Digital Commons Network^™

Impact Of Fast Advancement And Early Fortification Of Enteral Feedings In Preterm Infants, A Retrospective, Observational Study., Enrique Gomez-Pomar, Holly Clarke, Jamie Adams

Pediatrics Faculty Publications

UNLABELLED: We aimed to evaluate the outcomes and growth of preterm infants at a Neonatal Intensive Care Unit that focuses on early initiation, fast advancement, and early fortification of enteral feeds.

METHODS: Retrospective study conducted at a community hospital level III NICU. Extensive feeding data and outcomes were collected by utilizing a NutritionIQ software application, NICUtrition®. Infants born between 26- and 34-weeks gestational age were included, whereas infants with congenital defects, deceased or with incomplete data were excluded. Frequency and descriptive statistical analysis were conducted using chi-square and Fisher's exact test. Unadjusted odds ratios were computed for categorical variables and …

Affordable Miniaturized Speckle Contrast Diffuse Correlation Tomography Device For Depth-Sensitive Mapping Of Cerebral Blood Flow In Rodents, Fatemeh Hamedi, Faezeh Akbari, Mehrana Mohtasebi, Chong Huang, Li Chen, Lei Chen, Guoqiang Yu

Biomedical Engineering Faculty Publications

Significance: Continuous and longitudinal monitoring of cerebral blood flow (CBF) is critical for understanding brain pathophysiology and guiding interventions. Although rodents are the primary models in neuroscience, existing imaging modalities often fail to provide the optimal combination of low cost, high spatiotemporal resolution, wide head coverage, and sufficient penetration depth for small-animal brain imaging.

Aim: Leveraging a clinical speckle contrast diffuse correlation tomography (scDCT) system, we aimed to develop an affordable, user-friendly, fast, and miniaturized scDCT (mini-scDCT) device tailored for depth-sensitive CBF imaging in small rodents.

Approach: The mini-scDCT replaces bulky and costly optoelectronic components with compact, low-cost alternatives while …

A 40-Week Phase 2b Randomized, Multicenter, Double-Blind, Placebo-Controlled Study Evaluating The Safety And Efficacy Of Memantine In Amyotrophic Lateral Sclerosis, Salman Bhai, Todd Levine, Dan Moore, Robert Bowser, Andrew J. Heim, Maureen Walsh, Aziz Shibani, Zachary Simmons, James Grogan, Namita A. Goyal, Raghav Govindarajan, Yessar Hussain, Tania Papsdorf, Tiffany Schwasinger-Schmidt, Nick Olney, Kim Goslin, Michael Pulley, Edward J. Kasarskis, Michael Weiss, Susan W. Katz, Suzan Moser, Duaa Jabari, Omar Jawdat, Jeffrey Statland, Mazen M. Dimachkie, Richard Barohn, Neuromuscular Study Group And Western Als Consortium Memantine Als Study Group

Neurology Faculty Publications

Introduction: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies.

Aims: This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020. ALS patients were enrolled in-person and remotely across 13 sites in the United States. Participants were randomized to memantine (20 mg twice daily) or placebo in a 2:1 ratio …

Interaction Between Riluzole Treatment And Dietary Glycemic Index In The Disease Progression Of Amyotrophic Lateral Sclerosis, Ikjae Lee, Hiroshi Mitsumoto, Seonjoo Lee, Edward J. Kasarskis, Michael Rosenbaum, Pam Factor-Litvak, Jeri W. Nieves

Neurology Faculty Publications

Objective: We examined whether riluzole treatment modifies the associations between the dietary glycemic index (GI) and load (GL) and disease progression in amyotrophic lateral sclerosis (ALS).

Methods: Sporadic ALS patients in the Multicenter Cohort Study of Oxidative Stress who completed a baseline food frequency questionnaire were included (n = 304). Interactions between baseline riluzole treatment and GI/GL on functional decline and tracheostomy-free survival were examined using linear regression and Cox proportional hazard models adjusted for covariates. Age, sex, disease duration, diagnostic certainty, body mass index, bulbar onset, revised ALS functional rating scale (ALSFRS-r) total score, and forced vital capacity, from …

Blood Biomarkers In Down Syndrome: Facilitating Alzheimer’S Disease Detection And Monitoring, Melissa E. Petersen, Lisi Flores-Aguilar, Elizabeth Head, Laia Montoliu-Gaya, Andre Strydom, Sarah E. Pape, Juan Fortea, Nicholas J. Ashton, Chinedu Udeh-Momoh, Sid E. O’Bryant, Dwight German, Florin Despa, Mark Mapstone, Henrik Zetterberg

Neurology Faculty Publications

Blood-based biomarkers continue to be explored for disease detection, monitoring of progression, and therapeutic outcomes as the diagnostic determination of Alzheimer’s Disease in Down Syndrome (DS-AD) remains challenging in clinical settings. This perspective highlights the current status of this effort. Overall, amyloid (A), tau (T), and neurodegeneration (AT[N]) blood-based biomarkers have been shown to increase with disease pathology for individuals with DS. Phosphorylated tau biomarkers (p-tau217, p-tau181) have been consistently shown to track disease progression for DS-AD and are likely good candidates for use in clinical settings. Biomarkers of inflammation (glial fibrillary acidic protein) also show promise; however, additional work …

Bones And Brains: The Association Between Osteoporosis And Depression, Mason Taylor

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

Introduction: Osteoporosis and depression are two public health problems that are increasing in prevalence. Previous studies have found a positive association between the two variables in women and men and women together, but there is a gap when looking at men. Therefore, it was important to investigate the odds of depression in men, women, and men and women together to make comparisons by sex.

Methods: 1,602 participants aged 65 and older were included in the study from the National Health and Nutrition Examination Survey (NHANES) 2017 – March 2020 Pre-Pandemic dataset. One unadjusted and seven adjusted models were created for …

Evaluation Of The Bourbon County Health Department Physical Activity Program, Walker S. Hancock

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

Bourbon County has a low physical activity rate. A program has been implemented to increase rates of physical activity. An evaluation has been performed using the CDC’s 6-step program evaluation process framework.

According the the framework, two recommendations were made. The first one is to increase access to parks or exercise facilities for those outside of Paris city limits. The second one is to increase the number of indoor facilities for people to use during the cold, winter months.

How Sleep Disorders And Sleep Duration Impact Memory, Alexandria J. Sims

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

INTRODUCTION: Sleep duration and sleep disorders can cause changes in memory function as populations age. Previous studies have shown that disordered sleep is associated with increased risk of cognitive dysfunction and long and short sleep durations can cause memory impairment. This study studies aims to find if there is an association between sleep disorders and sleep duration and the impacts on memory.

METHODS: In this study, 3,478 participants aged 60 year and older from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 dataset were included in adjusted and unadjusted models, comparing the sleep disorders and sleep duration exposures to …

Changes In Local Public Health System Characteristics Before And After The Implementation Of Ohio’S Public Health Accreditation Board Policy For Local Public Health Departments., Christine Lynn Vazquez

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

The Public Health Accreditation Board is a nationally recognized nonprofit organization that manages a series of programs including the national public health accreditation program. Public health accreditation is awarded to health departments that achieve a set of nationally recognized goals and standards for departments to adopt. The state of Ohio initiated policy requiring that Local Health Departments to achieve accreditation by 2018. In result, Ohio has the largest number of accredited local health departments. This study looked at the local health departments in Ohio responses to the National Longitudinal Survey of Public Health Systems to understand if services provided improved …

Comparative Effects Of Low- And High- Tech Visual Activity Schedules On Transition Latency In Young Children With Autism, Mikayla Nelson

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Low-technology (low-tech) and high-technology (high-tech) visual activity schedules (VAS) were implemented for transitions with three kindergarten males diagnosed with autism spectrum disorder (ASD). An alternating treatment design was used to compare the latency of transitions from a preferred activity to an academic task after presenting a low- or high-tech VAS. Results indicated different effects between participants. Low-tech VAS was effective for one participant, and high-tech VAS was not effective for any participants in this study. Implications and further research are discussed regarding the importance of creating VAS on an individual basis, ensuring that each VAS meets an individual's communication and …

You’Re On Fire: Social Skills Training To Increase Sportsmanship For Teenagers With Disabilities, Madeline K. Wainwright

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

This study presents findings from a multiple probe design that evaluated the effects of social skills training as a method of teaching an increase of good sportsmanship, more particularly compliments of gameplay, for individuals with intellectual disabilities. The research included three U.S. high school students with intellectual disabilities and the data was analyzed across conditions. Following mastery criterion, generalization sessions across contexts were conducted. All participants acquired complimenting behavior through social skills training. However, none of the participants were able to generalize the skill to different contexts. Results and directions for future research regarding generalization in replication and use of …

Assessing The Content Validity And Usability Of An Implementation Fidelity Checklist For The Assessment, Evaluation, And Programming System, 3rd Edition (Aeps-3), Cameron A. Tyrrell

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

The included studies examined the content validity and useability of an implementation fidelity checklist for the Assessment, Evaluation, and Programming System (AEPS) for Infants and Young Children 3^rd Edition (AEPS-3). Study 1 assessed a revised version of an implementation fidelity checklist for item clarity and criterion clarity. After further revisions, Study 2 asked administrators of early childhood educational programs to implement the fidelity checklist in a classroom environment and assess the clarity of items, criterion, and feasibility of scoring different items. In addition, administrators included the length of time it took the implement the checklist and the strengths and …

Exercise As An Antecedent Intervention, Alexis M. Estephan

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Special education classroom teachers often experience students demonstrating challenging behaviors causing themselves and their peers to fall off task. This study examined the effect of antecedent exercise on on-task behaviors. This exercise included modeling a dance video to assess increasing levels of duration of on-task behaviors.

Cancer Screening In Appalachia, Kimberly M. Kelly, Sabina O. Nduaguba, Randi Shedlosky, Electra D. Paskett, Nancy Schoenberg, Nicole Yantes

Anthropology Faculty Publications

Background: The Appalachian region in the USA has some of the highest rates of cancer and cancer mortality in the country, due in part to suboptimal screening. Routine screening for cervical and colorectal cancer can decrease cancer morbidity and mortality. The current study sought to assess the feasibility and preliminary impact of an intervention guided by the Common-sense Model of Self-regulation to improve cervical and colorectal cancer attitudes and screening intentions. Method: Participants were approached in safety net clinics in Appalachian communities. Individuals completed surveys before and after an intervention that was designed to address lay understandings about the risks …

Early Changes In Inflammation-Related Proteins In The Cerebrospinal Fluid And Plasma Of Patients With Aneurysmal Subarachnoid Hemorrhage, David J. Braun, Kevin W. Hatton, Justin F. Fraser, Robert M. Flight, Hunter N. B. Moseley, Caleb S. Bailey, Josh M. Morganti, Bingqing Zhang, Ishara S. Ariyapala, Tae K. Kim, Linda J. Van Eldik

Sanders-Brown Center on Aging Faculty Publications

Background

Aneurysmal subarachnoid hemorrhage (aSAH) is a relatively uncommon but high mortality form of stroke that can result in long-lasting disability. A better understanding of key neuroinflammatory changes during the early phase (< 72 h) may provide potential avenues of treatment.

Methods

In an attempt to understand these early changes, we recruited 7 aSAH patients for profiling of longitudinal plasma and cerebrospinal fluid (CSF) proteins at up to 72 h post injury. We additionally compared this to control plasma obtained previously from healthy elderly volunteers. Using the Alamar Biosciences NULISAseq platform, we obtained a comprehensive picture of early peripheral and central inflammatory changes after injury.

Results

This study …

Nicorandil Treatment Improves Survival And Spatial Learning In Aged Granulin Knockout Mice, Dana M. Niedowicz, Wang-Xia Wang, Paresh Prajapati, Yu Zhong, Shuling X. Fister, Colin B. Rogers, Pradoldej Sompol, David K. Powell, Indumati Patel, Christopher M. Norris, Kathryn E. Saatman, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

Mutations in the human granulin (GRN) gene are associated with multiple diseases, including dementia disorders such as frontotemporal dementia (FTD) and limbic-predominant age-related TDP-43 encephalopathy (LATE). We studied a Grn knockout (Grn-KO) mouse model in order to evaluate a potential therapeutic strategy for these diseases using nicorandil, a commercially available agonist for the ABCC9/Abcc9-encoded regulatory subunit of the “K⁺ATP” channel that is well-tolerated in humans. Aged (13 months) Grn-KO and wild-type (WT) mice were treated as controls or with nicorandil (15 mg/kg/day) in drinking water for 7 months, then tested for neurobehavioral …

Gait Variability As A Marker Of White Matter Integrity In Individuals With Down Syndrome, Elizabeth M. Leach, David K. Powell, Amanda C. Glueck, Elizabeth Head, Moaz W. Ibrahim, Amelia J. Anderson-Mooney, Kathryn L. Van Pelt, Jordan P. Harp, Frederick A. Schmitt, Ahmed A. Bahrani

Sanders-Brown Center on Aging Faculty Publications

Introduction: Individuals with Down syndrome (DS) face a significant risk of neurodegeneration, and gait variability may serve as a clinical biomarker of neurological health. This longitudinal parent substudy aimed to explore relationships between gait, white matter (WM) integrity, and cognitive function in DS.

Methods: The associations were investigated between magnetic resonance imaging diffusion tensor imaging (DTI), cognition, and self-paced gait data from 22 DS participants (mean age ± SD 37 ± 7.5 years).

Results: DTI measures, such as lower fractional anisotropy (FA) and higher mean diffusivity, were correlated with greater step time variability but not normalized velocities. Lower cognitive scores …

Disrupted Calcium Dynamics In Reactive Astrocytes Occur With End Feet–Arteriole Decoupling In An Amyloid Mouse Model Of Alzheimer’S Disease, Blaine Weiss, John C. Gant, Ruei-Lung Lin, Jenna L. Gollihue, Colin B. Rogers, Susan D. Kraner, Edmund B. Rucker, Yuriko Katsumata, Yang Jiang, Peter T. Nelson, Donna M. Wilcock, Pradoldej Sompol, Olivier Thibault, Christopher M. Norris

Sanders-Brown Center on Aging Faculty Publications

While cerebrovascular dysfunction and reactive astrocytosis are extensively characterized hallmarks of Alzheimer's disease (AD) and related dementias, the dynamic relationship between reactive astrocytes and cerebral vessels remains poorly understood. Here, we used jGCaMP8f and two-photon microscopy to investigate calcium signaling in multiple astrocyte subcompartments, concurrent with changes in cerebral arteriole activity, in fully awake 7- to 8-month-old male and female 5xFAD mice, a model for AD-like pathology, and wild-type (WT) littermates. In the absence of movement, spontaneous calcium transients in barrel cortex occurred more frequently in astrocyte somata, processes, and perivascular regions of 5xFAD mice. However, evoked arteriole dilations (in …

Deceptive Exploitation: Deepfakes, The Rights Of Publicity And Privacy, And Trademark Law, Michael D. Murray

Law Faculty Scholarly Articles

This article addresses the application of right of publicity, right of privacy, and trademark law to the problem of deepfakes. It will explore the routine and not so routine ways that personality and persona attributes are exploited in traditional privacy contexts and publicity contexts. It will also examine the use of First Amendment defenses in legal actions traditionally associated with the exploitation of celebrities, sports figures, and other persons under state law theories of name-image-likeness exploitation, as well as and federal trademark law theories of false endorsement and false designation of origin.

Part I provides an introduction and background to …

Networking Among The Human Capitalists: The Organizational Dynamics Of Change And Power In The Large Corporate Law Firm, Alan James Klugel

Law Faculty Scholarly Articles

Law firms are unique creatures. They are subject to market pressures as well as ethical obligations and professional norms. They are in direct competition with other organizations for both clients and the lawyers necessary to perform work for those clients. They are comprised of lawyers who are simultaneously cooperative and competitive with one another. They are neither hierarchy nor anarchy, neither a collection of independent actors nor an entity under which its employees are subsumed. Instead, they are organizations shaped and reshaped by their members; organized around shared goals, internal contestations and external constraints; and defined by the ties between …

The Case Against Surge Pricing, Ramsi A. Woodcock

Law Faculty Scholarly Articles

Surge pricing—using data and algorithms to raise prices in response to unexpected increases in demand—has spread across the economy in recent years, from Amazon and Disney World to commuter highways and, of course, Uber, which is infamous for surge pricing rides. Companies claim that surge pricing equilibrates supply and demand, but that is impossible, at least in the short run when demand unexpectedly outstrips supply. What surge pricing really does is to ration existing supply based on ability to pay. That is both distributively unjust and potentially inefficient. It should also be considered a violation of the antitrust laws because …

Gender Disparity In Social Security, Kathryn L. Moore

Law Faculty Scholarly Articles

Facially neutral, the U.S. Social Security system structurally discriminates against women because it prefers those who successfully fulfill the traditional male breadwinner role rather than the traditional female caregiving role. Overall, women receive lower worker benefits, are much more likely to claim spouse and surviving spouse benefits, and are more dependent on Social Security for their retirement benefits than are men.

This Article assesses Social Security’s disparate treatment of women and how Social Security might be reformed to enhance benefits for women. It begins by providing a broad overview of Social Security benefits. It then discusses how women and couples …

Adapting A Mobile Health Intervention To Improve Prep Adherence Among Young Black Msm In Fulton County, Georgia, Kassidy Maust

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

Young Black men who have sex with men (YBMSM) in the southern United States, particularly in Fulton County, Georgia, face disproportionately high rates of HIV and unique structural barriers to pre-exposure prophylaxis (PrEP) uptake and adherence. Sustained adherence among YBMSM remains low due to intersecting structural, social, and behavioral barriers. To address these disparities, this paper presents an adapted implementation of the evidence-based M-Cubed (Mobile Messaging for Men) mHealth intervention. Prior studies of M-Cubed and similar mHealth interventions have shown promising outcomes in increasing PrEP adherence among Black MSM populations. The adapted intervention integrates culturally tailored messaging specific to behaviors …

Implementing An Opioid Overdose Education And Naloxone Distribution (Oend) Program Among Law Enforcement Officers In Lee County, Ky, Keelie Jolly

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

This grant proposal describes an implementation strategy for introducing an OEND training program among law enforcement officers (LEOs) to reduce opioid overdose deaths. The goal of the project is to increase LEOs' awareness and knowledge of opioid overdose and Naloxone administration and usage of Naloxone.

Rct Pre-Post Training Analysis Of The Vipcorps Maternal Mortality Prevention Course With A Focus On Intimate Partner Violence (Ipv), Rose A. Wood

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

Maternal mortality rates rob families across the U.S. of a mother figure, and each death is preventable. The U.S. has the highest maternal mortality rate of high-earning countries. This study assesses the effects of the VIPCorps program, a course on the top 3 risk factors of maternal mortality, on improving knowledge and attitudes towards victims of IPV. Students in helping professions at the University of Kentucky (n = 223) were recruited via on campus advertising and remotely allocated to either the VIPCorps program or a mock maternal mortality training control. Generalized linear modeling was used to estimate the difference in …

Demonstration Of An Enhanced Dosing Pattern For Debulking Large And Bulky Unresectable Tumors Via Differential Hole-Size Spatially Fractionated Radiotherapy, Joshua Misa, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose/objective

We propose a novel lattice deployment for spatially fractionated radiotherapy (SFRT) treatments. In this approach, a larger diameter high-dose sphere is centrally placed in the bulky tumor mass and surrounded by smaller diameter high-dose spheres.

Materials/methods

Thirty SFRT patients (10 head and neck [HN], 10 abdominal/pelvis, and 10 chest/lung cases) treated with an MLC-based crossfire method were retrospectively analyzed. Eleven differential hole-size lattice patterns were benchmarked against the clinically delivered SFRT plans (1 cm diameter cylinders, 2 cm spacing) and the standard uniform lattice pattern (1.5 cm diameter spheres, 3 cm spacing). These patterns varied in core diameter (C: …

Using A Self-Report Survey To Determine Students’ Self-Concept, Math Attitudes, And Achievement In Ability-Grouped Math Classrooms, Jessica T. Blake

Theses and Dissertations--Educational, School, and Counseling Psychology

Ability grouping is a common practice in the United States that aims to acknowledge differences in student ability by dividing students into more homogeneous groups. Numerous studies have examined factors associated with ability grouping such as self-concept, math achievement, and attitudes toward math, but there is little empirical research exploring these three factors simultaneously. The current study examines the differences in achievement level, achievement gains, math self-concept, and attitudes toward math in middle school students enrolled in math classes based on student ability. Participants included 407 middle school students across two schools that use between-class ability grouping for math. Students …

A Scoring Approach For Evaluating And Ranking Complete Streets Projects, Eirini Stavropoulou

Theses and Dissertations--Civil Engineering

Complete Streets is a vital strategy for developing an equitable transportation network that provides access to all users and transportation options to communities. A growing interest in this concept has been noted in the United States, with over 1,700 Complete Streets-related policies implemented nationwide. The Kentucky Transportation Cabinet (KYTC) has developed the “Complete Streets, Roads, and Highways Manual” and the “Complete Streets Policy” aiming to promote a safer and more inclusive transportation system statewide through Complete Streets implementation. A recent KYTC initiative was the development of a scorecard to systematically evaluate Complete Streets projects competing for funding. The scorecard is …

Advancing Vapor Intrusion Science Using Systematic Frameworks To Foster Informed Decision Making, Hong Cheng Tay

Theses and Dissertations--Civil Engineering

Vapor intrusion, the migration of subsurface vapors into indoor air spaces, is an important source of indoor air contamination to consider at hazardous waste sites contaminated by volatile organic compounds (VOCs). There is considerable uncertainty and variability in the factors that influence vapor intrusion processes, which poses a significant challenge for decision making, despite advancements in vapor intrusion science. This dissertation consolidates knowledge from existing scientific advances and investigates scientific gaps associated with the vapor intrusion preferential pathway conceptual model (i.e. conduit vapor intrusion), associated with the vapor entry pathway into buildings via sewer systems. The overall goal of this …

The Disappearance Of Shannon White, Kathryn J. Limberg

Theses and Dissertations--English

The Disappearance of Shannon White is a Mystery-Thriller novel. The aim of the piece is to explore thematic components including perseverance, socio-economic inequities, the stigmas and medical malpractice of the American mental health system in the late twentieth century, and, ultimately, to entertain. My earliest love in the literary world was science fiction and fantasy. Writers like Robert Jordan, and more recently, Simone St. James, create worlds that test the bounds of reality in a way that I find liberating, and I seek to implement this in my own work. Such authors have taught me that fiction offers freedom to …