Search Results (107)

Background: Depression is a key psychosocial risk factor for cardiovascular disease (CVD); however, the degree to which lack of health insurance amplifies this risk remains unclear. Geographical disparities in mental health, cardiovascular outcomes, and insurance coverage further complicate prevention efforts. Understanding the interplay between these factors is crucial for planning targeted interventions to mitigate population-level cardiovascular risk. Objective: To assess whether health insurance modifies the relationship between depression and CVD among adults and to illustrate geographic disparities in combined mental health, cardiovascular risk, and insurance burden across US states and territories. Methods: We analyzed Behavioral Risk Factor Surveillance System (BRFSS) data from 2019 to 2023, including adults aged ≥18 years with complete data on depression, CVD, and health insurance status (n = 457,670). Logistic regression models were employed to estimate the relationship between depression and CVD, adjusting for demographic and behavioral risk factors. An interaction term between depression and lack of health insurance was included to examine moderation. State-level prevalence estimates were used to construct a four-tier composite burden index incorporating depression, CVD, and rates of lack of health insurance. Choropleth maps were developed to depict geographic patterns. Results: Overall, 21.1% of adults were found to have depression, 12.3% had CVD, and 5.8% had no health insurance. Depression was significantly associated with CVD (adjusted OR = 1.69; 95% CI: 1.65–1.72). Lack of health insurance significantly moderated the relationship between depression and CVD (interaction OR = 1.33; 95% CI: 1.18–1.51, p < 0.001). Geographic mapping analyses demonstrated marked heterogeneity. Tier 4 (highest burden) states included Kentucky, West Virginia, Louisiana, Oklahoma, Texas, New Jersey, Guam, and the U.S. Virgin Islands. Many Tier 3 and Tier 4 regions were clustered in the South and Appalachia. Conclusions: Depression is strongly associated with an increased prevalence of CVD, and this association is further amplified among individuals without health insurance coverage. Geographic disparities demonstrate critical hotspots where simultaneous mental health challenges, elevated risk of CVD, and limited insurance converge, highlighting the need for combined, area-specific public health strategies and approaches addressing both mental and cardiovascular health. Full article

The French Broad River in eastern Tennessee is a critical water resource for the Tennessee Valley Authority’s hydropower and drought relief, yet its instrumental record spans less than a century. To evaluate new dendrochronological tools and examine long-term streamflow trends, we extended the stream record by 1500 years using linear regression and machine learning reconstruction models informed by the tree-ring-derived self-calibrating Palmer Drought Severity Index (scPDSI). Linear regression models provided skillful reconstruction and stable performance across calibration and validation periods. Random Forest and Deep Learning achieved higher skill but lost some of their skill advantage with validation periods, indicating overfitting. All models captured drought years more reliably than flood years, reflecting the sensitivity of scPDSI to soil moisture but its limitations for high-flow extremes in the Appalachian region. Trend analyses identified a significant change point in 1271 CE, separating a drought-dominated early period (500–1272 CE) from a wetter, less variable regime (1273–1970 CE). An emerging trend shows higher average flow interrupted by severe single-year droughts, consistent with regional evidence and projected changes to hydrologic regimes in Appalachia. These findings provide a millennial perspective on hydrologic extremes and guidance on using paleohydrology tools for water resource planning in a changing climate. Full article

Small rural water utilities in the Appalachia region of the US often experience extreme water loss while struggling to maintain water quality compliance. This study quantifies the impact of reducing water loss on distribution system water quality in Martin County, Kentucky. Hydraulic and water quality models were developed, calibrated, and validated using EPANET for chlorine residuals and KYPIPE for trihalomethane (TTHM) formation. The models evaluated water loss reduction scenarios ranging from the current 70% to the industry target of 15%. Results showed that lowering water loss increased residence times, causing chlorine residual declines of 22–68%, with one site falling to the 0.2 mg/L threshold. TTHM concentrations increased by 12–18% in winter–spring and 26–44% in summer–fall, with two sites exceeding the individual 0.080 mg/L maximum contaminant level. These novel findings indicate that reducing water loss can unintentionally degrade water quality, underscoring the need for integrated planning. Recommended mitigation strategies include seasonal operational adjustments, water source and TTHM precursor management, optimized tank management, targeted flushing, and phased infrastructure upgrades. The modeling framework developed offers potential for broader application in other rural systems facing similar challenges. Full article

The COVID-19 pandemic increased mental health issues and heavily affected the academic performance of college students. The study aimed to assess the association of psychological health and behavioral factors with academic performance among undergraduate students during the third year of the COVID-19 pandemic. The study was conducted at a small liberal arts undergraduate college in rural Appalachia. A cross-sectional research design was followed. Data was collected online using Qualtrics in person in July 2021. Participants were selected randomly. World Health Organization-5, Perceived Stress Scale 4, The Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder-7, and Patient Health Questionnaire scales for well-being, stress, sleep quality, anxiety, and depression were used, respectively. Spearman’s correlation, t-test, analysis of variance, and multiple regression were conducted. Overall well-being, perceived stress, generalized anxiety, depression, and sleep quality were found to be significantly different by gender and exercise. The Grade Point Average (GPA) was found to be negatively associated with depression and positively associated with Sleep quality. Findings suggest that students who have scored higher on the depression and sleep quality scale may be affected more during this COVID-19 pandemic in maintaining a good GPA. The findings of this study can help generate hypotheses for further research and guide interventions to address poor academic performance. Full article

The Central Appalachian region, where family forest landowners (FFLs) control much of the carbon sequestration potential, holds the potential for forest-based climate solutions. Despite this, participation in carbon offset programs remains low, largely due to the disconnect between small landowner needs and program structure. This study examines FFL preferences for carbon programs in Central Appalachia. Utilizing a panel-data mixed logit model, we evaluated the effects of contract length, payment amount, harvest requirements, and program administration on participation decisions. Our results indicate that higher payments significantly increase program participation. Furthermore, contract lengths of at least 15 years and restrictive harvests negatively influence program participation. Program administration played a significant role, with government-administered programs being less preferred, with odds 48% lower than privately administered programs. Landowner characteristics such as carbon-oriented ownership, education, and income also influence participation. The willingness-to-accept analysis shows high compensation demands for less favorable terms: $107–$397/ha/year for longer contracts and $104–$173/ha/year for harvest restrictions. Additionally, landowners require an extra $66/ha/year for government administration. The findings underscore the importance of designing carbon offset programs that are flexible, offer adequate compensation, and foster trust, while aligning with landowners’ management objectives. Full article

Diesel particulate matter—primarily ultrafine particles (UFPs), defined as particles smaller than 0.1 µm—are released by diesel-powered vehicles, especially those used in heavy-duty hauling. While much of the existing research on traffic-related air pollution focuses on urban environments, limited attention has been paid to how complex topography influences the concentration of UFPs, particularly in areas with significant truck traffic. With a focus on Morgantown, West Virginia, an area distinguished by a steep topography, this study investigates how travel over two different terrain conditions affects UFP concentrations close to roadways. Specifically, we sought to determine if the truck count taken from simultaneous video evidence could be used as a surrogate for varying topography in determining the concentration of UFPs. This study shows that “TRUCK COUNT” and “TRUCK SPEED” have a linear relationship and yield a possible surrogate measure of the lung dose of UFP number concentration. Our results demonstrate a statistically significant (p < 0.1) linear relationship between truck count and UFP number concentration (R = 0.77 and 0.40), validating truck count along with truck speed as a medium effect surrogate for estimating near-road UFP exposure. Dose estimation using the Multiple-Path Particle Dosimetry (MPPD) model further revealed that approximately 30% of inhaled UFPs are deposited in the alveolar region, underscoring the public health relevance of this exposure pathway in topographically complex areas. This method ultimately awaits comparison with health effects to determine its true potential as a useful exposure metric. Full article

(1) Background: Geospatial associations for COVID-19 mortality were estimated using a cohort of 28,128 hospitalized Medicaid patients identified from the 2020–2021 Kentucky Health Facility and Services administrative claims data. (2) Methods: County-level patient information (age, sex, chronic obstructive pulmonary disease [COPD], and mechanical ventilation use [96 hrs. plus]); social deprivation index (SDI) scores; physician and nurse rates per 100,000; and annual average particulate matter 2.5 (PM_2.5) were used as the predictors. Ordinary least-squares (OLS) regression and multiscale geographically weighted regression (MGWR) with the dependent variable, COVID-19 mortality per 100,000, were performed to compute global and local effects, respectively. (3) Results: MGWR (adjusted R²: 0.52; corrected Akaike information criterion [AICc]: 292.51) performed better at explaining the association between the dependent variable and predictors than the OLS regression (adjusted R²: 0.36; AICc: 301.20). The percentages of patients with COPD and who were mechanically ventilated (96 hrs. plus) were significantly associated with COVID-19 mortality, respectively (OLS standardized βCOPD: 0.22; βventilation: 0.53; MGWR mean βCOPD: 0.38; βventilation: 0.57). Other predictors were not statistically significant in both models. (4) Conclusions: A risk of COVID-19 mortality was observed among patients with COPD and prolonged mechanical ventilation use, after controlling for social determinants, the healthcare workforce, and PM_2.5 in rural and Appalachian counties of Kentucky. These counties are characterized by persistent poverty, healthcare workforce shortages, economic distress, and poor population health outcomes. Improving population health protection through multisector collaborations in rural and Appalachian counties may help reduce future health burdens. Full article

Detrital zircon (DZ) ages of Cretaceous sandstones in the United States contain critical spatial and temporal information on their sedimentary provenance and on the reorganization of drainage patterns. Herein, we report zircon U-Pb ages of sandstones from Lower Cretaceous and Upper Cretaceous formations of Arkansas. All Arkansas sandstones studied, except for those from the Upper Cretaceous Nacatoch Formation, display dominant Appalachian-Grenville DZ ages from among the Appalachian-Ouachita DZ grains that were studied. Our work shows that the sedimentary provenance of Arkansas sandstones started to change during the middle part of the Cretaceous. Notably, DZ grains from the Woodbine formation, which was deposited during the middle part of Cretaceous, show moderate contributions from Western Cordillera sources (275–55 Ma), and DZ grains from the Upper Cretaceous Nacatoch Formation exhibit dominant Western Cordillera sourcing. Our Arkansas-based DZ data suggest that the onset of DZ contribution of the Western Cordillera began at about 94 Ma, and the peak of the Western Cordillera source contribution occurred at about 73 Ma. Therefore, we can show that North American drainage reorganization with regard to Western Cordilleran DZ sourcing in Arkansas began during the time span 94–73 Ma, which is earlier than the previously reported onset of drainage reorganization with regard to Texas (i.e., 66–55 Ma). Full article

Foliar endophytic fungi (FEF) live within leaves without causing visible signs of disease. FEF occur in all vascular plants, yet the exact nature of interactions between specific FEF and their hosts is not well understood. Some FEF are associated with enhanced water use efficiency, nutrient acquisition, and defense. However, others may have negative effects under high-stress conditions. We examined a series of gas exchange traits in sweet birch (Betula lenta, Fagaceae) along an elevation gradient in the Pisgah National Forest Asheville, North Carolina, USA. From these leaves, we cultured surface-sterilized samples to examine FEF frequency and diversity. FEF cultures were categorized by morphotype and identified through analysis of internal transcribed spacer (ITS) sequences. FEF colonization frequency was 100% across all sites, and we identified 68 distinct morphotypes. Genetic identification of a subset of cultures suggests highly diverse FEF communities within this study system. Leaf gas exchange traits showed significant correlations with elevation at the site level, supporting the hypothesis that water stress increases with increasing elevation. However, further research is needed to determine associations between FEF communities and elevation. These findings, especially considering the limited sample size and small spatial scale of this study, indicate that the southern Appalachians are a promising region for future studies of FEF in forest systems. Full article

Microplastic pollution levels and potential sources of contamination in North Central Appalachia are evaluated to fill a major knowledge gap regarding microplastics in freshwater systems, which lead to negative consequences for the sustainability of healthy freshwaters. Fifty-five northern hogsucker fish were sampled from nine sites throughout seven freshwater streams in the region. Microplastic particles were extracted from the gastrointestinal (GI) tracts via 10% KOH digestion and identified visually. A total of 2185 particles were identified, ranging between 8 and 274 particles/individual and an average of 39.73 particles/individual. The most particles were found in fish within the Cheat watershed, particularly at the Big Sandy Creek downstream site, followed by tributaries of the Monongahela and Ohio Rivers. The most identified particle type was fiber (96.61%). There was a positive relationship between the total length of fish and number of particles. Agricultural land use and E. coli abundance were both positively correlated with microplastic abundance. Agricultural land use and sewage input both appear to be important drivers of microplastic pollution in these streams, although we cannot rule out the influence of atmospheric deposition. These results point to widespread levels of microplastic contamination in freshwater ecosystems in North Central Appalachia. Full article

Previous research has shown that Appalachian Studies as a field, by drawing upon Appalachian Studies scholars and activists such as Harry Caudill, Helen Lewis, and Chris Irwin, misapplied the colonialism model to whites in the region, which resulted in clear remnants of self-Indigenization in the field. I show through a rhetorical analysis of recent (2020–2023) editions of the Journal of Appalachian Studies that these critiques have been left largely unaddressed in the field. In reviewing these issues, a tenet of Appalachian Studies is to employ “Appalachian” as an identity (rather than as solely a regional analytic) that is claimable by whites as distinct from other white settler colonizer identities. Applying the peoplehood matrix, which is a theory of that which imbues Indigenous peoples with Indigeneity and sovereignty, I reveal that white Appalachia often rhetorically presents itself as a colonized Indigenous people—though not necessarily as American Indians. Full article

This paper employs approaches from religious studies and Appalachian studies to examine the history, influence, and future of a multifaceted ethos of extraction, particularly as it influences the coal industry, in the Appalachian region of the United States. While many studies of extraction and the coal industry focus on their economic and political dimensions, by examining a broader ethos of extraction, this paper highlights multiple religious influences, including the entanglements between religious communities and extraction-based industries, the powerful moral narratives that serve to interpret and justify extraction, and the dynamics involved in shaping local identities and perceptions of place that enable this ethos to influence post-coal transition efforts. The result is a broad survey of the influences and impacts of resource extraction in Appalachia that challenges many of the longstanding stereotypes that can still be commonly found deployed about the region. In examining these influences, the paper also describes how academic interpreters have helped to shape popular conceptions of the Appalachian region that ultimately support ongoing extractive practices. Building upon insights from grassroots, anti-extractive activist communities in the region, the paper concludes by suggesting some ways that academics might adopt restorative ethics and practices in their work to address the entanglements between extractive scholarship and exploitation and devise alternative paths for just futures. Full article

The end of the Cretaceous saw the Western Interior Seaway divide North America into two land masses, Laramidia in the west and Appalachia in the east. Laramidian dinosaurs inhabited a narrow strip of land extending from Mexico to Alaska. Within this geographically restricted area, dinosaurs evolved high diversity and endemism, with distinct species in the north and south. Here, we report a new tyrannosaurid from the Late Campanian-aged Cerro del Pueblo Formation of Coahuila, Mexico, which is part of a tribe of tyrannosaurs originating in southern Laramidia. Phylogenetic analysis recovers the new tyrannosaur as part of a clade including Labocania anomala from the La Bocana Roja Formation of Baja California Norte, Bistahieversor sealeyi from the Kirtland Formation of New Mexico, Teratophoneus curriei from the Kaiparowits Formation in Utah, and Dynamoterror dynastes from the Menefee Formation of New Mexico. Distinct frontal morphology and the younger age (~72.5–73 Ma versus >75.8 Ma for L. anomala) support recognition of the new tyrannosaur as a distinct species of Labocania, Labocania aguillonae. The Labocania clade dominated southern Laramidia at a time when the north was dominated by daspletosaurins and albertosaurines. The high endemism seen in tyrannosaurids is remarkable, given that modern apex predators have large geographic ranges and hints that the diversity of carnivorous dinosaurs has been underestimated. Full article

Water contamination resulting from coal spills is one of the largest environmental problems affecting communities in the Appalachia Region of the United States. This coal slurry contains potentially toxic substances, such as hydrocarbons, heavy metals, and coal cleaning chemicals, and its leakage into water bodies (lakes, rivers, and aquifers) can lead to adverse health effects not only for freshwater bodies and plant life but also for humans. This study focused on two major experiments. The first experiment involved the use of biochar to create a biochar–polysulfone (BC-PSf) flat-sheet multifunctional membrane to remove organic contaminants, and the other major experiment compared eco-friendly (gamma-valerolactone—GVL; Rhodiasolv^® PolarClean—PC) and petroleum-derived solvents (i.e., N-methyl-pyrrolidone—NMP) in the fabrication of the biochar–polysulfone membranes. The resulting membranes were tested for their efficiency in removing both positively and negatively charged organic contaminants from the collected water at varying pH values. A comparative life cycle assessment (LCA) with accompanying uncertainty and sensitivity analyses was carried out to understand the global environmental impacts of incorporating biochar, NMP, GVL, and PC in the synthesis of PSf/NMP, BC-PSf/NMP, PSf/GVL, BC-PSf/GVL, PSf/PC, and BC-PSf/PC membranes at a set surface area of 1000 m². The results showed that the addition of biochar to the membrane matrix increased the surface area of the membranes and improved both their adsorptive and mechanical properties. The membranes with biochar incorporated in their matrix showed a higher potential for contaminant removal than those without biochar. The environmental impacts normalized to the BC-PSf/GVL membrane showed that the addition of biochar increased global warming impacts, eutrophication, and respiratory impacts by over 100% in all the membrane configurations with biochar. The environmental impacts were highly sensitive to biochar addition (Spearman’s coefficient > 0.8). The BC/PSf membrane with Rhodiasolv^® PolarClean had the lowest associated global environmental impacts among all the membranes with biochar. Ultimately, this study highlighted potential tradeoffs between functional performance and global environmental impacts regarding choices for membrane fabrication. Full article

Simulating shallow groundwater (SGW) flow dynamics and stream–SGW interactions using numerical modeling tools is necessary to develop a mechanistic understanding of water flow systems and improve confidence in water resource management practices. A three-dimensional (3D) SGW flow model was developed for a riparian wetland in a mixed forest and agricultural catchment in West Virginia (WV), Appalachia, USA, using a Modular 3D Groundwater Model (MODFLOW). The MODFLOW simulation was calibrated in steady (R² = 0.98, ME = −0.21, and RMSE = 0.77), transient state (R² = 0.97, ME = −0.41, and RMSE = 1.28) and validated (R² = 0.97, ME = −0.28, and RMSE = 1.05) using observed SGW levels from thirteen nested piezometers under steady and transient states. An experimental MT3D transport scenario was developed to show the lateral transport of NO₃-N from the aquifer to stream cells. Relatively stable SGW head distribution was observed. In the downstream reach, SGW discharge varied from 948 m³/day to 907 m³/day in 2020, with creek seepage ranging from 802 m³/day to 790 m³/day. Similarly, SGW input to the stream ranged from 891 m³/day to 978 m³/day, while creek seepage ranged from 796 m³/day to 800 m³/day in 2021. In upstream reaches, losing stream conditions were observed in January, June, and September 2020 and January to April 2021, while gaining stream conditions prevailed during other months. Thus, an approximately monthly alternating gaining–losing stream condition was observed in the upstream area. An experimental MT3D transport scenario resulted in an advection–dispersion scenario, showing a cumulative loss of 947 g of NO₃-N from SGW to the stream. Denitrification accounted for the cumulative loss of 1406 g of NO₃-N from SGW, surpassing 639 g of nitrate from the SGW to the stream during the study period. Additionally, particle tracking using MODPATH indicated a long residence time for SGW nutrients, affirming the efficiency of nitrogen transformation through denitrification. This study is among the first to simulate hydrologic and nutrient interactions in riparian wetlands of a mixed land use catchment in the Appalachian region of the northeastern United States. The results better inform water resource management decisions and modeling efforts in the Appalachian region and similar physiographic regions globally. Full article