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Alumni Journal - Volume 94, Number 2, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | From the Editor
4 | From the President
6 | From the Dean

News
8 | School of Medicine News
10 | Alumni News
12 | This & That
13 | Students
14 | AIMS Report: Impacting Lives
16 | Department Report: Surgery

Graduation 2023
21 | Graduation Feature

Features
38 | By the Graduates: Reflections and stories form graduates
44 | Honoring Two Epochal Leaders
46 | I Died Four Times
50 | Alumni Association: A Power for Good
54 | Alumni Spotlight: Get to know
56 | Life After Medicine

In Memoriam
57 | Alumni …

Prenatal Depression And Breastfeeding Practices Healthy Start Participants, 2019-2022, Peyton Ashleigh Mosher

Theses and Dissertations

Background: Breastfeeding has health benefits for both mother and child, but breastfeeding practices among Black and lower-income women are the poorest in the United States. Few studies have examined the associations between maternal prenatal depression and breastfeeding duration, even fewer among a predominantly low-income Black population. Objective: To explore the association between prenatal depression and breastfeeding practices among low-income Black women during the COVID-19 pandemic.

Methods: Prospective cohort data from Midlands Healthy Start (MHS) was analyzed to examine women’s depression symptoms during pregnancy and their breastfeeding initiation and duration through two and six months. Perinatal depressive symptoms were identified using …

Unravelling Spatial Gene Associations With Seagal: A Python Package For Spatial Transcriptomics Data Analysis And Visualization, Linhua Wang, Chaozhong Liu, Yang Gao, Xiang H-F Zhang, Zhandong Liu

Faculty, Staff and Students Publications

SUMMARY: In the era where transcriptome profiling moves toward single-cell and spatial resolutions, the traditional co-expression analysis lacks the power to fully utilize such rich information to unravel spatial gene associations. Here, we present a Python package called Spatial Enrichment Analysis of Gene Associations using L-index (SEAGAL) to detect and visualize spatial gene correlations at both single-gene and gene-set levels. Our package takes spatial transcriptomics datasets with gene expression and the aligned spatial coordinates as input. It allows for analyzing and visualizing genes' spatial correlations and cell types' colocalization within the precise spatial context. The output could be visualized as …

Coping Mechanisms During The Covid-19 Pandemic And Lockdown In Metropolitan Johannesburg, South Africa: A Qualitative Study, Nerli Paredes Ruvalcaba, Andrew Wooyoung Kim, Nokubonga Ndaba, Lindile Cele, Someleze Swana, Edna Bosire, Aneesa Moolla

Brain and Mind Institute

Background: The COVID-19 pandemic has caused prolonged stress on numerous fronts. While the acute health impacts of psychosocial stress due to the pandemic are well-documented, less is known about the resources and mechanisms utilized to cope in response to stresses during the pandemic and lockdown.

Objective: The aim of this study was to identify and describe the coping mechanisms adults utilized in response to the stressors of the COVID-19 pandemic during the 2020 South African lockdown.

Methods: This study included adults (n=47: 32 female; 14 male; 1 non-binary) from the greater Johannesburg region in South Africa. Interviews …

Institute Of Public Health Newsletter- Volume 5, Issue 2, Institute Of Public Health (Iph)

Institute of Public Health Newsletter (IPHNL) and Other Publications

No abstract provided.

Dupilumab-Induced Pancreatitis., Vivek V Jasti, Sean T Mccarthy, Shail M Govani

Ambulatory and Primary Care Articles

Drug-induced pancreatitis (DIP) is a rare cause of pancreatitis with an extensive and growing list of offending medications. Drawing a causative relationship between a medication and pancreatitis can be challenging, requiring a thorough workup to exclude other potential etiologies. By using scoring systems to identify DIP, we have identified another case of suspected DIP. In this study, we present a case of pancreatitis 10 days after initiation of dupilumab. An evaluation for other causes was unrevealing. As dupilumab use increases, providers should be aware of this possible adverse effect.

Nsu Kpcom Link - Summer 2023 - Volume 2.2, Nova Southeastern University

NSU Florida Link Newsletter

No abstract provided.

Socioeconomic Status And Home Affordances Moderate Effects Of Motor Delay And Intervention, Iryna Babik, Andrea B. Cunha, Dongho Choi, Natalie A. Koziol, Lin-Ya Hsu, Regina T. Harbourne, Stacey C. Dusing, Sarah W. Mccoy, James A. Bovaird, Sandra L. Willett, Michele A. Lobo

Psychological Sciences Faculty Publications and Presentations

This study explored effects of socioeconomic status (SES) and home affordances on motor, language, and cognitive development in children with motor delays; it also tested whether SES and home affordances moderate the effect of the novel START-Play early intervention or motor delay severity on development. Participants were 112 children (64 males, 36.6% low SES) with motor delays tested longitudinally across 12 months (baseline age: Mean = 10.80, SD = 2.59 months). The results showed that more advanced motor, language, and cognitive development of children with motor delays is associated with high SES and enriched home affordances. Importantly, SES and home …

Sers Of Human Red Blood Cells In Non-Resonant Conditions: Benefits, Limitations, And Complementary Tools (Cytoviva And Gfaas), Kelsey L. Wells, Praveen K. Alla, Kyra G. Kaiser, Ioana T. Murgulet, Norma C. Adragna, Ioana E. Pavel

Pharmacology and Toxicology Faculty Publications

Herein, Raman and surface-enhanced Raman spectroscopies (SERS) were successfully employed to establish the chemical interactions of citrate-capped silver nanoparticles (AgNPs, 10–15 nm) with human red blood cells (RBCs). The Raman/SERS spectra offered spectral evidence for the cellular uptake of AgNPs and the subsequent change in the conformation of the most abundant component, hemoglobin (Hb), from oxyhemoglobin to deoxyhemoglobin. The spectral characterization of AgNPs’ interactions with other RBC biomarkers (membrane proteins and lipids) was impeded by the dominant Hb bands, even for non-resonant Hb conditions. CytoViva hyperspectral imaging and graphite furnace atomic absorption spectroscopy (GFAAS) served as complementary tools to effectively …

An Occupation-Based Intergenerational Program, Jennifer Luong

Occupational Therapy Student Capstones

No abstract provided.

The Relationship Between Mental Health & Physical Health In Agriculture, Brenda Fonseca

Occupational Therapy Student Capstones

No abstract provided.

Introduction To Health Sciences, Karinne A. Osumi

Occupational Therapy Student Capstones

No abstract provided.

Treatment Of Chronic Migraine With Botox (Onabotulinumtoxina): Development, Insights, And Impact, Catherine C. Turkel, Sheena Aurora, Hans-Christoph Diener, David W. Dodick, Richard B. Lipton, Stephen D. Silberstein, Mitchell F. Brin

Department of Jefferson Headache Center Papers and Presentations

Chronic migraine (CM) is a neurological disease characterized by frequent migraine attacks that prevent affected individuals from performing daily activities of living, significantly diminish quality of life, and increase familial burden. Before onabotulinumtoxinA was approved for CM, there were few treatment options for these seriously disabled patients and none had regulatory approval. The terminology and recognition of CM evolved in parallel with the onabotulinumtoxinA clinical development program. Because there were no globally accepted classification criteria for CM when onabotulinumtoxinA was in development, the patient populations for the trials conducted by Allergan were determined by the Allergan migraine team in collaboration …

Differentially Expressed Genes In Dental Pulp Tissues Of Individuals With Symptomatic Irreversible Pulpitis With And Without History Of Covid-19, Han Na Cho, Leticia Chaves De Souza, Cleverick Johnson, John R Klein, Timothy C Kirkpatrick, Renato Silva, Ariadne Letra

Faculty, Staff and Student Publications

Introduction: Increased levels of proinflammatory markers have been reported in tissues of individuals with Coronavirus Disease 2019 (COVID-19). We hypothesize that inflamed dental pulp tissues of individuals with previous history of COVID-19 may present a differential inflammatory gene expression profile in comparison with individuals who never had COVID-19.

Materials and methods: Dental pulp tissues were collected from 27 individuals referred for endodontic treatment due to symptomatic irreversible pulpitis. Of these, 16 individuals had a history of COVID-19 (6 months to 1 year post infection) and 11 individuals had no previous history of COVID-19 (controls). Total RNA from pulp tissue samples …

Factors Affecting Treatment Adherence Among Leprosy Patients: Perceptions Of Healthcare Providers, Veincent Christian F. Pepito, Arianna Maever Loreche, Rae Erica D. Samontina, Sarah Jane A. Abdon, David Norman L. Fuentes, Ofelia P. Saniel

Ateneo School of Medicine and Public Health Publications

Background

Treatment adherence is a vital aspect in the management of chronic diseases like leprosy; however, most studies on treatment adherence focus on patients. This study aims to examine the perceptions of healthcare providers on factors that can promote or prevent patients from adhering to treatment.

Methods

We conducted three focus group discussions (FGDs) with healthcare providers who have at least one year experience in managing leprosy in three large leprosy case-holding hospitals in Metro Manila, Philippines. We audio-recorded, transcribed, translated the FGD proceedings, and analyzed the transcripts thematically to identify patient-intrinsic and patient-extrinsic enablers and barriers to treatment adherence …

The Viral Picture Of Well-Being: Biggest Concerns, Losses, And Unintended Gifts Of Covid-19 In The Philippines, Ma Teresa Tuason, Kelly Perniciaro, Richel Lamadrid, Jego Mallillin, C. Dominik Güss

Ateneo School of Medicine and Public Health Publications

The COVID-19 pandemic revealed more than anticipated about global human functioning and resiliency. This Philippines-based study replicated a recent U.S. COVID analysis on psychological well-being (PWB). Factors examined herein were grouped into categories for analysis: 1) predictors of PWB, 2) areas of greatest stress or worry (biggest concerns), 3) perceived or real losses across SES, and 4) identified “unintended gifts” across PWB. Participants (n = 1345) were volunteers who responded to an online survey from August to September 2021, peak of the Delta variant. Three general groups of predictors (biological, psychological, and socio-economic) contributed to PWB. A regression model containing …

Salivary Extracellular Micrornas For Early Detection And Prognostication Of Esophageal Cancer: A Clinical Study., Kai Li, Yusheng Lin, Yu Zhou, Xiao Xiong, Lu Wang, Junkuo Li, Fuyou Zhou, Yi Guo, Shaobin Chen, Yuping Chen, Hui Tang, Xiaofu Qiu, Songwang Cai, Dianzheng Zhang, Edwin Bremer, Sai-Ching Jim Yeung, Hao Zhang

PCOM Scholarly Works

BACKGROUND & AIMS: Early detection of esophageal squamous cell carcinoma (ESCC) will facilitate curative treatment. We aimed to establish a microRNA (miRNA) signature derived from salivary extracellular vesicles and particles (EVPs) for early ESCC detection and prognostication.

METHODS: Salivary EVP miRNA expression was profiled in a pilot cohort (n = 54) using microarray. Area under the receiver operator characteristic curve (AUROC) and least absolute shrinkage and selector operation regression analyses were used to prioritize miRNAs that discriminated patients with ESCC from controls. Using quantitative reverse transcription polymerase chain reaction, the candidates were measured in a discovery cohort (n = 72) …

Implications Of Caspase 1/ Interleukin-1 Beta (Il-1Β) Signaling And Hypoxia-Inducible Factor 1-Alpha (Hif-1Α) On Diabetic Retinopathy Pathology., Drew Garber, Shu Zhu

PCOM Scholarly Works

Diabetic retinopathy (DR) is the leading cause of adult blindness and partial vision loss in modern society for hyperglycemic patients. Accordingly, new treatment options are imperative to the overall reduction of DR prevalence and the ongoing progression of already affected candidates. There are many diseases that are the direct result of specific inflammatory processes. In this literature, DR is looked at as a potential disease that can be alleviated by targeting caspase 1/ interleukin-1 beta (IL-1β), and hypoxia-inducible factor 1-alpha (HIF-1α) signaling pathways and reducing cytokine mobilization within retinal tissues. Caspase-1 is thought to be upregulated during retinal capillary degeneration …

Labrad : Vol 48, Issue 1 - July 2023, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Editorial
• Articles
• Toxicology In Public Health: Mitigating Risk, Fostering Well-Being
• Predictive And Prognostic Biomarkers in Histopathology
• Cancer Registry and Public Health Surveillance - Role of Pathologists
• Diagnosis of Celiac Disease DQA1*02,05; DQB1*02,03:02 (DQ2&DQ8) in patients
• Magnifying The Clinical Value of Expert Review and Reassessment
• Urine Cytology: A Screening and Surveillance Test
• An Overview of Convalescent Plasma for The Treatment of COVID-19
• Role of Imaging in Public Health Care
• Microsatellite Instability (MSI) Testing
• MRI Liver with Hepatocyte-Specific Contrast Agent
• Basics and Role of Cytopathology
• Bone Tumors: From Timely Diagnosis to Improved Patient Outcome
• Differentiating Between Dengue Fever and Malaria Using The …

Oxygen Therapy Education To Improve Oxygen Safety In The Emergency Department: A Quality Improvement Project, Latania Wolfe

DNP Projects

Background and Significance: Oxygen is often administered in emergency departments (ED) in US without the nurses and other healthcare staff inputting orders for this medication. This gap in placing orders poses a risk to patient safety and poses a regulation issue.

Purpose: The goal of this quality improvement project is to increase the rate of orders placed for patients using oxygen in ED staff by 12% from March 1, 2023 to May 31, 2023.

Methods: The Model for Improvement guided this quality improvement project. Two PDSA cycles were completed.

Results: PDSA #1 Completed SWOT analysis and used information to …

Phenotype And Genetic Analysis Of Data Collected Within The First Year Of Neurodev, Patricia Kipkemoi, Heesu Ally Kim, Bjorn Christ, Emily O’Heir, Jake Allen, Christina Austin-Tse, Samantha Baxter, Amina Abubakar, Charles Newton, Alicia Martin

Institute for Human Development, East Africa

Genetic association studies have made significant contributions to our understanding of the etiology of neurodevelopmental disorders (NDDs). However, these studies rarely focused on the African continent. The NeuroDev Project aims to address this diversity gap through detailed phenotypic and genetic characterization of children with NDDs from Kenya and South Africa. We present results from NeuroDev’s first year of data collection, including phenotype data from 206 cases and clinical genetic analyses of 99 parent-child trios. Most cases met criteria for global developmental delay/intellectual disability (GDD/ID, 80.3%). Approximately half of the children with GDD/ID also met criteria for autism. Analysis of exome-sequencing …

Strategies For Improving Mental Health And Wellbeing Used By Adults Ageing With Hiv From The Kenyan Coast: A Qualitative Exploration, Peter Mwangala, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing.

Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in …

Cost-Effectiveness Of Hydroxyurea For Sickle Cell Anemia In A Low-Income African Setting: A Model-Based Evaluation Of Two Dosing Regimens, David Teigen, Robert Opoka, Phillip Kasirye, Catherine Nabaggala, Heather A. Hume, Bjørn Blomberg, Chandy John, Russell Ware, Bjarne Robberstad

Paediatrics and Child Health, East Africa

Background and Objective: The disease burden of sickle cell anemia (SCA) in sub-Saharan African (SSA) countries is substantial, with many children dying without an established diagnosis or proper treatment. The global burden of SCA is increasing each year, making therapeutic intervention a high priority. Hydroxyurea is the only disease-modifying therapy with proven feasibility and efcacy suitable for SSA; however, no one has quantifed the health economic implications of its use. Therefore, from the perspective of the health care provider, we estimated the incremental cost-efectiveness of hydroxyurea as a fxed-dose regimen or maximum tolerated dose (MTD) regimen, versus SCA care without …

The Hipaa Privacy Rule At Age 25: Privacy For Equitable Ai, Barbara J. Evans

UF Law Faculty Publications

This Article argues that unconsented access to data is not ethically problematic in and of itself. What has made it problematic is the weak framework of alternative protections that the Privacy Rule prescribes when data are used without individual consent. This Article proposes specific measures to strengthen those protections so that the pursuit of greater health care equity need not imply a loss of meaningful privacy standards.

Part I describes two competing visions of how to protect data privacy, examining the roots of ongoing discontent with the Privacy Rule and tracing policymakers’ original rationale for fashioning a major federal privacy …

Does Surgical Approach To The Hip Play A Role In Same-Day Discharge Outcomes?, Brandon Passano, Trevor Simcox, Vivek Singh, Utkarsh Anil, Ran Schwarzkopf, Roy I Davidovitch

Faculty, Staff and Student Publications

Background: Different approaches for total hip arthroplasty (THA) may offer advantages in regard to achieving same-day-discharge (SDD) success.

Methods: We retrospectively identified patients aged ≥ 18 years who underwent elective primary THA from 2015 to 2020 who were formally enrolled in a single institution's SDD program. A total of 1,127 and 207 patients underwent THA via direct anterior approach and posterior approach, respectively, were included. Cohorts were assigned based on approach. The primary outcome was failure-to-launch, defined as hospital stay extending past 1 midnight. Secondary outcomes included Forgotten Joint Score-12, Hip Disability and Osteoarthritis Outcome Score for Joint Replacement, 90-day …

Evaluating An Mhealth Application For Cancer Survivors With Disabilities Through Usability Testing, Kevin Baez

University Honors Program Senior Projects

The effect of cancer treatment can cause difficulties in a cancer survivor's life due to the risk of attaining a long-term disability which has potential negative cognitive, psychological, physical, and social consequences. Furthermore, post-treatment support has been shown to be severely limited, leaving many to deal with new obstacles and struggles on their own. With no real support system in place, cancer survivors with disabilities can be lost during post-cancer transition. However, mHealth interventions have been proven to effectively aid users in dealing with various health issues. We aim to support and empower cancer survivors through an application called, WeCanManage. …

The Relationship Between Alkaline Phosphates Level, Liver Diseases And Gallstone, Abdulameer Jassim Mohammed, Qasim Mohammed Banjah, Walaa Abdulhussein Abbas Al-Azzawi

Al-Nisour Journal for Medical Sciences

Alkaline phosphatase is an enzyme produced primarily by the liver. Tests for alkaline phosphatase can be part of routine lab work or part of a series of tests called a liver panel, which includes tests for other liver enzymes, such as aspartate aminotransferase, or alanine aminotransferase. This study aims to find out the effect of alkaline phosphatase enzyme on liver diseases and gallstones. Alkaline phosphatase level was measured for fifty patients suffering from gallstone (30 patients), obstructive disease (10 patients) and liver cirrhosis (10 patients). All patients grouped according to the ages (Each five years as a group), all female …

Relationship Between The Demographic Factors Of People Living In Cholera Endemic Areas And Their Knowledge Towards The Preventive Measures Against The Disease, Zainab Mohamed Mahmmod, Tabarek Ayad Noori, Ali Najm Abdullah

Al-Nisour Journal for Medical Sciences

Cholera is an infectious, acute bacterial disease caused by Vibrio Cholera. Watery diarrhea is the predominant clinical sign of the disease. Around the world, it is thought to be responsible for up to 4 million cases annually. This digestive contagious is characterized by high-volume fluid loss and electrolyte disturbances that may advance to hypovolemic shock and finally death. This survey study seeks to discover how well-informed, how individuals in Diyala, Iraq, feel about cholera epidemics, and how they behave in practice. In the present research, there were a total of 272 participants, with a mean age of 20 to 29 …

Knowledge Regarding Covid-19 Disease Among Primary Health Care Centers' Reviewers In Baghdad City, Tabarek Ayad Noori, Ishraq Ahmed Chiad, Essa Khalil Hasan

Al-Nisour Journal for Medical Sciences

Corona virus disease is an infectious, viral disease caused by SARS-CoV-2 and resulted in high percentage of morbidity and mortality throughout the world since December 2019. Several kinds of vaccines developed after short period of time. Is determine the knowledge about Corona (covid_19) among attendance in primary health care centers in Baghdad city. A cross sectional study performed in Baghdad city with 100 persons selected conveniently who visit primary health care centers, which are (Abdul-Saheb Al-dakhil, first Al-Hurriya and second Al-Hurriya primary health care center); the study begun at December 2022 to March 2023. From the participants there were 32% …

Michigan Appropriateness Guideline For Intravenous Catheters And The Impact On Utilization And Infection Ratios In Peripherally Inserted Central Catheters, Kasey Smith Bustamante

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients are at increased risk for central line-associated bloodstream infections when central line utilization rates are increased and are inserted inappropriately, based on patient criteria. Purpose: Determine if utilization of the Michigan Appropriateness Guidelines for Intravenous Catheters (MAGIC) will reduce central line utilization ratios (focusing on peripherally inserted central catheters (PICC)) and reduce risk of central line-associated bloodstream infections among an adult population in the Trauma Surgical Care Unit (TSCU) and Medical Intensive Care Unit (MICU) at a tertiary care center in the South Carolina Pee Dee Region. Methods: The Plan Do Study Act (PDSA) quality improvement …