Cancer-Associated Fibroblast Secreted Dkk1 Promotes The Immunosuppressive Tumor Microenvironment And Colorectal Cancer Resistance To Chemotherapy, Zhijie Yin, Yuning Zhou, Xudong Zhu, Ryan A. Goettl, Chi Wang, Heidi L. Weiss, B. Mark Evers, Qingding Wang

Markey Cancer Center Faculty Publications

Chemotherapy is the cornerstone of treatment for colorectal cancer (CRC). However, acquired resistance can lead to a decrease in the efficiency of chemotherapy. Here, we show that cancer-associated fibroblasts (CAFs) play a critical role in acquired resistance to chemotherapy. Treatment with 5-fluorouracil (5-FU), oxaliplatin, or SN38 (an active metabolite of irinotecan) increased DKK1 expression and secretion, activation of MEK/ERK, and upregulation of p53 in CAFs. Knockdown of p53 or inhibition of MEK/ERK blocked the increase in DKK1 expression induced by chemotherapeutic agents in CAFs. Consistently, elevated DKK1 and phospho-ERK levels were found in CAFs isolated from surgically resected samples of …

Hsp47 Drives Obesity-Associated Breast Cancer Progression By Enhancing Asporin Deposition In Adipose Tissue, Gaofeng Xiong, Daheng He, Dana L. Napier, Jing Chen, Haizhu Shi, Chun Li, Paula J. Hurley, Chi Wang, Haining Zhu, Changcheng Zhou, Therese J. Bocklage, Ren Xu

Markey Cancer Center Faculty Publications

Fibrosis is an important feature of adipose tissue in obese individuals; nevertheless, roles of obesity-associated extracellular matrix (ECM) deposition in breast cancer progression largely remain elusive. Here, we show that expression of Hsp47, a chaperone protein involving collagen secretion, is induced in adipose tissue from obese humans and mice. Adipocyte-specific Hsp47 deletion (Adi-KO) suppresses the high-fat diet (HFD)-induced obesity and mammary tumor progression, accompanied by a reduction in ECM deposition. Matrisome analyses lead to the identification of asporin as a new target of Hsp47 in adipose tissue. Co-immunoprecipitation results confirm that the recruitment of Hsp47 enhances asporin secretion in adipocytes. …

Cancer Advocacy Empowers Appalachian Kentucky Youth, Lauren Hudson Rose, Holly Burke, Olivia Thornsbury, Kameron Jackson, Rebecca Spradlin, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky has the highest cancer incidence rate and second highest cancer mortality rate in the United States, and the Appalachian region of the state experiences a disproportionate cancer burden. Cancer-related advocacy, a movement that strives to provide support to cancer patients, families, and organizations, along with policy creation, could help address this disparity by enhancing cancer-related prevention and control efforts. The University of Kentucky Markey Cancer Center’s Appalachian Career Training in Oncology (ACTION) Program partners with the American Cancer Society Cancer Advocacy Network (ACS CAN) to involve Appalachian Kentucky high school and undergraduate students in cancer advocacy activities at the …

Identifying Risk Factors For Adverse Lung Health Outcomes Among Rural Appalachian Women, Jessica R. Thompson, Courtney J. Walker, John C. Flunker, W. Jay Christian, Wayne T. Sanderson, Nancy E. Schoenberg, Steven R. Browning

Markey Cancer Center Faculty Publications

Purpose: Despite high rates of lung disease and lung cancer among women, few studies have focused on adverse lung health risk factors among rural Appalachian women. We aim to describe the prevalence of demographic, behavioral, and economic characteristics among a cohort of rural Appalachian women and ascertain the association between these risk factors and lung function.

Methods: Through a cross-sectional study in two rural Appalachian Kentucky counties (2015–2017), we collected demographics, health history/behaviors, and lung function via pulmonary function tests. Restricting to female participants with interpretable pulmonary function tests (N = 456), we estimated prevalence ratios of the association …

Characterizing Agroecosystem Effects Of Industrial Hemp On A Rotational Row Cropping System And Microbial Communities, Kent D. Pham

Theses and Dissertations--Plant and Soil Sciences

The implementation of crop rotation on a farm can have many benefits for agroecosystem health and production. This practice can potentially reduce nutrient amendments, disrupt pest and disease cycles, and increase crop yields. In Kentucky, one common rotation consists of either corn or soybean grown the first year, followed by the other crop, repeated every two years. Industrial hemp, grown for fiber or grain, is an emerging crop that has shown promise as a rotation alternative, although not much is known about its effects on soil health, agroecosystem functioning, and microbial communities. To better characterize hemp’s role within American agriculture, …

Factors Impacting Germination, Emergence, And Establishment Of Direct Seeded And Transplanted Hemp (Cannabis Sativa L.), Paul Cockson Dr.

Theses and Dissertations--Plant and Soil Sciences

Industrial hemp (IH) establishment has many challenges including: poor emergence, low stand establishment, and variable plant development in direct seeded hemp. In floral hemp production, quality transplant production is a challenge with seedlings often becoming root bound and etiolated. In both direct seeded and transplant hemp, the relationship between root vigor and vegetative growth has not been studied and may prove insightful for managing emergence and establishment challenges. The goals of this study were three-fold: 1) to measure and describe root system architecture (RSA) and root phenotypes observed in selected IH cultivars especially in regard to identifying agronomically important RSA …

Evaluation Of Poaceae Species And Suppression Application Methods For Perennial Groundcover In Corn, Hallie A. Sandeen

Theses and Dissertations--Plant and Soil Sciences

Intensive grain production aims to provide food security but has depleted once-perennialized land. Perennial groundcover (PGC) offers ecosystem services to intensive annual corn (Zea mays L.) production. In past research conducted in the U.S. Midwest, Kentucky bluegrass (Poa pratensis L.) has been the standard PGC species. However, it is slow growing and difficult to suppress. To characterize the PGC system in the midsouth, two separate field trials in Lexington, Kentucky, were conducted to (i) compare the first-year establishment of alternative cool-season species to Kentucky bluegrass, with and without a spring-applied broadleaf herbicide, and their impact on corn grain …

Fault Identification And Localization In Distribution Grids Based On An Attention-Hybrid Graph Neural Network, Xingjian Shan

Theses and Dissertations--Electrical and Computer Engineering

This thesis proposes a multi-task fault diagnosis framework for distribution systems based on Graph Convolutional Networks (GCN) and an enhanced Graph Attention Network (GATv2). By representing the power grid as a graph with electrical features and topological connections, the model simultaneously performs fault type classification and fault location prediction. The architecture incorporates residual connections, multi-head attention, and a Jumping Knowledge module to capture multi-scale structural patterns, while dynamic loss weighting ensures balanced task optimization under noise and sparsity. Experimental results on the IEEE 123-node test feeder demonstrate a fault classification accuracy of 96.43%, and fault localization accuracies of 84.64% (strict), …

Surface Morphology And Moisture Adsorption/Desorption Characteristics Of Hybrid-Dielectric Moisture Sensors, Ronak Ali

Theses and Dissertations--Electrical and Computer Engineering

Relative humidity sensors are used for high-humidity measurement. Moisture sensors, or dew point sensors are used for low-humidity measurement (< 1 ppm_v). The dissertation contains two parts of studies. In the first part, the effect of surface morphology on the response speed of moisture sensors is studied. Moisture sensors using α-Al₂O₃ films as porous dielectric materials deposited by anodic spark deposition are studied. In this part of the study, a variety of small pores have been studied to investigate the response speed of moisture sensors. Three different surface morphologies have been studied using scanning electron microscopy. One …

Measurement Of Moisture Levels In Oils And Lubricants Using A Novel Moisture Sensor, Aaron Swartz

Theses and Dissertations--Electrical and Computer Engineering

It is very challenging to measure moisture levels in oils. There is not a good method to measure it. Using the novel moisture sensor, we tried various methods to measure the moisture levels in oils. The initial trials are to immerse the sensor chip into the oils to see any sensor reading changes with the change of moisture levels in oils. It was observed that the sensor reading was unstable. The idea for immersion of the sensor chip into the oils failed. The last idea is to heat the oil to let all moisture evaporate fully. Before heating, the dew …

Mathematical-Programming Modeling Of Power-Electronics-Based Microgrid Systems, Jack A. Robey

Theses and Dissertations--Electrical and Computer Engineering

The emergence of power-electronics-based microgrid systems is driven by the shift to cleaner energy, transportation electrification, renewable integration, grid modernization through smart grid advancements, and growing demand for energy-efficient solutions. For utilities, these systems present unique opportunities for enhancing grid resilience, improving load management, and enabling distributed energy resource integration. This work presents a modeling and simulation approach for microgrid systems that uses mathematical programming to represent power flow and capture the system dynamics. By solving an optimization problem at each time step, the method enables evaluation of power distribution and system performance under a range of operating conditions, without …

Computing With Photonic Phase Change Memory, David B. Pippen

Theses and Dissertations--Electrical and Computer Engineering

A recent breakthrough in silicon photonics includes the discovery and use of phase changing materials (PCMs). These materials can be programmed to store nonvolatile values, and when a stored value in a PCM cell is read, it changes the amplitude of the read signal, imprinting the value held into the PCM cell on the amplitude of the read signal. This thesis proposes a new approach to using PCM cells not only for photonic memory but also as a substrate to perform multiplications in the photonic domain. The proposed multiplier uses PCM cells to encode amplitude-analog weight values and differing lengths …

Scalable Hypergraph Structure Learning With Diverse Smoothness Priors, Benjamin T. Brown

Theses and Dissertations--Electrical and Computer Engineering

In graph signal processing, learning weighted connections between nodes from signals is a fundamental task when the underlying relationships are unknown. With the extension of graphs to hypergraphs, where edges can connect more than two nodes, graph learning methods have similarly been generalized to hypergraphs. However, the absence of a unified framework for calculating total variation has led to divergent definitions of smoothness and, consequently, differing approaches to hyperedge recovery. This challenge is confronted in this work through generalization of several previously proposed hypergraph total variations, allowing ease of substitution into a vector-based optimization. To this end, a novel hypergraph …

Electromagnetic Integral Equation Methods For High-Order Field Predictions, Jordon N. Blackburn

Theses and Dissertations--Electrical and Computer Engineering

Methods like the Method of Moments (MoM) or the locally-corrected Nyström (LCN) method are employed to discretize and solve electromagnetic integral equations. This process results in large, dense systems of linear equations that must be solved. In many cases, the elements of the system matrix can be computed analytically or approximated with high-order numerical methods. In this thesis, various approaches are presented to improve the accuracy and efficiency of integral equation solutions.

The second chapter derives a modified form of the low-rank matrix approximation algorithm known as the adaptive cross approximation (ACA). The original ACA has been observed to lose …

Lifecycle Carbon Footprint And Sustainability Evaluation Of Dram-Based Processing In Memory Computing Architectures, Samrat Pravin Patel

Theses and Dissertations--Electrical and Computer Engineering

The use of computing technologies has significantly enhanced several aspects of our day-to-day lives. But it has still revealed significant environmental concerns, primarily related to greenhouse gas emissions and energy consumption. Initially, the primary environmental problems associated with computing were energy consumption during device operation. However, with the rapid advancement of technology and increasing computational demands, attention has shifted towards the embodied carbon footprint. This term refers to the total greenhouse gas emissions throughout a product’s lifecycle from the extraction of raw materials to end-of-life processing. It has become increasingly significant in the context of manufacturing integrated circuits (ICs), such …

Afapbp: Aggregate Function Accelerated Parallel Bit-Pattern Computing, Charles Z. Armstrong

Theses and Dissertations--Electrical and Computer Engineering

Classical computing models have proven sufficient for problems of the complexity class ``P", but problems of a higher complexity class like ``NP", ``NP-Hard", etc. have been shown to be more resistant to efficient computation. Quantum Computing is an alternative computing model that specifically targets performing computations within the ``NP" complexity class in close to linear time. However, Quantum Computing has its own set of problems. Methods for dealing with quantum decoherence, error correction, and difficulty in scaling have all inhibited Quantum Computing from becoming a commonly used computational model. This thesis introduces AFAPBP (Aggregate Function Accelerated Parallel Bit Pattern), a …

Scalable Systems And Devices For Wireless Charging Of Electric Vehicles, Donovin D. Lewis

Theses and Dissertations--Electrical and Computer Engineering

The rising adoption of electric vehicles creates new opportunities that are not possible with conventional gas-powered vehicles such as wireless charging of electric vehicles (EV). Wide-scale implementation of wireless charging could result in benefits unique to EVs such as operation without human intervention, improved charging accessibility, and even in-route wireless charging for charge-sustaining or extended driving range operation. As the technology is in the early stages of development, there are many open-ended challenges to tackle including but not limited to coil and systems cost, weight and size, stray field emissions in high-power, high-frequency operation, and dynamic wireless charging system design …

Analysis And Design Optimization Of Electric Machines With Field Intensifying Configuration, Ali Mohammadi

Theses and Dissertations--Electrical and Computer Engineering

The design and optimization of electric machines face increasing demands for efficiency, improved torque density, manufacturability, and effective utilization of materials. Meeting these demands is particularly vital in for example, electric vehicles (EVs) and renewable energy systems, where performance, reliability, and cost are critical. In this dissertation innovative field-intensifying electric machine configurations have been explored, emphasizing advanced topologies, computational modeling, and optimization techniques to advance the state of the art in electric machine design and analysis.

Electric machines with high torque density are essential for many low-speed direct-drive systems, such as wind turbines, in-wheel traction, and industrial automation. This dissertation …

Multi-Objective Design Optimization Of Power Converters For Electric Aircraft Propulsion, Ben Luckett

Theses and Dissertations--Electrical and Computer Engineering

As global focus shifts to the electrification of the aviation sector, the need for high efficiency, lightweight, and reliable electric aircraft propulsion power converter systems has become apparent. These goals can be somewhat conflicting with each other, and a single multi-domain-optimized solution is not guaranteed. The search for a design which presents satisfactory merits becomes a drudge through various trade-off studies which can expend vast quantities of manpower and time. As a remedy to this, design automation allows the process to be computer-assisted. This dissertation presents the core fundamentals for a general multi-objective design optimization framework intended for the design …

A Nurse-Driven Protocol To Increase Music Therapy Referrals To Manage Patient Pain And Anxiety In The Medicine Intensive Care Unit, Ashley Fox

DNP Projects

Background: Critically ill patients often suffer from pain and anxiety. Music therapy is a safe and effective treatment option. However, most nurses never receive education or training on it, resulting in a lack of awareness of its value and its actual usage in care.

Purpose: The purpose of this project was to increase the number of music therapy referrals to manage pain and anxiety in eligible medicine intensive care unit (MICU) patients via a music therapy protocol that increased nurses’ knowledge, attitudes, and skills related to the use of music as an alternative treatment option for pain and anxiety in …

Evaluating The Efficacy Of A Progressive Mobility Protocol Among Adult Icu Patients, Clayton Chroust

DNP Projects

Background: Many intensive care unit (ICU) patients are critically ill and require ventilator support, and they often do not receive any progressive mobility interventions until after they are liberated from the ventilator or receive transfer orders out of the ICU. Current literature suggests that patients in the ICU face deconditioning, increased ventilator days, development of deep vein thrombosis, pressure ulcers, pulmonary embolism, muscular atrophy, and increased days in the ICU which can be attributed to a lack of mobility. Current evidence-based research identifies that utilization of a progressive mobility protocol is one way to improve patient outcomes and reduce …

Implementation Of A Process To Improve Compliance With A Nurse Driven Foley Catheter Removal Protocol In Nursing Staff Of A Medicine Intensive Care Unit, Kendall L. Pfister

DNP Projects

Background: Catheter associated urinary tract infections (CAUTI) are the most prevalent healthcare acquired infection (HAI) in the acute care setting. Unfortunately, CAUTIs can lead to high morbidity and mortality rates, longer length of stay (LOS) and increased healthcare costs. Unfortunately, in critically ill patients which often suffer multi-organ failure/injury, there remains an increased risk for infection and poor outcomes.

Purpose: The purpose of this project is to increase medical intensive care unit (MICU) nursing staffs’ knowledge of existing nurse driven indwelling urinary catheter removal protocol and to implement an electronic medical record (EMR) prompt for removal of unnecessary urinary catheters …

Utilizing Integrative Medicine Services For Yoga To Reduce Cancer Related Fatigue, Leah R. Yeager

DNP Projects

Background: Cancer related fatigue (CRF) is one of the most prevalent and distressing side effects experienced by individuals undergoing cancer treatment. In fact, many patients report CRF as more debilitating than pain itself. CRF is characterized by persistent, severe exhaustion that is not alleviated by sleep and is not linked to prior exertion. Despite its widespread impact, the options available to manage CRF are limited, typically including practices like good sleep hygiene, balanced nutrition, mindfulness, and supplements. Integrative medicine, particularly yoga, has emerged as a promising intervention for reducing CRF. However, yoga is underutilized as a therapeutic approach to combat …

Implementation And Evaluation Of A Competency-Based Phased Orientation Program For Nurse Practitioners In The Intensive Care Unit Setting, Meredith Sherer

DNP Projects

Background: Research has demonstrated that structured orientation helps to integrate new nurse practitioners (NPs) into practice, ease role transition, decrease NP turnover, and lead to better patient care. However, at University of Kentucky HealthCare (UKHC) clinical orientation programs for NPs are not standardized.

Purpose: The purpose of this project was to implement and evaluate a competency-based phased orientation program for NPs in the intensive care unit (ICU) setting at UKHC.

Methods: This project utilized a prospective, single group, presurvey-postsurvey design to examine the effect of a three-phased competency-based orientation program on the outcome variables of NP confidence, autonomy, proficiency of …

Evaluating Knowledge, Skills, Attitudes, And Suicide Hotline Referrals In Aprns Screening Children For Depression And Suicide In Primary Care, Brooklyn D. Higginbotham

DNP Projects

Background: Suicide is the 2nd leading cause of death in adolescents across the United States (US). Primary care providers (PCPs) are often the first people an adolescent sees for depression or suicide symptoms; however, evidence shows PCPs may not be comprehensively screening for suicide in the primary care setting by using the Patient Health Questionnaire (PHQ) alone. Screening tool usage for depression and suicide among PCPs is currently at rates as low as 26% due to lack of knowledge and insufficient resources. Evidence-based education on American Academy of Pediatrics (AAP) recommendations can improve PCPs’ knowledge, skills, and attitudes when assessing …

The Effect Of A Hospital Community Garden On Healthcare Workers’ Professional Quality Of Life, Madelyn Renee Cline

DNP Projects

Background: Healthcare professionals experience a variety of stressors which negatively impact their professional quality of life (ProQOL) potentially leading to increased turnover and nurse shortages in hospitals. There are growing studies addressing ways to improve healthcare ProQOL, yet few have examined the impact of alterations to the workplace on these outcomes.

Purpose: The purpose of this project was to evaluate the effect of a dedicated outdoor green space for nurses during shift breaks on their ProQOL.

Methods: This project used a one-group pretest-posttest design. Data analysis was completed using descriptive and inferential statistics using SPSS software. The Professional Quality of …

Implementation Of A Pilot Post-Code Debrief Tool Initiated By The Chaplains And Unit Lead Nurses Within The Medicine Intensive Care Unit, Sarah Stigall

DNP Projects

Background: Post-code debriefs are shown to improve teamwork and communication, increase performance, and reduce burnout. According to the University of Kentucky HealthCare (UKHC) policy, teams are to perform a post-code debrief immediately after an in-hospital cardiac arrest (IHCA). However, the current policy does not provide guidance on what to include during a debrief session. At UK post-code debrief sessions are documented as occurring 60-72% of the time; however, personal observation and discussions with other bedside and rapid response nurses suggest that post-code debriefs are underperformed when compared to the documentation. Purpose: This study aimed to explore barriers to post-code debriefs …

Nurse-Led Cbt For Depression In Heart Transplant Patients: A Feasibility Study, Matthew R. Wallace

DNP Projects

Background: Heart transplant recipients are at an elevated risk of experiencing depressive symptoms compared to the general population. Those with depression post-transplant face increased complications, e.g., infection, organ rejection, prolonged hospitalization, and higher mortality rates. However, specific psychotherapeutic interventions tailored for heart transplant recipients remain limited. Nevertheless, there is substantial evidence supporting the effectiveness of various interventions for adults with heart failure, a condition frequently diagnosed in these patients. This suggests that successful strategies for managing depressive symptoms in heart failure patients could be adapted for heart transplant recipients.

Purpose: The purpose of this project was to evaluate …

Effectiveness Of A Multi-Departmental Nursing Tiered Orientation Model On Service Line Culture, Self-Efficacy Of Nurses, Positive Patient Outcomes And Nurse Satisfaction, Kimberly Thompson

DNP Projects

Abstract
Background: Nurses who transition into specialty practice areas in healthcare settings may demonstrate a lack of confidence and a high level of stress. Decreased levels of nursing engagement, self-efficacy, and interdepartmental team collaboration may also be seen. Multi-departmental tiered orientation models can help facilitate the development of increased confidence and competence and ultimately lead to improved patient outcomes.

Purpose: The purpose of this doctoral project was to evaluate the effectiveness of a multi-departmental tiered orientation model for nurses hired into a specialty area. The specific objectives included were to a) determine the effectiveness of the model on service line …

Evaluation On The Effectiveness Of A Virtual Reality (Vr) Guided Meditation Intervention On Pre-Procedural Anxiety In An Outpatient Dental Clinic, Anansa Thompson

DNP Projects

Background: Mental health issues, particularly anxiety, represent a significant public health concern in the United States, with dental anxiety affecting anywhere between 50% and 80% of adults (White et al., 2017). Pre-procedural anxiety in outpatient dental clinics complicates patient care and can lead to avoidance of necessary dental treatments, impacting both oral and overall health. Non-pharmacological interventions, such as immersive virtual reality (VR) guided meditation, offer promising solutions to address anxiety in healthcare settings.

Purpose: This study aims to evaluate the effectiveness of VR guided meditation on pre-procedural anxiety among adults undergoing painful dental procedures at an outpatient …