Medicine and Health Sciences Commons^™

Metabolomics Driven Discovery Of Bioactive Natural Products Leads From Marine And Terrestrial Sources For The Development Of Analgesics, Sahar Mofidi Tabatabaei

University of Kentucky Doctoral Dissertations

Natural products remain a rich source of structurally diverse bioactive compounds for drug discovery, particularly for pain therapeutics. However, the chemical complexity of natural product extracts presents significant challenges for the efficient identification and prioritization of bioactive metabolites. This dissertation integrates untargeted LC-MS/MS-based metabolomics, molecular networking, classical natural products chemistry, and neurobiological assays to accelerate the discovery of analgesic lead compounds targeting the emerging pain-associated receptor σ₂R/TMEM97.

An untargeted metabolomics workflow was developed to systematically profile complex biological extracts and guide bioactive compound isolation. High-resolution LC-MS/MS data were analyzed using molecular networking (GNPS/GNPS2) to visualize chemical space, dereplicate known metabolites, …

Atrial Fibrillation Detection From At-Rest Ppg Signals Using An Sdof-Tf Method, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

At-rest PPG signals have been explored for detecting atrial fibrillation (AF), yet current signal-processing techniques do not achieve perfect accuracy even under low-motion artifact (MA) conditions. This study evaluates the effectiveness of a single-degree-of-freedom time–frequency (SDOF-TF) method in analyzing at-rest PPG signals for AF detection. The method leverages the influence of MA on the instant parameters of each harmonic, which is identified using an SDOF model in which the tissue–contact–sensor (TCS) stack is treated as an SDOF system. In this model, MA induces baseline drift and time-varying system parameters. The SDOF-TF method enables the quantification and removal of MA and …

Radial And Carotid Arterial Pulse Signals For Assessing Cardiovascular Function At Rest And During Post-Exercise Recovery In A Heart Transplant Patient: A Case Study, Md Mahfuzur Rahman, Mamun Hasan, Jennifer F. May, John M. Herre, Leryn Reynolds, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Aim: This study investigates the feasibility of using radial and carotid arterial pulse signals to assess cardiovascular (CV) function at rest and during post-exercise recovery in a heart transplant (HTx) patient. Method: Two micro-fabricated tactile sensors were used to simultaneously acquire arterial pulse signals at the radial artery (RA) and carotid artery (CA). Measurements were taken at rest and at multiple time points post-exercise on three subjects: an HTx patient, a percutaneous coronary intervention (PCI; coronary stent) patient and a healthy control. An SDOF-TF-based time-frequency analysis algorithm was applied to extract a comprehensive set of CV parameters, including heart rate …

Hardin Health Link: A Community-Integrated Paramedicine (Cip) Program In Hardin County, Kentucky, Samantha Jones

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

Rural and mixed rural–urban communities face persistent disparities in access to timely emergency medical services (EMS), contributing to preventable morbidity and mortality from time-sensitive conditions such as cardiovascular disease, stroke, and injury. Hardin County, Kentucky, reflects these challenges due to its geographically dispersed population, high burden of chronic disease, and variability in EMS response times. This capstone proposes Hardin Health Link, a Community-Integrated Paramedicine (CIP) program designed to expand the traditional role of EMS providers through in-home health assessments, chronic disease monitoring, post-discharge follow-up, medication reconciliation, and connection to clinical and social services.

Guided by an evidence-informed framework, the program …

Stronger Starts: Advancing Maternal And Infant Health In Breathitt County, Kentucky, Madisyn Smith

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

Maternal and infant health outcomes remain significantly poorer in rural Appalachian communities, where structural and socioeconomic barriers limit access to timely and comprehensive care. Kentucky reports elevated rates of preterm birth and infant mortality, with counties such as Breathitt County facing challenges including limited obstetric services, transportation barriers, and high poverty rates. These factors contribute to delayed prenatal care, fragmented services, and increased risk of adverse outcomes.

The Stronger Starts Initiative is an evidence-informed public health program designed to improve maternal and infant health outcomes through a coordinated, multi-level approach. The program integrates nurse-led home visiting, telehealth obstetric consultations, community-based …

Rapid Response To Recovery: Expand Integrated, Technology-Enabled Crisis Care, Madison Chandler

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

Behavioral health challenges in rural communities continue to place significant strain on healthcare systems, particularly through repeated reliance on emergency departments for crisis care. Nelson County, Kentucky, reflects this pattern, with higher reported rates of poor mental health and limited access to behavioral health providers. This paper proposes the Beacon Behavioral Health Response Program, a community-based, multidisciplinary crisis intervention model designed to improve access to timely care and strengthen continuity of support. The program combines mobile crisis response—delivered by a licensed clinical social worker and a peer support specialist—with a technology-enabled component using the Luma AI-supported mental health platform. Together, …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

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

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

A Program To Increase Prenatal And Postnatal Care Access In A Rural Kentucky County, Alyssa Thomas

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

Prenatal and postpartum health care access is necessary for positive pregnancy and postpartum outcomes. Many rural areas in the United States are facing maternity care deserts, where there are no obstetric services available in their county. Maternity care deserts typically have higher rates in maternal mortality, low-birth weight, and pre-term births. Fleming County, Kentucky is a small rural community with a population of about 15,000 that is a maternity care desert. To improve prenatal and postpartum care access in this county, this program will use a mobile health clinic and community health workers (CHWs). The mobile health clinic will operate …

Momentum For Healthy Births-Hardin County, Ky, Brittany R. Jackson

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

Maternal and infant health disparities in Hardin County, Kentucky, reflect persistent gaps in timely access to care, particularly among rural and underserved populations. Structural barriers, including transportation limitations and unmet social needs, contribute to delayed prenatal care initiation and low postpartum follow-up, increasing the risk of adverse outcomes. This capstone project proposes the MOMentum (Maternal Outreach and Monitoring for Mothers) Program, an integrated care model designed to strengthen access, improve care coordination, and enhance continuity across the prenatal and postpartum period.

The program combines a Community Health Worker (CHW)-led navigation model with enhanced postpartum care supported by telehealth services and …

Improving Prenatal And Postpartum Care Gaps In Breathitt County, Megan Deaton

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

Maternal and infant health remain a major public health issue across the United States, particularly in rural communities. Barriers such as shortages of obstetric providers, transportation challenges, and limited access to prenatal and postpartum care contribute to delayed care, low follow-up rates, and an increased risk of poor outcomes, including preterm birth and low birth weight. In response, the proposed Maternal and Infant Health Program aims to address gaps in care access through a home visiting model that provides in-home support, maternal health education, care coordination, and referrals to healthcare services, with a direct focus on Breathitt County. Expected outcomes …

Implementation Of A Reminder/Recall Messaging Program In Kentucky, Laura Schwarz

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

Childhood vaccination remains a critical public health priority, yet measles, mumps, and rubella (MMR) vaccination rates in several rural Kentucky counties fall below the 95% threshold required for herd immunity. Recent declines in coverage, compounded by socioeconomic disparities and barriers to healthcare access, place children at increased risk for vaccine-preventable diseases and outbreaks. This capstone project proposes the implementation of an evidence-based reminder/recall (R/R) text messaging intervention utilizing the Kentucky Immunization Registry (KYIR) to improve timely MMR vaccination among children aged 4–6 years before kindergarten entry.

The proposed program targets thirteen Kentucky counties with vaccination rates below 70% and documented …

Strengthening Rural Mental Health Crisis Response: Integrating Broadband Telehealth Care Across Counties Served By Kentucky River District Health Department, Mary K. Mcnabb

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

Rural communities in Eastern Kentucky face persistent barriers to timely and effective mental health crisis care, including provider shortages, transportation challenges, and limited broadband infrastructure. Counties served by the Kentucky River Health Department Wolfe, Lee, Owsley, Perry, Knott, Leslie, and Letcher experience disproportionately high behavioral health needs while relying on shared regional resources. The Broadband-Enabled Rural Crisis Stabilization Initiative (BERCSI) is a proposed public health program designed to strengthen rural mental health crisis response through integrated, technology-enabled care. Grounded in evidence-based practices, including tele-mental health and crisis stabilization models, BERCSI leverages broadband expansion to facilitate rapid assessment, coordinated care, and …

Simulating Social Attitudes With Llms: Accuracy, Demographic Effects, And Refusal Behavior In The Sensitive Domain Of Suicide Prevention, Cristina J. Perez, Michael P. Vasquez Jr., Philippe J. Giabbanelli, Patrick Y. Wu

VMASC Publications

Large language models (LLMs) are increasingly used to simulate public opinion, yet their validity in sensitive policy domains remains underexplored. We evaluate whether LLMs can reproduce attitudes toward suicide prevention policies using 32 questions drawn from seven nationally representative U.S. surveys (2023-2025). We systematically vary demographic conditioning (race/ethnicity, gender, age, education, income, party), prompt framing (direct elicitation, respondent embodiment, specialist embodiment), and model architecture (GPT-5 Nano, DeepSeek V3.2, Meta Llama 3.1 8B, Mistral Small 24B). Across 811,560 prompts, the mean absolute error—the average gap between predicted and human response distributions—is 23 percentage points. We also find that LLM responses to …

Dual Regulation Of Osteogenesis And Inflammation By Pomegranate (Punica Granatum L.) Extract In Periodontal Ligament-Derived Stem Cells: Implications For Regenerative Medicine, Mai Hafez

Dentistry

Objectives

This article aims to compare the osteogenic along with anti-inflammatory activity of different concentrations of pomegranate extract (PG) on human periodontal ligament-derived stem cells (hPDLSCs) in vitro.

Materials and Methods

hPDLSCs were acquired from the root surface of removed molars, cultured, and then distinguished by flow cytometry analysis and several lineage differentiation potentials. To identify the effect of PG on hPDLSCs' viability, an MTT assay was performed. hPDLSCs were maintained in osteogenic induction medium with varying concentrations of PG. At the end of the induction period, osteogenesis was assessed using Alizarin Red staining, ALP assay, and qRT-PCR to determine …

Cytocompatibility, Osteogenic Potential, Antibacterial And Antibiofilm Efficacy Of A Calcium-Silicate-Based Intracanal Medication, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

This study assessed the biological and antimicrobial properties of a calcium silicate-based material and calcium hydroxide (CH) when used as intracanal medications. MTT assay, osteogenic differentiation of human periodontal stem cells (hPDLSCs), cell mineralization-assay, and determination of ALP activity were assessed to investigate the biological properties. While the agar well diffusion, crystal violet (CRV) assay and LIVE/DEAD staining of dentin slices infected with a mature E. faecalis biofilm were used to assess the antimicrobial properties. Normally distributed data were analyzed using one and two-way ANOVA and post hoc Tukey test, while for non-normally distributed data Kruskal Wallis and Dunn's tests …

Automatic Teeth Segmentation In Panoramic Radiographs Using Attention U-Net, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Aim: The aim of this study is to investigate the effectiveness of the Attention U-Net architecture for teeth segmentation in panoramic dental images. By exploring the potential of Attention U-Net, the study aims to contribute to the development of more precise and automated dental imaging analysis, which could enhance diagnosis, treatment planning, and computer-aided dental systems. Subjects and methods: The TUFTS University dataset consisting of 1000 de-identified panoramic radiographs was used for training and testing an Attention U-Net architecture with 10-fold cross-validation. These scores surpass those of all other networks implemented on the same dataset. using a newly available benchmark …

Enhancing Severely Compromised Premolar Strength: Role Of Cusp Reduction Design In Cad/Cam Composite Restorations, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

The objective of this study was to assess the effect of different designs and depths of cusp reduction on fracture resistance of maxillary permanent premolars restored with CAD/CAM composite restorations. A total of 42 sound maxillary premolars were used. Standardized MOD cavities were prepared in all specimens. Teeth were randomly divided according to form of cusp reduction into three main groups (n = 14); G1:MOD cavities restored with inlays with no cusp reduction, G2:MOD cavities restored with overlays with buccal and palatal anatomical cusps reduction, G3; MOD cavities restored with overlays with buccal and palatal flat cusps reduction. Groups 2 …

Effect Of Caries Removal Techniques On Micro-Tensile Bond Strength Of Cad/Cam Composite Blocks To Dentine (In-Vitro Study), Hend Sayed Ahmed, Mohamed Fouad Haridy, Hoda Fouda, Basma Khalifa, Youssef M. Haridy

Dentistry

No abstract provided.

Clinical Evaluation Of The Remineralizing Potential Of Biomimetic Scaffolds On Enamel White Spot Lesions: A 12-Month Randomized Controlled Trial, Eman Soliman, Wegdan Abdelfattah, Doaa Ragai M Ahmed, Dina Nagui, Ahmed Holiel

Dentistry

No abstract provided.

The Effects Of Cigarette Smoke And Heated-Tobacco Aerosol On Streptococcus Mutans Adhesion And Surface Topography Of Dental Hard Tissues In Vitro, Mahmoud Bakr, Mohamed Shamel, Mahmoud Al Ankily

Dentistry

No abstract provided.

The Effects Of Cigarette Smoke And Heated-Tobacco Aerosol On Streptococcus Mutans Adhesion And Surface Topography Of Dental Hard Tissues In Vitro, Mohamed Shamel, Mahmoud Al Ankily, Nourhan Taha

Dentistry

No abstract provided.

Considerations For The Analysis Of Urinary Environmental Chemical Concentrations During Pregnancy, Danielle R. Stevens, Kaleigh Hinton, Katie M. O'Brien, Jessie P. Buckley, Barrett M. Welch, Jason A. Watts, Antonia M. Calafat, Julianne C. Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background:

Pregnancy physiology may impact indicators of hydration, affecting exposure assessment in gestational studies with urinary chemical biomarkers.

Methods:

We aimed to characterize hydration and demonstrate the impact of different methods for standardizing urinary chemical biomarker concentrations on exposure descriptives in the Human Placenta and Phthalates Study (n = 303, 2017-2020), a prospective pregnancy cohort with eight study visits between 12 and 38 weeks of gestation. We assessed trajectories and predictors of hydration using urine flow rate (UFR) and specific gravity (SG). Likewise, we examined trajectories and predictors of mono-n-butyl phthalate (MBP), for which concentrations were unstandardized or standardized via …

Standardization Of Neuromuscular Reflex Analysis—Role Of Fine-Tuned Vision-Language Model Consortium And Openai Gpt-Oss Reasoning Llm-Enabled Decision Support System, Eranga Bandara, Ross Gore, Sachin Shetty, Ravi Mukkamala, Christopher K. Rhea, Brittany S. Samulski, Amin Hass, Atmaram Yarlagadda, Shaifali Kaushik, Malith De Silva, Andriy Maznychenko, Inna Sokolowska, Kasun De Zoysa

VMASC Publications

Background/Objectives: Accurate assessment of neuromuscular reflexes, such as the Hoffmann reflex (H-reflex), plays a critical role in sports science, rehabilitation, and clinical neurology. Conventional interpretation of H-reflex electromyography (EMG) waveforms is subject to inter-rater variability and interpretive bias, limiting reliability and standardization. This study aims to develop an automated, interpretable, and robust agentic AI–driven framework for H-reflex waveform analysis. Methods: We propose a fine-tuned Vision–Language Model (VLM) consortium combined with a reasoning Large Language Model (LLM)–enabled decision support system for automated H-reflex interpretation. Multiple VLMs were fine-tuned on curated datasets of H-reflex EMG waveform images annotated with expert clinical observations, …

Increasing Hpv Vaccination Among Early Adolescents Using A Game-Based Digital Intervention: A Randomized Controlled Trial, Angela Chia-Chen Chen, Lihong Ou, Elizabeth Reifsnider, Kimberly Arcoleo, Ashish Amresh, Michael Todd

Ellmer School of Nursing Faculty Publications

Background/Objectives: Human papillomavirus (HPV) vaccination coverage among adolescents remains below public health targets despite strong evidence of vaccine effectiveness in preventing HPV-related cancers. Digital interventions (e.g., serious games) may improve HPV vaccine uptake, but evidence for effects on vaccination behavior remains limited. Methods: This secondary analysis of a randomized controlled trial evaluated a co-designed, game-based digital intervention to increase HPV vaccine initiation among unvaccinated youth aged 11-14 years and their parents. The sample included 64 parent-adolescent dyads (33 intervention and 31 usual care dyads). The primary outcome was HPV vaccine initiation at 2-month follow-up. Results: A significantly greater proportion of …

Feeding Mode Is Associated With Infant Night Sleep Trajectories During The First Postnatal Year, Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov, Corrie M. Whisner

Ellmer School of Nursing Faculty Publications

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, …

Estrogen Deprivation During Primate (Papio Anubis) Pregnancy: Impact On Systemic Microvascular Flow And Cardiovascular Development And Function After Birth In Offspring, Sifa Turan, Jeffery S. Babischkin, Graham W. Aberdeen, Gerald J. Pepe, Eugene D. Albrecht

Department of Biomedical and Translational Sciences Faculty Publications

Background

Suppressing estradiol (E₂) during baboon pregnancy lowers offspring skeletal muscle capillary density, vital for insulin-mediated glucose uptake, and induces insulin resistance. We examined whether E₂ deprivation also impairs microvascular flow and cardiac function.

Methods

Offspring of untreated baboons, letrozole-treated baboons, or letrozole plus E₂ (maternal s.c. injections during the second half of gestation) underwent contrast-enhanced microbubble ultrasonography to quantify microvessel flow and echocardiography to assess cardiac performance.

Results

Letrozole reduced maternal serum E₂ by 95% (p <  0.01). In letrozole offspring, microbubble flux rate (β) fell 55% (p <  0.02), replenishment was 5 s slower (p <  0.03), and microvessel flow declined 40% (p = 0.05); all were restored by added E₂. Indices of systolic (isovolumic contraction), diastolic (isovolumic relaxation), global performance (Tei index), and cardiac output were unchanged.

Conclusion

Prolonged gestational E₂ deprivation programs a reduction in microvascular flow without altering cardiac function; maternal E₂ prevents this, supporting E₂'s role in …

Comparative Mass Spectrometry Analysis Of High And Low Centrifugation Extracellular Vesicle (Ev) Pellets From Healthy Urine Following Tamm-Horsfall Protein Removal, Dana Bielopolski, Luca Musante, Henrik Molina, Douglas Barrows, Samantha Upson, Lifang Yang, Thomas Carrol, Jonathan N. Tobin, Rhonda G. Kost, U. Erdbrügger

Department of Biomedical and Translational Sciences Faculty Publications

Objectives

Urinary extracellular vesicles (uEVs) are potential biomarkers for renal physiology and disease. Their isolation is challenged by Tamm-Horsfall protein (THP) contamination, particularly in high-speed ultracentrifugation (P100) fractions. Low-speed (P20) fractions contain biologically relevant uEVs, yet their proteomic composition is underexplored. This study evaluates strategies for THP removal to optimize mass spectrometry analysis and characterizes P20 and P100 uEV proteomes and its combination in healthy urine.

Methods

Urine from a healthy volunteer was processed via sequential centrifugation at 21,200 g (P20) and 164,244 g (P100). THP removal was performed using low ionic strength buffer (P20) and size-exclusion chromatography (P100). Western …

Ovarian Cancer Immunology And Immunotherapy: Editorial Note, Chris D. Platsoucas

Biological Sciences Faculty Publications

[Introduction] As the guest editor of the Special Issue on Ovarian Cancer Immunology Immunotherapy, I would like to include certain brief comments on the current state of the field and to introduce the Special Issue. Ovarian carcinoma and malignant melanoma are the first human tumors where immune responses, primarily restricted to autologous tumor cells, were first demonstrated. T-cell lines and clones developed in recombinant interleukin-2 (rIL-2) from tumor-infiltrating lymphocytes (TIL) from these tumors exhibited cytotoxicity and/or cytokine production, primarily restricted to autologous tumor cells. The T-cell receptor (TCR) and the CD3 differentiation antigen on effector T cells and HLA on …

Bayesian Multivariate Modelling Of Lone Star (Amblyomma Americanum) Tick Life Stage Abundance And Temporal Trends To Inform Public Health Risk In Virginia, Thabo Lephoto, Henry Mwambi, Oliver Bodhlyera, Holly Gaff

Biological Sciences Faculty Publications

The increasing abundance of ticks poses a growing public health concern due to heightened human exposure to tick bites. The lone star tick (Amblyomma americanum: Ixodida: Ixodidae), a common human-biting species in the United States, has expanded its range in recent years. However, how its different life stages vary across time, habitats, and locations remains insufficiently understood. We analyzed tick abundance data collected in southeastern Virginia between 2009 and 2018, focusing on larval, nymphal, and adult life stages. A Bayesian multivariate modelling framework was used to examine seasonal patterns, habitat effects, spatial variation, and biological links between life stages. Two …

Culturally Responsive Dialectical Behavior Therapy With Chinese Sexual And Gender Minority Individuals: A Qualitative Study, Weiyi Liao M.S.

Selected Full Text Dissertations, 2011-

Professional guidelines emphasize the importance of adapting evidence-based treatments to the cultural and contextual needs of minoritized populations. Although substantial research has examined lesbian, gay, bisexual, transgender, and queer (LGBTQ+) mental health, comparatively little is known about the psychotherapy experiences of Chinese sexual and gender minority individuals or how dialectical behavior therapy (DBT) may be delivered responsively with this population. DBT is an evidence-based treatment for emotion dysregulation, self-harm, and suicidal behavior that explicitly addresses the effects of invalidating environments. Because Chinese cultural contexts and LGBTQ-related minority stress may both shape emotional expression, help-seeking, and treatment experiences, this qualitative study …