Medicine and Health Sciences Commons^™

Prephiral Bacterial Infectious Agent Triggers Neuroinflammatory Responses And Neurobehavioral Impairment In Wild-Type Mice, Hadeer Atalah

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's and Parkinson's, present an increasing global challenge, with chronic neuroinflammation identified as a principal factor alongside genetic, environmental, and infectious influences (Boyd et al., 2022).  Epidemiological data associate bacterial infections with a 40% heightened risk of Parkinson's disease; however, the mechanisms—especially the direct connection between peripheral sepsis and the silent onset of central nervous system pathology absent acute meningitis—are inadequately investigated (Smeyne et al., 2021), particularly concerning common pathogens like Klebsiella pneumoniae in high-burden areas such as Egyptian ICUs, where it constitutes 30% of cases (Alkompoz et al., 2023). This study filled the gap by creating …

A Damaging Mutation In Col6a3 Alters The Mechanobiologic Response Of Chondrocytes Derived From Human Induced Pluripotent Stem Cells, Zainab Harissa, Niek Bloks, Nancy Steward, Sara F Tufa, Douglas R Keene, Yolande F M Ramos, Ingrid Meulenbelt, Farshid Guilak

2020-Current year OA Pubs

Osteoarthritis (OA) is a complex disease associated with genetic, biological, and mechanical risk factors that act, in part, to alter chondrocyte homeostasis. Our recent exome sequencing studies identified a damaging genetic variant in COL6A3, a monomeric unit of collagen type VI and a distinguishing component of the pericellular matrix (PCM) of articular cartilage, a transducer of mechanical and biochemical signals for the chondrocyte. To study the effect of this genetic variant, human induced pluripotent stem cell (hiPSC)-derived chondrocytes, genetically edited to harbor the COL6A3 mutation, were used as an in vitro model to investigate chondrocyte mechanobiology and pathobiology. The COL6A3 …

Quality Improvement Project: Impact Of Evidence-Based Self-Care Practice On Burnout In Nursing Faculty, Lori Boyd

Doctor of Nursing Practice Projects

Nursing faculty burnout is a national concern supported by literature, which compromises faculty well-being, creativity, retention, and sustainability of nursing programs. Burnout is characterized by the subscales of emotional exhaustion, depersonalization, and feelings of reduced personal accomplishment. At the project site, leaders reported that faculty often left their roles due to increased workload and being overwhelmed by the rigorous expectations of the role, underscoring the need for a process to support nursing faculty burnout. This quality improvement (QI) project aimed to evaluate the impact of evidence-based self-care practices on nursing faculty burnout using Maslach's Burnout Inventory Toolkit, a valid and …

Feasibility And Form Factor Validation Of Reflective Shoulder-Mounted Pulse Oximeter In Patients With Suspected Sleep Apnea, Katie N. Kanter, Aaron Wang, David Gordon, Adina Singer, Jacob S. Brenner, Indira Gurubhagavatula, Anush Lingamoorthy, Olumuyiwa Oni, Cameron M. Baston

SKMC Student Presentations and Publications

The shoulder may be an effective central site for continuous oxygen saturation (SpO2) monitoring but studies of shoulder-mounted pulse oximetry technology are limited. We hypothesized that an alternative location would be similar in function and user acceptance to a standard FDA-cleared finger-based pulse oximeter. We conducted a quantitative and descriptive pilot study of two prototype biosensor designs in patients with clinical suspicion of hypoxic episodes at an outpatient sleep center. Participants wore two prototype biosensors-the primary a shoulder-mounted adhesive and the secondary a combination ring-bracelet-in addition to a control FDA-approved finger-based pulse oximeter. We assessed the comfort of the devices …

Evaluating Website Resources Shared Online Amongst Women With Intimate Partner Violence Experiences: Analysis Of An Online Health Community, Vivian Hui, Lidan Tian, Malavika Eby, Bohan Zhang, Rose E. Constantino

SKMC Student Presentations and Publications

INTRODUCTION: Intimate partner violence (IPV) affects around one in four women globally, posing substantial health risks. IPV survivors often consult online health communities for anonymous assistance rather than formal services. Though online health community members frequently share websites to answer questions, no studies have investigated the characteristics and relevance of websites shared in IPV online health communities. This study aims to identify the categories of websites shared in IPV online health communities and evaluate associations between post characteristics and website relevance to survivors' help-seeking needs.

METHODS: Data were extracted from posts and comments on the r/domesticviolence, a subreddit (topic-specific community) …

Evolving Strategies In Prostate Cancer: Emerging Approaches And Unmet Needs From The Bridging The Gaps In Prostate Cancer Expert Panel, Rana Mckay, Benjamin Maughan, Alicia Morgans, Neal Shore, Evan Yu, Ravi Madan, Jacob Berchuck, Bradley Carthon, Steven Finkelstein, Leonard Gomella, Michael Gorin, Andrew Hahn, Stacy Loeb, Vivek Narayan, Daniel Petrylak, Charles Ryan, Karine Tawagi, Phuoc Tran, Tanya Dorff

Department of Urology Faculty Papers

BACKGROUND: The expansion of treatment options for prostate cancer (PC) has improved disease-specific and overall survival outcomes but has also raised questions about the optimal level of treatment needed for patients based on their individual prognosis and accounting for potential toxicity, incorporating quality of life considerations.

METHODS: A panel of experts met to discuss current controversies in the care of patients with PC across the disease continuum. Multidisciplinary experts review advances and persistent uncertainties in biomarker-guided assessment, imaging, and systemic therapy for prostate cancer. The discussion outlines priority gaps in evidence that must be addressed to optimize individualized patient care. …

Optimizing Electrode Placement And Information Capacity For Local Field Potentials In Cortex, Jace A Willis, Christopher E Wright, Ruoqian Zhu, Yilan Ruan, Joshua Stallings, Amada M Abrego, Takfarinas Medani, Promit Moitra, Arjun Ramakrishnan, Charles E Schroeder, Anand A Joshi, Nitin Tandon, Richard M Leahy, John C Mosher, John P Seymour

Faculty, Staff and Student Publications

Recent neurosurgery advancements include improved stereotactic targeting and increased density and specificity of electrophysiological evaluation. This study introduces a subject-specific, in silico modeling tool for optimizing electrode placement and maximizing coverage with a variety of devices. The basis for optimization is the Shannon-Hartley information capacity of field potentials derived from dipolar sources. The approach integrates subject-specific MRI data with finite element modeling (FEM) used to simulate the sensitivity of subdural and intracortical devices. Sensitivity maps, or lead fields, from these models enable the comparison of different electrode placements, contact sizes, contact configurations, and substrate properties, which are often overlooked factors. …

Self-Medication And Pharmaceutical Dispensing In Egypt: Practices, Policies, And Regulatory Challenges, Lobna Fawzy Ali Shaheen

Theses and Dissertations

Access to safe and appropriate medications is a critical component of public health, particularly in low- and middle-income countries. In Egypt, self-medication and informal pharmaceutical dispensing have become deeply embedded practices shaped by systemic, economic, and cultural factors. This research explores the complex interplay between self-medication behaviors, pharmaceutical regulation, and healthcare access in Egypt. Through qualitative interviews with policymakers, pharmacists, physicians, industry professionals, and citizens, the research uncovers widespread informal dispensing of prescription-only medicines, driven by high out-of-pocket costs, limited insurance coverage, and high public reliance on pharmacists as primary care providers. Despite the presence of regulatory frameworks, weak enforcement, …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Facebook Interaction As A Potential Marker Of Cognitive Decline: Pilot Study, Esraa M. Qansuwa

Theses and Dissertations

One of the critical challenges in brain disorder research is the early identification of individuals with mild cognitive impairment (MCI) who may later develop Alzheimer’s disease (AD) or other dementias. MCI in older adults is frequently associated with diminished social engagement and observable behavioral changes. With the rapid expansion of social media platforms and advances in Machine Learning (ML), digital traces from online activity present a novel and scalable avenue for mental health screening. In particular, predictive ML approaches have demonstrated strong potential in building reliable classifiers for early detection of neurocognitive decline. This study introduces an innovative framework that …

Perceptions Of Healthcare Access Barriers Among Eritrean, Sudanese, And Somali Refugees And Asylum Seekers In Cairo., Ayan Musa Mohamed

Theses and Dissertations

As the world witnesses an increase in different displacements of individuals for various reasons, ranging from wars, civil conflicts, human rights violations, and natural disasters, refugees and asylum seekers, who are among those forcibly displaced, continue to face challenges in access to health care services in host countries. The topic of barriers to health care has been widely researched, with a large body of literature on refugees' interactions with health care systems. However, there is limited literature on the perceptions of Eritrean, Sudanese, and Somali refugees and asylum seekers' experience with healthcare access in host countries. Therefore, this thesis aims …

Hubungan Marketing Mix Dan Hospital Brand Image Dengan Minat Kunjungan Ulang Pasien Di Rsi Sultan Agung Banjarbaru, Fitriani Fitriani, M. Noor Ifansyah, Zubaidah Zubaidah

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospitals are required to provide high-quality services to increase patient visits. Over the past six months, RSI Sultan Agung Banjarbaru has experienced a decline in the number of patient visits. This study aimed to analyze the relationship between the marketing mix and hospital brand image with revisit intention. The study employed a correlational analytic design, involving an outpatient population of 107,146 patients. A total of 100 respondents were selected using purposive sampling, and data were collected through questionnaires. Data analysis was conducted using the Spearman’s Rho test. The results showed that the marketing mix and hospital brand image variables were …

Epigenetic Age Acceleration In Young Adults With Congenital Heart Disease, Parag N Jain, Beryl C Zhuang, Joanne Whitehead, Julia L Macisaac, Kristy Dever, Mallory Gahm, Peter Ermis, Thomas W Mcdade, Michael S Kobor, Paul A Checchia

Faculty, Staff and Students Publications

Background: Adults with congenital heart disease (ACHD) having undergone palliative surgery experience chronic stress due to altered physiology and repeated surgical interventions since infancy.

Objectives: To investigate whether ACHD, who had experienced chronic physiological stress from their underlying condition and early-life cardiac surgeries, was associated with epigenetic age acceleration (EAA) and other DNA methylation (DNAm)-based biomarkers, and to assess the potential contribution of derived inflammatory markers to EAA.

Methods: A case-control study comparing ACHD patients and healthy adults. Whole blood DNAm profile was used to estimate DNAm-based blood cell type proportions, multiple epigenetic age measures, and interleukin-6 (IL-6) and C-reactive …

P-15 Peptide Enhanced Bone Graft In Transforaminal Lumbar Interbody Fusion: A Randomized, Controlled, Investigational Device Exemption Study Demonstrating Improved Composite Clinical Success, James Harrop, John E. O'Toole, Michael P. Steinmetz, Rick C. Sasso, Christopher D. Chaput, K. Brandon Strenge, Greg Maislin, Jeffrey P. Mullin, Thomas B. Freeman, Anthony Guanciale, Howard Lantner, Michael E. Janssen, David G. Schwartz, John M. Small, Wellington K. Hsu, Paul M. Arnold

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Prospective, multicenter, single-blind, randomized, controlled pivotal study.

OBJECTIVE: To evaluate whether P-15L (PearlMatrix P-15 Peptide Enhanced Bone Graft) is noninferior in effectiveness to local autograft when applied in single-level instrumented transforaminal lumbar interbody fusion (TLIF).

SUMMARY OF BACKGROUND DATA: P-15L, an FDA-designated Breakthrough Drug-Device, is a composite drug-device combination bone graft containing P-15, a 15-amino acid polypeptide, which enhances cell binding, proliferation, and differentiation, resulting in bone formation.

MATERIALS AND METHODS: Skeletally mature patients, aged 22 to 80 years, with degenerative disc disease (DDD) were randomized 1:1 to P-15L (investigational) or to the local autograft (control) during single-level …

Clinical, Genetic, And Familial Features Of Pot1 Tumor Predisposition Syndrome, Courtney D Dinardo, Jennifer Croden, Hiam M Abdel-Salam, Tapan Kadia, Matteo Molica, Alexandre Bazinet, Prithviraj Bose, Abhishek Maiti, Fadi Haddad, Jan Burger, Hagop Kantarjian, William Wierda, Nitin Jain, Alessandra Ferrajoli

Faculty, Staff and Student Publications

Background: Protection of telomere 1 (POT1) tumor predisposition syndrome (POT1-TPD) is a hereditary leukemia syndrome that is identified in ∼5% of patients with chronic lymphocytic leukemia (CLL) and is characterized by a predisposition to other cancers, including gliomas, melanomas, and angiosarcomas. This study reports clinical and genetic characteristics of a large cohort of individuals with POT1-TPD.

Materials and methods: Individuals with pathogenic/likely pathogenic germline POT1 variants referred to the Hereditary Hematologic Malignancy Clinic at The University of Texas MD Anderson Cancer Center were included. Individuals with variants of uncertain significance were included if found to have telomeres >90th percentile of …

Control Arm Overperformance In Phase 3 Oncology Clinical Trials, Ansel P Nalin, Pavlos Msaouel, Adam J Grippin, Ramez Kouzy, Joseph Abi Jaoude, Timothy A Lin, Avital M Miller, Noah S Meimoun, Ethan B Ludmir, Alexander D Sherry

Faculty, Staff and Student Publications

Background: In randomized clinical trials (RCTs), anticipating control arm outcomes is important for power calculations and enrollment goals. Unexpected overperformance of the control arm can underpower RCTs. The objective of this study was to estimate the prevalence of control arm overperformance in phase 3 oncology RCTs.

Methods: The authors conducted a meta-epidemiological study of two-arm, superiority-design, phase 3 oncology RCTs. They reviewed articles/publications and protocols for power calculations, justification, and outcomes. Control arm performance was measured as the ratio of observed control arm outcomes relative to pretrial estimates, and overperformance was defined as a 10% improvement.

Results: In total, 385 …

Antidepressant Use In Older Age Bipolar Disorder (Oabd): Results From The Gage-Bd International Consortium, Christina Rigas, Paola Lavin, P J Chen, Susana G Torres-Platas, Chien-Lin Su, Lisa T Eyler, Andrew T Olagunju, Antonio L Teixeira, Annemieke Dols, Martin Alda, Osvaldo P Almeida, Kursat Altinbas, Vicent Balanzá-Martínez, Izabela G Barbosa, Hilary P Blumberg, Farren B S Briggs, Cynthia V Calkin, Brent P Forester, Orestes V Forlenza, Tomas Hajek, Barthomeus C M Haarman, Esther Jimenez, Beny Lafer, Benoit Mulsant, Stephen O Oluwaniyi, Regan Patrick, Joaquim Radua, Kaylee Sarna, Sigfried Schouws, Christian Simhandl, Jair C Soares, Ashley N Sutherland, Shang-Ying Tsai, Eduard Vieta, Luca M Villa, Nicole Fiorelli, Paula Villela Nunes, Joy M Yala, Martha Sajatovic, Soham Rej, All Gage-Bd Investigators

Faculty, Staff and Student Publications

Background: Antidepressants are still commonly prescribed in bipolar disorders, despite ongoing controversy of the potential risk of inducing hypomania/mania. There is limited knowledge about the characteristics of antidepressant use in older age bipolar disorder (OABD; age ≥50) in the current literature.

Aim: To describe antidepressant use, sociodemographic and clinical correlates of a global sample of OABD individuals.

Methods: The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) consortium provided cross-sectional international data on OABD individuals (n = 746) and younger-age bipolar disorder (YABD, age < 50 years; n = 692) regarding antidepressant use. Multivariate logistic regression was employed to assess the association between AD use with demographic and clinical variables.

Results: Of 1252 participants, 33.1 % of OABD individuals and 38.1 % of YABD individuals …

Efektivitas Pertemuan Tim Multidisiplin Dalam Meningkatkan Outcome Tata Laksana Kanker Di Rumah Sakit: Literature Review, Ngakan Putu Daksa Ganapati, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Optimal cancer management requires a multidisciplinary approach to improve the quality of patient care. Multidisciplinary teams (MDTs) enable interprofessional collaboration in designing comprehensive, patient-centered care. However, the implementation of MDTs in Indonesia still faces various challenges, necessitating a systematic review to understand their effectiveness in improving cancer management outcomes. This systematic review employed the PRISMA method, searching articles from the ScienceDirect, Semantic Scholar, and PubMed databases, published between 2014 and 2024. Ten scientific articles were analyzed from 745 articles retrieved to understand the effectiveness of MDTs in improving cancer management outcomes. The results indicate that MDTs improve the quality of …

Investigating Tau Pathology In The Retina And Anterior Segment Structures Of The Eye In A 3-Nitropropionic Acid–Induced Tauopathy Mouse Model, Mohamed Sayed Ahmed Abdel-Kader Qasem

Theses and Dissertations

Background and Objectives: Alzheimer's disease, the most prevalent neurodegenerative disorder in older adults, is characterized by accumulation of hyperphosphorylated tau and amyloid-beta (Aβ) plaques in the central nervous system. Given the retina's shared embryological origin with the brain, its direct neural connectivity via the optic nerve, and similarities in vasculature and age-related degeneration patterns, retinal pathology may serve as an early, non-invasive biomarker for Alzheimer's disease. This study employed 3-nitropropionic acid (3NP) as a pathway-specific tauopathy model driven by mitochondrial dysfunction. The study particularly aimed to investigate whether retinal and corneal tau pathology reflects underlying tau-related neurodegeneration triggered by …

Uncovering Potential Therapeutic Targets For Spinal Cord Injury; Insights From Single-Cell And Cross-Species Transcriptomics, Sara Samy Abouzekry

Theses and Dissertations

Central nervous system (CNS) injury remains a devastating healthcare problem. Despite years of research, it remains almost impossible to achieve meaningful functional repair following traumatic brain injury (TBI) and spinal cord injury (SCI). Spinal cord injury (SCI), a highly devastating subset of CNS trauma, is considered a challenge due to the extremely limited regenerative capacity of the nervous system in adult mammals. In contrast, certain species display remarkable repair abilities followed by moderate regenerative ability in neonatal mammals, indicating that regeneration is shaped by the evolutionary context as well as the developmental age.

To uncover the core molecular mediators of …

Pediatric Inflammatory Bowel Disease Tissue Classification From Pathology Slide Images: Detecting Phenotypes Using Computer Vision, Chloe Martin-King, Ali Nael, Louis Ehwerhemuepha, Blake Calvo, Quinn Gates, Jamie Janchoi, Elisa Ornelas, Melissa Perez, Andrea Venderby, John Miklavcic, Peter Chang, Aaron Sassoon, Brian Rubio, Ghislaine Barrigan, Kenneth Grant

Food Science Faculty Articles and Research

Background and Aims

Methods

Results …

Re: Genetic Screening Of Genome-Wide Association Studies-Derived Risk Loci For Type 2 Diabetes Mellitus: Confirmation In The North Indian Population, Mostafa Saadat

Sultan Qaboos University Medical Journal

No abstract provided.

Charting A New Era To Modernize United States Infant Formula Regulation, Douglas G Burrin, Amy B Hair, Sharon M Donovan

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Safety Of Carotid Endarterectomy In The Elderly And Octogenarian Population: A Nationwide Study Including 80,000 Patients, Victor Gabriel El-Hajj, Joanna Roy, Basel Musmar, Wi Jin Kim, Michael Rizzuto, Nathaniel Ellens, Rabab Alshahrani, Victor Staartjes, Adrian Elmi-Terander, Ramachandra Tummala, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Ziad Khabbaz, Pascal Jabbour

Department of Neurosurgery Faculty Papers

INTRODUCTION: Carotid endarterectomy (CEA) is an established procedure for stroke prevention in patients with carotid artery stenosis. While CEA is considered safe in younger patients, perioperative risks in octogenarians remain debated, with current guidelines classifying the procedure as "high-risk" in this patient population. This study aimed to evaluate short-term outcomes of CEA across age groups and to assess whether comorbidity burden better predicts outcomes than chronological age.

METHODS: The ACS-NSQIP database (2013-2020), was used to identify patients eligible for inclusion. The cohort was stratified based on age <  60, 60-80, and > 80 years. Propensity score matching and multivariable logistic regression were used to compare …

Resiliency Training In Collegiate Pilots, Revati Dodani

Student Research Symposium (SRS)

This ongoing longitudinal study in a quasi-experimental design addresses the growing need for mental health (MH) support and awareness in aviation, especially for Part 141 collegiate pilots, considering incidents like the Germanwings Flight 9525 tragedy. The study evaluates a five-day Mental Wellness workshop, which is integrated into a Flight Safety course that focuses on building resilience, managing stress, regulating emotions, promoting healthy lifestyle habits, and stigma reduction. Using a one-group pretest-posttest design, participants complete the Predictive 6-Factor Resilience Scale (PR6-50) before and after the workshop, along with demographic questions. Quantitative analysis is conducted using SPSS® with a paired t-test to …

Face And Content Validation Analysis Of The Professional Pain Preparation Questionnaire For Use In Physical Therapist Education, Rodiel Kirby Baloy

Journal of Innovation in Health Sciences Education

Introduction: Physical therapy educational preparation for the management of individuals in pain may be determined based on the themes of: (1) level of academic preparation, (2) educational hours spent studying pain, including postgraduate training and certification, and (3) clinical experience. This study assessed the face and content validity of a tool, the Professional Pain Preparation Questionnaire (PPP-Q), to assess expert perception as to the value and relevance of each of the identified domains.

Methods: Twelve respondents were enlisted for face validity, and five experts were recruited for content validity. Descriptive statistics, specifically frequency and percentage, were used to describe …

Health Science Students’ Knowledge, Attitude, And Readiness Toward Health Management Learning In The Gulf Cooperation Council Region: A Multi-Institutional Study, Ali Artaman, Amjad Abu Elsamen, Hillani Tadesse Bekele, Heba Hijazi, Ghada Moh Samir Elhessewi, Fatima Al-Ghadban, Mohaimen Mansur

All Works

Background: Health management represents a core competency for healthcare professionals, especially in systems experiencing rapid reform and resource constraints. While traditionally overlooked in undergraduate curricula, it is vital for promoting efficiency, patient safety, and interprofessional collaboration. Methods: Four universities were partner sites for this classroom-based research: Zayed University (ZU), with two campuses, the University of Sharjah (US), Princess Noura Bint Abdul Rahman University (PNU), and Kuwait University. A total of 307 health science students were recruited from each university through email and in-class invitations from August 2022 to January 2024. Following the data check, score variables were created for general …

The State Of Mental Health In The Mountain West, 2025, Cason Noll, Anirudh Polagani, Taylor Volk, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data on the mental health of youth and adults, as well as the availability of mental health care, across the five Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah in 2025. The data are derived from "The State of Mental Health in America 2025,” originally published by Mental Health America (MHA).

Generative Artificial Intelligence: Clinical Perceptions And Use In Physical Therapy Practice, Robert Dekerlegand, Malachy Clancy, Alison Bell, Erin Pletcher, Travis Pollen

Department of Physical Therapy Posters

Background and Purpose

• Generative artificial intelligence (GenAI) is an innovative technology that is reshaping healthcare with potentials ranging from improved efficiency to advancing personalized medicine.¹
• Ensuring the appropriate use of GenAI in teaching and learning has expanded in academia to also ensure graduates can competently use and partner with this technology in their fields.^2-4
• GenAI needs to be both accepted and adopted for these initiatives to translate into professional practice.
• Use of GenAI in physical therapy (PT) is being explored5,6and though therapists appear to understand aspects of this technology, current perceptions and actual use of GenAI in practice …

Leo Ii...A Remembrance, The Flor-Ala

Documents

A special edition issue of The Flor-Ala in remembrance of Leo II.