammadi, Yaser Chulaee, Aaron M. Cramer, Ion G. Boldea, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

This paper presents the optimization study targeting a specific drive cycle for a MAGNUS-type axial-flux permanent magnet vernier machine (AFPMVM). The proposed MAGNUS machine has a novel design with a dual-stator configuration, where only one stator is wound, with a high-polarity spoke permanent magnet (PM) rotor. The machine topology has a 3D flux path, which necessitates the analysis of a large finite element (FE) model. However, due to the computational complexity and time required for such a large FE model, a new approach was developed. This approach involves a computationally efficient finite element analysis (CE-FEA) model combined with a single …

Perceived Versus Actual Hiv Risk Among Prep Indicated Persons With Criminal Legal Involvement, Taylor Krajewski, Katherine H. Lemasters, Carrie B. Oser, Lauren Brinkley-Rubinstein

Behavioral Science Faculty Publications

Individuals involved with community supervision experience multi-level obstacles impacting health outcomes. This is a high-risk period for HIV acquisition due to potential reengagement in unprotected sex and/or unsafe injection drug practices. This study aimed to assess the congruence between actual and perceived HIV risk and the degree to which individual, social, and behavioral factors impact risk perception among individuals on community supervision. While all participants were clinically indicated for PrEP, most participants (81.5%) did not consider themselves at risk for HIV (69.5%) or were not sure of their risk (12.0%). Among those with no or unsure perceived risk, 94% engaged …

Screening Incarcerated Women For Opioid Use Disorder, Michele Staton, Martha Tillson, Mary M. Levi, Matthew Webster, Carrie B. Oser, Carl Leukefeld

Behavioral Science Faculty Publications

The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree …

Trends In Youth Opinions About Police Agencies In The United States, 2017–2021, Delvon T. Mattingly, Nancy L. Fleischer

Behavioral Science Faculty Publications

Introduction: As civil unrest about policing in the United States (US) continue, research on changing opinions about police agencies is needed, especially among younger populations. These opinions may be associated with distress and other health outcomes that come with public health implications.

Methods: We aggregated and used yearly 2017 to 2021 data on 12th-grade youth living in the US from the Monitoring the Future cross-sectional study (n = 7132). We categorized opinions about police agency job per- formance into 1) very poor/poor (hereafter: poor), 2) fair/good/very good, and 3) no opinion. To examine trends in policy agency opinions over time, …

A Social History Of Opioids’ Crimedical Cycle, Jerel M. Ezell, Alex Rains, Babatunde Patrick Ajayi, Kyle Miller, Erin Augustine, Dawn Goddard-Eckrich, Elizabeth N. Kinnard, Michelle R. Lofwall

Behavioral Science Faculty Publications

Historically, public and political discourse around people who nonmedically use opioids has largely been rendered via a deficits-oriented lens, presenting this population as weak, disinterested, and deviant,and thus undesirable and ill-positioned for wellness and communal integration. These narratives, and subsequent policies used to engage people who use opioids, are intermittently formed and disrupted by geopolitical changes, as public and institutional attitudes, often driven by racial and class-related considerations, shift. As part of what we term the crimedical cycle, a population’s behaviors fluctuate between periods of medicalization and criminalization. Strengths-based theory, an offshoot of ‘positive psychology’ that helps contextualize the crimedical …

Extended-Release Injection Vs Sublingual Buprenorphine For Opioid Use Disorder With Fentanyl Use, Edward V. Nunes, Sandra D. Comer, Michelle R. Lofwall, Sharon L. Walsh, Stefan Peterson, Fredrik Tiberg, Peter Hjelmstrom, Natalie R. Budilovsky-Kelley

Behavioral Science Faculty Publications

Importance: Fentanyl has exacerbated the opioid use disorder (OUD) and opioid overdose epidemic. Data on the effectiveness of medications for OUD among patients using fentanyl are limited.

Objective: To assess the effectiveness of sublingual or extended-release injection formulations of buprenorphine for the treatment of OUD among patients with and without fentanyl use.

Design, Setting, and Participants: Post hoc analysis of a 24-week, randomized, double-blind clinical trial conducted at 35 outpatient sites in the US from December 2015 to November 2016 of sublingual buprenorphine-naloxone vs extended-release subcutaneous injection buprenorphine (CAM2038) for patients with OUD subgrouped by presence vs absence of fentanyl …

Rare Variant Analyses Validate Known Als Genes In A Multi-Ethnic Population And Identifies Antxr2 As A Candidate In Pls, Tess D. Pottinger, Joshua E. Motelow, Gundula Povysil, Cristiane A. Martins Moreno, Zhong Ren, Hemali Phatnani, The New York Genome Center Als Sequencing Consortium, Timothy J. Aitman, Javier Santoyo‑Lopez, Scottish Genomes Partnership, Hiroshi Mitsumoto, Als Cosmos Study Group, Pls Cosmos Study Group, Gtac Investigators, David B. Goldstein, Matthew B. Harms

Neurology Faculty Publications

Background Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting over 300,000 people world‑ wide. It is characterized by the progressive decline of the nervous system that leads to the weakening of muscles which impacts physical function. Approximately, 15% of individuals diagnosed with ALS have a known genetic variant that contributes to their disease. As therapies that slow or prevent symptoms continue to develop, such as antisense oligonucleotides, it is important to discover novel genes that could be targets for treatment. Additionally, as cohorts continue to grow, performing analyses in ALS subtypes, such as primary lateral sclerosis (PLS), becomes possible …

Correction: Bayesian Kinetic Modeling For Tracer-Based Metabolomic Data, Xu Zhang, Ya Su, Andrew N. Lane, Arnold Stromberg, Teresa Whei-Mei Fan, Chi Wang

Statistics Faculty Publications

No abstract provided.

Astrocytic Mitochondrial Transfer To Brain Endothelial Cells And Pericytes In Vivo Increases With Aging, Gopal V. Velmurugan, Hemendra J. Vekaria, Samir P. Patel, Patrick G. Sullivan, W. Brad Hubbard

Neurology Faculty Publications

Intercellular mitochondrial transfer (IMT) is an intriguing biological phenomenon where mitochondria are transferred between different cells and notably, cell types. IMT is physiological, occurring in normal conditions, but also is utilized to deliver healthy mitochondria to cells in distress. Transferred mitochondria can be integrated to improve cellular metabolism, and mitochondrial function. Research on the mitochondrial transfer axis between astrocytes and brain capillaries in vivo is limited by the cellular heterogeneity of the neurovascular unit. To this end, we developed an inducible mouse model that expresses mitochondrial Dendra2 only in astrocytes and then isolated brain capillaries to remove all intact astrocytes. …

Astrocytic Stress Response Is Induced By Exposure To Astrocyte-Binding Antibodies Expressed By Plasmablasts From Pediatric Patients With Acute Transverse Myelitis, Chad Smith, Kiel M. Telesford, Sara G. M. Piccirillo, Yamhilette Licon‑Munoz, Wei Zhang, Key M. Tse, Jacqueline R. Rivas, Chaitanya Joshi, Dilan S. Shah, Angela X. Wu, Ritu Trivedi, Scott Christley, Yu Qian, Lindsay G. Cowell, Richard H. Scheuermann, Ann M. Stowe, Linda Nguyen, Benjamin M. Greenberg, Nancy L. Monson

Neurology Faculty Publications

Background Pediatric acute transverse myelitis (ATM) accounts for 20–30% of children presenting with a first acquired demyelinating syndrome (ADS) and may be the first clinical presentation of a relapsing ADS such as multiple sclerosis (MS). B cells have been strongly implicated in the pathogenesis of adult MS. However, little is known about B cells in pediatric MS, and even less so in pediatric ATM. Our lab previously showed that plasmablasts (PB), the earliest B cell subtype producing antibody, are expanded in adult ATM, and that these PBs produce self‑reactive antibodies that target neurons. The goal of this study was to …

Using Digital Pathology To Analyze The Murine Cerebrovasculature, Dana M. Niedowicz, Jenna L. Gollihue, Erica M. Weekman, Panhavuth Phe, Donna M. Wilcock, Christopher M. Norris, Peter T. Nelson

Neurology Faculty Publications

Research on the cerebrovasculature may provide insights into brain health and disease. Immunohistochemical staining is one way to visualize blood vessels, and digital pathology has the potential to revolutionize the measurement of blood vessel parameters. These tools provide opportunities for translational mouse model research. However, mouse brain tissue presents a formidable set of technical challenges, including potentially high background staining and crossreactivity of endogenous IgG. Formalin-fixed paraffin-embedded (FFPE) and fixed frozen sections, both of which are widely used, may require different methods. In this study, we optimized blood vessel staining in mouse brain tissue, testing both FFPE and frozen fixed …

Anterior Circulation Location-Specific Results For Stent- Assisted Coiling – Carotid Versus Distal Aneurysms: 1- Year Outcomes From The Neuroform Atlas Stent Pivotal Trial, Ricardo A. Hanel, Gustavo M. Cortez, Brian T. Jankowitz, Eric Sauvageau, Amin Aghaebrahim, Eugene Lin, Ashutosh P. Jadhav, Bradley Gross, Ahmad Khaldi, Rishi Gupta, Donald Frei, David Loy, Lori Lyn Price, Steven W. Hetts, Osama O. Zaidat, Atlas Investigators

Neurology Faculty Publications

Background The Neuroform Atlas Stent System is an established treatment modality for unruptured anterior and posterior circulation intracranial aneurysms. Location-specific results are needed to guide treatment decision- making. However, it is unclear whether there are differences in safety and efficacy outcomes between carotid and more distal anterior circulation aneurysms. Methods The ATLAS IDE trial was a prospective, multicenter, single- arm, open-label interventional study that evaluated the safety and efficacy of the Neuroform Atlas Stent System. We compared differences in efficacy and safety outcomes of proximal internal carotid artery (ICA) versus distal and bifurcation anterior circulation aneurysms.

Results Of 182 cases, …