Wholeness Research 2015

WHOLENESS

RESEARCH

R P

F O O

Research is in our DNA Because of its importance to the well-being of humanity, research is emerging as a central focus at Loma Linda University Health.

With that in mind, it is with great pleasure that I introduce this publication highlighting many research projects currently underway or envisioned for the future. As one of the leading private health sciences universities in the United States, Loma Linda University Health engages in extensive research programs across a broad spectrum of inquiry. In this first-of-its-kind compilation, you will read about projects ranging from how DNA is affected by our good and bad habits, lifesaving extracts from marine shellfish and why it takes so long to bring great ideas to fruition.

More than 400 research studies are published each year by our faculty, scientists, clinicians and students. But we do more than impart knowledge; we create it. The result is a culture of collaboration that fosters creative ideas and brings them to the patient bedside as quickly and efficiently as possible.

We will soon build a large central research building on campus where researchers and clinicians from dozens of disciplines can work together — a center for new scientific discovery. We know what happens when these creative people work synergistically toward a common mission: their interaction leads to incredible results and builds seamless teams that benefit more than patient care.

John Zhang is a great example of this collaboration. As head of a team of seven scientists and faculty members, Zhang recently opened the new Center for Brain Hemorrhage Research at Loma Linda University Health, thanks to a $6 million grant from the National Institutes of Health (NIH). This collaborative center thrusts Loma Linda University Health to the forefront of trailblazing research into the causes of hemorrhagic stroke as well as lifesaving treatments and preventive measures.

Research is nothing new at Loma Linda University Health. In the past, Dr. Roger Barnes developed the trans-urethral prostatectomy technique, or TURP, saving many men from open abdominal surgery for benign prostatic hypertrophy. Dr. Edward Hon developed the initial technique for fetal monitoring during labor and delivery. Dr. Melvin Judkins developed the Judkins coronary catheter, making coronary angiography safer and easier. Dr. Leonard Bailey introduced infant heart transplantation to the world. Dr. Jim Slater developed the first hospital-based Proton Treatment & Research Center. And Dr. Gary Fraser is uncovering new findings in helping Americans be healthier through the Adventist Health Study. Each of these, and many others, are wonderful parts of our heritage and valuable contributions to the world of health care.

You might say research is in our DNA. Please enjoy these stories, a selection of just a few of our most recent research initiatives led by our talented researchers, and share this meaningful publication with your colleagues and friends.

Sincerely,

Richard H. Hart, MD, DrPH President, Loma Linda University Health

Table of Contents Defining health at the molecular level

Promising cancer treatment found by scraping the ocean floor

Study on vegetarianism attracts international attention A complicated collaboration

Researcher studies stillbirth and grief in rural India Research internship inspires teens to make a difference

Research paves the way for active beam scanning proton therapy Researchers seek solutions to medical problems in China

Snake studies reveal biodiversity in environmental research

Study finds significant injury risk in multi-rider ATV accidents Review of “The Rise of Fetal and Neonatal Physiology: Basic Science to Clinical Care�

Student researcher creates database of pterosaur sites around the world Study explores new method for AIDS prevention

A research facility worthy of our legacy

| 1 |

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Defining health at the molecular level An ambitious new research project at Loma Linda University Health will attempt to do something completely unprecedented in the history of medicine.

According to Penelope Duerksen-Hughes, PhD, associate dean and professor of basic sciences at Loma Linda University School of Medicine, an important benefit of the new project — which is temporarily being called “A molecular definition of health” — is to allow researchers to define what health looks like at the cellular and molecular levels.

“Most biomedical research has focused on asking what causes disease,” Duerksen-Hughes observes. “The idea of what ‘health’ looks like is an entirely new way of phrasing the question.”

An anticipated downstream benefit is that physicians would be able to design a personalized program for each patient, to achieve optimal health. After obtaining a blood or saliva sample from a patient, physicians would analyze the DNA, RNA and other biomolecules to assess the current status of the patient’s health and attempt to predict what illnesses or medical conditions the patient is likely to develop. They would then prescribe a series of lifestyle changes and medical interventions that may enable the patient to literally turn off the expression of those genes whose activation would otherwise lead to illness and disease.

Duerksen-Hughes says patients wouldn’t even have to travel to Loma Linda to participate and observes that the groundbreaking project is only possible because we have a unique resource not available at any other academic health sciences center in the world: Loma Linda University Health’s Adventist Health Studies.

The studies she mentions were initiated after several Loma Linda physicians observed that their vegetarian patients seemed to live longer, healthier lives than their omnivorous counterparts.

To date, more than 130,000 Adventists have participated in the studies. As Dan Buettner reports on page 129 of his 2006 book, “The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest,” the Adventist Health Studies (see related article on p. 6) found that Adventist men who are vegetarians live an average of 9.5 years longer than their peers who are neither vegetarian nor Adventist. For women, the increase in longevity is 6.1 years.

We are attempting something unprecedented in the history of medicine – creating the world’s first definition of health at the molecular level.

Loma Linda received worldwide acclaim when Buettner and a team of National Geographic researchers identified five regions of the world where people live noticeably healthier and longer lives.

Loma Linda is the only Blue Zone, as Buettner calls these health hotspots, in the United States.

“In the Adventist Health Studies,” she reports, “we have a highly detailed database of information that has been continuously gathered since 1958 on lifestyle and medical factors proven to contribute significantly to health and longevity. This resource is of paramount importance to the success of the project.”

“We have another unique resource that equips us to conduct this project,” Duerksen-Hughes insists. “It’s our community of healthy seniors, many of whom have lived to the age of 90 and beyond.”

| 2 |

Ellsworth E. Wareham, MD

Tony Zuccarelli, PhD, associate vice president for research affairs, said, “This study has three things going for it. First, it is remarkably innovative, making use of matchless research data and underutilized expertise to great advantage. Second, it is eminently fundable; capable of attracting major grants from multiple sources. Third, it is at the heart of our motto, “to make man whole.” We have been talking about health for more than 100 years. It’s time we defined what it is in terms that make sense to the worlds of medicine and science. We should do everything possible to get this project started.”

According to an article on the Blue Zones website, bluezones.com, people in Loma Linda and the four other Blue Zones in the world reach the age of 100 at rates 10 times greater than anywhere else.

As an example of how Loma Linda’s healthy seniors stay active and healthy, Duerksen-Hughes points to Ellsworth E. Wareham, MD, who turned 100 in October 2014.

Thirty or 40 years ago (he is not sure exactly when), Wareham, a cardiac surgeon, observed that the coronary arteries of the meat eaters he operated on were far more clogged than those of his vegetarian and vegan patients. As a result, he decided to go vegan, being careful to include lots of fruits, whole grains, vegetables and nuts — which have been associated with cardiac health — in his diet.

Duerksen-Hughes concurs.

“The more I think about this,” she concludes, “the more I’m convinced we now have the potential to change the way we think about health and disease, and to help people optimize their health more precisely than ever before.”

Throughout his high-profile career, Wareham traveled the world as a founding member of the Loma Linda University Overseas Heart Surgery Team. He finally retired in 2009, at the age of 95, but has scarcely been idle since. At the age of 100, he drives his own car and mows his own lawn. He and his wife, Barbara, maintain an active social life in their church and community.

Buettner devoted several pages in his book to telling Wareham’s story and sharing his ideas on health and longevity.

Penelope Duerksen-Hughes, PhD

| 3 |

Promising cancer treatment found by scraping the ocean floor Researchers at Loma Linda University School of Medicine (LLUSM) and their commercial partner, Scion BioMedical, Inc., are developing a potentially powerful new resource in the battle against bladder cancer from an extract of crab, lobster and shrimp shells.

“We’ve developed a patented process for cleaning it up with nitrogen gas plasma,” he reports. “LLUSM holds the patent on the process, and we partnered with the only company currently capable of producing biomedical-grade chitosan from crustaceans: Scion BioMedical, Inc.”

“Chitosan is amazing,” says Wolff Kirsch, MD, director of the Neurosurgery Center for Research, Training and Education at LLUSM. “It promotes hemostasis, or blood-clotting, potentially immunizes against superficial bladder cancer and fights inflammation.”

A substance derived from the sea promotes blood clotting and reduces inflammation, but is it also a powerful weapon in the war on bladder cancer?

Bladder cancer is deadly. Although the specific condition targeted in this study — a type of bladder cancer that does not spread into the muscle layer of the bladder wall — is not as dangerous as more advanced forms, there is strong demand for better treatments.

Kirsch says the idea of using chitosan (“kite-o-san”) as a treatment for bladder cancer originated in pioneering research

by David Zaharoff, PhD, and John W. Greiner, PhD, at the National Cancer Institute (NCI). But he credits a conversation between Andrew Crofton, an LLUSM graduate student, and James L. Gulley, MD, PhD, chief of the genitourinary malignancies branch at the NCI Center for Cancer Research, and a 1995 LLUSM graduate, with creating a potential solution to a problem that plagued those earlier studies.

Before chitosan can be tested on humans, however, pre-clinical studies must establish that the plasma-treated variety meets baseline values for cleanliness and safety without significant loss of functionality.

To accomplish this, Kirsch and Crofton submitted a Phase I SBIR grant application to NCI under the name of Scion BioMedical, Inc. The acronym, which stands for “small business innovative research,” denotes grants from the U.S. government to enable small businesses to conduct research and develop projects with commercial potential. Based in Miami, Florida, Scion will produce the biomedical-grade chitosan in Washington State.

During that discussion, Crofton told Gulley that he and Kirsch were developing a procedure for purifying chitosan with nitrogen gas plasma to enable its use as an implantable blood-clotting agent in surgery.

If the initial study is successful, purified chitosan will then be subjected to a far more extensive SBIR Phase II review to establish that it meets the “safety and efficacy” standards of the Food and Drug Administration (FDA). The Phase II study will also compare the performance and cost of the chitosan and IL-12 combination to similar products.

Gulley became very interested. He said the NCI had tested the combination of chitosan and interleukin-12 (IL-12), an immune molecule, and found it to be highly effective against bladder cancer in mice. However, the combination could not advance to clinical trials because of the lack of sufficiently purified chitosan to safely implant in humans.

Kirsch conceived the idea for using nitrogen gas plasma to produce a grade of chitosan that meets FDA standards for internal use by humans.

As they talked, Gulley and Crofton suddenly realized nitrogen gas plasma might be the solution.

Kirsch, who has been studying chitosan for more than 20 years, was delighted when Crofton said the National Institute of Health (NIH) might be interested in funding research into his nitrogen gas plasma process.

Louis R. Rose, Scion BioMedical, Inc.

Because chitosan is harvested from the sea, Kirsch says it contains very high levels of endotoxins.

| 4 |

At 83 years of age, Kirsch is proud of his students, Crofton and Gulley.

On August 11, 2014, he and Crofton learned their application for an initial $225,000 SBIR Phase I study had been approved by the NCI. Under NIH guidelines, Kirsch will serve as principal investigator, with Crofton and Sam Hudson, PhD, from North Carolina State University, as co-investigators. The trio will conduct the research at LLUSM as Scion employees, and Scion will administer the research funds.

“Andrew Crofton is one of the most talented graduate students I’ve ever worked with,” Kirsch explains, noting that Crofton recently made chitosan the subject of his doctoral dissertation.

“I was on the dissertation committee when Gulley defended his research on an amino acid I discovered several years earlier,” Kirsch continues. “I knew he was destined for a very bright future, and he has achieved it. He was decorated by President Barack Obama in 2011 with the Presidential Early Career Award for Scientists and Engineers.”

According to Louis R. Rose, president & CEO of Scion, his company will supply the chitosan that will be “depyrogenated” at LLUSM. The word denotes the process of inactivating toxins that produce fever and inflammation.

“Scion BioMedical Corp. is a U.S.-based biomedical technology company that develops medical solutions for hemostasis, wound management, infection control, antimicrobial barrier protection and drug delivery systems,” Rose explains. “We are pleased and proud to partner together with the illustrious research team headed by Dr. Wolff Kirsch of Loma Linda University and Dr. Sam Hudson of North Carolina State University. Together we hope to discover immunotherapies that can change the face of medicine and improve the lives of patients. This is our mission and our collective goal.”

Crofton hopes the project will save lives.

“We believe nitrogen plasma will enable us to decontaminate chitosan without degrading it and thus preserve its functionality,” he notes. “Achieving this objective would be a tremendous advance since chitosan has a long list of extraordinarily useful biomedical properties.”

Kirsch takes a similar big-picture view.

“Chitosan,” he concludes, “has potential to make real strides against bladder cancer. And that’s a pretty big deal!”

Wolff Kirsch, MD, with Andrew Crofton and Nicholas Sanchez, School of Medicine Graduate Students | 5 |

Study on vegetarianism attracts international attention

Vegetarians were divided into three categories: 5,548 were vegans who ate only plant-based foods; 21,177 were lacto-ovo vegetarians who supplemented their vegetarian diet with dairy products and eggs; and 7,194 were pesco-vegetarians who ate fish, but no other meats. Together, the three vegetarian groups represented approximately 46 percent of study participants.

The Adventist Health Study (AHS) at Loma Linda University recently attracted a flurry of international media attention after an article in JAMA Internal Medicine, a publication of the American Medical Association, reported a link between vegetarian nutrition and increased longevity.

According to Michael J. Orlich, MD, a researcher at Loma Linda University School of Public Health and lead author of the article, the findings confirm the potential advantages of vegetarian nutrition.

According to Gary Fraser, MD, PhD, director of the second phase of the study (AHS-2) and professor at the Loma Linda University Schools of Medicine and Public Health, similar studies are being conducted at Oxford University, Harvard University, University of Southern California and Vanderbilt University.

The study, which evaluated dietary habits and mortality patterns among 73,308 members of the Seventh-day Adventist Church in the United States and Canada, found that vegetarians experienced 12 percent fewer deaths during the six-year course of the investigation than their peers who ate meat.

Thanks to the findings of Adventist Health Study-2, the world is waking up to the fact that vegetarians live longer and die older than their meat-eating peers.

The story generated an international media buzz. Within two weeks, it was published in 86 media outlets, including TIME.com, Wall Street Journal, Reuters, Bloomberg News, Yahoo! News and the Daily Express of London, England.

In the study, 35,358 participants regularly ate meat while another 4,031 ate meat, poultry and fish on an infrequent basis. Together, the two meat-eating groups represented approximately 54 percent of study participants.

| 6 |

AHS has been gathering long-term, or longitudinal, data on the dietary and lifestyle habits and health status and outcomes of Adventists in the United States and Canada since 1974.

Dr. Fraser says individuals who share their personal health information with AHS researchers are crucial to its success. He says the information they share provides data that is critical to the scientific outcomes of the study. He urges study participants to update their contact information with AHS researchers every two years.

“The Adventist Health Study-2 is one of the largest long-term, multi-decadal studies currently underway examining the interface between dietary patterns and various types of disease processes,” Dr. Fraser reports.

In 2011, the study received its tenth major award, a $5 million grant from the National Institutes of Health’s National Cancer Institute. The funding will support the continuing exploration of the relationship between dietary habits and incidence of cancer among various populations of Seventh-day Adventists for five more years.

Gary Fraser, MD, PhD and Michael J. Orlich, MD | 7 |

A complicated collaboration Two Loma Linda University School of Medicine researchers bring notable grants to the school while redefining the meaning of collaborative partnership.

In 2013, the duo — John H. Zhang, MD, PhD, professor of neurosurgery and physiology, and Jiping Tang, MD, professor of basic sciences — secured a $1.9 million grant from the National Institutes of Health (NIH) to develop a lifesaving stroke treatment. In 2014, they received a $6.03 million program project grant to establish the NIH Center for Brain Hemorrhage Research at Loma Linda University.

“It’s a big grant to support a group of scientists at a respected research institute studying a singular theme,” Zhang observes.

“This is the second one in the history of Loma Linda University.”

The center is good news for millions of people who suffer from stroke and brain injury. Zhang believes researchers will discover lifesaving new treatments and prevention strategies.

When the failure of their original research hypothesis led to unexpected complications, these clever investigators improvised their way to success.

Yet despite the pair’s success with grant proposals, they are best known for a failed research project they initiated as students at Chongqing Medical University in China. The objective — to determine if studying together enhances academic performance — soon became complicated.

Zhang attributes the difficulty to long walks beside the Yangzi and Jialing rivers and the fact that he found it difficult to concentrate while studying with Tang. The couple married February 29, 1984, the only day they could both miss work.

Later, they realized the date consigns them to just one anniversary every four years.

Today, Zhang and Tang work together on a variety of exciting research projects designed to enhance the health and quality of life for patients at Loma Linda University Health, in China and throughout the world. Romance, it would seem, isn’t necessarily the enemy of desirable research outcomes.

| 8 |

Jiping Tang, MD and John H. Zhang, MD, PhD | 9 |

Lisa Roberts, DrPH, conducts a structured interview with rural Indian women in Chhattisgarh

Researcher studies stillbirth and grief in rural India | 10 |

A Loma Linda University School of Nursing researcher is helping women in Chhattisgarh, a state in central India, recover from the grief of losing a child during pregnancy.

How one researcher inspired the government of the second-mostpopulous nation on Earth to reduce the incidence of stillbirth among rural women.

“In rural Chhattisgarh, women are expected to give birth at home,” notes Lisa Roberts, DrPH, associate professor. “They are usually brought to the hospital only if there is a problem with the delivery. Unfortunately, it is often too late for the baby and sometimes for the mother as well.”

With the support of her faculty advisor, Loma Linda University School of Public Health professor Susanne Montgomery, PhD, Roberts headed to India in December 2010. After collecting data, she returned to California in March 2011 to tabulate her findings and complete her doctoral degree. In November 2012, seed money from the Loma Linda University School of Nursing enabled her to return to Chhattisgarh for stage two of her project.

In Western medicine, mind and body are often considered separate entities, but in India, they are seen as a unity. Local regulations mandated that Roberts, who is a Christian, use a method not overtly connected to her religion.

Even so, when she tried to teach MBSR to women in the villages of Kosavadi and Chatto, Roberts discovered many women were not able to attend a full two weeks. The reasons are embedded in Indian life.

Roberts, who grew up in India as the daughter of missionary parents, selected Christian Hospital Mungeli (CHM) as her base. An earlier study conducted there by a Danish physician found that while the overall stillbirth rate is 27 per 1,000 deliveries in India, there were as many as 300 per 1,000 in parts of Chhattisgarh.

“Their lives are event-based,” Roberts explains. “The rainy season came early, so they had to harvest crops. My assistant’s mother had an accident, so we had to delay. Then we ran into a holiday.

They prepare for the Devali holiday for a month in advance. That was another significant delay.”

“CHM is the only hospital available for emergency C-sections in the area,” she reveals. “It serves patients from as far as 60 to 120 kilometers (37 to 75 miles) away.” After interviewing key people at CHM, Roberts randomly selected 21 rural villages in which to gather data.

Despite the setbacks, women who attended Roberts’ classes experienced a huge sense of relief and found renewed commitment to moving forward with their lives.

Recovery from stillbirth is a complex process that requires working through the loss of both child and pregnancy. Roberts discovered two reasons why Indian women who lose a child do not usually receive much support.

Currently, she is seeking and collecting funds for the next phase of intervention.

Roberts is not alone in sensitizing the Indian health care community to the trauma of perinatal bereavement. Efforts by the government to reduce stillbirth are paying off, and more women are giving birth in hospitals. In 2011, 84 percent of the women she interviewed preferred giving birth at home, but the percentage is lower today and continues to drop.

“The Indian medical community doesn’t recognize stillbirth as a cause for grief,” she observes, adding that so long as the women have another child, they are considered OK. “But they’re not. I found a very high rate of grief, using the Perinatal Grief Scale.

Many families don’t allow the expression of grief. For me to ask these women to talk about it was cathartic. We shared a lot of tears.”

“The government is really trying to turn those traditions around,” she concludes.

After returning to Loma Linda, Roberts analyzed the data, which confirmed that the level of suffering was staggering.

“I wanted to do something,” she reports, “so I returned at the end of 2012 and conducted a study on the feasibility and possibility of intervention.” Knowing she would need an intervention with a proven record if she hoped to win support from local physicians, Roberts selected mindfulness-based stress reduction, or MBSR. “MBSR has been shown to be very effective at improving wellbeing, reducing anxiety and depression, increasing self-compassion and decreasing grief,” she says. The program normally takes eight weeks, but the women she studied could not afford that much time off, so Roberts adapted the intervention to two weeks.

Dr. Roberts with research assistants returning to the village of Mungeli after a day of structured one-on-one interviews.

| 11 |

Research internship inspires teens to make a difference Growing up in the rough, inner city neighborhood of Inglewood in South Central Los Angeles, Love says school was not his highest priority and college seemed an unattainable option.

Arthur Love is far from your typical high school student. Typical high school students do not use words like glucocorticoid in their everyday conversation, and they certainly do not spend their summer days exploring new frontiers of prostate cancer research.

But for Love, studying glucocorticoids and prostate cancer research is an exciting beginning to what may become a lifelong career.

“I wanted to go to college, but I thought the chances of an inner city kid actually getting anywhere were slim to none,” Love recalls. “No one in my family had ever come close to going to college, and I was not going to change this any time soon.”

“We’re talking about health disparities — the relationship between tumor aggressiveness and glucocorticoids,” explains 18-year-old Love. “This research can open eyes to what we think about prostate cancer. There are so many more frontiers that haven’t been touched on.”

Things changed, however, when Love moved to a suburb of Riverside and encountered, “a type of violence I had never experienced before.” He remembers the perception teachers and students had of him — the stereotypes attached to a young black male from Inglewood — and resolved to do better.

Love is a student in the Apprenticeship Bridge to College (ABC) program at Loma Linda University School of Medicine. The eight-week research internship program recruits promising Inland Empire high school students from disadvantaged backgrounds, such as households with no college graduates or students from minority groups underrepresented in the STEM (science, technology, engineering and mathematics) disciplines. Through paid internships, these students are introduced to the world of biomedical research as they perform hands-on projects under the supervision of an established scientist.

“After my first language arts class, the teacher told me, ‘We do things differently here. This isn’t L.A., so get rid of that gangster mentality now!’ It was devastating,” he reminisces.

But Love’s devastation turned to motivation and a personal mission to “break down such an ugly stereotype of black people and prove my ability to succeed.” The recent John W. North High School graduate looks forward to attending Washington Lee University on a full scholarship. He plans to complete a PhD in neuroscience and become either a neurosurgeon or a clinical psychologist.

Each student in the ABC program performs research that has a connection to health disparities, which frequently affect the very communities from which they come. For Love, an AfricanAmerican male, his research on the tumor aggressiveness of prostate cancer in African-American men hits very close to home.

Innovative summer research program inspires minority students to careers in medicine and science while simultaneously reducing health disparities

Love admits that when he first started the program last summer, prostate cancer was not an obvious choice for research, but his attitude soon changed. “I was so pressed on neuroscience, prostate cancer wasn’t even my second option,” he recalls. “It wasn’t until the first lab that I sat down and thought, ‘This could affect me.’ I could die of this at 50.’”

After this realization, he became so engaged in the topic that he came back for a second year to expand his project. This year, he is looking for a connection between the protein LEDGF/p75, that is found in the nucleus and promotes cancer cell survival, and the glucocorticoid stress hormone cortisol, which appear at higher levels in African-American males. He understands the implications of his work and is excited about its potential impact.

ABC alumna Shannalee Martinez is another example of how the program works. Martinez is completing the MD/PhD degree at Loma Linda University, receiving a PhD in microbiology and molecular genetics and becoming either a pediatric cardiologist or pediatric hematologist/oncologist.

She often looks back at how the program has impacted her life and credits her first summer research experience as the reason she fell in love with science. Martinez, whose family comes from Peru and Mexico, remembers the first time the concept was presented to her.

“Doing research that a PhD student can take and use was amazing!” Love reports. “I actually got to help.”

However, research was not always an option he could explore.

| 12 |

from. For both Love and Martinez, their highest aspiration is to serve the community and help those who come up after them.

“It was an insane amount of learning — not school learning, it was just learning for the sake of learning; learning for fun,” she says. “That was really the first time I experienced that.”

Love’s end goal is to own his own medical practice back home in Inglewood, where he can make a difference.

The exposure to research and mentorship the ABC program offers students is a vital part of the program’s success.

“I want, to go back after I get my degrees, whether it be an MD, PhD, or a combination of both, and give back to disadvantaged communities, especially the one I grew up in. It’s important to do that for the kids sitting in the same place I was.”

“I’m lucky that someone opened the door for me. It was a step into the unknown. No one in my family is a doctor or did research, but to still have someone there makes all the difference — to watch out for you and talk you through — because it’s tough,” says Martinez.

About the Apprenticeship Bridge to College Program The Apprenticeship Bridge to College is a summer health disparities research internship for high school students offered by the Loma Linda University Center for Health Disparities and Molecular Medicine (LLUCHDMM).

Both students believe that a major reason minorities are underrepresented in the sciences is because they cannot imagine themselves in the field and therefore do not consider it an option.

The ABC program, however, opens its students to a new world of possibilities and career options in the biomedical sciences.

The LLUCHDMM is a National Institutes of Health (NIH)designated research Center of Excellence supported by the National Institute of Minority Health and Health Disparities.

The LLUCHDMM, based in the LLU School of Medicine, brings together faculty from different schools to address diseases that disproportionally affect the poor and minority populations in the United States.

“The program showed me the broader picture of what’s missing in the health care field and convinced me that I was needed as a female, Hispanic minority student,” Martinez says. “The program shows the possibility of how you would look in the system and then shows where and why you’re needed.”

Perhaps the greatest success of the ABC program is that its graduates are resolved to give back to the communities they came

Aurthur Love, ABC Student | 13 |

Andrew Wroe, PhD

Research paves the way for active beam scanning proton therapy | 14 |

Both ABS and PBS technology depend on precisely locating the tumor in the patient’s body and delivering a proton beam to the diseased area with minimal damage to surrounding organs and tissues. In general terms, Wroe explains the differences as follows:

Andrew Wroe, PhD, associate professor of radiation medicine at Loma Linda University, is excited about an upcoming innovation at theLoma Linda University Medical Center James M. Slater, MD Proton Treatment & Research Center.

“We’re getting ready for active beam scanning,” he reports.

Passive beam scattering:

Wroe says Loma Linda researchers have been monitoring active beam scanning, or ABS, for a long time but were hampered by technological limitations.

• Is the safest method of proton delivery • Excels at treating simpler targets • Provides a sharper treatment beam

“This center was originally designed to be an ABS facility, but in the 1980s and 1990s, the technology really wasn’t there, so the decision was made to focus on passive beam scattering proton delivery and save ABS for the future,” he says. Since then, Loma Linda University Medical Center has treated over 18,000 patients, making it the most successful proton center in the world.

• Is safer for treating mobile targets Active beam scanning: • Excels at treating large targets • Can treat more complex targets with fewer beams “The active beam scanning project is the largest upgrade in the history of proton therapy at Loma Linda University Medical Center,” Wroe observes.

Bad news for complex tumors!

Enabled by research innovations, active beam scanning proton therapy targets diseases in multiple organs of the body.

“It’s great that we can start creating ABS plans to cover much more complex cancers and diseases as well as larger tumors,” he adds. “The question of which conditions it will allow us to treat is one for the physicians to determine as they develop a clinical understanding of the new technology, but I see a large number of targets in the head and neck and along the spine that will benefit from ABS treatment.”

About a year ago, Wroe and his colleauges became encouraged by the progress of ABS research and decided to make it a priority.

Plans call for construction to begin in October 2015, and the ABS unit is expected to be fully operational, tested and ready for use in May 2016. The center will feature both ABS and PBS technologies, along with a proven track record of treating numerous cancers and other diseases.

| 15 |

Researchers seek solutions to medical problems in China Nevertheless, Wang notes that there are 28 full-time researchers and 17 principal investigators at the hospital right now. She laughs when asked how many researchers she would like to see if she had access to limitless funds. “Maybe about 100 more,” she says.

Biomedical research is a high priority at Sir Run Run Shaw Hospital, the 1,200-bed health care facility located in Hangzhou, People’s Republic of China, that is affiliated with Loma Linda University Health.

According to Wang Qingqing, MD, director of research at the hospital, doctors have become increasingly more interested in research in recent years, even though it has been a focus since the institution was founded in 1994.

“The goal of research at Sir Run Run Shaw is to help us help our patients,” she observes. “Our focus is on medical research. We conduct studies designed to relieve the patients’ problems. A lot of research conducted in other places concerns basic science, but that can be very difficult to translate to the clinical side. Here at the hospital, we keep it focused on patients.”

“Every physician, nurse and technician on the staff is involved in research,” she explains. “The young doctors conduct research in medical school and then join a research team as soon as they begin working at Sir Run Run Shaw.”

All hands on deck — pioneering Asian hospital enlists every physician, nurse and technician on staff in the ongoing research quest to improve patient health.

As she speaks, Wang takes a guest on a tour of an ultramodern lab on the third floor of the four-story research and education building. A profusion of sophisticated equipment and computers suggests that several studies are in progress simultaneously, and Wang confirms that is the case.

“We have researchers studying the mechanisms of tumors and their treatments, liver cancer and pulmonary cancer,” she says.

“Another big study is investigating antibiotic-resistant infections.

Last year, there were 20 studies going on here.”

The lab opened in 2013, with 200 million Chinese RMB — approximately $32 million in U.S. currency — provided by three agencies of the national government and their provincial counterparts: the ministries of health, education and science and technology.

Wang, an endocrinologist, has been the head of research for five years. Her personal research projects involve investigations into diabetes and osteoporosis.

“Those are both very big problems in China,” she says. “The incidence of patients with those problems is increasing rapidly.”

“The biggest challenge to research is time,” Wang discloses.

“Doctors are very busy, and the interns do most of the work.”

Wang is looking forward to an upcoming trip to Loma Linda University Health to interact with her peers on this side of the Pacific and learn the latest in evidence-based best practices in the field. She is especially interested in training programs at the Medical Simulation Center in the Centennial Complex.

When she returns to China, she will share what she learns with members of her team.

Right now, however, she is focused on the future.

“There is a group working on key disciplines in future research work at Sir Run Run Shaw Hospital,” she informs. “We want to become the best and most famous research department in China.”

She pauses a moment, then extends her horizons.

“Maybe in the world,” she concludes.

Rao Mingyuan, teaching assistant; Jin Hongchuan, MD, chief of the laboratory; and Wang Qingqing, MD, director of research. | 16 |

Sir Run Run Shaw Hospital in Hangzhou, China | 17 |

Snake studies reveal biodiversity in environmental research It’s shortly after nightfall as a rattlesnake moves across the desert floor, 120 miles away from Loma Linda. The creature, suddenly lit up by the bright light from an approaching vehicle, turns its head to investigate. Three human figures, researchers, rapidly approach, illuminating the scene with more light. The lead researcher calls out, “Adult sidewinder. Male.”

Following are some of the studies on snakes and venom taking place at Loma Linda University Health: • Phylogeography and behavioral ecology of the Southern Pacific Rattlesnake, with emphasis on island populations: a PhD dissertation nearing completion by Carl Person.

This study includes a behavioral study showing that the rattlesnakes on Catalina Island exhibit paradoxically higher levels of defensiveness than mainland snakes, for reasons that are not yet known.

Three people gather behind him, illuminating the scene even more brightly. Though they talk excitedly, the snake cannot hear them; it is deaf. As the sidewinder makes several desperate lunges to escape, the lead researcher uses a snake hook to immobilize it.

With great skill, he gently pins its head to the ground. He picks up the snake, and, as it opens its jaws, positions a glass beaker so its fangs pierce a layer of Parafilm, a thin stretchable plastic material that has been secured across the top of the beaker. After the snake releases its venom, it finds itself free again at the side of the road. Without looking back, the creature disappears into the darkness.

• Behavioral ecology of the Red Diamond Rattlesnake and their visits to human property: a PhD dissertation nearing completion by Aaron Corbit. This study includes data on how often transmitter-tagged rattlesnakes in Loma Linda return to human property after being moved a distance away at the owner’s request.

• Geographic variation in the venom of the Southern Pacific Rattlesnake: a PhD dissertation nearing completion by Eric Gren. This study includes documentation of Mojave toxin, a highly potent neurotoxin component of the venom of rattlesnakes on Mt. San Jacinto. A major portion of this study was published recently in Journal of Proteomics.

No other group in the entire animal kingdom has yielded more FDA-approved medications than venomous reptiles.

• Geographic variation in the venom of the Speckled Rattlesnake. Chip Cochran is pursuing this study as a PhD project.

• Factors that influence the etiology and clinical severity of venomous snakebites in Southern California. Aaron Corbit and Sean Bush, MD, (now at East Carolina University), are pursuing this study, which is part of Corbit’s dissertation.

The study examines how factors such as snake size and patient body mass influence the severity of bites, as well as possible correlations between alcohol/drug use and the high relative incidence of male snakebite victims.

Researchers at Loma Linda University Health believe that environmental research will reveal biodiversity that is essential to human health and healing.

In spite of the medical risks associated with their bites, rattlesnakes benefit humans in important ways. “Not only do they occupy an important ecological niche, controlling the small rodent populations they prey upon,” informs William Hayes, PhD, professor of biology, “their venom has also been tapped by researchers to yield novel biomedical and pharmaceutical products.”

While venomous vipers have yielded more FDA-approved medications than any other animal group, only a few dozen universities in the United States are studying them.

• From venome to syndrome: The study documents the unique venom composition (known as the venome) in different snake species that produce different symptoms in snakebite victims.

Researchers for this study include Corbit, Bush and other students in Hayes’s lab. According to Hayes, the researchers are identifying the specific venom components that produce the major clinical symptoms.

“My students and I find it rewarding that everyone, it seems, wants to see our research subjects and learn about our studies,” says Hayes. “They always have lots of questions. And the media love to exploit the public’s fascination with snakes.”

| 18 |

William Hayes, PhD | 19 |

Danny Wongworawat, MD

Study finds significant injury risk in multi-rider ATV accidents | 20 |

People thinking about buying a multi-rider all-terrain vehicle (ATV) for off-road adventure may wish to consider the findings of a study recently conducted by a team of researchers at the Loma Linda University School of Medicine (LLUSM).

“ATVs with multi-rider capabilities are inherently unsafe,” says Danny Wongworawat, MD, associate professor at LLUSM. “Accidents involving multi-rider ATVs present a significantly higher risk of severe injuries — including traumatic limb injuries and amputations — than similar accidents involving single-rider ATVs.”

In addition to the higher risk of amputation, the study found that multi-rider ATVs are associated with more open extremity fractures and more severe morbid extremity trauma.

“People think the multi-rider ATVs are safer,” Wongworawat observes, “but they’re actually far more dangerous. Some of the worst injuries occur when an arm or hand gets crunched under the roll bar or a leg gets mangled under the sides of the vehicle.

All that momentum, mass and energy adds up to devastating injuries involving a lot of crushing and cracking. These vehicles are inherently unsafe by design.”

There are two main types of ATVs — four-wheeled single-rider, and four-wheeled, bench-seat multi-rider — and after being called to the emergency department of Loma Linda University Medical Center (LLUMC) on numerous occasions to consult on ATV accident cases, senior resident Gregg Schellack, DO, began to suspect that multi-rider ATVs were the more dangerous of the two.

For one thing, multi-rider ATVs — sometimes called glorified golf carts — have a much higher center of gravity and tend to roll over easier than single-rider units. For another, they weigh a lot more — as much as 1,100 pounds — so when accidents occur, the risk of severe crushing injuries is much greater.

To test Schellack’s hypothesis, Wongworawat assembled a research team composed of Schellack, Daniel Patton, MS-III, Alan Afsari, MD, and himself, and designed a study to see if the data supports the initial observations.

The test evaluated all LLUMC emergency department patients who had sustained fractures related to ATV accidents. In all, 110 patients with ATV-associated extremity fractures were evaluated in the emergency department. Of that number, 39 cases involved the use of a multi-rider ATV and 71 involved single-rider ATVs. “What we found,” Wongworawat shares, “is that the risk of amputation is almost 11 times higher in accidents involving multi-rider units than those involving regular single-rider ATVs. That’s a very significant increase!”

In crunching the numbers, Wongworawat and his team found that six of the 39 patients involved in multi-rider ATV accidents required amputation, while only one of the 71 accidents involving single-rider ATVs required the surgical removal of a limb or extremity. In other words, 15 percent of patients injured in multirider ATV accidents required amputation, but only 1 percent of those suffering injury on single-rider units did.

People injured in accidents involving multi-rider all-terrain vehicles are 11 times more likely to require amputation than those on single-rider units.

Wongworawat is quick to point out that although single-rider ATVs are safer than multi-rider units, they can not be considered safe by any means.

“Multiple studies have shown that single-rider units are also dangerous,” he informs. “A 2003 study in Clinical Orthopaedics and Related Research described the single-rider units as ‘a perfect recipe for injury.’ No type of all-terrain vehicle can be considered safe at this point.”

Findings of the LLU study were presented at the March 2010 annual meeting of the American Academy of Orthopaedic Surgeons.

Additional study is needed to determine which ATV is implicated in the greater number of fatal injury accidents.

“We didn’t evaluate fatality statistics in our study,” he notes.

“If the patient died en route to the Medical Center or in the emergency department, we didn’t hear about them. Our study only involved survivors.”

| 21 |

Review of ‘The Rise of Fetal and Neonatal Physiology: Basic Science to Clinical Care’

| 22 |

and the United States during the 50-plus years of his very productive career, but that would contradict his nature.

One of the world’s foremost authorities on developmental physiology has written the definitive history of this biomedical scientific discipline and its contributions to improved health for women and children.

Instead, he humbly posits himself as merely an insider with a broad perspective and access to bibliographic resources.

Lawrence D. Longo, MD, the eighty-something founder and director emeritus of the Center for Perinatal Biology at Loma Linda University School of Medicine, took a decade to write “The Rise of Fetal and Neonatal Physiology: Basic Science to Clinical Care” on weekends, evenings and holidays. In 2013, Springer published it as an imprint of the American Physiological Society.

Renowned scientist John R.G. Challis, PhD, DSc, wrote the foreword.

At the beginning of the first chapter, Sir Cyril Norman Hinshelwood, DSc, poignantly observes that, “Science is not the dry syllogistic handling of obvious facts. It is an imaginative adventure of the mind seeking truth in a world of mystery.”

That accords with how Longo views physiology. He elegantly introduces poetry, philosophy and literature into his text as he weaves colorful stories of the countless researchers and clinicians whose lives and labors have improved health outcomes for millions of mothers and children during the infancy and childhood of fetal and neonatal physiology.

Much of the 530-page treatise focuses on the life and contributions of the late head of the Nuffield Institute for Medical Research at Oxford University, Geoffrey S. Dawes, MD.

Astute readers can gain the impression that Longo himself is the proverbial elephant in the room. Despite his luminous reputation as top-flight researcher, educator and mentor to hundreds of the brightest luminaries in the field, Dr. Longo — who has served as advisor to the World Health Organization, National Institutes of Health, National Science Foundation and National Research Council — refuses to indulge in self-promotion.

Writing on weekends and holidays, an iconic octogenarian takes 10 years to write the definitive and colorful history of his profession.

The concluding chapter, however, opens a tiny window into his personal involvement with the subject. In it, he retells an incident from the dawn of his career when, at the request of his UCLA mentor, the late Daniel Green Morton, MD, Longo spent three days escorting Nicholson J. Eastman, MD, of Johns Hopkins University — widely considered one of the giants of medicine at the time — around Los Angeles to deliver a series of lectures.

Longo’s motivation for writing stemmed from the importance of the field and an appreciation of how basic science has contributed to clinical care.

“As an investigator with more than a passing interest in the history of biomedical science, and presently one of the few people who knew almost all of the major figures in the field during the latter half of the 20th century, I believe that it was incumbent on me to do so,” he notes.

The story is touching, funny and self-revelatory, but it shall not be disclosed here. Instead, readers are invited to obtain a copy of the book. Some things are best read in context.

Compared to other “hot topics” in neuroscience and molecular biology, Longo sees developmental physiology as a neglected area of research. “Many consider it too 19th century,” he explains.

Nevertheless, the field has birthed great improvements in the care of pregnant mothers, their fetuses and newborn infants.

Importantly, the past several decades have witnessed the demonstration of the role of antenatal stress to the pregnant mother and the long-term health of her offspring into adulthood.

Lawrence D. Longo, MD

Longo could buttress that claim by pointing to his own groundbreaking research at Loma Linda University and cite the fact that he has nurtured more than 200 postdoctoral fellows and countless visiting scientists from Asia, Europe, South America

| 23 |

Student researcher creates database of pterosaur sites around the world

Matthew McLain, Loma Linda University School of Medicine, Graduate Student | 24 |

While the vast majority of research conducted at Loma Linda University Health focuses on human health and wholeness, a few studies deal with inquiries in other fields.

of pterosaurs, so people may tend to ignore them even if they find them. And finally, political instability and violence keeps researchers out of some areas.”

A project recently completed by Matthew McLain, a 24-yearold graduate student in the department of earth and biological sciences at Loma Linda University School of Medicine, falls within that category. McLain and two of his colleagues — Eric Bryant from Cedarville University and Brad Chase of digital development firm DoubleClick Detroit — created a database that uses Google Earth to map known findings of fossilized pterosaurs worldwide.

A pterosaur recently discovered in Antarctica highlights another reason some areas do not produce pterosaurs.

Their PteroTerra database — found online at pteroterra.herokuapp.com — has given paleontologists a whole new way to evaluate distribution patterns of the long-extinct flying reptiles.

“There hasn’t been a lot of research there because it’s very expensive and difficult to work in that environment,” he notes.

“There are probably many fossils deep under the ice in Antarctica and Greenland.”

McLain says credit for the project must be shared among all three members of his team.

“The main idea was mine,” he reports, “but Eric said we should try to interface this with Google Earth and my friend Brad works in digital marketing. He took over in getting it online.”

On two levels, it is years ahead of competing sites. First, it maps the locations where individual specimens were found, while other programs only display major clusters. Second, it allows users to create groups of specimens based on characteristics like diet or wingspan and then to map those groups.

Thanks to an interactive database created by one of our graduate students, you can locate the fossilized remains of prehistoric flying reptiles all over the world.

“Paleontology has been what I wanted to do ever since I was a little kid,” he shares. “As a boy, I was interested in animals in general and dinosaurs in particular.” When it came time to choose a career, he was torn between zoology and paleontology, but paleontology won.

“I’ve always thought pterosaurs were really neat,” he adds. “There are less than 200 known species on Earth. We have over 1,300 individual specimens in the database, but there are many more specimens that we haven’t had time to input yet.”

Contrary to popular opinion, pterosaurs are neither flying dinosaurs nor lizards with wings.

“They may look like lizards or dinosaurs,” he acknowledges, “but those are actually very specific categories. It’s best to refer to pterosaurs as flying reptiles.”

A glance at the PteroTerra database shows large numbers of pterosaur findings in the Western and Midwestern regions of the United States, but none in California, the Pacific Northwest or the Eastern Seaboard. Western Europe and South America are densely populated by fossilized pterosaurs, but there are only scattered findings in Asia and the Middle East. There are hardly any in Russia, Canada, Iceland, Greenland and Africa.

McLain says pterosaur fossils are rare even in areas where they appear heavily clustered on his database.

“Part of the reason is that pterosaurs have hollow, thinly walled bones that don’t fossilize well,” he notes, adding that pterosaur fossils are not found in all parts of the world.

“Some areas don’t have the Mesozoic rocks that pterosaurs are found in,” he observes. “The Mesozoic rocks in Canada, for instance, were almost totally sheared off by glaciers. In parts of Africa and Southeast Asia, the rainforests have taken over, and in other places, there may not be much awareness of the importance

McLain hopes to add locations where pterosaur footprints will be found in the future, since that would help in understanding their behavior around bodies of water. He would also like to create another database mapping the location of dinosaur footprints with Google Earth. “That might allow us to look for migration patterns or similar phenomena, since dinosaurs have left us many footprints to study,” he says.

McLain introduced his wife to pterosaurs.

“I’ve been talking to Jessica about the subject for a while,” he says.

“She likes it. She knows a lot about paleontology and geology now.” The couple hopes their toddler son, Alaric, will one day share their enthusiasm.

McLain also hopes to integrate pterosaur research into his future career. “I want to teach,” he announces. “And I’d like to do research as well.”

Leonard Brand, PhD, professor of biology and paleontology and immediate past chair of the department, says pterosaur research at Loma Linda University might not be as ironic as it seems, since vertebrate paleontologists often teach anatomy at medical schools.

“Loma Linda University gains respect among scientists,” Brand insists, “for its basic science research with projects like Matthew McLain’s pterosaur database. This library of information about this group of fossils is an important and expandable resource for the scientific community.”

| 25 |

Study explores new method for AIDS prevention A recently completed Loma Linda University School of Pharmacy study sheds light on why it takes so long to bring lifesaving new medical treatments to market.

“At any specific temperature,” he reports, “the release rate of a given microbicide is controlled by the sublimation enthalpy of the particular matrix into which the drug has been incorporated.”

In 2010, Richard Maskiewicz, PhD, then assistant but now associate professor, received a $2.4 million grant from the National Institutes of Health to test a long-acting drug delivery method he invented to prevent HIV/AIDS and other sexually transmitted diseases at the point of contact.

Although not exactly a household phrase, “sublimation enthalpy” describes the chemical process by which a substance passes directly from a solid to a gas or vapor without first becoming a liquid. In this case, his first-time-ever demonstration means that the rate at which a microbicide releases into the patient’s body to prevent infection depends solely on how fast the host material transforms from a solid to a vapor.

Maskiewicz thought that if introduced into the vagina and cervix, microbicide compounds could potentially save millions of lives by killing bacteria, viruses and other harmful microbes, so long as they did not have to be applied prior to each sexual act.

Researcher uses $2.4 million NIH grant to develop a highly effective AIDS prevention method. So why won’t it be heading to market any time soon?

Although his four-year study ended in May 2014, he predicts future product development will focus on more conventional delivery systems instead of the one he developed. Nevertheless, Maskiewicz says five important findings confirm his novel system’s effectiveness in broadening the ability to prevent deadly disease.

“First,” he asserts, “the release rate of a broad range of HIV microbicides was shown to be independent of their molecular size or structure. This will potentially allow the use of drugs, which, to date, have not been deliverable by conventional sustainedrelease technologies.”

The second finding is a bit more complex.

The third finding demonstrated that the duration of release for the microbicide molecules ranges from a few days to several months depending on the type of host matrix. This is good news,

| 26 |

since this method will protect women from sexually transmitted infections long after original insertion.

The fourth finding is particularly exciting. Maskiewicz and his co-investigators from Scripps Institute and the University of Pittsburgh found that while none of the tested matrix materials harmed cervical cells or vaginal immune tissues, they all provided complete protection against HIV infection, even after multiple challenges.

The final finding reveals that the best way to ensure that microbicides do not lose their ability to combat HIV/AIDS during prolonged release is to conceal them in a subliming matrix.

“Complete suppression of chemical reactivity for the several microbicides could be achieved by incorporating these drugs into the interior of subliming matrices,” he explains. “This was done to achieve sustained release in the first place.”

While he remains hopeful that microbicides will one day prevent the spread of sexually transmitted diseases, Maskiewicz predicts that no microbicidal HIV/AIDS prevention product will win approval for commercial development any time soon.

“When I was awarded the grant, no sustained-release HIV microbicides were in clinical trials,” he reports, noting that it would take an exorbitant financial investment to guide such a product through the approval process. As a result, even if a sponsor came forward tomorrow with the necessary capital, it would take a minimum of five to seven years before a commercial microbicide could pass the Food and Drug Administration’s stringent requirements. “Any way you look at it,” he concludes, “it’s a long and very expensive process.”

Maskiewicz concludes with a somewhat melancholy observation: “If you build a better mousetrap, don’t make it too novel.”

Despite the encouraging results, Maskiewicz says few outside researchers or manuscript reviewers took the time to understand how his system achieves sustained release of microbicides. They also failed to grasp and appreciate how simple his method is when compared to existing technologies. As a result, it is no closer to widespread use than it was before the study began.

“The delivery system demonstrated through my grant is too new and different to interest the mainstream microbicide-based HIV prevention research community,” he adds.

| 27 |

Richard Maskiewicz, PhD

A research facility worthy of our legacy

Conceptual rendering

From the beginning, wholeness has been the focus of research at Loma Linda University Health.

We have made incredible progress. We have discovered unexpected connections between lifestyle and health — invented new medications, technologies and procedures in our quest “to make man whole.” We have saved countless thousands of lives.

In the past, we have made do with limited resources, outmoded facilities and crowded spaces. But in the sophisticated digital world of tomorrow, organizations that fail to keep pace will fall hopelessly behind.

tomorrow’s scientists can explore the health of mind, body and spirit in state-of-the-art laboratories and clinical trials facilities.

They will enjoy sophisticated new resources such as biomedical research data manipulation and a new bio repository and genetics facility. In addition, the Wholeness Institute will be housed in the same building. Working together, they will discover unimagined new allies in the quest for optimal health.

We invite you to partner with us in laying the foundation for a new era of research to extend our mission to people close to home and around the world.

That won’t happen at Loma Linda University Health. As part of our wide-ranging Vision 2020 campaign, we are preparing to build a brand new, 90,000-square-foot research facility where

| 28 |

Loma Linda University Health includes Loma Linda University’s eight professional schools, Loma Linda University Medical Center’s six hospitals and 800 faculty physicians located in the Inland Empire of Southern California. Established in 1905, Loma Linda University Health is a global leader in education, research and clinical care. It offers over 100 academic programs and provides quality health care to 40,000 inpatients and 1.5 million outpatients each year. A Seventh-day Adventist organization, Loma Linda University Health is a faithbased health system with a mission “to continue the teaching and healing ministry of Jesus Christ.”

Richard H. Hart, MD, DrPH

Rachelle Bussell, CFRE

President Loma Linda University Health

Senior Vice President, Advancement Loma Linda University Health

Anthony J. Zuccarelli, PhD

Tony Yang, MBA

Assistant Vice President, Research Affairs Loma Linda University

Assistant Vice President for Public Affairs, Editor-in-Chief Loma Linda University Health

Editorial Advisory Committee Samuel Achilefu, PhD Adjunct Professor, Department of Radiology, School of Medicine Loma Linda University School of Medicine Penny Duerksen-Hughes, PhD Associate Dean, Basic Sciences & Translational Research, School of Medicine Chair and Professor, Department of Basic Sciences Loma Linda University School of Medicine Gary Fraser, MD, PhD Professor Loma Linda University School of Public Health Paul Herrmann, MD, PhD Chair and Associate Professor, Department of Pathology and Human Anatomy Loma Linda University School of Medicine James Ponder Writer/Editor, Department of Public Relations David R. Williams, PhD, MPH Board of Trustees/Directors Loma Linda University Health Patrick Y. Wong, MBBS Board of Trustees/Directors Loma Linda University Health Anthony J. Zuccarelli, PhD Assistant Vice President, Research Affairs Loma Linda University James Ponder, Editor and Lead Writer Writer/Editor, Department of Public Relations Melissa Mollner, Creative Editor and Project Manager Senior Marketing Specialist, Department of Marketing LLUMCMKTG#PA-147-15/0215/TBD

Jhanelle Ocampo, Designer Designer, Department of Marketing RaeChelle English, Contributing Writer Intern, Department of Public Relations Nancy Yuen, MPW, Contributing Writer Writer/Editor, Department of Public Relations

MANY STRENGTHS. ONE MISSION. A Seventh-day Adventist Organization | LLUHEALTH.ORG