Public Health Commons^™

Aftermath: A Word To Appalachia Following Hurricane Helene, Emily Wilson

Journal of Appalachian Health

On September 27, 2024, Hurricane Helene caused massive and catastrophic flash flooding in the lower Appalachian Region, leveling towns and forever altering much of the landscape. This is an open letter to the people of Appalachia who were affected by the disaster that blindsided our region.

Communities That Heal Intervention And Mortality Including Polysubstance Overdose Deaths: A Randomized Clinical Trial, Bridget Freisthler, Rouba A. Chahine, Jennifer Villani, Redonna Chandler, Daniel J. Feaster, Svetla Slavova, Jolene Defiore-Hyrmer, Alexander Y. Walley, Sarah Kosakowski, Arnie Aldridge, Carolina Barbosa, Sabana Bhatta, Candace Brancato, Carly Bridden, Mia Christopher, Tom Clarke, James David, Lauren D'Costa, Irene Ewing, Soledad Fernandez, Erin Gibson, Louisa Gilbert, Megan E. Hall, Sarah Hargrove, Timothy Hunt, Elizabeth N. Kinnard, Lauren Larochelle, Aaron Macoubray, Shawn R. Nigam, Edward V. Nunes, Carrie B. Oser, Sharon Pagnano, Peter J. Rock, Pamela Salsberry, Aimee Shadwick, Thomas J. Stopka, Sylvia Tan, Jessica L. Taylor, Philip M. Westgate, Elwin Wu, Gary A. Zarkin, Sharon L. Walsh, Nabila El-Bassel, T. John Winhusen, Jeffrey H. Samet, Emmanuel A. Oga

Biostatistics Faculty Publications

IMPORTANCE: The HEALing Communities Study (HCS) evaluated the effectiveness of the Communities That HEAL (CTH) intervention in preventing fatal overdoses amidst the US opioid epidemic.

OBJECTIVE: To evaluate the impact of the CTH intervention on total drug overdose deaths and overdose deaths involving combinations of opioids with psychostimulants or benzodiazepines.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was a parallel-arm, multisite, community-randomized, open, and waitlisted controlled comparison trial of communities in 4 US states between 2020 and 2023. Eligible communities were those reporting high opioid overdose fatality rates in Kentucky, Massachusetts, New York, and Ohio. Covariate constrained randomization stratified …

Parallel Electrophysiological Abnormalities Due To Covid-19 Infection And To Alzheimer’S Disease And Related Dementia, Yang Jiang, Jennifer Neal, Pradoldej Sompol, Görsev Yener, Xianghong Arakaki, Christopher M. Norris, Francesca R. Farina, Agustin Ibanez, Susanna Lopez, Abdulhakim Al-Ezzi, Voyko Kavcic, Bahar Güntekin, Claudio Babiloni, Mihály Hajós

Neurology Faculty Publications

Many coronavirus disease 2019 (COVID-19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting-state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID-19 and to Alzheimer’s disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID-19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in …

Planetary Health Learning Objectives: Foundational Knowledge For Global Health Education In An Era Of Climate Change, Kathryn H. Jacobsen, Caryl E. Waggett, Pamela Berenbaum, Brett R. Bayles, Gail L. Carlson, René English, Carlos A Faerron Guzmán, Meredith L. Gartin, Liz Grant, Thomas L. Henshaw, Lora L. Iannotti, Philip J. Landrigan, Nina Lansbury, Hao Li, Maureen Y. Lichtveld, Ketrell Mcwhorter, Jessica E. Rettig, Cecilia J. Sorensen, Eric J. Wetzel, Dawn Michele Whitehead, Peter J. Winch, Keith Martin

Earth and Environmental Sciences Faculty Publications

Planetary health is an emerging field that emphasises that humans depend on a healthy Earth for survival and, conversely, that the sustainability of Earth systems is dependent on human behaviours. In response to member demands for resources to support teaching and learning related to planetary health, the Consortium of Universities for Global Health (CUGH) convened a working group to develop a set of planetary health learning objectives (PHLOs) that would complement the existing ten CUGH global health learning objectives. The eight PHLOs feature Earth system changes, planetary boundaries, and climate change science; ecological systems and One Health; human health outcomes; …

Evaluating The Effectiveness Of A Student-Run Clinic On Reducing Cigarette Smoking In A Homeless Population, Briana Taormina, Bryson Jones, Kiah Gledhill Md, Audrey Darville Phd, Aprn, Cpaha-Tt

ePublications of Emerging Medical Research Scholars

Objective

Cigarette smoking remains a major health crisis in the United States, claiming the lives of hundreds of thousands of tobacco users each year. Access to evidence-based smoking cessation remains a challenge for many people that use tobacco products. Prior research demonstrates that the homeless population is exceedingly vulnerable to cigarette smoking and faces more barriers to quitting than their domiciled counterparts. This study explores the effectiveness of a free Smoking Cessation Clinic (SCC) within a homeless shelter for women and children, run by a nurse practitioner and a clinical nurse specialist trained as Tobacco Treatment Specialists, along with two …

Writing For The Journal: A Guide For Community-Based Organizations, Randy Wykoff, Rachel E. Dixon

Journal of Appalachian Health

The Journal of Appalachian Health welcomes submissions from a variety of stakeholders interested in and contributing to improvement of health across the Appalachian Region. This editorial provides basic guidelines for those working in community settings who may with to make JAH (or any other journal) their publication home.

Asap: A Pharmacy-Level Intervention To Increase Nonprescription Syringe Sales To Reduce Bloodborne Illnesses., B. E. Meyerson, J. Agley, Richard A. Crosby, K. G. Bentele, N. Vadiei, L. B. Linde-Krieger, D. R. Russell, K. Fine, L. A. Eldridge

Health, Behavior & Society Faculty Publications

BACKGROUND: Pharmacy syringe sales are effective structural interventions to reduce bloodborne illnesses in populations, and are legal in all but two states. Yet evidence indicates reduced syringe sales in recent years. This study was designed as a feasibility test of an intervention to promote syringe sales by pharmacies in Arizona.

METHODS: A four-month pilot among three Arizona pharmacies measured feasibility and acceptability through monthly surveys to 18 enrolled pharmacy staff members.

RESULTS: Pharmacy staff reported increased ease of dispensing syringes across the study. Rankings of syringe dispensing as 'easiest' among 6 measured pharmacy practices increased from 38.9 % at baseline …

Potential Impact Of Curative And Preventive Interventions Toward Hepatitis C Elimination In People Who Inject Drugs-A Network Modeling Study., Lin Zhu, William W. Thompson, Liesl Hagan, Liisa M. Randall, Abby E. Rudolph, April M. Young, Jennifer R. Havens, Joshua A. Salomon, Benjamin P. Linas

Center on Drug and Alcohol Research Faculty Publications

BACKGROUND: Injection-equipment-sharing networks play an important role in hepatitis C virus (HCV) transmission among people who inject drugs (PWID). Direct-acting antiviral (DAA) treatments for HCV infection and interventions to prevent HCV transmission are critical components of an overall hepatitis C elimination strategy, but how they contribute to the elimination outcomes in different PWID network settings are unclear.

METHODS: We developed an agent-based network model of HCV transmission through the sharing of injection equipment among PWID and parameterized and calibrated the model with rural PWID data in the United States. We modeled curative and preventive interventions at annual coverage levels of …

Cerebrovascular Reactivity Mri As A Biomarker For Cerebral Small Vessel Disease–Related Cognitive Decline: Multi-Site Validation In The Markvcid Consortium, Peiying Liu, Zixuan Lin, Kaisha Hazel, George Pottanat, Cuimei Xu, Dengrong Jiang, Jay J. Pillai, Emma Lucke, Christopher E. Bauer, Brian T. Gold, Steven M. Greenburg, Karl G. Helmer, Kay Jann, Gregory Jicha, Joel Kramer, Pauline Maillard, Rachel M. Mulavelil, Pavel Rodriguez, Claudia L. Satizabal, Kristin Schwab, Sudha Seshadri, Herpreet Singh, Ángel G. Velarde Dediós, Danny J. J. Wang, Rita R. Kalyani, Abhay Moghekar, Paul B. Rosenberg, Sevil Yasar, Marilyn Albert, Hanzhang Lu

Neurology Faculty Publications

INTRODUCTION: Vascular contributions to cognitive impairment and dementia (VCID) represent a major factor in cognitive decline in older adults. The present study examined the relationship between cerebrovascular reactivity (CVR) measured by magnetic resonance imaging (MRI) and cognitive function in a multi-site study, using a predefined hypothesis.

METHODS: We conducted the study in a total of three analysis sites and 263 subjects. Each site performed an identical CVR MRI procedure using 5% carbon dioxide inhalation. A global cognitive measure of Montreal Cognitive Assessment (MoCA) and an executive function measure of item response theory (IRT) score were used as outcomes.

RESULTS: CVR …

Community-Level Factors And Their Associations With Changing Opioid Overdose Fatality Rates In Kentucky, 2019–2021, Shawn R. Nigam, Philip M. Westgate, Svetla Slavova, Rachel Vickers-Smith, Katherine L. Thompson

Journal of Appalachian Health

Introduction: Kentucky has one of the highest opioid overdose fatality rates in the United States, which has increased significantly from 2019 to 2020. The COVID-19 pandemic has caused lasting effects on mental health and health care, which have been linked with increased opioid overdose. These effects are exacerbated in Appalachian regions, where there is a lack of sufficient access to community pharmacies and adequate health care.

Purpose: In this study, we characterize changes in opioid overdose fatality rates in Kentucky from 2019 to 2021, with a specific focus on changes in Appalachian vs non-Appalachian counties. We aim to identify associations …

Decentralized Clinical Trials For Medications To Reduce The Risk Of Dementia: Consensus Report And Guidance, Leanne Howard, Carla Abdelnour, Erin Abner, Ricardo F. Allegri, Hiroko H. Dodge, Serge Gauthier, Camilla M. Hoyos, Gregory Jicha, Patrick G. Kehoe, Catherine J. Mummery, Adesola Ogunniyi, Nikolaos Scarmeas, Xiaoying Chen, Jodie R. Titiner, Christopher R. Weber, Ruth Peters

Neurology Faculty Publications

INTRODUCTION: Recent growth in the functionality and use of technology has prompted an increased interest in the potential for remote or decentralized clinical trials in dementia. There are many potential benefits associated with decentralized medication trials, but we currently lack specific recommendations for their delivery in the dementia field.

METHODS: A modified Delphi method engaged an expert panel to develop recommendations for the conduct of decentralized medication trials in dementia prevention. A working group of researchers and clinicians with expertise in dementia trials further refined the recommendations.

RESULTS: Overall, the recommendations support the delivery of decentralized trials in dementia prevention …

Discussions Of Cancer Survivorship Care Needs: Are There Rural Versus Urban Inequities?, Tyrone F. Borders, Lindsey R. Hammerslag

Markey Cancer Center Faculty Publications

Background: Rural cancer survivors may face greater challenges receiving survivorship care than urban cancer survivors.

Purpose: To test for rural versus urban inequities and identify other correlates of discussions about cancer survivorship care with healthcare professionals.

Methods: Data are from the 2017 Medical Expenditure Panel Survey (MEPS), which included a cancer survivorship supplement. Adult survivors were asked if they discussed with a healthcare professional 5 components of survivorship care: need for follow-up services, lifestyle/health recommendations, emotional/social needs, long-term side effects, and a summary of treatments received. The Behavioral Model of Health Services guided the inclusion of predisposing, enabling, and need …

Aerobic And Anaerobic Exercise's Impact On Cognitive Functions In Eighth Grade Students., Heather Erwin, Sarah Schreiber

Kinesiology and Health Promotion Faculty Publications

The present study examined the impact of aerobic and anaerobic exercise on cognitive abilities in eighth grade students at one middle school in southeastern US. It is known that youth do not meet recommended physical activity levels, yet there is research demonstrating a clear connection between aerobic exercise and academic performance. There is a gap in evidence regarding anaerobic exercise and cognitive capabilities. If professionals know which type of exercise is most beneficial for enhancing cognition in youth, it will behoove them to incorporate these practices in physical education and other areas throughout the school day for students. Thus, this …

Wastewater Surveillance For Xylazine In Kentucky, Chris Delcher, Dana Quesinberry, Soroosh Torabi, Scott Berry, James W. Keck, Abhya Rani, Bikram Subedi

UK CARES Faculty Publications

Introduction: In the U.S., xylazine, the veterinary non-opioid sedative, has emerged as a major threat to people who use illicitly manufactured fentanyl and other drugs. The aim of this study was to compare wastewater detection of xylazine with other public health and safety surveillance data from 2019 to 2023 in Kentucky.

Methods: Wastewater samples from 5 rest areas, 2 truck weigh stations, and 4 wastewater treat- ment plants were tested for xylazine. Wastewater xylazine positivity rates were compared with xyla- zine-positive submission rates from the National Forensic Laboratory Information System and Kentucky’s fatal overdoses in 6-month periods (Period 1=January−June; Period …

Smoking Cessation By Cancer Treatment Status Among Cervical Cancer Survivors, Cherell Cottrell-Daniels, Charles E. Hoogland, Bethany Shorey Fennell, Vani N. Simmons, Damon J. Vidrine, Jennifer I. Vidrine

Markey Cancer Center Faculty Publications

Introduction: Continued smoking following a cancer diagnosis is associated with poorer cancer treatment outcomes and survival times. Little is known about how cancer treatment status at the time of tobacco treatment enrollment impacts long-term smoking cessation outcomes. Using data from a smoking cessation RCT, this study compared long-term cessation outcomes of women undergoing active treatment for cervical cancer at trial enrollment (n=40) to outcomes of women with a history of cervical cancer or cervical intraepithelial neoplasia (CIN) who were not undergo- ing active cancer treatment at enrollment (n=154)

Methods: Participants (n=194) were randomized to Standard Treatment (ST) or ST plus …

Social/Emotional Health, Mental Health And Quality Of Life Among Adults With Comorbid Diabetes And Hypertension: A Population-Based Cross-Sectional Study, Ranjita Misra, Sara Nayeem

Journal of Appalachian Health

Introduction: West Virginia has a disproportionately large population of rural adults with diabetes and hypertension, two common chronic, comorbid conditions that represent a national economic, social, and public health burden. Anxiety, depression, and severe mental illness are associated with poor motivation to engage in coping/self-care behaviors and related increased morbidity/mortality.

Purpose: This study examines the relationship between self-reported mental health, selected social and emotional health factors, health-related quality of life (HRQoL), and clinical outcomes among adults with comorbid diabetes and hypertension.

Methods: This cross-sectional study consisted of 75 participants who participated in a diabetes and hypertension self-management program (DHSMP) in …

Community Needs Assessment Collaboration Following The July 2022 Flooding In Eastern Kentucky, Melissa Slone Dsw, Frances Feltner Dnp, William M. Baker Rn, Anthony S. Lockard Msw, Csw, Angela Raleigh Rd

Journal of Appalachian Health

Rapidly rising waters due to flash floods and thunderstorms on the night of July 27, 2022, resulted in hundreds of water rescues throughout 14 rural Appalachian Kentucky counties. Lives were lost, thousands were injured, homes and property were damaged or destroyed, and many roadways were unpassable. Community partners serving these counties collaborated to design and conduct an assessment to gain a better understanding of the needs of individuals residing in certain remote sections within the communities. The assessment, conducted three months after the flood, collected information regarding flooding impact on housing, physical and behavioral health, transportation, work, and finances.

Disasters And Impacts In Appalachian Kentucky: A Behavioral Health Analysis, Walter David Mathews Phd, Joseph M. Clark, Amy S. Potts

Journal of Appalachian Health

Introduction: Major disasters continue to occur in Appalachian Kentucky with devastating consequences. A major disaster, defined by the Federal Emergency Management Agency (FEMA) as an event too large for a community to manage without outside help, involves emergency responders from the local, state, and federal disaster agencies, plus national volunteers.

Purpose: This paper reports on recent disasters in eight southeast Kentucky counties, the changing nature of these disasters, and the behavioral health impact on the people affected.

Methods: In this large-scale disaster survey in the Appalachian counties in Southeast Kentucky, over 3,500 people were asked about their recent disaster experiences …

Ensuring Equitable Application Of Interventions To Vulnerable Subpopulations In The Kentucky Consortium For Accountable Health Communities (Kc-Ahc), Jing Li, Jessica M. Clouser, Akosua Adu, Aiko Weverka, Nikita Vundi, Terry D. Stratton, Mark V. Williams

Journal of Appalachian Health

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Purpsoe: This study aims to assess the equity of KC-AHC model activities in three vulnerable sub-populations: dual enrollees, disabled individuals, and women.

Methods: Twenty-eight primary …

Trilogies: Lessons From 50 Years Facilitating Community-Based Health Assessments And Planning In Appalachia, Bruce Behringer

Journal of Appalachian Health

Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration.

Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation …

Maternal Age And Inadequate Prenatal Care In West Virginia: A Project Watch Study, Madelin Gardner, Amna Umer, Brian Hendricks, Toni Marie Rudisill, Candice Lefeber, Collin John, Christa Lilly

Journal of Appalachian Health

Introduction: Adequate prenatal care (PNC) is essential to the overall health of mother and infant. Teen age and advanced maternal age (AMA) are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC.

Purpose: This study sought to determine the potential association between maternal age (in groups, aged 20–24, 25–29, 30–34, 35–39, and >40) and inadequate PNC (visits).

Methods: West Virginia (WV) Project WATCH population-level data (May 2018–March 2022) were used for this study. Multiple logistic regressions were performed on inadequate PNC (less than 10 visits) with maternal age …

Treatment At An Academic Medical Center Eliminates Survival Disparities For Appalachian Kentuckians With Pancreatic Ductal Adenocarcinoma, Emily Cassim, Hannah Mcdonald, Megan Harper, Quan Chen, Miranda Lin, Reema Patel, Michael Cavnar, Prakash Pandalai, Bin Huang, Pamela C. Hull, Joseph Kim, Erin Burke

Journal of Appalachian Health

Introduction: Rates of cancer mortality in Appalachian Kentucky is among the highest in the nation. It is unknown whether geographic location of treatment for pancreatic ductal adenocarcinoma (PDAC), one of the deadliest cancers worldwide, influences survival in Appalachian Kentuckians.

Purpose: This study compares outcomes among Appalachian Kentuckians with PDAC who received treatment at an academic medical center (AMC) or community facility (CF).

Methods: Using the Kentucky Cancer Registry, patients diagnosed with PDAC between 2003 and 2018 were identified. Patients were categorized according to treatment location (AMC v. CF) and county of residence (Appalachian v. non-Appalachian). Kaplan-Meier curves were constructed to …

Check With The Intended Audience First! Content Validation As A Method For Inclusive Research For Primary Care Engagement In Rural Appalachia, Sydeena E. Isaacs, Jennifer Schroeder Tyson, Ashley Parks, Danielle Adams

Journal of Appalachian Health

Introduction: To date, referral practices based on social determinants of health (SDOH) among primary care providers (PCPs) and clinic staff in rural regions, including Appalachian North Carolina (NC), are not well understood.

Purpose: This study aims to develop and content validate a primary care engagement (PCE) survey to assess (1) engagement and burnout; (2) referral practices; and (3) self-efficacy and confidence in making referrals based on SDOH among PCPs and clinic staff in Appalachian NC.

Methods: Using the Social-Ecological Model as a theoretical framework, researchers developed a 37-item PCE survey. Content validation was completed by a panel of experts recruited …

Willingness To Utilize A Mobile Treatment Unit In Five Counties At The Epicenter Of The Us Rural Opioid Epidemic., Snigdha R. Peddireddy, Melvin D. Livingston Iii, April M. Young, Patricia R. Freeman, Umedjon Ibragimov, Kelli A. Komro, Michelle R. Lofwall, Carrie B. Oser, Michele Staton, Hannah L. F. Cooper

Epidemiology and Environmental Health Faculty Publications

INTRODUCTION: US federal policies are evolving to expand the provision of mobile treatment units (MTUs) offering medications for opioid use disorder (MOUD). Mobile MOUD services are critical for rural areas with poor geographic access to fixed-site treatment providers. This study explored willingness to utilize an MTU among a sample of people who use opioids in rural Eastern Kentucky counties at the epicenter of the US opioid epidemic.

METHODS: The study analyzed Cross-sectional survey data from the Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE) study covering five rural counties in the state. Logistic regression models investigated the …

A Multi-Ancestry Genetic Study Of Pain Intensity In 598,339 Veterans., Sylvanus Toikumo, Rachel Vickers-Smith, Zeal Jinwala, Heng Xu, Divya Saini, Emily E Hartwell, Mirko Pavicic, Kyle A Sullivan, Ke Xu, Daniel A Jacobson, Joel Gelernter, Christopher T Rentsch, Million Veteran Program, Eli Stahl, Martin Cheatle, Hang Zhou, Stephen G Waxman, Amy C Justice, Rachel L Kember, Henry R Kranzler

Epidemiology and Environmental Health Faculty Publications

Chronic pain is a common problem, with more than one-fifth of adult Americans reporting pain daily or on most days. It adversely affects the quality of life and imposes substantial personal and economic costs. Efforts to treat chronic pain using opioids had a central role in precipitating the opioid crisis. Despite an estimated heritability of 25-50%, the genetic architecture of chronic pain is not well-characterized, in part because studies have largely been limited to samples of European ancestry. To help address this knowledge gap, we conducted a cross-ancestry meta-analysis of pain intensity in 598,339 participants in the Million Veteran Program, …

Barriers To Opioid Use Disorder Treatment Among People Who Use Drugs In The Rural United States: A Qualitative, Multi-Site Study., T. J. Stopka, A. T. Estadt, G. Leichtling, J. C. Schleicher, L. S. Mixson, J. Bresett, E. Romo, P. Dowd, S. M. Walters, A. M. Young, W. Zule, P. D. Friedmann, V. F. Go, R. Baker, R. J. Fredericksen

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: In 2020, 2.8 million people required substance use disorder (SUD) treatment in nonmetropolitan or 'rural' areas in the U.S. Among this population, only 10% received SUD treatment from a specialty facility, and 1 in 500 received medication for opioid use disorder (MOUD). We explored the context surrounding barriers to SUD treatment in the rural United States.

METHODS: We conducted semi-structured, in-depth interviews from 2018 to 2019 to assess barriers to SUD treatment among people who use drugs (PWUD) across seven rural U.S. study sites. Using the social-ecological model (SEM), we examined individual, interpersonal, organizational, community, and policy factors contributing …

Wastewater Surveillance For Identifying Sars-Cov-2 Infections In Long-Term Care Facilities, Kentucky, Usa, 2021–2022, James W. Keck, Reuben Adatorwovor, Matthew Liversedge, Blazan Mijotavich, Cullen Olsson, William D. Strike, Atena Amirsoleimani, Ann Noble, Soroosh Torabi, Alexus Lori Rockward, Mohammad Dehghan Banadaki, Ted Smith, Parker Lacy, Scott M. Berry

UK CARES Faculty Publications

Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour compos- ite wastewater samples 2–4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021–February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed vari- able correlation with clinical test data; we observed the strongest …

Alzheimer’S Disease And Inflammatory Biomarkers Positively Correlate In Plasma In The Uk-Adrc Cohort, Kate E. Foley, Zachary Winder, Tiffany L. Sudduth, Barbara J. Martin, Peter T. Nelson, Gregory Jicha, Jordan P. Harp, Erica M. Weekman, Donna M. Wilcock

Neurology Faculty Publications

INTRODUCTION: Protein-based plasma assays provide hope for improving accessibility and specificity of molecular diagnostics to diagnose dementia. METHODS: Plasma was obtained from participants (N = 837) in our community-based University of Kentucky Alzheimer’s Disease Research Center cohort. We evaluated six Alzheimer’s disease (AD)- and neurodegeneration-related (Aβ40, Aβ42, Aβ42/40, p- tau181, total tau, and NfLight) and five inflammatory biomarkers (TNF𝛼, IL6, IL8, IL10, and GFAP) using the SIMOA-based protein assay platform. Statistics were performed to assess correlations. RESULTS: Our large cohort reflects previous plasma biomarker findings. Relationships between biomarkers to understand AD–inflammatory biomarker correlations showed significant associations between AD and inflammatory …

A 2‑Year Longitudinal Randomized Control Trial Of Speed Of Processing Cognitive Training In Aging Adults With Hiv‑Associated Neurocognitive Disorder: Results Of The Think Fast Study, David E. Vance, Pariya L. Fazeli, Andres Azuero, Jennifer S. Frank, Virginia G. Wadley, James L. Raper, Caitlin N. Pope, Karlene K. Ball

Epidemiology and Environmental Health Faculty Publications

Nearly 40% of people with HIV (PWH) experience HIV-associated Neurocognitive Disorder (HAND). In this 3-group efficacy study, 216 PWH 40 + years with HAND or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73), or (3) 10 h of Internet navigation training (n = 73; contact control group). Participants were administered a measure of SOP [i.e., the Useful Field of View Test (UFOV®)] at baseline, at posttest immediately after training, and at year 1 and year 2 follow up. Intent-to-treat linear mixed-effect models with subject-specific …

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 …