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Pernicious Anemia Presenting As Pseudothrombotic Microangiopathy: A Case Report, Sai Sushrutha M Vemula, Shreeya Adhikari, Shreya Motkur, Alfarooq Alshaikhli, Borys Hrinczenko May 2026

Pernicious Anemia Presenting As Pseudothrombotic Microangiopathy: A Case Report, Sai Sushrutha M Vemula, Shreeya Adhikari, Shreya Motkur, Alfarooq Alshaikhli, Borys Hrinczenko

School of Medicine Publications

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ dysfunction, with high untreated mortality that can be effectively reduced with timely plasma exchange (PLEX) and immunosuppressive therapy. However, several conditions can produce a clinically similar pseudo-TMA picture, among which severe vitamin B12 deficiency is an underrecognized and potentially treatable mimic that occurs due to ineffective intramedullary erythropoiesis, megaloblastic fragmentation of structurally abnormal erythrocytes, and pancytopenia in the absence of true endothelial injury or ADAMTS13 deficiency. We present a 74-year-old female patient who presented with altered mental status, bradycardia, and severe …


Ai-Based Simulated Patient Encounters For Clinical Reasoning: A Needs Assessment, Alex Sorrick, David Liebovitz, Sarah Vick, Andrew S. Parsons, Brian W. Locke, Jonathan Herskovitz, Cory Rohlfsen May 2026

Ai-Based Simulated Patient Encounters For Clinical Reasoning: A Needs Assessment, Alex Sorrick, David Liebovitz, Sarah Vick, Andrew S. Parsons, Brian W. Locke, Jonathan Herskovitz, Cory Rohlfsen

Graduate Medical Education Research Journal

Background. Artificial Intelligence (AI) offers an opportunity to enhance formative assessment of clinical reasoning skills. Traditionally, these skills have been assessed through workplace-based assessment or simulated patient encounters, both of which are limited by variability in case exposure, faculty resources, scheduling logistics, and cost. AI-based simulated patient encounters provide a scalable solution for convenient, low-stakes practice. At the University of Nebraska Medical Center (UNMC), we piloted an AI-based simulated patient case and conducted a needs assessment to explore current practices and user experiences.

Methods. From June to August 2025, participants trialed an AI-based simulated patient case and received feedback on …


Artificial Intelligence In Healthcare: Ethical Frameworks, Challenges, And Global Approaches To Responsible Implementation: A Perspective, Vikas Vaibhav, Arwinder Singh, Yashpal S, Raviprakash Meshram, Varun Chandran A, Kshitiza Sharma May 2026

Artificial Intelligence In Healthcare: Ethical Frameworks, Challenges, And Global Approaches To Responsible Implementation: A Perspective, Vikas Vaibhav, Arwinder Singh, Yashpal S, Raviprakash Meshram, Varun Chandran A, Kshitiza Sharma

Graduate Medical Education Research Journal

Major advancements in domains like diagnosis and personalised treatment will be seen because of the rapid growth of artificial intelligence (AI) in healthcare. But this shift additionally presents significant ethical concerns that need to be carefully considered at every stage of AI's research, use, and impact on society in medical settings.

This review summarises the findings of multiple systematic and scoping reviews, as well as studies of specific AI applications published between 2013 and 2025. Additionally, it examines ethical norms from different countries and international organisations objectively. Consistent ethical challenges identified include the "black box" problem (lack of transparency and …


Knowledge And Perception Of Patients Regarding A Postpartum Standardized Hypertensive Disorder Educational Program, Arin Everett, Niranjana Balu, Santiago Ortiz Barragan, Marly Azzi, Sanela Potchileev, Courtney Bisson, Ariel Mueller, Lea Runesha, Sajid Shahul, Sarosh Rana May 2026

Knowledge And Perception Of Patients Regarding A Postpartum Standardized Hypertensive Disorder Educational Program, Arin Everett, Niranjana Balu, Santiago Ortiz Barragan, Marly Azzi, Sanela Potchileev, Courtney Bisson, Ariel Mueller, Lea Runesha, Sajid Shahul, Sarosh Rana

Graduate Medical Education Research Journal

Background. Hypertensive disorders of pregnancy (HDP) are a major contributor to rising maternal mortality in the United States. The postpartum period represents a critical window to provide education aimed at reducing the risks of complications. This study evaluates the patients’ understanding of HDP and their retention of key education concepts during the first six weeks postpartum after participation in a structured quality improvement program.

Methods. Prospective cohort study of patients diagnosed with HDP were enrolled in the remote blood pressure monitoring program (RPM) and delivered between June 2023 and January 2024. Baseline surveys were administered prior to discharge and repeated …


A Literature Review Of Burnout And Associated Tools In Residency Programs, Foluso Obisanya, Fatima Mncube-Barnes, Kudiratu A. Proctor, Charles A. Mcdaniel, Donna M. Alexander, Tyrece D. Hunter May 2026

A Literature Review Of Burnout And Associated Tools In Residency Programs, Foluso Obisanya, Fatima Mncube-Barnes, Kudiratu A. Proctor, Charles A. Mcdaniel, Donna M. Alexander, Tyrece D. Hunter

Graduate Medical Education Research Journal

Background. Burnout poses considerable challenges in workplaces, particularly for resident physicians. This intricate phenomenon stems from a myriad of factors that include, but are not limited to, staff shortages, excessive workloads, specific job responsibilities, work environments, and individual psychological factors. The Accreditation Council for Graduate Medical Education encourages institutions to incorporate wellness as a fundamental component of residency training programs.

Methods. The aim of this review was to investigate burnout among resident physicians via a comprehensive literature review to elucidate this significant issue and identify potential preventative intervention strategies. We analyzed the issue of burnout across various residency specialties, providing …


Increasing Access To Medications For Opioid Use Disorder For All Justice-Associated Populations, Edgar Rodriguez May 2026

Increasing Access To Medications For Opioid Use Disorder For All Justice-Associated Populations, Edgar Rodriguez

Doctor of Nursing Practice Final Manuscripts

The purpose of this paper is to support a federal mandate requiring universal access to medication of opioid use disorder for all the justice-involved populations. The policy proposal aims to standardize evidence-based treatment across correctional systems, improve treatment initiation during incarceration, strengthen continuity of care after release, reduce overdose mortality, and address disparities in access for racial and economic groups and rural communities. This policy paper calls for the increase of access to medications of opioid use disorder across the United States for all justice-involved population. The opioid crisis has created a public health problem in the United States by …


The Importance Of Socialization: Family, School, Peer, And Media Influence On White Identity Development, Miandria Erickson May 2026

The Importance Of Socialization: Family, School, Peer, And Media Influence On White Identity Development, Miandria Erickson

Honors Projects

This study aims to explore the different aspects of socialization that can impact one’s White racial identity development, in order to analyze why White individuals struggle to describe their racial identity. Acknowledging an individual’s White identity is an imperative aspect to understanding diversity and race, and yet, White individuals will often have difficulty recognizing and explaining their racial identity. This qualitative study used data collected from semi-structured interviews of 60 young White college participants (ages 18-25) in two different geographical locations, the Northwest and Southeast of the U.S.[1] Several themes were extracted from these interviews, among them were family, …


Efficacy And Safety Of A Bodyweight-Adjusted Higher Dose Of Ocrelizumab In Relapsing (Musette) And Primary Progressive (Gavotte) Multiple Sclerosis: Two Multicentre, Randomised, Double-Blind, Parallel-Group Phase 3b Trials., Stephen L Hauser, Gavin Giovannoni, Xavier Montalban, Jiwon Oh, Amit Bar-Or, Maria Pia Sormani, Martin S Weber, Sharon Stoll, Jacqueline A Nicholas, Tetyana Nehrych, Robert Bonek, Krzysztof Selmaj, Maciej Maciejowski, Dusanka Zecevic, Catarina Raposo, Rebecca Owen, Ulrike Bonati, Katrin Madjar, Eva Harfst, Qing Wang, Anastasiia Raievska, Marianna Manfrini, Hans-Martin Schneble, Ludwig Kappos, Musette And Gavotte Study Groups May 2026

Efficacy And Safety Of A Bodyweight-Adjusted Higher Dose Of Ocrelizumab In Relapsing (Musette) And Primary Progressive (Gavotte) Multiple Sclerosis: Two Multicentre, Randomised, Double-Blind, Parallel-Group Phase 3b Trials., Stephen L Hauser, Gavin Giovannoni, Xavier Montalban, Jiwon Oh, Amit Bar-Or, Maria Pia Sormani, Martin S Weber, Sharon Stoll, Jacqueline A Nicholas, Tetyana Nehrych, Robert Bonek, Krzysztof Selmaj, Maciej Maciejowski, Dusanka Zecevic, Catarina Raposo, Rebecca Owen, Ulrike Bonati, Katrin Madjar, Eva Harfst, Qing Wang, Anastasiia Raievska, Marianna Manfrini, Hans-Martin Schneble, Ludwig Kappos, Musette And Gavotte Study Groups

Neuroscience Articles

BACKGROUND: Ocrelizumab is a humanised anti-CD20 monoclonal antibody approved for people with relapsing (RMS) or primary progressive multiple sclerosis (PPMS). In a post-hoc analysis of phase 3 trials in RMS and PPMS using a 600 mg dose, higher exposure to ocrelizumab was associated with greater B-cell depletion and lower risk of confirmed disability progression. Here, we prospectively assessed the efficacy and safety of a high dose of ocrelizumab in patients with RMS or PPMS.

METHODS: Two multicentre, double-blind, phase 3 controlled trials were conducted to compare high-dose ocrelizumab with the approved 600 mg dose of the drug in patients with …


Mri-Based Deep Learning Radiomics Model For Automated Classification Of Disc Degeneration In The Lumbar Spine, Shiv Patil, Om Gandhi, Mert Karabacak, Matthew Carr, Konstantinos Margetis May 2026

Mri-Based Deep Learning Radiomics Model For Automated Classification Of Disc Degeneration In The Lumbar Spine, Shiv Patil, Om Gandhi, Mert Karabacak, Matthew Carr, Konstantinos Margetis

Student Papers, Posters & Projects

Disc degeneration in the lumbar spine is a major cause of low back pain (LBP). The accurate grading of disc degeneration on magnetic resonance imaging (MRI) is critical for clinical management and patient selection for spine surgery. This study aims to develop and evaluate machine learning (ML) models that combine features from deep learning (DL) and radiomics for the automated prediction of Pfirrmann grade (PG), a measure of disc degeneration, using multi-parametric lumbar spine MRI. Sagittal T1, T2, and T2 SPACE MRIs of 218 patients with LBP were acquired from the SPIDER dataset. For each intervertebral disc and available sequence, …


Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards May 2026

Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards

Population Health Leadership and Analytics Theses

Cardiovascular disease remains a leading cause of morbidity and mortality among adults in the United States, particularly during midlife and older adulthood. Periodontal inflammation and poor oral hygiene behaviors have been linked to increased cardiovascular risk through systemic inflammatory pathways. This exploratory cross-sectional study described patterns of self reported gum bleeding, oral hygiene behaviors, and cardiovascular risk factors among 29 adults aged 45 to 70 at a community dental clinic using the researcher-developed Oral and Heart Health Study Questionnaire. Fourteen participants reported both gum bleeding and at least one cardiovascular risk factor. Participants who reported inconsistent flossing and infrequent professional …


Iterative Cannabis Care Plans Are Associated With Higher Rates Of Symptom Relief And Lower Side-Effect Burden In Oncology Patients, Brooke Worster, Md, Kristen Parton, Mba, Gregory Garber, Msw May 2026

Iterative Cannabis Care Plans Are Associated With Higher Rates Of Symptom Relief And Lower Side-Effect Burden In Oncology Patients, Brooke Worster, Md, Kristen Parton, Mba, Gregory Garber, Msw

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Background/Research Objective

Cannabis is increasingly used to manage cancer-related symptoms including pain, sleep disturbance, anxiety, and appetite or gastrointestinal complaints. However, patient responses are highly variable, clinicians report limited confidence in guiding use, and optimal dosing is difficult to predict from baseline characteristics. We evaluated whether an iterative, guided cannabis care model incorporating ongoing patient feedback and care-plan adjustments is associated with improved symptom relief and lower side-effect burden in a real-world oncology population.


A Call To Action: Towards A Compendium For Culturally Responsive And Inclusive Pain Management, Arvie Vitente, Rob Sweet, Lester Jones May 2026

A Call To Action: Towards A Compendium For Culturally Responsive And Inclusive Pain Management, Arvie Vitente, Rob Sweet, Lester Jones

Philippine Journal of Physical Therapy

Introduction: Pain is a pervasive global health problem, yet its assessment and management remain shaped by biomedical, monolingual, and culturally narrow assumptions that do not fully reflect the lived realities of diverse populations. Although contemporary pain science recognizes pain as a personal experience influenced by biological, psychological, and social factors, inequities persist across racial, ethnic, linguistic, and cultural groups.

Main Body: These inequities affect how pain is expressed, interpreted, documented, and treated, particularly among Indigenous peoples, migrants, refugees, and patients with limited English proficiency. In this perspective, we call for the development of a comprehensive compendium on culturally responsive and …


Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard May 2026

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …


Rocatinlimab As A Novel Treatment Strategy For Atopic Dermatitis, Haylee Whyde, Evan Blazek, Macy Davis, Parker George, Alex Lowery, Connor Dains, Brenna Hissong, David Koh May 2026

Rocatinlimab As A Novel Treatment Strategy For Atopic Dermatitis, Haylee Whyde, Evan Blazek, Macy Davis, Parker George, Alex Lowery, Connor Dains, Brenna Hissong, David Koh

Pharmacy and Wellness Review

Atopic dermatitis is a common chronic inflammatory skin disease that affects millions of children and adults in the United States. Atopic dermatitis is characterized by recurrent pruritus, erythema, and relapsing symptoms that can significantly impair quality of life. The pathophysiology of atopic dermatitis involves epidermal barrier dysfunction, immune dysregulation, and genetic susceptibility. Atopic dermatitis guidelines follow a stepwise approach that begins with a severity assessment, trigger avoidance, and nonpharmacologic and pharmacologic treatments. First-line therapies include topical corticosteroids (TCSs), topical calcineurin inhibitors (TCIs), and emollients. Crisaborole and topical ruxolitinib are used for mild-to-moderate disease when prior therapy has been inadequate. Monoclonal …


Fda Approval Of Tradipitant: A Novel Approach To Motion Sickness Treatment, Haley Brown, Jennifer Cao, Allie Honigford, Leah Heitkamp, Sarah Hiett, Connor Dains, Brenna Hissong, Manoranjan D'Souza May 2026

Fda Approval Of Tradipitant: A Novel Approach To Motion Sickness Treatment, Haley Brown, Jennifer Cao, Allie Honigford, Leah Heitkamp, Sarah Hiett, Connor Dains, Brenna Hissong, Manoranjan D'Souza

Pharmacy and Wellness Review

Motion sickness is a prevalent neurophysiological condition affecting approximately one-third of the worldwide population, resulting from sensory mismatch and the brain’s internal model of motion. It is characterized by nausea, vomiting, dizziness, and autonomic symptoms during exposure to actual or virtual motion, which may significantly impair daily functioning and quality of life. Current guidelines recommend the prevention and treatment of motion sickness through pharmacologic, herbal, and non-pharmacologic strategies. Scopolamine and first-generation antihistamines are effective pharmacologic options, while ginger has demonstrated some benefit in reducing symptoms as an herbal option. Non-pharmacologic interventions such as habituation training, behavioral techniques, and sensory strategies …


Navigating Trust: The Impact Of Social Media Influencers On Gen Z Health Behaviors, Abigail Stelling May 2026

Navigating Trust: The Impact Of Social Media Influencers On Gen Z Health Behaviors, Abigail Stelling

Honors Thesis

Social media plays a defining role in the daily lives of Gen Z, influencing how people communicate, access information, and make decisions. More than a form of entertainment, social media is a powerful source that shapes identity, perceptions, and behaviors. As the first generation to grow up fully immersed in a digital world, Gen Z is uniquely impacted by the content and interactions that occur on social media platforms. Within this digital landscape, social media influencers have emerged as powerful figures. These individuals use large online platforms to promote lifestyles, products, and behaviors. Influencers often have the ability to shape …


Evaluating The Market Withdrawal Of Andexanet Alfa, Jordyn Linfield, Addisyn Cooper, Alexander Defranco, Emma Gerding, Jessica Kelley, Tyler Henney, Connor Dains, Brenna Hissong, Brittany Bates May 2026

Evaluating The Market Withdrawal Of Andexanet Alfa, Jordyn Linfield, Addisyn Cooper, Alexander Defranco, Emma Gerding, Jessica Kelley, Tyler Henney, Connor Dains, Brenna Hissong, Brittany Bates

Pharmacy and Wellness Review

The coagulation cascade comprises intrinsic, extrinsic, and common pathways that converge when thrombin converts fibrinogen (factor I) into fibrin, leading to fibrin mesh formation, stabilization of the platelet plug, and ultimately thrombus formation. Inhibition of the coagulation cascade can be achieved with a variety of anticoagulant medications, including direct oral anticoagulants (DOACs). The mechanism of action of DOACs is to inhibit either factor Xa or thrombin. Reversal of anticoagulation remains an important clinical consideration when managing patients on DOACs who experience serious bleeding events. Andexanet alfa is a recombinant, modified human factor Xa protein previously indicated for patients receiving rivaroxaban …


Fda Approval Of Etripamil For The Treatment Of Paroxysmal Supraventricular Tachycardia, Kiley Devoll, Daniella Egbujor, Katy Grainger, Katherine Cook, Victoria Niese, Connor Dains, Brenna Hissong, Andrew Roecker May 2026

Fda Approval Of Etripamil For The Treatment Of Paroxysmal Supraventricular Tachycardia, Kiley Devoll, Daniella Egbujor, Katy Grainger, Katherine Cook, Victoria Niese, Connor Dains, Brenna Hissong, Andrew Roecker

Pharmacy and Wellness Review

Paroxysmal supraventricular tachycardia (PSVT) is characterized by sudden, brief, intermittent episodes that result in a heart rate of 150 to 250 beats per minute (bpm). PSVT is difficult to diagnose, making proper treatment challenging. According to the 2015 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Rhythm Society (HRS) guidelines, current pharmacologic recommendations for PSVT include adenosine, verapamil, diltiazem, or nonpharmacologic vagal maneuvers.1 These treatments each have a variety of adverse effects, contraindications, and dosing considerations, which highlight a need for novel therapies for the acute treatment and maintenance of PSVT.1 The NODE-301 trial assessed the safety and …


Rural-Urban Differences In Hypertension Prevalence And Control In A Large Regional Health System Cohort, Yordanos M Tiruneh, Susan Mcbride, Huaxin Song, Matthew Decaro, Alaa Rihan, Theresa Byrd, Alex Baham, Jared W Magnani, Elmer V Bernstam, Jarett D Berry May 2026

Rural-Urban Differences In Hypertension Prevalence And Control In A Large Regional Health System Cohort, Yordanos M Tiruneh, Susan Mcbride, Huaxin Song, Matthew Decaro, Alaa Rihan, Theresa Byrd, Alex Baham, Jared W Magnani, Elmer V Bernstam, Jarett D Berry

Faculty, Staff and Student Publications

Background: Rural US populations bear a high burden of cardiovascular disease, with hypertension contributing to the rural-urban gap. We examined hypertension prevalence and control across the rural-urban continuum among patients in a large healthcare system in Northeast Texas.

Methods: We analyzed the electronic health record data from 363,539 patients with at least one outpatient encounter between September 2021 and April 2025. We defined hypertension using ICD-10-CM codes, antihypertensive prescriptions, or a blood pressure ≥ 130/80 mm Hg. We classified rurality using the Rural-Urban Commuting Area categories. Multivariable logistic regression models were adjusted for age, sex, race, ethnicity, insurance, and level …


Effects Of A 10-Day Remote Ischemic Preconditioning Protocol On Anaerobic And Aerobic Performance And Post-Exercise Cytokine Responses, Paulina Brzezińska, Jan Mieszkowski, Madalena Kochanowicz, Andżelika Borkowska, Jędrzej Antosiewicz, Andrzej Kochanowicz May 2026

Effects Of A 10-Day Remote Ischemic Preconditioning Protocol On Anaerobic And Aerobic Performance And Post-Exercise Cytokine Responses, Paulina Brzezińska, Jan Mieszkowski, Madalena Kochanowicz, Andżelika Borkowska, Jędrzej Antosiewicz, Andrzej Kochanowicz

Baltic Journal of Health and Physical Activity

Background: Remote ischemic preconditioning (RIPC) consists of brief cycles of limb is-chemia and reperfusion and has been proposed as an ergogenic strategy. This study examined whether a 10-day lower-limb RIPC protocol affects anaerobic and aerobic performance and post-exercise cytokine responses in physically active men. Materials and methods: Sixty healthy, physically active men were assigned to anaerobic (Wingate Anaerobic Test (WAnT), n = 29) or aerobic (Bruce treadmill test (BTT), n = 28) protocols and completed a 10-day lower-limb RIPC (220 mmHg) or SHAM (20 mmHg) intervention. Serum IL-6, IL-10, and IL-15 were measured at baseline and immediately post-exercise before and …


Can Behavioral Interventions Promote Health Equity In Pediatric Type 1 Diabetes? A Narrative Review Of Promising Treatments, Paul T. Enlow, Jaquelin Flores Garcia, Julia Price, Kristen A. Torres, David V. Wagner May 2026

Can Behavioral Interventions Promote Health Equity In Pediatric Type 1 Diabetes? A Narrative Review Of Promising Treatments, Paul T. Enlow, Jaquelin Flores Garcia, Julia Price, Kristen A. Torres, David V. Wagner

Department of Pediatrics Faculty Papers

Purpose of review: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes.

Recent findings: While existing behavioral interventions demonstrated efficacy in improving health and/or psychosocial outcomes, evidence that these same interventions may improve health equity were lacking. Most interventions were evaluated using predominantly White and affluent samples and some studies did not report on racial, ethnic, or sociodemographic characteristics of their sample. Only a few interventions have been adapted for youth from minoritized backgrounds. Recent multisystemic and technology/mHealth interventions recruited samples that were sociodemographically representative of youth experiencing disparities, suggesting that these …


Choline Counteracts Pregnancy Undernutrition-Associated Colitis In Sheep By Restoring Microbiota Driven Bile Acid Metabolism, Weibin Wu, Peng Jiao, Yamei Gu, Huizhen Lu, Caiyun Fan, Zheng Sun, Lizhuang Hao, Shengyong Mao, Jianbo Cheng, Yanfeng Xue May 2026

Choline Counteracts Pregnancy Undernutrition-Associated Colitis In Sheep By Restoring Microbiota Driven Bile Acid Metabolism, Weibin Wu, Peng Jiao, Yamei Gu, Huizhen Lu, Caiyun Fan, Zheng Sun, Lizhuang Hao, Shengyong Mao, Jianbo Cheng, Yanfeng Xue

Faculty, Staff and Students Publications

High-fertility sheep experience undernutrition during late gestation, which induces body metabolic disruption and intestinal inflammation. Crucially, the gut microbiota-bile acid axis is a promising intestinal inflammation target, but how choline modulates this axis in livestock enteritis is unknown. This study investigated choline's protective mechanisms against undernutrition-induced intestinal inflammation in sheep, focusing on gut microbiota and bile acid regulation. Choline consistently alleviates colitis severity, restores epithelial barrier integrity, and suppresses intestinal inflammation. These protective effects are accompanied by pronounced remodeling of the colonic microbial ecosystem, characterized by the enrichment of Clostridiales bacterium to elevate bile salt hydrolase activity and regulate bile …


Coxfa4l2 Upregulation Preserves Residual Cytochrome C Oxidase Activity In Coxfa4-Related Leigh-Like Encephalopathy, Micol Falabella, Sandra Lopez Calcerrada, Jana Aref, Jiaze Gao, William L Macken, Chiara Pizzamiglio, Renata Kabiljo, Anna Lucia Francavilla, Pauline Gaignard, Antoine Pouzet, Jonathan Levy, Giulia Barcia, Jamie K Leighton, Efstathia Chronopoulou, Germaine Pierre, Riza Köksal Özgül, Ali Dursun, Rebecca Halligan, Helen Mundy, Javeria Raza Alvi, Tipu Sultan, William James Craigen, Lisa Emrick, Jill A Rosenfeld, Gehad Elmakkawy, Jihye Kim, Joseph J Gleeson, Aboulfazl Rad, Gabriela Oprea, Maqbool Hussain, Khalil Ur Rehman, Sadia Riaz, Robert W Taylor, Vincent Procaccio, Maha S Zaki, Erika Fernandez-Vizarra, Ciro Leonardo Pierri, Michael G Hanna, Henry Houlden, Reza Maroofian, Cristina Ugalde, Jan-Willem Taanman, Robert D S Pitceathly May 2026

Coxfa4l2 Upregulation Preserves Residual Cytochrome C Oxidase Activity In Coxfa4-Related Leigh-Like Encephalopathy, Micol Falabella, Sandra Lopez Calcerrada, Jana Aref, Jiaze Gao, William L Macken, Chiara Pizzamiglio, Renata Kabiljo, Anna Lucia Francavilla, Pauline Gaignard, Antoine Pouzet, Jonathan Levy, Giulia Barcia, Jamie K Leighton, Efstathia Chronopoulou, Germaine Pierre, Riza Köksal Özgül, Ali Dursun, Rebecca Halligan, Helen Mundy, Javeria Raza Alvi, Tipu Sultan, William James Craigen, Lisa Emrick, Jill A Rosenfeld, Gehad Elmakkawy, Jihye Kim, Joseph J Gleeson, Aboulfazl Rad, Gabriela Oprea, Maqbool Hussain, Khalil Ur Rehman, Sadia Riaz, Robert W Taylor, Vincent Procaccio, Maha S Zaki, Erika Fernandez-Vizarra, Ciro Leonardo Pierri, Michael G Hanna, Henry Houlden, Reza Maroofian, Cristina Ugalde, Jan-Willem Taanman, Robert D S Pitceathly

Faculty, Staff and Students Publications

Primary mitochondrial diseases (PMDs) affect approximately 1 in 4300 individuals and cause early-onset neuromuscular and multisystem dysfunction with reduced lifespan. They result from pathogenic variants in mitochondrial or nuclear DNA that impair oxidative phosphorylation. Cytochrome c oxidase (COX; complex IV) deficiency is a well-established cause of PMD, leading to a broad spectrum of phenotypes. COXFA4 (cytochrome c oxidase subunit FA4), formerly NDUFA4, is a nuclear-encoded COX subunit, but its role in disease remains poorly defined. We report the largest genetically confirmed cohort of COXFA4-related PMD to date, comprising 13 individuals from 12 families with biallelic pathogenic COXFA4 variants. All present …


Institutional Responses To The College Mental Health Crisis: A Critical Systems Review, Angel Huerta May 2026

Institutional Responses To The College Mental Health Crisis: A Critical Systems Review, Angel Huerta

The Scholarship Without Borders Journal

The mental health crisis among U.S. college students continues to escalate, exposing structural, cultural, and systemic failures within higher education. This review synthesizes evidence on institutional responses, drawing on Bronfenbrenner’s Ecological Systems Theory and Critical Theory, to examine how policies, faculty interactions, campus climate, and resource distribution influence student mental health outcomes. Findings reveal persistent gaps between policy intentions and practice, insufficient counseling capacity, inconsistency in faculty accountability, and inequities affecting marginalized student groups. The review highlights how organizational structures can unintentionally reinforce power imbalances and reproduce harm. Recommendations include system-level alignment of policies and practices, mandatory faculty training, enhanced …


When The Therapist Is An Algorithm: Understanding Autism Spectrum Students’ Acceptance Of Generative Ai As A Mental Well-Being Tool Through The Technological Acceptance Model, Jossy P. George, Peter Muttungal, Benny Jeyekumar Davidson, Nishi Priya May 2026

When The Therapist Is An Algorithm: Understanding Autism Spectrum Students’ Acceptance Of Generative Ai As A Mental Well-Being Tool Through The Technological Acceptance Model, Jossy P. George, Peter Muttungal, Benny Jeyekumar Davidson, Nishi Priya

Northeast Journal of Complex Systems (NEJCS)

This study examines the psychological and technological factors of the acceptance and emotional well-being of 349 college students with autism who use generative artificial intelligence tools as sources of psychological and emotional support. Grounded on the model of Technology Acceptance Model (TAM), the research studies relationships among perceived empathy, perceived usefulness, ease of use, emotional trust, continuance intention, and overall well-being. Structural equation modelling found that the perceived empathy was a significant predictor of ease of use and usefulness, while emotional trust and continuance intention proved to be significant predictors of emotional well-being. To reinforce these results, predictive modelling performed …


Cognitive Predictors Of Functional Recovery After Traumatic Brain Injury, Disha A. Thakkar, Charles J. Golden May 2026

Cognitive Predictors Of Functional Recovery After Traumatic Brain Injury, Disha A. Thakkar, Charles J. Golden

Archives of Assessment Psychology

This study examined whether the Brief Test of Adult Cognition by Telephone (BTACT), administered during acute rehabilitation, improved the prediction of 5-year functional outcomes after traumatic brain injury (TBI) beyond standard demographic and injury-severity variables. Data were obtained from the Traumatic Brain Injury Model Systems (TBIMS) National Database (N = 6,880; enrolled 2017 onward). Missing data were handled using multiple imputation (20 datasets). Hierarchical multiple regressions were conducted with the Functional Independence Measure (FIM) and the Glasgow Outcome Scale–Extended (GOS-E) as outcome measures. Demographics (age, sex, education, race) were entered in Block 1, injury severity indicators (post-traumatic amnesia [PTA] duration, …


Self-Esteem Development And Emotional And Behavioral Disorders, Bahaa Al Ghraibeh May 2026

Self-Esteem Development And Emotional And Behavioral Disorders, Bahaa Al Ghraibeh

Archives of Assessment Psychology

Self-esteem is a fundamental psychological construct that develops across the lifespan and influences academic, social, emotional, and behavioral functioning. Research consistently links healthy self-esteem with positive developmental outcomes, including improved educational achievement, stronger interpersonal relationships, and better mental health. At the same time, emotional and behavioral disorders (EBD) are associated with persistent emotional, behavioral, academic, and social difficulties that can interfere with healthy self-development. This paper reviews the developmental trajectory of self-esteem from early childhood through adulthood and examines how the experiences commonly associated with EBD may negatively affect that trajectory. The review discusses how children begin forming self-esteem at …


Prior Traumatic Brain Injury As A Predictor Of Cognitive Deficits After Moderate-To-Severe Injury, Disha A. Thakkar, Charles J. Golden May 2026

Prior Traumatic Brain Injury As A Predictor Of Cognitive Deficits After Moderate-To-Severe Injury, Disha A. Thakkar, Charles J. Golden

Archives of Assessment Psychology

Prior traumatic brain injuries (TBIs) are common among individuals who later sustain a moderate-to-severe TBI (msTBI), and cumulative injury models suggest repeated TBIs may worsen long-term cognitive outcomes. This study tested whether prior TBI history independently contributes to cognitive performance one year after an index msTBI beyond demographic and injury-severity factors. Data were drawn from the Traumatic Brain Injury Model Systems National Database (N = 6,880 enrolled since 2017). 2,773 participants completed the Brief Test of Adult Cognition by Telephone at one-year follow-up. Hierarchical regression models evaluated whether prior TBI history accounted for incremental variance in overall cognitive status and …


Poor Compliance With Private Nursing And Midwifery Practice Guidelines In Urban Settings In Uganda, Dan Muramuzi, Edson Atwine, Barbara Okiror, Mercy Muwema, Christine Nimwesiga, Laban Muteebwa May 2026

Poor Compliance With Private Nursing And Midwifery Practice Guidelines In Urban Settings In Uganda, Dan Muramuzi, Edson Atwine, Barbara Okiror, Mercy Muwema, Christine Nimwesiga, Laban Muteebwa

School of Nursing & Midwifery, East Africa

Background: Optimal compliance with private practice guidelines is one of the core components of quality improvement in nursing and midwifery professions. Private nursing and midwifery practice guidelines in Uganda were introduced in 2019. However, little has been documented about compliance with these guidelines, despite playing a crucial role in ensuring safe nursing and midwifery practice and maintenance of professional standards.  We assessed the compliance with private nursing and midwifery practice guidelines of Uganda (2019) and explored barriers to optimal compliance with these guidelines in private health facilities licensed by the Uganda Nursing and Midwifery Council (UNMC) in Kampala Metropolitan …


Finding Happiness In "The Orange", Malachi Myers May 2026

Finding Happiness In "The Orange", Malachi Myers

Student Work

"Everything in the world, no matter how ordinary, is better when shared with friends.

Posting about ­­­­­­­­finding joy in the everyday from In All Things, an online hub that offers insight into maintaining and faithful and orthodox  Reformed Christian worldview while fearlessly engaging in  every aspect of contemporary life – until all is made new.

Finding Happiness in "The Orange"