Digital Commons Network^™

The Status Of Children’S Dental Health In Rural Appalachian West Virginia, R. Constance Wiener, Gina Graziani

Journal of Appalachian Health

Introduction: Non-metro/rural Appalachian West Virginia (WV) residents have been stigmatized for poor oral health (OH), despite many advances.

Purpose: The aims of this study were to examine current OH in children in WV, as compared to children in the greater United States (U.S.), and secondarily in subgroup non-metro/rural comparisons.

Methods: This observational study involved the U.S. National Survey of Children’s Health 2022–2023 data from parents/guardians who were asked about their child’s previous 12-month OH. Rao-Scott Chi-square and logistic regression analyses were used.

Results: Nationally, the mean age was 9.7 years; for WV children, it was 9.9 years. Nationally, 12.4% of …

Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland

Journal of Appalachian Health

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …

Person-Centered Trauma-Informed Care (Pctic): A Training Needs Assessment For Home And Community-Based Services In West Virginia, Ranjita Misra, A. Brianna Sheppard, Natalie Wilson, Megan C. Govindan, Matthew Myers, Amanda Acord-Vira, Steven Wheeler, Heather Henderson, Christena Ross, Laura Cooper, Rachel A. Goff

Journal of Appalachian Health

Introduction: Person-centered, trauma-informed care (PCTIC) is a combined, holistic service model promoting the well-being and empowerment of trauma survivors.

Purpose: This study examined the PCTIC knowledge, skills, and abilities needed by West Virginia (WV) Medicaid Home and Community-Based Services (HCBS) direct service professionals (DSPs) to serve clients that may have experienced trauma.

Methods: Semi-structured interviews were conducted with diverse stakeholders (n = 32) from 19 organizations that provide HCBS services in all 55 counties. Interviews focused on identifying current training, needs and knowledge gaps, and priority areas for additional PCTIC training. ATLAS.ti software was used to manage and code. Validity …

Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson

Journal of Appalachian Health

Introduction: Radon, a radioactive gas, poses significant health risks, including lung cancer, and is prevalent in indoor environments. Understanding radon testing behavior and Environmental Health Literacy (EHL) is crucial for individuals to take appropriate preventive measures.

Purpose: This study assessed radon-related EHL among Health Council participants in seven Northeast Tennessee (NETN) counties and examined associations between sociodemographic factors and EHL levels. Understanding radon knowledge and behaviors within this influential group is critical, as they often serve as trusted public health advocates.

Methods: A cross-sectional survey was conducted from September – November 2023 among Health Council participants across seven counties in …

Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener

Journal of Appalachian Health

Introduction: Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.

Purpose: The purpose of this cross-sectional study is to determine the likelihood …

Finding Community: A Thematic Analysis Of Resilience During The Pandemic, Myles Kwitny, Quinn Richards, Grace Digirolamo, Shannon Freedman, Sophie Wenzel

Journal of Appalachian Health

Introduction: The Covid-19 pandemic impacted those within rural Appalachian communities, particularly people with marginalized identities.

Purpose: Through interviewing 44 participants from New River Valley, an Appalachian community in Virginia, this study sought to understand how resilience impacted individuals' experiences during the pandemic.

Methods: Participants belonged to one of the following groups: African American, Hispanic, older adults, or people who use drugs. Participants were required to reside in the New River Valley and be older than 18. Each participant was interviewed either in person, by phone, or over video call. Interviews were recorded, transcribed, then thematically analyzed for themes of resilience. …

Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold

Journal of Appalachian Health

Introduction: The Southwest Virginia Health Authority (SWVHA) recently commissioned a community health needs assessment (CHNA) to reduce the high rate of preventable health problems in Virginia’s (VA) Appalachian Region. The CHNA took place over a two-year period from 2023 – 2025.

Purpose: This iterative, mixed-method CHNA informed the development of a new iteration of the regional Blueprint for Health Improvement and Health-Enabled Prosperity identifying and prioritizing health issues and develop strategic planning to address them in VA’s three westernmost regional health districts.

Methods: The CHNA followed a sequential mixed methods design to assess the regional health status, the contextual factors …

Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow

Journal of Appalachian Health

State and local governments across Appalachia are allocating opioid-settlement dollars over the coming years. This funding opportunity can support lasting public health infrastructure or be spent on short-term programs anchored in the opioid crisis of the past. Evidence indicates that emerging synthetic drugs such as nitazenes and xylazine are altering overdose risk patterns in ways that require urgent policy attention.

Magnolia Tapichalacaensis (Magnoliaceae), A New Species From The Andean Foothills Of Zamora Chinchipe, Ecuador, Álvaro J. Pérez, Edison Rea, Jennifer Martínez, Fanny Hidalgo, Franco Mendoza, Ramiro Mendoza, Nelson Jaramillo Díaz, Fredy Archila, Kevin S. Burgess, Rosana Zenil-Ferguson, J. Antonio Vázquez-García

Biology Faculty Publications

The number of new species of Ecuadorian Magnolia Linnaeus (1753: 535) continues to increase as exploration of the Andes progresses. Currently, 24 species of Magnolia are recorded for Ecuador (Vázquez-García et al. 2012, 2013, 2015a, 2015b, 2016, 2017, 2018, Arroyo et al. 2013a, 2013b, 2019, Pérez et al. 2016, 2023), which belong to M. sect. Splendentes Dandy in Vázquez (1994: 4) and Talauma Baillon (1866: 3) (Wang et al. 2020), the former consisting of six species, including the new species described here, and the latter 19 species. There are 17 endemic species in Ecuador, three of which also occur in …

Integrated Clinical Research Ensembles, Sergey Tarima, John R. Meurer, David Friedland, Ndidiamaka Ojiako, Michael Anello, David Zimmerman, Renee Mccoy, Reza Shaker

Biostatistics Faculty Publications

Introduction: The study objective was to evaluate whether the formation and funding of team science-guided Integrated Clinical Research Ensembles (ICREs) enhance individual faculty productivity, measured by publication and impact factor adjusted citation rates. The setting was a multi-institutional NIH Clinical and Translational Science Award-supported hub. Methods: Monthly faculty publication and impact factor adjusted citation rates were analyzed using data extracted from the hub-managed Faculty Collaboration Database (FCD). The FCD imports indexed publications for all faculty members across four academic institutions, drawing from PubMed and faculty curriculum vitae. Monthly publication counts were modeled using Poisson regression, fitted using generalized estimating equations …

Performance Evaluation Of Kytc Bridge Deck Overlays Used For Maintenance Activities, Sudhir Palle, Christopher Goff

Kentucky Transportation Center Research Report

State departments of transportation use bridge deck overlay systems to prolong bridge deck service lives. Consisting of a thin layer of material applied to a concrete bridge deck surface, overlays form a protective barrier that improves ride quality, protects embedded reinforcement from harsh environmental conditions, enhances structure durability, and improves deck drainage. Over the past 20 years, the Kentucky Transportation Cabinet has made significant investments in overlays, rehabilitating nearly 5,000 bridge decks with them — roughly ¹/₃ of all bridges statewide. Given the significant investment in overlays, and the fact they degrade over time — eventually re-exposing bridge …

Formation Of A Prism-Focused Working Group To Address Mcrs Issues And Expanded Prism Requirements, Brian Howell, Robin Baskette, Jennifer Walton

Kentucky Transportation Center Research Report

This study, sponsored by the International Registration Plan (IRP), Inc. in partnership with the Kentucky Transportation Center (KTC), examined systemic challenges and opportunities to strengthen two critical safety oversight mechanisms in U.S. commercial vehicle operations—the Motor Carrier Responsible for Safety (MCRS) and the Expanded Performance and Registration Information Systems Management (PRISM) program. The research traced the evolution of federal and state data systems used to identify and monitor carriers, emphasizing the modernization role of the IRP Data Repository (IDR). The IDR now provides a secure, centralized platform for daily vehicle registration data and financial transactions, facilitating the exchange of carrier …

The First Complete Assembly For A Lungless Urodelan With A “Miniaturized” Genome, The Northern Dusky Salamander (Plethodontidae: Desmognathus Fuscus), Edward A. Myers, Alexander A. Stewart, Aidan E. O’Brien, Jeramiah J. Smith, R. Alexander Pyron

Biology Faculty Publications

Salamanders have some of the largest genomes among animals, driven primarily by expansion of repeat elements and slow rates of DNA loss. However, species in the lungless genus Desmognathus (Plethodontidae) have some of the smallest genomes at ∼13 to 15 GB, though previous sequencing attempts with short-read assemblies were still fragmentary. Here, we assemble an annotated draft genome of Desmognathus fuscus using PacBio HiFi reads and transcriptomic data from 2 specimens from the same population. The combined dataset resulted in a 16.1 GB assembly in 19,632 contigs and an L/N50 of 2,459/1.74 MB, with the longest contig at 27.9 MB. …

Kentucky Model Minimum Uniform Crash Criteria (Mmucc) Sixth Edition Report Card, William Staats, Nikiforos Stamatiadis, Eric Green, Nathaniel Swallom

Kentucky Transportation Center Research Report

The National Highway Traffic Safety Administration published the Model Minimum Uniform Crash Criteria (6th Edition) (MMUCC) in 2024. This updated version of the MMUCC contains recommendations for improving and standardizing electronic crash data. Its guidelines address the collection and presentation of 105 data elements and 1,056 data attributes. To facilitate a possible redesign of Kentucky’s crash reporting process, Kentucky Transportation Center (KTC) researchers reviewed the updated criteria and evaluated the degree to which the state complies with its recommended methods of gathering, storing, and presenting crash data. At the level of data elements, Kentucky is 25 percent compliant; for data …

A Participatory Photovoice Investigation Of Community Assets, Barriers, And Opportunities To Curb The Opioid Epidemic, P. Balvanz, R. G. Olvera, M. Booty, J. Mcswiggan, C. Damato-Macpherson, S. Ellison, A. Farmer, K. Klingler, A. Kuntz, N. Lewis, C. B. Oser, L. Sprague Martinez, S. Stitzer, H. Surratt, O. Yamoah, A. Berkshire, T. Carter, K. Campbell, S. Dynes, B. Gealy, F. Harris, B. Herrington, S. Matthews, D. Myers, C. Rapier, A. Shouse, S. Szelagowsi, M. Mcgladrey

Sociology Faculty Publications

The opioid epidemic remains an entrenched issue in communities due to its multiple and interrelated risk factors. As part of the HEALing Communities Study, we recruited people with lived experience of substance use disorder and practitioners in the field to participate in multi-session Photovoice projects to contextualize the opioid use landscape in their respective communities. Photovoice combines photography and group discussion to explore concerns and strengths in a community. Researchers facilitated 21 Photovoice projects (N = 127 participants) across 19 communities in the Kentucky, Massachusetts, and Ohio HCS sites. We performed template analysis on the Photovoice discussion transcripts to develop …

Kentucky Traffic Collision Facts Calendar Year 2024 Report, Paul Ross, Eric Green, Christopher Blackden, Kenneth Agent, Christopher Van Dyke

Kentucky Transportation Center Research Report

No abstract provided.

2025 Safety Belt Usage Survey In Kentucky, Erin Lammers-Staats, Derek Young, Kenneth Agent

Kentucky Transportation Center Research Report

No abstract provided.

Irp Commercial Trailer Data Feasibility Study, Brian Howell, Jennifer Walton

Kentucky Transportation Center Research Report

This study evaluates the feasibility for developing and maintaining a comprehensive tractor truck trailer database. The commercial motor vehicle (CMV) community currently lacks a cross-jurisdictional, centralized repository for commercial trailers registered in United States and Canadian jurisdictions. Existing federal databases provide information on interstate commercial motor carriers, vehicles, and drivers but exclude trailers. Similarly, IRP and IFTA do not collect trailer-level data, and trailer data is displayed inconsistently across its customer base. Approximately one fifth of violations in Kentucky during inspections from 2020 to 2022 were attributed to trailers, including worn tires, inadequate brakes or improper registration. The rise of …

Analysis Of Traffic Crash Data In Kentucky 2020-2024, Paul Ross, Eric Green, Christopher Blackden, Christopher Van Dyke

Kentucky Transportation Center Research Report

No abstract provided.

Lung Cancer Prevention Among Appalachian Kentucky Women, Jessica R. Thompson, Nancy E. Schoenberg, Pamela C. Hull

Anthropology Faculty Publications

Purpose: Appalachian Kentucky (KY) residents experience the highest lung cancer rates in the US with declines lagging among women; we sought to uncover barriers and facilitators to lung cancer prevention for Appalachian KY women and to identify community-specific interventions. Approach: We utilized concept mapping, a participatory mixed method, to generate consensus on perceived barriers and facilitators. Setting/Participants: We recruited 71 adult women from Appalachian KY counties. Method: After collecting online concept mapping data, we used multidimensional scaling to generate a point map of perceived similarities and hierarchical cluster analysis to create a thematic cluster map. We compared average cluster ratings …

Multidimensional Biocircuitry Of Exercise Adaptation, Jeremy S. Mcadam, Zachary A. Graham, S. Craig Tuggle, Kaleen M. Lavin, Marcas M. Bamman, Jeremy S. Mcadam, Zachary A. Graham, Brandon Peoples, Regina S. Seay, Kaleen M. Lavin, Amber B. Gargus, Sufen Yang, Samia M. O’Bryan, Devin J. Drummer, Christian J. Kelley, Margaret B. Bell, Inmaculada Aban, Gary R. Cutter, Marcas M. Bamman, Michael P. Craig, Jin Zhang, Akshay Hira, Timothy J. Broderick, Madhavi P. Kadakia, Zachary A. Graham, Kalyani Peri, Margaret B. Bell, Inmaculada Aban

Physiology Faculty Publications

In a randomized, dose-response trial, we used molecular and phenomic profiling to compare responses with traditional moder ate-intensity endurance and resistance training (TRAD) versus high-intensity tactical training (HITT) that encompassed explosive whole-body interval training and high-intensity resistance training. Ninety-four participants (18–27 yr) completed 12 wk of TRAD or HITT followed by 4 wk of detraining. Although similar performance and body composition improvements were observed in response to HITT and TRAD, some dose-dependent differences were observed for: 1) ex vivo muscle tissue changes in myofiber size, capillarization, satellite cell frequency, and mitochondrial function and 2) differential gene expression (DGE) of muscle …

Satellite Cells Choreograph An Immune Cell-Fibrogenic Cell Circuit During Mechanical Loading In Geriatric Skeletal Muscle, Nicholas T. Thomas, Camille R. Brightwell, Allison M. Owen, Alexander R. Keeble, Sabin Khadgi, Yuan Wen, Christopher S. Fry, Kevin A. Murach

Physiology Faculty Publications

Muscle stem cells, or satellite cells (SCs), decline in number throughout the lifespan and may become senescent in very old age. Whether and how remaining SCs contribute to muscle adaptation in the oldest-old is unclear. Using acute mechanical overload in geriatric SC replete and depleted mice (28-month-old) combined with single-cell RNA-sequencing, we show: (i) subsets of geriatric SCs display signs of senescence as well as normal fate progression during overload, (ii) SCs express markers that may contribute to the regulation of innervation, (iii) the presence of SCs during overload enhances global intercellular communication and increases mRNA levels of the cell …

One-Pot Synthesis Of Sustainable Aviation Fuel From Brown Grease Using Multifunctional Zeolite-Supported Catalysts, Clara Mongelli, Great Umenweke, Tyler St Clair, Gilles Caboche, Olivier Heintz, Robert Pace, Eduardo Santillan-Jimenez

Chemistry Faculty Publications

The most viable way to decarbonize aviation in the near term is through Sustainable Aviation Fuel (SAF), most of which is currently produced via the deoxygenation of fats, oils, and greases (FOG) followed by a separate isomerization step. Multifunctional zeolite-supported catalysts offer several advantages over existing formulations, such as enabling the use of waste FOG streams, performing their deoxygenation via decarboxylation/decarbonylation (deCO_x), and effecting the synthesis of SAF in one-pot. Previous work has shown that while supported Ni-Cu catalysts can afford excellent results in the conversion of waste FOG to fuel-like hydrocarbons via deCO_x, zeolitic materials …

Noncontact Diffuse Optical Imaging Of Blood Flow And Oxygenation Distributions In Reconstructive Rat Skin Flaps, Samaneh Rabienia Haratbar, Fatemeh Hamedi, Mehrana Mohtasebi, Faraneh Fathi, Faezeh Akbari, Dara Singh, L. I.U. Xuhui, Li Chen, Lesley Wong, Lei Chen, Guoqiang Yu

Surgery Faculty Publications

Perioperative identification of ischemic-hypoxic tissue is essential for reducing the risk of mastectomy skin flap necrosis (MSFN), a major complication following mastectomy. Implant-based breast reconstruction is jeopardized in the presence of MSFN. However, existing technologies are limited by depth insensitivity, dye-related risks, the need for contact sensors, and an inability to simultaneously assess both blood flow and oxygenation. A multi-wavelength speckle contrast diffuse correlation tomography (MW-scDCT) system was developed for noncontact, dye-free, and depth-sensitive imaging of tissue hemodynamics in a rat model incorporating four distinct flap scenarios: sham (SH), implant (IM), half necrosis (HN), and full necrosis (FN), representing varying …

Identification Of Metabolic Pathways And Hub Genes Associated With Ultrasound Subcutaneous Fat And Muscle Depth Of The Longissimus Muscle In Cull Beef Cows Using Gene Co-Expression Analysis, Harshraj Shinde, Kyle R. Mcleod, Jeffrey W. Lehmkuhler

Animal and Food Sciences Faculty Publications

Beef production is an important component of the world’s food supply, with production being near 59 million tons in 2023 (USDA, 2023). Enhancing our understanding of the factors influencing metabolism will lead to improvements in production efficiency. Using RNA-seq and WGCNA of longissimus muscle samples, gene expression and metabolic pathway analyses were performed to examine relationships with ultrasound and body mass variables. In this study, body weight (BW), ultrasound back fat (BF), ultrasound muscle depth (MD), and body condition score (BCS) were traits recorded for 18 cull beef cows. As expected, all production-related traits monitored (WT, BF, MD, and BCS) …

Prospective Cohort Study Of Fentanyl Test Strip Use And Distribution In Three States, Janet E Childerhose, Kitty Gelberg, Rachel Vickers-Smith, Megan E Dzurec, Emmanuel Oga, Mallory Harris, Rachel Caspar, Denise C Babineau, Megan E Hall, Beth S Linas, Katherine E Marks, Amanda Fallin-Bennett, Laura C Fanucchi, Louisa Gilbert, James L David, Mary Russo, Kathryn E Lancaster, Soledad Fernandez, Michael Konstan, Redonna K Chandler, Carter Roeber, Jennifer Villani, Rebecca D Jackson, Bridget Freisthler, Sharon L Walsh, Nabila El-Bassel

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: The Stay Safe Study is the first observational prospective cohort study investigating fentanyl test strip (FTS) use by people who use drugs (PWUD) and distribution by community organizations that provide harm reduction services (e.g., naloxone distribution) in three states (Kentucky, New York, and Ohio). The purpose of this paper is to describe the study design, along with implementation successes and challenges. A related goal is to provide recommendations and encourage researchers to undertake multi-state and multilevel studies of FTS use and distribution.

METHODS: The Stay Safe Study has one primary, five secondary, and three exploratory objectives. From May-December 2023, …

Real-Time Dynamic Hazard Maps For Shallow Colluvial Landslides In Eastern Kentucky, Lindsey Sebastian Bryson, Nathaniel O'Leary

Civil Engineering Research Data

Landslide hazards pose a persistent threat to communities and infrastructure in Eastern Kentucky, where steep slopes, shallow colluvial soils, and variable hydrological conditions drive frequent slope failures. This work advances landslide hazard mapping (LHM) through the development of dynamic, spatiotemporal models for shallow colluvial landslides. Two studies refine the use of a limit equilibrium framework to enhance predictive capability. The first study establishes a novel LHM workflow that integrates Hydrus-1D simulations of soil moisture dynamics, driven by precipitation and evapotranspiration data, into slope stability analysis. Factor of Safety (FS) parameters are applied to statistics-based landslide susceptibility maps (LSM), producing accurate, …

Dynamic Remodeling Of Centrioles And The Microtubule Cytoskeleton In The Lifecycle Of Chytrid Fungi, Alexandra F Long, Krishnakumar Vasudevan, Andrew Swafford, Claire M Venard, Jason E Stajich, Lillian K Fritz-Laylin, Jessica L Feldman, Tim Stearns

Biology Faculty Publications

Cell movement and division are complex behaviors driven by a dynamic internal cytoskeleton. The molecular components and principles of cytoskeletal assembly are well studied, but less is known about cytoskeletal remodeling events, including how centrioles transition from ciliary base to centrosome. Here we address this using the chytrid Rhizoclosmatium globosum, a zoosporic fungus which has centrioles and cilia, lost in most fungal lineages. Chytrids undergo reorganization of their microtubule cytoskeleton as they grow from zoospore to multinucleated coenocyte. We use evolutionary comparison, RNA sequencing, and expansion microscopy to understand this reorganization and further develop this organism as a model for …

Fournier Gangrene Is Associated With Increased Length Of Stay And Higher Healthcare Costs Compared To Non-Perineal Necrotizing Soft Tissue Infections, Hayato Mitaka, Kristen Mcquerry, Kelsey Karnik, Alexandre R. Marra, Toshio Naito, Patrick Ten Eyck, Paul G. Auwaerter, Yuji Yamada, Takaaki Kobayashi

Biostatistics Faculty Publications

Background: Fournier gangrene (FG) is a necrotizing soft tissue infection (NSTI) of the perineum. Recent retrospective studies from quaternary centers suggest improved outcomes and a potentially less aggressive clinical course for FG than non-perineal NSTIs. However, comprehensive nationwide data remain limited. Methods: This retrospective cohort study analyzed the National Inpatient Sample (2016-2020) to compare outcomes between FG and non-perineal NSTIs. Adult patients undergoing surgical debridement with a diagnosis of FG or NSTI were identified using ICD-10 codes. Outcomes included in-hospital mortality, length of stay (LOS), hospital costs, and home discharge rates. Multivariable regression analyses adjusted for patient demographics, comorbidities, and …

“Literally Made Me Cry”: The Impact Of Course Material Costs On University Of Kentucky Students, Stephen Krueger

Library Reports and White Papers

The Student Course Materials Cost Survey was administered September 16 – October 6, 2024. It was open to current students at the University of Kentucky (UK). The goals were to help UK Libraries better understand how the cost of course materials affects students at UK and to provide a snapshot of student spending across the university. The questions were based on similar research done at other institutions in Virginia (Virginia Course Materials Survey, 2021) and Florida (2022 Student Textbook and Instructional Materials Survey, 2022). Other work based on those surveys includes the 2023 Illinois Course Materials Survey (CARLI, 2023) and …