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Concordia Seminary Magazine Spring 2026, Ken Ohlemeyer

Concordia Seminary Magazine

Shaped for His Service

Evolving Landscape Of Respiratory Infections And Amr In The Uae: A 12-Year Nationwide Study Of Regional Burden, Epidemiologic Trends And Policy Implications, Madikay Senghore, Jens Thomsen, Najiba M. Abdulrazzaq, Wei Chen, Eveline Kaambo, Stefan Weber, Fouzia Jabeen, Godfred Antony Menezes, Carole Ayoub Moubareck, Dean B. Everett, Abiola Senok

All Works

Objectives This study characterizes the epidemiological trends and resistance profiles of respiratory tract infections (RTIs) in the United Arab Emirates (UAE) from 2010 to 2022, aiming to inform national control strategies. Method We conducted a retrospective observational study of RTI cases across 345 UAE healthcare settings using data from the national surveillance network. Pathogen identification and resistance profiling were performed using advanced diagnostics and standardized antimicrobial susceptibility testing, in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Lower respiratory tract infections (LRI) comprised most cases (73.1%; n = 100,856), including 6416 due to Mycobacterium tuberculosis , while upper …

Disease Burden Attributable To Intimate Partner Violence Against Females And Sexual Violence Against Children In 204 Countries And Territories, 1990–2023: A Systematic Analysis For The Global Burden Of Disease Study 2023, Luisa S. Flor, Cory N. Spencer, Jack Cagney, Gabriela Fernanda Gil, Hasan Aalruz, Samar Abd Elhafeez, Siddig Ibrahim Abdelwahab, Meriem Abdoun, Mesfin Abebe, Yonas Abebe, Armita Abedi, Roberto Ariel Abeldaño Zuñiga, Alemwork Abie, Olumide Abiodun, Richard Gyan Aboagye, Lucas Guimarães Abreu, Rana Kamal Abu Farha, Bilyaminu Abubakar, Sawsan Abuhammad, Meshack Achore, Lisa C. Adams, Babatope Oluwadamilare Adebiyi, Kamoru Ademola Adedokun, Oluwatobi E. Adegbile, Nurudeen A. Adegoke, Olumide Thomas Adeleke, Makinde Adebayo Adeniyi, Zahir Vally

All Works

Background Violence against women and against children are human rights violations with lasting harms to survivors and societies at large. Intimate partner violence (IPV) and sexual violence against children (SVAC) are two major forms of such abuse. Despite their wide-reaching effects on individual and community health, these risk factors have not been adequately prioritised as key drivers of global health burden. Comprehensive x§and reliable estimates of the comparative health burden of IPV and SVAC are urgently needed to inform investments in prevention and support for survivors at both national and global levels. Methods We estimated the prevalence and attributable burden …

Europe–Africa Collaboration: Working Together To Strengthen Health Research, Implementation, And Equitable Systems, Lara Pandya, Irene Norstedt, Martin Seychell, Emer Cooke, Isabel De La Mata Barranco, Niklas Blomberg, Marleen Temmerman, Michael Makanga

Centre of Excellence in Women and Child Health

In September 2024, key representatives from European Union (EU) directorates and agencies convened to enhance collaboration with Africa in strengthening health research, innovation, and implementation. The meeting focused on bolstering joint efforts to improve health outcomes and support wellbeing across all ages in Africa. Despite progress in addressing infectious diseases, the continent faces a dual burden with the rise of non-communicable diseases and emerging threats such as antimicrobial resistance, climate change, falsified medicines, and pandemic risks. These challenges are exacerbated by fragile health systems, rapid population growth, urbanisation, and limited access to affordable medical interventions.

To address these issues, the …

In Silico Prediction Of Cytotoxic T-Cell Epitopes From Helicobacter Pylori Virulence Factors Using An Immunoinformatics Approach, Demy Valerie Chacon, Kiana Alika Co, Daphne Noreen Enriquez, Aubrey Love Labarda

Biology Faculty Publications

Background: Helicobacter pylori infects approximately half of the global population, leading to gastric and duodenal ulcers. Despite the availability of antibiotics, challenges such as patient reluctance, high treatment costs, and antibiotic resistance limit their effectiveness, making vaccination a promising alternative. This study used immunoinformatics to identify candidate epitopes for a multiepitope vaccine construct against H. pylori. Material and methods: The protein variability server was utilized for conservation analysis. The epitopes were screened for antigenicity, allergenicity, toxicity, cross-reactivity, and population coverage. Selected epitopes were docked with their corresponding human leukocyte antigen (HLA) alleles, and thermodynamic quantities were determined. Five virulence factors …

Examining Aid Fragmentation And Collaboration Opportunities In Cambodia’S Health Sector, Suyeon Lee, Eunice Y. Park

Department of Public Health Scholarship and Creative Works

Background: Cambodia’s health sector faces significant challenges exacerbated by aid fragmentation, where development aid is dispersed among numerous small, uncoordinated projects. This study examines the distribution of health sector aid among Cambodia’s principal donors to identify priorities, overlaps, and potential collaboration opportunities, addressing the urgent need for aid efficiency and alignment with national health priorities. Methods: Utilizing OECD datasets and the Herfindahl-Hirschman Index (HHI) for the years 2010–2021, this study quantifies aid fragmentation within Cambodia’s health sector. It analyzes aid allocations from the top five donors—United States, Australia, South Korea, Japan, and Germany—across various health projects and initiatives, evaluating the …

Global, Regional, And National Burden Of Hiv/Aids, 1990–2021, And Forecasts To 2050, For 204 Countries And Territories: The Global Burden Of Disease Study 2021, Austin Carter, Magdalene K. Walters, Deepa Jahagirdar, Edmond D. Brewer

Open Access archive

Background: As set out in Sustainable Development Goal 3.3, the target date for ending the HIV epidemic as a public health threat is 2030. Therefore, there is a crucial need to evaluate current epidemiological trends and monitor global progress towards HIV incidence and mortality reduction goals. In this analysis, we assess the current burden of HIV in 204 countries and territories and forecast HIV incidence, prevalence, and mortality up to 2050 to allow countries to plan for a sustained response with an increasing number of people living with HIV globally. Methods: We used the Global Burden of Diseases, Injuries, and …

Antibiogram Pattern Of Enterococcus Species Among Urinary Tract-Infected Patients Visiting Tertiary Care Hospital In Karnataka, India, Sujatha Bhat, Dushan Uvindu Gunawardana, Delisha Kaur Boparai, Tharinya Kasundie Bamunusinghe

Open Access archive

Background: During the past several decades, enterococci are emerging as an important cause of healthcare-associated infections. They have developed resistance to various antimicrobials previously used for the treatment of urinary tract infections (UTIs). This study was aimed to determine the prevalence of Enterococcus species among urinary tract-infected patients in a tertiary care hospital, in Karnataka, India. Material and Methods: We have analyzed 4341 culture-positive urine samples received by microbiology laboratory during the year 2021. The bacterial identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry. The antibiotic sensitivity was tested by automated VITEK-2® COMPACT (bioMérieux) system. Results: …

Putting Gpt-4o To The Sword: A Comprehensive Evaluation Of Language, Vision, Speech, And Multimodal Proficiency, Sakib Shahriar, Brady D. Lund, Nishith Reddy Mannuru, Muhammad Arbab Arshad, Kadhim Hayawi, Ravi Varma Kumar Bevara, Aashrith Mannuru, Laiba Batool

All Works

As large language models (LLMs) continue to advance, evaluating their comprehensive capabilities becomes significant for their application in various fields. This research study comprehensively evaluates the language, vision, speech, and multimodal capabilities of GPT-4o. The study employs standardized exam questions, reasoning tasks, and translation assessments to assess the model’s language capability. Additionally, GPT-4o’s vision and speech capabilities are tested through image classification and object-recognition tasks, as well as accent classification. The multimodal evaluation assesses the model’s performance in integrating visual and linguistic data. Our findings reveal that GPT-4o demonstrates high accuracy and efficiency across multiple domains in language and reasoning …

Global, Regional, And National Age-Specific Progress Towards The 2020 Milestones Of The Who End Tb Strategy: A Systematic Analysis For The Global Burden Of Disease Study 2021, Jorge R. Ledesma, Jianing Ma, Meixin Zhang, Ann V.L. Basting

Open Access archive

Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020. Methods: We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990–2021 inclusive). We quantified …

Characterization And Reprogramming Of T-Cell Metabolic Dysfunction In Chronic Lymphocytic Leukemia For Improved Adoptive Cell Therapy, Wael B. Gamal

USF Tampa Graduate Theses and Dissertations

Chronic lymphocytic leukemia (CLL) is a predominant B-cell malignancy impacting elderly populations in Western societies. Targeted therapies have revolutionized the CLL treatment landscape. Still, patients often require long-term therapy and are subject to drug-induced resistance and severe toxicities, for which CLL is still considered an incurable disease. T-cell-based immunotherapy, particularly chimeric antigen receptor (CAR) T cells, has shown remarkable success, leading to various FDA approvals in hematological malignancies. Nonetheless, CAR T-cell therapy success rate is limited in CLL because of the dysfunctional nature of T cells. CLL T cells exhibit skewing toward immunosuppressive and terminally differentiated phenotypes, leading to hindrances …

Macrophage-Driven Car T Cell Resistance In B Cell Lymphoma, Sae Bom Lee

USF Tampa Graduate Theses and Dissertations

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of patients with relapsed/ refractory large B cell lymphoma (LBCL). Despite its promising efficacy, a subset of patients experiences primary resistance or relapse. In Chapter 2, we explore the tumor microenvironment (TME)-induced resistance mechanisms in patients with LBCL. Analysis of the intratumoral immune infiltrates in pre-infusion tumor biopsies revealed that the levels of immunoregulatory macrophages were elevated in patients who responded poorly to axicabtagene ciloleucel (axi-cel). Using preclinical mouse B cell tumor models, we found that the CAR T-cell-produced interferon-gamma (IFN-γ) enhanced the expression of inducible nitric oxide synthase (iNOS, …

A Communication-Efficient Federated Learning Framework For Sustainable Development Using Lemurs Optimizer, Mohammed Azmi Al-Betar, Ammar Kamal Abasi, Zaid Abdi Alkareem Alyasseri, Salam Fraihat, Raghad Falih Mohammed

Machine Learning Faculty Publications

The pressing need for sustainable development solutions necessitates innovative data-driven tools. Machine learning (ML) offers significant potential, but faces challenges in centralized approaches, particularly concerning data privacy and resource constraints in geographically dispersed settings. Federated learning (FL) emerges as a transformative paradigm for sustainable development by decentralizing ML training to edge devices. However, communication bottlenecks hinder its scalability and sustainability. This paper introduces an innovative FL framework that enhances communication efficiency. The proposed framework addresses the communication bottleneck by harnessing the power of the Lemurs optimizer (LO), a nature-inspired metaheuristic algorithm. Inspired by the cooperative foraging behavior of lemurs, the …

A Summary Of Two Decades Of Qtl And Candidate Genes That Control Seed Tocopherol Contents In Maize (Zea Mays L.), My Abdelmajid Kassem, Dounya Knizia, Khalid Meksem

College of Health, Science, and Technology

Tocopherols are secondary metabolites synthesized through the shikimate biosynthetic pathway in the plastids of most plants. It is well known that ?–Tocopherol (vitamin E) has many health benefits for humans and animals; therefore, it is highly used in human and animal diets. Tocopherols vary considerably in most crop (and plant) species and within cultivars of the same species depending on environmental and growth conditions; tocopherol content is a polygenic, complex traits, and its inheritance is poorly understood. The objective of this review paper was to summarize all identified quantitative trait loci (QTL) that control seed tocopherols and related contents identified …

Why Is This Man's Urine Flaky?, Brittney Hulsey

PA Faculty Publications

No abstract provided.

Salmonella Paratyphi Causing Endocarditis: A Rare Case Report, Harshvir Singh Bal, Aadya Chawla, Aakanksha Shetty, Mohammad Sinan

Open Access archive

With the trends of emerging paratyphi infections, especially in South Asia, the increase in the incidence of its rarer manifestations is around the corner. Here, we describe the case of Paratyphoid Endocarditis in a 55-year-old man, presenting to the ER with fever, vomiting, and aortic murmur, the subsequent diagnostic workup, and the treatment plan. The rarity of the disease has led to a scarcity of knowledge about the appropriate course of treatment, particularly whether surgery is required. Furthermore, a broader community-level strategy, such as the development of vaccines including the paratyphi strains, and measures to disrupt the modalities of disease …

A Young Dancer With Hand Pain And Tremors, Brittney Hulsey

PA Faculty Publications

No abstract provided.

Association Between Hematological Parameters And Severity Of Covid-19 Disease, Gokul Krishnan, Shubhada Karanth, Sudha Vidyasagar, Archit Aggarwal

Open Access archive

Background: This study aimed to determine the relationships between hematological parameters- hemoglobin, Total Leucocyte Counts (TLC), platelet counts, Absolute Neutrophil Counts (ANC), Absolute Lymphocyte Counts (ALC), Neutrophil Lymphocyte Ratio (NLR), Systemic Immune Inflammatory Index (SII), Neutrophil Monocyte Ratio (NMR), Platelet Lymphocyte Ratio (PLR) and the severity of COVID-19 disease and their use in predicting severity of COVID-19 disease. Methods and Material: This was a prospective, observational, single-center study of 573 symptomatic adult inpatients of COVID 19 admitted to our tertiary care center. Statistical analysis used: The above-mentioned hematological parameter levels were noted and compared between the two categories of COVID-19 …

Efficacy Of Lycium Barbarum (Goji Berry) Mouthwash For Managing Periodontitis: A Randomized Clinical Trial, Amee Sanghavi, Laasya Shettigar, Aditi Chopra, Ashmeet Shah

Open Access archive

Background: Removal of the microbial deposits (plaque and calculus) by performing effective scaling and root planing (SRP) is the fundamental step for managing periodontal disease (gingivitis and periodontitis). Various adjuncts in the form of mouthwash, gels, and toothpaste are also being used as adjuncts to SRP for managing periodontitis. Recently, Lycium barbarum (L. barbarum), commonly known as goji berry or wolfberry, has gained popularity for managing chronic inflammatory and infectious diseases. However, its efficacy in managing periodontitis has never been explored. Hence the present study aims to evaluate the efficacy of goji berry mouthwash compared to chlorhexidine mouthwash for managing …

Development Of Levofloxacin Glycosylated Mesoporous Silica Nanoparticles For Urinary Tract Infections, Songhita Mukhopadhyay, Reema Narayan, Shivaprasad Gadag, Padmaja A. Shenoy

Open Access archive

Nanoparticle drug delivery for infectious disease has paved the way for effective treatment; mesoporous silica nanoparticles (MSNs) with versatile design options, tunable pore size, high surface area, and adequate pore volume have garnered widespread interest. The current study deals with the synthesis of MSNs loaded with levofloxacin (LVF), followed by glycosylation to enhance the uptake by bacterial cells. The MSNs were prepared by modifying Stober’s process. The amino-modified MSNs were glycosylated using D-Glucuronic acid by EDAC-NHS coupling chemistry. The LVF -loaded glycosylated MSNs (GLY-MSN) were characterized for various parameters and in vitro antimicrobial efficacy study. The surface functionalized MSNs had …

Pass: A Scoring System To Evaluate Persistent Kidney Injury In Critically Ill Icu Adult Patients, Dattatray Prabhu, Sonali Dattatray Prabhu, Chakrapani Mahabala, Mayoor V. Prabhu

Open Access archive

Background: We evaluated if the course of recovery from sepsis-induced acute kidney injury (AKI) can be predicted using variables collected at admission. Methods: A total of 63 patients admitted for sepsis-induced AKI in our Mangalore ICU were evaluated and baseline demographic and clinical/laboratory parameters, including serum creatinine (SCr), base excess (BE), Plethysmographic Variability Index (PVI), Caval Index, R wave variability index (RVI), mean arterial pressure (MAP) and renal resistivity index (RI) using renal doppler and need for inotropes were assessed on admission. Patients were managed as per standard protocol. After six hours of fluid resuscitation, patients were classified as volume …

Signals Of Positive Selection In Genomes Of Palearctic Myotis-Bats Coexisting With A Fungal Pathogen, V. G. Twort, V. N. Laine, K. A. Field, F. Whiting-Fawcett, Ito, M. Reiman, T. Bartonicka, M. Fritze, V. A. Ilyukha, V. V. Belkin, E. A. Khizhkin, D. M. Reeder, D. Fukui, T. L. Jiang, T. M. Lilley

Faculty Journal Articles

Disease can act as a driving force in shaping genetic makeup across populations, even species, if the impacts influence a particularly sensitive part of their life cycles. White-nose disease is caused by a fungal pathogen infecting bats during hibernation. The mycosis has caused massive population declines of susceptible species in North America, particularly in the genus Myotis. However, Myotis bats appear to tolerate infection in Eurasia, where the fungal pathogen has co-evolved with its bat hosts for an extended period of time. Therefore, with susceptible and tolerant populations, the fungal disease provides a unique opportunity to tease apart factors contributing …

A Study Of Association Between Early Menarche And Anxiety In Undergraduate Students, Poorva Bakshi, Sharanya B. Shetty, Abira Sharma, K. G. Vasudha

Open Access archive

Background: Anxiety has been reported to be one of the most common epidemics in recent years. The present study focused on understanding the association between early menarche and the prevalence of anxiety and anxiety symptoms among adult undergraduate students. Methods: This was an observational, case-control study. The sample included 146 young female adults aged more than or equal to 18 years pursuing the Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Sciences (BDS). Using an online questionnaire, participants were asked to recall and enter the age at which they attained menarche. We used the Generalized Anxiety …

Lasiodiplodia Theobromae Keratitis: A Rare Tropical Fungal Keratitis In A Non-Tropical Climate, Calvin Hamerski, A D. Proia

Osteopathic Medicine, Jerry M. Wallace School of

PURPOSE: We present the clinical and histopathological findings of a geographically unique fungal keratitis case in North Carolina. . is a rare cause of fungal keratitis, and all but one of the 51 previously reported cases have occurred in patients living in the tropics. OBSERVATIONS: A man in his early 50s developed keratitis after being struck in the left eye by a piece of debris while using a flexible-cord weed trimmer. Intracapsular lensectomy and penetrating keratoplasty were necessary when initial antimicrobial therapy was ineffective. The best-corrected visual acuity was 20/40 four years postoperatively. CONCLUSIONS AND IMPORTANCE: Our patient is only …

Analysis Of Online Platforms’ Free Trial Strategies For Digital Content Subscription, Li Chen

College of Business and Economics

Adopting subscription models has become a popular trend in e-commerce. Digital content platforms often use free trials to attract potential subscribers. However, rigorous research on platforms’ free trial strategies is lacking. Our paper aims to fill this gap using a horizontal duopoly framework. We investigate both the scenario of market symmetry and of market asymmetry. We study the benchmark case with no free trial for each scenario and derive equilibrium results with free trial promotion. We find that the platform will not benefit from free trials unless consumers’ learning rate exceeds a threshold. When a free trial is introduced in …

Evaluating The Response Of Glycine Soja Accessions To Fungal Pathogen Macrophomina Phaseolina During Seedling Growth, Shirley Jacquet, Shuxian Li, Rouf Mian, My Abdelmajid Kassem, Layla Rashad, Sonia Viera, Francisco Reta, Juan Reta, Jiazheng Yuan

College of Health, Science, and Technology

Charcoal rot caused by the fungal pathogen Macrophomina phaseolina (Tassi) Goid is one of various devastating soybean (Glycine max (L.) Merr.) diseases, which can severely reduce crop yield. The investigation into the genetic potential for charcoal rot resistance of wild soybean (Glycine soja) accessions will enrich our understanding of the impact of soybean domestication on disease resistance; moreover, the identified charcoal rot-resistant lines can be used to improve soybean resistance to charcoal rot. The objective of this study was to evaluate the resistance of wild soybean accessions to M. phaseolina at the seedling stage and thereby select the disease-resistant lines. …

Enhancing Rice Leaf Disease Classification: A Customized Convolutional Neural Network Approach, Ammar Kamal Abasi, Sharif Naser Makhadmeh, Osama Ahmad Alomari, Mohammad Tubishat, Husam Jasim Mohammed

Machine Learning Faculty Publications

In modern agriculture, correctly identifying rice leaf diseases is crucial for maintaining crop health and promoting sustainable food production. This study presents a detailed methodology to enhance the accuracy of rice leaf disease classification. We achieve this by employing a Convolutional Neural Network (CNN) model specifically designed for rice leaf images. The proposed method achieved an accuracy of 0.914 during the final epoch, demonstrating highly competitive performance compared to other models, with low loss and minimal overfitting. A comparison was conducted with Transfer Learning Inception-v3 and Transfer Learning EfficientNet-B2 models, and the proposed method showed superior accuracy and performance. With …

What Is It Like To Be A Brain Organoid? Phenomenal Consciousness In A Biological Neural Network, Ivanna Montoya, Daniel Montoya

College of Humanities and Social Sciences

It has been shown that three-dimensional self-assembled multicellular structures derived from human pluripotent stem cells show electrical activity similar to EEG. More recently, neurons were successfully embedded in digital game worlds. The biologically inspired neural network (BNN), expressing human cortical cells, was able to show internal modification and learn the task at hand (predicting the trajectory of a digital ball while moving a digital paddle). In other words, the system allowed to read motor information and write sensory data into cell cultures. In this article, we discuss Neural Correlates of Consciousness (NCC) theories, and their capacity to predict or even …

Transmission Of Yellow Fever Vaccine Virus Through Blood Transfusion And Organ Transplantation In The Usa In 2021: Report Of An Investigation, Carolyn V. Gould, Rebecca J. Free, Julu Bhatnagar, Raymond A. Soto, Tricia L. Royer, Warren R. Maley, Sean Moss, Matthew A. Berk, Rebecca Craig-Shapiro, Rosy Priya L. Kodiyanplakkal, Lars F. Westblade, Thangamani Muthukumar, Yoram A. Puius, Amresh Raina, Azam Hadi, Kymberly A. Gyure, Danielle Trief, Marcus Pereira, Matthew J. Kuehnert, Vennus Ballen, Debra A. Kessler, Kimberly Dailey, Charles Omura, Thuy Doan, Steve Miller, Michael R. Wilson, Jennifer A. Lehman, Jana M. Ritter, Elizabeth Lee, Luciana Silva-Flannery, Sarah Reagan-Steiner, Jason O. Velez, Janeen J. Laven, Kelly A. Fitzpatrick, Amanda Panella, Emily H. Davis, Holly R. Hughes, Aaron C. Brault, Kirsten St George, Amy B. Dean, Joel Ackelsberg, Sridhar V. Basavaraju, Charles Y. Chiu, J. Erin Staples

Department of Medicine Faculty Papers

BACKGROUND: In 2021, four patients who had received solid organ transplants in the USA developed encephalitis beginning 2-6 weeks after transplantation from a common organ donor. We describe an investigation into the cause of encephalitis in these patients.

METHODS: From Nov 7, 2021, to Feb 24, 2022, we conducted a public health investigation involving 15 agencies and medical centres in the USA. We tested various specimens (blood, cerebrospinal fluid, intraocular fluid, serum, and tissues) from the organ donor and recipients by serology, RT-PCR, immunohistochemistry, metagenomic next-generation sequencing, and host gene expression, and conducted a traceback of blood transfusions received by …

Out-Of-Pocket Health Expenditures Associated With Chronic Health Conditions And Disability In China, Jingyi Gao, Hoolda Kim, Sophie Mitra

College of Business and Economics

The objective of this study is to estimate the extra costs of living associated with chronic health conditions and disabilities in China. Leveraging the 2018 China Health and Retirement Longitudinal Study involving 13,530 respondents aged 50 and over, we apply both an ordinary least squares linear regression model and a logistic model to analyze the correlation between medical out-of-pocket expenditures (OOPEs) and chronic health conditions, as well as disabilities measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) limitations. This paper bridges the gap in the literature on OOPEs and their association with disabilities and …