Medicine and Health Sciences Commons^™

Llu Dentistry - Volume 33, Number 2, Loma Linda University School Of Dentistry

Articulator (Dentistry)

In this issue:

4 | Dean's Message
5 | 39th Annual Children's Day
6 | Leading the Way: The Journey of an RDAEF Program Director
8 | Charles Goodacre, DDS'71, MSD - Fellowship in the Royal College of Surgeons and Dr. Thaddeus V. Weclaw Award
9 | LLU Shines with Silver at Men's NCPA National Pickleball Tournament
10 | Summer Programs
11 | Yumi & Ashangbi Luikham Endowed Scholarship
12 | Where are they now? Travis Tramel, RDHAP, MA, PhD
14 | Ukrainian Children Find Hope & Healing
16 | The Global Burden of Oral Health
22 | Yearbook Roundup …

Parenting Identity And Parental Mental Health In Chinese Parents In Mainland China, Zhenqiao Yang

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

In the modern context of mainland China, parents of young children face unique parenting stressors, making parental mental health during the early stages of parenting a significant public concern. Increasing awareness of the role of self-concepts in mental health underscores the importance of exploring the relationships between parenting identity concepts, parenting stress, parental mental health, and familial factors. This study aims to examine the relationship between parenting identity and parental mental health, specifically depression and anxiety, in the context of early childhood parenting stress. Data were collected from 456 parents at four daycare centers and public spaces in an Eastern …

Performance Fatigability And Neuromuscular Responses During And After One Set Of Forearm Flexion Muscle Actions To Failure At 30% Versus 70% One-Repetition Maximum In Men And Women, Tyler Joseph Neltner

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Previous studies have examined sex differences in performance fatigability during isometric, isokinetic and controlled dynamic constant external resistance (DCER) fatiguing tasks (FT), however, whether those sex differences remain during maximal intended velocity (MIV) DCER muscle actions remains unclear. The purpose of this study was to examine the sex-related differences in the time course of fatigue, neuromuscular responses, and coactivation from the ipsilateral and contralateral limbs during MIV DCER muscle actions to failure at low versus high relative loads, as well as performance fatigability from pre- to post-testing. Twenty-seven college-aged men (n = 14) and women (n = 13) …

Assessment Of Foam Decontamination In Tomato Washing Process, Basim M. Alohali

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The work of the dissertation investigated the efficacy of foam-based decontamination treatments to enhance microbial safety in Roma tomatoes, specifically targeting natural microflora and Salmonella contamination. Growing concerns over foodborne illnesses linked to fresh tomatoes and the limitations of conventional decontamination techniques, such as organic matter built-up and limited microbial reduction, are addressed. The primary objectives were to characterize the physiochemical properties of foams formed using various concentrations of Tween 20 (T20) and sodium dodecyl sulfate (SDS) with and without the addition of sodium hypochlorite (NaOCl) and peracetic acid (PAA), compare the efficacy of foam and traditional dump tank (DT) …

Development Of A Durable And Low-Dose Universal Vaccine Against Swine Influenza A Virus, Erika Petro-Turnquist

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Swine Influenza A Virus (IAV-S) imposes a significant burden on the pork industry and poses a great threat to public health due to its zoonotic potential. Susceptibility to human, avian, and swine influenza make pigs the ultimate mixing vessels for reassorted influenza A virus strains. Current vaccination strategies induce short-lived and strain-specific responses against IAV-S. Further, the substantial genetic diversity of IAV-S necessitates consistent revaccination and updating of commercial vaccines. Computational platforms have recently emerged as a promising strategy to develop new-age vaccines against infectious diseases in livestock animals. Here, we describe a computationally derived set of vaccine immunogens, called …

Exploring Prescribing Practitioners’ Experiences And Perceptions Associated With Opioid Clinical Practice Guidelines Adherence To Treat Older Adults For Chronic Pain In Primary Care Practice Settings In The United States, Dara D. Skinner

Seton Hall University Dissertations and Theses (ETDs)

Background: Chronic pain is a common complaint in older adults,’ and they often seek treatment from their primary care provider who may prescribe opioids to treat their chronic pain. Treating and managing an older adult chronic pain can be complex due to several factors such as the patient’s co-morbidities (other medical conditions), impaired cognition, and advanced age. Opioids have been used since the 1890s for treatment of pain (acute and chronic). Opioid use can cause fractures, falls, kidney failure, addiction, respiratory depression, and overdose in older adults. According to Tong et al. (2016) primary care providers were responsible for writing …

Menstrual Hygiene Amongst School Girls: Still A Messy Business, Naghma Rizvi, Saleema A. Gulzar, Tazeen S. Ali, Syeda Aleena Fazal, Alishah Aziz Gulzar, Yasmin Parpio, Rimsha Hirani

Journal of Asian Midwives (JAM)

Background: Menstruation has become a taboo topic among adolescent females, affecting their reproductive health, particularly in more traditional South Asian nations such as Pakistan. The study highlights the societal silence surrounds menstruation, which leads to detrimental practices and attitudes among school-age females. The study reveals the sociocultural, psychological, and educational challenges that teenagers encounter. The presence of myths and misconceptions adds to unsanitary habits, which undermine education and reproductive health.
Methodology: A descriptive cross-sectional study was conducted in urban Karachi. The participants were 850 unmarried school-going female adolescents aged 13 to 19. The data were collected using a pre-coded questionnaire. …

Use Of Social Media For Receiving Professional Support In Enhancing Mothers’ Lactation Self-Efficacy, Mehtab Lalwani, Zohra Kurji, Salma Rattani, Zahra Shaheen, Hussain Maqbool Ahmed Khuwaja, Shabina Ariff

Journal of Asian Midwives (JAM)

Background: Insufficient support for breastfeeding and limited exclusive breastfeeding rates emphasize the need for high-impact approaches to enhance maternal confidence in lactation. Social media has emerged as a promising platform for professional support and information dissemination in this context. This review aims to examine the role of social media in providing professional lactation support to mothers in enhancing their lactation self-efficacy.
Method: Employing PRISMA guidelines, the review sought relevant literature on professional assistance in enhancing breastfeeding self-efficacy. Major databases, including PubMed, CINAHL, Google Scholar, and Science Direct, were meticulously queried using targeted keywords. Every selected article underwent screening for English …

Strengthening Lady Health Visitors And Midwives For Sindh, Pakistan For Non-Communicable Diseases (Ncds) Prevention And Management With Refresh Essential Skills, Zulekha Saleem Tharwani, Khairunnissa Mansoor, Zahra Tharani, Ambreen Merchant, Zohra Asif Jetha

Journal of Asian Midwives (JAM)

They were addressing the rising burden of non-communicable diseases (NCDs), particularly in Low-Middle Income Countries (LMICs) like Pakistan. A proactive initiative undertaken by a Primary Health Service (PHS) in collaboration with a Private School of Nursing and Midwifery in Karachi conducted a 14-week project. 28 LHVs and Midwives (MWs) working in the community of PHS in various parts of Sindh, Pakistan were equipped with some common NCD prevention and management through online sessions and in-person refresher essential skills. The project aimed to equip them with the knowledge of early identification and management of some common NCDs and freshen some skills …

Post-Partum Hemorrhage (Pph) Management In Emergency, Learning Experience, Gul Raihan

Journal of Asian Midwives (JAM)

No abstract provided.

Complicated Home Delivery: A Real Story, Nusrat Jahan

Journal of Asian Midwives (JAM)

No abstract provided.

Enhancing Maternal And Fetal Well-Being: Exploring The Determinants Of Preconception Care, Mahak Mehdi Hashim Mehdi Hashim, Nurmeen Anwar Ali

Journal of Asian Midwives (JAM)

Preconception care is the delivery of biomedical, behavioral, and social health interventions to women and couples of reproductive ages. The significance of care is emphasized by the World Health Organization (WHO), as it greatly affects the quality of life of the mother and child. However, the uptake of pre-conception care services in Low and Middle-income countries (LMIC) such as Pakistan is low due to several factors. This discussion paper will identify some of the contextual factors related to the quality of health care services, acceptability due to cultural value beliefs, and affordability that largely influence the utilization of preconception care …

Characteristics And Treatment Of Acute Myeloid Neoplasms With Cutaneous Involvement In Infants Up To 6 Months Of Age: A Retrospective Study., Juliette Renaud, Bianca F. Goemans, Franco Locatelli, Martina Pigazzi, Shelagh Redmond, Claudia E. Kuehni, Alice Destaillats, Todd A. Alonzo, Robert B. Gerbing, Alan S. Gamis, Richard Aplenc, Raffaele Renella, Todd Cooper, Francesco Ceppi

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Myeloid neoplasms account for 50% of cases of pediatric leukemias in infants. Approximately 25%-50% of patients with newborn leukemia have cutaneous extramedullary disease (EMD). In less than 10% of patients, aleukemic leukemia cutis or isolated extramedullary disease with cutaneous involvement (cEMD) occurs when skin lesions appear prior to bone marrow involvement and systemic symptoms. Interestingly, in acute myeloid leukemia with cutaneous EMD (AML-cEMD) and cEMD, spontaneous remissions have been reported.

METHOD: This is a multicentric retrospective cohort study aiming to describe characteristics, treatment, and outcome of infants with either cEMD or presence of cutaneous disease with involvement of the …

Use Of Clearguard Hd Caps In Pediatric Hemodialysis Patients., Amy E. Nau, Troy Richardson, Diana Cardwell, Jennifer Ehrlich, Jyothsna Gattineni, Melisha Hanna, Mahima Keswani, Emily Neibauer, Kelly Nitz, Raymond Quigley, Michelle Rheault, Rebekah Sims, Mayna Woo, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Bloodstream infections (BSIs) are a leading cause of hospitalizations and mortality among patients receiving hemodialysis (HD) therapy, especially those with a central venous catheter (CVC) for dialysis access. The use of chlorhexidine impregnated catheter caps (ClearGuard) has been associated with a decrease in the rate of HD catheter-related BSIs (CA-BSIs) in adults; similar data have not been published for children.

METHODS: We compared CA-BSI data from participating centers within the Standardizing Care to Improve Outcomes in Pediatric Endstage Kidney Disease (SCOPE) collaborative based on the center's use of ClearGuard caps for patients with HD catheter access. Centers were characterized …

Juvenile Polyposis Syndrome In Children: The Impact Of Smad4 And Bmpr1a Mutations On Clinical Phenotype And Polyp Burden., Shlomi Cohen, Anat Yerushalmy-Feler, Isabel Rojas, Claudia Phen, David A. Rudnick, Colleen B. Flahive, Steven H. Erdman, Ramit Magen-Rimon, Ivana Copova, Thomas M. Attard, Andrew Latchford, Warren Hyer

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: A constitutional disease-causing variant (DCV) in the SMAD4 or BMPR1A genes is present in 40%-60% of patients with juvenile polyposis syndrome (JPS). The aim of this study was to characterize the clinical course and polyp burden in children with DCV-positive JPS compared to DCV-negative JPS.

METHODS: Demographic, clinical, genetic, and endoscopic data of children with JPS were compiled from eight international centers in the ESPHGAN/NASPGHAN polyposis working group.

RESULTS: A total of 124 children with JPS were included: 69 (56%) DCV-negative and 55 (44%) DCV-positive (53% SMAD4 and 47% BMPR1A) with a median (interquartile range) follow-up of 4 (2.8-6.4) …

Risk Factors For Postpartum Depression And Severe Distress Among Mothers Of Very Preterm Infants At Nicu Discharge., Julie A. Hofheimer, Elisabeth C. Mcgowan, Lynne M. Smith, Samantha Meltzer-Brody, Brian S. Carter, Lynne M. Dansereau, Steven Pastyrnak, Jennifer B. Helderman, Charles R. Neal, Sheri A. Dellagrotta, Thomas Michael D O'Shea, Barry M. Lester

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE:  To identify psychological, medical, and socioenvironmental risk factors for maternal postpartum depression (PPD) and severe psychological distress (SPD) at intensive care nursery discharge among mothers of very preterm infants.

STUDY DESIGN:  We studied 562 self-identified mothers of 641 infants born(NOVI) conducted in nine university-affiliated intensive care nurseries. Enrollment interviews collected socioenvironmental data, depression, and anxiety diagnoses prior to and during the study pregnancy. Standardized medical record reviews ascertained prenatal substance use, maternal and neonatal medical complications. The Edinburgh Postnatal Depression Scale and Brief Symptom Inventory were administered at nursery discharge to screen for PPD and SPD symptoms, respectively.

RESULTS: …

Preeclampsia, Fetal Growth Restriction, And 24-Month Neurodevelopment In Very Preterm Infants., Jennifer Check, Coral Shuster, Julie Hofheimer, Marie Camerota, Lynne M. Dansereau, Lynne M. Smith, Brian S. Carter, Sheri A. Dellagrotta, Jennifer Helderman, Howard Kilbride, Cynthia M. Loncar, Elisabeth Mcgowan, Charles R. Neal, T Michael O'Shea, Steven L. Pastyrnak, Stephen J. Sheinkopf, Barry M. Lester

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Preeclampsia has direct influences on a developing fetus and may impact postnatal health, and fetal growth restriction (FGR) is often seen co-occurring with preeclampsia. The development of children born very preterm after preeclampsia diagnosis with and without FGR is not well characterized.

OBJECTIVE: To examine the associations of preeclampsia and FGR with developmental and/or behavioral outcomes in a cohort of very preterm infants.

DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, infants in the prospective Neonatal Neurobehavior and Outcomes in Very Preterm Infants study were enrolled between April 2014 and June 2016 from 9 US university-affiliated neonatal intensive care …

The Use Of Hearing Tests To Assess Otitis Media With Effusion In Children With Down Syndrome., Mackenzie O'Donnell, Nasrin Sultana, Nasreen Talib, Jason May, Michael Slogic

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Down syndrome is associated with an increased risk for otitis media with effusion (OME), a childhood condition in which fluid accumulates in the middle ear, potentially leading to hearing loss. The American Academy of Pediatrics Down syndrome guidelines and the American Academy of Otolaryngology - Head and Neck Surgery OME guidelines recommend hearing testing to assess the hearing status of children with Down syndrome diagnosed with OME.

METHODS: Through an Institutional Review Board approved retrospective chart review at Children's Mercy, this project assessed how clinical factors affect the frequency in which children with Down syndrome receive hearing testing after …

Including Young Children In Their Food Allergy Care: A Pilot Study., Jodi Shroba, Susan F. Mcelroy

Manuscripts, Articles, Book Chapters and Other Papers

RATIONALE: Food allergy education is often directed toward adult caregivers. However, once children go to school, they must participate in their food allergy care to remain safe. The purpose of this study was to assess food allergy knowledge and test an educational intervention targeted toward the child. We hypothesized that child-based teaching will be equal in safety and knowledge outcomes compared with standard parental education.

METHODS: Twenty-nine children between the ages of 5-11 years and their caregivers were enrolled. Child subjects completed a food allergy knowledge questionnaire. Each caregiver/child dyad was randomized to receive parent-targeted education (control) or child-targeted education …

Psychotropic Medication Usage In Pediatric Ckd: Reporting From The Ckd In Children Cohort., Ryan C. Ward, Amy J. Kogon, Matthew B. Matheson, Anne Dawson, Stephen R. Hooper, Stephen Molitor, Cynthia Wong, Susan L. Furth, Bradley A. Warady, Lyndsay A. Harshman

Manuscripts, Articles, Book Chapters and Other Papers

Background: Mental health disorders within the pediatric CKD population are prevalent. The frequency is unknown with which psychotropic medications that commonly treat these conditions are used in this population.

Methods: Data from the CKD in Children (CKiD) cohort study were used to describe the use of psychotropic medications and patient-related characteristics of use. Medications were classified into three groups: antidepressants, central nervous system (CNS) stimulants, and antipsychotic/mood stabilizing medications. Participant age, sex, CKD severity, and duration of medication use were ascertained. Medication use was evaluated in parallel with CKD disease type, presence of urological comorbidity, and hypertension. Chi-square tests compared …

The Internist's Post V.1 N.5, The University Of Texas Rio Grande Valley. School Of Medicine, Diana Othon Martinez, Edgar Dorsey Trevino, Eunbee Cho, Jian Garcia Cruz, Ramon Elizondo Romo, Roque Mifuji, Martha Solis, Cesar Gutierrez

School of Medicine Publications

No abstract provided.

Exosomes Derived From Tumor Adjacent Fibroblasts Efficiently Target Pancreatic Tumors, Saini Setua, Poornima Devi Shaji, Ana Martinez Bulnes, Anupam Dhasmana, Swathi Holla, Nirakar Sahoo, Tripti Saini, Mohammed Sikander, Bilal B. Hafeez, Manish K. Tripathi, Vincent Diego, Meena Jaggi, Murali M. Yallapu, Sheema Khan, Subhash C. Chauhan

School of Medicine Publications

The application of extracellular vesicles, particularly exosomes (EXs), is rapidly expanding in the field of medicine, owing to their remarkable properties as natural carriers of biological cargo. This study investigates utilization of exosomes derived from stromal cells of tumor adjacent normal tissues (NAF-EXs) for personalized medicine, which can be derived at the time of diagnosis by endoscopic ultrasound. Herein, we show that exosomes (EXs) derived from NAFs demonstrate differential bio-physical characteristics, efficient cellular internalization, drug loading efficiency, pancreatic tumor targeting and delivery of payloads. NAF-derived EXs (NAF-EXs) were used for loading ormeloxifene (ORM), a potent anti-cancer and desmoplasia inhibitor as …

Abc Efflux Transporters And Solute Carriers In The Early Developing Brain Of A Marsupial Monodelphis Domestica (South American Gray Short-Tailed Opossum), Yifan Huang, Katarzyna M. Dziegielewska, Mark D. Habgood, Fiona Qiu, Ana C. Leandro, Paul D. Callaghan, Joanne E. Curran, John L. Vandeberg, Norman R. Saunders

School of Medicine Publications

This study used a marsupial Monodelphis domestica, which is born very immature and most of its development is postnatal without placental protection. RNA-sequencing (RNA-Seq) was used to identify the expression of influx and efflux transporters (ATP-binding cassettes [ABCs] and solute carriers [SLCs]) and metabolizing enzymes in brains of newborn to juvenile Monodelphis. Results were compared to published data in the developing eutherian rat. To test the functionality of these transporters at similar ages, the entry of paracetamol (acetaminophen) into the brain and cerebrospinal fluid (CSF) was measured using liquid scintillation counting following a single administration of the drug along with …

Surgical Opportunism For Hand Reconstruction Following A Mutilating Injury: A Case Report., Krishna A Patel, Tuna Özyurekoglu

Trauma and Acute Care Articles

We report our management of a 53-year-old female who suffered a wood planer hand-mutilating injury with significant dorsal soft tissue loss and partial metacarpophalangeal joint (MCPJ) amputations of the thumb, index, and middle fingers. The middle finger was deconstructed for "spare parts" and a vascularized osteochondral graft was utilized to reconstruct the metacarpal articular surface of the index finger proximal phalanx, allowing the pedicled transposition of the index finger to the third metacarpal. The middle finger's distal interphalangeal joint was transplanted non-vascularly to recreate the thumb MCPJ and the elevation of a middle finger fillet flap allowed dorsal wound coverage. …

Associations Between Combat Exposure, Moral Injury, And Suicidality Among U.S. Military Members: The Moderating Impact Of Positive Rumination, Jeffrey M. Gabelmann

Psychology Theses & Dissertations

Numerous studies have documented the risk for suicide among recent-era veterans with combat experience. Recently, moral injury has emerged as a possible contributor to suicidality in veterans. To that end, no study has approached the combat exposure-moral injury-suicidality link with a focus grounded in positive psychology. Specifically, the present study explored whether positive rumination, or the reflection on positive emotions and moods, may buffer the deleterious effects of potentially traumatic experiences in warzones on moral injury and suicidality. This study was a secondary analysis of 250 current or former U.S. military members (M_age = 33.3 years) who had …

Prevalence Of Sexuality Implicit Bias In Entry-Level Dental Hygiene Students – A Pilot Study, Monica Mercedez Drew

Dental Hygiene Theses & Dissertations

Purpose: Bias and discrimination may create barriers and affect the delivery of culturally competent care to sexual minorities. An awareness of biases early in education may promote equitable care and increase the quality of oral healthcare delivered to diverse populations. The purpose of this study was to determine the prevalence of sexuality-implicit attitudes in entry-level dental hygiene students at one university. Methods: This cross-sectional study included a convenience sample of junior and senior dental hygiene students (n=74) and was determined exempt by a university Health Sciences Human Subjects Review Committee (2151633-2). The Implicit Associations Test (IAT) is a validated tool …

Medical Practice As Rhetorical Art Functional Medicine’S Therapeutic Partnership, Cristina Elena De León-Menjivar

English Theses & Dissertations

The current rates of provider burnout are at an all-time high, and our healthcare system is currently seeing numerous providers leave the system. The U.S. Surgeon General has deemed burnout rates at crisis levels, creating an exigency for research and work to help ameliorate this issue. One main issue at the heart of provider burnout is the idea of meaning and purpose in one’s professional life, and Functional Medicine methodology argues that it provides the means by which it can mitigate burnout while improving professional fulfillment and joy through deeper connections with patients. Their methodology is rooted in a concept …

Body Image Dissatisfaction, Positive Body Image, And Health Behaviors During Pregnancy: A Between-Trimester Comparison, Cassidy M. Sandoval

Psychology Theses & Dissertations

Body image during pregnancy is a critical concern for maternal and fetal health, as it is associated with adverse health outcomes for mothers and neonates. Findings regarding if and how body image dissatisfaction changes during pregnancy are equivocal. A vast majority of studies examining body image during pregnancy focus on negative aspects of body image (e.g., body dissatisfaction), and there are limited studies of positive body image during pregnancy. Although the literature examining body image’s association with mental health concerns during pregnancy is well-developed, there is far less research exploring associations with physical health. Given these notable gaps, the present …

Using An Artificial Intelligence (Ai) Tool (Chatgpt) To Identify The Main Indications And Side Effects Of Drugs, Mai Elzieny, Christian Santiago, Zhenhong Qu

Posters

This study evaluated the efficacy of ChatGPT, an AI powered language model (1), in retrieving drug information for pathology practice compared to UpToDate. The research focused on 160 commonly prescribed drugs, assessing the speed and accuracy of information retrieval. Results showed that ChatGPT efficiently provided indications and side effects of multiple drugs in batches within seconds, comparable to UpToDate's information but remarkably faster (2). The study suggests that ChatGPT is a promising valuable tool to help pathologists in accessing drug information, potentially improving diagnostic accuracy and work efficiency

Optimize Artificial Intelligence Language Model Use In Medical Board Exams: Insights From Instruction Quality And Domain Context Analysis, Zhenhong Qu, Mai Elzieny, Kanika Arora

Posters

Artificial intelligence language models (AI-LMs) show promise in medical education and clinical problem solving, but their performance in medical board exams has been inconsistent (1,2,3).

This study investigated how prompt engineering and providing essential reference material influence AI-LM performance on board exam questions.

We tested ChatGPT and Claude-2 on 360 questions in various formats under three conditions: simple prompt, elaborate CRAFTS prompt, and CRAFTS prompt with references (CRAFTS stands for context, role, action, format, tone, and style).

Results showed significant improvement in accuracy from simple prompts (67-83.5%) to CRAFTS prompts (76.2-92.5%) to CRAFTS prompts with references (97.3- 99.4%)

These findings …