Digital Commons Network^™

Association Of State Cannabis Legalization With Cannabis Use Disorder And Cannabis Poisoning, Jayani Jayawardhana, Jialin Hou, Patricia Freeman, Jeffery C. Talbert

Health Management and Policy Faculty Publications

IMPORTANCE Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident.

OBJECTIVE To examine state-level medical and recreational cannabis laws’ associations with CUD and cannabis poisoning, overall and by sex and age subgroups.

DESIGN, SETTING, AND PARTICIPANTS In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption …

Demographic Variation In Continuous Glucose Monitoring Utilisation Among Patients With Type 1 Diabetes From A Us Regional Academic Medical Centre: A Retrospective Cohort Study, 2018–2021, Omer Atac, Kory R. Heier, Daniela Moga, John L. Fowlkes, Min-Woong Sohn, Aaron J. Kruse-Diehr, Teresa M. Waters, Mary E. Lacy

Health Management and Policy Faculty Publications

Objective: While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM utilisation among patients with T1D from a regional academic medical centre across all insurance types.

Design and Setting: This is a retrospective cohort study including both paediatric and adult patients with T1D who visited a regional academic medical centre between 1 January 2018 and 31 December 2021.

Methods: Patients were followed from the date of their first T1D encounter during the study period …

“A Safe Place”: Exploring Black Couples’ Perceptions Of Black Love And Relationship Coping In The Context Of Their Lived Experiences With Racism, Melinda Murdock

Theses and Dissertations--Family Sciences

Historically, Black couples have not been studied within the context of their lived experiences as it relates to the effects of racism on relationship health. Only in the last decade have relationship scholars begun to consistently link racism-related stressors to relationship processes and outcomes. Despite the growing literature, recent studies are primarily quantitative in method and rely on samples, theoretical models, and measures that predominantly represent White couples’ experiences. It remains unclear how Black couples’ perceptions of love and relationship coping lead to resilient outcomes despite the negative effects of racism.

Therefore, the goal of the present study is to …

Diet Of Adult Ladybird Beetle Hosts Modifies The Postdiapause Development Of The Parasitoid Dinocampus Coccinellae (Hymenoptera: Braconidae), John J. Obrycki

Lady Beetle Research Data

Our study showed that under natural conditions the rate and speed of postdiapause emergence by overwintering larvae of the endoparasitic wasp, Dinocampus coccinellae (Schrank) is enhanced when its ladybird beetle host Coleomegilla maculata (DeGeer) receives a nutritious (proteinaceous) diet during late winter and early spring. Living aphid prey provided during April and May yielded the fastest rates of D. coccinellae postdiapause development, followed by an artificial protein/carbohydrate diet and flowering (pollen-producing) heads of dandelion. D. coccinellae development was slowest when hosts received only sugar water or water alone. These results indicate that there is an interaction during late dormancy between …

Voltage And Var Control And Real-Time Digital Simulator-Based Protection System Testing For Power Distribution Systems, Gaurav Yadav

Theses and Dissertations--Electrical and Computer Engineering

Rising power demand calls for electric distribution systems to manage peak load. One option is reducing feeder voltage, which lowers voltage-dependent load demand and may also reduce energy usage. The technique, known as Conservation Voltage Reduction (CVR), may operate independently or within a volt/var control system. This dissertation examines CVR factor calculation using measurements collected at the substation, and proposes a curve-fitting and artificial neural network method to estimate active power losses using input active power, reactive power, and substation voltage. As utilities integrate more inverter-based resources (IBRs) to support increasing demand, rapid voltage fluctuations arise due to the intermittent …

Plasma S100Β Is A Predictor For Pathology And Cognitive Decline In Alzheimer’S Disease, Geetika Nehra, Bryan J. Maloney, Rebecca Smith, Wijitra Chumboatong, Erin L. Abner, Peter T. Nelson, Björn Bauer, Anika M. S. Hartz

UK CARES Faculty Publications

Background Blood–brain barrier dysfunction is one characteristic of Alzheimer’s disease (AD) and is recognized as both a cause and consequence of the pathological cascade leading to cognitive decline. The goal of this study was to assess markers for barrier dysfunction in postmortem tissue samples from research participants who were either cognitively normal individuals (CNI) or diagnosed with AD at the time of autopsy and determine to what extent these markers are associated with AD neuropathologic changes (ADNC) and cognitive impairment.

Methods We used postmortem brain tissue and plasma samples from 19 participants: 9 CNI and 10 AD dementia patients who …

Artesunate Enhances The Efficacy Of Enzalutamide In Advanced Prostate Cancer, Xinyi Wang, Jinghui Liu, Fengyi Mao, Yifan Kong, Qiongsi Zhang, Chaohao Li, Daheng He, Chi Wang, Yanquan Zhang, Ruixin Wang, Sally R. Ellingson, Qiou Wei, Zhiguo Li, Xiaoqi Liu

Toxicology and Cancer Biology Faculty Publications

Prostate cancer (PCa) is one of the leading causes of death among men worldwide. Treatments targeting the androgen receptor pathway remain the standard therapy for PCa patients. Enzalutamide (ENZ), a second-generation androgen receptor inhibitor, was developed to treat castration-resistant prostate cancer. However, while patients initially respond to ENZ, drug resistance typically develops within a few months. Artesunate (ART), a semisynthetic derivative of the Artemisinin plant, is approved for antimalaria treatment. In this study, we conducted an FDA-approved drug screening and identified ART as a potential candidate for overcoming ENZ resistance in PCa. Mechanistically, ART induces the degradation of c-Myc, enhancing …

Current Practices In Training Paraeducators: A Literature Review, Rebekah Pearson

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

I conducted a brief literature review to examine current practices for training paraeducators in school settings. I reviewed literature published after 2010 using an online database. Using an author-made inclusion criterion, 13 articles were considered for review. Findings suggest that behavior skills training (BST), brief performance feedback, didactic training, and a strategy instruction framework are currently being used to train paraeducators. These trainings have yielded positive results in increasing desired paraeducator behaviors. I conclude by discussing the limitations and directions for future research.

Influence Of Naturalistic Language Intervention On Child Communication And Engagement, Olivia R. Abate

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

The purpose of this study is to parallel naturalistic instructional contexts that often occur during caregiver-child interactions (e.g., one-to-one arrangement during play) to learn more about how children respond when prompting is introduced compared to responsive interaction strategies alone or with environmental arrangement strategies. This exploratory study was designed to evaluate the potential differential effects within an ATD, comparing RI alone, RI + EA, and RI + MP on joint engagement, communication acts, and interfering behaviors. This study is ongoing and lacks results for communication acts. Preliminary results supported and contradicted aspects of the hypothesis: joint engagement would occur at …

Impacts Of School-Based Agricultural Education On The Resilience Of Senior Appalachian High School Students Living In Economically Disadvantaged Counties In Kentucky And Virginia, Ruth D. Toole

Theses and Dissertations--Community & Leadership Development

Students in Central Appalachia, particularly those in economically disadvantaged (ED) counties, may face unique risks related to their geographic and socioeconomic circumstances. However, school-based and youth development programs have been shown to foster resilience among youth. This convergent mixed-methods study aimed to explore whether involvement in School-Based Agricultural Education (SBAE) can enhance youth resilience. Data were collected through a resilience questionnaire and semi-structured focus group interviews, which were analyzed, interpreted, and integrated to uncover key findings. Results indicated that participants living in ED areas exhibited relatively high resilience scores. Focus group discussions revealed that, despite the challenges they face, participants …

Metformin In Overcoming Enzalutamide Resistance In Castration-Resistant Prostate Cancer, Kendall Simpson, Derek B. Allison, Daheng He, Jinpeng Liu, Chi Wang, Xiaoqi Liu

Markey Cancer Center Faculty Publications

Androgen deprivation is the standard treatment for patients with prostate cancer. However, the disease eventually progresses as castration-resistant prostate cancer (CRPC). Enzalutamide, an androgen receptor inhibitor, is a typical drug for treating CRPC and with continuous reliance on the drug, can lead to enzalutamide resistance. This highlights the necessity for developing novel therapeutic targets to combat the gain of resistance. Metformin has been recently investigated for its potential antitumorigenic effects in many cancer types. In this study, we used enzalutamide and metformin in combination to explore the possible rescued efficacy of enzalutamide in the treatment of enzalutamide-resistant CRPC. We first …

Portable Multi-Parametric Microscopy For Noninvasive Metabolic And Vascular Imaging Of Orthotopic Tongue Cancer Models In Vivo, Pranto Soumik Saha, Jing Yan, Caigang Zhu

Markey Cancer Center Faculty Publications

Significance: Precise imaging of tumor metabolism with its vascular microenvironment becomes emerging critical for cancer research because increasing evidence shows that the key attribute that allows a tumor to survive therapies is metabolic and vascular reprogramming. However, there are surprisingly few imaging techniques available to provide a systems-level view of tumor metabolism and vasculature in vivo on small animals for cancer discoveries.

Aim: We aim to develop a new multi-parametric microscope that can faithfully recapitulate in vivo metabolic and vascular changes with a wide field of view and microscope-level resolution to advance cancer-related investigations. To maximize the ease and accessibility …

Dihydropyrimidine Enzyme Activity And Its Effect On Chemotherapy Toxicity: Importance Of Genetic Testing, Alexia Shamaei Zadeh, Danielle Roberts, Abby Williams, Deepali Pandey, John L. Villano

Markey Cancer Center Faculty Publications

Purpose

Patients with partial or complete DPD deficiency have decreased capacity to degrade fluorouracil and are at risk of developing toxicity, which can be even life-threatening.

Case

A 43-year-old man with moderately differentiated rectal adenocarcinoma on capecitabine presented to the emergency department with complaints of nausea, vomiting, diarrhea, weakness, and lower abdominal pain for several days. Laboratory findings include grade 4 neutropenia (ANC 10) and thrombocytopenia (platelets 36,000). Capecitabine is used as a component of first-line adjuvant therapy by approximately 2 million patients worldwide each year. Capecitabine is metabolized to fluorouracil via the enzyme dihydropyrimidine dehydrogenase (DPD). With worsening pancytopenia …

Discovering My Sonic Identity Through Intent And Self-Belief: A Portfolio Of Compositions, Addison J. Bird

Theses and Dissertations--Music

An analysis and overview of a master’s degree electroacoustic composition portfolio. These works represent significant benchmarks in terms of musical development and composer intent. Each piece is analyzed for its musical methods and inspirations as well as the non-musical ideas surrounding them. The pieces covered are a mixture of fixed media electroacoustic works and live electronic works incorporating popular and folk music influences.

Clonal Variation In Effector Gene Expression As A Mechanism For Pathogenic Adaptation In Magnaporthe Oryzae, Rebekah J. Ellsworth

Theses and Dissertations--Plant Pathology

Magnaporthe oryzae is a filamentous fungal pathogen that causes destructive diseases in cereals, including rice blast, wheat blast, and gray leaf spot. It is responsible for 10–30% annual yield losses in rice (Nalley et al., 2016) and up to 100% loss in wheat under favorable conditions (Kohli et al., 2011). Disease management typically relies on the use of resistant cultivars, but M. oryzae rapidly overcomes host resistance by mutating or deleting avirulence (AVR) genes recognized by host immune receptors. This rapid adaptation, often occurring within one to two growing seasons, presents a major challenge to breeding for durable resistance.

The …

Astrovascular Decoupling In Awake 5×Fad Mice Is Associated With Reduced Astrocytic Calcium, Ruei-Lung Lin, Sophiya L. Sims, Nicholas A. Wright, Léopoldine B. Galopin, Blaine Weiss, Susan D. Kraner, Jacquelyn E. Rhinehart, Ting-Hsuan Lu, Pradoldej Sompol, Christopher M. Norris, Olivier Thibault

Pharmacology and Nutritional Sciences Faculty Publications

INTRODUCTION

Evidence points to dysregulated Ca²⁺ in neurons and astrocytes in models of amyloidosis. While most of these data were obtained in vitro or in vivo under anesthesia, less work has investigated these variables in awake ambulating mice.

METHODS

Astrocytic Ca²⁺ fluctuations (GCaMP8f) were imaged concomitantly with vasoreactivity in S1 on a two-photon microscope during rest and ambulation. Single-cell resolution variables were extracted using continuous wavelet transform and traditional ΔF/F measures.

RESULTS

Along with increases in amyloid beta (Aβ) accumulation, we found significant reductions in measures of astrocyte functional connectivity, pairwise correlations, and network synchronicity in older 5×FAD …

The Influence Of Glacial Topography On Fluvial Efficiency In The Teton Range, Wyoming (Usa), Sarah E. Johnson, Meredith Swallom, J. Ryan Thigpen, Michael M. Mcglue, Jason M. Dortch, Sean Gallen, Edward W. Woolery, Kevin M. Yeager

Earth and Environmental Sciences Faculty Publications

This study examines the role of topography as a dynamic boundary condition that limits the efficiency of fluvial erosion in the post-glacial Teton Range landscape. The volume of sediment currently stored in two major catchments was estimated using high-resolution LiDAR and geometric reconstructions of depth to bedrock. Seismic reflection data in Moran Bay reveals post-glacial sediment preserved behind a submerged moraine, which isolates the bay from the larger Jackson Lake depocenter. The volume of post-glacial sediment stored in the canyons and bay totals 173.82 ± 19.5336.0 (×10−3 km3), which translates to a catchment-wide sediment production rate of 0.17 ± 0.02 …

A Framework For Ai Implementation In Construction: Use Cases, Challenges, And Benefits For Contractors, Jaqueline De Aquino Leite Gomes

Theses and Dissertations--Civil Engineering

The construction industry is one of the most important sectors that contribute to the economy worldwide, but it has been very slow in adopting digital transformation. Artificial Intelligence is the backbone of digital innovation, and it can help solve inefficiencies, improve safety, and enhance decision-making in construction. This thesis reviews 85 academic papers, identifies 354 AI use-cases, 180 benefits, and 173 challenges. Key findings have looked at the role of AI in safety monitoring, design optimization, and operational efficiency, while barriers involve data scarcity, high costs, and readiness of the workforce.

All of these challenges have one very handy framework …

Advancing Clinical Trial Readiness In White Matter Disease And Related Dementias: Key Steps For Future Research Progress, Pradoldej Sompol, Gregory A. Jicha, Jason D. Hinman, Adam M. Brickman, Steven M. Greenberg, Konstantinos Arfanakis, Marion S. Buckwalter, Irene Lorenzo Llorente, Jeff D. Williamson, Michael S. Wolf, Eric E. Smith, Aditi Gupta, Margaret E. Flanagan, Miguel A. Vazquez, Jeffrey M. Burns, S. Thomas Carmichael, Frank C. Barone

Pharmacology and Nutritional Sciences Faculty Publications

White matter disease, a broad-spectrum term that covers various types of white matter lesions and degeneration, is strongly related to age-related neurodegenerative disorders including Alzheimer’s disease (AD), and vascular contributions to cognitive impairment and dementia (VCID) and Alzheimer’s related dementias (ADRD). There is no specific treatment for white matter disease. Therefore, basic research and clinical studies are essential for future outcomes. Since its formation in 2020, the Albert Research Institute for White Matter and Cognition (ARIWMC) mission has been to support white matter research by providing a forum for communication where basic and clinical scientists meet to discuss and debate …

Description Of Implementing A Mail-Based Overdose Education And Naloxone Distribution Program In Community Supervision Settings During Covid-19, Carrie B. Oser, Margaret Louise Mcgladrey, Douglas Oyler, Hannah K. Knudsen, Sharon L. Walsh, Susannah Stitzer, Michael Goetz, Marisa Booty, Erica Hargis, Sarah Johnson, Michele Staton, Patricia R. Freeman

Behavioral Science Faculty Publications

Introduction: This study uses the Exploration, Preparation, Implementation , and Sustainment (EPIS) model to retrospectively describe the mail-based overdose education and naloxone distribution (OEND) program developed in collaboration with the Kentucky Department of Corrections (DOC) for use in the HEALing Communities Study in Kentucky (HCS-KY) and details the reach of this innovative delivery model.

Methods: HCS-KY is a community-engaged cluster-randomized trial assessing the effects of implementing evidence-based practices, including OEND, on overdose death reduction across 16 communities highly impacted by the opioid epidemic in Kentucky. ⁶ The study launch coincided with the COVID-19 pandemic. All coalitions in the 16 HCS-KY …

Multi-Scale Computational Mechanical Modeling Of Complex Multi-Phase Materials Systems, Naji Al-Mashrafi

Theses and Dissertations--Chemical and Materials Engineering

This thesis employs finite-element–based computational methods to investigate how microstructural features and material heterogeneity govern mechanical behavior across three distinct complex systems. First, the elastic response of open-cell metallic foams is analyzed using large ensembles of model RVEs generated with the Kentucky Random Structures Toolkit (KRaSTk); finite-element homogenization reveals that effective stiffness is not dictated by relative density alone, as the skewness of ligament-length distributions—captured by the second Pearson’s coefficient—exerts a strong and previously unrecognized influence, with structures enriched in short load-bearing ligaments exhibiting consistently higher stiffness even at fixed density and connectivity. The second study examines heterogeneous polycrystalline solids …

A Knowledge-Based Planning Model To Identify Fraction-Reduction Opportunities In Brain Stereotactic Radiotherapy, Shane Mccarthy, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Objective: To develop and validate a HyperArc-based RapidPlan (HARP) model for three-fraction brain stereotactic radiotherapy (SRT) plans to then use to replan previously treated five-fraction SRT plans. Demonstrating the possibility of reducing the number of fractions while achieving acceptable organs-at-risk (OAR) doses with improved target biological effective dose (BED) to brain lesions. Methods: Thirty-nine high-quality clinical three-fraction HyperArc brain SRT plans (24–27 Gy) were used to train the HARP model, with a separate 10 plans used to validate its effectiveness. Fifty-eight five-fraction HyperArc brain SRT plans (30–40 Gy) attempted to be retrospectively replanned for three fractions scheme using the HARP …

An Investigation Into The Feasibility And Efficacy Of Stereotactic Radiosurgery For 1–3 Cm Single Brain Lesions On The Ring-Mounted Halcyon Linac, Kristin J. Hazelwood, Shane Mccarthy, Josh Misa, David Castelvetere, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose: An evaluation of the accuracy, safety, and efficiency of the Halcyon ring delivery system (RDS) for stereotactic radiosurgery (SRS) treatment to relatively small (1–3 cm) brain lesions.

Methods: After completing the extensive in-house quality assurance checks including Winston–Lutz test and independent dose verification via MD Anderson IROC SRS head phantom irradiation on Halcyon, fifteen brain SRS patients previously treated with a single dose of 20 Gy on TrueBeam (6MV-FFF) with HyperArc geometry were retrospectively replanned on Halcyon (6MV-FFF). Plan quality metrics including conformity index (CI), gradient index (GI), gradient distance (GD), PTV coverage, gross tumor volume (GTV) dose, heterogeneity …

A Predictive Quality Assurance Model For Patient-Specific Gamma Passing Rate Of Hyperarc-Based Stereotactic Radiotherapy And Radiosurgery Of Brain Metastases, Shane Mccarthy, Brent Harrison, Damodar Pokhrel

Radiation Medicine Faculty Publications

Objective: Measurement-based patient specific quality assurance (PSQA) is an increasingly debated topic among medical physicists. Developments like online adaptive radiotherapy and same-day stereotactic treatments limit the time to do measurement-based PSQA. Herein, we develop a predictive machine learning model to supplement PSQA by predicting the gamma passing rate (GPR) per stereotactic arc. This streamlines PSQA, providing planners the insight to replan potentially sub-optimal plans, to mitigate machine time inefficiencies.

Methods: 122 patients that had previously received HyperArc stereotactic radiosurgery/radiotherapy on a TrueBeam LINAC (Millenium 120 MLCs, 6MV-FFF) were used to generate a long short-term memory (LSTM) recurrent neural network to …

Automated Hippocampal Sparing Whole Brain Radiotherapy With Simultaneous Integrated Boost For Multiple Brain Metastases: Halcyon, Hyperarc On Truebeam, And Coplanar Truebeam, Shane Mccarthy, Ryan Clark, Anthony Magliari, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose: To demonstrate the ease and feasibility that hippocampal sparing whole brain (WB) simultaneous integrated boost (HSWB-SIB) plans can be generated using knowledge-based planning and Eclipse Scripting Application Programming Interface (ESAPI) for three different modalities, HyperArc on TrueBeam (TB-HA), a coplanar beam arrangement on TrueBeam (TB-Co), and the ring-mounted Halcyon LINAC (Hal).

Methods: Twelve patients with 2–14 brain metastases were retrospectively replanned for HSWB-SIB using a published HSWB RapidPlan model with modifications for the automated addition of SIB to metastases. Prescribed dose was 30 Gy to the WB planning target volume (PTV) and 50 Gy to the metastases in 10 …

Feasibility Of Treatment Planning With Hyperarc Stereotactic Radiosurgery Methods For Ocular Tumors, Chase Cochran, Shane Mccarthy, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose/objectives

Currently, ocular disease is primarily managed with COMS plaque brachytherapy. Various stereotactic radiosurgery (SRS) platforms have also been employed, yet widespread access remains a challenge. Herein, we demonstrate the feasibility of using the HyperArc SRS system to provide an additional platform for the treatment of ocular malignancies.

Materials/methods

Twenty previously treated COMS patients with ocular melanoma were selected for a retrospective HyperArc SRS planning study. The average gross tumor volume (GTV) derived from MRI was 1.19 ± 0.60 cc. Planning target volumes (PTV) were generated from a 2 mm expansion of the GTVs. HyperArc plans were created for a …

Establishing A Variant Allele Frequency Cutoff For Manual Curation Of Medical Exome Sequencing Data, Kate Sears, Caylin Hickey, Ryan Vincent, Jennifer Stocks-Candelaria, Jason Tate, Cody Bumgardner, Shulin Zhang, Justin B. Miller

Pathology and Laboratory Medicine Faculty Publications

Medical exome sequencing pipelines consist of various preprocessing steps to prioritize credible causal variants before a pathologist or variant curation scientist manually interprets potential findings that are then reported to patients. The variant allele frequency (VAF), reported as the fraction of sequencing reads supporting a variant call, can be used to screen for technical artifacts, yet a specific filtering threshold has yet to be established. A total of 13,122 manually curated variants, sequenced from 289 patients using the Agilent SureSelect Focused Exome enrichment kit at the University of Kentucky Clinical Genomics laboratory from October 2019 to May 2023, were evaluated. …

Forage News [2025-07], University Of Kentucky

Forage News

No abstract provided.

Ex Vivo Single-Molecule Analysis Of Ryanodine Receptor 2 Assembly In Cardiac And Neuronal Tissue, Qianye Yin, Christopher I. Richards

Chemistry Faculty Publications

Understanding receptor assembly is critical for elucidating the mechanisms underlying their function and regulation in physiological processes. While traditional in vitro single-molecule studies rely on isolating proteins from heterologous expression systems, they often fail to capture the in vivo physiological complexity involved in the organization and assembly of cell surface proteins. This protocol employs Total Internal Reflection Fluorescence Microscopy (TIRFM) to study GFP-tagged Ryanodine Receptor 2 (RyR2) molecules encapsulated within nanoscale vesicles. These vesicles, generated from organs rapidly extracted from the animal, effectively provide a snapshot of the receptor's assembly state at the time of extraction, enabling detailed analysis of …

Incarceration Reimagined: A Diversionary Option For Serious Felony Offenders, Jane Mitchell

Kentucky Law Journal

No abstract provided.