Medicine and Health Sciences Commons^™

Geographic And Temporal Trends In Pediatric And Young Adult Brain Tumors In Kentucky, 1995–2019, W. Jay Christian, C. J. Walker, Jaclyn K. Mcdowell, B. Huang, T. C. Tucker, John L. Villano, Eric B. Durbin

UK CARES Faculty Publications

Introduction: Pediatric and young adult brain tumors (PYBT) account for a large share of cancer-related morbidity and mortality among children in the United States, but their etiology is not well understood. Previous research suggests the Appalachian region of Kentucky has high rates of PYBT. This study explored PYBT incidence over 25 years in Kentucky to identify geographic and temporal trends and generate hypotheses for future research. Methods: The Kentucky Cancer Registry contributed data on all PYBT diagnosed among those aged 0–29 during years 1995–2019. Age- and sex-adjusted spatio-temporal scan statistics—one for each type of PYBT, and one for all types—comprised …

Cbt And Me: A Beginning Therapist's Journey Utilizing Client Feedback, Haley Scruggs

Theses and Dissertations--Family Sciences

Cognitive behavioral couple therapy (CBCT) is a model of therapy targeting cognitions, emotional responses, and behavioral interactions between couples experiencing relationship distress. Routine outcome monitoring (ROM) is a tool that clinicians can use to track the progress of their clients in therapy from the perspective of the client. This study aimed to use MFT-PRN, a type of ROM, to gather client progress throughout CBCT treatment. Prototypical change trajectories were created in Microsoft Excel for examination of presenting problem progress, couple satisfaction, and overall relationship functioning. It was found that small data sensitivity affected the trajectories immensely, though ROM outcomes revealed …

Routine Outcome Monitoring In Emotionally Focused Therapy: A Clinical Perspective, Lillian Dunn

Theses and Dissertations--Family Sciences

The field of couple and family therapy has a foundation in systems theory and recognizes the intricate dynamics of relationships. Therapists often navigate complex webs of connection, aiming to enhance communication, foster healthy interaction patterns, and cultivate emotional well-being to strengthen relational bonds. This thesis focuses on the integration of routine outcome monitoring (ROM) within Emotionally Focused Therapy (EFT) and aims to shed light on its role in achieving therapeutic goals. ROM tools offer insights into the therapeutic process, facilitating tailored interventions to meet clients' needs. The findings suggest that integrating ROM into EFT benefits therapists and clients, enhancing our …

Thermophilic Aerobic Digestion Using Aquaculture Sludge From Rainbow Trout Aquaculture Facilities: Effect Of Salinity, Jihyun Chun, Su Min Kim, Gwangil Ko, Hyo Jeong Shin, Minjae Kim, Hyun Uk Cho

UK CARES Faculty Publications

The objectives of this study were to evaluate the potential of using thermophilic aerobic digestion (TAD) to hydrolyze aquaculture sludge, and to investigate the hydrolysis efficiency and changes in microbial community structure during TAD at 0, 15, and 30 practical salinity units (psu). As digestion progressed, soluble organic matter concentrations in all reactors increased to their maximum values at 6 h. The hydrolysis efficiency at 6 h decreased as salinity increased: 2.42% at 0 psu, 1.78% at 15 psu, and 1.04% at 30 psu. The microbial community compositions at the genus level prominently differed in the relative abundances of dominant …

Treating Young Adult Cannabis Use Disorder With Text Message-Delivered Peer Network Counseling, Nikola Zaharakis, J. Douglas Coatsworth, Nathaniel R. Riggs, Aubrie Radford, Stephanie Rayburn, Jeremy Mennis, Michael A. Russell, Aaron Brown, Michael J. Mason

Social Work Faculty Publications

Background: Approximately 16.5% of U.S. young adults have a cannabis use disorder (CUD) and are at risk for negative outcomes. Treatment can reduce cannabis use, but young adults are less likely to seek help than older adults. Peer Network Counseling-txt (PNC-txt) is a brief, text-delivered, Motivational Interviewing-informed substance use intervention focusing on peer relations and activity spaces as mechanisms for behavioral change. PNC-txt has shown evidence of reducing tobacco and cannabis use with adolescents and young adults, but it has not been tested in the context of legal cannabis use. The current randomized controlled trial sought to expand the evidence …

Neonatal Abstinence Signs During Treatment: Trajectory, Resurgence And Heterogeneity, Jennifer S. Miller, Henrietta S. Bada, Philip M. Westgate, Thitinart Sithisarn, Markos Leggas

Pediatrics Faculty Publications

Neonatal abstinence syndrome (NAS) presents with a varying severity of withdrawal signs and length of treatment (LOT). We examined the course and relevance of each of the NAS withdrawal signs during treatment in a sample of 182 infants with any prenatal opioid exposure, gestational age ≥ 35 weeks, without other medical conditions, and meeting the criteria for pharmacological treatment. Infants were monitored using the Finnegan Neonatal Abstinence Scoring Tool. Daily mean Finnegan scores were estimated using linear mixed models with random subject effects to account for repeated withdrawal scores from the same subject. Daily item prevalence was estimated using generalized …

Relationships Between Cognitive And Physical Performance And Readiness In Military Populations, Lina Ochoa

Theses and Dissertations--Rehabilitation Sciences

Military missions and operations expose warfighters to stressful and demanding situations and dynamic environments. These situations and environments require that warfighters have optimal performance in several dimensions of human performance, such as cognitive and physical performance. Military readiness is the potential these military units or personnel have to successfully deploy and sustain assigned operational missions worldwide. Military readiness is essential for increased physical and cognitive performance, ensuring augmented individual and unit effectiveness, lethality, and national security. The primary challenge is understanding and finding ways to measure and assess the cognitive, behavioral, and physical performance effects of complex and challenging environments …

Neuroimmune Response And Neurodegeneration In Adolescent Rats Following Binge Alcohol Exposure, Catherine Van Doorn

Theses and Dissertations--Pharmacy

Studies of adolescent drinking show a distinct prevalence of binge drinking, including at extreme levels, and this type of drinking has been identified as increasing risk of developing an Alcohol Use Disorder (AUD). Additionally, females suffer greater levels of harm from binge drinking and AUD and in an abbreviated timeline compared to males. Neuroimmune reactivity, specifically with microglial reactivity following binge drinking, may influence the sex differences seen in negative alcohol-related health disparities.

The first set of experiments sought to examine a marker of microglial reactivity, TSPO, in adolescent females and males and found the sexes displayed different temporal and …

Sustainable Additive Manufacturing Of Polysulfone Membranes For Liquid Separations, Brian Leonard, Harrison Loh, David Lu, Ebuka A. Ogbuoji, Isabel Escobar, Konstantinos Sierros, Oishi Sanyal

UK CARES Faculty Publications

Membranes serve as important components for modern manufacturing and purification processes but are conventionally associated with excessive solvent usage. Here, for the first time, a procedure for fabricating large area polysulfone membranes is demonstrated via the combination of direct ink writing (DIW) with non-solvent induced phase inversion (NIPS). The superior control and precision of this process allows for complete utilization of the polymer dope solution during membrane fabrication, thus enabling a significant reduction in material usage. Compared to doctor blade fabrication, a 63% reduction in dope solution volume was achieved using the DIW technique for fabricating similarly sized membranes. Cross …

Temperature-Dependent Stress–Strain Behavior Of Amorphous And Crystalline P3ht, Kehinde H. Fagbohungbe, Connor P. Callaway, Chad Risko

UK CARES Faculty Publications

The scalable commercialization of organic electronics wherein p-conjugated polymers serve as the semiconductors hinges on precise control of the material electronic, redox, optical, and mechanical properties, which are each highly influenced by local and long-range morphology. Here, we undertake atomistic molecular dynamics (MD) simulations at three temperatures (150 K, 300 K, and 400 K) to assess the morphological and mechanical response of bulk poly(3-hexylthiophene) (P3HT), a representative homopolymer of interest as an organic semiconductor (OS). As P3HT is a semicrystalline polymer, we characterize mechanical properties for both amorphous and crystalline P3HT models to derive insights into structure–property relationships, including Young’s …

A Case Study In Program Evaluation, Alyssa Osborne

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

As a result of a Methicillin-Resistant Staphylococcus Aureus (MRSA) outbreak at a local high school, the Lexington Fayette County Health Department (LFCHD) has been tasked with developing a program to ensure timely reporting of actions taken in the event of a MRSA outbreak or disease outbreak of similar nature (1). This program evaluation is guided by the CDC’s 6-step program evaluation framework (2), which was used to inform this assessment.

Evaluation Of Public Radon Messaging In Kentucky As Compared To Three Other States, Abigail Knapp

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

Radon poses a large health risk to those exposed to it, as it is an invisible, odorless, carcinogenic gas. Kentucky has high ambient levels of radon, but public awareness remains low as tobacco has been publicized as the main cause of lung cancer. As Kentucky has the highest incidence of lung and bronchial cancers in the United States, we aimed to examine the state’s health department radon page to see if it has sufficient information to warn residents about radon and provide resources. We reviewed the current Kentucky public messaging, radon rates, testing rates, and legislation compared to Ohio, Washington, …

8th Cauthen Seminar (2024) Program, Cauthen-Seminar

Veterinary Science Presentations

Contained here is the complete program for the 8th Annual Cauthen Seminar held at the Gluck Equine Research Center.

The Cauthen seminar series was started in 2017 as a tribute and memorial to respected and beloved farrier and teacher, “Tex” Cauthen, developed to encourage the sharing of best practices, technology, research, experience, and insight among all communities in the equine industry, from owners, farriers, track managers, veterinarians, and jockeys.

The annual series has been hosted at the Gluck Equine Research Center at the University of Kentucky in Lexington, KY along with a live broadcast as a Zoom webinar, offered free …

Navigating Religious Attitudes Towards Assisted Reproductive Technology, Gretchen Ruschman

Gaines Fellow Senior Theses

As global infertility rates increase, the growing utilization of assisted reproductive technology (ART), specifically in vitro fertilization (IVF), has introduced a range of ethical concerns. Religious beliefs play a crucial role in shaping societal norms and guiding individual ethical deliberation, which is also true in navigating the ethical framework surrounding ART. Therefore, it is important to acknowledge the role of religion in shaping perspectives on ART and explore the role of religion in ethical decision-making on an individual and a community scale. This study explored different religious perspectives on ethical issues surrounding the current state and potential future advancements of …

A Closer Look At The Humanistic Aspects Of The Opioid Epidemic And Its Implications For Pharmaceutical Ethics And Law, Eriel Burns

Gaines Fellow Senior Theses

This paper elucidates the humanistic elements of this crisis, that is, the ethical challenges it poses and the role of culture in it. The opioid crisis disturbs several bioethics principles as indicated by the fact that it burgeoned out of the health care system as opposed to the illicit environments of the underground market. The book Dreamland by investigative journalist and storyteller, Sam Quinones encapsulates the complexity of the opioid epidemic through research and interviews with important figures related to the crisis such as physicians, people with opioid use disorder, and pharmaceutical sales representatives, among others. Quinones details that the …

Acceptability And Feasibility Of Screening With A Pediatric Care Provider-Led Social Determinants Of Health Identification Tool, Alison Eyre, Janice Cohen, Sarah Funnell, Lynsey James, Sheena Guglani, Hounaida Abi Haidar, Lindy Samson, Michelle Ward, Radha Jetty, Megan Harrison, John Lyons Dr., Leigh Fraser-Roberts, Susan Bennet, Douglas Archibald, Soha Khorsand, Tobey Audcent

Health Management and Policy Faculty Publications

Background Complex social determinants of health may not be easily recognized by health care providers and pose a unique challenge in the vulnerable pediatric population where patients may not be able to advocate for themselves. The goal of this study was to examine the acceptability and feasibility of health care providers using an integrated brief pediatric screening tool in primary care and hospital settings.

Methods The framework of the Child and Adolescent Needs and Strengths (CANS) and Pediatric Intermed tools was used to inform the selection of items for the 9-item Child and Adolescent Needs and Strengths-Pediatric Complexity Indicator (CANS-PCI). …

Leveraging Local Knowledge To Contextualize The Opioid Epidemic Within Healing Communities Study Communities: A Photovoice Protocol, Peter Balvanz, Ramona G. Olvera, Margaret Louise Mcgladrey, Marisa Booty, Dacia Beard, Sylvia Ellison, Craig Mcclay, Monica Nouvong, Carrie B. Oser, Owusua Yamoah, Linda Sprague Martinez

Health Management and Policy Faculty Publications

Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 …

Students Participating As Ambassadors For Research In Kentucky (Spark): A Health Equity Undergraduate Research Training Program, Ariel A. Arthur, Rebecca L. Delacerda Allen, Fidelis Y. Sesenu, Maxwell Groznik, Carrie B. Oser, Justin X. Moore, Jessica R. Thompson, Alexis N. James, Madeline Dunfee, Philip A. Kern, Nancy Schoenberg

Center for Health Equity Transformation Faculty Publications

The Students Participating as Ambassadors for Research in Kentucky (SPARK) program provides novel health equity research training and targeted mentorship for undergraduates, particularly those from groups underrepresented in the biomedical and behavioral research and workforce. SPARK aims to address inadequate diversity in the medical and scientific research fields by providing comprehensive research mentorship and skill-building. Unlike most existing research training programs that are brief, focus on laboratory research, or are limited to graduate students and junior faculty, SPARK delivers a 16-month intensive behavioral and population health science training, equipping students with needed tools to conceptualize, plan, execute, and analyze their …

Environmental Sustainability In Gynecologic Oncology, Allison L. Swiecki-Sikora, Mariel V. Becker, Laura M. Harbin, Elizabeth Knapp, Rashmi T. Nair, Marcelo I. Guzman, David A. Atwood, Syed Z. Ali, Charles S. Dietrich

UK CARES Faculty Publications

Climate change is a complex, global issue that is impacting human health in various ways, with healthcare being a significant contributor to carbon emissions in the United States. This review discusses the environmental impact of important aspects of gynecologic oncology care, including surgery, anesthesia care, radiology, chemotherapy, and radiation oncology. Operating room energy and material use is highlighted, with a focus on the environmental impact of robotic surgery. The contribution of certain anesthetic gases in increasing green- house gas emissions is addressed. Additionally, the environmental impacts of radiologic imaging, chemotherapy, and radiation oncology are also discussed. Despite the complexity of …

Using The Consolidated Framework For Implementation Research To Identify Church Leaders’ Perspectives On Contextual Determinants Of Community‑Based Colorectal Cancer Screening For Black Kentuckians, Aaron J. Kruse-Diehr, Derek Cegelka, Carlee Combs, Rose Wood, Elizabeth Holtsclaw, Jerod L. Stapleton, Lovoria B. Williams

UK CARES Faculty Publications

Background Black Kentuckians experience more deleterious colorectal cancer (CRC) outcomes than their White counterparts, a disparity that could be reduced by increased screening in Black communities. Previous research has shown that Black Kentuckians may not be equitably informed of different CRC screening options by health care providers, making community‑based screening a potentially effective option among this disparate population. We used the Consolidated Framework for Implementation Research (CFIR) to identify church leaders’ perspectives of con‑ textual factors that might influence community‑based screening and explore the feasibility of using church‑based screening outreach.

Methods Six participants were selected, based on leadership roles and …

Protocol For A Feasibility Randomized Controlled Trial Of Gentle Yoga In Older Patients Discharged From Phase Ii Cardiac Rehabilitation, Geunyeong Cha, Misook L. Chung, Nicholas R. Heebner, Ulf G. Bronas, Martha J. Biddle, Chin-Yen Lin, Junghee Kang, Jia-Rong Wu, Jessica H. Thompson, Ashmita Thapa, Debra K. Moser

UK CARES Faculty Publications

Background: Physical activity (PA) is essential following an acute cardiac event. Cardiac rehabilitation (CR) is commonly prescribed, and PA after CR is recommended. Because of age-related changes in functional ability and multi-comorbidity, many older cardiac patients struggle to continue performing PA at home after CR. Depressive symptoms and anxiety are prevalent in cardiac patients and associated with poor self-care, including lack of daily PA. Yoga has been demonstrated to improve psychological and physical health outcomes in cardiac patients, but it is unknown whether yoga, modified for older CR patients – Gentle Yoga – is beneficial in managing psycho- logical distress …

Glioblastoma Standard Of Care: Effects On Tumor Evolution And Reverse Translation In Preclinical Models, Louis Rodgers, John L. Villano, Anika M. S. Hartz, Björn Bauer

UK CARES Faculty Publications

Glioblastoma (GBM) presents a significant public health challenge as the deadliest and most common malignant brain tumor in adults. Despite standard-of-care treatment, which includes surgery, radiation, and chemotherapy, mortality rates are high, underscoring the critical need for advancing GBM therapy. Over the past two decades, numerous clinical trials have been performed, yet only a small fraction demonstrated a benefit, raising concerns about the predictability of current preclinical models. Traditionally, preclinical studies utilize treatment-naïve tumors, failing to model the clinical scenario where patients undergo standard-of-care treatment prior to recurrence. Recurrent GBM generally exhibits distinct molecular alterations influenced by treatment selection pressures. …

Public Library Lending Programs Increase Radon Testing In Rural Communities, Stacy Stanifer, Kathy Rademacher, Whitney Beckett, King Simpson, Mary Kay Rayens, Amanda Thaxton Wigging, Ellen J. Hahn

UK CARES Faculty Publications

Radon exposure is the second leading cause of lung cancer, yet few Americans test their homes for radon, particularly in rural areas. The academic team and community partners engaged the public library systems in four rural counties to offer digital radon detectors for check-out as a means of increasing the public’s access to free radon testing. The check-out procedures and instructional materials were created through an iterative process, and library personnel were educated on radon and home radon testing prior to launching the lending program. Library patrons reported high usability, feasibility, and acceptability of the program. Library patron- staff interactions …

Adapting The Serious Illness Conversation Guide For Unhoused Older Adults: A Rapid Qualitative Study, Abigail Latimer, Natalie D. Pope, Chin-Yen Lin, Junghee Kang, Olivia M. Sasdi, Jia-Rong Wu, Debra K. Moser, Terry A. Lennie

UK CARES Faculty Publications

Background Older adults experiencing homelessness (OAEH) age quickly and die earlier than their housed counterparts. Illness-related decisions are best guided by patients’ values, but healthcare and homelessness service providers need support in facilitating these discussions. The Serious Illness Conversation Guide (SICG) is a communication tool to guide discussions but has not yet been adapted for OAEH.

Methods We aimed to adapt the SICG for use with OAEH by nurses, social workers, and other homelessness service providers. We conducted semi-structured interviews with homelessness service providers and cognitive interviews with OAEH using the SICG. Service providers included nurses, social workers, or others …

What Influences Trust In And Understanding Of Clinical Trials? An Analysis Of Information And Communication Technology Use And Online Health Behavior From The Health Information National Trends Survey, Aurora Occa, Allison S. Merritt, Allison Leip, Jerod L. Stapleton

UK CARES Faculty Publications

Background: Using information and communication technologies to seek, discuss, and share health-related information influences people’s trust and knowledge of several health practices. However, we know little about the associations between individuals’ information and communication technology use and their perceptions of trust and knowledge of clinical trials. Examining these associations may lead to the identification of target audiences and channels for developing effective educational interventions and campaigns about clinical trials.

Methods: In this study, we analyzed Health Information National Trends Survey data to document perceptions of clinical trial-related knowledge and trust that were recently added as questions in this annual national …

Cancer Research Provides A Model For Advancing Clinical Trials In Dementia In The Era Of Disease-Modifying Alzheimer’S-Type Dementia Therapies, Gregory Jicha, Thomas Tucker, Susanne Arnold, Peter T. Nelson

Neurology Faculty Publications

Dementia and cancer are multifactorial, widely-feared, age-associated clinical syndromes that are increasing in prevalence. There have been major breakthroughs in clinical cancer research leading to some effective treatments, whereas the field of dementia has achieved comparatively limited success in clinical research. The lessons of cancer research may help those in the dementia research field in confronting some of the dilemmas faced when the clinical care regimen is not entirely safe or efficacious. Cancer clinical trials have assumed that untreated individuals with cancer are at high risk for morbidity and mortality after primary diagnoses. Thus, patients deserve a choice of clinical …

Estimating Socio-Economic Status For Alzheimer’S Disease Trials, D. M. Rentz, J. D. Grill, D. P. Molina-Henry, Gregory Jicha, Michael S. Rafii, A. Liu, Reisa A. Sperling, Paul Aisen, R. Raman

Neurology Faculty Publications

INTRODUCTION: Metrics of a participant’s socioeconomic status (SES) are not routinely collected or standardized in clinical trials. This omission limits the ability to evaluate the generalizability of trial results and restricts clinicians from confidently interpreting the efficacy of new treatments across important sub-populations. METHODS: We adapted an SES measure of social disparity; the Hollingshead Two Factor Index of Social Position, which combines education and occupation into a single metric. We modernized the 1965 occupations to reflect the 2017 careers tabulated by the US Bureau of Labor Statistics. We currently use this adapted measure in Alzheimer’s Clinical Trials Consortium studies. RESULTS: …

Clinical Trial Protocol For Beach: A Phase 2a Study Of Mw189 In Patients With Acute Nontraumatic Intracerebral Hemorrhage, Radhika Avadhani, Wendy C. Ziai, Richard E. Thompson, W. Andrew Mould, Karen Lane, Angeline Nanni, Michael Lacobelli, Matthew F. Sharrock, Lauren H. Sansing, Linda J. Van Eldik, Daniel F. Hanley

Neurology Faculty Publications

Patients with acute spontaneous intracerebral hemorrhage (ICH) develop secondary neuroinflammation and cerebral edema that can further damage the brain and lead to increased risk of neurologic complications. Preclinical studies in animal models of acute brain injury have shown that a novel small-molecule drug candidate, MW01-6-189WH (MW189), decreases neuroinflammation and cerebral edema and improves functional outcomes. MW189 was also safe and well tolerated in phase 1 studies in healthy adults. The proof-of-concept phase 2a Biomarker and Edema Attenuation in IntraCerebral Hemorrhage (BEACH) clinical trial is a first-in-patient, multicenter, randomized, double-blind, placebo-controlled trial. It is designed to determine the safety and tolerability …

Multiomics Analysis To Explore Blood Metabolite Biomarkers In An Alzheimer’S Disease Neuroimaging Initiative Cohort, Takaki Oka, Yuki Matsuzawa, Momoka Tsuneyoshi, Yoshitaka Nakamura, Ken Aoshima, Hiroshi Tsugawa, Alzheimer’S Disease Metabolomics Consortium

Neurology Faculty Publications

Alzheimer’s disease (AD) is a neurodegenerative disease that commonly causes dementia. Identifying biomarkers for the early detection of AD is an emerging need, as brain dysfunction begins two decades before the onset of clinical symptoms. To this end, we reanalyzed untargeted metabolomic mass spectrometry data from 905 patients enrolled in the AD Neuroimaging Initiative (ADNI) cohort using MS-DIAL, with 1,304,633 spectra of 39,108 unique biomolecules. Metabolic profiles of 93 hydrophilic metabolites were determined. Additionally, we integrated targeted lipidomic data (4873 samples from 1524 patients) to explore candidate biomarkers for predicting progressive mild cognitive impairment (pMCI) in patients diagnosed with AD …

Cancer Survivorship Care In The United States At Facilities Accredited By The Commission On Cancer, Julia Stal, Kimberly A. Miller, Timothy W. Mullett, Judy C. Boughey, Amanda B. Francescatti, Elizabeth Funk, Heidi Nelson, David R. Freyer

Markey Cancer Center Faculty Publications

IMPORTANCE Since 2021, American College of Surgeons Commission on Cancer (CoC) accreditation standards require providing a survivorship program for patients with adult-onset cancer treated with curative intent. Since more than 70% of all patients with cancer in the US are treated at CoC-accredited facilities, this presents an opportunity for a landscape analysis of survivorship care availability.

OBJECTIVE To determine the prevalence, types, and outcomes of cancer survivorship services at CoC-accredited facilities.

DESIGN, SETTING, AND PARTICIPANTS This survey study used an anonymous, online, cross-sectional survey conducted from May 4 to 25, 2023. Participants were CoC-accredited facilities in the US representing diverse …