Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 30 of 40

Full-Text Articles in Medicine and Health Sciences

Comparison Of Bracket Bond Strength By Total, Self-Etch And Laser Treatment, Kyo Sung Shawn Kim Dec 2003

Comparison Of Bracket Bond Strength By Total, Self-Etch And Laser Treatment, Kyo Sung Shawn Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Laser etching of enamel surfaces alters the physical and chemical characteristics of the enamel. These changes in characteristics enhance the bonding to enamel. The purpose of this study was to compare the shear and tensile bond strength of Er,Cr:YSGG hydrokinetic laser system (Biolase) with 37% phosphoric acid and self etching primer 30 minutes and 72 hours after bonding. Four different laser power output setting was observed: 1.5W, 2.0W, 2.5W, and 3.0W. Two hundred forty bovine teeth free of defect, caries, and dentin exposure were mounted in acrylic resin and divided into 24 groups of 10 teeth. Sixteen groups of 10 …


Clinical Effectiveness Of A Subperiosteal Anchorage Device, Monica Anne Witte Dec 2003

Clinical Effectiveness Of A Subperiosteal Anchorage Device, Monica Anne Witte

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this pilot study was to evaluate the clinical efficacy of a subperiosteal anchorage device, the palatal OnPlant™, during orthodontic retraction of protruding anterior teeth in cases requiring maxillary premolar extraction. Seven subjects (5 female, 2 male), ages 13 to 55, were selected for the study. The OnPlant was surgically placed in the mid-palatal region through a well-defined subperiosteal tunnel. Following the manufacturer recommended osseointegration period of four months, the OnPlant was uncovered and attached to the first molars by means of a transpalatal bar. Standard orthodontic treatment then commenced to retract the anterior teeth after the first …


A Bond Strength Comparison Of Led And Halogen Light Curing Units, John Richard Kavanagh Dec 2003

A Bond Strength Comparison Of Led And Halogen Light Curing Units, John Richard Kavanagh

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to compare the tensile bond strength of orthodontic flat based buttons bonded to bovine teeth with four commercial light-emitting diode (LED) curing lights and one conventional quartz tungsten halogen (QTH) curing light.

The dental market has recently been introduced to a number of commercially available light-emitting diode (LED) curing lights. Tensile bond strength was evaluated for LED curing lights (Rembrandt® AllegroTM, Den-Mat Corp, Santa Maria, CA), (LEDemetron, Kerr/Demetron Corp, Danbury, Conn), (Ortholux LED, 3MTMESPETM, St. Paul, MN),and (FLASH-lite 1001, Discus Dental, Culver City, CA) are compared with one …


Dental Treatment Options For Snoring - A Pilot Study, Kainaz Khushrooh Byramjee Dec 2003

Dental Treatment Options For Snoring - A Pilot Study, Kainaz Khushrooh Byramjee

Loma Linda University Electronic Theses, Dissertations & Projects

This study compared the effectiveness of an anterior repositioning device, the Silent Nite®, to two new treatments in their ability to stop/reduce snoring. Comfort and side effects of each treatment were also evaluated.

Twenty-three subjects, in good medical condition along with their spouse/partner participated in the five-week study. A disposable sleep apnea screener, SleepStrip,™ was used to select only non-sleep apnea patients. The treatments tested were: (1) Silent Nite® (control - Treatment A), (2) Loma Linda Appliance (Treatment B), and (3) Snore Tape (Treatment C). Each participant received all three treatments separated by a one week "wash-out" period of no …


Measured Effects Of Rapid Palatal Expansion On Nasal Cavity Volume Utilizing Cbct, Jon Neal Robinson Dec 2003

Measured Effects Of Rapid Palatal Expansion On Nasal Cavity Volume Utilizing Cbct, Jon Neal Robinson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate and predict the expected changes that occur in the nasal cavity volume following rapid palatal expansion. Eighteen subjects (11 female, 7 male), ages 9 to 18, requiring rapid palatal expansion in conjunction with comprehensive orthodontic treatment, were selected for the study. Rapid palatal expansion was accomplished using the standard, banded hyrax appliance. Three-dimensional cone beam computed tomograms using the NewTom 9000™ were acquired before and after expansion. Serial coronal slices of the nasal cavity were made using the QV9000™ software program. The resultant serial images were imported into 3-D Doctor™ for analysis …


The Histological Effects Of Mandibular Distraction Osteogenesis On Rabbit Condyles, Eunice Jungmin Hong Dec 2003

The Histological Effects Of Mandibular Distraction Osteogenesis On Rabbit Condyles, Eunice Jungmin Hong

Loma Linda University Electronic Theses, Dissertations & Projects

The present study is a histological evaluation of condyles taken from rabbits that underwent either a midline or paramedian distraction osteogenesis procedure on the mandibles. Fifteen rabbits were originally operated on and eight of these fifteen successfully made it through both the distraction osteogenesis procedure and the 1 month holding period that followed. There was one control animal.

In the present study, the condyles from these nine rabbits (1 control, 2 midline distraction osteogenesis, 6 paramedian distraction osteogenesis) were prepared for histological evaluation (18 total). Step serial sections were cut along the coronal plane and the sections from the anterior …


Healing Following Placement Of A Subperiosteal Orthodontic Anchoring Device, Oliver Hoffmann Dec 2003

Healing Following Placement Of A Subperiosteal Orthodontic Anchoring Device, Oliver Hoffmann

Loma Linda University Electronic Theses, Dissertations & Projects

Background: A method to accomplish orthodontic anchorage using a hydroxyapatite-coated disk that is placed below the periosteum in the mid-palatal area has been developed (OnPlant, Nobel Biocare, Yorba Linda, CA, USA). This report describes the early to 8-month healing events of the first 8 consecutive cases of placement of the OnPlant device at the Advanced Periodontics Clinic at Loma Linda University School of Dentistry. In addition, it presents the results of a questionnaire on how the patients experienced the various procedures. A radiographic analysis of the side of placement of the device was performed.

Methods: At 2 weeks and at …


Update - November 2003, Loma Linda University Center For Christian Bioethics Nov 2003

Update - November 2003, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Editorial
-- Hindu Perspectives on Genetic Enhancements in Humans
-- HIPAA: Privacy and Public Good
-- 2003 Graduates


Loma Linda Nurse - Vol. 12, No. 02, Loma Linda University School Of Nursing Oct 2003

Loma Linda Nurse - Vol. 12, No. 02, Loma Linda University School Of Nursing

Loma Linda Nurse

Table of Contents:

2 | A message from the dean

4 | Loma Linda NURSE news

6 | EXPANDING HORIZONS: the development of international nursing at LLU

12 | Alumni news

13 | LLUSN development report

15 | 2002-2003 donor report

21 | Near and far

22 | In memory


Effects Of Various Hemostatic Agents On Bone, David Daryl Roland Sep 2003

Effects Of Various Hemostatic Agents On Bone, David Daryl Roland

Loma Linda University Electronic Theses, Dissertations & Projects

Previous studies have evaluated the effects of various hemostatic agents on radicular tissues following apical surgery. The purpose of this study was to examine the early osseous responses to seven hemostatic agents under identical conditions in rabbits. Sixteen adult male New Zealand white rabbits were used for this study. Following anesthesia, utilizing a midline submandibular incision, standardized bony defects were prepared on the lateral-superior regions of the mandible. Test materials were placed using standardized volumes and exposure times. Bone wax, Surgicel, Capset, alginate, Cut-Trol, Hemogin-L, and silver nitrate were compared to control sites irrigated with saline. Test materials or controls …


The Radiopacity Of 29 Resin Restorative Materials Compared To Enamel, Peter Lubisich Iv Sep 2003

The Radiopacity Of 29 Resin Restorative Materials Compared To Enamel, Peter Lubisich Iv

Loma Linda University Electronic Theses, Dissertations & Projects

The radiodensity of a composite resin can greatly influence a clinician's ability to analyze a restoration for failure. The purpose of this study was to determine the relative radiopacities of 29 resin restorative materials compared to enamel, and to verify the comparable radiopacity between shades of 23 of the restorative composite resin materials. Composite resin discs measuring >5mm in diameter and 2 mm in thickness were made and polymerized. Radiographs were taken of the composite resin discs, which included an aluminum step wedge for calibration and a densitometer was used to measure the radiodensity of the composite resin samples. The …


Prediction Of Fetal Sheep Brain Metabolic Rate During Hypoxia And Cord Occlusion, Adam D. Hickerson Sep 2003

Prediction Of Fetal Sheep Brain Metabolic Rate During Hypoxia And Cord Occlusion, Adam D. Hickerson

Loma Linda University Electronic Theses, Dissertations & Projects

Many investigators have observed that fetal and neonatal animals are remarkably tolerant to hypoxia compared to the adult. The precise mechanisms however are still unclear. In order to better characterize the hemodynamic and metabolic responses of the fetal brain to hypoxic stress, we have designed a mathematical model to predict tissue oxygenation and metabolic rate of the fetal brain during both moderate hypoxia and severe asphyxia.

The model is based on the Krogh cylinder concept and is similar to one previously published by our lab. Several new concepts were added including the ability to run the model over time using …


Synovial Fluid Hydrostatic Pressure In The Tmj After Mandibular Advancement In Sus Scrofa, Samuel A. Demirdji Sep 2003

Synovial Fluid Hydrostatic Pressure In The Tmj After Mandibular Advancement In Sus Scrofa, Samuel A. Demirdji

Loma Linda University Electronic Theses, Dissertations & Projects

Mandibular advancement is performed in patients routinely by traditional bilateral sagittal split osteotomy (BSSO) or less commonly by distraction osteogenesis (DO). The influence of mandibular advancement on the temporomandibular joint (TMJ) is well recognized but not fully explored. This study involved the direct measurement of synovial fluid hydrostatic pressure (SFHP) in the TMJ after mandibular advancement by either BSSO or DO in two male mature minipigs, Sus scrofa. Titanium pressure transducers were inserted into the right superior temporomandibular joint spaces of the minipigs and the measurements were displayed on an AC/DC amplifier. The first minipig underwent BSSO, which involved immediate …


Validation Of A Serotonin Checklist In A Parkinson’S Disease Population, Kelly Diane Darby-Holder Sep 2003

Validation Of A Serotonin Checklist In A Parkinson’S Disease Population, Kelly Diane Darby-Holder

Loma Linda University Electronic Theses, Dissertations & Projects

Although the distinctive pathological marker of Parkinson’s Disease is the progressive death of neurons that produce dopamine, there are also alterations in the production of quantities of other neurotransmitters, such as norepinephrine and serotonin that contribute to the disease. Parkinson’s Disease (PD) can be divided into two distinct classes based on the manifestation of motor symptoms, Type A and Type B Parkinson’s Disease. Type B PD patients often manifest symptoms in which serotonin deficiency plays an important role, which often includes a history of depression. Within the brain and spinal cord serotonin has wide spread projections, acting as an important …


Quantification Of Bone Deposition In Onlay Bone Grafting, Gregory Alan Kammeyer Sep 2003

Quantification Of Bone Deposition In Onlay Bone Grafting, Gregory Alan Kammeyer

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to quantitatively evaluate; 1) mandibular posterior mono-cortical block onlay bone graft success rates 2) the amount of grafted bone retained after initial resorption in radiographic projections. Seven consecutive patients with 14 mandibular posterior implant sites requiring bone augmentation for implants of a standard 3.8mm x 10mm dimension were sought. Mono-cortical block bone grafts from the ipsilateral ascending ramus were placed then observed with two standardized CT scans, dividing them into two groups: Group A had the first CT at 4 weeks after graft placement and a second taken before Prosthodontic reconstruction, 36.7 weeks later. …


Assessment Of Alveolar Bone Density Using Implant Insertion Resistance Torque, Scott Sangmoo Lee Sep 2003

Assessment Of Alveolar Bone Density Using Implant Insertion Resistance Torque, Scott Sangmoo Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Implant stability during healing is a pre-requisite for successful osseointegration. In the case of early or immediate implant loading, it is necessary to achieve high level of stabilization during surgical placement. Fixture stabilization can be measured by resonance frequency analysis or implant insertion resistance torque measurement. The aim of this study is to correlate pre-operative radiographic bone density to implant insertion resistance torque in human cadaver jaw bone.

Materials & Methods: Sixty-four implant osteotomy sites in human cadaver jaw bones were previously examined radiographically using quantitative computed tomography (QCT) and quantitative cone-beam computed tomography (QCBCT). Forty-two implant insertion sites …


Intensive Care Medical Procedure : Ptsd Symptoms In Children, Ludmila Zaytsev Sep 2003

Intensive Care Medical Procedure : Ptsd Symptoms In Children, Ludmila Zaytsev

Loma Linda University Electronic Theses, Dissertations & Projects

Studies indicate that medical procedures may cause post-traumatic stress (PTS) symptoms (fear, avoidance, sleep disturbances, irritability, concentration difficulties. hypervigilance). It has been suggested that administration of midazolam hydrochloride, a sedative/amnesic medication commonly used in the Pediatric Intensive Care Units (PICU), may help decrease if not prevent the development of PTS symptoms. This study examined if PTS symptoms were related to procedural invasiveness (PI) and whether midazolam had a moderating effect on the development and intensity of PTS symptoms in children. English-speaking children ages 8-16 (N=20) who had been in the PICU for at least 3 days were recruited at Loma …


The Psychological Characteristics Of Obese Children, Thomas Taylor Mitchell Sep 2003

The Psychological Characteristics Of Obese Children, Thomas Taylor Mitchell

Loma Linda University Electronic Theses, Dissertations & Projects

Several studies along with the surgeon general of the United States have identified obesity as a national health issue. Research indicates that adult obesity treatment has relatively poor long-term effects. Consequently increased attention has been given to addressing obesity in children. This focus is particularly vital due to the fact that children are one of the populations showing the most rapid increase in overweight and obesity. The purpose of this study was to identify the some of the unique psychological characteristics of obese children by analyzing the intake data of children and adolescents attending the Loma Linda University Growing Fit …


Multiple Psychosocial Factors As Predictors In The Progression Of Hiv-1 To Aids, Robert Louis Dutile Sep 2003

Multiple Psychosocial Factors As Predictors In The Progression Of Hiv-1 To Aids, Robert Louis Dutile

Loma Linda University Electronic Theses, Dissertations & Projects

Nearly 3.1 million individuals have died of AIDS as of December 2002 and more than 38.6 million individuals were identified as being infected with HIV (Joint United Nations Programme on HIV/AEDS (UNAIDS) and World Health Organization (WHO) 2002). Psychoneuroimmunology is a discipline that increases our understanding of the relationships between psychosocial factors, the central nervous system, the immune system, and disease. From this perspective, this study reviews the biopsychosocial medical model and components of the stress-immunity-health (SET) model. The constructs of stress and social support are discussed and defined referencing current theory and research. In addition, physiological mechanisms of stress …


Radiation Effects On Dopamine-Mediated Prepulse Inhibition In The C57bl/6 Mouse, Cara Nicole Zuccarelli Miller Sep 2003

Radiation Effects On Dopamine-Mediated Prepulse Inhibition In The C57bl/6 Mouse, Cara Nicole Zuccarelli Miller

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effects of proton and gamma radiation on a dopamine-dependent sensory gating mechanism: prepulse inhibition of the startle reflex. The purpose of this research was to describe potential hazards of proton radiation to the central nervous system in long-term space fight and for proton therapy patients. Results from previous research indicate that startle behavior is modified by proton and iron radiation. Forty-eight 10-½ week old, male C57BL/6 mice were used to characterize the optimal parameters for the model (prepulse duration, probe duration, and stimulus-onset-asynchrony). Three hundred and fifty two mice were used to characterize the time course …


Prediction Of 1976 Diabetes Incidence From 1960 Animal Product Consumption Among California Seventh-Day Adventists, Arnold Vang Jul 2003

Prediction Of 1976 Diabetes Incidence From 1960 Animal Product Consumption Among California Seventh-Day Adventists, Arnold Vang

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of diagnosed and undiagnosed diabetes in the US has been estimated at more than 16 million individuals (King, 1998). This has led to research into lifestyle practices (Astrup, 2001; Touomilehto, 2001), which has identified several of primary prevention. High fat diet and type 2 diabetes has been attributed to the wellareas known mechanisms of hyperglycemia, hyperinsulinaemia and insulin resistance (Ferrannini, 1999; Reaven, 1988).

We examined the association between all animal product consumption, specific animal product consumption and diabetes incidence among California Seventh-day Adventists who were cohort members of the Adventist Mortality Study (Kahn, 1984) and the Adventist Health …


Commencement Program 2003, Loma Linda University Jun 2003

Commencement Program 2003, Loma Linda University

Commencement Programs

CONTENTS

2 | 2003 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Speakers

12 | The University Honorees

21 | The School Honorees

29 | The Programs

  • School of Medicine, 30
  • School of Dentistry, 37
  • Graduate School, 45
  • School of Nursing, 55
  • School of Allied Health Professions - Physical Therapy, 60
  • School of Allied Health Professions, 68
  • School of Public Health, 77


Effects Of Moral Sensitivity And Moral Climate On Moral Reasoning, Marita Louise Mahoney Jun 2003

Effects Of Moral Sensitivity And Moral Climate On Moral Reasoning, Marita Louise Mahoney

Loma Linda University Electronic Theses, Dissertations & Projects

As healthcare professionals, psychology students and psychologists are expected to behave ethically and morally. It is assumed that moral and ethical reasoning in psychology students develops through exposure to ethical dilemmas within ethics classes and during clinical training experiences. Rest's Four Component Model of Moral Behavior, a neo-Kohlbergian approach to understanding moral development, posits an interaction of Moral Sensitivity, Moral Motivation, Moral Reasoning and Moral Character. Moral sensitivity, or awareness of a moral dilemma, is posited to cue the moral reasoning process, though little is known about how the training environment can facilitate or hamper such developments. Fifty".'two psychology-graduate students …


Are Antinuclear Antibodies And Rheumatiod Factor Positivity More Prevalent In Apparently Healthy Smokers Compared To Ex-Smokers And Never Smokers?, Susan Nyanzi Jun 2003

Are Antinuclear Antibodies And Rheumatiod Factor Positivity More Prevalent In Apparently Healthy Smokers Compared To Ex-Smokers And Never Smokers?, Susan Nyanzi

Loma Linda University Electronic Theses, Dissertations & Projects

Context: There is now consistent evidence from population and epidemiological studies that cigarette smoking is an independent risk factor for Rheumatoid Arthritis (RA), via Rheumatoid Factor (RF) production (Deighton, 1997; Saag, 1997; Silman, 1996; Uhlig, 1999; Wolfe, 2000). Antinuclear Antibodies (ANA) are another collection of autoantibodies that are being associated with smoking and RA initiation. To our knowledge, no studies have examined the effects of smoking on both ANA and RF simultaneously in healthy subjects.

Objectives: To determine whether cigarette smoking has an effect on ANA and RF positivity in healthy blood donors.

Design, Setting, Participants: This was a cross-sectional, …


The Role Of Health Promotion In Physical Therapy, Brenda L. Rea Jun 2003

The Role Of Health Promotion In Physical Therapy, Brenda L. Rea

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to investigate physical therapy practice patterns in four focus areas of Healthy People 2010 (focus area #6, disability and secondary conditions by looking at psychological well-being; focus area #19, nutrition and overweight; focus area #22, physical fitness and activity; focus area #27, tobacco use) and identify self-efficacy and outcome expectations related to those practice patterns across California, New York and Tennessee using Bandura’s Social Cognitive Theory as a framework. It was hypothesized that physical therapists’ self-efficacy and outcome expectations in the four focus areas of Healthy People 2010 would be significantly associated with …


Predicting Sacroiliac Syndrome: The Association Between Noninvasive Sacroiliac Joint Tests And Sacroiliac Joint Injections, Lorraine D. Webb Jun 2003

Predicting Sacroiliac Syndrome: The Association Between Noninvasive Sacroiliac Joint Tests And Sacroiliac Joint Injections, Lorraine D. Webb

Loma Linda University Electronic Theses, Dissertations & Projects

Study Design. A prospective single sample observational design was performed. Sacroiliac tests that predicted ≥ 75% pain relief after sacroiliac joint (SIJ) injection were considered valid diagnostic tests for SIJ syndrome.

Objectives. To identify valid noninvasive sacroiliac tests that can be used to diagnose SIJ syndrome.

Summary of Background Data. The criterion standard for diagnosing SIJ syndrome is with SIJ intraarticular injections under fluoroscopy. This procedure is costly, invasive, and impractical for routine use. Clinicians need practical ways to diagnose SIJ syndrome; however, few studies have been performed to validate existing sacroiliac tests against SIJ Injections.

Methods. Nineteen subjects …


Potential Mechanisms Explaining The Antitumor Effect Of Total-Body Irradiation, Glen Michael Miller Jun 2003

Potential Mechanisms Explaining The Antitumor Effect Of Total-Body Irradiation, Glen Michael Miller

Loma Linda University Electronic Theses, Dissertations & Projects

While numerous reports have documented that radiation exposure increases the risk for malignancy and suppresses immune mechanisms, increasing evidence has suggested that low-dose total-body irradiation (TBI) may alter leukocyte composition and function leading to heightened immune responsiveness and long-term remission of certain cancers. Having observed that moderate-dose TBI produces an antitumor effect in the Lewis lung carcinoma (EEC) model, the major goal of this study was to determine whether changes in tumor growth could be correlated with radiation-induced alterations of immune system parameters. The governing hypothesis was that selective immune augmentation, i.e. upregulation of specific leukocyte subsets, is primarily responsible …


Distraction Osteogenesis In Edentulous Alveolar Bone With Rhbmp-2 Enhancement, Liviu F. Eftimie Jun 2003

Distraction Osteogenesis In Edentulous Alveolar Bone With Rhbmp-2 Enhancement, Liviu F. Eftimie

Loma Linda University Electronic Theses, Dissertations & Projects

Distraction osteogenesis, a unique system of affecting rapid bone healing in fractures, realigning malformed bones, and lengthening congenitally short and traumatically shortened bones has become an increasingly utilized technique for the maxillofacial region. The use of distraction osteogenesis has been described for increasing the height of edentulous mandibular alveolar ridges while concurrently forming new bone within the ridge to allow for adequate reconstruction. A standard protocol for performing distraction osteogenesis in the maxillofacial region has been well documented in the literature. Standard distraction osteogenesis requires an initial surgery to place the distraction osteogenesis device and mobilize the segment to be …


Exploring The Physician’S Processes: Diagnosing Autism, Gwennyth Li Sze Palafox Jun 2003

Exploring The Physician’S Processes: Diagnosing Autism, Gwennyth Li Sze Palafox

Loma Linda University Electronic Theses, Dissertations & Projects

Physicians are customarily the first point of contact for parents who are concerned about a child’s development. Thus, it is important for physicians to be current and educated about childhood disorders and subsequent treatment for those disorders. Recently, empirical evidence has led to the proposal of early indicators of autism supporting that autism may be diagnosed accurately in children less than three years old. Furthermore, formal screening and assessment parameters developed by medical organizations have been proposed in order to identify autism as early as possible (American Academy of Neurology, 2000). While the proposed parameters and empirical evidence support early …


Ultrasonic Removal Of Bacteria From Plated Cells, Cecilia Chi-Pei Kao Jun 2003

Ultrasonic Removal Of Bacteria From Plated Cells, Cecilia Chi-Pei Kao

Loma Linda University Electronic Theses, Dissertations & Projects

Children often present with dental trauma to pediatric emergency departments and pediatric dental offices. There is a wide spectrum of types of dental trauma. Although research has been done concerning the treatment of avulsed teeth, the current recommendations in the published guidelines might still be improved for better long term prognoses. One may speculate that ultrasonification of an avulsed tooth prior to replantation may dislodge existing surface bacteria and improve the prognosis for the tooth. This was as an in vitro study to test this concept. Epithelial cells were grown in 6-well tissue culture plates. Standardized amounts of Staphylococcus aureus …