Translation: The University of Toledo Journal of Medical Sciences
Translation: The University of Toledo Journal of Medical Sciences is the online journal launched by the University of Toledo. Manuscripts will be considered on the understanding that they report original work and are not under consideration for publication by any other journal. The journal publishes original articles reporting experimental results of basic or clinical research, case reports, and reviews. The journal uses a single blind peer review system and each manuscript, based on the results presented in its original submission, will be evaluated by two student reviewers and one faculty reviewer. This process will provide an opportunity for medical students, graduate students, residents, fellows and faculty to publish research observation in a timely manner. Please contact the Student Editor-in-Chief if you are interested in being a reviewer for the journal. ISSN: 2469-6706 DOI: 10.46570/utjms.2469-6706
Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
Access to Psychiatric Medications in Unhoused Populations: Implications for Hospitalization and Readmission Rates
Persons experiencing homelessness (PEH) face disproportionately high rates of psychiatric illness and hospitalization, with mental illness prevalence reported as high as 76.2%—significantly higher than in the general population. Psychiatric treatment for PEH is often hindered by systemic barriers to care, including medication nonadherence stemming from fragmented healthcare delivery, stigma, transportation challenges, and unstable housing. This discontinuity contributes to elevated readmission rates, with studies showing 30-day psychiatric readmission rates up to 2.04 times higher for unhoused individuals. Medication access is further complicated by inappropriate prescribing patterns and difficulty in maintaining treatment regimens for chronic mental illnesses such as schizophrenia and bipolar disorder. Multifactorial barriers—spanning patient-level, treatment-related, and structural factors—worsen adherence. Evidence-based interventions such as Assertive Community Treatment, Customized Adherence Enhancement with long-acting injectables, and Housing First models have shown success in improving treatment continuity and reducing psychiatric symptomatology. Emerging solutions like street medicine and mobile outreach deliver low-barrier care directly to shelters and encampments. Addressing psychiatric medication adherence among PEH is not only a clinical priority but a public health imperative, requiring integrated, compassionate, and housing-informed care models.
Perspectives in Psychiatry: A Learner’s Viewpoint
Copyright (c) 2026 Peyton Roth, Tarak Davuluri, Hunter Eby (Author) https://creativecommons.org/licenses/by/4.0
Pediatric Mental Health Crisis: Current Guidelines and Adjustments
Pediatric anxiety, depression, and suicide rates are on the rise across the U.S. and Ohio. This mental health crisis has placed significant burden on both the emergency department and primary care providers. The emergency department does not have the resources for the long-term care of pediatric patients struggling with mental health. Furthermore, primary care providers do not feel their training has equipped them to manage the psychiatric conditions plaguing today’s youth. To help address this crisis and decreased the number of patients resorting to emergency care, primary care and pediatric residency programs can implement seminars, simulations, and trauma-informed care trainings. Additionally, robust screening protocols, discussions about pediatric mental health in office, and increasing connections between physicians and mental health services will ensure patients are appropriately screened, diagnosed, and treated for psychiatric conditions.
Copyright (c) 2026 Sarah Roehrs, Gianna LoPresti, Hunter Eby (Author) https://creativecommons.org/licenses/by/4.0
MDMA-Assisted Therapy for PTSD: Neuroplastic Change or Psychotherapeutic Catalyst?
MDMA-assisted psychotherapy has emerged as a promising treatment for post-traumatic stress disorder (PTSD), particularly in individuals unresponsive to conventional interventions such as SSRIs and trauma-focused cognitive behavioral therapy. As recent clinical trials report durable symptom remission, ongoing debate surrounds the mechanisms underlying its therapeutic effects. This review explores two major frameworks: a neurobiological model proposing that MDMA supports trauma reprocessing through fear extinction, memory reconsolidation, and neuroplasticity, and a relational model highlighting MDMA’s prosocial and empathogenic properties that enhance therapeutic alliance and suggestibility. Evidence from both human and rodent studies indicates that MDMA reduces amygdala reactivity, increases hippocampal connectivity, and modulates serotonergic and oxytocinergic signaling. Concurrently, clinical findings suggest that the quality of the therapeutic relationship plays a critical role in treatment outcomes. Rather than viewing these processes as mutually exclusive, we propose a synergistic model in which MDMA creates a “window of emotional safety” that allows for both neurobiological and interpersonal mechanisms to support healing. Understanding this dual-action model is essential for refining treatment protocols, improving therapist training, and guiding future research in psychedelic-assisted psychotherapy.
Copyright (c) 2026 Aidan Butler, Robert McCullumsmith (Author) https://creativecommons.org/licenses/by/4.0
The Utility of Metformin in the Management of Metabolic Syndrome Induced by Atypical Antipsychotics
Copyright (c) 2026 Sweta Desai, Fatimah Aftab, Sara Razoky (Author) https://creativecommons.org/licenses/by/4.0
Toward a Treatment Algorithm for Misophonia:
Copyright (c) 2026 Grant Nelson, Andrew Edgington, Amanda Springer (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Fatimah Aftab, Sara Razoky, Sweta Desai (Author) https://creativecommons.org/licenses/by/4.0
The Potential Utility of Supportive Psychotherapy for Medically Admitted Patients
The use of psychotherapy in inpatient settings is underexplored but shows promising benefits. This review summarizes the literature on its application in both inpatient psychiatric and medical units, with a focus on supportive psychotherapy as a potential modality for providing medically hospitalized patients with psychotherapeutic care. To further explore this, we piloted an acting internship in which fourth-year medical students provided supportive psychotherapy to medically admitted patients of the psychiatry consult-liaison service. The model proved feasible and anecdotally beneficial for patients. It underscores the need for further investigation into the role of psychotherapy, and particularly supportive psychotherapy, in the care of medically admitted patients.
Copyright (c) 2026 Conor Segur (Author) https://creativecommons.org/licenses/by/4.0
Pre-eclampsia and the Risk of Development of Psychiatric Disorders
Pre-eclampsia (PE) is a severe disease of pregnancy occurring most often around 20 weeks gestation and marked by symptoms of new-onset hypertension, proteinuria, and end organ damage. Given its high prevalence and serious risk in causing complications, it is important to understand the etiology and potential outcomes of PE. Emerging research suggests that PE during pregnancy may be associated with an increased risk of severe psychiatric disorders in the mother. In this study, we aim to review the current literature examining whether women with PE are more likely to develop subsequent psychiatric disorders including psychosis, mania, and PTSD.
Copyright (c) 2026 Sabrina Khuder, Nithara Murthy, Mirlinda Elmazi, Navtej Mann (Author) https://creativecommons.org/licenses/by/4.0
New Onset Psychosis throughout Pregnancy and Postpartum: Risk Factors and Maintenance Therapy
Copyright (c) 2026 Sara Razoky, Sweta Desai, Fatimah Aftab, Jessica Sedlak (Author) https://creativecommons.org/licenses/by/4.0
A Mini Review: The Impact of Family-Centered Interventions and Peer Support in Improving Mental Health Outcomes for Suicidal Youth
Copyright (c) 2026 Angela Rooks (Author) https://creativecommons.org/licenses/by/4.0
Role of Stress and Inflammation in the Etiology, Treatment, and Management of Premenstrual Dysphoric Disorder (PMDD)
According to the DSM-5, Premenstrual Dysphoric Disorder (PMDD) is defined as a mood disorder characterized by physical, emotional, and behavioral symptoms that occur during the luteal phase and cause significant distress or impairment. While epidemiological studies highlight that PMDD occurs in 1.8-5.8% of menstruating individuals, this is a vast underestimation prevalence due in part to cultural and systematic factors that impact diagnosis. That said, it is imperative to conduct research on this debilitating condition and its impact on overall wellbeing. The objective of this review is to explore the role stress and inflammation plays on etiology, treatment, and management of PMDD. To ensure a thorough review, the inclusion criteria focused on studies published in peer reviewed journals on etiology (stress and inflammation in relation to PMDD) and the treatment and management of PMDD. Studies conducted on topics pertaining to genetics and serotonin dysregulation were not included. Additionally, research conducted prior to 2005 were also excluded from the review process. Overall, existing literature demonstrates that stress and inflammation has been found in individuals with PMDD. However, more research must be done on the potential therapeutic value of Yaz, other COCs, and anti-inflammatory agents in treatment of PMDD.
Copyright (c) 2026 Nithara Murthy, Sabrina Khuder, Manasa Swaminathan (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Andrew Edgington, Grant Nelson (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Annie Y. Lei (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Puvi Venkataratnam (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Radha Shah (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Sampriti Senapati (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Laya Gokula, Annie Y. Lei, Aditi Musalgavkar, Sampriti Senapati, Amanda Springer, MD, Robert E. McCullumsmith, MD, PhD, FACS (Author) https://creativecommons.org/licenses/by/4.0
Sex-Based Transcriptomic Variations in Schizophrenia: Prospects for Targeted Therapy
Schizophrenia is a complex neuropsychiatric disorder with significant sex differences in onset, symptoms, and outcomes, suggesting that biological sex may influence disease mechanisms. However, molecular differences between males and females with schizophrenia remain poorly defined. This study examined sex-specific transcriptional alterations in the dorsolateral prefrontal cortex (DLPFC) of individuals with schizophrenia using publicly available RNA-sequencing data (GSE144136). Differential gene expression (DGE) analyses were performed separately for male and female cohorts, followed by gene set enrichment analysis (GSEA), leading-edge (LE) gene analysis, and perturbagen signature matching using the Library of Integrated Network-Based Cellular Signatures (iLINCS). No genes reached significance after correction, but unadjusted analyses revealed marked sex differences. Using the uncorrected analysis, Males exhibited over 2,000 differentially expressed genes distributed evenly between up- and downregulation, whereas females showed a smaller set of differentially expressed genes that were skewed towards upregulation. Pathway-level analyses showed that males displayed upregulation of metabolic pathways and downregulation of synaptic transport processes, while females exhibited upregulation of immune pathways alongside downregulation of vesicle organization and phosphoinositide metabolism. LE gene analysis supported the pathway changes. iLINCS analysis further highlighted sex-specific drug candidates whose expression profiles were discordant schizophrenia-associated signatures. FDA approved medications with high discordance included JAK2/mTOR pathway inhibitors and metabolic regulators in males, and immune or hormonal modulators in females. Taken together, these results reveal divergent molecular signatures that may underlie sex differences in schizophrenia pathophysiology. The identification of candidate drugs with discordant transcriptomic effects suggests potential therapeutic avenues and emphasizes the importance of sex stratified approaches in schizophrenia research.
Copyright (c) 2025 Eire Chen, Jasleen Mann, Fred Muler, Henry Sun, Eleza Zaidi, Robert McCullumsmith, Jacob Schmieder, Hunter Eby (Author) https://creativecommons.org/licenses/by/4.0
Copyright (c) 2026 Dr. Emily Cooper (Author) https://creativecommons.org/licenses/by/4.0
Tracking Neural Deterioration in proNGF-Overexpressing Mice: Hippocampal Serotonergic Dysfunction and Synaptic Loss Drive Neurodegeneration
ProNGF, the precursor protein of mature nerve growth factor (NGF), plays a complex role in neural signaling and has been implicated in neurodegeneration through its apoptotic signaling with the p75NTR receptor. For example, in Alzheimer's disease increased levels of proNGF are associated with cholinergic neuron loss and excitatory/inhibitory imbalance. This study deploys cutting edge a bioinformatic analyses of RNAseq data from TgproNGF#3 mice models that express furin-resistant proNGF. The TgproNGF#3 mouse mimics the pathological accumulation of the precursor NGF protein observed in these diseased brains. Our analysis revealed that proNGF accumulation in the hippocampus and entorhinal regions leads to early downregulation of genes critical for neuronal communication, such as pion and KCNAB2, and later to the upregulation of stress-related and signaling genes, including Neurod1, Neurod2, and Gnai1. These shifts in gene regulation suggest that while the brain attempts to counteract the excess in proNGF, its delay and inefficacy may contribute to early-stage Alzheimer's disease processes.
Copyright (c) 2025 Nicole A. Bell, Ali S. Imami, Mahathi Srivatsan, Noah Jiang, Anya Musalgavkar, Ali Ridi, Robert E. McCullumsmith (Author) https://creativecommons.org/licenses/by/4.0
An Essay on Parkinson’s Disease and the Gut-Brain Connection
Copyright (c) 2026 Leena A. Ahmed, Caroline C. Swain (Author) https://creativecommons.org/licenses/by/4.0
Engaging Minds: A Brain Cutting Experience for Undergraduate and Pre-Medical Students
Brain anatomy is notoriously difficult to teach and visualize to first-time learners. To make neuroanatomy more digestible, our group designed an educational brain-cutting experience that used gross dissection of a cadaver brain alongside digital dissection through the Anatomage Table technology to elucidate more difficult structures in three dimensions. A slide presentation was also prepared to help guide the learners through the dissection and to teach structure, function, and pathology. Two sessions with undergraduate learners were performed, with the first having four learners and the second having eight. Pacing and improper cutting technique were the main obstacles encountered in the first session; however, this was remedied by proper communication, teaching, and changing the format of the visual presentation. We feel that Anatomage helped the learners better visualize each structure in three dimensions, which aided in understanding the content. Early exposure to anatomy and pathology can inspire students to pursue careers in medicine, so we hope that this experience inspires others to develop their own neuroanatomy program.
Copyright (c) 2026 Leo Roberts, Kate Simer, Leena Ahmed, Kayden Cuneo, Kyan Mwatha, Robert McCullumsmith, James Burkett (Author) https://creativecommons.org/licenses/by/4.0
Drug Identification and Repurposing in Lung Adenocarcinoma: Differences in Male and Female Subjects
Lung adenocarcinoma (LACA) presents with a range of debilitating symptoms, including chronic cough, hemoptysis, and shortness of breath. In this study, we reanalyzed a published transcriptomic dataset to compare male and female LACA samples with healthy lung tissue and identify potential therapeutic targets capable of reversing disease-associated gene expression signatures. Utilizing cutting-edge bioinformatics approaches, including differential expression analysis, pathway analyses and analyses of signature-reversing drug profiles, we assessed male and female signatures separately. Using Gene Set Enrichment Analysis, we identified sex-specific differences in tumor-associated pathways, including the downregulation of blood angiogenesis in female lung adenocarcinoma subjects. Leading-edge gene analysis further revealed that angiogenesis-related genes were downregulated in both sexes, though the specific genes contributing to these pathways differed between males and females. Integrative drug repurposing analysis using the LINCs database, based on our transcriptomic profiles, uncovered potential therapeutic candidates for male and female LACA compared with healthy controls. Notably, a VEGFR inhibitor showed the highest discordance score in males, while a CLK2 inhibitor demonstrated one of the highest discordance scores in females. Together, these findings highlight distinct molecular and pharmacologic signatures between sexes and suggest potential sex-specific therapeutic strategies for lung adenocarcinoma.
Copyright (c) 2025 Oliver Dunn, Ria Khatri, Riddhima Singh , Ray Sun, Erica Wang, Robert E. McCullumsmith, John M. Vergis, Jacob F. Wood (Author) https://creativecommons.org/licenses/by/4.0
Designing an Elective Psychodynamic Curriculum for Medical Students
Departments of Neuroscience and Psychiatry Research Symposium
Copyright (c) 2025 Jack Mariani, Robert McCullumsmith, Sweta Desai, Julia Dillard, Angad "Josh" Pelia, T. Nicholas Domitrovic (Author) https://creativecommons.org/licenses/by/4.0
Asymmetry in Parkinson’s Disease: Exploring the Role of Hemispheric Specialization in Treatment Success
Copyright (c) 2025 Dipesh Pokharel, Caroline Swain , Dilshan Beligala, Isable Nester , Khoi Le , Vaibhavi Peshattiwar, Kala Venkiteswaran , Thyagarajan Subramanian (Author) https://creativecommons.org/licenses/by/4.0
Using iLINCS to mine for Oxytocin signature to find new drug candidates or molecular pathways that can be used for future treatment for autism
Copyright (c) 2025 Gabby, Elissar Andari (Author) https://creativecommons.org/licenses/by/4.0
Biphasic Onset of Spinal Epidural Hematoma: A Diagnostic Challenge
Copyright (c) 2025 Brianna Bailey, Daniel Branch, Aditya Acharya, Clayton Buback (Author) https://creativecommons.org/licenses/by/4.0
Ventriculoperitoneal Shunt-Associated Neuropsychiatric Symptoms: A Literature Review and Two Case Reports
Ventriculoperitoneal (VP) shunts are a common use for the treatment of hydrocephalus, which is a condition causing excessive cerebrospinal fluid (CSF) buildup in the brain. The shunt drains the CSF from the brain and into the abdomen, where it can be absorbed by the body. Although a widely used and successful procedure, it is unclear whether neurosurgical placement of this shunt may directly cause psychiatric abnormalities, especially regarding the dopaminergic system. In this paper, we first review relevant literature and discuss the dopamine circuitry in the brain. The literature suggests a shunt-associated clinical syndrome, which may include a reduction in facial and/or verbal expressivity, reduced willful movement, rigidity, and vertical gaze palsy. Typical presentation occurs within three months of a shunt revision. In patients with a VP shunt, these signs may be a strong indicator of mechanical or functional shunt malfunction. We then present two cases of hydrocephalus managed with a VP shunt, where both patients developed symptoms suggestive of psychosis and/or dopamine pathway pathology after shunt placement. We conclude that clinicians should have a suspicion for shunt-associated symptomology in patients with a history of recently treated hydrocephalus who present with psychomotor, personality, or cognitive changes.
Copyright (c) 2026 Olivia R. Thomas, Madhu Vishnu Sankar Reddy Rami Reddy, Jacob F. Wood, Jacob J. Tan, Tressel Holton, Katherine Simer, Samuel A. McCord, Daniel Maixner, John Hammond, Robert E. McCullumsmith (Author) https://creativecommons.org/licenses/by/4.0