Digital Commons Network^™

Genomics Define Malignant Transformation In Myeloma Precursor Conditions, Francesco Maura, P Leif Bergsagel, Bachisio Ziccheddu, Shaji Kumar, Kylee Maclachlan, Juan-Jose Garces, Esteban Braggio, Yan Asmann, Michael Durante, Benjamin T Diamond, Marios Papadimitriou, Malin Hultcrantz, Alessio Marella, Giancarlo Castellano, Akihiro Maeda, Marta Lionetti, Antonio Matera, Stefania Pioggia, Matteo Claudio Da Vià, Claudio De Magistris, Daniel Leongamornlert, Danny Deavila, Praneeth Reddy Sudalagunta, Rafael Renatino Canevarolo, Erin M Siegel, Phaedra Agius, Jamie Teer, Andrew Mcpherson, Yusuke Yamashita, Ariosto S Silva, Patrick Blaney, Rachid Baz, Krina K Patel, Peter Campbell, Gareth Morgan, Rafael Fonseca, Ola Landgren, Robert Z Orlowski, Kenneth H Shain, Niccolo Bolli, Saad Usmani, S Vincent Rajkumar

Faculty, Staff and Student Publications

Multiple myeloma (MM) is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). While these precursor conditions are asymptomatic, they are not entirely benign and carry a lifelong risk of progression to MM. Unlike other cancers defined by pathology, malignant transformation from MGUS or SMM to MM has so far relied on demonstration of clinical end-organ damage as morphology and cytogenetics cannot reliably distinguish them. In this study, using genomic data from 374 patients with MGUS or SMM (277 training, 97 validation), to our knowledge, we demonstrate for the first time the ability to identify …

Simulated Complex Cells Contribute To Object Recognition Through Representational Untangling, Mitchell B Slapik, Harel Z Shouval

Faculty, Staff and Student Publications

The visual system performs a remarkable feat: it takes complex retinal activation patterns and decodes them for object recognition. This operation, termed "representational untangling," organizes neural representations by clustering similar objects together while separating different categories of objects. While representational untangling is usually associated with higher-order visual areas like the inferior temporal cortex, it remains unclear how the early visual system contributes to this process-whether through highly selective neurons or high-dimensional population codes. This article investigates how a computational model of early vision contributes to representational untangling. Using a computational visual hierarchy and two different data sets consisting of numerals …

Diagnostic Performance Of Non-Hyperemic Pressure Ratios Versus Fractional Flow Reserve Stratified By Coronary Artery: A Systematic Review And Meta-Analysis Of Individual Patient Data, Tatyana Storozhenko, Damien Collison, Nils P Johnson, Koshiro Sakai, Takuya Mizukami, Toshiro Shinke, Hitoshi Matsuo, Daniel Munhoz, Dimitri Buytaert, Hirohiko Ando, Brian Ko, Abdul Ihdayhid, Simone Biscaglia, Fernando Rivero, Thomas Engstrøm, Ketina Arslani, Antonio Maria Leone, Lokien X Van Nunen, William F Fearon, Evald Høj Christiansen, Bjarne L Nørgaard, Michael Maeng, Liyew Desta, Andy Yong, Hiromasa Otake, Yu Takahashi, Daniele Andreini, Jonathon Leipsic, Bon-Kwon Koo, Paola Monique Barbato, Jozef Bartunek, Emanuele Barbato, Jeroen Sonck, Bernard De Bruyne, Carlos Collet

Faculty, Staff and Student Publications

BACKGROUND: In the assessment of coronary physiology, non-hyperemic pressure ratios (NHPRs) provide an alternative to fractional flow reserve (FFR) without the need for hyperemic agents, reducing procedural time, side effects, and costs. However, it remains unclear whether NHPRs have similar diagnostic performance in the different coronary arteries. This study evaluates the diagnostic performance of NHPRs compared with FFR, stratified by coronary artery, in stable patients with coronary artery disease.

METHODS: We conducted a systematic review and individual patient-level data meta-analysis from prospective studies involving patients with intermediate to severe coronary stenosis who underwent physiological assessment with NHPRs and FFR. NHPRs …

Pseudoamniotic Band Sequence Risk Factors Following Fetoscopic Laser For Twin-Twin Transfusion Syndrome, Felicia V Lemoine, Sami Backley, Gustavo Vilchez-Lagos, Jimmy Espinoza, Edgar Hernandez-Andrade, Anthony Johnson, Ramesha Papanna, Eric Bergh

Faculty, Staff and Student Publications

Introduction: Pseudoamniotic band sequence (PABS) is a rare but serious complication following fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). We aim to explore associations between perioperative factors and PABS in monochorionic, diamniotic twins undergoing FLP for TTTS.

Methods: A secondary analysis was conducted using a prospective cohort of 816 FLP procedures performed between 2011 and 2024 at a single fetal therapy center. All cases had confirmed absence of PABS prior to FLP via ultrasound and fetoscopic evaluation. PABS was diagnosed postnatally or suspected after FLP and confirmed after birth. Clinical and perioperative variables were compared between cases with …

Students’ Perceptions Of The Use Of Technology In Rural Elementary Schools, Evadney Moncrieffe - Jumpp

Walden Dissertations and Doctoral Studies

Rapid technological advancements have transformed educational experiences, optimizing learning outcomes while providing interesting experiences to learners and educators. More insight was needed on how students perceive learning via technology, as this information can shape how teachers implement technology, especially in rural elementary schools. The main purpose of this research was to investigate the perceptions of students in rural areas between Grades 1–5 regarding the increased use of technology education. The research questions concerned how students in rural elementary schools perceive (a) the use of technology in education and (b) the quality of the teaching–learning process when using or mediating technological …

Fire Service Leadership Cost-Effective Strategies To Reduce Sudden Cardiac Death, Kathryn Marie Bernardo-Preston

Walden Dissertations and Doctoral Studies

Abstract A high incidence of on-duty firefighter sudden cardiac death (SCD) results in increased costs and decreased organizational performance. Fire department leaders are concerned about the financial burden of SCDs as they put strain on departmental budgets and subsequently limit operational readiness. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry project was to explore how fire department leaders used cost-effective strategies to reduce SCD episodes among on-duty firefighters. Participants comprised six fire department leaders located on the East Coast of the United States who had successfully implemented strategies to minimize firefighter SCD. Data were collected using …

Faculty Perceptions Of Student Use Of Critical Thinking And Clinical Judgment In Prelicensure Alternative Pediatric Clinical Education, Vanessa Lee Lugo

Walden Dissertations and Doctoral Studies

Both the changing healthcare environment and diverse pediatric care needs highlight the importance of exploring nontraditional clinical placements for entry-level pediatric nursing students to assess their critical thinking (CT) and clinical judgment (CJ). Many graduates are unprepared for pediatric care, creating safety risks and gaps in meeting children’s healthcare needs. The purpose of this study, guided by communities of practice theory, was to explore faculty experiences with and perceptions of CT and CJ use at alternative pediatric clinical sites for prelicensure undergraduate students in the Northeastern United States. Eleven nursing faculty with recent experience working in nontraditional pediatric sites and …

Racial Identity, Student Engagement, Student Satisfaction, And Persistence In African American Students Attending Predominately White Institutions, Antoinette Drakeford

Walden Dissertations and Doctoral Studies

African American college students attending predominantly White institutions (PWIs), such as Old Dominion University, face challenges, including experiences with microaggressions and limited engagement opportunities, which may affect their persistence. The purpose of this study was to examine whether racial identity and microaggressions moderate the relationship between student engagement, satisfaction, and persistence among African American students at a PWI. Cross’s theory of nigrescence served as the theoretical framework for understanding African American racial identity development. A quantitative, non-experimental design was employed. Data were collected from 50 African American undergraduate students using standardized instruments measuring racial identity, microaggressions, engagement, satisfaction, and persistence. …

Postdischarge Pediatric Mortality In Nigeria For Children Under 5 Years Of Age, Philomina Nwaugo Chukwudike

Walden Dissertations and Doctoral Studies

Child mortality has remained a public health issue that is prevalent among families living in Nigeria and low- and middle-income countries. Factors associated with post-discharge pediatric mortality among children under 5 have not been explored. The study involved examining associations between timely individual follow-up visits, availability of healthcare facilities for follow-up care, and likelihood of post-discharge mortality among children under 5 while adjusting for household income, geographical location, mothers’ age, and mothers’ education. The theoretical framework was the social ecological model. Data were generated from the 2018 Demographic and Health Survey. A sample size of N=21,671 was used to determine …

Ndls Communicator: Week Of 01.20.26, Notre Dame Law School

NDLS Communicator

The Latest News

• Notre Dame Exoneration Justice Clinic Notches Third Victory in 15 Months
• Notre Dame Law Professors Share Expertise at 2026 Association of American Law Schools Annual Meeting

Student News

• J.S.D. candidate Juan Carlos Gazmuri

Faculty Briefs

• Christine Venter
• Paul Miller
• Patrick Corrigan
• Rick Garnett
• Diane Desierto
• Mary Ellen O'Connell
• Derek Muller

Events

• Faculty Colloquium - Randy Kozel
• Faculty and Staff Birthday Celebration
• Sadie Blanchard's Private Law Workshop

Around the Watercooler

• Justin Gonzalez joined the Law School as the new Associate Director of Operations and Finance
• Walk the Walk Week

Staff Spot Awards

• Accepting nominations

Appraisal Of Aquifer Protective Capacity And Groundwater Potential Using The Vertical Electrical Sounding Technique In Illah, Delta State, Nigeria, John E. Okonkwo, Efemena D. Emmanuel

Al-Bahir

Groundwater is a critical resource in Illah, Delta State, where surface water is unreliable. This study aims to evaluate groundwater potential and aquifer properties using geoelectric methods, with a particular focus on Dar-Zarrouk parameters. Thirteen Vertical Electrical Sounding (VES) surveys were conducted using the Schlumberger array. Derived parameters, including resistivity, thickness, and Dar-Zarrouk indices, were analysed to characterise the aquifers’ hydraulic properties. Four to five geoelectric layers underlie the study area. Aquifer resistivity ranged from 124–2499 Ω·m, thickness from 3.4–57.9 m, and transmissivity from 27.54–468.99 m²/day. VES 4, VES 1, and VES 7 were identified as high-potential sites. Longitudinal conductance …

Biopcm-Integrated Smart Façade For Hospitals: Thermal Performance Across Floor Levels In A Hot-Arid Climate, Aia A. Qindil, Esraa Elazab, Mohamed M. Shawky Abou Liela

Mansoura Engineering Journal

Hospitals are among the most energy-intensive building types because they operate around the clock and must maintain strict indoor environmental conditions, especially in hot-arid climates. Improving their performance calls for façade solutions that can store thermal energy effectively and help cut carbon emissions. This study evaluates the use of macro-encapsulated BioPCM® within the south façade of a high-rise hospital in Mansoura, Egypt, using dynamic simulations in DesignBuilder (EnergyPlus). The analysis focuses on two vertical levels, the third floor as a typical ward and the seventh floor as a rooftop ward, to investigate how elevation influences PCM performance, an aspect rarely …

Credit Card Fraud Detection Using Metaheuristic Techniques, Narges Sabry Anwer Mohammed, Mohammed Sabry Saraya, Amr M. Thabet, Labib M. Labib

Mansoura Engineering Journal

Credit Card Fraud Detection (CCFD) has become a critical challenge to financial security due to increasingly sophisticated fraudulent activities. This study investigates the effectiveness of Meta-Heuristic (MHT) optimization techniques in improving fraud detection (FD) through feature selection (FS) and model optimization. To address class imbalance, Random Under-Sampling (RUS) was applied. The selected feature subsets were evaluated using three machine learning (ML) classifiers—Decision Tree (DT), KNearest Neighbours (KNN), and XGBoost (Xgb-Tree)—across four benchmark datasets: European, Statlog (Australian Credit Approval), PaySim, and Credit Card Transactions Fraud Detection (CCTFD). Eleven binary MHT algorithms were implemented and compared. The comparative analysis shows that the …

Theoretical And Empirical Analysis Of The New Payroll Tax Scheme: Improving Efficiency And Compliance In Indonesia, Mainita Hidayati, Fitria Arianty

Jurnal Vokasi Indonesia

The potential for tax revenue from Payroll Tax in Indonesia can still be optimized. In December 2023, the government issued Presidential Regulation Number 55 of 2023 and Minister of Finance Regulation Number 168 of 2023 to alter the payroll tax scheme and simplify the calculation procedures of Income Tax Article 21. Additionally, Director General of Taxes Regulation Number PER-2/PJ/2024 was issued to regulate changes in creating withholding evidence and reporting the periodic Income Tax Article 21/26 return. This paper aims to analyze the impact of the new payroll tax scheme on the tax burden for taxpayers, the new reporting scheme's …

Tolkien And The Mystery Of Literary Creation (2025), By Giuseppe Pezzini, Mitchell Kooh

Journal of Tolkien Research

Book review, by Mitchell Kooh, of Tolkien and the Mystery of Literary Creation (2025) by Giuseppe Pezzini

Humanizing Online Learning Through Culturally Responsive Pedagogy: Preserving Cultural Identity And Human Connection In Digital Spaces, Michael Mills

International Journal of Teaching and Learning in Higher Education

The rapid shift to online and hybrid learning environments has highlighted the need for culturally responsive pedagogical approaches in digital spaces. While much research has explored culturally responsive teaching in traditional classrooms, less attention has been paid to how these principles can be effectively translated to online learning environments. This article examines how culturally responsive pedagogy can be meaningfully integrated into online learning spaces through intentional course design, assessment practices, and community building. Drawing from existing literature on culturally responsive teaching, online learning, and digital equity, this paper provides a framework for educators to create more inclusive and culturally sustaining …

Enhancing Deep Learning And Workload Management In Online Education: The Power Of Scaffolded Weekly Assessments, Maryam Mohammad Zadeh, Rebecca Ferrari

International Journal of Teaching and Learning in Higher Education

This study investigates the use of scaffolded weekly assessments with individual feedback in promoting deep learning and managing workload among engineering students in online education. The research focuses on how these assessment strategies shape students’ learning approaches and workload distribution. The study involved the implementation of weekly assessments aligned with intended learning outcomes, complemented by personalized feedback. Data collection comprised student surveys and qualitative feedback to assess the impact on learning approaches and workload management. The qualitative results show that 91.9% of the students adopted deep learning, where only 8.1% engaging in surface learning. Students reported that this approach not …

Understanding Technology Integration Through Hermeneutic Interpretation: A Study Of Faculty Experiences At An Hbcu, Jill Ardley, Tamara Smith-Moyler, Keesha M. Kerns, Beatrice Darden-Woody, Priscilla Spencer, Ronald White

International Journal of Teaching and Learning in Higher Education

This study explores how six education faculty members in the School of Education at a Historically Black College and University (HBCU) in the southeastern United States interpret and implement instructional technology instruction through a hermeneutic theoretical lens. Grounded in the HBCU’s School of Education vision statement, the research investigates how faculty members’ understanding of human learning behaviors shapes their pedagogical choices within School of Education courses. The qualitative analysis revealed three key themes: (1) Technology as a Tool for Equity and Inclusion, (2) Alignment with the School of Education Vision, and (3) Student-Centered, Practice-Oriented Use of Technology. Rather than employing …

Doctoral Students’ Perceived Academic Research Reading Ability: A Mixed-Methods Study, Ryan Glaman

International Journal of Teaching and Learning in Higher Education

Empirical research is useful for informing educational policy and practice. However, doctoral students often struggle with reading and evaluating empirical research papers. The present study examined doctoral students’ perceptions of their ability to read and evaluate empirical research articles, both before and after an educational research methods course, as well as which course components students perceived as most impacting their ability to read and evaluate research articles. The study used a convergent mixed methods design, involving pre- and post-course survey data. Results indicated students felt they improved in their experience levels, comfort levels, interpretation ability, and evaluation ability regarding reading …

The Legal Framework For Consumer Protection: Comparative Aspects, Lamya Bassime

Revue Marocaine de Droit, d'Economie et de Gestion (Moroccan Journal of Law, Economics and Management)

This contribution defines the consumer–professional relationship and reviews the main legal tools designed to protect consumers. Using a comparative perspective, it highlights convergences and differences in consumer protection approaches and the influence of marketing practices.

Consumer Protection In Contractual Relations, Aboubakr Mohim

Revue Marocaine de Droit, d'Economie et de Gestion (Moroccan Journal of Law, Economics and Management)

Focusing on contracts between professionals and consumers, this paper highlights the imbalance of information and bargaining power that often harms consumers. It emphasizes the need for good faith, transparency and mechanisms that restore contractual balance and protect informed consent.

Engaging Asl-English Interpreting Undergraduates In Research: A Model For Student Engagement And Faculty Productivity, Kimberly J. Hale, Valerie Freeman

Journal of Interpretation

Engaging undergraduate ASL-English interpreting students in research yields multiple benefits beyond enhancing faculty scholarly productivity. In this innovative practices article, we first summarize scholarly literature showing that including undergraduates in research experiences supports development of career-readiness skills while simultaneously building the pipeline of future faculty. We then discuss the benefits of undergraduate research experiences and argue that research activities can be integrated throughout an interpreter education program curriculum. Using a detailed description of a course-based undergraduate research experience (CURE) and course-embedded project examples, we demonstrate how structured research experiences can be integrated into programs without creating additional burden for faculty …

The Effects Of A Nurse-Led Peace Program On Perceived Peaceful End-Of-Life And Quality Of Life Among Head And Neck Cancer Patients Undergoing Concurrent Chemoradiation, Sirinya Pimvichai, Yaowarat Matchim, Tanadej Sinthusake, Kiratiya Wongkalasin

Journal of Health Research

Background: Evidence indicates that peaceful end-of-life care programs benefit terminally ill patients, with nurses playing a central role in program delivery. However, no structured end-of-life care programs currently exist for patients with head and neck cancer (HNC), who often experience profound physical and psychological distress. A nurse-led Peaceful End-of-Life Care (PEACE) program was therefore developed. This study aimed to evaluate the effects of the PEACE program on perceived peaceful end-of-life (PEOL) and quality of life (QoL) among HNC patients undergoing concurrent chemoradiotherapy (CCRT).

Methods: A quasi-experimental, two-group time-series design was conducted with 64 HNC patients recruited from oncology wards at …

Preventive Health Behaviors Among Vegetable Farmers In Indonesia: An Application Of The Extended Theory Of Planned Behavior, Aria Gusti, Wira Iqbal, Fitrahul Afifah

Journal of Health Research

Background: Farmers in low- and middle-income countries face serious occupational and environmental health risks, including pesticide exposure, musculoskeletal disorders, and skin diseases. In Indonesia, limited evidence exists on the psychosocial factors that shape preventive health behaviors, hindering the design of effective interventions. This study applies an extended Theory of Planned Behavior (TPB) framework to analyze preventive practices among vegetable farmers.

Methods: A cross-sectional survey was conducted among 254 vegetable farmers in Koto Laweh Village, West Sumatra, Indonesia, during July–August 2025. Data were collected using a validated TPB-based questionnaire and analyzed with Partial Least Squares Structural Equation Modelling (PLS-SEM).

Results: Knowledge …

The Shocking Case Of A Bleeding Heart, Muhammad Ijaz Khan, Samra Israr, Muhammad Haris Khan, Nadim Jaafar, Rahul Sharma, Shilpi Ahmed

Journal of Community Hospital Internal Medicine Perspectives

Hemopericardium is a rare but life-threatening complication of anticoagulation therapy. Although bleeding complications are well documented with direct oral anticoagulants (DOACs), apixaban-induced hemopericardium is exceedingly rare. We report a case of a 56-year-old female with multiple comorbidities, including end-stage renal disease (ESRD) on hemodialysis, paroxysmal atrial fibrillation, cerebral vascular accident with residual right-sided weakness, and coronary artery disease, who presented with progressive dyspnea over two months. Imaging revealed a massive pericardial effusion without tamponade Physiology. Despite initial conservative measures, the patient developed hemodynamic instability following fluid removal during dialysis, necessitating urgent pericardiocentesis, which drained 1560 mL of hemorrhagic fluid. Pericardial …

Hidden Malignancy: Ileocecal Intussusception As An Atypical First Presentation Of Diffuse Large B-Cell Lymphoma In Adulthood, Komal Harisinghani, Parth Adrejiya, Mohammad Abubaker, Oluchi Idenyi, Raman Babayeuski, Noor Qureshi, Ashok Kanugula, Sara Assaf, Daniel Assaf, Srikanth Maddika

Journal of Community Hospital Internal Medicine Perspectives

Intussusception is predominantly a pediatric condition, with only about 5% of all intussusception cases occurring in adults with primary intestinal lymphomas comprising 1%–4% of gastrointestinal malignancies, 90% of which are B-cell non-Hodgkin lymphomas (NHL). Diffuse large B-cell lymphoma (DLBCL), the most common subtype of NHL, often leads to intussusception without classical B symptoms. We present the case of a 33-year-old male with ileocolonic intussusception caused by a 4.8 × 5.3 × 5.5 cm enhancing mass. Histopathology and FISH confirmed DLBCL without MYC, BCL2, or BCL6 rearrangements, ruling out double- or triple-hit lymphoma. Following a right ileo-colectomy, R-CHOP(rituximab, cyclophosphamide, doxorubicin, vincristine, …

Disguised And Dangerous: A Case Of Cervicofacial Actinomycosis Presenting With Hemoptysis, Tharun Shyam, Shamanth M Reddy, Saumya Nanda, Yan Naing Tun, Rohan Pinto, Navjot Somal, Ravi Karan Patti

Journal of Community Hospital Internal Medicine Perspectives

Actinomycosis is a rare, chronic, suppurative bacterial infection caused by Actinomyces spp with an incidence of 0.3 cases per million people annually. The cervicofacial area is the most common site of infection and accounts for approximately 50 percent of all cases. Most cases of cervicofacial actinomycosis are odontogenic in origin.

Hemoptysis in the setting of actinomycosis commonly occurs from pulmonary involvement. Hemoptysis secondary to isolated cervicofacial actinomycosis has seldom been documented in literature. We hereby present a case of cervicofacial actinomycosis presenting with hemoptysis likely secondary to an oro-cervical fistula. We aim to highlight the challenges in diagnosis of this …

Losartan-Induced Angioedema: A Case Report And Review Of Literature, Leila C. Tou, Audrey Nourse, Rachel Cox, Spencer Stanford

Journal of Community Hospital Internal Medicine Perspectives

Angiotensin receptor blockers (ARBs) are frequently prescribed as alternatives to angiotensin-converting enzyme inhibitors (ACEIs), particularly in patients who experience ACEI-induced adverse effects including cough. Although ARBs are associated with a lower incidence of angioedema, rare cases have been reported in patients without prior ACEI exposure. Here, we describe a 58-year-old Black male who developed lip and facial swelling six months after starting losartan. His symptoms did not improve with antihistamines or corticosteroids but resolved after discontinuation of losartan, which was replaced with amlodipine without recurrence. This case emphasizes the need for clinician awareness of ARB-induced angioedema and the importance of …

Slipping Through The Chasm Of Multicenter Hand-Offs - Rare Incidence Of Nintedanib Induced Renal Failure: Case Report, Abid Mm, Khan Mi, Jain T, Daniel A, Flack T, Posner J

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Nintedanib, a receptor tyrosine kinase inhibitor (TKI), is approved for idiopathic pulmonary fibrosis (IPF). While its common adverse effects include gastrointestinal symptoms and elevated liver enzymes, renal toxicity is rare. We report a case of nintedanib-induced kidney failure. Case: An 82-year-old man with IPF and no prior kidney disease developed acute kidney injury (AKI), nephrotic-range proteinuria, volume overload, metabolic acidosis, and hyperkalemia 10 days after starting nintedanib. Extensive serologic investigations were unremarkable. Kidney biopsy showed acute tubular injury, minimal change disease (MCD), focal global glomerulosclerosis, and interstitial fibrosis. Nintedanib and other potential nephrotoxins were stopped, and the patient was …

A Comparison Of Biological Therapies Vs Traditional Immunosuppressant In The Management Of Inflammatory Bowel Diseases: A Narrative Review, Umme Farwah Tahir Dr, Sadaf Noureen, Fnu Partab, Muhammad Waqas Afzal, Maham Afzal, Asad Mehmood, Fatima Afzal, Kaynat Hasan, Fnu Sameeha, Seerat Riaz, Sumyya Tariq, Abida Perveen

Journal of Community Hospital Internal Medicine Perspectives

Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is a chronic immune-mediated condition requiring long-term management. Traditional immunosuppressants, such as corticosteroids, thiopurines, and methotrexate, have been widely used but are associated with broad immunosuppressive effects and significant adverse events. The advent of biological therapies, including tumor necrosis factor (TNF) inhibitors, integrin inhibitors, and interleukin (IL)-12/23 inhibitors, has revolutionized IBD treatment by offering targeted immune modulation. Biologics have demonstrated superior efficacy in achieving and maintaining remission compared to traditional immunosuppressants, particularly in moderate to severe IBD. They provide targeted immune suppression, reducing systemic side effects, but are associated with …