Digital Commons Network^™

Variation In The Potentially Inappropriate Use Of Antipsychotic And Benzodiazepine Medications Among Individuals Receiving Residential Medication Management Reviews, Mouna J. Sawan, Alexander J. Clough, Jodie Hillen, Andrew R. Zullo, Daniela C. Moga, Natalie Soulsby, Danijela Gnjidic

Epidemiology and Environmental Health Faculty Publications

Objectives To describe the variation in the use of potentially inappropriate antipsychotic and benzodiazepine medications in residents who have received a medication review and to evaluate the extent to which this variation is associated with aged care home (ACH) and resident characteristics. Methods This cross-sectional, retrospective study used pharmacist-extracted data from 15,442 residents across 342 Australian ACHs who had a medication review during 2019. The proportion of residents receiving ≥1 potentially inappropriate antipsychotic and benzodiazepine medication according to Beers criteria were classified into quintiles by facility usage (Q1-Q5). Quintile characteristics were compared using descriptive analysis of facility and resident data. …

Wetland Treatment Systems For Municipal Wastewater At A Bourbon Distillery And Potential Value Of Incorporating Stillage For Water Treatment Enhancement, Katherine Ristola, Tiffany Messer, Czarena Crofcheck, Tyler Barzee, Wayne Sanderson

Epidemiology and Environmental Health Faculty Publications

The use of constructed treatment wetlands as a secondary treatment method for wastewater effluent from package treatment plants and distillery stillage has the potential to be an innovative, sustainable method for improving water quality. However, the use of constructed wetlands to treat bourbon whole stillage and a distillery bottling facility’s wastewater treatment plant effluent has been limited. Therefore, the objectives of this study were to (1) quantify constructed wetland water quality improvement as a secondary treatment method for a distillery’s municipal wastewater, (2) optimize treatment design to meet wastewater effluent discharge limits, and (3) quantify the potential to enhance constructed …

Thriving In The Tropics, Hansika K. Herath, D. Nicholas Mcletchie

Biology Faculty Publications

Increasing frequency and intensity of global warming pose a profound threat to plant species persistence. Most investigations on plants' resilience to heat events focus on few genotypes of model species. Novel insights into resilience mechanisms will be gained by focusing on natural variation in thermotolerance and its relationship to local-abiotic factors. Additionally, studying species that survived 'ancient periods' of high temperatures provides insight into resilience mechanisms. Within a species, we assessed spatial thermotolerance variation, its association with temperature and light, while testing for thermotolerance sex differences and its relationship with population sex ratios. We used Marchantia inflexa, a species with …

Development Of A Health And Wellness Assessment For Kytc Personnel, Gabriel Dadi, Farshid Taherpour, Caitlin Pope

Kentucky Transportation Center Research Report

Highway construction workers operate in high-stress, hazardous settings where they have to perform physically taxing labor in environments where exposure to variable weather conditions, heavy equipment, high volumes of vehicle traffic, and other conditions that induce stress and anxiety are the norm. Up to 70% of workers in this industry have reported experiencing mental health issues, including secondary traumatic stress, post-traumatic stress disorder, depression, anxiety, and substance abuse disorders. Few state departments of transportation, however, offer adequate resources staff can draw on to effectively manage their psychological well-being. To help Kentucky Transportation Cabinet (KYTC) roadway maintenance and construction workers develop …

Using Photovoice To Define “Community” In Substance Use Disorder Research Engaging Service Users, Providers, And Policymakers, Mcgladrey Margaret L, Marisa Booty, Ramona Olvera, Peter Balvanz, Hilary L. Surratt, Shannon Matthews, Susannah Stitzer, Owusua Yamoah, Sylvia Ellison, Kevin Campbell, Amy Farmer, Bethany Gealy, Mike Greenwell, Felicia Harris, Amy Kuntz, Sara Szelagowski, Alexandrea Shouse, Carrie B. Oser

Sociology Faculty Publications

(197 words)The ideals of community-engaged health research are challenging to realize ethically and methodologically, particularly when focused on substance use disorder (SUD), in which the power differentials inherent to stigma marginalize people with lived experience (LE) as full community participants. This study provides a typology and exploratory data generated through Photovoice to understand relationships among community members with different roles related to LE of SUD (i.e., SUD service providers, service users, and the public) in the context of a large-scale community-engaged opioid overdose reduction intervention. A team of 14 participants and researchers used an adapted thematic analysis method to interpret …

Aggregator Zone Selection For Ev Smart Controls Based-On Ml Clustering Of Grid Strength, Distance, And Charging Homogeneity, Rosemary E. Alden, Sam H. Lowe Ii, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

Smart electric vehicle (EV) charging control methods from a central utility hub often require communication infrastructure over a large service area of electric power distribution systems with a large number of nodes. Industry standards such as Open Charge Point Protocol (OCPP) 2.1 have evolved to include topologies for local controllers to the individual chargers, i.e. EV aggregator zones. A machine learning (ML) application of k-means clustering is proposed to establish zones for coordination of EV charging based on grid strength and EV owner decision-making to charge per day. Very large-scale distribution networks including the IEEE 123 and 8500 benchmark feeders …

Cluster-Based Volt/Var Optimization On A Utility Distribution Feeder With Forecasted Ev Penetration, Steven B. Poore, Grant M. Fischer, Rosemary E. Alden, Evan S. Jones, Aron Patrick, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

With significant increase in EV adoption expected in the near future and the associated impacts on power systems, the effect of volt/var optimization (VVO) as the next step to conservation voltage reduction (CVR), requires reevaluation. Implementation of a cluster-based VVO control strategy employs a novel approach with machine learning (ML) load forecasting to reduce device adjustments through k-means clustering of contiguous time steps with similar active power load in which a single adjustment would be sufficient. The cluster-based VVO method is tested on a complex real world utility distribution feeder with 2,018 nodes, 8.65MW peak load, 9 capacitor banks (CBs), …

Hybrid Fea And Meta-Modeling For De Optimization Of A Pm Stator-Excited Motor With A Reluctance Rotor, Oluwaseun A. Badewa, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

This paper presents an innovative method for designing high-performance electric motors by integrating machine learning (ML) based meta-modeling with a differential evolution (DE) optimization algorithm. The approach utilizes finite element analysis (FEA) data to train the ML meta-model, allowing for efficient optimization of high-power-density machines, such as the reluctance rotor and permanent magnet (PM) stator combined excitation motor, which is characterized by nonlinearities. The meta-modeling process employs an Artificial Neural Network (ANN) with 3 hidden layers and uses the motor’s geometrical variables as inputs. The accuracy of the meta-model in capturing the nonlinear relationships between design parameters, core losses, and …

Three And Two Phase Rotating Field Inductive Couplers For Wireless Power Transfer With One Phase Per Layer Windings, Donovin D. Lewis, Lucas Gastineau, Omer Onar, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

Multiphase inductive wireless charging coils have been proposed recently to improve coupler surface power density, reduce component stress and size, and provide near-constant power delivery to charge mobile electric systems. Several aspects for the fundamental characterization of multiphase coils are explored up to six phases including approximate mutual inductance with size and turn variation, induced voltage, and output power estimation. The relative component stress and size of passive components for resonant operation are compared between the multiphase variants. A combination of an experimentally validated 3D electromagnetic finite element analysis (FEA) and power electronic co-simulations are used to validate the estimated …

Cryogenic Thermal System For Coreless Axial Flux Pm Machine With Litz Wire Winding For Electric Aircraft Propulsion, Matin Vatani, Chaianan Sailabada, Philippe Masson, Juan C. Ordonez, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

Electric machines for aviation demand ultra-efficient, compact designs with high specific power density, which can be achieved through advancements in both electromagnetic design and thermal management. This paper proposes and investigates an integrated thermal management approach for a coreless stator axial flux permanent magnet (AFPM) machine featuring a double-sided Halbach array PM rotor, two stators, and an aluminum nitride (AlN) cold plate positioned between the stators for direct cooling. The cold plate incorporates internal serpentine channels for liquid hydrogen circulation. The electromagnetic performance and efficiency of the machine at cryogenic temperatures are assessed using temperature-dependent data from the literature, indicating …

Mitigation Of Pm Eddy Current Losses Using Offset Windings In Coreless Afpm Machines, Matin Vatani, Diego A. Lopez Guerrero, John F. Eastham, Dan M. Ionel

Electrical and Computer Engineering Graduate Research

Permanent magnet eddy current losses can become substantial in coreless stator axial flux permanent magnet (AFPM) machines operating at high speeds and under high electric loading, potentially leading to elevated temperatures and an increased risk of demagnetization. This paper investigates the origins of these losses through a detailed harmonic analysis of the winding factor and introduces a mitigation strategy. The proposed method utilizes two-layer offset windings, effectively minimizing undesirable armature flux harmonics through harmonic interaction between the offset layers. Two cases are studied: one in which each stator layer is connected to a separate inverter and another in which both …

Research Into Job Classifications For Kentucky Department Of Vehicle Regulation Employees, Mallory Brown, Andrew Martin, Jeeyen Koo, Jennifer Walton

Kentucky Transportation Center Research Report

The Kentucky Department of Vehicle Regulation (DVR) faces persistent challenges with employee recruitment, retention, and workforce alignment due to outdated job classifications and compensation structures. This study investigates if DVR’s reliance on the general Administrative Specialist job series is warranted given the duties performed by its staff. Through a job task analysis, financial modeling, and personnel data review, researchers assessed the feasibility of introducing a new DVR-specific job series based on the Vehicle Regulation Specialist (VRS) position currently being used by the Division of Motor Carriers. The proposed VRS series includes two levels — VRS I (Grade 13) and VRS …

Inferring The Timing Of Antiretroviral Therapy By Zero-Inflated Random Change Point Models Using Longitudinal Data Subject To Left-Censoring, Hongbin Zhang, Mckaylee Robertson, Sarah L. Braunstein, David B. Hanna, Uriel R. Felsen, Levi Waldron, Denis Nash

Biostatistics Faculty Publications

We propose a new random change point model that utilizes routinely recorded individual-level HIV viral load data to estimate the timing of antiretroviral therapy (ART) initiation in people living with HIV. The change point distribution is assumed to follow a zero-inflated exponential distribution for the longitudinal data, which is also subject to left-censoring, and the underlying data-generating mechanism is a nonlinear mixed-effects model. We extend the Stochastic EM (StEM) algorithm by combining a Gibbs sampler with a Metropolis–Hastings sampling. We apply the method to real HIV data to infer the timing of ART initiation since diagnosis. Additionally, we conduct simulation …

The Positive Association Of Physical Activity On Sadness And Suicide Behaviors For Youth Who Have Been Bullied, Katelon Kerns, Kahir Jawad, Yana Feygin, V. Faye Jones, W. David Lohr, Jennifer Le, Kiana Fields, Jennifer Porter, Sarah Ouellette, Theresa Kluthe, Deborah Winders Davis

Biostatistics Faculty Publications

Background: Youth mental health is a public health crisis. Bullying has been associated with adverse mental health outcomes including depression and suicidal ideation. We aimed to update information regarding the associations between bullying and sadness and three suicide-related outcomes, along with the potential moderating effect of physical activity (PA). Methods: Using the 2017–2021 Youth Risk Behavior Surveillance System (YRBSS) with students in grades 9–12 we used descriptive statistics, chi-square tests, and multivariable logistic regressions to examine the association between students who have been bullied and who reported feeling sad or hopeless, as well as considered, planned, and/or attempted suicide, within …

From Gains To Liver Pain, Benjamin I. Burke, John J. Mccarthy, Ahmed Ismaeel

Physiology Faculty Publications

A recent study from Liu et al. described the role of skeletal muscle-derived extracellular vesicles in promoting liver fibrosis as an outcome of chronic overtraining in mice. Here, we highlight this work and discuss its implications within the fields of exercise physiology and inter-organ communication.

Male Layer-Type Birds (Lohmann Brown Classic Hybrid) As A Meat Source For Chicken Pâtés, Nikolay Kolev, Desislav Balev, Stefan Dragoev, Teodora Popova, Evgeni Petkov, Krasimir Dimov, Surendranath Suman, Ana Paula Salim, Desislava Vlahova-Vangelova

Animal and Food Sciences Faculty Publications

The valorisation of underutilized male layer-type chickens offers a sustainable and ethically aligned opportunity for the poultry industry. This study evaluated the feasibility of male layer-type chicken meat in the production of chicken pâtés and compared the effects of different meat sources—commercial broiler (CP), and 5 (5wP) and 9-week-old (9wP) male layer-type chickens—on product quality during refrigerated storage using the general linear model with the Tukey–Kramer post-hoc test. Pâtés made from 5wP meat exhibited the most favourable technological properties, including the lowest (p < 0.05) total expressible fluid (TEF), highest (p < 0.05) water retention (TEF_Water), and lowest (p < 0.05) fat content (TEF_Fat) than CP and 9wP indicating superior emulsion stability. The 5wP …

Development And Evaluation Of A Simple Human Body Link Model Considering The Degrees-Of-Freedom Of Shoulders, Mizuki Takeda, Yuki Saito, Kaiji Sato

Progress in Scale Modeling, an International Journal

Modeling of the human body is widely utilized in the field of human–robot interaction, warranting the development of a simple model to measure and recognize the human body movements. To this end, a two-dimensional (2D) human body link model in the sagittal plane has been used to represent the human body with rotating joints and links connecting these joints. The joint positions can be determined by using the coordinates of a limited number of points on the links and estimated using a few sensor outputs when the links are of constant length. However, models with constant link lengths may result …

Prediction Of The Digestible And Metabolizable Energy Content Of Forages From Their Chemical Composition And Organic Matter Digestibility, J Andrieu, C Demarquilly

IGC Proceedings (1977-2023)

In France, the 'net energy' system (INRA, 1978) permits cal­culation of the net energy (NE) of a feed in an analytical manner: NE = GE x Ed x ME/DE x k

where GE, DE and ME are respectively the gross, digestible and metabolisable energy contents, Ed the energy digestibility and k the net availability of ME for lactation, maintenance or fattening. The publication of Feed Tables (Demarquilly et al., 1978) and their revision (Andrieu et al., 1988) led to re&.earch on whether it is possible to predict the different terms of this formula, at least as far as the ME, …

La Consommation De Matiere Sche De Fourrages Disponibles En Zone Tropicale, D Richard, H Guerin, G Roberge, D Friot

IGC Proceedings (1977-2023)

Un certain nombre de publications fournissent des donnees sur les consommations de matiere seche (MS) des fourrages dans les regions intertropicales sans qu'il soit toujours possible de differencier les variations liees a la capacite d'ingestion de !'animal ou a l'ingestibilite du fourrage, facteurs conditionnant les quantites de matiere seche volontairement ingerees (MSVI). Par ailleurs, les donnees publiees pour un meme fourrage sont souvent tres variables ; par exemple, les quantites de MSVI de Digitaria decumbens extraites de 5 publications varient de plus de 40 p. 100 pour des repousses de meme age (Richard, 1987) sans qu'il soit possible d'identifier les …

Enhancing Communication For Individuals With Complex Communication Needs: The Critical Role Of Training And Evidence-Based Aac Strategies, Rachel H. Williams

Early Childhood, Special Education, and Counselor Education Faculty Publications

Communication is a basic human right, as affirmed by the National Joint Committee for the Communication Needs of Persons with Severe Disabilities (NJC, 2024). For individuals with complex communication needs (CCN), special considerations must be taken into account to ensure equitable access to this right and must be supported through appropriate services, tools, and strategies. Augmentative and alternative communication (AAC) systems are essential for many individuals with CCN, enabling access to expressive and receptive language. However, successful AAC implementation requires well-trained educators, speech-language pathologists, and support staff who understand how to assess, model, and support communication effectively (Brady et al., …

Impact Wv: Adapting Patient Navigation Models Of Care To Improve Services To Caregivers Of Infants Exposed To Substances In Utero, Charlotte S. Workman Bsms, Ccrp, Lesley Cottrell, Mawyah Bashatah, Aisha Hashmi, Kayla Richard, Poornima Murthy, Susan Harrison, Ashleigh Mckinsey, Amy Bott, Sydney Leary, Cody Smith, Melina Danko

Journal of Appalachian Health

Patient navigation (PN) is a healthcare service delivery model designed to partner clients with service providers to reduce challenges to health care, as well as to improve access to care by identifying opportunities to coordinate services for clients. The IMPACT WV project at the West Virginia University Center for Excellence in Disabilities (WVU CED) implemented PN models of care for caregivers of infants exposed to substances in utero. The purpose of this program was to reduce burden for potentially at-risk families and improve caregiver and infant outcomes as a result. To understand the processes that influence the implementation of PN …

Drive Time Analysis Of New Gynecologic Oncology Patients At West Virginia University, Kassandra Whitfield, Ariel Cohen, Krista Pfaendler, Kristy Ward

Journal of Appalachian Health

Introduction: West Virginia is a rural mountain state; access to medical care, especially specialty care, can be difficult for patients.

Purpose: The purpose of this study is to analyze the geographic status and transportation times of new gynecologic oncology patients.

Methods: Home zip codes for new patient gynecologic oncology patients were analyzed for drive times to the cancer center. Zip codes of oncology providers in the state were compared to the location of patients.

Results: A total of 1,097 new gynecologic oncology patients lived within a 240-minute drive of MBRCC; nearly half (48.9%) of them drove greater than 60 minutes. …

Tailoring Statewide Training For Local Impact: A Burke County Public Health Case Study, Miranda Smith, Ashley Jarrett, Danny Scalise, Samantha Simmons

Journal of Appalachian Health

Addressing health-related social needs is crucial for improving health outcomes, especially for vulnerable populations. NCCARE360 is North Carolina’s statewide coordinated care platform powered by Unite Us.¹ Burke County Public Health (BCPH) identified gaps in the standardized NCCARE360 training, prompting a tailored approach. Using the Plan-Do-Study-Act cycle, BCPH refined training materials with interactive guides, real-life scenarios, and one-on-one sessions. This adaptation led to increased staff engagement and improved referral outcomes. Recognized as a model for local implementation, BCPH’s approach signifies the importance of customizing statewide initiatives to meet local operational realities. This case highlights the value of iterative training improvements …

Patient-Clinician Communication In The Appalachian Region: A Scoping Review, Kawther Al Ksir, Hadii M. Mamudu, Chidiebube J. Ugwu, Emily K. Flores, Tracy Fasolino, Holly Wei, Rick L. Wallace, Florence M. Weierbach

Journal of Appalachian Health

Introduction: Effective communication between patients and clinicians is a critical component of quality health care, influencing disease prevention, management, and outcomes. In regions with unique socioeconomic and geographic challenges, communication barriers can further exacerbate health disparities. Understanding the factors that facilitate or hinder patient-clinician communication is essential for developing targeted interventions that improve health care delivery.

Purpose: This review explores the existing literature on patient-clinician communication concerning cardiovascular disease (CVD) in the Appalachian Region with the aim to understand existing gaps and interventions.

Methods: PubMed and Web of Science databases were utilized to conduct a systematic search. The Population, Concept, …

Using Photovoice To Define The Experiences, Needs, Strengths, And Priorities Of Gay Men In South Central Appalachia, Ana D. Sucaldito, Lilli Mann-Jackson, Jorge Alonzo, John W. Chaffin, Scott D. Rhodes

Journal of Appalachian Health

Introduction: Gay, bisexual, queer, and other men who have sex with men and transgender and nonbinary persons living in rural Appalachia experience profound health disparities. Limited research, however, has focused on the needs, strengths, and priorities of these communities.

Purpose: This study sought to better understand the lived experiences of the vulnerable, underrepresented, and underserved Appalachian gay male community by working with a small group of self-identified gay Appalachian men.

Methods: As part of a larger community-based participatory research study (the Appalachian Access Project), four self-identified gay men participated in a photovoice project. Participants took photos based on …

Determinants Of Willingness To Share Wearable Health Data With Health Care Providers In Appalachian Populations: An Exploratory Study, Gilbert Munoz Cornejo, Joonghee Lee

Journal of Appalachian Health

Background: Wearable health devices capture metrics (e.g., physical activity, ECG, sleep) that can enhance care when shared with providers. Yet, willingness to share wearable data may differ in Appalachia, where chronic disease burdens, mistrust, and limited infrastructure pose unique challenges.

Objective: This study explored (1) which sociodemographic, health, and digital behaviors correlate with willingness to share wearable data and (2) how these insights can guide region-specific interventions in Appalachia.

Methods: We analyzed 320 Appalachian respondents from the Health Information National Trends Survey (HINTS 6). Descriptive statistics and logistic regression models examined willingness to share wearable data. Because of small cell …

Heartache In The Heartland: Unraveling The Social Roots Of Deaths Of Despair In Kentucky, Lyndsey K. Blair, Madeline M. Tomlinson, Michele Abee-Biskis, Jessica Hume, Gabri Warren

Journal of Appalachian Health

Introduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.

Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The …

Finding Freedom In Appalachia: Evaluating A Mental Health Intervention In West Virginia, Elizabeth A. Claydon, Karen Haring, Jessica Haring, Kelsey Riggi, Beth Currence

Journal of Appalachian Health

Introduction: Rural areas have limited capacity to provide comprehensive mental health treatment and resources. This creates the need for interventions to ensure individuals with mental health concerns have access to resources to improve their mental health.

Purpose: The purpose of this mixed-methods evaluation was to assess the effectiveness and impact of Libera, a mental health program tailored for girls and women within the Appalachian region.

Methods: Quantitative surveys, including validated measures for depression, anxiety, and eating disorder symptoms, and life satisfaction, were collected pre- and post-Libera intervention for participants. Simultaneously, annual surveys were sent to Listeners in addition to qualitative …

Time And Location: Physical Activity Trends In Parents And Children In A Rural Region During Covid-19, Brooke C. Towner, Robert Broce, Rebecca A. Battista

Journal of Appalachian Health

Introduction: COVID-19 restrictions altered the structure of the school and workday for families with children and led to changes in active transportation. Continued restrictions impacted access to many community locations and led to changes in physical activity (PA) behavior.

Purpose: The objectives of the study were to describe the changes in the 1) amount of PA time per day, 2) frequency of PA, and 3) sitting time. Information about how PA changed for parents and children during the COVID-19 pandemic will have potential implications for education, public health, and recreation management.

Methods: This cross-sectional study enlisted participants via an online …

Children Living With Type 1 Diabetes In The Public School System, Madison M. Wilson

Kentucky Undergraduate Journal for the Health Humanities

Type 1 Diabetes is a worldwide chronic condition that typically develops during adolescence and requires life-long treatment and management. Management of this disease is extremely complicated for a child to manage on their own and requires a community of individuals to help them. With children spending most of their days at school, the school’s teachers and staff are vital to the care and management of their condition while attending public school. Children with Type 1 Diabetes in public school systems face many disparities and a reform is needed. Looking at this population through a holistic health science lens can help …