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Loyalism was a potent force in the Trans-Appalachian West during the American Revolution. However, the experiences of western Loyalists differed from those elsewhere and provide a broader understanding of the forces affecting Loyalism in the British Empire. There were few reasons for western Loyalists to declare their sympathies and even fewer opportunities to seek assistance from the British. Geography meant that western Loyalists were isolated and could not cooperate effectively with the British government and army, while the threat of Indian attack also gave Loyalists and Whigs a common cause. Consequently, they lacked a clear identity, especially as most westerners were, to some degree, disaffected. Indeed, many frontier "patriots," from George Rogers Clark to Daniel Boone, were associated with disaffection, if not outright Loyalism. Finally, the reintegration of Loyalists into western society after the Revolution meant that memories of Loyalism were written out of family and local histories. [ABSTRACT FROM AUTHOR]

After Dobbs, religion, commonly seen as an argument against abortion, has been used to argue for the right to choose. In July 2022, a synagogue sued Florida, asserting that its ban on abortion after fifteen weeks violated Article 1, Section 3 of the Florida Constitution, which prohibits the penalization of free expression of religion. In September 2022, the ACLU argued that the state's abortion ban violated Indiana's Religious Freedom Restoration Act. And in October 2022, three Jewish women sued the state of Kentucky, alleging that its abortion ban violated the Kentucky Religious Freedom Restoration Act. This Note provides a guide to the merits and challenges of the argument that an abortion ban violates a state Religious Freedom Restoration Act (RFRA). Although this Note focuses on how Jewish plaintiffs can raise such claims, the arguments outlined could be raised by individuals of multiple faiths. This Note contributes to a growing debate about religious arguments for the right to an abortion. And it is the first paper to outline how religious freedom claims to obtaining an abortion might fare under state RFRAs. The approach to RFRA outlined in this paper lays the groundwork for a rights-advancing framework of religious exercise. [ABSTRACT FROM AUTHOR]

Suboptimal multidisciplinary team collaboration is a barrier to effective health care provision for patients with chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM). We describe an example practice model of a clinical practice called Baptist Health Deaconess, based in Madisonville, Kentucky, USA, where a small multidisciplinary team consisting of an endocrinologist, nurse practitioner, and pharmacist (authors of this article) work collaboratively in an ambulatory care setting to provide health care to the patients they serve. Many of the patients who receive care at Baptist Health Deaconess are on a low income, have poor health literacy, and do not have a primary care physician. The presence of a pharmacist in the team allows for insurance/access investigations to assess drug choice and affordability; such aspects can be performed quickly with a pharmacist in the office. Plain Language Summary: Health care professionals (HCPs) supporting people living with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) may work at one or more health care settings such as a health care practice, a hospital, a pharmacy, or they might support people in their own homes. When HCPs do not work well together this negatively affects the quality of care that people visiting them receive. This paper gives the point of view of three HCPs (a nurse practitioner, a pharmacist, and a diabetes specialist [an endocrinologist]) who work at a health care practice called Baptist Health Deaconess situated in Kentucky, USA. The three HCPs describe how many of the people who visit them at their practice do not have much money, they do not really understand what their conditions are about or how they can be best treated, and they do not have a primary care physician. The HCP team believe that having a pharmacist on their team (which is not common throughout the USA) means that they work better together because it saves money, people with T2DM and CKD visiting get the best treatment recommendations for them, and this is all done quicker compared to having no pharmacist on the team. [ABSTRACT FROM AUTHOR]

Monitoring of compensatory stream mitigation projects conventionally relies on spatially discrete geometric data and habitat assessments collected from representative reaches. Project success is evaluated by extrapolating site‐scale metrics such as rapid bioassessment protocol (RBP) scores and time‐series changes in width‐to‐depth ratios to adjacent reaches. For example, an excellent RBP score at one location is used to infer excellent habitat in nearby reaches. This paper compares spatially discrete and continuous monitoring data from 38 km of restored stream length on a stream mitigation project in central Kentucky to document how conventional site‐level metrics may not represent conditions in adjacent reaches, particularly on projects plagued by post‐construction geomorphic instability (e.g., headcut migration, propagation of bank erosion, and chute cutoff formation). Over a 5‐year monitoring period, rapid visual assessment walkabouts documented project‐scale geomorphic process trajectories that were not captured by conventional site‐specific monitoring. Early detection of geomorphic instability from this rapid monitoring approach facilitated cost‐effective and tailored adaptive management (e.g., planting of live stakes to arrest bank erosion). Full‐census walkabouts can thereby help to improve mitigation credit valuation, enhance long‐term habitat protection, and facilitate successful steam restoration outcomes. [ABSTRACT FROM AUTHOR]

Rates of exposure to traumatic events are up to two times higher among people with substance use disorders (SUDs) compared to the US general population. Overdoses (OD) and overdose fatalities have continued to increase nationally and in Kentucky and are associated with elevated trauma symptoms. This paper examines the impacts of witnessing and experiencing OD among people who inject drugs (PWIDs) in Kentucky. Study participants were recruited via Respondent-Driven Sampling techniques supplemented with direct community outreach. Our findings showed that participants reporting past year severe mental health distress and lifetime violence exposure had higher odds of both witnessing and experiencing OD. Additionally, participants who reported early abuse had higher odds of both witnessing and experiencing OD as did participants with early onset injection drug use. The study findings suggest the need for incorporating knowledge about trauma into policies, procedures, and practices in treating SUD among PWID. [ABSTRACT FROM AUTHOR]

Foliar fungicides are available to suppress Diplodia ear rot (DER), caused by Stenocarpella maydis (Berk.) Sutton and Stenocarpella macrospora (Earle) Sutton) in corn (Zea mays L.), but previous research has indicated these fungicides have limited efficacy against the disease using traditional over‐canopy application methods. In an effort to improve coverage within the canopy and potentially improve disease control of DER, experiments were conducted in 2020, 2021, and 2022 to examine the effect of ground‐driven, in‐canopy fungicide nozzle technology on DER severity and spray coverage on the ear leaf and ear of corn plants. Application methods included over‐canopy nozzles, over‐canopy + drop nozzles, and over‐canopy + 360 Undercover nozzles. Within each application method, treatments consisted of a non‐inoculated control, or were inoculated with a conidial suspension of S. maydis. The fungicides benzovindiflupyr + azoxystrobin + propiconazole and pydiflumetofen + azoxystrobin + propiconazole were applied within each application method to measure efficacy against DER. In all years, neither fungicide product nor application method reduced DER severity. No fungicide applications increased yield compared to the non‐treated control. The addition of drop nozzles or 360 Undercover nozzles to traditional over‐canopy nozzles increased spray coverage on the ear (P < 0.0001) compared to over‐canopy nozzles alone. Plain Language Summary: Experiments conducted in Kentucky from 2020 to 2022 examined the efficacy of fungicide application method and foliar fungicides in controlling Diplodia ear rot (DER) in corn. Over‐canopy nozzles, over‐canopy + drop nozzles, and over‐canopy + 360 Undercover nozzles were tested along with two different labeled fungicides. Results showed that neither fungicide nor application method significantly reduced DER severity or increased yield compared to the non‐treated control. The addition of drop nozzles or 360 Undercover nozzles did enhance spray coverage on the ear compared to over‐canopy nozzles alone. [ABSTRACT FROM AUTHOR]

Pretrial assessments are criticized for inherent biases. We conduct research in Kentucky to assess the predictive validity and differential prediction by sex of one pretrial assessment, the Public Safety Assessment (PSA). Our research is unique because we find equal base rates by sex for missing a court date, which allows us to assess for error rate balance by sex. We find the PSA to have predictive validity within acceptable ranges for the criminal legal field. The analyses show a lack of evidence of predictive bias for any arrest or missing a court date, and we find equal error rates for five different error measures. The analyses contribute to methodological debates about how to measure predictive bias with assessments. [ABSTRACT FROM AUTHOR]

The U.S. opioid overdose crisis persists. Outpatient behavioral health services (BHS) are essential components of a comprehensive response to opioid use disorder and overdose fatalities. The Helping to End Addiction Long-Term® (HEALing) Communities Study developed the Communities That HEAL (CTH) intervention to reduce opioid overdose deaths in 67 communities in Kentucky, Ohio, New York, and Massachusetts through the implementation of evidence-based practices (EBPs), including BHS. This paper compares the rate of individuals receiving outpatient BHS in Wave 1 intervention communities (n = 34) to waitlisted Wave 2 communities (n = 33). Medicaid data included individuals ≥18 years of age receiving any of five BHS categories: intensive outpatient, outpatient, case management, peer support, and case management or peer support. Negative binomial regression models estimated the rate of receiving each BHS for Wave 1 and Wave 2. Effect modification analyses evaluated changes in the effect of the CTH intervention between Wave 1 and Wave 2 by research site, rurality, age, sex, and race/ethnicity. No significant differences were detected between intervention and waitlisted communities in the rate of individuals receiving any of the five BHS categories. None of the interaction effects used to test the effect modification were significant. Several factors should be considered when interpreting results—no significant intervention effects were observed through Medicaid claims data, the best available data source but limited in terms of capturing individuals reached by the intervention. Also, the 12-month evaluation window may have been too brief to see improved outcomes considering the time required to stand-up BHS. Clinical Trials.gov http://www.clinicaltrials.gov : Identifier: NCT04111939 • Evidence-based practices to reduce opioid overdose deaths implemented in 67 communities. • Outpatient behavioral health services are key element of opioid addiction treatment. • Similar receipt of behavioral services in control and intervention communities. • More research needed to test the impact of comprehensive, community-driven interventions. [ABSTRACT FROM AUTHOR]

Objectives. To assess heterogeneity in pandemic-period excess fatal overdoses in the United States, by location (state, county) and substance type. Methods. We used seasonal autoregressive integrated moving average (SARIMA) models to estimate counterfactual death counts in the scenario that no pandemic had occurred. Such estimates were subtracted from actual death counts to assess the magnitude of pandemic-period excess mortality between March 2020 and August 2021. Results. Nationwide, we estimated 25 668 (95% prediction interval [PI] = 2811, 48 524) excess overdose deaths. Specifically, 17 of 47 states and 197 of 592 counties analyzed had statistically significant excess overdose-related mortality. West Virginia, Louisiana, Tennessee, Kentucky, and New Mexico had the highest rates (20–37 per 100 000). Nationally, there were 5.7 (95% PI = 1.0, 10.4), 3.1 (95% PI = 2.1, 4.2), and 1.4 (95% PI = 0.5, 2.4) excess deaths per 100 000 involving synthetic opioids, psychostimulants, and alcohol, respectively. Conclusions. The steep increase in overdose-related mortality affected primarily the southern and western United States. We identified synthetic opioids and psychostimulants as the main contributors. Public Health Implications. Characterizing overdose-related excess mortality across locations and substance types is critical for optimal allocation of public health resources. (Am J Public Health. 2024;114(6):599–609. https://doi.org/10.2105/AJPH.2024.307618) [ABSTRACT FROM AUTHOR]

Open burning poses a significant threat to human health and the environment by releasing hazardous chemicals and exacerbating plastic pollution. Urgent action is required to address its pervasive impact and the substantial release of gaseous pollutants. Limited research has explored the demographic aspect of open burning behavior, with none specifically conducted in Kentucky. An analysis of open burning complaints reported to the Kentucky Division for Air Quality in 2015, 2019, and 2021 revealed no significant differences in reported incidents by month and county. Binary logistic regression analyses identified the urban vs rural divide as significant predictors of open burning incidents, while violations were influenced by both urban and rural factors and average household income. Unemployment rates and the percentage of individuals with less than a high school diploma did not significantly predict open burning violations. Targeted interventions at the state and local level, focusing on rural areas and economically disadvantaged communities, can effectively address and mitigate open burning issues. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate factors influencing one's decision to become a live kidney donor under the framework of sociotechnical systems, by expanding the focus to include larger organizational influences and technological considerations. Semi-structured interviews were conducted with live kidney donors who donated through University of Louisville Health, Trager Transplant Center, a mid-scale transplant program, in the years 2017 through 2019. The interview transcripts were analyzed for barriers and facilitators to live kidney donation within a sociotechnical system. The most salient facilitators included: having an informative, caring, and available care team; the absence of any negative external pressure toward donating; donating to a family or friend; and the ability to take extra time off work for recovery. The most recurrent barriers included: short/medium-term (<1 year) negative health impacts because of donation; the need to make minor lifestyle changes (e.g., less alcohol consumption) after donation; and mental health deterioration stemming from the donation process. The sociotechnical systems framework promotes a balanced system comprised of social, technical, and environmental subsystems. Assessing the facilitators and barriers from the sociotechnical system perspective revealed the importance of and opportunities for developing strategies to promote integration of technical subsystem, such as social media apps and interactive AI platforms, with social and environmental subsystems to enable facilitators and reduce barriers effectively. [ABSTRACT FROM AUTHOR]

The P1 phage has garnered attention as a carrier of antibiotic resistance genes (ARGs) in Enterobacteriaceae. However, the transferability of ARGs by P1-like phages carrying ARGs, in addition to the mechanism underlying ARG acquisition, remain largely unknown. In this study, we elucidated the biological characteristics, the induction and transmission abilities, and the acquisition mechanism of the blaCTX-M-27 gene in the P1 phage. The P1-CTX phage exhibited distinct lytic plaques and possessed a complete head and tail structure. Additionally, the P1-CTX phage was induced successfully under various conditions, including UV exposure, heat treatment at 42 °C, and subinhibitory concentrations (sub-MICs) of antibiotics. Moreover, the P1-CTX phage could mobilize the blaCTX-M-27 gene into three strains of Escherichia coli (E. coli) and the following seven different serotypes of Salmonella: Rissen, Derby, Kentucky, Typhimurium, Cerro, Senftenberg, and Muenster. The mechanism underlying ARG acquisition by the P1-CTX phage involved Tn1721 transposition-mediated movement of blaCTX-M-27 into the ref and mat genes within its genome. To our knowledge, this is the first report documenting the dynamic processes of ARG acquisition by a phage. Furthermore, this study enriches the research on the mechanism underlying the phage acquisition of drug resistance genes and provides a basis for determining the risk of drug resistance during phage transmission. [ABSTRACT FROM AUTHOR]

Injury-prevention programs (IPPs) have been effective in reducing lower extremity injury rates, but user compliance plays a major role in their effectiveness. Race and collegiate division may affect attitudes toward participation in IPPs and compliance in female collegiate athletes. To compare attitudes toward IPPs based on race and collegiate division. Cross-sectional study. Survey. A total of 118 female collegiate athletes (age = 19.71 ± 1.47 years, height = 169.46 ± 9.09 cm, mass = 69.57 ± 11.57 kg) volunteered. Participants completed the Health Belief Model Scale and the Theory of Planned Behavior Scale (TPBS) on 1 occasion. The Health Belief Model Scale contains 9 subscales (perceived susceptibility, perceived consequences, fear of injury, perceived benefits, perceived barriers, community-led self-efficacy, individual self-efficacy, general health cues, external health cues), whereas the TPBS has 5 subscales (perceived benefits, perceived barriers, perceived social norms, social influence, intention to participate). The independent variables were race (White versus Black, Indigenous, and other people of color [BIPOC]) and National Collegiate Athletic Association division (I and III). Mann-Whitney U tests were used to detect differences in attitudes toward IPP participation based on race and collegiate division. White female athletes perceived fewer TPBS barriers to participation in IPPs (P =.003) and more community-led self-efficacy when compared with BIPOC female athletes (P =.009). Division I athletes perceived a greater fear of injury (P =.002) and more general health cues (P =.01) than Division III athletes. For lower extremity IPPs, BIPOC and Division III female collegiate athletes may need different implementation strategies. Individuals who identify as BIPOC may benefit from interventions focusing on solutions for common barriers to participation and improving community-led self-efficacy, and Division III athletes may benefit from interventions focusing on education related to the risk of injury and general preventive health behaviors. [ABSTRACT FROM AUTHOR]

Background: Communities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e., start-up costs). Despite the importance of these start-up costs in investment decisions to stakeholders, they are typically excluded from cost-effectiveness analyses. The objective of this study is to report a detailed analysis of CTH start-up costs pre-intervention implementation and to describe the relevance of these data for stakeholders to determine implementation feasibility. Methods: This study is guided by the community perspective, reflecting the investments that a real-world community would need to incur to implement the CTH intervention. We adopted an activity-based costing approach, in which resources related to hiring, training, purchasing, and community dashboard creation were identified through macro- and micro-costing techniques from 34 communities with high rates of fatal opioid overdoses, across four states—Kentucky, Massachusetts, New York, and Ohio. Resources were identified and assigned a unit cost using administrative and semi-structured-interview data. All cost estimates were reported in 2019 dollars. Results: State-level average and median start-up cost (representing 8–10 communities per state) were $268,657 and $175,683, respectively. Hiring and training represented 40%, equipment and infrastructure costs represented 24%, and dashboard creation represented 36% of the total average start-up cost. Comparatively, hiring and training represented 49%, purchasing costs represented 18%, and dashboard creation represented 34% of the total median start-up cost. Conclusion: We identified three distinct CTH hiring models that affected start-up costs: hospital-academic (Massachusetts), university-academic (Kentucky and Ohio), and community-leveraged (New York). Hiring, training, and purchasing start-up costs were lowest in New York due to existing local infrastructure. Community-based implementation similar to the New York model may have lower start-up costs due to leveraging of existing infrastructure, relationships, and support from local health departments. [ABSTRACT FROM AUTHOR]

Background: Police violence is increasingly recognized as an urgent public health problem. Basic questions about police violence, however, remain unanswered, including which types of law enforcement agency are responsible for fatal police violence deaths. Methods: We estimated the proportion of police violence deaths in the U.S. (2013–2022) that were attributable to local, county, state, federal, or tribal police agencies, using mapping police violence data. We examined proportions overall, by decedent race/ethnicity, and by state. Results: Nationally, 60% of decedents were killed by municipal, 29% by county, 8% by state, and 3% by federal, police, with < 1% killed by tribal or other officers. These proportions varied by race/ethnicity, with 56% of Native American decedents killed by municipal police compared to 70–75% among other racially minoritized people. While municipal police were responsible for most deaths in most states, in the Southeast, county police predominated. In some Northeastern states (and Alaska), state police were responsible for > 40% of deaths. Conclusions: We identify wide geographic & racial/ethnic variation in the agencies responsible for fatal police violence. Findings suggest that the budgetary and infrastructural shifts required to prevent fatal police violence need to occur at multiple levels of government. [ABSTRACT FROM AUTHOR]

Each year, numerous tornadoes occur in forested regions of the United States. Due to the substantial number of fallen trees and accessibility issues, many of these tornadoes remain poorly documented and evaluated. The process of documenting tree damage to assess tornado intensity is known as the treefall method, an established and reliable technique for estimating near-surface wind speed. Consequently, the demand for documenting fallen trees has increased in recent years. However, the treefall method proves to be extremely expensive and time-consuming, requiring a laborious assessment of each treefall instance. This research proposes a novel approach to evaluating treefall in large, forested regions using deep learning-based automated detection and advanced image processing techniques. The developed treefall method relies on high-resolution aerial imagery from a damaged forest and involves three main steps: (1) instance segmentation detection, (2) estimating tree taper and predicting fallen tree directions, and (3) obtaining subsampled treefall vector results indicating the predominant flow direction in geospatial coordinates. To demonstrate the method's effectiveness, the algorithm was applied to a tornado track rated EF-4, which occurred on 10 December 2021, cutting through the Land Between the Lakes National Recreation Area in Kentucky. Upon observation of the predicted results, the model is demonstrated to accurately predict the predominant treefall angles. This deep-learning-based treefall algorithm has the potential to speed up data processing and facilitate the application of treefall methods in tornado evaluation. [ABSTRACT FROM AUTHOR]

This study examined how interruptions in insurance coverage affect purchases of prescription drugs for young adults. It used data spanning 2014 to 2018 from Kentucky's prescription drug monitoring program, which tracked the universe of federally-regulated (Schedule II–V) prescription drugs dispensed in the state. The study employed a regression discontinuity design based on the age limit at 26 for dependent insurance coverage for children. At age 26, the probability of purchasing a prescription decreased by 5%, with all subcategories of prescriptions affected. The share of generic prescriptions increased for stimulants (the only category observed with substantial branded prescriptions). By age 27, prescription purchases returned to levels observed at 25, but the share purchased with public insurance and the generic share for stimulants remained higher. The findings suggest that interruptions in insurance coverage decrease prescription drug utilization by young adults and that public insurance programs such as Medicaid are important for resuming treatment. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic produced system-level changes within the criminal legal system and community-based substance use disorder (SUD) treatment system with impacts on recovery efforts. This study examines rural and urban clinicians' perspectives of COVID-19 on SUD treatment delivery for people on community supervision. Methods: Virtual qualitative interviews were conducted between April and October 2020 with 25 community supervision clinicians employed by Kentucky's Department of Corrections (DOC), who conduct assessments and facilitate community-based treatment linkages for individuals on probation or parole. Transcripts were analyzed in NVivo using directed content analysis methods. Results: Clinicians were predominantly white (92%) and female (88%) with an average of over 9 years working in the SUD treatment field and 4.6 years in their current job. Four COVID-19 themes were identified by both rural and urban clinicians including: (1) telehealth increases the modes of communication, but (2) also creates paperwork and technological challenges, (3) telehealth requires more effort for inter/intra-agency collaboration, and (4) it limits client information (e.g., no urine drug screens). Two additional rural-specific themes emerged related to COVID-19: (5) increasing telehealth options removes SUD treatment transportation barriers and (6) requires flexibility with programmatic requirements for rural clients. Conclusions: Findings indicate the need for community-based SUD treatment providers approved or contracted by DOC to support and train clients to access technology and improve information-sharing with community supervision officers. A positive lesson learned from COVID-19 transitions was a reduction in costly travel for rural clients, allowing for greater engagement and treatment adherence. Telehealth should continue to be included within the SUD continuum of care, especially to promote equitable services for individuals from rural areas. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of type 2 diabetes (T2D) is 17% higher in rural dwellers compared to their urban counterparts, and it increases with age, with an estimated 25% of older adults (≥ 65 years) diagnosed. Appropriate self-care is necessary for optimal clinical outcomes. Overall, T2D self-care is consistently poor among the general population but is even worse in rural-dwellers and older adults. In rural Kentucky, up to 23% of adults in Appalachian communities have been diagnosed with T2D and, of those, 26.8% are older adults. To attain optimal clinical outcomes, social environmental factors, including social support, are vital when promoting T2D self-care. Specifically, peer support has shown to be efficacious in improving T2D self-care behaviors and clinical and psychosocial outcomes related to T2D; however, literature also suggests self-selected social support can be obstructive when engaging in healthful activities. Currently available evidence-based interventions (EBIs) using peer support have not been used to prioritize older adults, especially those living in rural communities. Method: To address this gap, we conducted formative research with stakeholders, and collaboratively identified an acceptable and feasible peer support EBI—peer health coaching (PHC)—that has resulted in improved clinical and psychosocial T2D-related outcomes among participants who did not reside in rural communities nor were ≥65 years. The goal of the proposed study is to use a 2x2 factorial design to test the adapted PHC components and determine their preliminary effectiveness to promote self-care behaviors and improve glycemic control among older adults living in Appalachian Kentucky. Testing the PHC components of the peer support intervention will be instrumental in promoting care for older adults in Appalachia, as it will allow for a larger scale intervention, which if effective, could be disseminated to community partners in Appalachia. Trial registration: This study was registered at www.clinicaltrials.gov (NCT06003634) in August 2023. [ABSTRACT FROM AUTHOR]

Intensive pasture management that aims at providing season-long forage while minimizing soil degradation is increasingly becoming an important grazing strategy in Kentucky. Typically, it involves the use of high-yielding warm and cool season forage species that are well suited to local soil and climate conditions, meeting the dual-purpose provision of high nutritional value while remaining resilient to grazing pressure and changing climate. Monitoring carbon exchange is a crucial component for effective pasture management to promote sustainable pastureland management practices. We hypothesized that pasturelands, when intensively managed, would exhibit a small but important CO2 cumulative uptake year-round. We used the Eddy covariance method to measure the net ecosystem exchange of CO2 (NEE) and productivity of an intensively managed pastureland at Kentucky State University Research and Demonstration station from 2015 to 2020. The study has two objectives: to quantify interannual variability in net ecosystem exchange, and examine the controlling environmental factors, in particular temperature, sunlight, and precipitation of NEE. Diurnal and seasonal fluctuations followed typical patterns of carbon uptake and release. Overall, the pasture site consistently was carbon sink except for 2016, in part due to a warmer winter season than usual, sequestering 1394 gCm−2 over the study period. Precipitation and temperature were critical environmental factors underpinning seasonal CO2 uptake and release. Of critical importance was the net carbon uptake during the non-growing season. [ABSTRACT FROM AUTHOR]

E-ticketing was an intriguing technology to many state transportation agencies (STAs) pre-COVID-19 pandemic but gained significant attention upon arrival of the pandemic due to the contactless nature of the technology. Research completed prior to the pandemic into E-ticketing for asphalt paving primarily identified qualitative benefits and concerns. However, minimal academic literature exists in the postpandemic era discussing the additional E-ticketing benefits not previously captured which resulted in increased implementation by STAs. This research seeks to address this gap by gathering information from state members of the American Association of State Highway and Transportation Officials Committee on Construction (AASHTO COC), employees of the Kentucky Transportation Cabinet (KYTC), and members of the Kentucky Association of Highway Contractors (KAHC) and the Plantmix Asphalt Industry of Kentucky (PAIKY) regarding E-ticketing practices for asphalt paving in the postpandemic era. The first portion of the study combines national and state-level survey responses to create a qualitative benefit-cost analysis for E-ticketing for asphalt paving operations based upon experience gained through emergency implementation during the pandemic. To reinforce the results of the qualitative analysis and increase the power of the study, the second portion of the research creates a quantitative benefit-cost analysis (BCA) from data collected from KYTC construction projects to compare the traditional weigh ticket collection process with E-ticketing processes for both project engineers and inspectors. The analysis shows a statistically significant time savings for field employees but not project management personnel. The monetary analysis for Kentucky indicates that whereas E-ticketing does not result in significant time savings for all employees, there is substantial monetary benefit worthy of STAs adopting E-ticketing as policy. The primary contributions to the body of knowledge include an improved BCA methodology applied to a new domain of electronic bulk material tickets and an informed quantitative BCA framework useful for STAs as a proof-of-concept to champion E-ticketing implementation and by transportation-focused researchers for evaluating emerging technological applications. Previous research has focused on improving safety and task efficiency for field employees associated with asphalt paving operations. E-ticketing (electronic ticketing) has been proposed as an innovative technology to help augment typical tasks associated with asphalt paving. Before the COVID-19 pandemic, several state transportation agencies (STAs) had introduced pilot projects to study E-ticketing, but these yielded minimal policy adoption results. During the COVID-19 pandemic, many STAs pivoted to emergency usage of E-ticketing as the primary means of collecting information about asphalt material used on construction projects. This research compares previous qualitative analyses regarding the benefits and concerns associated with E-ticketing prior to the COVID-19 pandemic with lessons learned by STAs across the country after utilizing E-ticketing during the pandemic. Additionally, a case study focused on the Kentucky Transportation Cabinet (KYTC) is used to create a quantitative benefit-cost analysis from project-level data collected from various asphalt paving projects during the 2022 construction season. The findings indicate a statistically significant time savings for field employees utilizing E-ticketing and a benefit-cost ratio that promotes STAs adopting E-ticketing as a permanent policy. [ABSTRACT FROM AUTHOR]

Kentucky is one of the largest coal-producing states; surface coal mining has led to changes in natural land cover, soil loss, and water quality. This study explored relationships between actively mined and reclaimed areas, vegetation change, and water quality parameters. The study site evaluated 58 watersheds with Landsat-derived variables (reclamation age and percentage of mining, reclaimed forest, and reclaimed woods) as well as topographic variables (such as elevation, slope, drainage density, and infiltration). Water samples were collected in spring (n = 9), summer (n = 14), and fall (n = 58) 2017 to study changes in water quality variables (SO42−, alkalinity, conductivity, Ca2+, Mg2+, Mn2+, Al3+, and Fe2+, Fe3+) in response to changes in land cover. Pearson correlation analyses indicated that conductivity has strong to very strong relationships with water quality variables related to coal mining (except Al3+, Fe2+, Fe3+, Mn2+, elevation, slope, and drainage density) and land cover variables. In addition, separate regression analyses were performed, with conductivity values based on samples collected in the fall. First, conductivity responses to mining percentage, reclamation age and topographic variables were examined (adjusted R2 = 0.818, p < 0.01). Next, vegetation cover change parameters were added to the same model, which yielded slightly improved R2 (adjusted R2 = 0.826, p < 0.01). Finally, reclamation age and mining percentages were used to explain the quantity of reclaimed forested areas as a percentage of watersheds. The model was significant (p < 0.01), with an adjusted R2 value of 0.641. Results suggest that the quantity (area as a percentage) of reclaimed forests may be a predictor of the mining percentage and reclamation age. This study indicated that conductivity is a predictable water quality indicator that is highly associated with Coal-Mine-Related Stream Chemistry in areas where agriculture and urban development are limited. Water quality is not suitable for various purposes due to the presence of contaminants, especially in mined sites. These findings may help the scientific community and key state and federal agencies improve their understanding of water quality attributes in watersheds affected by coal mining, as well as refine land reclamation practices more effectively while such practices are in action. [ABSTRACT FROM AUTHOR]

Objective: Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation. Method: Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they seeking treatment. ACE scores were calculated, and age of substance use initiation was recorded. A Cox proportional hazard model was used to examine the effect of ACE score on age of substance use initiation. Results: A total of 107 participants completed the study. An average number of 2.3 ACEs (SD = 2.2) were endorsed with 24% of participants reporting 4 or more ACEs. Higher ACE scores were associated with cigarette smoking and non-medical prescription opioid use onset (hazard ratio (HR) = 1.14, 95% CI=1.02–1.28, p = 0.02, and HR=1.19, 95% CI = 1.04–1.37, p = 0.01, respectively. Conclusions: A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use, consistent with prior research. Primary prevention of ACEs, screening for ACEs during childhood, and interventions for ACEs if detected, may help to reduce the risk of substance use/SUD in adulthood. [ABSTRACT FROM AUTHOR]

Topminnows of the Teleost genus Fundulus serve as model organisms in ecotoxicology because of their broad physiological tolerance and propensity to breed in captivity. This research has been primarily limited to intraspecific comparisons, due to incomplete understanding of the evolutionary history of the genus, which is necessary for use of phylogenetic comparative methods. Interspecific relationships of topminnows remain unresolved, despite recent advances in mitochondrial and nuclear genome sequencing. Specifically, interrelationships of a group containing the starhead topminnows (Fundulus blairae, F. dispar, F. escambiae, F. lineolatus, and F. nottii) typically yield low node support values. Here, we present the first annotated mitochondrial genome of the Starhead Topminnow (F. dispar) and provide a phylogenetic hypothesis for starhead topminnows within the genus Fundulus. DNA was isolated from a specimen of F. dispar collected in Kentucky, USA. The circular genome is 16,564 bp long and contains 13 protein-coding genes, two ribosomal RNAs (rRNA), 22 transfer RNAs (tRNA), and one control region (D-loop). Our phylogenetic analysis supports a sister relationship between F. dispar and a group containing F. notatus and F. olivaceus. This data helps to resolve the phylogenetic placement of starhead topminnows. [ABSTRACT FROM AUTHOR]

Introduction: The United States is currently facing an opioid overdose crisis. Research suggests that multiple interventions are needed to reduce overdose deaths including increasing access and retention to medications to treat opioid use disorders (MOUD, i.e., methadone, buprenorphine, and naltrexone) and increasing the distribution and use of naloxone, a medication that can reverse the respiratory depression that occurs during opioid overdoses. However, barriers to MOUD initiation and retention persist and discontinuations of MOUD carry a heightened risk of overdose. Many times, MOUD is not sought as a first line of treatment by people with opioid use disorder (OUD), many of whom seek treatment from medically managed withdrawal (detox) programs. Among those who do initiate MOUD, retention is generally low. The present study examines the treatment experiences of people who use opioids in three states, Connecticut, Kentucky, and Wisconsin. Methods: We conducted in-depth interviews with people who use opioids in a rural, urban, and suburban area of three states: Connecticut, Kentucky and Wisconsin. Data analysis was collaborative and key themes were identified through multiple readings, coding of transcripts and discussion with all research team members. Results: Results reveal a number of systemic issues that reduce the likelihood that people initiate and are retained on MOUD including the ubiquity of detox as a first step in drug treatment, abstinence requirements and requiring patients to attend group treatment. MOUD-related stigma was a significant factor in the kinds of treatment participants chose and their experiences in treatment. Conclusions: Interventions to reduce MOUD stigma are needed to encourage MOUD as a first course of treatment. Eliminating abstinence-based rules for MOUD treatment may improve treatment retention and decrease overdose risk. [ABSTRACT FROM AUTHOR]

The passage to middle school has been identified as a confusing period for adolescents, involving a series of major transitions. A new variable that permeates these already lofty transitions is the firm entrenchment of Generation Alpha in the middle grades classroom, a cohort that includes anyone born from 2010 onward, making them the first generation born and shaped entirely in the twenty-first century. The purpose of this study was to explore the attitudes and perceptions of current middle school teachers across Indiana, Kentucky, and Ohio toward their Gen Alpha students so as to uncover the concrete issues these teachers encounter as they work with this undeniably unique cohort. A total of 139 teachers responded to the researcher-generated electronic survey, which was coded inductively and analyzed for content. The feedback points to a cohort that is digitally literate with great adaptability, but also a cohort that exhibits delayed social development and a myriad of global concerns. These factors all have implications for the ways they learn, interact, and function in the middle school classroom. [ABSTRACT FROM AUTHOR]

Demand for high-quality white oak sawlogs in Kentucky has been increasing for decades. Concurrently, Kentucky is witnessing ecological shifts in the historically white oak-dominated forests, mirroring the structural changes in oak forests in the eastern US. This demand–supply dissonance presents a growing concern among stakeholders on the sustainability of white oak and its associated economic implications. In this context, the objective of this study was to assess the potential economic impacts of the projected white oak timber supply following an overall increased supply of white oak sawlogs but reduced supply of high-quality white oak sawlogs in Kentucky. Results generated from a dynamic computable general equilibrium (CGE) model indicate a cumulative present-value GDP reduction of USD 3.66 billion, a USD 0.71 billion decline in consumer welfare, and other sectoral contractions over 40 years (2018–2058). These results can be used to advocate for more proactive forest management practices to stabilize a sustained supply of high-quality white oak timber in Kentucky and beyond. [ABSTRACT FROM AUTHOR]

Background: University freshmen experience increased stress levels, and women, in particular, experience more stress and anxiety. Maintaining mindfulness through mindfulness programs may contribute to a successful university experience. This study aims to determine the effects of a mindfulness-based education program on mindfulness, emotional regulation, interoceptive awareness, and university-life adjustment among Korean university freshmen. Methods: This study was a single-group pre-test-post-test design and a clinical trial (No. KCT0008309) registered with the clinical research information service of South Korea. This study was conducted with 46 female university freshmen using a volunteer sampling approach in Korea from March 2023 to June 2023. The mindfulness-based education program was conducted in 12 sessions, 1 day per week, for 12 weeks. Standard questionnaires were used, including the Kentucky inventory of mindfulness skills, positive affect, and negative affect schedule, multidimensional assessment of interoceptive awareness, and college life adjustment scale. A paired-sample t-test was used for statistical analysis using IBM SPSS software, version 29. Results: Only attention related to mindfulness had a significant difference before and after the intervention (P=0.013). Interoceptive awareness sub-items, including accept (P=0.022), return to the body (P<0.001), and trusting (P=0.035) showed significant increases following the intervention. The interpersonal relationships required during university-life adjustment also revealed a significant improvement (P=0.025). However, no significant changes were observed in the emotional regulation variables after the intervention. Conclusion: These results suggest that implementing a mindfulness program can effectively improve self-awareness and mutual acceptance skills among female university freshmen. This can help them establish strong social connections with their peers and professors. Therefore, we suggest incorporating a mindfulness program into university curricula to support adjustment to university life among female university freshmen experiencing various forms of stress. [ABSTRACT FROM AUTHOR]

A focused search for ancient Mississippian Subperiod marine vertebrates during a paleontological resource inventory of Mammoth Cave National Park, Kentucky, has yielded a wealth of new fossil data, previously unrecognized at this park. To date, we have identified marine vertebrate fossils from four primary horizons at the park, two of which are the first records of marine vertebrate fossils occurring in those horizons. Mammoth Cave sites have produced more than 70 species of ancient fish, about 90% representing cartilaginous fishes (sharks and kin), including several new species. The paleontological resource inventory of Mammoth Cave demonstrates that this park is an important resource for providing data on how fish assemblages changed during the formation of the super-continent Pangea. The inventory data also can help correct antiquated information on fossil sharks found in the region (in some cases not updated since their publication in the late 19th century). [ABSTRACT FROM AUTHOR]

Objective: Timely data on drug overdose deaths can help identify community needs, evaluate the effectiveness of interventions, and allocate resources. We identified variations in death investigation and reporting systems within and between states that affect the timeliness and accuracy of death certificate information. Methods: The HEALing Communities Study (HCS) is a community-engaged, data-driven approach to combating the opioid crisis in 67 communities in 4 states: Kentucky, Massachusetts, New York, and Ohio. HCS conducted a survey of coroners and medical examiners to understand variability in drug overdose death data. We compared survey results in Massachusetts, New York, and Ohio with national data to investigate the completeness of provisional death counts by type of death investigation system. Results: Communities in each HCS state had different ways of collecting and reporting mortality data. Completion of death certificates for drug overdoses ranged from <2 weeks in 23% (7 of 31) of those surveyed to more than 3 months in 10% (3 of 31) of those surveyed. Variabilities in the timeliness of reporting drug overdose deaths were not associated with type of coroner or medical examiner office in each state, urban versus rural setting, or specificity of drug information on the death certificate. Conclusion: Having specific drug information on the death certificate may increase death certificate quality, comparability, and accuracy. We recommend the following: (1) all coroners and medical examiners should be trained on conducting death investigations, interpreting toxicology reports, and completing death certificates; (2) 1 office in each state should oversee all coroners and medical examiners to increase data consistency; and (3) communities should identify and address barriers to timely death certification. [ABSTRACT FROM AUTHOR]

Bystander intervention programs have established efficacy to increase bystander behaviors to prevent interpersonal violence (IPV). Little research has investigated intervention efficacy among latent risk classes among high school students. Data from a five-year randomized control trial were used to conduct multigroup path analyses to assess the association between type of training received and bystander outcomes moderated by risk groups identified via latent profile analysis (LPA). LPA was used to identify risk based on six indicators related to violence exposure, association with aggressive friends, and alcohol use. Bystander training received was the primary independent variable characterized as: no training, overview speech alone, or skills training. Outcomes included (a) observed bystander behaviors; (b) reactive bystander behaviors; or (c) proactive bystander behaviors. Three risk groups were identified via LPA: low risk, moderate risk witnesses of IPV, and highest risk victims and perpetrators. Of the bystander trainings received, overview speeches only increased reactive bystander behaviors among low risk students. The skills training was effective at increasing most bystander outcomes among all risk groups, with the largest effect sizes observed among the highest risk victims and perpetrators profile. Findings suggest that tailoring or modifying bystander training based on the risk profiles of youth may lead to greater potential to increase bystander behaviors to reduce risk of violence. Specifically, overview speech trainings should be targeted to low risk youth, while skills training primarily delivered to higher risk youth. These skills trainings could incorporate content related to trauma-informed care as well as associations with alcohol use, which may enhance their effectiveness further. [ABSTRACT FROM AUTHOR]

Children develop within a context, and the nature or dynamics of a child's context can change the trajectory of their development. According to Bronfenbrenner (1979), children are affected and are impacted by individuals within various systems or environments. One of Bronfenbrenner's ecological systems is the microsystem, in which children directly interact with pertinent individuals such as children's teachers or parents. However, the quality or nature of the relationship within the microsystem is dependent on the children themselves as well as adults' responses to the children. The adults' reaction to children's same initiation may vary depending on what kind of day they are having or how much stress they are experiencing from their own activities that exist within ecological systems that are indirectly related to the children themselves. Thus, everyone who indirectly or directly touch children's lives within the context of Bronfenbrenner's ecological systems matter, because external factors to children play a role in the quality of relationships children have with people who children interact with directly. This systems perspective, or holistic perspective, can be beneficial in promoting children's development, especially during the first five years, because families have to navigate varied options for their children's early care and education as the average participation in the labor force for 2021 is more than 65 percent for families with children under 6-years-old (Bureau of Labor Statistics, U.S. Department of Labor, 2022). This paper will review the different early care and education choices families of young children have, describe results of a grant focusing on partnerships between public school districts and community early childhood partners, and present lessons learned for facilitating a systems approach to early care and education field.

This paper explores how a transnational emergent multilingual (TEM) student established himself in relation to his teacher and peers in a culturally and linguistically diverse, sheltered English Instruction classroom. Specifically, it documents how the student initiated translingual and cross-cultural social interactions positioning himself as a linguistically-agile member of the classroom community. Using positioning and translanguaging theory, the analysis illustrates how the student's translingual, cross-cultural interactions allowed him to build relationships and reposition himself in the face of school-imposed labels that otherwise positioned him as linguistically-lacking. Findings illustrate how the student strategically created opportunities to use his entire linguistic repertoire and suggest the need to consider alternatives to deficit-oriented school-imposed labels placed upon TEMs.

Introduction: Long-acting injectable buprenorphine (LAI-bup) formulations have advantages over transmucosal buprenorphine (TM-bup), but barriers may limit their utilization. Several policies shifted during the COVID-19 pandemic to promote buprenorphine access. The federal government expanded telemedicine treatment for opioid use disorder and Kentucky (KY) Medicaid lifted prior authorization requirements (PAs) for LAI-bup (i.e., Sublocade®). This retrospective cohort study evaluated changes in LAI-bup access, utilization, and retention before and after these policy changes in KY., Methods: Individual-level TM-bup and LAI-bup dispensing record data from KY's prescription drug monitoring program examined LAI-bup utilization and retention, without a >30-day gap in coverage, for patients starting a new episode of LAI-bup treatment. Two key time periods were examined: pre-policy changes (Apr 1, 2019 - Dec 31, 2019) and post-policy changes (Apr 1, 2020 - Dec 31, 2020). Data on PA requests among Medicaid managed care organizations and availability of LAI-bup Risk Evaluation and Mitigation Strategy (REMS)-certified pharmacies were also obtained. A multivariable Cox proportional hazard regression model analysis compared pre- versus post-policy period treatment discontinuation., Results: The number of patients initiating LAI-bup increased from 211 to 481 over the two periods. By the end of the post-policy period, 24.3 % of eligible patients were retained on LAI-bup, versus 12.5 % in the pre-policy change period. The adjusted hazard ratio, comparing discontinuation during the post- versus pre-policy change periods, was 0.70 (95 % confidence interval: 0.55-0.89). There were also more REMS-certified pharmacies and providers in the post-policy change period., Conclusions: LAI-bup access, utilization, and retention increased after several policy changes., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sharon Walsh reports financial support was provided by National Institutes of Health and the Substance Abuse and Mental Health Services Administration. Lindsey Hammerslag reports administrative support and data access were provided by Kentucky Cabinet for Health and Family Services (KASPER Data Access). Michelle Lofwall reports a relationship with Berkshire Biomedical that includes: consulting or advisory. Michelle Lofwall reports a relationship with Braeburn Pharmaceuticals Inc. that includes: consulting or advisory. Michelle Lofwall reports a relationship with Journey Colab that includes: consulting or advisory. Sharon Walsh reports a relationship with Braeburn Pharmaceuticals Inc. that includes: consulting or advisory. Sharon Walsh reports a relationship with Astra Zeneca that includes: consulting or advisory. Sharon Walsh reports a relationship with Cerevel Therapeutics Inc. that includes:. Sharon Walsh reports a relationship with Opiant Pharmaceuticals Inc. that includes: consulting or advisory. Sharon Walsh reports a relationship with Pocket Naloxone that includes: consulting or advisory. Sharon Walsh reports a relationship with Titan Pharmaceuticals that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)