Digital Commons Network^™

Aggressive Natural Killer Cell Leukemia: A Rare And Rapidly Progressive Hematologic Malignancy—Case Report And Literature Review, Jennifer Priessnitz, Ali Hariri, Yuliya Levkiavska, Kyle E. Bonner, Stephan I. Fisher, Joshua M. Sill

Department of Medicine Faculty Publications

Aggressive natural killer cell leukemia (ANKL) is a rare, fulminant hematologic malignancy characterized by neoplastic proliferation of mature NK cells. It is frequently associated with Epstein-Barr virus (EBV) infection, although EBV-negative cases have also been reported. While typically observed in young to middle-aged adults of East Asian descent, increasing recognition has led to identification of ANKL across diverse age groups and ethnicities. The disease is defined by a rapid clinical course and poor prognosis, underscoring the importance of early diagnosis and effective treatment. We present a case of a 71-year-old Caucasian male who developed fever, altered mental status, hepatosplenomegaly, pancytopenia, …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

T-Cells May Represent A Novel Biomarker For Female Pattern Hair Loss, Juan Marrero Berrios, Iain Noel Encarnacion, Noelle Desir, Aman Prasad, Matthew Hedberg, Susan Taylor, John T. Seykora

Department of Medicine Faculty Publications

[Introduction] Androgenetic alopecia (AGA) is a common non-scarring alopecia classically attributed to androgen sensitivity and genetics. Histopathologic studies have identified perifollicular and perivascular lymphocytic and histiocytic infiltrates, through the composition and clinical relevance of this infiltrate have not been fully characterized.¹ Our study aims to address this gap through detailed quantitative immunohistochemical characterization (IHC) of the inflammatory infiltrate in female patients with AGA compared to telogen effluvium (TE), a non-inflammatory control.

Drug-Induced Lichen Planus Associated With Ocrelizumab, Avery Seward, John D. Strickley, Jeffrey P. Callen

Department of Medicine Faculty Publications

This case report highlights recurrent cutaneous lichen planus as a rare adverse effect of ocrelizumab, with flares occurring after each infusion and improving with prophylactic prednisone. Recognizing this association may help clinicians diagnose and manage similar cases while allowing patients to continue an otherwise effective therapy.

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Element-Based Predictive Modeling Of Hydrothermal Liquefaction Bioproducts Derived From Corn Stover, Isamu Umeda, Meicen Liu, Yi Zheng, Jiefu Wang, Zhiwu Wang, Sandeep Kumar

Civil & Environmental Engineering Faculty Publications

The hydrothermal liquefaction (HTL) process offers an energetic advantage over pyrolysis because it does not require prior drying of the biomass feedstock. However, there are significant challenges in simultaneously estimating both the yields and characteristics of products from the HTL of biomass with theoretical support. This study developed a unique element-based kinetic model to predict the yields, higher heating values, and fuel characteristics of solid residue and heavy bio-oil, based on the temperature, residence time, solid loading, and elemental composition (C, H, N, and O) of corn stover. Furthermore, the model predicted the weights of dissolved carbon and nitrogen in …

Harnessing Activated Sludge For The Treatment Of Hydrothermal Liquefaction Wastewater: A Proof-Of-Concept Study, Cyrus Li, Jiefu Wang, Meicen Liu, Yi Zheng, Sandeep Kumar, Isamu Umeda, Chandan Mahata, John Norton

Civil & Environmental Engineering Faculty Publications

Although hydrothermal liquefaction (HTL) is the leading technology in converting wet biomass into bioenergy, the treatment of its toxic-laden aqueous phase wastewater presents a major challenge on its path toward commercial viability. This study presents the first-ever assessment of sewage sludge-fed HTL wastewater (SS-HTLWW) treatment and toxic compound removal using municipal activated sludge (AS) by optimizing its cultivation condition. It was found that AS with optimized pretreatment can remove up to 91.2% of the soluble chemical oxygen demand (sCOD) in SS-HTLWW, of which up to 82% can be attributed to biological mineralization and adsorption of sCOD by AS. Conventional bioprocess …

Technical Skills And Their Roles In Agribusiness Supply Chain Management Education, Ryan Loy, Logan L. Britton, F. Bailey Norwood

Agricultural Economics and Agribusiness Faculty Publications and Presentations

The integration of advanced technical skills and supply chain management (SCM) tools is critical for the evolving demands of agribusiness. This study identifies the technical competencies, software proficiencies, and educational strategies essential for preparing students to excel in modern SCM roles. Through semi-structured interviews with 26 SCM professionals across US agribusiness sectors, the study highlights the demand for expertise in tools such as SAP, Power BI, and SQL alongside capabilities in data-driven decision-making and adaptability. Despite theoretical preparation, graduates often lack practical experience with industry-standard technologies, underscoring a gap in academic curricula. The findings suggest that agribusiness programs should emphasize …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

A Multiple Case Study Exploring The Lived Experiences Of Special Education Teachers Of Students With Intellectual Disabilities, Patrece A. Scott

Doctor of Education Dissertations

Special educators, particularly the teachers of students with intellectual disabilities, remained an understudied group in research. The purpose of this phenomenological qualitative study was to examine how special educators navigated their lived experiences collaborating with three key stakeholder groups: parents, general education teachers, and administrators, particularly working with students with intellectual disabilities. Specifically, this study examined how special educators experienced collaboration with those stakeholder groups through the framework of McClelland's (1961) Theory of Needs. The study involved two semi-structured interviews with each of the 12 participants, all of whom were special educators at the middle or high school level. These …

(Reverse) Piercing The Trust Veil, Eric Kades

Faculty Publications

Emergent doctrine deems trusts legal entities distinct from their trustees and beneficiaries. Venerable doctrine empowers creditors to "pierce the veil" separating entities' and their owners' property to avoid inequitable treatment. This article weaves together the new and old to craft a legal roadmap for reversing the ongoing race to the bottom among the states authorizing indefensible self-settled asset protection trusts (SSAPTs) designed solely for the purpose of swindling creditors. As a matter of both policy and doctrine, piercing (more precisely, reverse piercing) an entity's veil is ideally suited to empower the creditor of a SSAPT beneficiary to get paid from …

The Specter Of Jury Nullification, Anna Offit

Faculty Publications

Attention to the trial of Luigi Mangione has renewed debate about nullification—the jury’s inviolate power to acquit a defendant contrary to the evidence presented. Jury nullification proponents hold that it is a mechanism of last resort for refusing to apply laws that conflict with the public conscience. Opponents, by contrast, argue that nullification undermines the law by diminishing its legitimacy. To prosecutors and defense attorneys, however, these arguments are immaterial: Jury nullification is part of the institutional landscape of the contemporary jury trial and thus must be treated as a potentiality—a feature of the agnostic, strategic, and ethical terrain of …

Hyena: An Observing System Simulation Experiment For Hypothetical Energetic Neutral Atom Imagers, Joel Tibbetts, Amy Keesee, Matina Gkioulidou, Robert Demajistre, Viacheslav Merkin

Faculty Publications

Mesoscale plasma sheet flows are widely understood to be a critical component of the overall picture of energy, particle, and magnetic flux transport during periods of geomagnetic activity. Without simultaneous measurements with true global coverage, the short lifetime (~10 min) and localized spatial extents (~1–3 R_E in azimuth) of these structures make obtaining a global picture of their contributions to stormtime magnetosphere dynamics difficult to characterize. Energetic neutral atom (ENA) imaging can enable remote mapping of plasma energization in the magnetosphere; however, its line-of-sight integrated nature, coupled with the challenging-to-characterize attributes of the target physical phenomena, means that numerous …