Medicine and Health Sciences Commons^™

Quality And Access To Care For Cardiovascular Disease Prevalence In Women Veterans: Population Estimate Using Electronic Health Records, Meena Marie Kim-Dopp, Vanessa Gow-Lee, Linda Ferry, Sharon Jamie, Ralph Clark, Suma Singh

Loma Linda University Student Journal

Electronic Health Records are used to measure quality indicators for cardiovascular disease (CVD), but have not been tested for sensitivity and specificity. Computerized Patient Record System (CPRS) used by the Veterans Health Affairs (VHA), has active CVD clinical reminders from Healthcare Effectiveness Data & Information Set (HEDIS) that are compared nationally. San Bernardino County, CA has a 7.8% prevalence of self-reported CVD in both genders. For HEDIS measures, there is only a 4 point CVD composite score gender difference for VHA nationally, but at the Loma Linda VHA there is an 18 point gender difference (2016). Women Veterans (WV) are …

Is Engagement Alone Sufficient To Ensure “Active Learning”?, Reed Krause, Amy C. Hayton Md, Jeff Wonoprabowo, Lawrence Loo

Loma Linda University Student Journal

“Active Learning” is commonly defined as any instructional method that engages students in the learning process. However, active learning encompasses a broad range of educational methods and its impact on learning outcomes has been variable. In 2015, our IM clerkship redesigned its half-day learning sessions from a largely passive didactic style of lecturing to more active learning approaches. We further revised the curriculum in 2016 to further convert the sessions to primarily case based learning led by a faculty or resident. The goal of our intervention was to increase the Self-Reported Engagement Measure (STOBE) of each didactic session and improve …

Does Ecg And Arrhythmia Simulation Training In Adjunct To Didactics Improve Medical Students’ Clinical Skills Compared To Didactics Alone?, Reed Krause, Amy C. Hayton Md

Loma Linda University Student Journal

Medical Schools continue to face the challenge of bridging the gap between classroom education and its application in the clinical environment. Several studies have shown utility of incorporating simulation training into a variety of healthcare related topics. We hypothesize that incorporating ECG and arrhythmia simulation training in adjunction to ECG and arrhythmia didactics; it would improve Year-3 medical students’ preparedness for managing arrhythmias in the clinical setting.

Percutaneous Externally Assembled Laparoscopic (Peal) Donor Nephrectomy: A Cohort Pain Comparison, Tyler Miskin, Isaac Kelly, Matthew Pierce, Samuel Abourbih, Duane D. Baldwin

Loma Linda University Student Journal

Donor nephrectomies can be technically demanding. Donors also may not be fully psychologically prepared for their post-operative pain or cosmetic outcome. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) paradigm was developed to decrease incisional pain and laparoscopic scars. The aim of this study is to compare the post-operative outcomes between donor nephrectomies performed with and without the PEAL instruments.

Glycemic Control In Insulin And Non-Insulin Dependent Diabetic Patients With St Elevation Predicts Time To Presentation, Jonathan Evans, David Hamilton, Tigran Khachatryan, Daniel K. Amponsah, Andrew Stewart, Islam Abudayyeh, Kenneth Jutzy, Eric Suh, Anthony Hilliard

Loma Linda University Student Journal

Worldwide, the annual number of people diagnosed with diabetes continues to increase. Classically, Diabetes Mellitus (DM) has been associated with silent or atypical initial symptoms and increased time to presentation in patients presenting with ST elevation myocardial infarction (STEMI) compared to non-DM patients. It is less clear whether the type of treatment or the adequacy of glycemic control impacts the time to presentation and type of symptoms. Therefore, we sought to evaluate the impact of poor glycemic control on these outcomes as measured by hemoglobin A1c.

Magnetically Focused Proton Irradiation Of Small Volume Radiosurgery Targets Using A Triplet Of Quadrupole Magnets, Patrick Mcgee, Grant Mcauley, Andrew Wroe, James M. Slater, Jerry D. Slater

Loma Linda University Student Journal

Proton therapy is an advantageous choice for the irradiation of tumors in proximity of critical structures due to rapid dose fall off and high dose deposition at target compared to dose at the surface of the patient (ie, peak-to-entrance dose ratio (P/E)). However, with target fields below 1.0 cm, as often encountered in proton radiosurgery, multiple Coulomb scattering (MCS) broadens proton beams leading to diminished P/E advantages and reduced dose delivery efficiency (DDE). Magnetic focusing tends to counteract MCS and is a promising method to reduce these undesirable effects. The purpose of this research is to investigate the advantages of …

Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes

Loma Linda University Student Journal

Approximately 14% of school age children with sports-related concussions (SRC) remain symptomatic 3 months after injury. Previous studies have used diffusion tensor imaging (DTI) to detect white matter tract changes in regions of interest in symptomatic patients; however data in the pediatric population remains limited. This study was undertaken to determine whether DTI metrics can provide valuable information in pediatric mTBI patients with persistent symptoms.

Multimodality Minimally Invasive Treatment Of Large Joint Osteoarthritis: A Pilot Trial Of Stromal Vascular Fraction From Autologous Fat Combined With Platelet-Rich Plasma, Phil Giddings, Insiyah Campwala, Subhas Gupta

Loma Linda University Student Journal

Osteoarthritis (OA) is a degenerative joint disease that can cause severe pain in those affected. Currently, there are no therapeutic drugs available to treat osteoarthritis. While total joint arthroplasties (TJA) allow for improved function, there are no less invasive, yet effective procedures that can be done for patients unwilling or unable to undergo major surgery.

Platelet-rich plasma (PRP) has been shown to reduce the symptoms of OA when injected into the affected joint. Patients treated by this method alone have improved self-reported pain (at least a 50% reduction from original value) as well as lower extremity function. While the effects …

Identification Of Unreported Sources Of Objects Containing High Release Nickel, David J. Eng, Mary A. Rasmussen, Chandler Rundle, James K. Parker, Daniel Bergman, Sharon E. Jacob

Loma Linda University Student Journal

Globally, nickel is the leading cause of allergic contact dermatitis (ACD). Nickel is ubiquitous, and published literature continues to index items most frequently associated with Ni-ACD. Unregulated nickel exposure in North America is evident by the unprecedented rates of sensitization seen in patch-tested cohorts, 18.5% in children (ages 0-18 years) and 28.1% in adults.¹ Conservative estimates of ACD within the pediatric population suggest at least one million cases in the US yearly with roughly one-quarter of those cases due to nickel.^2-3 The United States could potentially save $5.7 billion annually in health care costs, extrapolating current cost-saving data …

The Feasibility Of Percutaneous Externally Assembled Laparoscopic Nephrectomy: A New Surgical System, Benjamin West, Jerry Thomas, Mohamed Keheila, Nazih Khater, Samuel Abourbih, Salim Cheriyan, Matthew Pierce, Duane D. Baldwin, Jim Shen

Loma Linda University Student Journal

Laparoendoscopic single-site (LESS) nephrectomy provides excellent cosmetic outcomes, but is technically challenging due to loss of triangulation and increased instrument collision. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) surgical system was developed to simplify minimally invasive surgery while providing a nearly scarless outcome. In this study, the feasibility of the PEAL system for nephrectomy was determined.

Comparing The Vaginal Wall Sling With Autologous Rectus Fascia And Polypropylene Sling On Outcome And Patient Satisfaction, Mohamed Keheila, Salim Cheriyan, Jim Shen, Catalino J. Bautista, Josianne Bailey, Kevin Kim, Marina Germanos, Isaac Kelly, Matthew Pierce, Andrea Staack

Loma Linda University Student Journal

Since 2011 FDA safety update on transvaginal synthetic mesh for treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP), providers are encouraged to counsel patients on risks related to synthetic mesh slings, such as dyspareunia, erosion, and extrusion. As an alternative to synthetic slings patients often choose autologous slings. We aim to compare outcome and patient satisfaction in patients, who received an autologous vaginal wall sling (VWS), rectus fascia sling (RFS), or synthetic suburethral sling (SSS) for treatment of SUI.

Assessing Dietary Advancement For Dysphagia Patients At Risk For Aspiration, Cedric Thiel, Thomas Murry, Brianna Crawley, Priya Krishna

Loma Linda University Student Journal

Fiberoptic endoscopic evaluation of swallowing (FEES) evaluates oral intake safety by allowing direct observation of laryngeal function before and after swallowing. The purpose of this study was to delineate the impact of abnormal vocal fold mobility and altered laryngeal sensation on dietary management in hospitalized patients previously diagnosed with aspiration.

Impact Of Macra Legislation And Mips Scores On Cost Effective Analysis For Negative Pressure Wound Therapy Devices, Jeremy W. Kubiak, Subhas Gupta

Loma Linda University Student Journal

The Medicare Access and CHIP Reauthorization Act (MACRA) changes reimbursement from a fee-for-service payment system to fee-for-value. Physicians will be scored according to the quality of their care in the MIPS program and will receive a positive or negative modifier to their Medicare reimbursement based on that score.

Ischemic Time And Risk Factors Associated With The Incidence Of Cardiogenic Shock In Patients Presenting With St Elevation Myocardial Infarction, Daniel K. Amponsah, Jonathan Evans, David Hamilton, Tigran Khachatryan, Andrew Stewart, Islam Abudayyeh, Kenneth Jutzy, Anthony Hilliard

Loma Linda University Student Journal

Cardiogenic shock (CS) is the number one predictor of mortality in patients with ST-elevation myocardial infarction (STEMI). Emergent evaluation and treatment including revascularization when indicated is recommended upon arrival to hospital. There is variation in time to presentation and total ischemic time in this patient population. We sought to evaluate the impact of ischemic time on incidence of CS and variables which may influence its presentation.

Alumni Journal - Volume 88, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
10 | A Letter to Alumni
12 | The Alumni Association’s Historical Ties to Research
13 | The Opera Singer
15 | Interview: It All Began with a Bald Mouse, Gerald G. Krueger ’66
18 | Graduation 2017
32 | The Art of Unconventional Connections
34 | A Balancing Act
36 | When I Am Not Rewarded

Departments
2 | From the Editor
4 | From the President
6 | From the Vice Dean
7 | The Student Fund
8 | School of Medicine News
38 | Placement and Classified Ads
39 | Alumni News
40 | In Memoriam …

Parenting Stress And Emotion Dysregulation In Children With Dd: The Role Of Parenting Behaviors, Neilson Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Parents of children with developmental delays (DD) report higher levels of parenting stress compared to parents of typically developing children. High levels of parenting stress have been associated with negative outcomes for their children, including higher levels of emotion dysregulation. However, this relationship between parenting stress and child emotion dysregulation has rarely been examined in families of children with DD. Additionally, the mechanisms through which parenting stress influences child emotion dysregulation remain unclear; it may be that parenting stress impacts parenting behaviors (i.e., sensitive and intrusive parenting), which in turn influence the development of the child’s emotion regulatory abilities. In …

Comparison Of Antibacterial Activity Of Ozonated Olive Oil And Chlorhexidine Gluconate, Changmin Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Aim: The aim of this in vitro disk diffusion susceptibility test is to compare the antibacterial activity of ozonated olive oil (OzOO) with chlorhexidine gluconate (CHX) against periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter Actinomycetemcomitans. Materials and Methods: The antibacterial activity of two antiseptics, OzOO and CHX, and, two controls, olive oil and normal saline was assessed by disk diffusion susceptibility test. For disk diffusion susceptibility test, two periodontal pathogens, 20 petri dishes for P. gingivalis and 18 petri dishes for A. actinomycetemcomitans, were used. To assess the antibacterial activity, the diameters of the growth inhibition zone were measured with a …

The Substance Abuse Treatment Experience Of Men Who Have Sex With Men, Scott Sanford Johnson

Loma Linda University Electronic Theses, Dissertations & Projects

The following qualitative research study focuses on the substance abuse treatment experiences of men who have sex with men. Current research in this area indicates that while these men sometimes seek treatment for substance abuse issues, their treatment experience can be compromised due to personal fears or ignorance on the part of treatment staff members or others in treatment (Cabaj, 2008; Cheng, 2003; Hellman, Stanton, lee, Tytun, & Vachon, 1989). Specific goals of this study include: (1) gaining insight into the treatment experience(s) of these men and (2) learning about how their individual and collective treatment experience(s) contribute to their …

Behavioral Ecology And Associated Virology Of Mosquito-Host Interactions In Southern California, Oliver Eshun

Loma Linda University Electronic Theses, Dissertations & Projects

Elucidating characteristics of mosquito-host interactions are critical for understanding the ecology and epidemiology of mosquito-borne diseases. In this dissertation, I conducted three studies to explore potential mosquito-host interactions and associated virus infection rates. I first demonstrated that mosquito captures at CO2-baited traps decreased most markedly with height above ground, and also decreased with distance from water at a riparian area but not at an open water source lacking a vegetated border. Birds might therefore prefer elevated nests or roosts to avoid mosquitoes. The second study examined the anti-mosquito behaviors of budgerigars (Melopsittacus undulatus) in a laboratory study. The birds defended …

A Comparison Of Neuromuscular Control Between Subjects With And Without Chronic Ankle Instability, Hatem Jaber

Loma Linda University Electronic Theses, Dissertations & Projects

Ankle sprains are common and potentially disabling musculoskeletal injuries occur among physically active individuals. A subsequent problem that is commonly encountered by clinicians due to ankle sprains is the development of ongoing instability. The presence of ankle instability has been linked to impairments in postural and neuromuscular control; however, inconsistent findings have been reported. These discrepancies deem the need to further investigate and provide additional knowledge regarding postural and neuromuscular control strategies utilized by this population. This may enhance the current understanding of chronic ankle instability (CAI) and help to understand how rehabilitation can be customized to specifically target and …

Endothelin-1 And Hypoxic Vascular Remodeling In Ovine Fetal Cerebral Arteries, Jinjutha Silpanisong

Loma Linda University Electronic Theses, Dissertations & Projects

Intrauterine hypoxia resulting from decreased maternal oxygen uptake, insufficient oxygen carrying capacity, or compromised oxygen delivery to the fetus jeopardizes fetal oxygen delivery, detrimentally affecting growth and development of the immature vasculature. Hypoxia transiently increases Hypoxia Inducible Factor-1α (HIF- 1α), which complexes with HIF-1β to form the active HIF-1 dimer that can affect transcription. This temporary rise in HIF-1 can promote gene transcription of ligands such as Vascular Endothelial Growth Factor (VEGF) and Endothelin-1 (ET-1), which rises and falls with HIF levels. The absence of chronic elevation of these ligands prompted the question of how long-term effects of hypoxia is …

Llusd Articulator - Volume 28, Number 2, Loma Linda University School Of Dentistry, Montry S. Suprono

Articulator (Dentistry Journal)

Contents:

4 | The dean's brown bag
9 | Handysides appointed 6th LLUSD dean
10 | Tory Silvetrin runs life's marathon at a sprint
16 | Jess Hayden family donates his 50,000 prosection slides
20 | LLUSD's 61st Commencement
32 | Bonding & zirconia: a literature review
44 | Falling in L-O-V-E with dentistry
46 | Postgraduate Endo celebrates 50 years
48 | LLUSD News

Loma Linda Nurse - Vol. 25, No. 01, Loma Linda University School Of Nursing

Loma Linda Nurse

Contents

FEATURES

4 | Full Circle – Dexter Emoto and Mao Kimura

6 | Mentorship

8 | A Place for Excellence

10 | New Scholarships at the School of Nursing

LLUSN HIGHLIGHTS

12-17 | ALUMNI NEWS

18-23 | HOMECOMING

24-27 | COMMENCEMENT

28-32 | ACADEMICS

33-35 | FACULTY UPDATES

Prediction Of Root Form Using Crown Data: Mandibular Left First Premolar, Matthew E. Durschlag

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: The purpose of this study was to determine if a statistical shape model (SSM) of the lower left first premolar, consisting of both crown and root data, could adequately describe the root form from a surface scan consisting of only crown data. Secondly, it tested if there were any angles or measurements on the tooth crown that correlate with any aspects of root morphology. The average orthodontist practicing today or in the near future is likely to use or own a digital intraoral scanner in their office. Yet optical scans only allow visualization of the crowns of teeth and …

Factors Associated With Orthodontically Induced Apical Root Resorption Of Maxillary Incisors, Brandon Malan

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Resorption of root apices is a ubiquitous occurrence in orthodontic treatment. Although most occurrence of resorption during orthodontic treatment is clinically inconsequential, a small percentage of patients have a severe amount of root structure that is lost. There are factors that are widely accepted as responsible for apical root resorption (RR), such as heavy compressive forces on the periodontal ligament (PDL). Unfortunately, it is still largely unpredictable if one patient will experience more root loss than what is considered normal. Thus, it is of clinical interest to further study what factors play a role in RR. Purpose: The purpose …

The Role Of Vegf And Smooth Muscle Phenotype In Hypoxic Remodeling Of Ovine Carotid And Cerebral Arteries, Margaret C. Hubbell

Loma Linda University Electronic Theses, Dissertations & Projects

Arteries are a dynamic tissue with multiple cell types that incorporate systemic and local factors to maintain homeostasis. Hypoxia stimulates capillary angiogenesis to effectively match metabolic demand with perfusion. With chronic hypoxia, vascular remodeling of even large vessels can occur. This predisposes to pathologic states as seen with atherosclerosis, hypoxic brain injury, myocardial ischemia, diabetes, and developmental anomalies. With this remodeling comes changes in vessel structure including medial thickness and organization of contractile proteins as well as changes in myogenic tone. All of these factors culminate in changes in status or behavior of the vascular smooth muscle within the vessel …

Effects Of Wire Material, Deflection, And Interbracket Distance On Burstone Bracket Geometry Force Systems, Skyler J. Liatti

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. This paper aims to quantify the effect of wire material, dimension, and deflection on the most identifiable feature of the six-geometries: the moment dissociation point (force system with no moment on the lesser angled bracket), which may or may not occur at the classically defined geometry IV. Materials and Methods. A six-degree of freedom load cell was used to measure the force systems in different combinations of wire materials, wire dimensions, total angle of bracket, and interbracket distance. Brackets were progressively rotated through Burstone and Koenig’s six geometries and the moment on the right bracket was plotted against the …

Effect Of Extracellular Survivin And Lymphoma Exosomes On Natural Killer Cells, Heather R. Ferguson Bennit

Loma Linda University Electronic Theses, Dissertations & Projects

Tumors alter their microenvironment to promote survival using methods such as angiogenesis promotion, growth signals, and immune suppression. The immune system becomes unresponsive to transformed neoplastic cells through a variety of methods including T cell suppression, increased myeloid-derived suppressor cells (MDSCs), and reduced natural killer (NK) cell activity. NK cells have inherent killing capabilities and thus are among the first responders in recognizing and destroying abnormal cells. However, many types of cancers inhibit the surveillance and cytotoxic abilities of NK cells by releasing exosomes, vesicles that can modulate the tumor microenvironment (TME) and intercellular communication for the purpose of enhancing …

Comparison Of Tooth Length Measurements Made On Cbct And 3t Mr Images, Danielle A. Piano

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: The aim of this study is to compare tooth length measurements made on cone beam computed tomography (CBCT) scans and 3-Tesla (3T) magnetic resonance (MR) scans. Materials and Methods: One CBCT scan (NewTom5G, AFP Imaging, USA) and one 3T MR scan (Siemens Medical Solutions, DE) as performed on 12 subjects. CBCT images were captured with an 18x16 inch field of view that covered the whole head. Contiguous sagittal MR images of the whole head were produced in a 3.0T imaging system with a T1-weighted 3D imaging sequence (Magnetization Prepared Rapid Acquisition by Gradient Echo (MP-RAGE), TP/TE = 1950/2.26 ms) …

The Effects Of Wearing Headscarves On Cervical Spine Proprioception And Range Of Motion, Samiah Alqabbani

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Wearing the headscarf is a part of an essential religious practice by females in Islamic cultures. Regular wear of the headscarf might have an influence on cervical proprioception and range of motion (ROM). The cervical spine is unique in providing multidirectional movement as well as providing the sense of awareness of movement of the head and neck in space. Impairments in cervical mobility and proprioception have been reported in subjects with whiplash-associated disorder as well as subjects having neck pain. Objectives: 1) To determine the effects of wearing the headscarf on cervical spine ROM and joint position error …