Digital Commons Network^™

Comparing Condylar Parameters Assessed By Ultrasonic And Mechanical Axiography: An In Vivo Pilot Study, Mark Salame, Amine El Zoghbi, Marina Daher, Carole Abi Ghosn, Paul J. Boulos

International Arab Journal of Dentistry

Objectives: The objective of this clinical pilot study was to compare the condylar parameters (condylar path inclination and Bennett angle) obtained from two different axiographs: a mechanical axiography system and an ultrasonic axigraphy system, and thus to judge the reliability and degree of accuracy of the mechanical axiography compared with the ultrasonic axiography considered as a reference technique.

Methods: Eleven candidates, aged between 20 and 25 years, were selected (n = 11) following strict inclusion and exclusion criteria. Each individual underwent two axiographic recordings by a single experienced operator. The first one was done with an ultrasonic axiograph, …

Effectiveness Of Animated Video And Electronic Dental Booklet Among Children In Primary Healthcare Centers, Kediri, Indonesia: A Prospective Interventional Study, Arini Indriyasari, Sayekti Wahyuningsih, Indasah Ir, Yuli Peristiowati

International Arab Journal of Dentistry

Introductions: Dental caries and poor oral hygiene remain major public health problems among children in Indonesia. Conventional dental health education has shown limited effectiveness in achieving sustainable behavioral change. Digital media, such as an animated video and an electronic dental booklet (e-Saku Gigi), offer a promising strategy to improve oral hygiene behavior in children.

Aim: This study evaluated the effectiveness of a Dental Health Education (DHE) intervention using an animated video and e-Saku Gigi on oral hygiene status (OHI-S), dental caries experience (DMF-T), and the knowledge–attitude–behavior pathway.

Methodes: A two-stage design was used. The first stage employed an …

Destaining Of Stained Clear Aligners When Subjected To Different Cleaning Techniques: A Comparative In Vitro Analysis, Malik Cn Sadah, Raj Kumar Jaiswal, Amit Kumar Singh, Nishtha Srivastava, Stuti Raj, Ayushi Singh

International Arab Journal of Dentistry

Introduction: Clear aligners are widely used due to superior esthetics; however, staining and loss of transparency remain major clinical concerns. This study evaluated color changes in stained clear aligners after different destaining techniques.

Methods: In this in vitro comparative study, 40 new clear aligners were stained using coffee solution and divided into four groups: control, Invisalign cleaning crystals alone, crystals with ultrasonic cleaning, and crystals with motorized brushing. Color change was assessed using VITA Easyshade spectrophotometer, Adobe Photoshop LAB analysis, and Visual Analog Scale (VAS). Data were analysed using ANOVA, Tukey post hoc test, Kruskal–Wallis, and Mann–Whitney U …

Cholesterol Metabolism And Oral Health: An Integrative Review, Raíssa Colherinhas, Carla Guimarães Moutinho, Ana Cristina F Vinha, Carla Alexandra Lopes Andrade De Sousa E Silva

International Arab Journal of Dentistry

Background: This integrative review associated changes in cholesterol metabolism and oral diseases. Conditions such as periodontal disease, tooth loss and oral cancer may be influenced by imbalances in lipid levels through mechanisms involving inflammation, oxidative stress, and immune modulation.

Highlight: This review examined scientific studies published mainly in the last decade. The findings indicate consistent associations between hypercholesterolemia or hyperlipidemia and periodontal disease, diabetes mellitus, hypertension, cardiovascular conditions, peri-implant health, and tooth loss. Hypocholesterolemia was associated with oral squamous cell carcinoma. Periodontal disease was the most frequently investigated oral condition, representing almost half of the included studies.

Conclusion …

Psychological Therapy In The Management Of Temporomandibular Disorders: A Systematic Review, Pragatheeswari R, Kavitha M, Sarumathi T, Niveditha B, Barkavi Panchatcharam, Pavithra D, Samu Fathima A I, Vigneshwaran J

International Arab Journal of Dentistry

Aim: To evaluate the effectiveness of psychological therapy in the management of temperomandibular disorders compared to other treatment modalities.

Methodology: Studies were selected according to PICO criteria, considering the RDC/TMD as a reference, improvement of pain and psychological parameters were the primary outcomes. Data search was mainly carried out through electronic search in several renowned databases: PubMed, Embase, Scopus, Web of Science and Google scholar. The publications collected were published between 2010 and 2024. Randomized clinical trials that compared the efficacy of psychological treatment modality with other conservative treatment modalities were screened and evaluated. A total of 5 …

Stem Cell-Based Therapies In Periodontology And Implant Dentistry: A Systematic Review And Meta-Analysis, Abdullah Saeed, Marycris Padrigo

International Arab Journal of Dentistry

Introduction: Periodontal disease and peri-implantitis remain the leading causes of tooth and implant loss, and conventional regenerative procedures consistently fall short of full structural restoration. Stem cell therapies have emerged as a promising alternative, operating through multi-lineage differentiation, immunomodulation via paracrine signaling, and extracellular vesicle communication. Prior systematic reviews, however, lacked methodological rigor — omitting clustering adjustments, REML/HKSJ estimation, prediction intervals, and publication bias modeling.

Aim: This systematic review and meta-analysis evaluated whether stem cell therapy produces superior clinical and radiographic outcomes compared to cell-free controls in adults with periodontal or peri-implant bone defects.

Methods: Searches across …

Measuring And Understanding Geographic Inequities In Physician Distribution In The Philippines: A Multi-Method Study Protocol, Veincent Christian F. Pepito, Ryan Gabriel C. Molen, Julius R. Migriño Jr, Theo Prudencio Juhani Z. Capeding, Anne Rose D. Payumo, Hazel Ivy M. Jeremias, Karl R. Ubial, William C. Tiu, Manuel M. Dayrit

ASMPH Center for Research and Innovation (ACRI)

INTRODUCTION: The Philippines faces physician shortages, exacerbated by their propensity to practise in urban centres. Despite government placement programmes, recruitment and retention of physicians in many areas throughout the country remain difficult. This study aims to: (1) describe the distribution of general physicians and board-certified specialist physicians and (2) identify the individual, work environment, local environment, national environment and international environment factors that may influence physicians to establish their practice in areas with below-optimal physician-to-population ratios in the Philippines. METHODS AND ANALYSIS: To describe the distribution of general physicians and board-certified specialist physicians, we will map Philippine Health Insurance Corporation …

Program Proposal For A Nurse-Led Evidence-Based Protocol To Strengthen Contraceptive Counseling And Access In A Community Clinic, Zaida Luz Cabán

Walden Dissertations and Doctoral Studies

This executive leadership systems improvement program proposal addresses inconsistent contraceptive counseling within an outpatient community health clinic in the U.S. Virgin Islands. The EBP question asks: Among registered nurses in an outpatient community health clinic, what is the impact of a standardized nurse-led contraceptive counseling training program on nursing staff knowledge of evidence-based contraceptive counseling, as measured by pre- and post-training knowledge assessments? A systematic search conducted April 22, 2026, used CINAHL, MEDLINE/PubMed, Embase, PsycINFO, and Epistemonikos. After screening 638 records and removing duplicates and ineligible studies, 34 sources were included in the final synthesis. Evidence was appraised and synthesized …

Transactional Competence, Reliance, And Trustworthiness: Essential Attributes Of Successful Residents, Gabriel M. Daniels, Leah Colucci, Christina C. Huang, Donna A. Caniano, Timothy P. Brigham, Thomas J. Nasca

Department of Medicine Faculty Papers

No abstract provided.

Evaluating The Quality And Safety Of A Nurse Practitioner-Led Virtual Clinic For Secondary Prevention In Stable Coronary Artery Disease: A Pilot Feasibility Study., Anwar Abdi, Holly Rector, Vivian Hung, Shadi Akhtari

Medical Education Articles

Background Virtual care offers a complementary pathway to in-person visits for managing coronary artery disease (CAD). This study evaluated the feasibility of a nurse practitioner (NP)-led interdisciplinary virtual clinic dedicated to secondary prevention for individuals with stable CAD.

Methods A feasibility study was conducted in an academic cardiology practice in Canada from July 2021 to July 2024. A convenience sample of adults ≥18 years of age with stable CAD was included; each participant received at least one annual NP-led video visit reviewed with a cardiologist asynchronously. Primary outcomes: 1) percentage of self-reported maintenance of guideline-directed medical therapies (GDMT) and achieving …

Combined Effects Of Postdistillation Residue Blends From Medicinal Plants On In Vitro Ruminal Microorganisms, Enzymes, Nitrogen And Energy Efficiency, And Antioxidant Status, Mojtaba Akbari Shooshood, Javad Rezaei, Mahdi Ayyari, Yousef Rouzbehan

Turkish Journal of Veterinary & Animal Sciences

In this study, the combined effects of postdistillation residue blends, including pomace, wastewater, and their mixture, derived from rosemary (RO), fennel (FE), spearmint (SP), and rose (ROS), on in vitro microbial populations, enzymatic activities, fermentation, and antioxidant status were evaluated using the gas production technique. The three phytobiotic blends were MP (mixed pomace of RO, FE, SP, and ROS; 1:1:1:1 ratio), MW (mixed wastewater of RO, FE, SP, and ROS; 1:1:1:1 ratio), and MPW (mixed pomace–wastewater of MP and MW; 1:1 ratio). Each blend was used at 2% and 3% of diet dry matter (DM). The experimental diets were as …

Ethylcyanoacrylate Adhesive And Microperforated Polyethylene Tape For The Cutaneous Closure Of Bitches Following Unilateral Total Mastectomy, Leonardo Martins Leal, Fábio Rodrigo Castro Bastos, Joseneia Boeing, Gabriel Aguiar Pavilak, Isaac Romani, Tais Harumi De Castro Sasahara, Paola Castro Moraes

Turkish Journal of Veterinary & Animal Sciences

The use of ethylcyanoacrylate (Super Bonder®) adhesive and microperforated polyethylene tape (Transpore) for the cutaneous closure of extensive wounds following unilateral mastectomy was evaluated, and the healing process was clinically assessed. Included in the study were 15 bitches diagnosed with mammary neoplasia, aged 4–14 years and weighing 3–33 kg. All bitches underwent a 30–60 cm craniocaudal cutaneous incision through the skin in the ventral thoracoabdominal region. Following excision of the tumor and the entire mammary chain, the adjacent tissues were approximated with polyglecaprone 25 sutures. Skin-edge coaptation was achieved through the application of adhesive to half of each wound, while …

Investigation Of Feed Values With In Vitro Technique And Chemical Properties, Particle Size Of Total Mixed Rations Prepared In Commercial Dairy Farms, Özlem Karcioğlu, Betül Zehra Sariçi̇çek

Turkish Journal of Veterinary & Animal Sciences

This study was conducted to investigate the chemical and physical properties and feed values of total mixed rations used on dairy cattle farms in Ankara Province. Included in the study were three farms from each of the five districts of Ankara Province (atotal of 15 commercial dairy farms). Total mixed ration (TMR) samples were collected weekly from each farm over a 3-month period in 2025. The chemical composition (crude protein, crude fat, crude fiber, acid detergent fiber (ADF), neutral detergent fiber (NDF), and acid detergent lignin (ADL)), in vitro digestibility parameters (in vitro gas production (IVGP), methane production (MP), organic …

Optimizing Marination Methodology, Holding Temperature, And Holding Time To Upgrade The Physicochemical And Sensorial Attributes Of Japanese Quail (Coturnix Japonica) Breast Fillets, Naveen Uduwawithana, Ruvini Mutucumarana

Turkish Journal of Veterinary & Animal Sciences

The aim was to optimize the effect of meat marination method (unmarinated, tumbling, injection, and immersion), holding temperature (4 oC and 8 oC), and holding time (4 h, 8 h, and 12 h) on the physicochemical and sensorial properties of Japanese quail (Coturnix japonica) breast fillets. Ninety-six deboned breast fillets (mean weight ± SD; 10 g ± 2) from 42-day-old unsexed Japanese quails were marinated. Injection marination showed the highest uptake (p < 0.05). The method × temperature × time interaction (p < 0.05) was significant for cooking yield, meat pH, hardness, cooking loss, and surface color lightness (L*). The highest pH (p < 0.05) was reported when the unmarinated control was retained for 8 h. Tumbling marinated meat when held for 12 h at 8 oC yielded the maximum cooking yield (60.3%). The cooking loss was minimal in unmarinated, tumbled, and immersion-marinated meat when held for 12 h. Irrespective of the temperature, 4-h holding time caused the minimum meat hardness in all four treatments. Tumble-marinated meat when held for 12 h at 8 oC resulted in the minimum cooking loss, hardness, and lightness (L*), as well as the maximum cooking yield. Meat when held at 4 oC for 4 h following injection marination had the highest scores for color, aroma, marinade penetration, flavor, and overall acceptability. In conclusion, quail breast fillets when tumble-marinated and held at 8 oC for 12 h were the best in terms of overall meat quality. Quail breast fillets held for 4 h at 4 oC following injection marination were rated highest by the panelists.

Evaluation Of Apoptosis In Peripheral Blood And Milk Immune Cells During Lactation In Dairy Cows With Subclinical Mastitis, Mykola Mykolayovich Zhelavskyi

Turkish Journal of Veterinary & Animal Sciences

The lactation cycle is considered one of the most physiologically demanding periods in dairy cows and is accompanied by substantial immunological remodeling. In the present study, spontaneous apoptosis of lymphocytes, monocytes, and neutrophils was evaluated in clinically healthy Ukrainian Black and White dairy cows (n = 28, aged 3–5 years) during different stages of the lactation cycle: colostrum period (3–5 days), mid‑lactation (90–150 days), drying‑off (5–7 days), and dry period (12–20 days). A further group of 28 cows with subclinical mastitis confirmed by the California Mastitis Test was also included in the study. Peripheral blood and milk samples were collected …

Changes In Mohair Cortisol Concentration And Fiber Growth During Gestation In Angora Goats, Beyzanur Aköz, Erkan Pehli̇van

Turkish Journal of Veterinary & Animal Sciences

The hypothalamic–pituitary–adrenal (HPA) axis plays a central role in regulating long-term stress responses. Keratin-based matrices represent a noninvasive approach for assessing long-term HPA axis activity in farm animals. The present study investigates gestational changes in mohair cortisol concentration and mohair fiber length in Angora goats under routine farm conditions. Clinically healthy does (n = 29; 14 aged 1.5 years and 15 aged 2.5 years) were monitored during the breeding season, and pregnancy was confirmed in 16 does. Mohair samples were collected monthly, fiber length was measured, and cortisol concentrations were quantified using an ELISA. Mohair cortisol concentrations were not significantly …

Birth Cohort Effects In Adults Associated With Influenza A(H1n1)Pdm09 Vaccine Effectiveness, Feng Liu, Stacey L House, Tamair Curley, Et Al.

2020-Current year OA Pubs

BACKGROUND: In 2023-2024 influenza season, adults in the 1957-1985 birth cohort had the lowest vaccine effectiveness (VE) against A(H1N1)pdm09 viruses than other age groups, including those in the 1986-2005 birth cohort. We investigated A(H1N1)pdm09 antibody levels in sera collected from influenza cases and controls to explain the birth cohort effect of the low VE.

METHODS: Acute and convalescent sera were collected from adults (1986-2005 and 1957-1985 birth cohorts) during 2023-2024. Hemagglutination inhibiting (HI) and binding antibodies were assessed against representative A(H1N1) viruses and hemagglutinin antigens.

RESULTS: A(H1N1)pdm09-infected cases in the 1957-1985 birth cohort had significantly lower HI antibodies in the …

Corrigendum To “Characterizing The Metabolites Of The Tyrosine-Kinase Inhibitor Pexidartinib In Mouse Feces, Urine, Plasma, And Liver” [J. Pharm. Biomed. Anal. 265 (2025) 117034], Jian Wang, Lei Guo, Ashish Dogra, Zhaoyong Hu, Kevin R Mackenzie, Feng Li

Faculty, Staff and Students Publications

No abstract provided.

Interdisciplinary, Delphi-Driven Consensus Guidelines On The Use Of Intravenous Ketamine Infusions For Depressive Disorders From The American Society Of Ketamine Physicians, Psychotherapists, And Practitioners (Askp3), David S Mathai, Madeleine Cluck, Amna M Aslam, Erin Amato, Arsalan Azam, Michael Banov, Kathleen A Barrett, Carl J Bonnett, David Feifel, Nicolas Grundmann, H Samuel Ko, Rupert Mcshane, Sandhya Prashad, Tatiana Santini, Lowan H Stewart, Patrick Sullivan, Stefany D Wolfsohn, Jill O Robinson, Amy L Mcguire, L Alison Mcinnes

Center for Medical Ethics and Health Policy Staff Publications

Background: Off-label use of intravenous ketamine (IVK) for depression is a widespread practice with limited regulation in the United States. There is an urgent need for current, evidence-informed treatment guidelines to facilitate patient safety, clinical decision-making, and care quality in real-world contexts.

Methods: The American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3) convened an interdisciplinary working committee tasked with creating guidelines for use of IVK for depression in outpatient settings. Guideline development followed a two-stage process: 1) a hybrid systematic and targeted evidence review and preliminary drafting by the committee, and 2) consensus refinement through a modified Delphi method …

Single-Nuclei Transcriptomics Reveals Cellular Senescence In Pediatric Anthracycline-Induced Cardiomyopathy, Hanna J Tadros, Yi Zhao, Lalita Wadhwa, Iki Adachi, Xiao Li, James F Martin

Faculty, Staff and Students Publications

Chemotherapy drugs that fight childhood cancer can age heart cells prematurely. We found this "cellular aging" throughout the hearts of children with treatment-related heart failure.

The Use Of Case-Based Experiential Learning With First-Year Occupational Therapy Students: A Two-Year Pilot Study, Michelle Jackson

Journal of Applied Disciplines

Background: Understanding and applying biomechanical principles to participation in functional activities is vital to occupational therapy (OT) education. Exposure to such principles underlying prosthetic use and occupational engagement related to lower extremity (LE) limb loss provides opportunities to better understand these concepts as well as the role of OT with this population.

Method: An experiential learning framework was used to develop a three-phase, case-study-based pilot project, completed with first-year graduate-level OT students from two cohorts (n = 26, n = 31).  At the conclusion of the project, an anonymous Likert-style survey and a reflection assignment were completed by all students. …

Structuring Clinical Readiness Through The Core Model In Csd Graduate Education, Camille Byrd O'Quin, Elaine Reyna, Angela M. Riccelli, Jessica Bonner, Judy Platt, Nicole Bing

Teaching and Learning in Communication Sciences & Disorders

This article introduces the CORE Clinical Orientation Model, a conceptual framework designed to support early clinical readiness in speech-language pathology graduate education. Grounded in the field's shift from traditional site-based apprenticeship models toward more structured, faculty-supported approaches, the model addresses documented variability in early clinical supervision and student preparedness. The CORE Model is organized around four interrelated pillars: Clinical Foundations, Ongoing Reflection, Rigorous Clinical Application, and Engaged & Intentional Mentorship. Although the model was developed alongside a graduate clinical orientation course, the course represents one implementation of the framework. This article describes the theoretical and professional foundations of the CORE …

Exploring Graduate Students’ Perspectives Of Clinical Supervision In Speech-Language Pathology: A Qualitative Study Of Facilitators And Barriers, Andrew J. Clare, Joyce Maring

Teaching and Learning in Communication Sciences & Disorders

This qualitative study explored second-year graduate students’ perceptions of clinical supervision practices in Speech-Language Pathology (SLP), focusing on how specific aspects of the supervisory approach were experienced by students as either barriers or facilitators to their learning during clinical practicum experiences. Twenty graduate students from a single SLP program, each with experience in at least seven clinical practica, participated in semi-structured interviews. An inductive thematic analysis approach was used to examine the patterns in the students’ experiences. Two mirrored sets of themes emerged, reflecting the dual importance of relational and pedagogical aspects of supervision. Facilitators included supportive relationships and effective …

Evaluating The Link Between Metabolic Syndrome And Cognitive Dysfunction In People Who Use Cannabis: A Critical Review Of Mechanistic Pathways, Evidence Quality, And Future Research Directions, Ghadah Alharbi, Ahmad H. Alhowail, Ashraf Mahmoud Emara

Saudi Toxicology Journal

Background: Cannabis is the most commonly used internationally controlled substance worldwide, with increasing rates of heavy use and cannabis use disorder (CUD) among adolescents and adults. While epidemiological evidence links cannabis exposure to both metabolic dysfunction and cognitive impairment, these outcomes have been examined predominantly in isolation. The mechanistic relationship between metabolic syndrome (MetS) and cannabis-related cognitive deficits remains poorly characterized. Objective: This review critically appraises the evidence linking cannabis use to metabolic dysfunction and cognitive impairment, proposes an integrative ``Cannabis–Metabolic–Cognitive Axis'' model, and identifies gaps limiting causal inference in the existing literature. Key Findings: Human studies frequently report lower …

Oral Insulin Nanoparticles In Animal Models Of Diabetes: A Systematic Review Of Recent Studies, Dhea Rahmania, Shaum Shiyan, Yulianto Kusnadi, Subandrate Subandrate, Juliana Palungan, Ayeshah Augusta Rosdah

Pharmaceutical Sciences and Research

Oral insulin has long been explored as a potential alternative to injectable insulin therapy. However, the development remains challenging due to enzymatic degradation in the gastrointestinal tract and limited intestinal absorption. Nanoparticle-based delivery systems have also been proposed as a strategy to protect insulin and improve uptake after oral administration. Therefore, this systematic review aimed to summarize recent preclinical studies investigating oral insulin nanoparticles in diabetic animal models and examine the reported pharmacological outcomes. Relevant studies were identified through database searches in PubMed, SpringerLink, and ScienceDirect using predefined keywords related to oral insulin, nanoparticles, diabetes, and animal models. Articles published …

Diabetes Mortality In Georgia: Disparities, Social Determinants, And Rural-Urban Differences (2019-2021), Gwendolyn H. Cattledge, Temilola N. Luwoye, Gloria Elizabeth B. Ogionwo, Nyshanti B. Ross, Zachary M. Bremmer

Journal of the Georgia Public Health Association

Background: Diabetes mellitus remains a significant public health challenge globally and, in the U.S., notably impacts mortality. Georgia specifically faces a substantial burden, with disparities observed across populations and counties. Understanding the patterns and underlying drivers of diabetes-related deaths statewide is crucial for effective public health intervention.

Methods: This cross-sectional study analyzed age-adjusted diabetes mortality rates in Georgia from 2019-2021, using data from the Georgia Department of Public Health's OASIS and the CDC's Social Vulnerability Index (SVI) 2020. The study aimed to detail the distribution of mortality rates across counties, explore the role of social determinants of health, and analyze …

Clinic White Paper: Usd Tele-Mental Health Training Clinic, Nicholas Boyd, Lauren Bruaski

Community Engagement

California is home to over 1.8 million veterans and 18,000 National Guard members, representing one of the largest military-connected populations in the United States. Despite substantial demand, over 50% of veterans experiencing mental health symptoms do not seek treatment, while those seeking care within federal systems frequently face significant wait times. This academic white paper evaluates the operational framework, clinical effectiveness, and workforce expansion model of the University of San Diego (USD) Tele-Mental Health Training Clinic – Veterans Initiative. Utilizing a secure, HIPAA-compliant telehealth model paired with a tiered supervision structure, the clinic provides evidence-based psychotherapies (EBPs) at no cost …

Building Resilience: The Role Of Extension In Enhancing Mental Health And Well-Being Through Preventive Approaches, Lakshmi Mahadevan

Journal of Extension

In 2023, 58.7 million U.S. adults experienced a mental illness, yet nearly half did not receive treatment (SAMHSA, 2023). Building Resilience is a single-session, evidence-informed program delivered through Cooperative Extension to address mental well-being using practical, nonclinical strategies. Grounded in Antonovsky's (1979) Sense of Coherence framework, the program centers on self-awareness, emotional regulation, and stress management within each participant's lived experience. Evaluation data from 347 participants showed high satisfaction, with 88% planning to apply strategies and 77% anticipating improved well-being. A 2-hour facilitator training supports national scalability, positioning Extension as a key partner in resilience-based mental health promotion.

Editorial: Community Series In Unveiling The Next Generation Of Cancer Immunity & Immunotherapy In Lung Cancer, Volume Ii, Nethaji Muniraj, Mohanraj Sadasivam, Chellappagounder Thangavel

Center for Translational Medicine Faculty Papers

No abstract provided.

Case Report: Beyond The Initial Diagnosis: A Case Of Wilson's Disease Presenting As Acute Decompensated Cirrhosis, Aun Bangash, Muhammad Ali Bangash, Chloe Harris, Veronica O'Brien, Learsi R. De Hoyos, Jose Campo Maldonado

School of Medicine Publications

Wilson disease is a rare inherited disorder of copper metabolism that can cause progressive hepatic injury, cirrhosis, and, in severe cases, acute liver failure. Its variable presentation can overlap with more common causes of liver disease and delay recognition. We present a 28-year-old patient with one week of worsening jaundice, right upper quadrant abdominal pain, nausea and vomiting, and marked hyperbilirubinemia. Given a history of heavy alcohol use and a Maddrey Discriminant Function score of 73, severe alcohol-associated hepatitis was initially suspected. However, several months of reported alcohol abstinence, a strong maternal family history of early-onset cirrhosis, imaging evidence of …