Digital Commons Network^™

Leadership Coaching: Enduring Lessons From Mythology, Raymond L. Forbes

All Faculty and Staff Scholarship

The juxtaposition of leadership coaching and mythology together in the same sentence is probably enough in itself to set traditionalists on edge. How could a look at the myths of cultures thousands of years old possibly benefit a leadership coach working in a modern, complex, technologically-oriented society? While much of the current literature on leadership coaching takes a non-historical, rational-empirical approach to the subject, a great deal of practical, useful insight can be gained from assessing lessons derived from mythology. The content of leadership coaching typically focuses on the resolution of professional and organizational issues in the present and on …

The Villainess Does Damage Control: Cultural Rescue In The Man Of Law’S Tale, Lucy Esplin

Criterion: A Journal of Literary Criticism

In the late fourteenth century, Geoffrey Chaucer wrote his masterwork, The Canterbury Tales, a satirical frame narrative centered on English society. The tales follow a group of pilgrims spanning a wide range of English society, who engage in a storytelling contest as they embark on their pilgrimage. One story is the “Man of Law’s Tale,” a crusader romance that follows the pious Constance in her missionary-like journeys. She first travels to Syria to marry a Sultan, after negotiations between the Roman and Syrian rulers demanded the Sultan be baptized and control over Jerusalem would be handed over to Christians (Chaucer …

Painted As Political: The Cultural Significance Within Zitkala-Ša’S Boarding School Narratives, Toni Aguiar

Criterion: A Journal of Literary Criticism

Zitkala-Ša was a Dakota writer, educator, and political activist who was and is widely influential within and outside of Native American communities during the twentieth century. As a child, Zitkala-Ša was sent to school at White's Indiana Manual Labor Institute, which spurred her writings in “School Days of an Indian Girl” recounting her experiences at the school and the struggles she faced. Though many scholars debate the activist choices she made in her later life as either pro or anti assimilation, some also extend this political criticism into her childhood experiences. My paper argues an alternative reading of these boarding …

“Viewed In Prospect Or Retrospect”: Dorothy Wordsworth’S “Revisiting” On The 1820 Continental Tour, Eve Dixon Fennimore

Criterion: A Journal of Literary Criticism

This paper argues that Dorothy Wordsworth, in her often overlooked Journal of a Tour on the Continent, was essentially “revisiting” places that she was viewing for the first time, as she had visited them secondhand through William's stories and writings about them. In 1820, Dorothy, William, and Mary Wordsworth embarked on a tour of the continent in the inverse direction of William’s youthful 1790 trip. For thirty years, Dorothy had heard stories and read about his experiences, building up an image in her mind of what the Continent would be like which changed her own exploration of the sights. …

Blake’S Green Symbols Of Humanity, Society, And Spirituality, Angela J. Heagy

Criterion: A Journal of Literary Criticism

William Blake is an exemplar of Romantic poetry characterized by depictions of the occult, the divine, and human nature. Despite Blake’s reputation as a Romantic poet, many critics claim that there is not sufficient evidence to consider him a nature writer. As a result, Blake’s name is frequently omitted from ecological discussions; some scholars go so far as to claim that Blake’s poetry demonstrates a disregard for nature altogether. This article argues that an eco-critical analysis of Blake’s Songs of Innocence and of Experience reveals nature to be Blake’s continual source of inspiration. Within this collection, nature represents the struggles …

Real-Time Analysis Of Photoplethysmogram And Electrocardiogram For Assessment Of Physiological Correlates Of Attention, Bryce Landen Gautney

Honors Capstone Projects and Theses

No abstract provided.

The Pocketperio Application Significantly Increases The Accuracy Of Diagnosing Periodontal Conditions In Didactic And Chairside Settings, Karo Parsegian, David K Okano, Sangeetha Chandrasekaran, Yoolim Kim, Tonia C Carter, Neel Shimpi, Sadaf Fadakar, Nikola Angelov

Faculty, Staff and Student Publications

The study aimed to determine the accuracy of diagnosing periodontal conditions using the developed web-based PocketPerio application and evaluate the user’s perspective on the use of PocketPerio. First, 22 third-year dental students (DS3) diagnosed ten cases without PocketPerio (control) and with PocketPerio (test) during a mock examination. Then, 105 DS3, 13 fourth-year dental students (DS4), and 32 senior second-year International Standing Program students (ISP2) used PocketPerio chairside. Statistical analysis was performed using a non-parametric paired two-tailed test of significance with the Wilcoxon matched-pairs signed rank test. The null hypothesis that PocketPerio did not increase the accuracy of periodontal diagnoses …

Genetic Variants For Head Size Share Genes And Pathways With Cancer, Maria J Knol, Raymond A Poot, Tavia E Evans, Claudia L Satizabal, Aniket Mishra, Muralidharan Sargurupremraj, Sandra Van Der Auwera, Marie-Gabrielle Duperron, Xueqiu Jian, Isabel C Hostettler, Dianne H K Van Dam-Nolen, Sander Lamballais, Mikolaj A Pawlak, Cora E Lewis, Amaia Carrion-Castillo, Theo G M Van Erp, Céline S Reinbold, Jean Shin, Markus Scholz, Asta K Håberg, Anders Kämpe, Gloria H Y Li, Reut Avinun, Joshua R Atkins, Fang-Chi Hsu, Alyssa R Amod, Max Lam, Ami Tsuchida, Mariël W A Teunissen, Nil Aygün, Yash Patel, Dan Liang, Alexa S Beiser, Frauke Beyer, Joshua C Bis, Daniel Bos, R Nick Bryan, Robin Bülow, Svenja Caspers, Gwenaëlle Catheline, Charlotte A M Cecil, Shareefa Dalvie, Jean-François Dartigues, Charles Decarli, Maria Enlund-Cerullo, Judith M Ford, Barbara Franke, Barry I Freedman, Nele Friedrich, Melissa J Green, Simon Haworth, Catherine Helmer, Per Hoffmann, Georg Homuth, M Kamran Ikram, Clifford R Jack, Neda Jahanshad, Christiane Jockwitz, Yoichiro Kamatani, Annchen R Knodt, Shuo Li, Keane Lim, W T Longstreth, Fabio Macciardi, Outi Mäkitie, Bernard Mazoyer, Sarah E Medland, Susumu Miyamoto, Susanne Moebus, Thomas H Mosley, Ryan Muetzel, Thomas W Mühleisen, Manabu Nagata, Soichiro Nakahara, Nicholette D Palmer, Zdenka Pausova, Adrian Preda, Yann Quidé, William R Reay, Gennady V Roshchupkin, Reinhold Schmidt, Pamela J Schreiner, Kazuya Setoh, Chin Yang Shapland, Stephen Sidney, Beate St Pourcain, Jason L Stein, Yasuharu Tabara, Alexander Teumer, Anne Uhlmann, Aad Van Der Lugt, Meike W Vernooij, David J Werring, B Gwen Windham, A Veronica Witte, Katharina Wittfeld, Qiong Yang, Kazumichi Yoshida, Han G Brunner, Quentin Le Grand, Kang Sim, Dan J Stein, Donald W Bowden, Murray J Cairns, Ahmad R Hariri, Ching-Lung Cheung, Sture Andersson, Arno Villringer, Tomas Paus, Sven Cichon, Vince D Calhoun, Fabrice Crivello, Lenore J Launer, Tonya White, Peter J Koudstaal, Henry Houlden, Myriam Fornage, Fumihiko Matsuda, Hans J Grabe, M Arfan Ikram, Stéphanie Debette, Paul M Thompson, Sudha Seshadri, Hieab H H Adams

Faculty, Staff and Student Publications

The size of the human head is highly heritable, but genetic drivers of its variation within the general population remain unmapped. We perform a genome-wide association study on head size (N = 80,890) and identify 67 genetic loci, of which 50 are novel. Neuroimaging studies show that 17 variants affect specific brain areas, but most have widespread effects. Gene set enrichment is observed for various cancers and the p53, Wnt, and ErbB signaling pathways. Genes harboring lead variants are enriched for macrocephaly syndrome genes (37-fold) and high-fidelity cancer genes (9-fold), which is not seen for human height variants. Head size …

Strategies To Rapidly Decommission Information Technology Satellites To Prevent Low Earth Orbit Space Debris, Nathaniel Richard Juarez

Walden Dissertations and Doctoral Studies

Information technology (IT) assets rely heavily on satellites in space, with most of them in low Earth orbit (LEO). There is a growing threat towards IT satellites in LEO and cybersecurity professionals must implement proactive measures through policy reform and hardening procedures to prevent cyberattacks. The Kessler syndrome will become existent if satellites start crashing into each other or space debris orbiting the Earth. Grounded in the integrated system theory of information security management, the purpose of this qualitative pragmatic inquiry was to explore strategies IT satellite managers in the space industry use to properly harden and rapidly decommission satellites …

Effective Strategies To Reduce Registered Nurse Turnover In Hospitals, Adrienne Cozart

Walden Dissertations and Doctoral Studies

Registered nurse (RN) turnover remains a problem for many healthcare organizations. Hospital nurse leaders are concerned with RN turnover because of its negative effect on the profitability of hospitals. Grounded in transformational leadership theory, the purpose of this qualitative multiple case study was to explore the strategies that hospital nurse leaders use to reduce RN turnover. The participants were four hospital nurse leaders who reduced RN turnover in two hospitals in Texas. Data were collected using semistructured interviews and a review of organizational documentation. Thematic analysis of the data resulted in three themes: turnover reduction strategies, barriers or challenges to …

Risk Factors For Hepatitis A Hospitalizations And Mortality In Kentucky's 2018 Hepatitis A Outbreak, Tanya Campbell

Walden Dissertations and Doctoral Studies

In 2018, the state of Kentucky faced an outbreak of Hepatitis A virus (HAV), which led to a significant increase in HAV cases, hospitalizations, and fatalities. The social-ecological model (SEM) was used in a cross-sectional design to identify the factors associated with this outbreak. This approach employed secondary data extracted from the National Notifiable Disease Surveillance System (NNDSS). Logistic regression was used to test hypotheses determining homelessness, drug use, and HAV vaccine status were related to HAV hospitalizations. There was a statistically significant association between the covariate age and HAV hospitalization (p = 0.004), and between homelessness and hospitalization (p < .001); however, associations between drug use and HAV vaccine status were not statistically. Intervention programs should target homeless populations; such targeting can lead to a reduction in HAV infections and HAV outbreaks. Implications for positive social change include motivation for policymakers and public health officials to assist in curtailing hospitalization and mortality rates caused by HAV in high-risk groups. Targeted prevention and intervention measures can mitigate the incidence of HAV in high-risk populations and enhance their health prospects.

The Experience Of Remediation For At-Risk, Pre-Licensure Baccalaureate Student Nurses, Nicole Jager

Walden Dissertations and Doctoral Studies

At-risk students face academic challenges that can affect nursing program progression. Remediation strategies can increase student success. The research problem addressed through this study is a lack of information surrounding the students' remediation experience in an at-risk, pre-licensure baccalaureate student nurse population. Individualizing remediation to the student population can increase success; however, the student perspective is needed to correctly identify and tailor the remediation activities to fit the students’ needs. The purpose of this descriptive qualitative study was to explore the experience of remediation among at-risk, pre-licensure baccalaureate student nurses. Mezirow's transformative learning theory grounded this study. The research design …

The Lived Spiritual Experience Of Aging Adults (≥65), Eddie Doron Soffer

Walden Dissertations and Doctoral Studies

This phenomenological study explored the lived spiritual experience of aging adults (≥65), filling a gap in the literature relating to aging people’s spirituality in a variety of circumstances. The once-American youth-oriented society is growing older at an unprecedented rate as 76 million individuals of the baby-boomer generation (born 1946–1964) face retirement age. This demographic shift highlights a social problem of millions of aging baby boomers requiring a far-reaching change in the structure of society. This qualitative study aimed to gain insights into the lived experience of the spirituality of a sample of nine adults aged 65 and above by asking …

Mental Health Clinicians’ Experiences Of Treatment Length With Incarcerated Men In Therapeutic Community Substance Abuse Treatment, Crystal D. Nelson

Walden Dissertations and Doctoral Studies

Over half of the incarcerated population suffer from a substance abuse disorder; however, less than 20% of those incarcerated have access to substance abuse treatment while incarcerated. In those facilities where substance abuse treatment is an option, pressures of overcrowding and financial constraints threaten the length of treatment programming offered to move more people through treatment quicker. Therapeutic communities (TCs) have been shown to be the best substance abuse treatment option for those who are incarcerated, but TCs were designed to be a phase-based program based on developmental changes and signs of growth through the program. The purpose of this …

Probation And Pre-Trial Officers' Perspectives On The Impact Of Maternal Incarceration On Children, Shaniqua Anderson

Walden Dissertations and Doctoral Studies

Because of the mass incarceration of women, maternal incarceration has become a phenomenon within itself. This phenomenon has led to an increase in Black children with an incarcerated mother; however, there is a lack of information about how the cycle of the mass incarceration of Black women is perceived on the community supervision level. The purpose of this qualitative phenomenological study was to better understand probation and pre-trial officers’ perceptions of how the maternal incarceration of Black women impacts Black children. Three research questions explored how participants viewed the impact of maternal incarceration on Black children, recidivism, and positive reentry. …

From Cypherpunks To Congress: A Historical Analysis Of The Development, Uses, And Regulatory Landscape Of Cryptocurrencies, Andrew Moore

Honors Theses

As cryptocurrencies have begun to proliferate through the economy policymakers are asking questions of where they came from, how do they work, what they are used for and how should we regulate the market. Through a historical analysis, it can be seen that Bitcoin represented a legitimate innovation in money and provided significant improvements to earlier attempts at private commodity currency. Additionally, many of the criticisms lobbied against Bitcoin appear to be overstated, most notably the claim that it is a good tool for criminals. However, there has been a notable split in the market. The emerging crypto industry bears …

Focal Adhesion Kinase-Yap Signaling Axis Drives Drug-Tolerant Persister Cells And Residual Disease In Lung Cancer, Franziska Haderk, Yu-Ting Chou, Lauren Cech, Celia Fernández-Méndez, Johnny Yu, Victor Olivas, Ismail M Meraz, Dora Barbosa Rabago, D Lucas Kerr, Carlos Gomez, David V Allegakoen, Juan Guan, Khyati N Shah, Kari A Herrington, Oghenekevwe M Gbenedio, Shigeki Nanjo, Mourad Majidi, Whitney Tamaki, Yashar K Pourmoghadam, Julia K Rotow, Caroline E Mccoach, Jonathan W Riess, J Silvio Gutkind, Tracy T Tang, Leonard Post, Bo Huang, Pilar Santisteban, Hani Goodarzi, Sourav Bandyopadhyay, Calvin J Kuo, Jeroen P Roose, Wei Wu, Collin M Blakely, Jack A Roth, Trever G Bivona

Faculty, Staff and Student Publications

Targeted therapy is effective in many tumor types including lung cancer, the leading cause of cancer mortality. Paradigm defining examples are targeted therapies directed against non-small cell lung cancer (NSCLC) subtypes with oncogenic alterations in EGFR, ALK and KRAS. The success of targeted therapy is limited by drug-tolerant persister cells (DTPs) which withstand and adapt to treatment and comprise the residual disease state that is typical during treatment with clinical targeted therapies. Here, we integrate studies in patient-derived and immunocompetent lung cancer models and clinical specimens obtained from patients on targeted therapy to uncover a focal adhesion kinase (FAK)-YAP signaling …

Towards Scalable Autonomous Underwater Construction With Free-Floating Robots, Samuel Eric Lensgraf

Dartmouth College Ph.D Dissertations

This thesis presents the first free-floating autonomous underwater construction system. Our system built structures weighing up to 100Kg (75Kg in water). Our robot builds structures made of standard cinder blocks and custom designed interlocking cement blocks. It is the first construction robot that uses active buoyancy compensation to efficiently transport building materials. It is also the first construction robot that can reconfigure visual fiducial markers on a foundation during the construction process to expand its working area.

Underwater construction is a challenging problem for free-floating robots. Currents can buffet the robot, and visibility conditions can change. We focus on achieving …

Sga 55 Senate 2024-05-03 Minutes, Niu Student Government Association Senate

Student Government Association Archives

No abstract provided.

Using Student Interests To Explore Inclusion In Undergraduate Chemistry, Sonja Hoversten

CSB and SJU Distinguished Thesis

For students who are not chemistry majors, but who are on a career track requiring four chemistry courses, taking the final reactivity chemistry course (CHEM 251) for pre-health students can be daunting. For this reason, this research is focused on the CHEM 251 course at The College of Saint Benedict and Saint John’s University (CSBSJU) which is one of the four required chemistry courses for pre-medicine and some pre-physician assistant students, and all chemistry and biochemistry majors. Student perception of inclusion in the course increased through the implementation of group assignments including prompts for individual application of the material. The …

A Mceliece Cryptosystem, Using Permutation Error-Correcting Codes, Fiona Smith

CSB and SJU Distinguished Thesis

Using existing methods of cryptography, we can encrypt messages through the internet. However, these methods are vulnerable to attacks done by a quantum computer, which are a rising threat to security. In this thesis I discuss a possible method of encryption, secure against quantum attacks, using permutation groups and coding theory.

Representations Of Gender In Math-Related Films, Jacob Gathje

CSB and SJU Distinguished Thesis

This project analyzes how four popular math-related films - Hidden Figures, Mean Girls, Good Will Hunting, and A Beautiful Mind - either follow, resist, or reconfigure gender stereotypes in mathematics. It includes close readings of specific scenes in each of the films, along with broader analysis of the effects of how women and men are represented differently. It concludes forward-looking focus, providing suggestions for how future math-related movies can depict a more realistic and inclusive version of the field of mathematics. Ideally, this will help improve one part of the larger issue of gender disparities in math.

The Association Of Discrimination And Coping Style On Cardiovascular Health Among South Asian Individuals In The Masala Study, Raji Pillai

Dissertations and Theses (Open Access)

Objectives: South Asian individuals (SAs) are found to have a heightened state of inflammation contributing to increased cardiovascular disease (CVD). Additionally, social determinants like discrimination are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether an association between discrimination and self-rated health (SRH) is moderated by coping styles among SAs living in the United States to inform effective coping strategies against discrimination.

Design: This secondary data analysis used data from 1164 SAs (mean age = 57 years, SD 9.4, 48% women) enrolled in the Mediators of Atherosclerosis in South Asians …

We Can Do It! But Should We? Reflecting On Projects And Priorities, Claire Du Laney Dunker, Wendy Guerra, Amy Schindler, Lori Schwartz

Criss Library Faculty Proceedings & Presentations

What happens when you combine archivists and non-archivists with good intentions, unprocessed collections, institutional push to seek grants, competing pressures and deadlines? At the University of Nebraska at Omaha Archives and Special Collections, this familiar scenario occurred during a period focused on prioritizing Latinx collections including personal papers, Office of Latino and Latin American Studies Records, and oral histories. During our presentation, we will share how archivists attempted to wrangle multiple funding streams to meet processing, outreach, and digitization goals while internal and external forces took a toll. These included stakeholder expectations, the complexities of student employment, campus events, and …

Comparison Of The Fluorescence Of Bulk Cadmium Sulfide And Cadmium Sulfide Nanoparticles, Jacob Goranson

Celebrating Scholarship and Creativity Day (2018-)

The fluorescence of bulk cadmium sulfide and cadmium sulfide nanoparticles were compared. This was done using an 800-nm, unamplified Ti:sapphire laser producing 50-fs pulses. The pulses were frequency doubled using a beta barium borate (BBO) crystal. The 400-nm beam was used to induce fluorescence in the nanoparticles, while the original 800-nm beam was used to induce fluorescence in the bulk CdS by two-photon absorption. The bulk CdS showed a single fluorescent peak at 523 nm. The nanoparticles showed fluorescence at various wavelengths across the visible spectrum. In general, the nanoparticles showed a broad fluorescent spectrum between 500 nm and 750 …

Treatment Outcomes In Patients With Metastatic Renal Cell Carcinoma With Sarcomatoid And/Or Rhabdoid Dedifferentiation After Progression On Immune Checkpoint Therapy, Andrew W Hahn, Devaki Shilpa Surasi, Paul V Viscuse, Tharakeswara K Bathala, Andrew J Wiele, Matthew T Campbell, Amado J Zurita, Amishi Y Shah, Eric Jonasch, Jianjun Gao, Sangeeta Goswami, Omar Alhalabi, Priya Rao, Kanishka Sircar, Nizar M Tannir, Pavlos Msaouel

Faculty, Staff and Student Publications

BACKGROUND: Metastatic RCC with sarcomatoid and/or rhabdoid (S/R) dedifferentiation is an aggressive disease associated with improved response to immune checkpoint therapy (ICT). The outcomes of patients treated with VEGFR-targeted therapies (TT) following ICT progression have not been investigated.

PATIENTS AND METHODS: Retrospective review of 57 patients with sarcomatoid (S), rhabdoid (R), or sarcomatoid plus rhabdoid (S + R) dedifferentiation who received any TT after progression on ICT at an academic cancer center. Clinical endpoints of interest included time on TT, overall survival (OS) from initiation of TT, and objective response rate (ORR) by RECIST version 1.1. Multivariable models adjusted for …

Triggering Receptor Expressed On Myeloid Cells 2 (Trem2) Regulates Phagocytosis In Glioblastoma, Mekenzie M Peshoff, Pravesh Gupta, Shivangi Oberai, Rakesh Trivedi, Hiroshi Katayama, Prashanth Chakrapani, Minghao Dang, Simona Migliozzi, Joy Gumin, Divya B Kadri, Jessica K Lin, Nancy K Milam, Mark E Maynard, Brian D Vaillant, Brittany Parker-Kerrigan, Frederick F Lang, Jason T Huse, Antonio Iavarone, Linghua Wang, Karen Clise-Dwyer, Krishna P Bhat

Faculty, Staff and Student Publications

Background: Glioblastomas (GBMs) are central nervous system tumors that resist standard-of-care interventions and even immune checkpoint blockade. Myeloid cells in the tumor microenvironment can contribute to GBM progression; therefore, emerging immunotherapeutic approaches include reprogramming these cells to achieve desirable antitumor activity. Triggering receptor expressed on myeloid cells 2 (TREM2) is a myeloid signaling regulator that has been implicated in a variety of cancers and neurological diseases with contrasting functions, but its role in GBM immunopathology and progression is still under investigation.

Methods: Our reverse translational investigations leveraged single-cell RNA sequencing and cytometry of human gliomas to characterize TREM2 expression across …

Autologous Bone Marrow Mononuclear Cells To Treat Severe Traumatic Brain Injury In Children, Charles S Cox, David M Notrica, Jenifer Juranek, Jeffrey H Miller, Fabio Triolo, Steven Kosmach, Sean I Savitz, P David Adelson, Claudia Pedroza, Scott D Olson, Michael C Scott, Akshita Kumar, Benjamin M Aertker, Henry W Caplan, Margaret L Jackson, Brijesh S Gill, Robert A Hetz, Michael S Lavoie, Linda Ewing-Cobbs

Faculty, Staff and Student Publications

Autologous bone marrow mononuclear cells (BMMNCs) infused after severe traumatic brain injury have shown promise for treating the injury. We evaluated their impact in children, particularly their hypothesized ability to preserve the blood–brain barrier and diminish neuroinflammation, leading to structural CNS preservation with improved outcomes.

We performed a randomized, double-blind, placebo-sham-controlled Bayesian dose-escalation clinical trial at two children's hospitals in Houston, TX and Phoenix, AZ, USA (NCT01851083). Patients 5–17 years of age with severe traumatic brain injury (Glasgow Coma Scale score ≤ 8) were randomized to BMMNC or placebo (3:2). Bone marrow harvest, cell isolation and infusion were …

Euglycemic Dka: Commonly Missed Diagnosis, Atulya A. Khosla, Pawan Gyawali, Twahida Khatoon

Conference Presentation Abstracts

No abstract provided.

Non-Immune Hemolytic Anemia In The Setting Of Alcohol-Associated Hepatitis: Zieve's Syndrome, Morgan Kiryakoza, Nazli Begum Ozturk, Justin Skrzynski

Conference Presentation Abstracts

Introduction: Zieve’s syndrome describes a triad of non-immune hemolytic anemia, jaundice, and transient hyperlipidemia found in patients with alcohol-use disorder/alcohol-associated liver disease. This case involves a 39-year-old female with suspected Zieve’s syndrome in the setting of severe alcohol-associated hepatitis. Case Description: A 39-year-old female with alcohol-use disorder presented to the emergency department with complaints of jaundice, lethargy, and confusion. On initial presentation, patient was anemic with a hemoglobin of 7.8 g/dL (12.1- 15.0 g/dL), ALP of 235 U/L (33-120 U/L), AST of 116 U/L (< 35 U/L), ALT of 41 (< 37 U/L) total bilirubin of 24.2 mg/dL (< 1.2mg/dL), direct bilirubin of >15 mg/dL (< 0.4mg/dL). Her blood alcohol level was negative. She was admitted due to concerns for alcohol-associated hepatitis. Her hospital course was complicated by frequent declines in hemoglobin requiring a total of six transfusions of packed red blood cells. No overt bleeding such as hematemesis or hematochezia was ever evident during these declines. Further hematologic workup revealed a normal glucose 6 phosphate dehydrogenase (G6PD), normal pyruvate kinase, elevated plasma hemoglobin of 150 mg/dL (< 30 mg/dL), decreased haptoglobin of < 8 mg/dL (40-250 mg/dL), and elevated lactate dehydrogenase (LDH) of 595 (100-240 U/L), elevated reticulocyte count of 213 bil/L (21-100 bil/L). Direct Coombs Test was negative. The combination of these labs illustrated a picture of non-immune hemolytic anemia. Patient’s course was further complicated by a persistent rise in her total bilirubin, eventually peaking at 30.6 mg/dL, and ascites which required paracentesis and fluid studies was consistent with spontaneous bacterial peritonitis (SBP). Given the presence of SBP, corticosteroid therapy was not initiated for alcohol-associated hepatitis. Lipid panel remained within normal limits on two separate occasions. Vitamin E level was < 2.5 mg/L (5.5 – 17.0 mg/L). During hospitalization, she tested positive for Influenza A H1N1, developed acute hypoxic respiratory failure, was intubated, and was transferred to the intensive care unit and later extubated. Her mental status during her hospital stay was frequently waxing and waning and never fully recovered. The patient was eventually discharged home with hospice and her hemoglobin levels remained stable after supportive blood transfusions during her stay. Discussion: Zieve’s syndrome is an underdiagnosed cause of anemia in patients with alcohol-associated liver disease. There are multiple proposed mechanisms to explain the pathophysiology behind the red cell lysis seen in this disorder. One leading hypothesis suggests the red cell membrane becomes unstable due to vitamin E deficiency leading to disordered pyruvate kinase. Importance of early recognition of this syndrome is essential as treatment revolves around strict abstinence from alcohol.