Medicine and Health Sciences Commons^™

Developmental Intervention Patterns In A Level Iv Neonatal Intensive Care Unit (Nicu), Grace Winningham, Cy Nadler, Sarah Nyp, Eugenia K. Pallotto, Ashley Sherman

Posters

Background: There are no evidence-based standards for if/when developmental interventions should be initiated while an infant is in the neonatal intensive care unit (NICU), or these services yield incremental benefit. To support future prospective studies evaluating the neurodevelopmental benefits of NICU-based services as well as standardizing protocols for developmental interventions in the NICU, a thorough descriptive investigation of current developmental intervention practices is necessary. Objective: To describe trends in the delivery of developmental interventions [physical therapy (PT), occupational therapy (OT), speech-language therapy (ST), child life (CL), and music therapy (MT)] in high-risk infants in a large level-IV NICU. Methods: Electronic …

Walking For Our Health: Couple-Focused Interventions To Promote Physical Activity In Older Adults, Melissa M. Franks, Elizabeth A. Richards, Meghan H. Mcdonough, Sharon L. Christ, Mary E. Marshall

School of Nursing Faculty Publications

More than 50% of U.S. adults do not engage in sufficient physical activity to meet current recommendations, making physical activity change and maintenance a priority for health promotion throughout adulthood. Among married partners, change in physical activity of one partner often is concordant with change of activity of the other. The primary purpose of this study was to examine two couple-focused interventions that capitalize on the co-occurrence of health behavior change within couples to promote physical activity in older adults. In this study, partners (N = 31 couples) participated together in assessment and intervention activities, and were randomized together into …

Case Report: A Hard Cyst To Swallow, Anjalee Choudhury, Joshua Wood, Kristan Diaz-Rios, Jyothi Swarup

School of Medicine Publications

One day old neonate was born at 37 weeks gestation to a 41-year-old Gravida 5 Para 5 born via uncomplicated caesarean section. A physical exam of the newborn had unremarkable findings except for minor skin tags on the neck and a cleft palate.

Efficacy And Safety Of Varenicline For Smoking Cessation In Schizophrenia: A Meta-Analysis, Saeed Ahmed, Sanya Virani, Vijaya P. Kotapati, Ramya Bachu, Mahwish Adnan, Ali M. Khan

School of Medicine Publications

Objective: Smoking represents a major public health problem among patients with schizophrenia. To this end, some studies have investigated the efficacy of varenicline for facilitating smoking cessation in schizophrenia patients. The present review seeks to synthesize the results of these studies as well as document the reported side effects of using this medication.

Methods: An electronic search was performed using five major databases: PubMed, Scopus, EMBASE, Web of Science, and Cochrane Library. Included in the current analysis were randomized clinical trials (RCTs) that have investigated the effect of varenicline in promoting smoking cessation in patients with schizophrenia. Risk of …

Carglumic Acid Treatment Of A Patient With Recurrent Valproic Acid-Induced Hyperammonemia: A Rare Case Report, Yasar Sattar, Saad Wasiq, Waqas Yasin, Ali M. Khan, Mahwish Adnan, Shristi Shrestha, Nirav B. Patel, Sharaad Latchana

School of Medicine Publications

Valproic acid, first manufactured as an anticonvulsant, is commonly used to treat both neurological and psychiatric conditions. A rare and deadly side effect of this medication is hyperammonemia, presenting as lethargy, confusion, seizure, and, ultimately, coma. In rare circumstances, hyperammonemia can be recurrent and devastating, especially in patients with an underlying N-acetyl glutamate synthase (NAGS) deficiency, as the valproic acid can enhance this enzyme deficiency and inhibit the conversion of ammonia into urea in the liver. For these subtypes of patients, the United States Food and Drug Administration (US FDA) has recently approved carglumic acid, a medication that can act …

Postictal Mania Versus Postictal Psychosis, Sukaina Rizvi, Faiza Farooq, Shanila Shagufta, Ali M. Khan, Yasir Masood, Hina Saeed

School of Medicine Publications

PIM (postictal mania) or PIP (postictal psychosis) usually comes on after a single episode or a seizure cluster of generalized tonic-clonic or complex partial secondarily generalized seizures. Patients maintain a lucid interval of clear consciousness which precedes a psychotic episode. The symptoms may include insomnia, hallucinations, delusions, elated expansive mood, euphoria, and distractibility. We present a case of a 62-year-old male with PIP or mania preceding an episode of seizure. In the light of this case report, we illustrate the importance of being vigilant about the psychotic symptoms in a patient with epilepsy in order to minimize the morbidity.

Anxiety Modulates The Relation Between Attention-Deficit/Hyperactivity Disorder Severity And Working Memory-Related Brain Activity, Dennis Van Der Meer, Pieter J. Hoekstra, Daan Van Rooij, Anderson M. Winkler, Hanneke Van Ewijk, Dirk J. Heslenfeld, Jaap Oosterlaan, Stephen V. Faraone, Barbara Franke, Jan K. Buitelaar

School of Medicine Publications

OBJECTIVES: Individuals with attention-deficit/hyperactivity disorder (ADHD) often have heightened levels of anxiety, which has been associated with worse performance on working memory tasks. Knowledge of the neural pathways underlying the combined presence of ADHD and anxiety may aid in a better understanding of their co-occurrence. Therefore, we investigated how anxiety modulates the effect of ADHD severity on neural activity during a visuospatial working memory (VSWM) task.

METHODS: Neuroimaging data were available for 371 adolescents and young adults participating in the multicentre cohort study NeuroIMAGE (average age 17.1 years). We analysed the effects of ADHD severity, anxiety severity and their …

Neuroprotective Functions Of Docosahexaenoic Acid And Epidermal Fatty Acid Binding Protein, Manuel Luis Montero

Loma Linda University Electronic Theses, Dissertations & Projects

Lipotoxicity (LTx) is involved in mostly every process of neuronal injury. Using NGFDPC12 cells we show that palmitic acid (PA) induces the expression of stress response genes HIF-1α and BNIP3, increases the accumulation of reactive oxygen species, and decreases cell viability by apoptosis. Inhibition of cathepsins does not rescue neurons from PA-LTx but inhibition of necroptosis and promotion of autophagy do. DHA decreases the expression of HIF-1α and BNIP3 and rescues PA-induced cell death by inhibiting apoptosis and necroptosis. Besides DHA stimulates the mRNA expression, phosphorylation and conjugation of autophagy controlling proteins. Inhibiting autophagy during DHA treatment decreases its capacity …

A Novel Exo-Proteomic Approach To The Study Of Traumatic Brain Injury, Ron B. Moyron

Loma Linda University Electronic Theses, Dissertations & Projects

Concussions and Traumatic Brain Injuries (TBI) are significant health concerns and affect a wide cross section of society. Current diagnostic criteria and modalities, such as brain imaging and subjective measures of consciousness such as the Glasgow Coma Scale (GCS) score, are insufficient to properly diagnose the full spectrum of head injuries. Assessment of injury severity and outcome are further complicated by the vast array of symptoms, many of which mimic those displayed by other disorders. It is important to possess a better diagnostic tool for head injury triage and outcome prediction. One current line of inquiry seeks to discover a …

Using The Theory Of Planned Behavior To Understand Student Compliance To Tobacco-Free Policies In California Universities, Harit Agroia

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In California, the mortality rate associated with smoking ranks as the sixth highest among all states in the nation (CDPH, 2016). To reduce this rate, many universities in California have adopted tobacco-free policies in recent years (Mamudu, Veeranki, Kioko, Boghozian & Littleton, 2016). Due to the recent adoption of such policies, there is limited research available which aim to assess the effectiveness of these on tobacco use behavior on campus among university students.

Purpose: The purpose of this study was to understand student compliance to tobacco-free policies within select universities in California, specifically those that implemented their …

Ferritin Level Prospectively Predicts Hepatocarcinogenesis In Patients With Chronic Hepatitis B Virus Infection, Zhenyuan Bian, Hie-Won Hann, Zhong Ye, Chun Yin, Yang Wang, Wan Fang, Shaogui Wan, Chun Wang, Kaishan Tao

Department of Medical Oncology Faculty Papers

Previous studies have detected a higher level of ferritin in patients with hepatocellular carcinoma (HCC), but a potential causal association between serum ferritin level and hepatocarcinogenesis remains to be clarified. Using a well-established prospective cohort and longitudinally collected serial blood samples, the association between baseline ferritin levels and HCC risk were evaluated in 1,152 patients infected with hepatitis B virus (HBV), a major risk factor for HCC. The association was assessed by Cox proportional hazards regression model using univariate and multivariate analyses and longitudinal analysis. It was demonstrated that HBV patients who developed HCC had a significantly higher baseline ferritin …

Outcomes Of Shoulder Arthroplasty Performed For Postinfectious Arthritis., Eric M. Padegimas, Thema A. Nicholson, Stephen Silva, Matthew L. Ramsey, Gerald R. Williams, Mark D. Lazarus, Surena Namdari

Rothman Institute Papers

Background: The purpose of this study was to evaluate the functional outcomes, infection rate, and complications associated with shoulder arthroplasty for sequelae of prior septic arthritis.

Methods: This is a retrospective cohort study of 17 patients who underwent shoulder arthroplasty for sequelae of septic arthritis. Patients were analyzed for patient-reported outcomes, complications, and reoperations.

Results: The 17 patients in this cohort were an average age of 65.4 ± 12.2 years old, were 58.8% male, and had an average body mass index of 27.9 ± 4.1 kg/m

Conclusions: Shoulder arthroplasty after septic arthritis had inconsistent functional outcomes and high complication rates …

Synthesis And Characterization Of Cytocompatible Sponge-Mimetic Scaffolds And Biomedical Polymers, Kamia Punia

Dissertations, Theses, and Capstone Projects

This dissertation describes the novel synthetic methodologies towards: a) protein/polysaccharide intercalated sponge-mimetic scaffolds for 3D cell culture, b) peptide-mimetic cationic amphiphilic antibacterial polymers, and c) bioactive Poly(DL-lactide-co-glycolide) (PLGA) nanofibers by solution blow spinning for the treatment of cancer and traumatic wound care.

The classic “chemical garden” experiment is reconstructed to produce protein/polysaccharide (ingredients of cyanobacterial origin) intercalated silicate-phosphate tubules that resemble tubular sponges. The constructs were synthesized by seeding calcium chloride into a solution of sodium silicate-potassium phosphate and gelatin/polysaccharides. The morphology and composition of sponge-mimetic tubules were analyzed by a battery of techniques. Bioconjugation and coating protocols were developed …

Diagnosing The Will To Suffer: Lovesickness In The Medical And Literary Traditions, Jane Shmidt

Dissertations, Theses, and Capstone Projects

Throughout Western medical history, unconsummated, unreturned, or otherwise failed love was believed to generate a disorder of the mind and body that manifested in physiological and psychological symptoms. This study traces the medical and literary history of lovesickness from antiquity through the 19^th century, emphasizing significant moments in the development of the medical discourse on love. The project is part of the recent academic focus on the intersection between the humanities and the medical sciences, and it situates literary texts in concurrent medical and philosophical debates on afflictions of the psyche. By contextualizing the fictional works within the scientific …

What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis

Dissertations, Theses, and Capstone Projects

There is a robust evidence that childhood maltreatment contributes to the development of adult psychopathology (Brown & Anderson, 1991; Johnson, Cohen, Brown, Smailes, & Bernstein 1999; Johnson, Smailes, Cohen, Brown, & Bernstein, 2000; Ruggiero et al., 1999). However, the identification of childhood maltreatment remains a methodological problem that results in inconsistencies in the reported incidence and psychological sequelae of maltreatment. A primary method for identifying histories of childhood maltreatment among adults is retrospective self-report measures which are susceptible to multiple biases (Briere, 1992; Cicchetti & Rizley, 1981; Shaffer, Huston, & Egeland, 2008). This present study suggests that childhood maltreatment can …

The Effect Of Nurse Residency Program Completion On Work Readiness Of New Graduate Nurses Transitioning Into Professional Practice, Suzanne Mullings-Carter

Dissertations, Theses, and Capstone Projects

The transition of new graduate nurses from their roles as students to professional nurses is challenging. New graduate nurses have to complete cursory orientation with high performance expectations, increased level of accountability and meet the complex needs of the patients, leading to high turnover rates within the first year of practice.

To address this problem, nurse residency programs have been implemented to support new graduates with the transition into professional nursing. In addition to transitional support, new graduate nurses need to be ready to meet the demands of their new work environment. The problem is determining whether or not new …

Curcumin Inhibits The Ikk:Nf-Kappa B Pathway In Neural Fear Circuits, Miguel A. Briones

Dissertations, Theses, and Capstone Projects

The study of how the brain acquires fearful memories has attracted considerable experimental attention, due in part to the promise of discovering novel therapeutic approaches for psychiatric disorders that are characterized by unusually strong and persistent traumatic memories. In recent years, extensive research has focused on studying the neural and molecular mechanisms by which fear memories are acquired, stored, and retrieved in the brain. Once acquired, fear memories may be attenuated using one of 2 procedures: 1) fear extinction, which involves repeated presentation of the fear-arousing stimulus in the absence of an aversive consequence, or 2) interference with the reconsolidation …

Increasing Access To Pre-Exposure Prophylaxis (Prep) Among Transgender Women And Trans Feminine Non-Binary Individuals In New York City, Augustus Klein

Dissertations, Theses, and Capstone Projects

In the United States transgender women (i.e., individuals born male whose gender identity is on the feminine spectrum) are a highly vulnerable and marginalized population at high risk for HIV. Substance use, survival sex work, depression, unstable housing, and high levels of victimization and violence are commonly reported by transgender women and trans feminine individuals, indicating the potential for multiple concurrent HIV risks and underlying vulnerabilities. Structural forms of discrimination may contribute to these risk factors, possibly leading to poor outcomes such as unemployment or underemployment, homelessness, and lack of access to gender-affirming health care. Given this context, a biomedical …

Casualties Of Racism: Racial And Ethnic Discrimination And Suicidal Thoughts And Behaviors Among Racial And Ethnic Minority Emerging Adults, Lillian Anais Polanco

Dissertations, Theses, and Capstone Projects

The evidence demonstrating that experiences of racial/ethnic discrimination is detrimental to the mental health of racial/ethnic minority youth is unequivocal. What remains unclear, however, is whether racial/ethnic discrimination increases vulnerability for suicidal thoughts and behaviors in particular, and if so, what are the underlying mechanisms to explain this relation. Drawing upon the Race-based Traumatic Stress Theory (Carter, 2007), which suggests that some individuals may experience racial/ethnic discrimination as a traumatic stressor, and thus, eliciting a traumatic stress response, the present study examined posttraumatic stress reactions (i.e., posttraumatic stress, depression, dissociation, stress sensitivity) as mediators in the relation between racial/ethnic discrimination …

Linking Hostile/Helpless Maternal Representations In Pregnancy And Later Child Protection Involvement: A Pilot Study, Madeleine Terry

Dissertations, Theses, and Capstone Projects

The present pilot study examined whether there are reliable indices in the narratives of pregnant women that can be used to identify child abuse and neglect potential before the birth of the child. The Hostile/Helpless (HH) Classification system (Lyons-Ruth et al., 1995-2005), which detects mental states associated with trauma, disturbances in early attachment, and severe pathology, was adapted for use with the Pregnancy Interview (PI), a semi-structured clinical interview (Slade, 2003) that assesses a woman's emotional experience of pregnancy, and quality of her developing relationship with her baby. The study sample was drawn from a replication study of the Minding …

Demystifying The Placebo Effect, Phoebe Friesen

Dissertations, Theses, and Capstone Projects

This dissertation offers a philosophical analysis of the placebo effect. After offering an overview of recent evidence concerning the phenomenon, I consider several prominent accounts of the placebo effect that have been put forward and argue that none of them are able to adequately account for the diverse instantiations of the phenomenon. I then offer a novel account, which suggests that we ought to think of the placebo effect as encompassing three distinct responses: conditioned placebo responses, cognitive placebo responses, and network placebo responses. Next, I consider implications of the placebo effect’s role in complementary and alternative medicine for discussions …

Underlying Contribution Of Executive Functioning To Cognition And Academic Achievement In Individuals With Dystrophinopathy, Robert Fee

Dissertations, Theses, and Capstone Projects

Dystrophinopathy is a genetic disorder that results in the lack of or abnormal expression of the protein dystrophin. It is a disorder that alters cell structure and function, impacts the developing brain and brain function, presents with multi-domain cognitive deficits, and influences both mood and behavior. Cognitive impairments appear to be more localized to specific areas of functioning rather than a global deficit; however, deficits have been identified across multiple cognitive domains including language and aspects of executive functioning. A careful examination of the cognitive phenotype and its association to mutations affecting CNS isoforms is necessary to clarify the neuropsychological …

Resting-State Functional Connectivity In Youth With Gender Dysphoria, Felix L. Garcia

Dissertations, Theses, and Capstone Projects

Current developmental models of gender identity and gender dysphoria (GD) lack sex-specific profiles of brain function that differentiate between typically-developing and cross-gender identified youth, as postulated by models like the unified theory of the origins of sex differences (Arnold, 2009) and the neurobiological theory of the origins of transsexuality (Swaab & Garcia-Falgueras, 2009). Previously, investigators have used brain imaging modalities such as Resting-State functional Magnetic Resonance Imaging (R-fMRI) to demonstrate differences in resting-state functional connectivity (RSFC) between typically-developing male and female youth, and between typically-developing and GID-diagnosed youth. In the present pilot study, I used R-fMRI to investigate differences in …

The Effect Of A Voice Treatment On Facial Expression In Parkinson’S Disease: Clinical And Demographic Predictors, Amanda D. Bono

Dissertations, Theses, and Capstone Projects

Parkinson’s disease (PD) is a neurodegenerative disease associated with a wide range of motoric, cognitive, and behavioral symptoms. Impairments in facial mobility and emotional expressivity are common and can impair communication, in turn, affecting daily functioning and quality of life. Previous research suggests that the Lee Silverman Voice Treatment © (LSVT LOUD; Ramig et al., 2001, 2011) increases vocal loudness and facial expressivity in individuals with PD compared to PD and healthy controls. This study extends the literature by examining the effects of LSVT and an articulation-based control treatment (i.e., ARTIC) on multiple aspects of facial expressivity (i.e., emotional frequency …

Stereotype Threat As An Explanation For Sexual Risk Taking Behavior In Gay Men: A Multi-Study Exploration Of Mechanisms, Inna Saboshchuk

Dissertations, Theses, and Capstone Projects

Stereotype threat is a hindrance in performance that occurs when an individual’s awareness of negative stereotypes associated with his/her group results in inadvertent conforming to that stereotype. Stereotype threat research has been conducted on myriad group and domain identifications but gay men are strikingly absent from the stereotype threat literature. One of the most prevalent stereotypes about gay men indicates they are sexually promiscuous and that this promiscuity is linked to HIV infection. In a series of three research projects, a theoretical model proposing stereotype threat as a mechanism for sexual risk taking behavior in gay men is tested. In …

Strategies Involving The Food-Derived Agent Curcumin To Eliminate Brain Cancer, Sumit Mukherjee

Dissertations, Theses, and Capstone Projects

Glioblastoma (GBM) is one of the most deadly forms of cancer with a mean 5-year survival rate of ≤5%. We have used the non-invasive strategy of long-term intranasal (IN) delivery of a glioblastoma-directed adduct of curcumin (CC), CC-CD68Ab, into the brain of murine GBM cell line GL261-implanted mice to study the therapeutic effect of CC on GBM remission. The treatment caused GBM tumor remission in 50% of GL261-implanted GBM mice. A similar rescue rate (60%) was also achieved through long-term intraperitoneal (i.p) infusion of a highly bioavailable phosphotidylcholine (PC)-encapsulated formulation of CC, Curcumin Phytosome Meriva (CCP), into the GL261-implanted GBM …

Prevention Of Neural Tube Defects By Folic Acid In Pregnancy., Atiq Ahmed Khan, Ruth K.M.

Pakistan Journal of Neurological Sciences (PJNS)

Pakistan is a developing country facing variety of challenges including maternal malnutrition and neonatal mortality. Globally Pakistan has the third highest neonatal mortality rate(1). Maternal malnutrition contributes to low birth weight neonates and birth anomalies. A study conducted in tertiary care hospital of Karachi catering to lower socioeconomic background showed 10.9% of birth defects to be of central nervous system. Maternal factor related to neural tube defects in same study showed 81.3 % mothers had not taken folic acid during pregnancy(

Hyperglycemia In Acute Subarachnoid Hemorrhage, Maher Bano Malik, Jehangeer Shoro, Haris Majid Rajput

Pakistan Journal of Neurological Sciences (PJNS)

Subarachnoid hemorrhage (SAH) is associated with high inhospital mortality and morbidity. Hyperglycemia occurs frequently in acute medical conditions including SAH and is associated with poor outcome. The aim of the study was to determine the frequency of Hyperglycemia in patients of subarachnoid hemorrhage.

Chikungunya Virus Associated Guillain-Barre Syndrome With Variable Presentation: A Case Series., Salman Farooq, Muhammad Imran, Ejaz Karim, Dureshahwar Kanwar, Muhammad Bilal Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Chikungunya Virus Is A Mosquito-borne Alpha Virus Which Occasionally Causes Neurologic Complications Including Guillain-barre Syndrome, Myelitis, Myopathies And Encephalitis. Pakistan Experienced Its First Chikungunya Outbreak In The Metropolis Of Karachi Officially Confirmed By World Health Organization In December 2016. During This Outbreak, Over 30,000 People Have Been Reported To Be Infected In Different Parts Of Karachi. We Report Four Cases Of Chikungunya Virus Infection Associated Guillain-barre Syndrome Having An Atypical Clinical Presentation And Variable Outcome. Each Case Presented As A Different Variant Of Gbs Including Acute Inflammatory Demyelinating Polyneuropathy, Acute Motor And Sensory Axonal Neuropathy And Pharyngeal-cervical-brachial.

Personality Traits And Mental Health Of University Male Students Viewing Internet Pornography, Komal Razzaq, Muhammad Rafiq, Fatima Sana, Zahid Mahmood

Pakistan Journal of Neurological Sciences (PJNS)

Studies have indicated that viewing internet pornography is like addiction and has been implicated in the development of psychosocial issues leading to mental health. However, in view of Pakistani culture, psychosocial issues and mental health problems associated with viewing internet pornography especially in perspective to personality traits are not studied yet. Objective: Objective of the current study was to investigate any effect of personality traits on mental health of university male students viewing internet pornography.