Digital Commons Network^™

The Impact Of Quality Of Life And Recovery Capital On Inhibitory Control In Patients On Medication For Opioid Use Disorder, Caroline K. Jeffries

All Theses

The opioid crisis persists as a global health challenge, necessitating a comprehensive understanding of the complex interplay between psychological factors and neurocognitive responses among individuals with opioid use disorder (OUD). Two such psychological factors include recovery capital, an individual's internal and external resources to supporting recovery, and quality of life. Past work suggests that positive levels of recovery capital and quality of life may enhance individuals’ ability to regulate emotions and manage cravings. However, it is unclear how these variables are affected when buprenorphine is taken. This study investigates the influence of recovery capital and quality of life on inhibitory …

A Review On Treatment, Prevention, And Research Of Worldwide Parasitic Disease: Toxoplasmosis, Hannah Skinner

All Theses

Toxoplasmosis is a worldwide, yet often overlooked, parasitic disease caused by the protozoan parasite, Toxoplasma gondii. The parasite is capable of infecting humans and almost all warm-blooded vertebrates. Over a million people are infected in the United States with toxoplasmosis each year. Most infections are asymptomatic but severe cases can lead to vision impairment, neurological disorders, and congenital birth defects. T. gondii is transmitted through undercooked meat, infected feline feces, or contaminated water and soil. The burden of T. gondii infection is most notable in livestock, felines, and immunocompromised humans. Despite being a widespread disease, toxoplasmosis is neglected in …

Thymosin Beta-4: A Novel Treatment For Acanthamoeba Keratitis, Victoria A. Murphey

All Theses

Acanthamoeba keratitis (AK) is a severe corneal infection caused by the free-living amoeba, Acanthamoeba. Both stages of its life cycle (trophozoite and cyst) cause infection, primarily in contact lens wearers. It is often misdiagnosed, leading to delayed treatment and poor clinical outcomes. Current treatment options for AK rely on anti-amoebic agents that are toxic to corneal epithelial cells. Further, no single drug can eliminate both forms of the amoeba. Approximately 30% of all AK infections require a corneal transplant.

Thymosin beta-4 (Tβ4) is a G-actin binding protein synthesized in almost all human cells, including corneal epithelial cells. Tβ4 exhibits …

Healthy Dietary Patterns’ Impact On Depressive Symptoms: A Meta-Analysis Of Randomized Controlled Trials, Angela Encardone

All Theses

As the search for innovative mental health treatments expands, dietary interventions have emerged as a promising approach for alleviating depressive symptoms. This thesis presents a meta-analysis of randomized controlled trials (RCTs) examining the efficacy of whole-of-diet nutritional interventions in reducing depression symptoms among adults. Grounded in Bronfenbrenner’s Bioecological Model and Engel’s Biopsychosocial Model, this study explores the intersection of biological, psychological, and social factors that influence mental health outcomes. A systematic review identified six eligible RCTs assessing the impact of healthy dietary patterns, including the Mediterranean diet and other plant-based interventions, on depression symptoms. A random-effects meta-analysis revealed a significant …

Optimal Delay Time To Initiate Anticoagulation After Ischemic Stroke In Atrial Fibrillation: A Pragmatic, Response-Adaptive Randomized Clinical Trial, Steven J Warach, Lisa A Davis, Patrick Lawrence, Byron Gajewski, Jo Wick, Fred Shi, Ty T Shang, Daiwai M Olson, Sidarrth Prasad, Lee Birnbaum, Jody M Richardson, Sean I Savitz, Mark P Goldberg, Salvador Cruz-Flores, Israel Alba, Jane Anderson, Barbara Kimmel, Chethan P Venkatasubba Rao, Ben King, Adrienne N Dula, Truman J Milling

Faculty, Staff and Students Publications

Importance: Clinical practice guidelines recommend initiation of anticoagulation within 2 weeks after stroke with atrial fibrillation. It is unknown whether there is an optimal starting day within the 14-day period that balances the risks of recurrent embolic events against serious hemorrhagic events.

Objective: To determine if there is an optimal delay time to initiate treatment with a direct oral anticoagulant after atrial fibrillation-related stroke that minimizes the risk of a composite outcome of ischemic or hemorrhagic events.

Design, setting, and participants: This phase 2, pragmatic, response-adaptive randomized clinical trial was conducted between June 2017 and June 2023 at acute care …

Trajectories Of Attention Problems In Preschoolers Born Very Preterm., Marie Camerota, Francisco Xavier Castellanos, Brian S. Carter, Jennifer Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. Mcgowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Thomas Michael O'Shea, Carmen J. Marsit, Barry M. Lester

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born(GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention-deficit/hyperactivity disorder (ADHD) diagnosis.

METHODS: We studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of …

Accuracy Of Race And Ethnicity Data In The Pediatric Electronic Health Record: A Concordance And System Adequacy Study, John Cowden, Rachel Drake, Jessi Johnson, Kataina Kelty, Mehwish Ahmed

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Conventional race and ethnicity categories and analysis are reductive and prone to inaccuracy. Because race and ethnicity data validity is essential to health equity efforts, we measured the accuracy of race and ethnicity data in a pediatric electronic health record (EHR) to identify areas for improvement in data collection and use. Methods: Patients and their caregivers reported patient race and ethnicity via in-person survey in four pediatric settings (inpatient, emergency room, urgent care, and primary care). Race and ethnicity data from the EHR were compared with survey data to calculate four measures of EHR data accuracy. The U.S. Census …

Regulation Of Tfeb In Human Placental Cytotrophoblasts And Syncytiotrophoblasts, A Mathew, J S Trausch-Azar, C Azar, M Schuetz, M R Mahjoub, A L Schwartz

2020-Current year OA Pubs

While cellular proteins exist in a dynamic state maintained by the balance of synthesis and degradation, there is a paucity of information on these processes in placental trophoblasts, including within cytotrophoblasts which differentiate into multi-nucleate syncytiotrophoblasts. TFEB, a transcription factor with a myriad of cellular activities, is one of the most abundant genes expressed in syncytiotrophoblasts compared to cytotrophoblasts. TFEB is localized to the nucleus of human BeWo differentiated syncytiotrophoblasts and to the cytoplasm of the undifferentiated cytotrophoblasts. Within both the cytotrophoblasts and syncytiotrophoblasts, TFEB exists in subcellular compartments as both phosphorylated and unphosphorylated forms and translocates between cytoplasm and …

Elevated P16ink4a Expression Enhances Tau Phosphorylation In Neurons Differentiated From Human-Induced Pluripotent Stem Cells, Kristopher Holloway, Kashfia Neherin, Yingduo Song, Kazuhito Sato, Andrew Houston, Feng Chen, Li Ding, Hong Zhang

2020-Current year OA Pubs

Increased expression of the cyclin-dependent kinase inhibitor p16Ink4a (p16) is detected in neurons of human Alzheimer's disease (AD) brains and during normal aging. Importantly, selective eliminating p16-expressing cells in AD mouse models attenuates tau pathologies and improves cognition. But whether and how p16 contributes to AD pathogenesis remains unclear. To address this question, we tested whether induction of p16 expression in neurons exacerbates AD pathologies. We created a doxycycline-inducible system to trigger p16 up-regulation in human-induced pluripotent stem cells (iPSCs) and neurons differentiated from iPSCs. We demonstrated that up-regulated p16 expression in iPSCs reduces cell proliferation, down-regulates cell cycle genes, …

Treatment And Improved Outcomes Of Three Adult Patients With Guanidinoacetate Methyltransferase (Gamt) Deficiency, Angela Lee, Judith Weisenberg, Elizabeth Toolan, Marwan Shinawi

2020-Current year OA Pubs

Guanidinoacetate methyltransferase (GAMT) deficiency is a creatine synthesis disorder caused by biallelic pathogenic variants in

Brain Morphometry In Infants Later Diagnosed With Autism Is Related To Later Language Skills, Luke E Moraglia, Kelly N Botteron, Natasha Marrus, Et Al.

2020-Current year OA Pubs

Autism spectrum disorder (ASD) presents early in life with distinct social and language differences. This study explores the association between infant brain morphometry and language abilities using an infant-sibling design. Participants included infants who had an older sibling with autism (high likelihood, HL) who were later diagnosed with autism (HL-ASD; n = 31) and two non-autistic control groups: HL-Neg (HL infants not diagnosed with autism; n = 126) and LL-Neg (typically developing infants who did not have an older sibling with autism; n = 77). Using a whole-brain approach, we measured cortical thickness and surface area at 6 and 12 …

High-Dimensional Mediation Analysis For Longitudinal Mediators And Survival Outcomes, Lili Liu, Haixiang Zhang, Yinan Zheng, Tao Gao, Cheng Zheng, Kai Zhang, Lifang Hou, Lei Liu

2020-Current year OA Pubs

Mediation analysis with high-dimensional mediators is crucial for identifying epigenetic pathways linking environmental exposures to health outcomes. However, high-dimensional mediation analysis methods for longitudinal mediators and a survival outcome remain underdeveloped. This study fills that gap by introducing a method that captures mediation effects over time using multivariate, longitudinally measured time-varying mediators. Our approach uses a longitudinal mixed effects model to examine the relationship between the exposure and the mediating process. We connect the mediating process to the survival outcome using a Cox proportional hazards model with time-varying mediators. To handle high-dimensional data, we first employ a mediation-based sure independence …

Early-Life Factors And Body Mass Index Trajectories Among Children In The Echo Cohort, Chang Liu, Katherine Rivera-Spoljaric, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Identifying atypical body mass index (BMI) trajectories in children and understanding associated, modifiable early-life factors may help prevent childhood obesity.

OBJECTIVE: To characterize multiphase BMI trajectories in children and identify associated modifiable early-life factors.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included longitudinal data obtained from January 1997 to June 2024, from the Environmental influences on Child Health Outcomes (ECHO) cohort, which included children aged 1 to 9 years with 4 or more weight and height assessments. Analyses were conducted from January to June 2024.

EXPOSURES: Prenatal exposure to substances and stress (smoking, alcohol, depression, anxiety), maternal characteristics (prepregnancy …

Widespread Pain Phenotypes Impact Treatment Efficacy Results In Randomized Clinical Trials For Interstitial Cystitis/Bladder Pain Syndrome: A Multidisciplinary Approach To The Study Of Chronic Pelvic Pain Network Study, John T. Farrar, Siobhan Sutcliffe, Et Al.

2020-Current year OA Pubs

Pain clinical trials are notoriously complex and often inefficient in demonstrating efficacy, even for known efficacious treatments. A major issue is the difficulty in the a priori identification of specific phenotypes to include in the study population. Recent work has identified the extent of widespread pain as an important determinant of the likelihood of response to therapy, but it has not been tested in clinical trials for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS). We explored this hypothesis using data from 3 previously published trials testing treatments for IC/BPS, which suggested modest benefits but did not meet a priori …

A Standardized Nomenclature For The Rods And Cones Of The Vertebrate Retina, Tom Baden, Takeshi Yoshimatsu, Joseph C. Corbo, Et Al.

2020-Current year OA Pubs

Vertebrate photoreceptors have been studied for well over a century, but a fixed nomenclature for referring to orthologous cell types across diverse species has been lacking. Instead, photoreceptors have been variably-and often confusingly-named according to morphology, presence/absence of 'rhodopsin', spectral sensitivity, chromophore usage, and/or the gene family of the opsin(s) they express. Here, we propose a unified nomenclature for vertebrate rods and cones that aligns with the naming systems of other retinal cell classes and that is based on the photoreceptor type's putative evolutionary history. This classification is informed by the functional, anatomical, developmental, and molecular identities of the neuron …

The Multiverse Of Cd46 And Oncologic Interactions, M. Kathryn Liszewski, John P. Atkinson

2020-Current year OA Pubs

Initially identified as a regulator of complement activation on host cells, the known roles of CD46 (membrane cofactor protein [MCP]) have expanded. We now know that this ancient molecule is expressed on almost all nucleated cells as a family of four predominant isoforms. It also is involved in human reproduction, modulation of T cell activation and immunoinflammatory effector functions, autophagy, and the newly identified intracellular complement system (complosome). CD46 is also known as a "pathogen" magnet, being a port of entry for at least seven bacteria and five viruses. Moreover, CD46 has recently emerged as a key player in cancer …

Plasma P-Tau217 And Tau-Pet Predict Future Cognitive Decline Among Cognitively Unimpaired Individuals: Implications For Clinical Trials, Rik Ossenkoppele, Tammie L S Benzinger, Suzanne E Schindler, Randall J Bateman, Et Al.

2020-Current year OA Pubs

Plasma p-tau217 and tau positron emission tomography (PET) are strong prognostic biomarkers in Alzheimer's disease (AD), but their relative performance in predicting future cognitive decline among cognitively unimpaired (CU) individuals is unclear. In a head-to-head comparison study including nine cohorts and 1,474 individuals, we show that plasma p-tau217 and medial temporal lobe tau-PET signal display similar associations with cognitive decline on a global cognitive composite test (R

Targeting Bard1 Suppresses A Myc-Dependent Transcriptional Program And Tumor Growth In Pancreatic Ductal Adenocarcinoma, Sohum Patel, Eleanor Jenkins, Rutuj P. Kusurkar, Sherry Lee, Wei Jiang, Avinoam Nevler, Matthew Mccoy, Michael J. Pishvaian, Rosalie C. Sears, Jonathan R. Brody, Charles J. Yeo, Aditi Jain

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest cancers demanding better and more effective therapies. BARD1 or BRCA1-Associated -Ring Domain-1 plays a pivotal role in homologous recombination repair (HRR). However, its function and the underlying molecular mechanisms in PDAC are still not fully elucidated. Here, we demonstrate that BARD1 is overexpressed in PDAC and its genetic inhibition suppresses c-Myc and disrupts c-Myc dependent transcriptional program. Mechanistically, BARD1 stabilizes c-Myc through ubiquitin-proteasome system by regulating FBXW7. Importantly, targeting BARD1 using either siRNAs or CRISPR/Cas9 deletion blocks PDAC growth in vitro and in vivo, without any signs of toxicity to mice. …

Novel Application Of Orthopedic Suture Tape For Sternal Closure After Upper Hemisternotomy, Vishal N. Shah, Joshua R. Chen, Konstadinos A. Plestis

Department of Surgery Faculty Papers

The FiberTape (FT) System (Arthrex, Naples, FL, USA), initially developed for orthopedic surgery, is a new, nonmetallic, suture-based alternative to standard stainless-steel wires for sternal reapproximation. Publications on FT use after cardiothoracic surgery are limited. The FT System has not been used in upper hemisternotomy (UHS) closure. Consequently, we report the use of the FT System for sternal closure in a 70-year-old man after UHS aortic valve replacement and discuss several advantages of its application.

Graded Response Of The Pulmonary Circulation To Progressive Pulmonary Embolism In Sheep: From Compensation To Lethal Right Heart Failure, Cheng Zhou, Yuman Li, Kyle Polley, Cherry Ballard-Croft, Masashi Kawabori, Keshava Rajagopal, Joseph B. Zwischenberger, Dongfang Wang

Department of Surgery Faculty Papers

Background: Severe pulmonary embolism (PE) with right heart failure (RHF) has high mortality. To more fully understand PE progression, we evaluated the right ventricle (RV) and pulmonary circulation response to graded PE in an acute PE sheep model.

Methods: Polydextran beads were intravenously administered every 15 minutes in 250 mg doses to adult female sheep (n = 8) until death. Concurrent pulmonary artery (PA) blood flow/pressure was measured. RV pressure-volume (P-V) loops were generated with a conductance catheter. Pulmonary vascular resistance was used to stage PE severity into mild, moderate, and severe groups.

Results: All sheep developed graded RHF. For …

Exploring The Biasing Effects Of Gender On Personality Disorder Diagnoses Formulated By Artificial Intelligence, Zoe Colclough

Student Theses

Gender bias is prevalent in personality disorder assessments, and while artificial intelligence has been posited as a solution to improve diagnostic objectivity and accuracy, the potential for such technologies to propagate human gender bias in mental health contexts remains underexplored. This study investigated the influences of gender bias on the diagnostic performance of ChatGPT-4o for personality disorders using three factorial research designs, which involved experimentally manipulating patient gender in a combined sample of 360 vignettes and case studies. Vignettes were synthesized through a novel artificial intelligence-assisted methodology established for this research, and case studies were identified from the literature. Significant …

Histomorphology Of Sharp-Force Trauma On Partially Cremated Remains, Horaceena Findley

Student Theses

Identifying sharp-force trauma in thermally altered human remains presents a significant challenge in forensic investigations, particularly in arson-related deaths where traditional autopsy techniques may be limited. This study explores the efficacy of histological methods in detecting sharp-force trauma on partially cremated remains using pig ribs (Sus scrofa) as a human analog. Simulated tool marks from a knife, screwdriver, and flathead screwdriver were inflicted at varying angles (60° and 90°) and subsequently exposed to high temperatures in an open fire setting. Histological analyses, including Hematoxylin and Eosin Y (H&E) and Gomori’s Prussian Blue staining, were employed to assess tissue structure and …

Functional Genomics In Age-Related Macular Degeneration: From Genetic Associations To Understanding Disease Mechanisms, Rinki Ratnapriya, Felix Grassman, Rui Chen, Alex Hewitt, Jianhai Du, Daniel R Saban, Caroline C W Klaver, John Ash, Dwight Stambolian, Santa J Tumminia, Jiang Qian, Deeba Husain, Sudha K Iyengar, Anneke I Den Hollander

Faculty, Staff and Students Publications

Genome-wide association studies have been remarkably successful in identifying genetic variants associated with age-related macular degeneration (AMD), demonstrating a strong genetic component largely driven by common variants. However, progress in translating these genetic findings into a deeper understanding of disease mechanisms and new therapies has been slow. Slow progress in this area can be attributed to limited knowledge of the functional impact of AMD-associated non-coding variants on gene function, the molecular mechanisms and cell types underlying disease. This review offers a comprehensive overview of functional genomics approaches to uncover the genetic, epigenetic, cellular and molecular mechanisms underlying AMD and outlines …

Useful Measures Of Adult Attachment And Object Relations In Psychotherapy, Matilde A. Torallas Huerta

Dissertations

This is a literature review of objective and projective measures of attachment and object relations in adults, with the objective of reviewing outstanding research to identify the key factors for adult attachment assessment considered within attachment and object relations theories, what measures of adult attachment styles and dysfunction work best, and to provide key themes of assistance in the measurement of attachment and object relations in adult clients in psychotherapy. Theoretical foundations of attachment and object relations theory are reviewed as well as objective and projective instruments grouped by format. The 10 themes found to be useful in the assessment …

Atypical Presentation Of Iars1-Related Disorder: Expanding The Phenotype And Genotype, Parith Wongkittichote, Kira E Jonatzke, Benjamin T Hyde, Lance W Peterson, Mai He, Robert C Mckinstry, Anthony Antonellis, Marwan Shinawi

2020-Current year OA Pubs

Aminoacyl-tRNA synthetases (ARSs) catalyze the formation of aminoacyl-tRNA, which is required for protein translation. A growing number of cases are associated with ARS deficiencies. Pathogenic variants in

Evaluating The Test-Negative Design For Covid-19 Vaccine Effectiveness Using Randomized Trial Data: A Secondary Cross-Protocol Analysis Of 5 Randomized Clinical Trials, Leah I B Andrews, M Elizabeth Halloran, Kathleen M Neuzil, Lars Van Der Laan, Yunda Huang, Jessica Andriesen, Mayur Patel, Leigh H Fisher, Holly Janes, Nadine Rouphael, Stephen R Walsh, Deborah A Theodore, Hong-Van Tieu, Magdalena Sobieszczyk, Hana M El Sahly, Lindsey R Baden, Ann R Falsey, Thomas B Campbell, Colleen F Kelley, Catherine Mary Healy, Lilly Immergluck, Benjamin Luft, Ian Hirsch, Guy De Bruyn, Carla Truyers, Frances Priddy, Kelsey M Sumner, Brendan Flannery, Dean Follmann, Peter B Gilbert, Covid-19 Prevention Network (Covpn)

Faculty, Staff and Students Publications

Importance: The test-negative design (TND) has been widely used to assess postmarketing COVID-19 vaccine effectiveness but requires further evaluation for this application.

Objective: To determine whether the TND reliably evaluates vaccine effectiveness against symptomatic COVID-19 using placebo-controlled vaccine efficacy randomized clinical trials (RCTs).

Design, setting, and participants: This secondary cross-protocol analysis constructed TND study datasets from study sites in 16 countries across 5 continents using the blinded phase cohorts of 5 harmonized phase 3 COVID-19 Prevention Network RCTs: COVE (Coronavirus Vaccine Efficacy and Safety), AZD1222, ENSEMBLE, PREVENT-19 (Prefusion Protein Subunit Vaccine Efficacy Novavax Trial COVID-19), and VAT00008. Participants included adults …

Understanding The Impact Of Colloidal Calcium Phosphate On The Ph Variation In Cheddar Cheese During Early Stages Of Aging, Rachel Lindstrom

All Graduate Theses and Dissertations, Fall 2023 to Present

The Cheddar cheese industry has recently observed variation in the pH of their cheese during the early stage of storage. This variation may be due to the addition of the faster acid producing thermophilic starter culture Streptococcus thermophilus which was recently introduced into the Cheddar cheese making process. This starter culture may impact the calcium buffering properties of the cheese due to more retention of the insoluble calcium (INSOL Ca) within the cheese. To investigate this problem, we studied how insoluble calcium affects cheeses with pH ranging from 4.8 to 6.6 and found that INSOL Ca was positively correlated with …

The Burden Of Care: A Phenomenological Inquiry Into The Lived Experiences Of Homeless Shelter Administrators Leading Through The Pandemic And Lasting Implications On Program Operations, Marie Adele Wilson

Doctoral Dissertations and Projects

The theories guiding this study are Maslow's Hierarchy of Needs, conflict theory, and complex systems theory, which explain the relationship between the theory and resource limitations and acquisition, systems, and nature of acquiring human needs. The purpose of this phenomenological study is to describe homeless shelter administrators'/directors' experiences delivering services during the COVID-19 pandemic on the Eastern Coast of the United States and Texas. It further seeks to unravel how the pandemic informed the delivery of services and program administration related to homeless shelters and its impacts. The research questions sought to understand the impact of COVID-19 on delivering services …

A Qualitative Phenomenological Exploration Of The Experience Menopausal African American Women Have With Their Health Care Providers And Accessing Treatment For Menopausal Symptoms, Michelle Way-Houser

Doctoral Dissertations and Projects

This phenomenological qualitative case study delved into the underexplored area of menopausal research as it pertains to African American women. This study aimed to identify the existing gap in literature, through examining the factors contributing to the disparity, and proposed potential solutions. By conducting a thorough review of the available evidence, this study sheds light on the unique challenges faced by African American women during menopause and advocates for more inclusive and diverse research approaches in this field. Semi-structured interviews were conducted with ten participants and thematic analysis was used to identify key themes related to symptom management, healthcare access, …

Commencement Program 2025, Loma Linda University

Commencement Programs

CONTENTS

2 | Message from the President

3 | 2025 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

The Programs, The School Honorees, and The Speakers

29 | School of Medicine

50 | School of Pharmacy

63 | School of Dentistry

81 | School of Public Health

94 | San Manuel Gateway College

101 | School of Allied Health Professions - Allied Health …