Digital Commons Network^™

Targeting Rsk2 Reverses Endocrine Resistance In Er-Positive Breast Cancer Via Inhibiting The C-Myc–Erbb4 Signaling Pathway, Ting Jiang, Shilong Jiang, Yueying Cheng, Xiaohui Yu, Zonglin Chen, Hang Li, Shijun Cao, Zhongyuan Xiang, Ruigang Zhao, Wenjun Yi, Jinming Yang, Yan Cheng

Markey Cancer Center Faculty Publications

Endocrine therapy remains a major adjuvant treatment for estrogen receptor (ER)-positive breast cancer, yet its clinical efficacy is frequently compromised by primary or acquired resistance, leading to tumor recurrence and poor prognosis. In this study, we identified RSK2 (p90 ribosomal S6 kinase 2) as a critical mediator of endocrine resistance in ER-positive breast cancer. Analysis of publicly available datasets and our clinical samples revealed that high expression of RSK2 is associated with unfavorable outcomes in patients treated with endocrine therapy. RSK2 overexpression confers resistance to both tamoxifen and fulvestrant, two commonly used ER antagonists. We show that RSK2 is upregulated …

The Effect Of Cover Crop Management Strategies On Nutrient Availability In No-Till Corn, Emily C. Marsh

Theses and Dissertations--Plant and Soil Sciences

Cover crops are reported to have long-term soil health improvements, one of which is reducing erosion. However, popular cereal cover crops, such as rye (Secale cereale L.), have the potential to cause a yield penalty in the following corn (Zea mays L.) crop due to a reduction in available nitrogen. Legumes, such as Austrian winter pea (Pisum sativum L. var. arvense), are thought to reduce this yield penalty due to their capacity to fix nitrogen. Sulfur is another nutrient of interest, especially as rates of atmospheric deposition of sulfur have declined, leading to more deficiencies being …

Numerical Analysis And Simulation Of Enhanced Performance In Nanowire Cds/Cdte Solar Cells: A Pathway To Greater Than 25% Efficient Cdte Solar Cell, Riasad Badhan

Theses and Dissertations--Electrical and Computer Engineering

This Thesis finds a pathway to a significantly high-efficient CdTe based solar cell by demonstrating and harvesting the advantages of a nano-structure configuration in CdTe based solar cells. Nanowire CdS window layer and the “control”, planar CdS window layer films were fabricated in the laboratory and compared for their optical transmission and other characteristics affecting the performance of the CdS-CdTe solar cell. Numerical simulations were performed for a comparative evaluation of the embedded nanowire CdS-CdTe solar cell device and the traditional planar CdS-CdTe solar cell device. Experimentally measured spectral transmission of nanowire CdS film was used in the simulation environment. …

Robotizing Complex Welding Processes Through Imitation Learning And Generative Models From Human Demonstration, Yue Cao

Theses and Dissertations--Electrical and Computer Engineering

Arc welding processes demand real-time adaptive control that current robotic systems cannot achieve autonomously. This dissertation develops a systematic framework to robotize complex welding by learning from human demonstration, integrating generative modeling, physics-informed reconstruction, and model-based imitation learning. First, human--robot collaboration systems are established for both Gas Tungsten Arc Welding (GTAW) and Double-Electrode Gas Metal Arc Welding, combining robotic teleoperation with virtual reality interfaces to capture high-quality operator demonstrations. Second, a physics-informed neural network framework reconstructs complete molten pool flow fields from high-speed imaging, enriching process understanding beyond direct sensor observation. Third, generative models, including a hybrid latent variational autoencoder …

Challenges And Applications Of Fine-Grained Temporal Action Understanding: Modeling Temporal Granularity And Data Efficiency, Halil I. Helvaci

Theses and Dissertations--Electrical and Computer Engineering

Fine-grained Temporal Action Segmentation (TAS) has become a cornerstone of video understanding, offering dense frame-level predictions essential for clinical assessment, surgical skill evaluation, and human-computer interaction. While TAS methods have delivered strong results on coarse-grained benchmarks, two fundamental challenges persist: (1) global attention mechanisms dilute boundary information critical for subsecond precision, a phenomenon we term the temporal granularity bottleneck, and (2) dense frame-level annotation remains prohibitively expensive, with most datasets requiring exhaustive labeling of lengthy untrimmed videos. These challenges are particularly pronounced in medical domains, where sub-second primitives define clinical outcomes while expert annotation remains scarce. In this dissertation, we …

Design Of Energy-Efficient, Scalable, And Flexible Tensor Processing Architectures With Electro-Photonic Integrated Circuits, Oluwaseun Alo

Theses and Dissertations--Electrical and Computer Engineering

In recent years, artificial intelligence has achieved remarkable success across domains such as computer vision, natural language processing, and scientific computing. This progress has been driven largely by advances in deep learning, particularly deep neural networks (DNNs), including convolutional neural networks (CNNs) and transformer-based models. While these models deliver unprecedented accuracy, often surpassing human performance, their computational complexity continues to grow rapidly due to multibillion- and trillion-parameter designs. As model sizes and deployment scales expand, the demand for energy-efficient and high-throughput hardware accelerators has intensified. Conventional electronic platforms based on CPUs, GPUs, ASICs, and FPGAs are increasingly constrained by the …

Learning-Enabled Methods For Optimal, Constrained, And Fault-Tolerant Robot Motion Planning, Charles L. Clark

Theses and Dissertations--Electrical and Computer Engineering

Safe and efficient motion planning is a core requirement for robots operating in complex real-world environments, yet traditional model-based approaches struggle to simultaneously achieve computational efficiency, solution optimality, and the ability to handle complex constraints and potential hardware failures. This dissertation investigates how neural networks, as general purpose function approximators, can be leveraged in both traditional and novel ways to overcome these limitations and advance beyond what purely model-based methods can offer. Three distinct contributions are presented. First, a new motion planner is developed that uses ReLU neural networks to decompose the configuration space into linear cost regions, enabling existing …

Advancing Edge Intelligence: Strategies For Improving Machine Learning On Embedded Devices, Prakash Dhungana

Theses and Dissertations--Electrical and Computer Engineering

Artificial intelligence (AI) has demonstrated tremendous success in handling complex tasks across multiple domains, a leap largely attributed to complex deep neural network (DNN) architectures. However, the increasing demand for real-time processing, low latency, limited connectivity, and enhanced privacy necessitates edge intelligence, where computation is performed directly on resource-constrained embedded devices rather than relying on cloud infrastructures. While optimized TinyML techniques such as pruning, quantization, and neural architecture search (NAS) have made edge deployment feasible by significantly reducing computation and memory demands, achievable performance remains severely limited by hardware constraints. Furthermore, models deployed in highly dynamic real-world environments suffer from …

Frequency And Phase Synchronization Of Antenna Arrays With Phase Incoherent Microcontrollers, Harley W. Byrd

University of Kentucky Master's Theses

The construction of phased array antennas has traditionally been an expensive and complex task. It has recently been claimed that it is possible to construct high-performance Wi Fi antenna arrays using inexpensive consumer components. Motivated by some limited data available from online presentations of such devices, this thesis covers an attempt to construct a phased-array Wi-Fi antenna using several ESP32 chips, which have native Wi-Fi modulation and demodulation capabilities. While there are many positive aspects associated with utilizing ESP32 chips for this purpose, a key challenge is the inherent phase incoherence of their internal Phase Locked Loops (PLLs). The approach …

Making Sense Of Membership: Organizational Socialization Of African Immigrant Employees In U.S. Workplaces, Ikeola J. Bodunde

Theses and Dissertations--Communication

This dissertation examines how African immigrant employees make sense of organizational socialization in U.S. workplaces. As global mobility reshapes the labor force, nearly one in five U.S. workers is foreign-born, making organizational socialization an increasingly complex communicative process. Classic socialization models assume linear, uniform adjustment, yet international employees often face ambiguity, cultural mismatch, and racialized expectations that complicate early workplace experiences. Guided by sensemaking theory, this study conceptualizes socialization as an ongoing, nonlinear process through which newcomers notice cues, construct interpretations, act on provisional understandings, and revise meanings as contexts shift. Using a qualitative, interpretive design, I conducted semi-structured interviews …

Modeling Inherited Retinal Disease In Zebrafish, Meet Patel

Theses and Dissertations--Biology

Inherited retinal diseases (IRDs) affect millions of people worldwide. Majority of IRDs are caused by degeneration of rod and cone photoreceptor cells (PRCs) due to gene mutations. The overarching goal of my dissertation is to model and evaluate the molecular role of various gene candidates involved in IRDs such as cone rod dystrophy (CRD) and retinitis pigmentosa (RP).

Mutations in CDHR1, a photoreceptor specific cadherin have been associated with CRD and recapitulated in mouse CDHR1 knockouts. However, the molecular function of CDHR1 remains unknown. CDHR1 has been shown to localize at the leading edge of murine rod nascent outer segment …

Implementing A Competency-Based Cross-Training Program To Enhance Patient Flow, Jill E. Shanklin

DNP Projects

Objective: To evaluate the effect of a competency-based cross-training program on perinatal nurses’ preparedness to care for medical-surgical (med-surg) overflow patients and to support patient flow.

Design: Quality improvement project using a quasi-experimental pre–post design.

Setting: A 44-bed perinatal unit within a university-affiliated medical center in the United States.

Participants: Registered nurses employed in the perinatal unit for ≥6 months; 24 completed the preintervention survey and 28 completed the postintervention survey.

Interventions: A competency-based cross-training program consisting of e-learning modules, simulation-based competency validation, and structured policy and procedure review.

Main Outcome Measures: Self-reported comfort, …

Enhancing Tray Integrity: A Quality Improvement Project To Reduce Central Sterile Processing Defects, Ashley Conn

DNP Projects

Background: Instrument tray defects contribute to surgical delays, workflow disruptions, rework in sterile processing, inefficient instrument utilization, and patient safety risks.

Purpose: The purpose of this quality improvement project was to reduce orthopedic instrument tray defects through targeted education and standardized tray audits with double-check verification in a large academic medical center.

Methods: A quasi-experimental pre-post design was utilized to evaluate the impact of the intervention. Tray errors were captured using a standardized binary indicator. Staff satisfaction and confidence surveys were measured using Likert-scale surveys.

Results: Orthopedic trays were analyzed before (n=1,017) and after (n=941) implementation. Post-implementation, tray errors decreased …

Riddle Me Resilient: Investigating The Impact Of Riddle Based Class Openings On Student Resilience And Well-Being, Carolyn T. Brown

DNP Projects

Abstract

Background: Burnout among nurses and nursing students is a widespread and well‑documented problem that adversely affects professional performance and psychological well‑being. Resilience serves as a key protective factor, helping buffer the effects of academic stress and reducing burnout over time. Incorporating brief, low‑stakes cognitive challenges—such as a riddle—can help foster resilience.

Purpose: This project evaluated the impact of incorporating riddles into a wellness-focused course, Introduction to Mindfulness and Wellness, on resilience and well-being among undergraduate nursing students.

Methods: This project employed an Institutional Review Board approved pre-post survey design to measure the effect of an intervention focused on …

Evaluating The Implementation And Use Of A Standardized Screening Process To Increase Flu Vaccine Uptake In A Rural Health Primary Care Clinic, Mackenzie L. Pierce

DNP Projects

Background: Research has shown that an annual influenza vaccine is the most effective way to both prevent and reduce the risk of hospitalization and severe health complications of the flu. A yearly influenza vaccination is recommended for everyone age 6 moths and older.

Local Problem: Rural communities have lower rates of influenza vaccination which can be due in part to a lack of screening and education on vaccines and their importance. No process for influenza vaccine status screening existed at the project site prior to this project.

Methods: A quality-improvement project was conducted to evaluate the implementation of a standardized …

Evaluation Of A Nicotine Prevention Program In A Third Grade Classroom, Jennifer A. Pile

DNP Projects

Purpose: The purpose of this project was to increase knowledge of nicotine products and promote negative perceptions of nicotine use among third-grade students through early prevention education.

Background: Prevention is key and to prevent nicotine use, there must be an educational program with that aim in a much younger population. Third grade encompasses 8-, 9-, and 10-year-olds. This group is in the middle childhood stage and begin more complex thinking and problem-solving skills. There is physical and emotional development among this group.

Methods: This is a quasi-experimental study among third grade students in Breckinridge County Kentucky with pretest and …

Unintentional Medication Discrepancies In Outpatient Cardiac Procedures: Identifying Modifiable Barriers, Julie M. Turner

DNP Projects

Background: Medication reconciliation (MR) reduces medication errors during care transitions; however, unintentional medication discrepancies (UMDs) remain common due to variable practices and lack of standardization. Patients undergoing elective cardiac procedures are particularly vulnerable given complex medication regimens.

Purpose: This quality improvement project evaluated implementation of a Medication Reconciliation Barrier Identification Checklist (MRBIC) in the cardiac catheterization laboratory to identify patient, staff, and system-level contributors to UMDs.

Methods: A quasi-experimental pre–post design was conducted at a large academic medical center. During a six-week intervention, nurses and providers completed the MRBIC during pre-procedure MR. Barrier scores were compared with …

Advancing Rural Health Equity Through Systematic Sdoh Screening- A Quality Improvement Initiative, Laura C. Combs

DNP Projects

Background: Social determinants of health (SDoH) significantly affect health outcomes and healthcare utilization, particularly in rural communities. In 2024, the Centers for Medicare & Medicaid Services mandated SDoH screenings in the inpatient setting, with recommendation to implement in rural clinics without specifying a standardized tool, resulting in inconsistent identification of needs, e.g., food insecurity, housing instability, mental health concerns, financial strain, and transportation barriers.

Purpose: This quality improvement initiative implemented a standardized SDoH screening tool in a rural outpatient clinic to evaluate changes in referral rates to community-based resources pre- and post-implementation and to improve patient reporting of social needs. …

Building Confidence And Team Communication: Implementation Of A Rapid Response In Situ Simulation Program In The Neonatal Intensive Care Unit, Janell F. Hacker

DNP Projects

Background: Neonatal code events are high-risk, low-frequency occurrences in the neonatal intensive care unit (NICU). Simulation-based training is used to support skill development, maintain competencies, and enhance team performance.

Purpose: The purpose was to determine if a multidisciplinary, high-fidelity, rapid response in situ simulation program would impact confidence and communication among frontline healthcare providers during neonatal code events.

Methods: A quasi-experimental, pretest-posttest study was conducted in a 90-bed Level IV NICU. A multidisciplinary, high-fidelity in situ rapid response simulation program was implemented over a 3-month period for frontline NICU healthcare providers. Pre- and post-surveys assessed perceptions of role clarity, …

Implementation Of A Cardiomems Screening Tool To Increase Provider Awareness And Referrals In Eligible Patients, Monica Rios

DNP Projects

Background: Heart failure affects over 6 million Americans and causes more than one million hospitalizations annually. CardioMEMS, a remote pulmonary artery pressure monitoring device, effectively reduces hospitalizations, yet its use remains limited due to provider and system barriers. The purpose was to increase CardioMEMS referrals for eligible heart failure patients through targeted provider education and a standardized screening tool.

Local Problem: Kentucky experiences higher heart failure hospitalization rates than the national average, contributing to prolonged hospital stays and rising healthcare costs.

Methods: A pre—post quasi-experimental study was conducted at an academic medical center. Baseline chart review of 47 patients evaluated …

Improving Compliance With Preoperative Antibiotic Protocols For Cardiac Implanted Electronic Devices: A Quality Improvement Project, James Kaup

DNP Projects

Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained …

Implementing A Standardized App-Led Multidisciplinary Medication Review And Reconciliation To Improve Medication Safety Before Systemic Cancer Therapy: An Ambulatory Oncology Quality Improvement Initiative, Sarah R. Hines

DNP Projects

Background

Adult patients initiating systemic cancer therapy frequently present with pre-existing polypharmacy related to chronic comorbidities and cancer-related symptom management. The addition of anticancer therapies and supportive care medications further increases medication burden and the risk of medication-related harm. Although national organizations and institutional policies recommend comprehensive medication review before treatment initiation, implementation remains inconsistent in ambulatory oncology practice.

Purpose

To implement and evaluate a standardized Advanced Practice Provider (APP)-led multidisciplinary medication review and reconciliation process designed to identify medication medication-related safety risks before initiation of systemic cancer therapy in adult oncology patients receiving care in an ambulatory infusion center. …

Kentucky Bluegrass (Poa Pratensis L.) As A Perennial Groundcover: Establishment And Weed Management In Corn, Kiera S. Searcy

Theses and Dissertations--Plant and Soil Sciences

Perennial groundcover (PGC) systems offer a cost-effective alternative to annual cover crops, by providing continuous soil cover, reducing soil erosion, and contributing to integrated weed management (IWM) in corn (Zea mays L.) production systems. Kentucky bluegrass (Poa pratensis L.) has been proposed as a perennial groundcover for corn due to its low growth habit and seasonal dormancy; however, successful adoption is limited by challenges associated with establishment-phase weed competition and compatibility with weed management programs during corn production. The objectives of this research were to (1) evaluate weed management strategies that support Kentucky bluegrass establishment and (2) assess …

Impact Of Land Use On Soil Properties, Clay Mineralogy, And Behavior Of Ammonium Across A Precipitation Gradient, Isabel Delamater

Theses and Dissertations--Plant and Soil Sciences

Like soil texture, clay mineralogy is considered a permanent or inherent characteristic of soils reflecting the influence of soil forming factors over long periods of time. Despite the importance of clay mineralogy in providing ecosystem services, much remains unknown about whether land use (native grassland sod versus no-tillage) can modify clay mineralogy under short periods of time. Furthermore, in no-tillage agroecosystems, lower crop yields are often ascribed to immobilization of added N fertilizer where inorganic nitrogen (such as ammonium) is converted to organic nitrogen. The possible role of clay mineralogy in retaining added ammonium has been overlooked in no-tillage systems. …

Integrated Crop Management For Hemp (Cannabis Sativa L.) Grain Production In Kentucky, Maria M. Ricciardi

Theses and Dissertations--Plant and Soil Sciences

Cannabis sativa L. is legally defined (U.S.) as hemp if the total tetrahydrocannabinol (THC) concentration remains less than 0.3% on a dry weight basis. Hemp can be produced for cannabinoid extraction, fiber, or grain. Hempseed meal and hempseed oil were approved as feed ingredients for chickens and performance horses in Kentucky. To leverage this opportunity, production requires improvement through an integrated crop management approach. This dissertation (1) reports the main arthropod and disease pests impacting hemp grain; (2) identifies grain yield components and their relationship with corn earworm, Helicoverpa zea (Boddie) (CEW); (3) evaluates Fusarium head blight (FHB) development across …

Breeding For Fhb Resistance And Post-Harvest Quality In Soft Red Winter Wheat, Margaret E. Gillum

Theses and Dissertations--Plant and Soil Sciences

Soft red winter wheat (Triticum aestivum L.) is both an economically and nutritionally important crop in the global food supply. Despite its global importance, wheat is continually threatened by fungal diseases. Fusarium head blight (FHB), caused by Fusarium graminearum, is a devastating fungal disease affecting wheat worldwide, resulting in low yields, reduced test weight and mycotoxin production. The mycotoxin deoxynivalenol (DON) is toxic to humans, results in feed rejection in livestock, and is heavily monitored in the food supply. Because of wheat’s importance in the food system, post-harvest quality (milling, baking, and flavor) has been a growing area of …

Evaluating Spatial Variability Of Corn Yield Response To Phosphorus Fertilizer For Improved Precision Phosphorus Management, Jennifer Fridgen

Theses and Dissertations--Plant and Soil Sciences

Soil scientists did not develop soil test-based fertilizer recommendations to support precision nutrient management. Knowledge of crop responses to applied essential nutrients, such as phosphorus (P), and the processes governing these responses at high spatial resolution are necessary to improve precision agronomic recommendations. This dissertation investigates the limitations of current soil sampling methodologies and recommendation frameworks for crop response to fertilizer, with particular emphasis on P fertility in Kentucky (KY) corn production. The first study examined the relationship between the resolution of systematic grid sampling and the spatial structure of soil test variables (Mehlich-3 P (M3P), Mehlich-3 potassium (M3K), and …

When The Prosthetic Aortic Valve Fails, Harish Ram, Aibek Mirrakhimov, Sruthi Rangu, Olivia F. Garrett, Vincent L. Sorrell

Radiology Faculty Publications

No abstract provided.

Effects Of Student And School Technology Adoption On Student Reading Achievement In The United States: The Case Of Pisa 2018, Mikah J. Hughes

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

This study examined the relationship between student and school-level information and communication technology (ICT) factors and reading achievement using data from the Programme for International Student Assessment (PISA) 2018 in the United States. In an increasingly digital world, reading and information literacy are essential skills, yet significant gaps in digital competencies persist. This study investigated how ICT access, use, and perceptions relate to reading achievement in the context of student and school background factors.

A two-level hierarchical linear modeling (HLM) framework was employed to account for the nested structure of students within schools. The sample included approximately 4,000 students across …

Teachers, Dispositions, And Classroom Management: Social Origins, Professional Development, And The Datafication Of School Discipline, Paul L. Poggemeyer

Theses and Dissertations--Sociology

How do teachers’ social backgrounds and professional orientations shape the disciplinary and relational dimensions of their work? This dissertation takes up that question across three related but self-contained studies in the sociology of education, set in Central School District, a public school district in the southeastern United States. Each study examines a different facet of how teachers establish authority, manage behavior, and exercise care: the social origins of their orientations toward classroom management, the experience of becoming professionally competent in the early career, and the use of digital tools that increasingly govern how school discipline is recorded. Drawing broadly on …