THE EXPLORER Journal of USC Student Research

VOLUME 11, APRIL 2019 Volume 13 | May 2021

Herman Ostrow School of Dentistry of USC Herman Ostrow School of Dentistry of USC THIS ISSUE THE EXPLORER 2021

4 FROM THE DEAN Avishai Sadan, DMD, MBA Dean Herman Ostrow School of Dentistry of USC 6 INTRODUCTION TO RESEARCH DAY Yang Chai, DDS, PhD Associate Dean of Research Herman Ostrow School of Dentistry of USC 36 RESEARCH DAY - SCHEDULE OF

» p.24 EVENTS

37 RESEARCH DAY - KEYNOTE SPEAKERS Steve Kay, PhD, DSc Mariela Padilla, DDS, MEd James Finley, PhD 38 RESEARCH DAY ABSTRACTS

» p.11 » p.8 74 FROM THE EDITORS /STUDENT RESEARCH GROUP Teresa Nguyen DDS 2021 Chenxin Li DDS 2022 76 RESEARCH DAY PLANNING » p.22 COMMITTEE

77 COVER PHOTO CREDIT

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8 Bioengineering of Enamel and Dentin Sumi Chung and Jessica Kim 10 Trailblazing Surgeon, Mentor, Researcher, and Hip-Hop Dancer Ava Pournejad and William Chakar

12 New Frontiers in Orofacial Pain and Medicine DIVISION ARTICLES San Sheridan and Antranig Mesrobian 14 Dentures Go Digital Emilie Hsu and Greg Park 16 Acute Pain Management and Preventative Dentistry in Endodontics George Simonyan and Abraham Zilberstein 18 Pathway to Periodontology Fan Xu and Sarina Taylor 20 Ostrow’s CHAMPion of Dental Public Health Parinaz Esteghamat Tehrani and Isatu Malekani 22 Brightening Smiles Through Community Dentistry Christie Shen and Michael Debourg 24 An Interdisciplinary Collaboration Gives New Hope for Craniosynostosis Patients Catherine Frusetta and Ilan Kaboud 26 Compassionate Care through Dental Anesthesiology Iris Yu and Danielle Min 28 A Day in the Life of an Attending in a General Practice Residency Abigail Heleba and Brandon Pham 30 Committing to the Advancement of Orthodontic Education and Research Scott Barlow and Yoo Jin Kim

32 Locomotor Learning & Rehabilitation Andrea Diaz 34 Improving the Neurodevelopmental Outcomes of Preterm Infants in the NICU through Positive Sensory Exposures Chenxin Li Avishai Sadan, DMD, MBA Dean G. Donald and Marian James Montgomery Professor of Dentistry Herman Ostrow School of Dentistry of USC 5 FROM THE DEAN

Dear Ostrow Students and Colleagues:

I’m so excited once again to be able to experience Ostrow’s annual Research Day (virtually, of course) after we were forced to cancel last year’s event because of limitations imposed by the COVID-19 global pandemic. Seeing the intellectual spark and scientific curiosity in our students and then reading about their discoveries in our award-winning The Explorer is a highlight every year.

Living through a global pandemic has given new shape and dimension to the importance of science and research. That scientists were able to provide us with several highly effective vaccines in such a short period of time is a testament to the immense power of scientific investigation and discovery. There truly is nothing we can’t accomplish when we focus the world’s leading minds on a problem.

For our own professions, research is rocket fuel, launching us into ever-exciting and sometimes unexpected directions. In fact, to be successful in your careers — whether that be in the dental, biokinesiology/physical therapy or occupational science/occupational therapy professions — you will need an almost insatiable thirst for new knowledge. You must constantly consume new research, learn new technologies and be willing to evolve the way you practice. It is our hope that during your time with us we impart within you this lifelong love of learning.

As part of a research-intensive university, we have always taken scientific investigation incredibly seriously. When the pandemic temporarily shuttered our lab spaces on both campuses, our researchers found creative and innovative ways to proceed. And when the University asked each school to create guidelines to allow for the safe resumption of research operations, it was an Ostrow task force, composed of researchers from dentistry, physical therapy and occupational therapy, that was so comprehensive in their plan that parts of it were adopted University-wide.

The pandemic did not slow our researchers down one bit. In fact, this year, Ostrow was No. 4 on the list of top-funded U.S. dental institutions by the National Institute of Dental and Craniofacial Research, up significantly from the No. 13 last year. This demonstrates such a significant amount of trust that the NIDCR has in our researchers, and I could not feel prouder of the work they do, day in and day out.

I want to congratulate all of our faculty and student researchers for the hard work, long hours and dedication it took to complete these research endeavors this year. I hope that you will take the time to really peruse this issue of The Explorer — not only to see what your colleagues are studying in your own field but also what your colleagues in all of our divisions are doing to continue strengthening the science undergirding their professions.

Stay safe, stay healthy, and Fight On! INTRODUCTION TO RESEARCH DAY

Dear Ostrow Students and Colleagues,

We are excited to virtually welcome you to the 2021 Herman Ostrow School of Dentistry of USC Research Day. Next year, I look forward to seeing you all in person at our annual celebration at the Galen Center! Today, we honor our incredible students, staff, and faculty in Dentistry, Occupational Science, Occupational Therapy, Biokinesiology, and Physical Therapy who have worked extensively on their outstanding research endeavors despite the challenges of the past year.

It is an honor for all of us to have the opportunity to work with passionate students who dedicate their time and effort to pursuing cutting-edge research. The collaboration and sense of community within Herman Ostrow School of Dentistry are unlike any other. I have witnessed first-hand how compassionate our students are in helping one another, especially now in a moment of unprecedented change and uncertainty in the world. It is inspiring to witness the way our students and faculty have persevered and acclimated to the new “normal” by safely and creatively continuing their research at USC during this pandemic. Your work ethic and ability to withstand the challenges we faced this year have not gone unnoticed.

We strive to provide you with the best opportunities to promote your growth during your training at USC. You have proven to be exemplary leaders the world needs; leaders who devote themselves to their work and are driven to make a positive impact wherever they go. We hope that your research experience and training encourage you to continue to ask questions and explore unknown territories. We know that your research will continue to pave the way for new scientific discoveries in the future.

Our new issue of The Explorer includes a plethora of innovative research abstracts as well as articles that recognize some of our distinguished faculty members at Herman Ostrow School of Dentistry of USC. Our researchers who are represented in this issue are exemplary professional leaders who have proven through their work that they will continue to make remarkable contributions to science. I congratulate all of our students and researchers on their successes as we virtually come together to showcase their efforts on Research Day.

Fight on! 7

Yang Chai, DDS, PhD University Professor George and MaryLou Boone Chair in Craniofacial Molecular Biology Associate Dean of Research Director, Center for Craniofacial Molecular Biology Herman Ostrow School of Dentistry of the University of Southern California 8 Bioengineering of Enamel and Dentin Sumi Chung and Jessica Kim Dr. Janet Moradian-Oldak is Professor of Dentistry in the c-axis orientation, packed within rods that are separated by Division of Biomedical Sciences at the Herman Ostrow School interrod structures. It serves as a wear-resistant outer layer of Dentistry of USC and Professor of Biomedical Sciences and of the dental crown as well as an insulating barrier that Bioengineering in the Department of Biomedical Engineering protects the underlying dental pulp from physical, chemi- at the Viterbi School of Engineering of USC. cal, and thermal forces that would otherwise be injurious. Enamel formation follows an organic matrix-mediated bio- Dr. Moradian-Oldak received her bachelor’s degree in Chem- mineralization process involving various structural hierar- istry from Ben Gurion University in Israel. Her passion for chies to provide mechanical support and prevent enamel de- science further led her to pursue a master’s degree in Structur- formation, which can be caused by excessive external forces. al Chemistry and a Ph.D. in Structural Biology at Weizmann Enamel is the most highly mineralized tissue in the human Institute of Science in Israel. After her Ph.D., she wanted to body and is crucial for the function and structural support expand her knowledge in the biological sciences and decided of a tooth; however, it is acellular, has extremely limited to pursue postdoctoral training at USC, focusing on enamel ability to remineralize, and does not possess the capacity to protein biochemistry. Dr. Moradian-Oldak’s previous work on remodel or regenerate. Given the extremely high prevalence the biomineralization of seashells and bone led her to inves- of tooth decay, researchers in the dental field have taken up tigate biomineralization in teeth, as the fundamental mecha- the challenge of investigating minimally invasive strategies nisms of hard tissue formation are similar. that could enable a more preventative approach to halt and even reverse carious lesions by remineralizing them. Thus, Dr. Moradian-Oldak’s lab focuses on both basic science and Dr. Moradian-Oldak and her team have investigated ways to translational research. Her current major areas of research rebuild enamel through bioengineering. involve the development of enamel and dentin, which she further aims to translate into novel developments for tooth Biomimetic materials require careful manipulation of key mineralization. Her research strategy is unique and revolves elements of the composition, function, and structure of around her lab’s discovery of novel amelogenin-inspired biological systems to produce material formulations with synthetic peptides, which can be used to regenerate and repair the desired properties. Since amelogenin plays a role in the both enamel and dentin. Dr. Moradian-Oldak’s advances in formation of enamel, Dr. Moradian-Oldak together with her remineralization of tooth structures holds the promise of great former graduate student, Dr. Kaushik Mukherjee, designed contributions to minimally invasive treatments that could two synthetic amelogenin-inspired peptides of 26 and 32 extend the longevity of teeth and simplify oral care delivery. amino acid residues (thus called P26 and P32, respectively). Enamel is an outer protective layer of the crown of the tooth. These synthetic amelogenins retained the vital functions of It consists of hydroxyapatite crystals that exhibit a preferred native amelogenin while they were able to effectively control apatite nucleation in vitro, which resulted in the formation of small, homogenous crystallites.

Dr. Moradian-Oldak’s lab has demonstrated that repeated peptide applications can promote oriented nucleation of apatite crystal layers and form a seamless interface with the underlying native enamel. Results showed that P26 and P32 achieved controlled apatite crystal nucleation and size in solution, improved preferential orientation of apatite crystal formation, and promoted the formation of multilayered aprismatic crystals with desirable mechanical properties.The multilayered aprismatic crystals had greater hardness and elastic modulus than the demineralized enamel and formed in layers that grew in the absence of peptides. P32 differs

The Explorer Journal 2021 9 from P26 in the structural dimensions of peptide assem- proteins in bioengineering. In dentistry, these findings hold blies and crystal size it forms in vitro, but the two peptides therapeutic potential with clinical significance for the repair achieve similar mechanical performance and crystal mor- of lesions where both enamel and dentin are affected, such phology. Their work on the discovery of functional domains as non-carious cervical lesions. As these peptides have great within the amelogenin protein highlights opportunities to potential, it is only a matter of time before bioengineered further improve the design of bioinspired peptides for tissue material will be available to replace conventional restorative engineering and repair. materials.

Underneath the crown’s enamel, there is a layer of less mineralized, collagenous structure called dentin that also covers Beyond research, Dr. Moradian-Oldak the tooth root. Due to its composition, the progress of caries is faster in the dentin and may increase the risk of irrevers- has inspired many students in ible dental diseases. Between the crown enamel and the root positive ways by reminding us to dentin, a boundary layer called the dentinoenamel junction pursue something we love and to (DEJ) provides a crack-arrest barrier that helps diminish the stress on the dentin. Mineralization of dentinal tubules is remember the balance of family, crucial for addressing dentin hypersensitivity. Non-carious work, and oneself. cervical lesions, which can occur due to attrition, abrasion, abfraction, or erosion, are areas of damage to the exterior layer of protective enamel that can jeopardize the integrity of the tooth and the inner vascularized dentin-pulp com- For instance, in the dental clinic setting, patients may plex. Therefore, there is an increasing interest in the resto- receive a dental device, like a night guard for example, that ration of the long-term health of teeth through addressing holds a peptide-containing solution in place to promote these lesions. As a natural extension of the capabilities of enamel regrowth overnight instead of an invasive restorative the synthetic peptide P26 in enamel regeneration, this pep- procedure. Among Dr. Moradian-Oldak’s many significant tide has been further investigated for its ability to regenerate contributions to tooth mineralization research is this new both the enamel and dentin in cervical legions. class of therapeutic candidates that have obvious clinical significance. However, there are still challenges ahead that will need to be addressed before FDA approval, such as investigating application in vivo in the oral cavity.

Dr. Moradian-Oldak’s lab continues to showcase promising findings that will help combat the high prevalence of tooth decay and further complications. In the future, Dr. Moradi- an-Oldak hopes to one day start clinical trials. Her ultimate goal is to have her research become translated to the clinical setting and help benefit patients with a non-invasive technique. Many people have expressed interest in Dr. Moradi- Dr. Moradian-Oldak’s lab investigated the effects of P26 an-Oldak’s work and support her immense contribution to below the DEJ and examined the facets of dentin biominer- the field of dentistry. alization through in vitro, in situ, and functional studies to understand the peptide’s dentin biomineralization capa- Beyond research, Dr. Moradian-Oldak has inspired many bilities. Interactions between the enamel matrix protein students in positive ways by reminding us to pursue some- amelogenin and collagen at the DEJ are crucial to preserv- thing we love and to remember the balance of family, work, ing this vital junction. P26 interacts with collagen fibrils and and oneself. She has mentored students who have now be- promoted collagen mineralization in vitro and promotes come successful leaders, educators, and clinicians, including dentin remineralization in situ. It also increases mineral USC faculty members. Flexibility, resilience, and strength density in enamel and promotes dentin tensile strength, are important skills she considers crucial for success and in addition to restoring the hardness and elastic modulus that she indeed embodies herself. With these admirable of repaired superficial dentin. Dr. Moradian-Oldak’s lab qualities, she will continue to thrive in her field of research. has shown that short peptides such as P26 have practical, financial, and clinical advantages over the use of full-length

Herman Ostrow School of Dentistry of USC 10 Trailblazing Surgeon, Mentor, Researcher, and Hip-Hop Dancer Ava Pournejad and William Chakar Kimiko Agari, DDS, MD is a current 5th year resident in the Oral and Maxillofacial Surgery (OMFS) program at the University of Southern California. During her journey as a resident, she has excelled in providing patient care, mentoring students, and publishing research on novel topics in oral surgery.

Dr. Agari was born and raised in Stockton, California. From early childhood, she was drawn to the healthcare field. While exploring the different healthcare professions, Dr. Agari was particularly inspired by her own family dentist, who happened to be a close family friend. Her dentist’s superb patient care and passion for the profession sparked her interest in pursuing a career in dentistry.

Dr. Agari started her undergraduate journey at the University of the Pacific, where she was admitted into the accelerated program pathway to dental school. She then attended the University of California, San Francisco for dental school. Upon the start of her dental education, Dr. Agari actively explored all the different specialties in dentistry. During her first year of dental school, she came across the opportunity to participate in an event by a student-led organization called Passing the Scalpel at UCSF, where she met inspiring mentors and peers who played a vital role in introducing her to the field of OMFS. This organization was founded by current USC OMFS chief residents, Allen Huang, DDS, MD, and Brian Lee, DDS, MD, along with their mentor, Stanley Liu, DDS, MD. Dr. Agari was remarkably inspired by the field of OMFS and the broad scope of practice that it entails. She networked and learned from all these encouraging mentors, which led her to pursue OMFS as a specialty. Having experienced the tremendous impact that such an organization had on her journey into OMFS, Dr. Agari, along with the founders of Passing The Scalpel, Dr. Huang and Dr. Liu worked on their original research project, “Passing The Scalpel: A Student Initiative In Identifying and Addressing Unmet Needs In Dental Education,” which was recently published in the Journal of Oral and Maxillofacial Surgery. This study has brought light onto the significant impact that this student-led organization has had on the success of young trainees interested in pursuing the field of OMFS. Recognizing the value of a student-led initiative, Dr. Agari believes that an organization of this nature can provide early exposure to OMFS, as well as net- working and mentorship opportunities that would otherwise be difficult to find.

Dr. Agari also notes the unique opportunity she has to mentor and inspire females interested in oral surgery. When Dr. Agari first applied for OMFS, she knew this was a heavily male-dominated profession. For many women, this may seem overwhelming, but it did not discourage her from pursuing her passion. In light of her experiences, Dr. Kimiko Agari, along with her sister Dr. Kristi Agari, who is also a current resident in the USC Oral and Maxillofacial Surgery program, decided to start an organization called Sisters in OMFS through which they can provide support and mentorship to women pursuing a career in the field of OMFS.

The Explorer Journal 2021 11

Another one of Dr. Agari’s original research work is her study “Successive Reimplantation of Dental Implants Into Sites of Previous Failure,” published in the Journal of Oral and Maxillofacial Surgery which has been nominated for the 2020 Journal of Oral and Maxillofacial Surgery Best Paper Award. With dental implants being one of the best, most evolving treatment options for restoring edentulous spaces, Dr. Agari’s work plays an invaluable role in identifying factors that may lead to reimplantation failures. Along with her faculty mentor, Bach Le, DDS, MD, Dr. Agari investigated site-specific, patient-specific, and -im plant-specific factors in patients with implant and reimplant failures. Some key observations were consecutively lower survival rates with successive reimplantations into the same site, as well as a significantly greater percentage of postoperative pain and a significantly greater percentage of early implant failures (failure prior to abutment connection) in implants and reimplants that failed. Their recommendations for clinicians are to closely monitor for postoperative pain after implant or reimplant placement and use it as a possible predictor of implant failure. If postoperative pain is noted, clinicians may intervene with more aggressive postoperative management, whether that be closer follow-up visits, more frequent postoperative imaging, or postoperative antibiotics. Clinicians may also educate their patients with the likelihood that if they have reached the point of abutment connection, their risk of implant failure becomes much lower.

As an OMFS resident, Dr. Agari has rotated through the Children’s Hospital of Los Angeles (CHLA), where she has had the unique opportunity to care for pediatric patients and learn from craniofacial surgery attendings and mentors Mark Urata, DDS, MD, and Jeffrey Hammoudeh, DDS, MD. This experience inspired new research projects and an affinity for pediatric care. Dr. Agari is continuing the research work of her chief resident, Dr. Allen Huang, in pediatric craniofacial anomalies requiring mandibular distraction. Mandibular distraction is the novel technique of lengthening the mandible for patients with congenital and developmental micrognathia, such as Pierre Robin Sequence. A major advantage of this procedure is the ability to improve these patients’ airways and avoid the need for tracheostomy. Dr. Agari’s research, guided by faculty mentor Dr. Hammoudeh, aims to investigate and characterize the timeline of relapse for these patients who have undergone mandibular distraction, as well as compare the differences in relapse between males and females.

Following the completion of her residency program, Dr. Agari plans to remain involved in the academic world to both teach and provide patient care. She enjoys teaching and mentoring, a trait she attributes to both her parents being teachers. She particularly enjoys pediatric oral surgery and craniofacial care and would like to continue her contributions to this field. In her free time, Dr. Agari takes advantage of LA’s weather and diverse opportunities, participating in activities such as skateboarding, snowboarding, hot yoga, spending time at the beach, and, most recently, hip-hop dance classes.

Dr. Kimiko Agari is an accom- plished surgeon, academic, researcher, and mentor, and we wish her the best in her promising future. Fight On! Herman Ostrow School of Dentistry of USC 12 New Frontiers in Orofacial Pain and

MedicineSam Sheridan and Antranig Mesrobian

“Dentistry has always had an influ- his PhD in Dental Science while work- Current Research ence on my life…. The dental clinic ing alongside Dr. Saku. They continued is different, and I’ve always loved the to study and publish their work on the Dr. Al-Eryani is driven by a strong desire sound of the drill. I knew I wanted invasion and proliferation of specific to contribute to the field of dentistry to be a dentist one day” Dr. Kamal lines of oral carcinoma, with the goal through innovation and collaboration. Al-Eryani was only seventeen years of finding effective clinical measures to His research studies span a wide array of old when he embarked on his dream reduce the growth of oral cancer. topics, from oral squamous cell carcinoma and first enrolled as a dental student to temporomandibular joint disorder in in the well-recognized Damascus Following the completion of his PhD bisphosphonate users. A recent publica- University after graduating from high program, Dr. Al-Eryani returned to his tion titled “Modified protocol including school in Yemen. homeland of Yemen and was ultimately topical minocycline in Orabase to manage named the Head of the Department of medication-related osteonecrosis of the As an Assistant Professor of Clinical Oral Medicine, Pathology, Radiology, jaw cases” proved to be especially signif- Dentistry within the Orofacial Pain and Periodontology at Sana’a University. icant due to its clinical application of an and Medicine Center at the Herman He quickly noticed a high prevalence alternative treatment option for patients Ostrow School of Dentistry of USC, of temporomandibular joint disorders Dr. Al-Eryani continues to remain associated with the chewing of khat, active on multiple research projects. which is a central nervous system He currently teaches online cours- stimulant found in the leaves of a wild es about oral medicine, supervises shrub called Catha edulis. This trend dental students during their rotation motivated him to start learning from the in Orofacial Pain and Medicine, and numerous publications by Dr. Glenn spends much of his time working with Clark on the subject. Ultimately, this and helping to mentor residents and newfound interest and passion for learn- master’s students. ing more about temporomandibular joint problems opened the conversation Early Influences between him and Dr. Clark, and soon Dr. Al-Eryani applied and was accepted Dr. Al-Eryani’s journey to USC to join the Orofacial Pain and Medicine evolved over many years. Following program at USC. his graduation from Damascus Uni- versity in 2001, he initially returned to Dr. Al-Eryani’s passion for teaching and Yemen to work as a clinical instructor research continued to develop, and in a university Oral Surgery depart- he was soon hired as an Assistant ment for almost three years. It was Professor of Clinical Dentistry in there that he was introduced to one the Orofacial Pain and Medicine of his most influential mentors, Dr. Center at USC after completing his Takashi Saku. Dr. Saku was interested post-doctorate education. Upon in studying the oral chewing hab- reflection, Dr. Al-Eryani states, “My its associated with cancer, and he passion is to sit with students and visited Yemen to study this alongside teach them. I feel happy when I Dr. Al-Eryani. This early exposure to get feedback from students and research motivated Dr. Al-Eryani to hearing that they learned some- continue his education by enrolling at thing… This is the best reward Niigata University in Japan to pursue that a teacher can have.”

The Explorer Journal 2021 13 who have been diagnosed with medi- set forth by the AAOMS. Participants who tific community.” He has continued to help cation-related osteonecrosis of the jaw were unresponsive to the initial treatment propel the scientific community forward (MRONJ). MRONJ is a severe adverse were then enrolled in the research study and plans to continue to build on these drug reaction that leads to progressive and treated weekly with 10% topical mi- many findings he’s already achieved. bone destruction in the maxillofacial nocycline alongside surgical debridement Alongside his clinical research, Dr. Al-Ery- region. The pharmacological agents and chlorhexidine irrigation. The results ani remains at the forefront of patient care which can lead to this debilitating con- proved beneficial, as all patients reported and management. With Dr. Glenn Clark, Dr. dition include antiresorptives (such as pain relief after the first treatment with Al-Eryani is currently working on a software bisphosphonates and RANKL inhibi- minocycline. Furthermore, some patients platform that utilizes artificial intelligence tors) and antiangiogenics. saw complete healing within a few weeks to assess patient complaints and provide a of starting the protocol and showed bone preliminary diagnosis. In the coming years, regeneration at the three-month follow up. this screening tool will prove useful in These important results suggest further streamlining how clinicians diagnose and evaluation of 10% topical minocycline treat their patients. It is this forward-think- is warranted as an addition to the treating vision that makes Dr. Al-Eryani an ment protocol of patients who suffer from instrumental member of the USC Orofacial MRONJ and could offer patients a superior Pain and Medicine Center. treatment option. What Does the Future Hold?

The American Association of Oral and Dr. Al-Eryani continues to display the will- Maxillofacial Surgeons (AAOMS) clas- ingness and enthusiasm to learn, educate, sifies individuals with MRONJ as those discover, and inspire. His humble demean- who (I) do not have a history of radia- or speaks volumes about his character. tion therapy or manifest metastasis to When asked about the future, his outlook is the jaw; (II) have a history of ongoing quite simple: continue researching, contin- or antecedent treatment with anti- ue educating, and continue contributing to angiogenic or antiresorptive drugs; the betterment of dentistry. and (III) experience exposed bone or presence of an intraoral or extra- Dr. Al-Eryani’s passion for his work carries oral fistula in the maxillofacial region Figure 1: Topical minocycline compounding and use. (A) The over into how he goes about his person- upper left syringe contains 100 mg minocycline powder and al life. Whether it is spending time with persisting for more than eight weeks. the upper right syringe contains 1 gm of Orabase measured The current treatment protocol as set in the scale, and the two syringes connected by female/ his family or pursuing other interests, he forth by the AAOMS is to control the female connector. 10% minocycline paste is compounded by reminds us that a proper work-life balance mixing the powder and Orabase forward and backward from is crucial: life is meant to be enjoyed in infection through the use of systemic one tube to another until the mixture is completely homoge- antibiotics and surgical debridement, nous. (B) Applying the compounded topical minocycline into all aspects. With the COVID-19 pandemic provide pain management, and pre- the bony defect. tearing through the world, Dr. Al-Eryani’s scribe chlorhexidine rinses to main- words of wisdom ring true now more than tain the oral microbiome. ever before. Time may contextualize life, Dr. Al-Eryani’s relentless desire to learn but the very essence of life is determined Dr. Al-Eryani’s study assessed patients more and add to the current body of by the manner in which it is enjoyed. “Hap- who were unresponsive to the es- knowledge persists, which is evident in piness is of the utmost importance…it lies tablished protocol and applied 10% each of the research projects he is current- in one’s passions. Spend your lives with joy topical minocycline in an effort to im- ly working on. These include the manage- and happiness, and always remember to prove patient outcomes. Minocycline ment of post-implant neuropathic pain, the smile!” is a broad-spectrum antibiotic with prevalence of ear-re- anti-inflammatory properties and the lated symptoms in ability to stimulate osteoblasts, which temporomandibular can increase bone matrix formation. joint (TMJ) disorder Additionally, minocycline has the abil- patients, a review of ity to bind bone more than any other the use of stem cells antibiotic and maintains therapeutic in TMJ regeneration, levels in affected bone for a prolonged and a review on period of time. Topical minocycline lichen planus diagno- has demonstrated advantages over sis and treatment. Dr. systemic antibiotics, which exhibit low Al-Eryani reminds us penetration into the ischemic and ne- all that the purpose crotic bone tissue and present the risk of research is “not of systemic toxicity with long-term use. just to publish your name… it is how you Dr. Al-Eryani in the white coat with the endodontic The participants in the study were ini- could add something residents at the Universidad Catolica de Honduras. tially treated based on the guidelines valuable to the scien- Herman Ostrow School of Dentistry of USC 14 Dentures Go Digital Emilie Hsu and Greg Park

Dr. Fabiana Varjao is a researcher and Clinical Associate Professor in the Division of Periodontology, Diagnostic Services, & Dental Hygiene at the Herman Ostrow School of Dentistry of USC. She has published a plethora of publications focused on denture selection methods that promote both esthetics and function in the clinical applications of both conventional and digitally designed dentures. Dr. Varjao has been recognized with multiple teaching awards, including the Teacher of the Year Award by the Pierre Fauchard Academy, a renowned international honorary dental organization whose mission is to recognize and grow leaders in the dental profession, their communities methods across different ethnicities. Previous research had and society. primarily been conducted using white/caucasian populations Research has been a longstanding pillar in Dr. Varjao’s as their sample group, so Dr. Varjao wanted to explore whether education and career. Her interest in research began when more inclusive studies could produce better outcomes for she was selected as a scholarship student to conduct adhesive diverse patients. testing studies in the field of operative dentistry during her What she found is that there are in fact anatomical first year in dental school at the São Paulo State University in differences that can help improve outcomes relative to São Paulo, Brazil. As she continued with research during her traditionally used methods. “For example, there is one second year, Dr. Varjao undertook her first denture research guideline suggested and utilized in the clinic which is project where she explored the methods and materials of measuring the width of the nose corresponding to the creating an esthetic denture to emulate natural anatomy two canine tips, a distance representing how wide those and function. This particular experience helped Dr. Varjao teeth would be. The same method for African Americans discover her true passion within removable prosthodontics simply wouldn’t work because of differences in overall and set the foundation for her current research is on complete composition of the patients in different ethnic groups.” dentures. After receiving her Doctor of Dental Surgery Using the traditional method of selecting tooth width degree, Dr. Varjao pursued her Master’s degree and PhD by measuring the width of the nose to correspond to in oral rehabilitation also at the São Paulo State University. the width of the canine tips can create a smile with Since then, she has remained in close contact with faculty teeth that are too big or too small. Another example is members in the field of prosthodontics and has pursued the golden ratio for tooth height versus width. Nobody additional fellowships to direct her research projects on fixed in the dental field is unfamiliar with this ratio, but and removable prosthodontics. many are unfamiliar with the fact that it is not universal Dr. Varjao has published over 30 papers in peer-reviewed across ethnic groups. Dr. Varjao’s research shows that journals on her clinical research. Her current research although the golden ratio may hold true for Asians and investigates methods of selecting teeth to maximize esthetics Caucasians, it can be unhelpful when treating African and function in dentures. Seeing a disconnect between Americans, for whom a ratio closer to 90% may yield previous studies that have guided current tooth selection more natural aesthetics. Through Dr. Varjao’s controlled practices and actual clinical results with patient satisfaction, clinical studies, she devised 14 methods to select teeth Dr. Varjao’s current research unravels optimum selection to better accommodate tooth differences between

The Explorer Journal 2021 15 different ethnic groups. She explained big challenge.” that with this new discovery, we can and should apply this knowledge to Because she is studying the differences our clinical practice to provide more in natural anatomy across many ethnic personalized care for our patients and groups, she requires patients aged 18 increase patient satisfaction, which will to 40 years old who have fully intact help patients feel more confident with dentition, which means that they their new appliances. have never worn braces and have no restorations or crowns. In her study, it Another area of Dr. Varjao’s research is a huge challenge to search for 100 is studying the advantages and subjects that fit her criteria, but “if you applicability of digital dentistry in only collect data from 10 people, it does removable prosthodontics. Realizing not represent the whole population. In that the future of dentistry is steadfastly addition, volunteers and researchers as heading towards digital tools, together well as subjects should also show up for with Dr. Tae Kim, Dr. Varjao led the appointments and be committed to that digital transformation of removable study, which does not always work as prosthodontics at the Ostrow School. planned,” says Dr. Varjao. In her research, she has found that “digital dentures made with CAD/CAM technology She also finds that sometimes clinical practices and eliminate many human errors, so they have a superior dental manufacturers tend to lag behind new knowledge fit and comfort.” For example, because digitally printed and developments found in research. For example, dentures are fabricated by simultaneously laying although we now know that facial measurements do and curing resin layer-by-layer, distortion is reduced, not always correspond accurately to the teeth shape allowing for a better fit. and size across all ethnicities, it is still a widely used method for tooth selection. Although we know that An additional benefit, as well as a clinical implication tooth size, shape, and shade can vary widely, not many of research on digital dentures, is that chairside time is manufacturers carry options outside a relatively narrow significantly reduced. When the patient comes in, the range. But Dr. Varjao explains that this is not something scan is done digitally, and while the patient waits in that should discourage us; instead, she encourages the clinic, information is sent to the lab where dentures building awareness of new developments by publishing can be created. For final complete dentures, this can research. According to Dr. Varjao, “it’s nothing if you translate into just 2-3 appointments needed from the don’t publish your research.” start of the scan to the delivery of the denture. It is also even possible to deliver interim dentures to patients While talking to Dr. Varjao about her research, her in just one day, making an immediate impact on their passion and love for what she does in the clinic is quite quality of life. palpable. She explains that with a research background, she can apply all of her scientific and evidence-based Dr. Varjao understands that there is space and necessity knowledge to a clinical setting, which is quite exciting. for digital dentistry within removable prosthodontics, She considers a patient’s gratitude, smile, and happiness but also wants to ensure that the dental community to be the most satisfying for her as a researcher and is well-equipped to provide optimal results with the clinician. new technology. Digital dentistry is not a new concept, but there is a definite lag within the field of removable Dr. Varjao tells students who aren’t sure that research is prosthodontics in the adoption of these new technologies. what they want to do in the future, “If you’re not sure That is why Dr. Varjao is directing her research now to if this is what you’re going to do, try it first. Take the digital dentures, so that she can help promote the dental opportunity as much as possible. Look for a mentor with community in “making sure what’s available today [in research experience. Try it, but it takes a lot of effort and digital dentistry] will fulfill [both] function and esthetics commitment. It is difficult to find someone who balances of teeth.” clinical and research, but the fact that what I have studied can be applied to the clinic and to the patients is why I Dr. Varjao also shared one of her challenges as a researcher, am greatly passionate about research.” namely finding a sufficient number of volunteers for her clinical research. Clinical studies are crucial, and even more Dr. Varjao appreciated having great mentors who important is making sure that the study participants reflect guided her and confirmed her passion for research and the diversity of the population at large in a representative removable dentures. “The more I did,” she recalls, “the fashion. Says Dr. Varjao, “[In clinical studies] the criteria for more I wanted to do.” It is clear that she will continue inclusion and exclusion are very specific [to represent the to thrive in teaching students, educating patients, and population without bias]. And finding enough people is a continuing her passion for complete dentures. Herman Ostrow School of Dentistry of USC 16 Acute Pain Management and Preventive Dentistry in Endodontics George Simonyan and Abraham Zilberstein

Dr. Mario Alvarez has always strived to relieve patients from their pain and preserve their natural teeth. Born and raised in Honduras, Dr. Alvarez graduated from the Universidad Nacional Autonoma de Hon- duras with a D.D.S. degree in 2004. Following his graduation, Dr. Alvarez was able to fulfill his passion for helping communities in need by working as the lead dentist at an Episcopal Church Dental Clinic. Working solely with underserved communities, Dr. Alvarez was able to experience first-hand how these patients had severe oral health problems due to their inadequate access to dental care. Often, when treatment planning many teeth with guarded and poor prognosis, most practitioners would turn to extracting teeth – but Dr. Alvarez was committed to conserving natural teeth to maintain functionality and longevity by performing root canal therapy.

In 2010, Dr. Alvarez, along with his wife, moved to California. Interested in pursuing more in-depth exploration of endodontics, Dr. Alvarez started shadowing in the USC Advanced Endodon- tics Clinic. Throughout his time shadowing, Dr. Alvarez was impressed at the microscopes and rotary endodontic instruments that were being used, which not only improved the outcome and quality of root canal procedures but also increased efficiency and patient comfort. These techniques and instruments were something that he had not been exposed to in Honduras, and they proved to be one of the driving factors, along with his passion for Endodontics, which made him apply to USC’s Advanced End- odontics Program, to which he was accepted in 2012. Upon completion of the program in 2014, Dr. Alvarez undertook a part-time teaching position and recently became full-time faculty in the past year. Dr. Alvarez takes pride in being able to mentor and teach undergraduate and postgraduate students, in addition to working in the Urgent Care clinic a few days a week and preparing students for the endodontics portion of licensure exams for the WREB and ADEX. As important as the clinical aspect of Endodontics, treatment planning and choosing one procedure over another relies on research. Dr. Alvarez is currently involved in two clinical research projects, one that is aimed at exploring the management of endodontic pain and another with the goal of preventing dental caries before it can arise.

The Explorer ournalJ 2021 17 In endodontics, successful management of acute pain is Sodium hypochlorite rinsing exerts broad antimicro- essential. Often, dental emergencies and dental pain are bial activity against experimental oral biofilms and of endodontic origin, and being able to manage this pain has demonstrated substantial results including a 48% appropriately plays an important role in patient compli- reduction in Plaque Index (PI) score, 52% reduction in ance and the outcome of the procedure. Therefore, en- Gingival Index score, and 39% reduction in bleeding dodontists must often address the problem of odontalgia from probing sites. Furthermore, sodium hypochlorite before being able to render appropriate therapy. Local can also penetrate into and potentially kill cariogenic anesthesia via common anesthetics not only allows the bacteria within dentinal tubules; in a study by Galvan dentist to perform treatment but can also help reduce et. al, it was found that rinsing with a 0.25% sodium odontalgia – but this does not always address the pain hypochlorite twice weekly caused a 94% greater reduc- effectively. To dig more in-depth into pain management, tion in dental plaque mass than water-rinsing. Dr. Alvarez and Dr. Ramon Roges are running a clini- The treatment protocol being investigated by the team cal study on the effectiveness of infiltration (periapical) proposes a twice-weekly oral rinse for 30 seconds with injection of ketorolac tromethamine (Toradol) for the 0.1% sodium hypochlorite for the prevention of dental management of endodontic pain. Toradol is the first caries. The study will be conducted at local schools in non-steroidal anti-inflammatory drug (NSAID) that is Honduras and include 80 otherwise healthy 5-year- available for periapical infiltration and intramuscular old children, with the duration of the study lasting for injection. Endodontic pain is linked to the inflammatory approximately 1.5 years. Forty children will be assigned process that results from the stimulation of nociceptors to the sodium hypochlorite group, and the other 40 as well as additional central mechanisms. Irritation of children will be assigned to the control group that will the dental pulp produced by bacteria, mechanical stim- be rinsing with tea. The baseline visit will include a uli, or chemical stimuli can cause inflammation. These clinical assessment of caries and a general oral exam- stimuli can cause the enzymatic conversion of arachi- ination, microbiological sampling of whole stimulated donic acid in biologically active group mediators such saliva to be stored and analyzed, and recording of the as leukotrienes, PGs, and thromboxane acid, and many child’s DMFT caries. At the end of the clinical study, others. Similar to most NSAIDs, Toradol can combat the salivary samples will be examined for levels of S. inflammation and pain by competitively inhibiting the mutans and lactobacilli using established real-time cyclooxygenase (COX) enzyme, thus inhibiting prosta- PCR protocols, in addition to a second DMFT index to glandin synthesis. With the application of Toradol via compare to the pre-trial baseline. The proposed trial periapical infiltration, Dr. Alvarez and Dr. Roges hope hopes to establish this rinsing protocol as highly safe, to find an effective way to manage endodontic pain that minimally invasive, practical, and inexpensive antimi- will have a profound effect on treatment outcomes. crobial therapy for the prevention of dental caries. Dr. Being an oral health advocate and a mentor for students in endodontics, Dr. Alvarez hopes to keep helping students appreciate the specialty of endodontics while focusing on making a difference in the world through his clinical research. Worldwide, dental caries is one of the most common Alvarez is optimistic about the potential feasibility of a chronic diseases of childhood and is particularly preva- diluted sodium hypochlorite rinse being implemented lent in people living in poverty and those with poor oral in virtually all parts of the world using low-cost local hygiene. Caries prevention includes regular cleaning of resources. teeth, a diet low in sugar, and fluoride treatment. In developing countries, infrequent dental check-ups, lack of Being an oral health advocate and a mentor for stu- oral hygiene education, and lack of proper oral hygiene dents in endodontics, Dr. Alvarez hopes to keep tools such as a toothbrush and toothpaste have led to a helping students appreciate the specialty of endodon- rapid increase in caries in children. Dr. Alvarez, along tics while focusing on making a difference in the world with Dr. Ramon Roges, Dr. Rafael Roges, and Dr. Jorgen through his clinical research. He plans to continue Slots, is trying to reduce the prevalence of caries in chil- visiting Honduras frequently throughout his career dren by utilizing a powerful and cost-effective approach to provide dental treatment to communities in need, – diluted sodium hypochlorite rinses. Sodium hypo- while inspiring the children of Honduras to pursue chlorite has been used as an antiseptic agent in dentistry their career goals, just like his community inspired him for more than a century and remains a widely used root during his time at the Episcopal Church Dental Clinic. canal irrigant at concentrations of 1.0-5.25%. Herman Ostrow School of Dentistry of USC 18 Pathway to Periodontology Fan Xu and Sarina Taylor

Dr. Naomi Nguyen, DDS, MS, is a periodontist and an Assistant Professor of Clinical Dentistry at the Herman Ostrow School of Dentistry of USC. In addition, she is a part-time faculty recruiter for the Periodontology program, a guest lecturer for both DDS and dental hygiene students, as well as a volunteer dentist for CDA Cares mobile clinics. Dr. Nguyen has come a long way since she moved from Viet- nam to the United States as a teenag- er. Faced with a language barrier, she started her American education in an ESL program and diligently worked her way toward undergraduate education at California State University - Long Beach. It was there that she first realized her interest in dentistry. She recalled with amusement that the prospect of working in dentistry was introduced to her through a career assessment test, which recommended her to be either a janitor, a mechanic, or a dentist. Out of those three options she was most drawn to dentistry. The reasons for which she felt this pull subsequently began to manifest. During Dr. Nguyen’s gap years after college, she demonstrated two essential strengths needed to become a great clinician: altruism and an interest in science-based research.

With her biochemistry background, Dr. Nguyen worked for two biotechnol- ogy companies before dental school. She first participated in research on type 1 diabetes that focused on creat-

The Explorer Journal 2021 19 ing devices to encapsulate the islet of Lang- University of Nebraska Medical Center Col- erhans cells so that they could be transplant- lege of Dentistry. There, she not only refined ed into diabetic patients. She then joined her periodontal surgical skills, but also com- the research team for a clinical study on the pleted a Master of Science degree in Oral use of porcine blood vessels to bypass hu- Biology, studying the potential use of diode man cardiac arteries. This technique was al- lasers in periodontal therapy. Following the ready approved in Europe, and her team was completion of her residency, Dr. Nguyen re- working towards FDA approval. In addition turned home to Southern California where to her research, Dr. Nguyen was also a front- she started her career as an educator at USC. line Red Cross volunteer for three years. As Before dental school, teaching had played an a member of the Red Cross AmeriCorps, important part of her life, as she was a teach- she provided disaster relief to underserved ing assistant during her undergraduate stud- communities affected by natural disasters ies for a variety of courses including math, bi- through arranging food, clothing, and hous- ology, and French, not to mention her time as ing for the families. In particular, she was a a CPR instructor when she was a part of the part of the National Rapid Response Corps, American Red Cross. Furthermore, her en- which deployed her to Oklahoma for flood re- thusiasm for the prospect of working at the sponse. Not only was she trained extensively Herman Ostrow School of Dentistry of USC in emergency management, Dr. Nguyen also due to its exceptional reputation inspired her became a CPR instructor at Red Cross. to make a natural transition to education. Given her rich background as an educator, it After gaining substantial research and vol- is no surprise that Dr. Nguyen is excelling as unteer experience, Dr. Nguyen pursued her a Clinical Assistant Professor. dental aspirations at UCLA School of Den- tistry. She frankly noted that her initial clin- When asked to give a few words of advice ical experience with periodontology may to current dental students, Dr. Nguyen noted be relatable to many dental students: she the importance of understanding periodon- wanted to do more operative procedures tology in order to provide patients with prop- instead of basic, non-surgical periodontal er care. She understands that students may treatments. However, she became motivat- be initially more excited by the operative pro- ed to further her education in periodontology cedures, as she once was, but encourages due to a personal experience with the field. us to value periodontology as a fundamental Dr. Nguyen was diagnosed with periodontal component of patient care and a key tool in disease in college by a general dentist, who conserving teeth. Dr. Nguyen further noted in retrospect probed too aggressively and that in her experience, appreciation for the over-diagnosed her. She was then referred basic science behind treatment as well as to a periodontist, only to have a more unsat- a genuine passion for helping people are isfactory experience and severe postopera- the cornerstones of a successful career in tive pain for weeks. Nonetheless, this rather dentistry. As exemplified by her research in- traumatizing experience was a blessing in volvement, community service, and dedica- disguise. From the unpleasant dental visits, tion to education, Dr. Nguyen has proven to Dr. Nguyen began to appreciate the impor- be a role model for future dentists and an ex- tance of plaque control and management of ample of how to achieve one’s goals through periodontal diseases. diligence and passion.

After achieving her DDS degree, Dr. Nguyen soon started her Periodontal Residency at

Herman Ostrow School of Dentistry of USC 20 Ostrow’s CHAMPion of Dental Public Health Parinaz Esteghamat Tehrani and Isatu Malekani

nization, training professionals with skills that they need to prevent disease. The master’s program is open “Life is not a straight path; sometimes Professor in 2001. At the same time, to graduate students from a wide va- there are obstacles and opportunities while commuting from San Diego to riety of academic backgrounds who that get thrown at you,” says Dr. Mina Los Angeles, Dr. Habibian successful- meet the USC master’s degree pro- Habibian. Her journey to the Herman ly managed to build up her own private gram’s minimum requirements. Ostrow School of Dentistry of USC practice in San Diego from scratch. involved many such twists and turns. After almost two decades, Dr. Habib- Dr. Habibian is a board-certified pub- ian sold her private practice in 2019, Dr. Habibian has extensive formal lic health dentist. She started her re- and she joined USC as a full-time As- training in the public health field, in- search career in dental public health sociate Professor of Clinical Dentistry. cluding a PhD in dental public health. in 1991 at the University of London, When asked how she was able to bal- Dr. Habibian’s PhD thesis was on where she pursued her Master’s de- ance practice ownership, academia, the etiology of early childhood car- gree and PhD, worked as a Research and motherhood, she stated, “It wasn’t ies, and analyzed a prospective Fellow, and published in peer-re- easy raising two children, emigrating cohort study that investigated the viewed journals. When asked about to California, and having an academ- behavioral, microbiological and so- the differences between practicing ic job. But it worked really well for all cioeconomic risk factors involved dentistry in the United Kingdom and of us, especially my husband being a in the initiation of early childhood the United States, Dr. Habibian notes young professional who travels a lot caries. At the time of its publication, that the practical evidence and health and works hard, so I had to be in town her work was the first comprehen- care delivery are not any different. taking care of my children. Somehow it sive study that applied a prospective However, the United Kingdom has a worked with a little bit of luck and time research methodology to this top- unique national health care system, management.” ic. Dr. Habibian’s interest in public in which children are given full dental health research has inspired her to apply her knowledge and skills to coverage until age 18, in contrast to At USC, Dr. Habibian’s passion for a wide variety of research topics. the very different system in the United oral public health led her to create One of the issues of great concern States. an online master’s degree program in public health is lack of access to in Community Oral Health, which she healthcare; in the US, it is perhaps Dr. Habibian moved from the United currently continues to direct. “Since the homeless population that suffers Kingdom to join her husband, who got many communities face socioeconom- from this the most. In a study titled a job opportunity in San Diego, once ic problems, we need to train dental “Dental students’ attitudes toward her older child finished high school. Af- graduates to become knowledgeable homeless people while providing ter her move, she knew that she want- in social determinants of health, as- oral health care,” Dr. Habibian and ed to find her way into academia. She sessing the communities’ needs, and colleagues questioned the conven- was drawn to USC due to its extensive ultimately be community health sol- tional wisdom that health care pro- public health program, and she was diers.” The mission of the online providers’ negative attitudes toward hired as a part-time Clinical Assistant gram is to serve as a grassroots orga-

The Explorer Journal 2021 21

homeless people may be a reason for lack of access to were given both interventions were four times more likely to healthcare services. The researchers aimed to analyze schedule appointments by their second follow-up compared dental students’ attitudes before and after they attended to those in the control group. The program successfully rotations once per week at the USC Union Rescue Mis- concluded that outreach health promotion programs are in- sion Dental Clinic, which provides comprehensive den- herently important, and that the use of multiple motivational tal services to homeless patients. A total of 242 students techniques is critical in encouraging children and their fami- completed questionnaires before and after the rotation. lies to enroll and seek treatment at dental homes. Data collected over the course of two years revealed that students had positive attitudes towards the home- Building on CHAMP, Dr. Habibian furthered related re- less population even prior to the rotation. What’s more, search with the ECHO program, which was established 85% of students agreed that the rotation made them feel in 2017. The ECHO program is one of several local den- more comfortable treating homeless patients, and 98% tal pilot projects funded through the California Department agreed that the patients made their experience enjoy- of Health, and represents a partnership between USC and able. These findings suggest that participating in such California State University LA. The goal of ECHO is to pro- programs can provide future care providers with experi- vide dental homes for children, through means of profes- ence that helps them become more comfortable giving sional education, community education, and screening. The much-needed care to this important underprivileged and program provides oral health screenings, personalized oral underserved population. health education for children and families, and referrals to dental homes. In addition to providing dental services to the underprivileged populations in the community service clinics, Dr. Habibian’s research with Dr. Roseann Mulligan and USC DDS students take a Behavioral Dentistry module colleagues published in the Journal of the California Den- which is designed to teach future dental professionals tal Association, “Mobile Dental Clinic: an oral health care about multiculturalism, cultural issues, health literacy, delivery model for underserved migrant children,” revealed and different ways to address patients’ unique needs. rates of untreated decay to be as high as 87.4% in children This way, the students can have a better understanding in underserved communities. This research was completed of different populations’ health care issues as well as prior to the COVID-19 pandemic in 2020, which is expect- develop appreciation for patient-centered care. ed to have many lasting implications that will do particular harm to underserved communities. As many community Dr. Habibian has recently been involved in two major health outreach programs have been put on hold due to community programs, the Children’s Health and Main- the severity of the COVID-19 pandemic, Dr. Habibian is tenance Program (CHAMP) and the Education Com- highly concerned about the impact that this will have on munity Health Outreach (ECHO) program. Dr. Habibian vulnerable populations across Los Angeles. She described led the creation of CHAMP, which focused promoting different barriers to care that are currently faced by people the importance of maintaining good oral health to young within susceptible populations, which include dire financial children. The CHAMP program, targeted a cohort of status, limited access to transportation, and clinics working 45,000 underprivileged children and families in Los restricted hours at reduced capacity. As the effects of the Angeles County, between 2012 and 2018. The project pandemic continue to unfold, Dr. Habibian will continue to had several components, one of which had an empha- be a champion for our local underserved communities. sis on community education. The goal was to provide parents with training on how to handle their children’s Dr. Mina Habibian is a passionate, committed, innovative, oral health. Dr. Habibian led the professional education and diligent individual whose mission is to train future den- component of the program, which was directed towards tal professionals and make a meaningful contribution to the dental and medical staff, on the importance of referring dental community. Her endeavors in research and her con- children with oral health needs to dental offices. The re- tribution to the community are quite admirable and set a search arm of the program was a randomized clinical great example for future dentists. Her success story should trial (RCT) that enrolled children and families into one or inspire all of us in the dental professions to focus on com- more motivational interventions, which included use of munity-minded, patient-centered care. an intra-oral camera and/or social work consultation, in the hopes of improving subsequent scheduling of dental appointments. The RCT showed that children who

Herman Ostrow School of Dentistry of USC 22

Brightening Smiles through Community

Christie ShenDentistry and Michael Debourg II

Whether it be out of necessity or elective choice, Dr. Gardner Beale, during one of her volunteer days visiting the dentist has become routine for much of our at the mobile clinic. After a heartfelt conversation filled society. While many of us book our next appointments with encouraging words and wisdom with Dr. Beale, Dr. for whitening, porcelain veneers or the latest Invisalign, Sunny set out on a new path, one that would turn her others may consider dentistry a luxury, or in some cases, focus toward a deeper commitment to the mobile clinic even an impossibility. What happens to the oral health and her roots in public health dentistry. of those who do not have access to care? What do you tell the parents of a child who cannot find a dentist Dr. Sunny’s passion for service has been evident to all within a three-hour radius who would agree to see their who have had the pleasure of making her acquaintance. child despite the family’s finances? These are some Her passion is clearly contagious, as she was selected of the questions that have led Dr. Sanaz Fereshteh, for multiple appointments within USC’s renowned Mobile affectionately known as “Dr. Sunny,” to forge a path which Clinic from her start as a volunteer to becoming Co- translates her technical skill and expertise into solutions director, and now Director. Dr. Sunny has become the for those in desperate need. head of one of the largest fleets of mobile dental clinics in the nation, second only to the U.S. military. With a legacy The story of Dr. Sunny’s unwavering passion for public of over 50 years, UCS’s mobile dental clinics are staffed health dentistry started at a very young age. After receiving by dental hygiene and dentistry students and provide her bachelor’s degree in chemistry from Dickinson comprehensive dental care to thousands of children in College in Pennsylvania, Dr. Sunny worked in Boston as low-income and vulnerable populations across Central a hospital chemistry technician. She was first inspired to and Southern California. There is no question of how pursue a life of service through the actions of her mother, difficult it is to manage such a multifaceted organization, who ran a Head Start program in Pennsylvania while she yet when asked about her appointment as Director, was growing up. The stories she heard from her mother Dr. Sunny humbly responds by saying that “the mobile about underserved communities lit a fire in her that would team of staff and faculty really know how to run it with or only begin to burn brighter from that point on. without a director so I am very lucky to be a part of this incredible team!” During her first mobile clinic externship to San Luis Obispo while attending the Herman Ostrow School of Beyond her involvement in the Mobile Clinic, Dr. Sunny Dentistry of USC, she was so motivated by the things is also involved in other outreach programs such USC’s she saw that she pleaded for a job there even before Dental Humanitarian Outreach Program (DHOP). She she graduated. As luck would have it, she was offered ran DHOP for nearly 10 years, and though she recently a position. Dr. Sunny went on to gain some of her most stepped away from her role, she has been essential in pivotal experiences during the next five years while the transformation of the program from a small group of working at the federally qualified health clinic (FQHC). In students without faculty to an impressive team that has treating and changing the lives of hundreds of families, served thousands of patients across the world. During she came to a deeper understanding of how these clinics their most recent trip to the Philippines in 2019, members are run and what their limitations are. of the DHOP team were able to deliver partial removable dentures, quadrant dentistry, oral hygiene instructions, The tension between the breadth of preventative care over 60 endodontic treatments, and over 400 cleanings that Dr. Sunny wished to provide and the large portion within just five days. of funding for FQHCs that went toward restorative care was striking to her. These issues weighing on her Through USC’s Mobile Clinic, DHOP, and other community mind became visible to one of her closest mentors, outreach initiatives, Dr. Sunny serves as a mentor to

The Explorer Journal 2021 23

dental students, teaching them how to provide the best is that we’re constantly getting money to fix things quality care for children in need. She pushes students rather than prevent them,” she says. Fortunately, to not only become skilled in dentistry, but have recent years have seen public health and community empathy, kindness, and love for their patients. Many dentistry move more towards preventative care rather of the children who are treated at the Mobile Clinic than emergency care, with the onset of many programs have been traumatized by previous poor experiences for sealants, cleanings, and oral hygiene education. at the dentist and are faced with students who have Educational disparity is one of the greatest challenges little experience in behavior management. Without in community dentistry, as a large majority of patients the assistance of sedation, students must learn how to have never been instructed in oral hygiene. This build trusting relationships with their patients. “[We’re] unfortunate fact highlights the importance of placing trying to get the best quality of care for a child that has an emphasis on education during outreach programs, no other option,” Dr. Sunny states. which can in turn help to empower communities and provide a lasting impact, long after the end of a Outreach programs like Mobile Clinic not only change particular community dentistry initiative. the lives of the patients who are treated, but also change the lives of the students who get the chance The story of Dr. Sunny’s success is one which highlights to volunteer. Over the years, Dr. Sunny has seen how one modest person with an idea can soar to firsthand the huge influence that service trips, both incredible heights with the appropriate mentorship, domestic and international, can have on student tutelage, and most importantly, belief. Through Mobile experiences. She relates,“I definitely have seen the Clinic, DHOP, and lectures throughout the Ostrow impact [DHOP and Mobile Clinic have] on students School’s DDS program, she aims to encourage over and over again on the path that they choose.... I’ve students to remain motivated, passionate and inspired seen many students go into community service and to want to change disparities in dentistry. Using one’s community health because of their experiences.” The knowledge and expertise to better the communities life-changing and unique experiences that community around them could perhaps be considered the outreach provides make Dr. Sunny a strong proponent essence of our dental profession, wouldn’t you agree? of dental outreach as an essential part of the dental In the spirit of service, and with the same encouraging school experience. words that Dr. Beale left with Dr. Sunny, we ask you: “how are you going to make the greatest impact?” Dental outreach certainly does not come without its challenges. “Our biggest hurdle in community dentistry

Herman Ostrow School of Dentistry of USC 24 An Interdisciplinary Collaboration Gives New Hope for Craniosynostosis Catherine Frusetta and Ilan Kaboud

Many great scientific discoveries and concepts could not article published in January 2021 in the prestigious journal have been developed without the uniquely complementa- Cell titled “Cranial Suture Regeneration Mitigates Skull ry contributions of a diverse team. With larger and more and Neurocognitive Defects in Craniosynostosis.” varied teams, each member can contribute expertise in different fields, concepts, and ideas in order to achieve a Dr. Yuan Yuan received his Ph.D. in Biomedical engineer- more comprehensive view of the topic at hand. ing at the University of South Florida. He then went on to join Dr. Chai’s lab as a Postdoctoral Scholar - Research The Department of Biomedical Sciences at USC per- Associate in 2016 and is now a Senior Research Associ- fectly exemplifies this concept of diversifying science. ate in the Chai lab. He brings to the team his engineering There, Dr. Yuan Yuan, Dr. Mengfei Yu, and Dr. Li Ma background, which allows him to look at the field of biol- bring together their expertise in sequencing and molec- ogy from a different perspective. His interest in research ular signaling, neuroscience and basic behavior, and bio- stems from his desire to explore how stem cells choose material sciences, respectively, to contribute to tackling their fates and differentiate into different cell types. Dr. an interdisciplinary research topic with great potential for Yuan’s contributions to the collaboration with Dr. Ma and impact on patient health. Together, along with their prin- Dr. Yu occurred through his ability to “connect the dots” cipal investigators Dr. Jianfu-Chen and Dr. Yang Chai, concerning how a craniofacial defect on a molecular level and a multitude of other colleagues, they spearheaded an can give rise to a cognitive defect with the help of Dr. Ma. Dr. Yuan also contributed specifically to the craniosynostosis project through analysis of cellular movement during suture regeneration, cellular sequencing, and also with the surgical elements of the project. Along with the paper that he published with the two aforementioned colleagues, Dr. Yuan also displays a vast inventory of past publications and research interests. He is especially proud of his contributions to neural crest cell migration research, where the Chai lab has challenged the previous understanding of neural crest cell differentiation and movement during first pharyngeal arch morphogenesis.

Dr. Mengfei Yu earned his Ph.D. in Stomatology at Zheji- ang University and was a Postdoctoral Scholar – Research Associate in the Chai lab at the Center for Craniofacial Molecular Biology until his recent return to Zhejiang Uni- versity as an Associate Professor. Dr. Yu is no stranger to research science, with many publications concerning stem cell tissue regeneration and material sciences and engineering. Dr. Yu has published more than thirty papers in international journals.

The craniosynostosis project aligned perfectly with Dr. Yu’s interests in stem cell regeneration. Dr. Yu played a role in every step of the study. He did hands-on experi- The Explorer Journal 2021 25 mental work, analysis, and assisted in writing the paper. He also greatly contributed to the development of the biomaterial which served as a scaffolding for suture regeneration. Dr. Yu is currently continuing his research in tissue regeneration for functional tissue organ systems, thus cul- tivating his knowledge and skill in stem cell research.

Dr. Li Ma has a Ph.D. in Genetics and joined Dr. Chen’s lab, then at the University of Georgia, to begin his path into neuroscience in 2016. He followed Dr. Chen to the USC Center for Craniofacial Molecular Biology as a Post- doctoral Scholar – Research Associate in 2017. The transition from genetics to neuroscience was difficult for Dr. Ma, but through his research he has garnered a proficiency in molecular and cellular mechanisms of neurologic development and disease. Dr. Ma became interested in the project when Dr. Yu presented his progress in a seminar which Dr. Ma attended. After the seminar, Dr. Ma met with Dr. Yu to discuss the effect of craniosynostosis on brain size and subsequent neurologic deficiencies. This spurred a collaboration as Dr. Ma joined the project and tions seen in human craniosynostosis patients, giving the offered his expertise in mouse neuroscience and cognitive scientists an unprecedented view into the disease. testing, and he quantified the neurological effects of the mice during the course of the project. Outside of his work Working with these mice, Dr. Yuan played a part in surgi- on the paper, Dr. Ma is also interested in looking at the cally applying the biomaterial the team dubbed GM-Ma, cellular and molecular mechanisms of autism spectrum which was developed by Dr. Yu and consists of an opti- disorder as well as frontotemporal dementia. mized combination of GelMA, Matrigel, and Collagen I. The GM-Ma acts as a scaffolding on which mesenchymal The project that eventually became the 2021 Cell paper stem cells differentiate to produce a patent suture that acts got its start when Dr. Yu outlined the major experiment like a natural one, restoring the skull’s ability to grow in design along with Dr. Chai. Later, Dr. Yu encouraged Drs. concert with the brain. Here, Dr. Yuan was also able to Yuan and Ma to collaborate, and the three were each able provide insight through his specialties in cellular differ- to contribute their distinct skills to the project. entiation and movement. An important finding was that regenerated sutures reversed the skull deformities in the This study gives new hope to patients with craniosynos- mice and improved their neurocognitive functions, which tosis, a birth defect in which the bones of an infant’s skull were measured by Dr. Ma. fuse together prematurely at the fibrous joints known as the cranial sutures. The resulting skull deformity can have This study serves to establish key concepts about the mo- devastating effects including intellectual disability if not lecular, cellular, and circuit mechanisms about neurocog- surgically corrected due to the pressure it puts on the de- nitive dysfunctions in craniosynostosis mouse models. veloping brain. Currently, highly invasive surgery is the Additionally, the clinical implications of the research are only treatment for those afflicted with this disorder, and clear and present the possibility that the technique could patients often suffer suture re-fusion afterwards, neces- be translated to infants with craniosynostosis. This could sitating a second operation. The team of USC scientists greatly improve quality of life for those with craniosynos- set out to examine whether suture regeneration could be tosis and would represent a significant improvement over an effective alternative treatment, based on the Chai lab’s the current surgical treatment. previous groundbreaking identification of stem cells that reside in the sutures, a study which was published in Na- This study was made all the richer by the combined spe- ture Cell Biology in 2015. cialties of Dr. Yuan Yuan, Dr. Li Ma, and Dr. Mengfei Yu. The three researchers have significant complementary In the process of investigating the possibility of suture re- expertise in their respective fields and are pleased with generation, the team established the very first model of the results of their first project together. On the heels of neurocognitive deficits associated with craniosynostosis, this success, they express their interest in collaborating namely Twist1+/- mice with suture fusion. These specific on projects together in the future. mice model the neuroanatomical and cognitive dysfunc-

Herman Ostrow School of Dentistry of USC 26 Compassionate Care through Dental Anesthesiology Iris Yu and Danielle Min

Dental anesthesiology involves a dynamic dai- require a meticulous treatment plan to en- ly schedule, assisting in a wide range of pro- sure safe delivery of care. This compassion cedures while attending to patients of all ages and eagerness to serve resulted in his appli- and backgrounds. As a dental anesthesiologist, cation to the special patients selective pro- Dr. Yuen Ryan Wu provides anesthesia support gram, which is still active today. The selec- on the first floor of the Herman Ostrow School tive program primarily treats patients who of Dentistry to pediatric, special needs, and el- are categorized by the American Society of derly patients. Dr. Wu attended UCLA for his Anesthesiologists as type 3 (patients having undergraduate education before joining USC severe systemic disease) and are considered for dental school in 2004. After graduating, he at higher risk, requiring the assistance of remained at USC as a faculty member before multiple departments. pursuing his three-year residency in dental anesthesiology at SUNY Stony Brook University During his time within the selective, Dr. Hospital. Since his return to USC, Dr. Wu has Wu was invited to participate in a general chosen to focus on treating the pediatric and anesthesia case in the OR. Upon entry, he special patient populations and contributing his met Dr. James Tom, the supervising dental expertise to teaching and patient care. anesthesiologist on the case and a current Associate Clinical Professor in the Anesthe- Like many third-year dental students, Dr. Wu siology Department at Ostrow. This encoun- was introduced to a new world as he started his ter would mark his first exposure to dental tenure as a student dentist. Dr. Wu has always anesthesiology and the beginning of his carried a passion and curiosity for helping journey in this field. As his interest in dental the special patient population as he was anesthesia grew, he shadowed Dr. Tom and aware of the disparity of access to den- participated in airway checks and sedations, tal care for this large group of under- procedures quite distinct from those per- served community members. During formed by other specialties, as the only den- one of his first rotations in the tal student. During this time, Dr. Wu noted special patients clinic, he con- a huge population that did not have access firmed the many special needs to dental care because dental clinics were that were prevalent within unwilling or just did not have the resources this population. These to see the special patient population. It was patients often present profound to see how the ability to admin- complex cases that ister anesthesia allowed for many of these patients to finally receive care.

The Explorer Journal 2021 27

COVID- Although Dr. Wu notes that he does not per- 19 has form regular dental procedures anymore as an had a anesthesiologist, he realizes that anesthesia major is a profoundly important field within -den impact tistry and is one of the determining factors on many that influences a patient’s ability to proceed aspects of life, with treatment. Dr. Wu reiterates that there and the field of den- are large populations of underserved patients. tal anesthesiology There tends to be a mistaken impression that is no exception. As a only individuals from poor socioeconomic shortage of PPE, such backgrounds have difficulty accessing care. as N95 respirators, persisted While not discounting these factors, Dr. Wu through the country, maintain- notes it is also important to consider patients ing the safety of both the prac- who may not be capable of being treated in a titioners and patients was difficult typical dental clinic due to the lack of proper once dental practices were able to resume sedation or anesthesia resources. As anesthe- operations in May 2020. As the need for sur- sia becomes further integrated into dentistry, geries and sedation did not halt because of the this field can now include a population that pandemic, obtaining the required supplies was has not historically had equal access to care. necessary to continue providing this vital dental Dr. Wu encourages anyone who is interested care. Through lowering the number of sched- in working with the special patient population uled surgeries and with the aid of the ADA and to come to the first floor to experience the CDC, Dr. Wu was able to obtain sufficient PPE impact and importance of general to continue patient care. Dr. Wu noted that once anesthesia in dentistry. patient care had safely resumed, he saw a large population of pediatric patients, which may be attributed to a lack of proper oral hygiene at home leading to increased development of caries.

Today, Dr. Wu can be seen at USC teaching students and utilizing his skills to reduce anxiety and provide comfort during dental procedures through general anesthesia. On Wednesdays, Dr. Wu treats pediatric patients, and on Thurs- days, he attends to special needs patients. When he is not at the dental school, Dr. Wu can be found at his private practice group treating a more diverse group of patients. Dr. Wu describes dental anesthesiologists as “lone rangers” who often work independently even when they are in a group practice setting, one of the unique aspects of the job.

Herman Ostrow School of Dentistry of USC 28 A Day in the Life of an Attending in a General Practice Residency Abigail Helena & Brandon Pham As an attending at both the LAC+USC Medical Center and UCLA Medical Center with 30 years of experience as well as the owner of a private practice, Dr. Kari Saku- rai is a passionate individual who aims to provide only the best outcomes for her patients, mainly specializing in cosmetic and general dentistry. Dr. Sakurai’s path to dentistry was inspired by a bike accident in high school where she would have lost both of her two front teeth if it weren’t for the skillful work of her dentist. Although traumatic, this experience put her on a mission towards becoming a dentist.

After graduating from the University of California - Irvine with a degree in biology, Dr. Sakurai received her DDS degree in 1989 from UCLA before beginning a general practice residency in hospital dentistry at UCLA Medical Center, where she was exposed to a variety of medical cases and professions. Hospital dentistry is “extreme dentistry,” according to Dr. Sakurai, and one of the main reasons why she pursued a general practice residency at UCLA. Working as the first dentist on the heart & lung transplant team, Dr. Sakurai helped to provide patients with a basic dental clearance, which is especially important for immunocompromised patients, as lives can be at risk due to seemingly trivial bacterial infections within the oral cavity. Dr. Sakurai also worked closely with doctors of other departments, which she believes leads to better outcomes for the patients. Dr. Sakurai’s current role as an attending for the USC General Practice Residency (GPR) comes with great responsibility and prestige. She often sees trauma cases that a private practice dentist may not ever come across. For instance, Dr. Sakurai recently performed oral surgery on the victim of a surf- board accident, as the physical trauma had resulted in roots becoming exposed. Also, as part of the selection committee, Dr. Sakurai helps to inform other medical specialists that dentistry is a systemic issue that must be carefully observed and treated, enabling the specialists to become better educated in identifying specific oral conditions in their patients. Working in such clinically and mentally challenging roles, Dr. Sakurai developed skills in performing CPR, treating the medically compromised, performing sedation, and responding to a variety of ever-changing medical emergencies.

As an attending at both the UCLA Medical Center and the LAC+USC Medical Center, not only does Dr. Sakurai

The Explorer Journal 2021 29 treat patients, but she also supervises the residents during cy room and taking extra calls, and making new connec- rotations. The cases seen by Dr. Sakurai and the residents tions with various other medical workers. As noted by Dr. at USC are unique and unlike anything one would see out- Sakurai, the vigorous one-year program at USC will place side of a hospital setting. For example, a resident encoun- you on equal footing with those who have been practicing tered a patient with ameloblastoma that needed resection for two or three years. In addition, a vast array of financial and further treatment with an implant-retained obturator; aid options are offered to residents, including student loan in such a case, a distinct set of skills must be mastered in deferment, stipends, medical insurance plans, and retire- order to improve the patient’s quality of life. The residents ment plans, which can make it easier for students who at USC are in a constantly changing environment, and may be worried about financial burdens to focus more on must run cases by Dr. Sakurai every day to ensure that furthering their education. As an added bonus, students proper treatments are being administered. Residents may who complete their residency also receive the equivalent also perform consultations in other units, including the ICU of about 150 continuing education (CE) units, which can and cardiac departments. translate to approximately two years before having to take more CE courses. Both the USC and UCLA GPR pro- Dr. Sakurai also runs the Pacific View Smile Center in grams are heavily centered around hospital dentistry, last Santa Monica, CA, where she operates similarly to the around 12 months, and involve rotating through a variety services that she provides as an attending. A wide range of dental experiences, including oral surgery, anesthesia, of more traditional dental services are also provided, in- and emergency medicine. In USC’s GPR program, res- cluding periodontics, Invisalign®, and other cosmetic den- idents train under faculty members from both the Keck tal procedures. Even outside of her usual working sched- School of Medicine and Herman Ostrow School of Den- ule, she is dedicated to serving her community, being the tistry, and training is completed at the LAC+USC Medical former president of the Academy for Excellence in Dentist- Center and Veteran’s Affairs Outpatient Clinic. Because ry and working with the American Heart Association, the there are only four residents, the relationships that resi- Give Back a Smile program, and cancer research orga- dents form with the faculty and doctors in other fields are nizations. often tight-knit. This gives residents a boost in finding jobs after graduation because of the network of connections During 2020, both the LAC+USC Medical Center and Dr. one can establish at USC. Not only will you receive much Sakurai’s private practice were forced to adapt to the ev- hands-on experience, but the mentorship you will receive er-changing restrictions and regulations enforced by the in the GPR will be an invaluable investment in a long, ful- state of California in order to provide patient care while filling career in dentistry. minimizing the risk of transmission of SARS-CoV-2. The GPR program especially was put under a lot of stress, as it As a tip, to help ensure that one’s application will stand had to accommodate patients from the dental school and out when applying to a GPR, Dr. Sakurai recommends community, as well as emergency patients. LAC+USC shadowing a physician in a GPR program, which would is the number one trauma center in Los Angeles, so the be useful to grasp a better understanding of hospital den- residents and doctors had to come together to work and tistry and the procedures that are carried out, as well as treat patients to get them out of trouble. Extreme mea- to demonstrate to the faculty that the applicant shows a sures were put in place, which involved obtaining the nec- strong interest in the field. Students who have the ability essary personal protective equipment, purchasing HEPA to communicate and interact effectively with other physi- scrubbers, and rearranging the entire layout of the hospi- cians, as well as students who perform research that may tal. Currently, before any patient is admitted, a thorough be pertinent to hospital dentistry, will also likely be given screening and testing procedure is completed beforehand more careful consideration during the selection process, as a precaution to keep patients as safe as possible. The as they tend to possess the skills needed by residents to LAC+USC Medical Center mainly serves a large portion make logical fact-based decisions and to communicate of the prison population, most patients were largely unaf- ideas efficiently between both patients and doctors. fected even after the onset of the pandemic, but many pre- cautions were put into place to ensure that both patients When asked about whether a hospital-based GPR is and medical providers would be protected from the virus. better than a non-hospital based GPR, Dr. Sakurai’s response was, “Absolutely, you will not get that experience To any dental students who are considering applying to a anywhere or information else in the world. It’s just about hospital-based GPR program, Dr. Sakurai strongly recom- earning a little respect because you can [handle trau- mends submitting an application. Although only approx- ma] and you’re not afraid to handle something like that. imately four residents are chosen per application cycle When you see the big stuff, you can appreciate it, and out of about 70-80 applicants, the GPR program offers you can appreciate how people think and how physicians/ unparalleled hospital-based experience, according to Dr. colleagues think, and how you can be a part of that health- Sakurai. Residents find themselves constantly learning care team. I think that’s key, and I’m having fun doing it.” and performing new procedures, working in the emergen-

Herman Ostrow School of Dentistry of USC 30 Committing to the Advancement of Orthodontic Education and Research

Scott Barlow and Yoo Jin Kim Dr. Hovhanness Ivan Shnorhoki- in Orthodontics. Dr. Shnorhokian technologies and help new clini- an was born and raised in Beirut, continued his post-doctoral stud- cians to determine which of their Lebanon. He attended the Ameri- ies at the University of Pittsburgh future patients may benefit from can University of Beirut, where he and earned his Ph.D. in Higher referral to an orthodontist. After received his Bachelor’s Degree Education in 1990. While in his students complete the pre-clin- in Biology. While Dr. Shnorhoki- orthodontic residency program, ical Orthodontics module, Dr. an had always had an interest in Dr. Shnorhokian had the first of his Shnorhokian hopes that they feel dentistry, the only dental school three children. His oldest daugh- confident in properly identifying in Lebanon was on a French sys- ter, currently working as a lawyer orthodontic needs. tem. He set his mind to learning living in San Diego, has blessed the French language and spent him with two grandchildren. His During his career at the University a summer working in France in second daughter works as a ther- of Pittsburgh Department of Or- order to immerse himself in the apist in a hospital in Long Beach, thodontics, Dr. Shnorhokian was language. Ultimately, Dr. Shnor- and his third is a biomedical engi- involved in various research proj- hokian followed his dreams and neer working in Santa Monica. ects. His earlier studies focused overcame personal, professional, on the effects of sickle-cell dis- and language barriers to receive After serving as the Acting ease on skeletal maturation of the his D.D.S. from Faculte Francaise Chairman of the University of dentofacial complex in American de Medicine Et Ecole Dentaire, in Pittsburgh Department of Ortho- black children. The cephalomet- Beirut, Lebanon. When reflecting dontics, Dr. Shnorhokian moved ric results showed that patients on this experience, Dr. Shnorhoki- to Los Angeles to join the USC with sickle-cell disease exhibit an remarked that “with motivation Orthodontics Department as significantly retruded maxillary and drive, you are able to achieve Clinical Associate Faculty. Dr. and mandibular incisors as well as anything you strive for.” Shnorhokian also serves as the a tendency to have a more protru- Co-Director of the Undergradu- sive maxilla and a more forward Following completion of dental ate Orthodontics course and thor- growth of the mandible. His work school in Lebanon, Dr. Shnorhoki- oughly enjoys spending time with has since been cited by recent an entered work in private prac- his students. As part of a contin- studies that focus on managing tice as a general practitioner. His uous journey to construct an in- orthodontic treatment with sickle interest in craniofacial growth and tellectually rewarding curriculum, cell disease. development motivated him to his current goal is to allow DDS pursue specialty training in ortho- Class of 2024 students to use iTe- The following year, his research dontics, and he moved to the Unit- ro scanners to analyze their own regarding the influence of pe- ed States after being accepted to occlusion in preparation for the rennial allergic rhinitis with an the orthodontic program at the 2nd year Orthodontics course. Dr. allergic component (PRAC) on University of Pittsburgh where he Shnorhokian hopes that this ex- facial type was published. While received his Master of Dental Sci- ercise will allow students to better working towards his Master of ence in Dentistry and Certificate understand evolving diagnostic Dental Science degree and lat-

The Explorer Journal 2021 31

er as an Assistant Professor, Dr. prosopic facial type, and Angle nificantly associated with the dura- Shnorhokian and his co-investi- Class I dental occlusion. tion of treatment, which included gator received a research grant (1) the pretreatment PAR score, (2) from the NIH for this project. In Dr. Shnorhokian continued to the number of treatment stages, (3) this study, Dr. Shnorhokian stud- delve into dentofacial morpholo- the percentage of appointments ied a group of children aged 5-10 gy patterns by retrospectively an- attended, (4) the number of appli- years with PRAC to determine if alyzing the effectiveness of Class ance repairs, and (5) whether the allergy management is able to al- II, division 1 treatment in terms patient was treated with or without ter the facial growth pattern. His of two outcome variables. These extractions. research showed that his group variables included the percent- of patients showed a significantly age change in a valid and reliable Outside of school, Dr. Shnorhoki- greater palatomandibular angle occlusal index, the Peer Assess- an immerses himself in serving and lower anterior facial height ment Rating (PAR) score, and the his community. He regularly volun- compared to the matched control duration of treatment were cal- teers for the Armenian Evangelical sample. Additionally, transverse culated from a population of 250 Church and works for the Arme- cephalometric measurements of subjects with Class II, Division 1 nian Benevolence Organization, the PRAC patient showed signifi- malocclusion who were treated which oversees churches all over cantly narrower bilateral orbital in the Orthodontic Department of the world. Amidst the pandemic, breadth, bizygomatic, and binasal the University of Pittsburgh over Dr. Shnorhokian has continued to dimensions than the control sam- the span of 12 years. Multiple re- actively contribute to the Ostrow ple. Although his study indicated gression techniques were used to community, maintain involvement that PRAC with chronic mouth evaluate the relationship between with his church, and find ways to breathing can affect midface the outcome and the treatment connect with his family. Dr. Shnor- development, his pilot study of variables. While the pretreatment hokian is an integral member of the PRAC patients who received 2 PAR score was the only variable USC Orthodontics Department, ½ years of allergy management that influenced the percentage and his contributions to the field showed no significant dento-fa- change in PAR, there were five continue to inspire his students and cial dimensional change, and treatment variables that were sig- colleagues. thus, the effect of allergy therapy on altering facial growth pattern is still uncertain. Another research study conducted by Dr. Shnorhokian compared the dentofacial morphology of 35 bruxers to 28 non-bruxers. Anthropometric spreading cali- pers were used to measure direct head and facial size from which cephalic (head width vs. head length), facial (face height vs. face width), and “gonial” (gonial width vs. zygomatic width) indices were calculated to determine the headform and facial type for all subjects. Results showed no difference in the dentofacial morphology between the two study groups, but a predominant craniofacial type and dental morphology of both study groups were identified, which included dolichocephalic headform, eury-

Herman Ostrow School of Dentistry of USC 32 Locomotor Learning & Rehabilitation Andrea Diaz

about his field. It was there where he began to learn more about how to communicate science both in a professional setting, and to a broader audience in a way that people could understand.

As a postdoctoral student in Neuroscience at Johns Hopkins University, Dr. Finley had the opportunity to work with other passionate individuals within his field who helped him gain experience in running a laboratory and learn ways to build community within that space in order to excite students about their Dr. James Finley is an Associate Professor in the Divi- projects. During his time at Johns Hopkins, Dr. Finley sion of Biokinesiology and Physical Therapy, and the knew that he wanted to become a faculty member Director of the Locomotor Control Laboratory at USC. and start his own laboratory. His academic journey began as an undergraduate student at Florida A&M University, where he studied Me- In August of 2013, Dr. Finley joined USC and his first chanical Engineering due to his interest in automotive major accomplishment was building his Locomotor engineering and control systems. During his under- Control Laboratory in 2015. At the time of comple- graduate years, Dr. Finley had the opportunity to intern tion of his laboratory, Dr. Finley had a list of projects at a medical device company in Minnesota, working in that he wanted to begin. He recruited students and their Cardiac Surgery Technologies Division. His expo- began executing projects that were assigned to him, sure to the medical field shifted his career goals and while also working on new projects that were devel- encouraged him to consider ways to combine both oping through conversations and collaborations with engineering and health. Dr. Finley began to pursue his other passionate researchers at USC. passion in biomedical engineering and states that one of the things that excited him the most about the field Dr. Finley and his Locomotor Control Laboratory ex- is, “…how the brain and nervous system, interacts with amine the ways in which movement is controlled and our muscular skeletal system to produce movement.” adapted in both the healthy and injured neuromus- He wanted to understand how it all worked and ap- cular system. A lot of the work conducted in the lab ply engineering principles to that process since there focuses on the development of theoretical models are lots of parallels between biological systems. The and experiments based on principles of neurosci- ultimate goal for him was to use that knowledge to ence, biomechanics, and exercise physiology. The improve rehabilitation. goal of his work is to assist populations with damage to the nervous system by designing novel and effec- During his doctoral degree in Biomedical Engineer- tive interventions to improve their mobility. ing from Northwestern University, Dr. Finley learned how to read literature, ask scientific questions, and Dr. Finley’s favorite part of research is meeting with think critically about the advantages and limitations of his students, discussing new ideas for future projects, different approaches to answer the questions he had and working on the process of designing and exper- imenting a new project. Meeting with his students

The Explorer Journal 2021 33 to discuss and analyze data is the part that excites understand why people move the way they do. The him the most because it is the core of their research; project also applies principles from a field referred making measurements about how people move, to as behavioral economics. This approach will allow what they do, and what their decisions are. They them to design new experiments and integrate their take this data to infer new knowledge that they were virtual reality related work that focuses on the ways unaware of before, which is then used in the devel- people respond to trips and slips when walking. opment of their research. When asked what advice he would give to students who are thinking about getting involved in research, Dr. Finley suggests that students to commit a year at a laboratory in order to obtain a meaningful experience. A year of work at a laboratory is sufficient for a student to learn new skills and make an original and independent contribution to research. That time will also be beneficial in understanding how the research process works, given that the experiences in a laboratory are unlike the experiences one will have in their educational courses. A new project sponsored by the National Science Foundation is in the works for Dr. Finley and his laboratory. They will study the ways in which people trade-off risk and effort during walking by examining the decision-making process of individuals when they are faced with a situation that requires them to move their body somewhere safely. For instance, imagine that you are on a hike and need to cross a stream to continue onto the trail. There are two paths that you can take, one of them is short but the rocks are slippery, and you would risk slipping and falling but you could get to the trail quickly. Your second option is a path where the water is shallow and wider, but it will require more time and effort to Dr. Finley encourages undergraduate and graduate cross. Hypothetically, which path would you take to students who are involved in research to think about cross the stream safely? This is the concept that Dr. their work and how it can translate into a publication. Finley is fascinated with because these are the types He encourages students to talk to their advisors in of decisions we consider when making movements order to receive guidance in relation to their own with our body. This idea also comes up in the con- goals and long-term career. Dr. Finley states, “If you text of pathology, especially when observing the want to do research over the long run, I personally movement of individuals who have had a stroke and think that research should be something that excites have lost some form of mobility in their body. They you.” Dr. Finley considers research a challenging may choose to walk with a more effortful strategy career, but in order to get over those challenges and that may not look optimal to an able-bodied individ- stay motivated, one needs to be passionate about ual, however, it may be optimal for them given that the questions that they are asking. Although it may they are willing to spend more effort to minimize the seem at times that undergraduate and graduate chances of them falling. students have limitations as to what they can do, he encourages them to keep moving towards the direc- This project is one example of a much broader set tion of doing work that inspires them and motivates of work in the world of what Dr. Finley and his lab them to do all the things necessary to conduct their call motor control and motor learning, in order to experiments, debug, start over, and move forward.

Herman Ostrow School of Dentistry of USC 34 Improving the Neurodevelopmental Outcomes of Preterm Infants in the NICU through Positive Sensory Exposures Chenxin (Cindy) Li

through research, so she decided to go back to school again to pursue her PhD. In 2006, she received her PhD in Reha- bilitation Science from the University of Florida.

Dr. Pineda’s research is aimed at better understanding the early factors that can help to improve neurodevelopmental outcomes, specifically in “preemies.” Her research focuses on the time right after the preemie is born, when they are still in the NICU, and follows these babies through childhood. While there are some factors that cannot be avoided, such as the need for stressful medical interventions, there are many factors that are modifiable within the NICU envi- Dr. Bobbi Pineda is one of the newest faculty members in the ronment and can make a difference in improving outcomes. USC Chan Division of Occupational Science and Occupation- Modifiable factors she investigates include therapeutic- in al Therapy, having joined the department in February 2020. terventions performed on the preemies within the medical Dr. Pineda received her Bachelor of Health Science (BHS) in environment, strategies to decrease the impact of stressful Occupational Therapy in 1992 from the Florida Agricultural exposures, and the impact of sensory experiences (amount and Mechanical University. She always wanted to become a of light exposure, amount of time parents hold the child, pediatric clinician. Thus, she started working in pediatrics right whether the parents are engaged in care, etc.) on brain away after graduating with her Bachelor’s degree, but quickly development and outcome. One of the more surprising realized that she had a lot more to learn. So, Dr. Pineda went results that came from her work was when she studied the back to school to get her Master of Health Science (MHS) impact of the NICU environment on high-risk infants. Many degree in Occupational Therapy at the University of Florida hospitals have an “open ward” style NICU, where the beds one year later in 1994. After completing her Master’s degree, are stacked very close together in one large room. Now- she practiced for several years and worked in many different adays, hospitals are moving towards a more private envi- settings that included the neonatal intensive care unit (NICU). ronment with single patient rooms consisting of three solid She especially enjoyed working in the NICU, because it was walls and a fourth glass wall. This design allows nurses to be so specialized. However, in the 1990s, there was much less able to check in on the babies easily and for parents to have understanding about the role of the occupational therapist. a private space to spend time with their baby. Dr. Pineda Luckily, occupational therapy in the NICU has boomed, and looked at how the private rooms could reduce stress since occupational therapists consist of the largest proportion of the babies in this type of environment are not exposed to as the 3 disciplines who make up the multidisciplinary rehabili- much activity, noise, or light during a period of immaturity, tation team in the NICU. Dr. Pineda’s career path was further where their sensory systems may not be able to tolerate it. cemented when she gave birth to her first child, who was Surprisingly, the results showed that babies in the private born 2.5 months early and spent his first 5 weeks of life in the NICU setting actually did worse – these children had sig- NICU. This was a pivotal point in Dr. Pineda’s life, as she now nificantly poorer language outcomes at 2 years of age and had the personal experience of being a NICU parent coupled already had brain structural differences at the time they left with her professional interest in working with high-risk infants. the NICU. For context, this study was conducted in an area She wanted to be able to give back to premature infants with many families of low socioeconomic status. With that comes challenges which make it harder for these parents to

The Explorer Journal 2021 35 come into the NICU and engage with their babies. Thus, the engage parents in establishing a relationship with their baby babies often were in a quiet and dark private rooms devoid early on while providing appropriate sensory exposures to of age-appropriate sensory exposures. Therefore, in hind- the baby. “In many ways, just knowing what you need to do sight, the results of the study made sense, and highlighted and what can be done can be very empowering,” Dr. Pineda the need to better understand and ensure positive sensory explained. The article describes how early education on experiences within the NICU environment. the SENSE program relates to more parent engagement in the NICU and that parents were able to complete a large Bridging this and other work she has done, Dr. Pineda number of sensory exposures defined in he SENSE program. devised the Supporting and Enhancing NICU Sensory Ex- The other article, published in Early Human Development, periences (SENSE) program, a sensory-based intervention defined that more maternal confidence and better infant that aims to engage parents in providing age-appropriate, neurobehavior was observed among babies and families positive sensory exposures (auditory, tactile, vestibular, -kin who used the SENSE program. One additional article, that is esthetic, visual, olfactory) to their infants in the NICU. This now in press, will define the impact of the SENSE program program defines the appropriate doses for each sensory on later language development. exposure for each day of NICU hospitalization, something that has never been clearly specified before. To develop this program, Dr. Pineda and her team first performed a literature review of all the scholarly articles from the past 20 years on sensory exposures that were associated with positive neurodevelopmental outcomes. Then, they pulled together all the evidence to define what activities to do in each domain of sensation and defined the age at the time of beneficial sensory interventions. Next, she sought expert opinion to fill in the gaps from the evidence to gain a better understanding of the different sensory interventions one should do across time. During this process, she also engaged parents of NICU infants. It was very important to Dr. Pineda to make the program parent-friendly, because At USC, Dr. Pineda will continue conducting research with there is mounting evidence that shows the importance of the hope that she can make an impact, improve the quality parents participating, with parents being the center of care of life during the NICU stay, and improve neurodevelop- in the NICU. The program provides a step-by-step guide in mental outcomes. She looks forward to building a team of parent-friendly language describing what parents should students and experts in other fields with varying expertise do with their baby every day of NICU hospitalization, based in order to further study the SENSE program in both the on the baby’s postmenstrual age, which is defined as the Children’s Hospital LA (CHLA) and LAC+USC Medical Center. number of completed weeks of gestation at birth plus the Dr. Pineda also is studying how the SENSE program gets number of weeks elapsed since birth. The SENSE program implemented at different hospitals, what hospital charac- has been well received, with almost 250 hospitals in the US teristics allow the SENSE program to be more successful, and abroad now incorporating it into their NICUs. and what adaptations may enable the SENSE program to be successfully implemented across different NICU settings. Recently, Dr. Pineda had several papers published on The program has been translated to Spanish, isiZulu, and the SENSE program. One article, published in PLOS One, Tswana, and translations are underway in Hindi and He- demonstrates the feasibility of the SENSE program and brew. Dr. Pineda is excited about expanding the program to parents acceptance of it. Dr. Pineda recalled, “Before this other languages and cultures to increase accessibility of the program, even if parents came into the NICU to visit their SENSE program among diverse families here in the United babies, they would often feel disempowered, because they States as well as abroad. We welcome one of our newest would not know what to do with their babies. Often, they faculty members and wish her great success as a Trojan! would end up being on their phones sitting next to the -ba by’s bedside. The SENSE program helps parents understand how important they are to their baby and serves to actively

Herman Ostrow School of Dentistry of USC 36 RESEARCH DAY MAY 26, 2021

12:30 pm – 12:45 pm Opening Remarks: Maja Matarić, PhD Interim Vice President of Research Avishai Sadan, DMD, MBA Dean Yang Chai , DDS, PhD Associate Dean of Research

12:45 pm – 01:15 pm Keynote Speaker: Steve A. Kay, PhD, DSc University and Provost Professor of Neurology, Biomedical Engineering and Biological Sciences Director of Convergent Bioscience Director, MESH Academy University of Southern California

01:15 pm – 01:20 pm Activity

01:20 pm – 01:40 pm Keynote Speaker: Mariela Padilla, DDS, MEd Associate Professor of Clinical Dentistry Assistant Director of Distance Education Programs Division of Periodontology, Dental Hygiene and Diagnostic Sciences University of Southern California

01:40 pm – 01:45 pm Activity EVENTS

01:45 pm – 02:05 pm Keynote Speaker: James Finley, PhD Associate Professor of Biokinesiology Associate Professor of Biomedical Engineering University of Southern California

02:10 pm – 02:50 pm Poster Presentation: Dentistry - Basic Sciences

02:50 pm – 03:10 pm Poster Presentation: Dentistry - Clinical Sciences

03:10 pm – 03:40 pm Poster Presentation: Occupational Science & Occupational Therapy

03:40 pm – 04:10 pm Poster Presentation: Biokinesiology & Physical Therapy

04:10 pm – 04:15 pm Break

04:15 pm – 04:45 pm Award Presentations SCHEDULE OF

The Explorer Journal 2021 37 KEYNOTE

Steve Kay, PhD, DSc

Dr. Kay currently serves as the Director of the University of Southern California (USC) MESH (Medicine, Engineering, Sciences, and Humanities) Academy, the Director of the USC Michelson Center for Convergent Bioscience, and is a Provost Professor of Neurology, Biomedical Engineering and Biological Sciences at the Keck School of Medi- cine of USC. He held the position as the 21st dean of the USC Dornsife College of Letters, Arts and Sciences from 2012 to 2015.

Dr. Kay is one of the world’s top experts on the genetics and genomics of circadian rhythms. Having published more than 200 papers, he was named by Thomson Reuters as one of “The World’s Most Influential Scientific Minds” consecutively from 2014 to 2019 and has been cited in Science magazine’s “Breakthroughs of the Year” three times since 1997. In 2008, Dr. Kay was elected as a member of the National Academy of Sci- ences of the USA. In 2009, he was elected as a fellow of the American Association for the Advancement of Science, and in 2011 he was awarded the American Society of Plant Biologists’ 2011 Martin Gibbs Medal for his pioneering research on biological clocks in both plants and animals. In 2019, Dr. Kay was elected a Fellow of the Royal Society of SPEAKERS London in recognition of his contributions to science. In 2020, Dr. Kay was appointed as University Professor at the University of Southern California in recognition of his outstanding scholarship in the field of genetics and genomics of circadian rhythms.

Mariela Padilla, DDS, MEd

Dr. Padilla is the Assistant Director of Online Distance Education Programs and Associate Professor of Clinical Dentistry in the Division Periodontology, Diagnostic Sciences and Dental Hygiene at Herman Ostrow School of Dentistry of USC. She is also the Director of the online Certificate in Orofacial Pain. In addition to her DDS (from University of Costa Rica), she completed an Advanced Residency Program in Orofacial Pain at UCLA, a Master in Education and Curriculum Design in Latin Uni- versity, and is a Fellow from the Center for Excellence in Teaching of USC. She has combined her clinical practice with academics since 1990, as clinical provider, faculty, pedagogical adviser, and educational administrator. Her current work focuses in Educational Experiences Design related with Diagnostic Sciences in Dentistry, and is dedicated to create online academic programs and learning resources.

James Finley, PhD

Dr. James Finley is an Associate Professor in the Division of Biokinesiology and Physi- cal Therapy at the University of Southern California. Dr. Finley received his bachelor’s degree in Mechanical Engineering from Florida A&M University and his doctoral degree in Biomedical Engineering from Northwestern University. Following his doctoral training, Dr. Finley completed a postdoctoral fellowship in Neuroscience at Johns Hopkins University. Dr. Finley and his research team in the Locomotor Control Lab develop models and experiments based on principles of neuroscience, biomechanics, and exercise physiology to identify the factors that guide locomotor learning and rehabilitation. Dr. Finley is also one of the founding directors of the USC SensoriMotor Assessment and Rehabilitation Training Center (SMART-VR Center). The Center’s mission is to harness innovative advances in virtual reality to improve motor and cognitive function across multiple clinical populations such as stroke, Alzheimer’s, and Parkinson’s disease.

Herman Ostrow School of Dentistry of USC 38 RESEARCH DAY POSTER ABSTRACTS

ADVANCED showed degeneration, and the nosis-specific high-frequency Enciso & Kamal Al-Eryani average radiological score was variables which were extract- SPECIALTY 3.86±1.46. Non-parametric tests ed after text mining from 450 Background: Head and neck showed that females had signifi- first visit narrative notes. All cancer (HNC) adult patients cantly higher score (p=0.011). these patients attended a undergoing radiotherapy often PROGRAM There was a statistically University-based Orofacial experience oral mucositis, significant difference in radio- Pain Clinic. Methods: Cre- which is treated by various RESIDENTS logical score between muscle ating a Structured Data Set: drugs, including natural/syn- and joint (p=0.014), and in the Finding a set of diagnosis-spe- thetic, oral, or topical antioxidants. This review focuses on Poster #1 score across 8 categories of cific high-frequency variables diagnosis (p<0.001). There was (HFVs) involved text mining the use of natural antioxidants Title: Temporomandibular joint no associaton between scores of 450 first-visit narrative in the management of oral mu- findings in CBCT images and chief complaint (p>0.05), or orofacial pain patient notes. cositis. Purpose: To compare diagnoses associated with pain Our text-mining discovered antioxidants’ effectiveness Authors: Kevin S. Berry, Mari- (p>0.05). Conclusion: There 137 logical clinical history and in managing oral mucositis ela Padilla, Somsak Mitrirat- were differences among the examination variables and 25 in HNC adults undergoing tanakul, & Reyes Enciso radiological findings between diagnoses, as assigned by our radiotherapy with or without genders and joint/muscle TMD, clinical experts. Identified a chemotherapy with placebo. Faculty advisors: Mariela Pa- as well as across diagnoses as set of diagnosis-specific HFVs Methods: The Cochrane dilla, Somsak Mitrirattanakul, & expected. defined as being present >/= Library, MEDLINE, Web of Reyes Enciso 67% of the time. Of these Science, and EMBASE were original 137 variables, only 53 searched for randomized con- Background: The radiological trolled trials (RCTs) comparing Poster #2 were found as HFVs associat- evaluation of the TMJ includes a ed with our diagnoses. Next, antioxidants with placebo in wide variety of images, including HNC adult patients undergoing Title: Algorithms for creating 25 diagnostic predictive algo- CBCT. The correlation of sever- rithms were created to score radiotherapy to assess the ity of TMD and radiological find- a pre-encounter questionnaire prevalence and severity of oral for Orofacial Pain Clinic individual patient data for each ings is unclear, with cases with diagnosis. Results: The accu- mucositis. Results: The initial degenerative disease showing racy of the algorithms was ex- search up to February 19, Authors: Anette Vistoso Mon- 2021, yielded 203 unduplicated an intact jaw function. Purpose: amined using a new test data real & Glenn Clark references. A meta-analysis of Evaluate radiological findings set of 50 additional first-visit 15 RCTs, including 718 adult (CBCT) in the TMJ, and com- Faculty advisor: Glenn Clark narrative notes from Orofacial patients, showed a significant pare those findings with clinical Pain patients. An acceptable diagnosis in patients with TMD. Background: According to improvement in mucositis se- accuracy score 0.87 (percent verity score for all antioxidants Methods: Retrospective study the National Institute of Dental of time our predicted diagno- with 100 images (200 joints) and Craniofacial Research except melatonin. Patients ses and our actual diagnoses receiving vitamin E had 60% from ≥20 years old patients. All (NIDCR), 12% of the popu- agreed). The algorithms were cases were seen by the same lation is affected by orofacial fewer chances to develop used to develop the smart mucositis RTOG (Radiation provider from 2018 to 2020. Two pain (OFP) conditions. These questionnaire for patients. independent clinicians analyzed conditions present irregular Toxicity Grading System) grade Conclusion: The predictive 2 than placebo (P=0.040). No the images to evaluate sclero- clinical symptoms, making diagnostic algorithms used in sis, erosion, subchondral cysts, them challenging for care statistically significant differenc- this study demonstrated an es were found in the incidence osteophytes, and flattening, providers to diagnose and acceptable initial accuracy following the protocol described treat. The literature suggests of severe mucositis and the hit ratio for our customized number of patients requiring by Arayapisit et al. (2020), and a that well designed diagnostic pre-encounter questionnaire. radiological score was obtained system could provide more analgesics for melatonin, by combining the indicated structure through the data propolis/honey, aloe vera, and variables except flattening collection process that will vitamin E compared to placebo (physiological adaptation) (IRB# determine a more accurate Poster #3 in one trial. Due to unclear/high UP-20-00436). Results: 78% diagnosis. Purpose: The risk of bias, a small number of Title: Antioxidants for oral of the joints belonged to female rationale behind our study studies (2 for propolis/honey mucositis in head and neck patients. The main complaints was to create a pre-encounter and zinc and one for curcumin, cancer patients silymarin, and vitamin E) and were pain and headache (54%), questionary system based on reduced range of motion (21%) sample size (<400 in each), data collection that is high- Authors: Nelli Karimyan, and joint noises (18%). The the quality of evidence was ly structured and therefore Afsheen Raza, Chitra P. Em- most common primary diagno- low. Conclusion: Antioxidants amendable to advanced data perumal, Kamal Al-Eryani, & ses were disc dislocation with provided a significant improve- analysis (i.e. machine learn- Reyes Enciso reduction (36.5%), myofascial ment in mucositis severity ing). Step one of this process scores in these patients, but pain (20.5%) and osteoarthri- involved finding a set of diag- Faculty advisors: Reyes tis (15%). 96.5% of the joints additional studies are needed

The Explorer Journal 2021 39 to confirm these results. chronic neuropathic pain patients versus national data- tional denture material bases Authors: Bradley Sainsbury, Authors: Yun-Chu Chen, Sillas Jared Bloxham, Masoumeh Authors: Kamelia Ebrahimian Duarte, & Jin-Ho Phark Poster #4 Hassan Pour, Reyes Enciso, & Payvand, Mehdi Mohammadi, Faculty advisor: Jin-Ho Phark Title: Artificial intelligence for Mariela Padilla Reyes Enciso, & Roseann Mulligan & Sillas Duarte rapid clinical diagnosis in oral Faculty advisors: Reyes Enci- medicine so & Mariela Padilla Faculty advisor: Mehdi Background: Good color stability of denture materials Authors: Jouliana Davoudi, Mohammadi, Reyes Enciso, & Background: Chronic neuro- Roseann Mulligan is essential to meet patients’ Michael Asadoorian, & Parish pathic pain (NP) is challenging esthetic requirements. Purpose: Sedghizadeh to manage with current thera- Background: Adults with inad- This in vitro study compared the Faculty advisor: Parish pies, raising interest in the use equate housing have high rates color stability of subtractively and Sedghizadeh of alternatives approaches such of chronic illnesses and overall additively manufactured denture as cannabis-based formula- poor health status. Little is known bases against that of convention- Medical errors are now the third tions. Purpose: Evaluating the about the prevalence of their ally heat-activated polymethyl leading cause of death in the effectiveness of cannabis-based medical conditions upon arriving methacrylate (PMMA) denture US, accounting for 10% of all US medicines in patients with for dental treatment. Purpose: bases. Methods: A total of 135 deaths. Based on the American chronic NP. Methods: Ran- To compare the prevalence rate complete denture base spec- Cancer Society, estimated new domized placebo-controlled of chronic medical conditions in imens were fabricated using cases in 2021 is about 54,010 trials using cannabis-based patients seeking dental care at three different methods (n=45 and the mortality rate is about interventions to treat adults two dental clinics in downtown per group) and were immersed 10,850. The survival rate for this with NP were included. Co- Los Angeles Skid-Row to an age in three different solutions. Color type of cancer is not high despite chrane Library, MEDLINE, matched nationally represen- measurement were performed advances in surgery, radiation, Web of Science and EMBASE tative sample of self-reported by using Commission Interna- and chemotherapy. Early diagno- libraries were searched up chronic disease data. Methods: tional de I’Eclairage (CIE) color sis of oral cancer increases the to February 1, 2021. Primary Self-reported medical conditions parameters L*, a*, b* using a chance of survival and improves outcome was NP intensity. Risk (hypertension; congestive heart spectrophotometer at baseline, the life expectancy of patients. of bias was analyzed based on failure; previous heart attack; after 30-day immersion, and after The goal of Oromed AI is to Cochrane’s handbook. Results: elevated cholesterol; previ- re-polishing. The CIEDE2000 improve clinical diagnosis by The search of databases up to ous stroke; diabetes; arthritis; color difference (ΔE00) was cal- providing a simple AI tool to in- 2/1/2021 yielded 379 records asthma; cancer; and hepatitis) culated, and three-way ANOVA crease efficiency and accuracy in with seventeen RCTs included were extracted from records of and independent t-tests were clinical diagnostics, while reduc- (861 patients with NP). Me- dental patients visiting two dental performed (α = 0.05). Results: ing errors. As proof of concept, ta-analysis showed that there clinics (the USC + Union Rescue There was significantly less color our dataset is composed of 1089 was a significant reduction in Mission and the Center for Com- change in conventional and high and medium resolution oral pain intensity for THC/CBD munity Health Downtown + USC milled denture base compared lesion pictures, consisting of 558 by –6.624 units (p<0.001), dental clinics on Skid-Row, Los to the 3D-printed denture base labeled as mucocele and 531 THC by -8.681 units (p<0.001) Angeles during 2013-2017 years. (p<0.001) with no significant as lichen planus. These images and dronabinol by -6.0 units This data was compared to NHIS difference between conventional are taken by clinical experts in (p=0.008) compared to placebo and NHANES (IRB #UP-20- and milled PMMA, and no dif- oral medicine and pathology with on a 0-100 scale. CBD, CBDV 00044). Results: Adult patients ference in extrinsic and intrinsic training in intraoral photography. and CT-3 showed no significant attending the Skid-Row dental color change. Overall, coffee We used a classification scheme changes. Patients taking THC/ clinics had significantly higher produced more color change for oral lesion image classifica- CBD were 1.756 times more prevalence of diabetes and hep- when compared to red wine tion based on deep convolutional likely to get 30% reduction atitis in all age groups and races, and distilled water after 30 days neural networks (CNN). Convolu- in pain (p=0.008) and 1.422 with diabetes being significantly of immersion period (p<0.05). tional networks are considered times more likely to achieve higher in Hispanics (p<0.05) Conclusion: The color stabil- the state of the art technique for 50% reduction (p=0.373) than and hepatitis being significantly ity of conventional and milled classification problems when the placebo. Patients receiving THC higher in all races (p<0.05), com- PMMA was superior to 3D-print- input is high-dimensional data had a 21% higher improvement pared to the NHIS data. Our data ed denture base, and milled such as images. These networks in pain intensity (p=0.005) and shows significantly lower preva- denture bases was comparable “learn” to extract local features were 1.855 times more likely to lence of arthritis in all ages and to traditional PMMA denture from images and classify the get 30% reduction in pain than races from 2013-17 compared to base. Specimens stained with input according to the extracted placebo (p<0.001). Conclu- NHANES. Conclusions: These coffee had more color difference features. We trained the model sion: Though THC/CBD and findings offer statistically relevant compared to red wine and water. on 70% of our dataset, 10% for THC interventions provided a data to show that individuals of No significant color difference cross-validation, and the remain- significant improvement in pain all ages without housing who in extrinsic and intrinsic color Abstracts ing 20% for testing. Our testing intensity and were more likely to visit dental clinics at LA, Skid- changes was found for all the model achieved an accuracy of provide 30% reduction of pain, Row have higher percentages materials in this study. 84.9% in lichen planus recogni- evidence was moderate to low of diabetes and/or hepatitis and tion and 76.02% for mucocele. AI quality and the reduction in pain lower arthritis than the national can be an effective tool for rapid may not be clinically significant prevalence of these conditions in Poster #8 clinical diagnosis of oral lesions. in the treatment of NP. similarly aged US adults. Title: Does waxing impression technique distort the final Poster #5 Poster #6 Poster #7 impression? Title: Cannabis-based med- Title: Chronic medical con- Title: Comparison of color sta- Author: Kuan-Ming Chiu icines for the treatment of ditions of Skid-Row dental bility in CAD/CAM and conven-

Herman Ostrow School of Dentistry of USC 40

Faculty advisor: Winston cant morbidity, reduction in qual- design and computer-aided Poster #11 Chee ity of life, and loss of productiv- manufacturing CAD-CAM ity. Purpose: To evaluate the systems are increasingly utilized Title: Human stem cells-based Background: Recording tooth efficacy of ketamine on migraine to fabricate removable complete temporomandibular joint re- structure beyond the margin and other primary headache dentures. In contrast, Analysis generation: a review plays a key role in fabricating full disorders compared to placebo and comparison of the printing coverage restorations. The im- and other active interventions. trueness of complete denture Authors: Shan Gong, Kamal pression material extruded into Methods: Electronic search of bases produced by digital light Al-Eryani, Chitra Emperumal, the gingival sulcus forms a thin databases including PubMed, processing (DLP) are lacking. & Reyes Enciso skirt of material around the fin- EMBASE, Web of Science, and Purpose: The aim of this in vitro Faculty advisors: Reyes ishing line, which indicates suc- Cochrane library, along with study was to assess the printing Enciso & Kamal Al-Eryani cessfully capturing the margin of hand searching of the referenc- trueness of CAD-CAM maxillary tooth preparation. The waxing es published up to February complete denture bases fabri- Background: Temporoman- impression technique, which 2021, was conducted to identify cated by using two different 3D dibular joint disorders (TMDs) Mojmir Vacek first described in randomized controlled trials printers. Methods: A maxillary range from functional distur- 1965, is a modification of the (RCTs) investigating ketamine in complete denture base was bances to significant struc- impression before pouring the the treatment of migraine/head- digitally designed based on the tural destructions. Traditional cast. The procedure uses an ad- ache disorders compared to virtual reference model of the treatment of TMDs includes hesive wax to thicken the skirt of placebo. The authors assessed maxilla which was obtained physical therapy, pharmaco- impression material in order to risk of bias following Cochrane from scanning of a polyvinyl logical, surgical, and psycho- define the preparation finish line handbook. Results: The initial siloxane (PVS) impression of logical interventions. However, more clearly. This step also pro- search strategy yielded 398 the edentulous maxilla of one at the late stages of TMDs, tects impression material from unduplicated references, which patient. A total of 20 CAD-CAM traditional management often being torn after separating the were assessed independently maxillary complete denture results in inadequate relief of stone cast. However, the wax by three review authors. After bases were fabricated based on symptoms. Stem cell-based shrinkage from molten to sol- evaluation, this number was re- the virtual reference maxillary tissue regeneration has been id-phase may present a risk of duced to five RCTs (two unclear denture base from an ultravio- studied extensively in joint impression distortion. Purpose: risk of bias and three high risk let light-curable resin material regeneration, including the To investigate the absence or of bias). Due to the high risk by utilizing two different Digital Temporomandibular Joint presence of distortion of the im- of bias, small sample size, the Light Processing (DLP) 3D (TMJ). Purpose: This study pression after using the waxing heterogeneity of the outcomes printers (Asiga MAX/ MAX UV discusses the TMJ regenera- impression technique. Methods: reported, and the comparison and Cara Print 4.0 printers). The tive potential of various human Typodont teeth #8, 12, and 14 groups, the evidence’s quality intaglio and cameo surfaces stem cells (HSC). Methods: were prepared, scanned, and a was very low. Intranasal ket- of all printed complete denture Randomized controlled trials standard model was printed out. amine was superior to intranasal bases were scanned and super- (RCTs) and case series of TMJ Twenty PVS impressions were midazolam in improving attack imposed on the corresponding regeneration (in vivo studies) taken. Parafin wax, utility wax, severity but not duration in one virtual reference maxillary den- and human mesenchymal and margin wax were used for RCT, while another reported ture base to assess the printing stem cells (HMSC) cultured waxing impression technique. intranasal ketamine was not trueness of all printed maxillary under different conditions to 3D scanning of the impressions superior to metoclopramide and complete denture bases using evaluate regeneration of TMJ with and without waxing impres- diphenhydramine. In one trial, a surface matching software related structures (in vitro stud- sion technique were compared. subcutaneous ketamine was (Geomagic Qualify 12). Statis- ies) have been included, after Results: There is no signifi- superior to saline in migraine tical analysis was conducted a thorough search of PubMed, cant difference between PVS severity reduction; however, with two-way ANOVA and Tukey EMBASE, Cochrane, and impressions with and without intravenous (I.V.) ketamine was post-hoc, α=0.05. Results: The Web of Science up to March waxing impression technique inferior to I.V. prochlorperazine printing trueness of the max- 2020. The RCTs included use. Conclusion: The waxing and diphenhydramine in another illary complete denture bases patients with TMJ noises, pain, impression technique does not study. Conclusion: Further fabricated by the Asiga MAX/ dysfunction, and radiological affect the accuracy of the PVS long-term studies with follow-up MAX UV printer was significant- TMJ defects. Results: All three final impression. are needed to assess ketamine ly more accurate than those in vivo studies (two RCTs and in treating acute and chronic re- fabricated by the Cara Print 4.0 one case series) showed sig- fractory migraine using intrana- printer (p<0.001). ANOVA test nificant improvement of TMJ Poster #9 sal and subcutaneous routes. showed a significant effect of pain, noises and jaw opening printers (p<0.001) and surface with stem cell transplantation Title: Efficacy of ketamine on (p=0.047) with no significant compared to pre-treatment migraines and other primary Poster #10 interaction between printers and values or control groups. In headaches. surface (p=0.249). Conclusion: vitro studies utilized a variety Title: Evaluation of the print- There was a statistically signif- of stem cells, growth factors Authors: Neysan Chah, BMike ing trueness of CAD-CAM icant difference in the printing and scaffolds under different Jones, Steve Milord, Reyes maxillary complete denture trueness of CAD-CAM Maxillary cultured conditions. Increased Enciso, & Kamal Al-Eryani bases fabricated by using two complete denture bases fabri- osteogenesis and/or chondro- different DLP 3D printers cated by two different 3D DLP genesis were noted with stem Faculty advisors: Reyes printers. The Asiga MAX/ MAX Enciso & Kamal Al-Eryani cell interventions compared to Authors: Mostafa Ibrahim, Jin- UV printer was more accurate control groups on ALP activity, Ho Phark, & Sillas Duarte than the Cara Print 4.0 printer in Background: Migraine head- Col-II, Col-X, SOX9, RUNX2, terms of the printing trueness of LPL, and Aggrecan mRNA aches are the second highest Faculty advisor: Jin-Ho Phark the intaglio and cameo surfaces. cause of disability worldwide expression. Conclusions: and are responsible for signifi- Background: Computer-aided This review emphasizes the potential of stem cell therapies

The Explorer Journal 2021 Abstracts 41

- - - - - Pur- Conclu- examined for : TheResults: : ThisMethods: otalgia, who were temporomandibular disorders at the Orofacial Pain Clinic at USC Ostrow School of Dentistry (IRB #UP-07-00416). sample population was fairly evenly divided between males (56%) and females (44%). In this sample, 78% of the patients were diagnosed with tinnitus, and 30 % with ear fullness. Otalgia was reported by 70% of the patients, with symptoms in 46% being episodic and 54% TMD was presentcontinuous. in 100% of patients, regardless of ear symptoms, diagnosed as masticatory muscle myalgias TMJ arthralgias(100%) and high proportion of A (89%). inhibitors, and botulinum toxin. botulinum and inhibitors, modalities Other treatment suggested, such of care are and low-level as acupuncture Surgical intervention laser. in progressively is indicated sensation, increas decreasing due to neuroma, ing pain, pain after non-improving anesthesia and for- 3 months, transection, eign body presence. : This review summarized sion: - man NP possible post-implant treatment agement strategies, the options and discussed effectiveness. interventions’ Poster #15 - e: Presentation of temporo Titl mandibular disorders in pa tients with ear symptomatology Authors: Mary Ellen Chalm ers, Ramy Shams, Reyes Al-Eryani Enciso, & Kamal Faculty advisors: Reyes Al-Eryani Enciso & Kamal associa- The Background: tion between ear symptoms and temporomandibular joint disorders (TMD) is not widely recognized, in spite of recent systematic reviews indicating a bidirectional relationship. purpose of this studyThe pose: is to investigate the connections between various ear symp toms and TMD. retrospective study examined 27 patients presenting with primary and secondary complaints of ear symptoms such as tinnitus (which is a continuous or inter mittent ringing or buzzing in one or both ears), ear fullness, and ------Purpose: ry practice, the incidence of post-dental implant neuropath ic pain (NP) has increased Educating general significantly. dentists in the management of post-implant neuropathies is essential to improve outcomes as early treatment is vital to prevent the condition from becoming chronic. This study aims to summarize the literature and provide clin ical guidelines for the general related dentist to manage NP to dental implant placement; furthermore, this study will cov er the mechanism and clinical features of post-implant NP. search of PubMed A Methods: was performed in January 2020 to conduct a literature re Only the articles related view. to the management of post-im were included in this plant NP Results: 36 records study. were found with our electronic search, of which 22 referenc es that focused on post-im- management were plant NP identified. In these references, interventions associated with significant decreases in NP intensity and improved altered sensation were classified into acute phase and chronic man The management of agement. involves immediate acute NP removal or shortening of the implant and glucocorticoid administration, while chronic management includes NP pharmacological treatment such as anticonvulsants, sero tonin-noradrenaline reuptake an opportunity to suspect CD to suspect an opportunity with general medical and liaise to organize a practitioners for CD. Knowledge screening manifestations of of the oral can change celiac disease quality of life. someone’s Poster #14 : Post dental implant Title neuropathic pain management: a literature review Awwad, Authors: Mohamed & Reyes Al-Eryani, Kamal Enciso Faculty advisors: Kamal Al-Eryani & Reyes Enciso As dental Background: implants become a standard procedure in general dentist - - - - : Celiac : Oral manifestations of le: Oral manifestations disease affects around 1% of disease affects 90% of cas- children; however, es are considered to remain undiagnosed. In patients with undiagnosed CD, aphthous ulcers and migraine headache may be the only presenting feature. Dentists have regular contact with children, having ing, and waning in size and Migraine headache number. with aura began at age eleven. By age thirteen, the frequen cy and intensity of both the aphthous ulcers and migraine headaches required medical intervention. Positive serology for CD prompted a referral to a pediatric gastroenterologist to confirm the diagnosis of celiac. gluten-free diet completely A symp- resolved the patient’s toms. Conclusion for lidocaine in the treatment the treatment in for lidocaine studies are TN. Further of carbamazepine, needed for opioids and sodi sumatriptan, blockers as only um channel reported outcomes. one study Poster #13 Tit report and celiac disease: case literature review - Authors: Georgia Peter Al-Eryani, & son-Houle, Kamal Mariela Padilla Faculty advisor: Kamal Al-Eryani Background: Celiac Disease (CD) is an immune-mediated enteropathy occurring when genetically predisposed people Atypical are exposed to gluten. presentations of CD remain a challenge for the practitioner. The prevalence of recurrent aphthous ulcer and migraine headache in children before diagnosis with CD is unknown. report a case with To Purpose: aphthous ulcer and migraine with aura in a patient with CD. a case report This is Methods: of a 13 years old female with a recurrent aphthous ulcer and migraine headache with aura. These were her only symp A diagnosis. toms prior to CD’s review of literature in pediatric CD was completed from 2000 to 2021. Results: Starting at the age of three, the patient reported canker sores, wax - Herman Ostrow School of Dentistry USC School of of Ostrow Herman : ------Methods: Conclusion : 324 undupli 324 Results: gated included oral carbamaz Poster #12 : Medications for treatment Title compared of trigeminal neuralgia to placebo intervention - Authors: Georgia Peter Abdel son-Houle, Magda Reda & Mariela Fattah, Reyes Enciso, Padilla Faculty advisors: Reyes Enciso & Mariela Padilla neural Trigeminal Background: gia (TN) is recognized by brief, unilateral, sharp, stabbing and shooting pains in one or more branches of the fifth cranial TN is for Treatment nerve. typically successful with medica tion, with surgical interventions used only as a second-line Purpose: treatment modality. The aim of this systematic rview and meta-analysis was to of medica- determine the effect TN tions in adult patients with compared to placebo. Authors identified randomized placebo-controlled trials (RPCT) of Science, from PubMed, Web Cochrane and EMBASE up to February 2021. Studies were assessed for inclusion and exclusion criteria, as well as risk of bias based on the Cochrane handbook. cated references were scanned independently and reduced to 8 with 89 patients relevant RPCTs included. Medications investi epine, subcutaneous sumatrip tan, lidocaine (intranasal or 8% spray on oral mucosa or intravenous lidocaine), gangli onic local opioid analgesia, and oral Nav1.7 selective sodium Meta-analyses channel blocker. showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain of -3.8 points on a 0-10 scale (p<0.001). Patients who had lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (p<0.001). - TMJ-relat of regeneration in the further However, ed structures. are required to in vivo RCTs efficacy and safety evaluate the in humans. of these therapies Due to the unclear/high risk of bias and small sample size, the quality of the evidence was low 42

patients (74%) had associat- therapy including stabilization by ultrasound imaging of the non-diabetic patients. T2DM pa- ed symptoms of headache, splint treatment, was used. The same sextants. Results: The tients with poor glycemic control migraine, stress, and insomnia, patient is monitored for any ultrasound imaging identified show slower osseointegration and 74% also had bruxism and further mandibular condyle/ marginal gingiva, cementoe- and higher peri-implant tissue clenching. Other symptoms temporomandibular joint (TMJ) namel junction (CEJ), alveolar complications but no significant such as disc displacement degeneration or other signs of bone crest (ABC), measured difference in implant survival (52%), neck pain (56%), and temporomandibular disorders CAL, gingival recession, and compared to well-controlled anxiety/depression (40%) (TMD). Conclusion: Potential gingival thickness in both the pig patient. No specific clinical were also noteworthy. Twelve mandibular condyle degener- jaws and the human subjects. trials were identified for implant patients received treatment ation should be considered in The results of periodontal exam- treatment in older adults with over multiple visits, with six patients with SLE even in the ination by imaging and clinical T2DM. Conclusion: Although experiencing an improvement of absence of pain and movement examination were comparable. dental implant treatment can ear symptoms. Conclusions: limitations typical of TMD. Man- The ultrasound imaging has be performed successfully in This retrospective study shows agement of TMJ degeneration the advantage of providing a older adults with/without T2DM, a 100% prevalence of TMD in in patients with autoimmune precise measurement of the dentists must be attentive to patients presenting with a chief conditions depends upon the gingival thickness and the older patients’ compromised complaint of ear symptoms such level of disability, deterioration, direct visualization of the CEJ healing capacity, adverse as tinnitus, ear fullness, and and function. It is prudent to first and ABC and other anatomic effects of medications as well otalgia. pursue a conservative approach features underneath the gingi- as cognitive and social changes along with TMJ imaging for diag- va. Conclusion: Ultrasound to improve short- and long-term nosis and future evaluation. imaging is comparable to clinical implant treatment outcomes. examination and is promising as Prospective controlled clinical Poster #16 a fast, accurate, and non-inva- studies are needed in the areas Title: Severe bilateral man- Poster #17 sive approach for periodontal of specific glycemic control lev- dibular condyle resorption examination. els for older patients in order to accompanying Systemic Lupus Title: The application of a learn how to minimize treatment Erythematosus: case-report high-resolution ultrasound complications. imaging device in periodontal Poster #18 Authors: Neysan Chah & Sal examination Manrriquez Title: Impact of aging and CBY/ Authors: Jane Law, Moham- Type-2 Diabetes Mellitus on Faculty advisor: Sal Manr- med Hayati, Erin Lee, Colman implant treatment PIBBS riquez Moore, Joan Beleno Sanchez, Joe Chang, Jesse Jokerst, & Authors: Raymond Choi, GRADUATE Background: Systemic Lupus Casey Chen Phuu Han, & Reyes Enciso Erythematosus (SLE) is an au- STUDENTS toimmune, multisystem disease Faculty advisor: Casey Chen Faculty advisors: Phuu Han with various orofacial mani- & Reyes Enciso festations reported. Purpose: Background: Diagnosing To present a case of severe periodontal and peri-implant Background: Increasingly old- Poster #19 bilateral mandibular condyle diseases relies on precise er adults in the US are seeking clinical assessment. Clinical dental implant treatment. These Title: An antidote to COVID-19 resorption in a patient with SLE is xenophilia, NOT xenophobia presenting with anterior open assessment of periodontium individuals are also more at risk includes data collection of peri- for Type 2 diabetes (T2DM). bite and generalized mild-mod- Authors: Smruti J. Patel, odontal probing depths (PPD), Questions have been raised as erate tooth wear. Function was Chaeho Kim, & Simone Khouri maintained despite severe clinical attachment loss (CAL), to whether implants placed in condylar resorption. Methods: gingival phenotype, gingival older adults and/or in patients Faculty advisors: Joyce Sumi Review of the history, clinical recession, and inflammation. with T2DM are likely to be suc- & Mariela Padilla and radiographical examination However, clinic examination cessful. Purpose: To review the was carried out to determine the is often time-consuming and current understanding of dental Background: The COVID-19 cause of the anterior open bite painful for the patient, with implant treatment in older adults pandemic has affected social and anterior tooth wear, given large intra- and inter-operator with/without T2DM. Methods: relationships and may have also the lack of anterior occlusion. variations. Ultrasound imaging A PubMed electronic search of engendered a social stigma, Results: Bruxism and an acidic technique may provide a non-in- the English language literature xenophobia. This negative diet were culpable for tooth vasive approach in periodontal from 1/17/2010 to 2/19/21 was relationship between a person wear given the absence of other examination. Objective: The conducted on implant treatment or a group of people with certain risk factors. It was determined objective of this study is to in older adults >65 years with/ characteristics or a specific dis- that the anterior open bite compare periodontal examina- without T2DM followed by hand ease can affect health and hin- progressively developed due to tion by ultrasound imaging and search of relevant references. der access to care through dis- a degenerative process leading conventional clinical assess- Results: In this review, age-re- crimination. Purpose: To identify to severe bilateral mandibular ment. Methods: A pilot study lated physiologic and T2DM-re- groups affected by xenophobia condyle resorption, possibly was performed on ex-vivo pig lated pathological changes during the COVID-19 pandem- associated with SLE directly, or jaws by direct examination and important in implant treatment ic and recommendations to indirectly due to long-term med- ultrasound imaging of the peri- were assessed. When systemic address it. Methods: A topical ication use, e.g., corticosteroids, odontal supporting structures. diseases are in control, implant literature search was done in and bisphosphonates. Given Subsequently, maxillary anterior survival in older patients is Pubmed, with the keyword “Xe- that the patient was asymptom- and mandibular anterior sex- comparable to younger patients. nophobia” for articles dated from atic and jaw function was within tants were examined clinically Implant survival in patients with March 2020 to March 2021. The normal limits, conservative in 30 human subjects, followed T2DM is comparable to that of authors selected studies related

The Explorer Journal 2021 Abstracts 43 ------Con- Prmt4 de- : This, combined with : mutation in cleido clusion of analysis of the expression the connective tissue marker Scx, furthers our hypothesis that this fusion is caused by a disruption of the balance of cells which are fated to be come osteoblasts versus part of the ligament-like connective tissue of the suture. Further research will continue to inves interesting given that several that several given interesting are derived of these sutures mesoderm from the paraxial the neural crest. rather than with Wnt1-Cre Lineage tracing that there shows, however, of the neural is a contribution sutures from the crest to these - the out underlying dura mater, ermost layer of the meninges. This suggests that signaling within this tissue is moderating model. fusion in our BBDS lineage TdTomato Using the investigat we have marker, these ed the contribution of and cells to the mutant suture shown that they contribute to heterotrophic bone. tigate this and the role of Fgfr2 in these fate decisions. Poster #23 : PRMT4-Runx2 signal Title ing regulates posterior frontal suture closure Authors: Nicha Ungvijanpu nya, Yongchao Gou, Abhijit Gou, Yongchao nya, Mark Yen, Shinde, Stephen Amy Merrill-Brugger, Bedford, Chai, Baruch Frenkel, & Yang Jian Xu Faculty advisors: Jian Xu & Yen Stephen Background: Cranial sutures accommodate brain and skull growth during development. RUNX2 in osteo- est expressing PRMT its role genic cells. However, in osteogenesis is unknown. investigate the To Purpose: role of PRMT4 in skull forma tion Methods: Neural crest cell (NCC)-specific cranial dysplasia patients has been associatedwith open metopic suture. Runx2 is a master regulator of bone formation and its activity is regulated by multiple types of post-trans lational modifications. Protein arginine methyltransferase 4 (PRMT4/CARM1) is the high ------Re- mutation in

M391R : 3D culture of le: Mechanisms of craniosyn (height/width) was measured measured was (height/width) Analyzer. BZX Image using the epithelial cells) TCMK-1 (kidney as control cells. were used of rAmbn sults: In the presence ALC clustered and rAmel, and preferen (surface view), along the Z axis tially elongated ALC aspect (3D reconstruction). the pres ratio was highest in n=30). ence of rAmbn (p<0.001; rAmbn or Heat denaturation of 5 encoded removal of its exon abolished fragment (rAmbn ∆5) The morphological this effect. 3D were changes observed in ALC. Immunolabel specific to a ing intensity of E-cadherin, marker junctional epithelium of increased in the presence the control. rAmbn compared to Conclusion ALC in the presence of rAmbn leads to cytoskeletal changes as evidenced by the increased aspect ratio and expression of This could suggest E-cadherin. potential signaling roles of am eloblastin in the development of polarized ameloblasts. Poster #22 Tit ostosis in Bent Bone Dysplasia Syndrome, an FGFR2 disorder Amy Audrey Nickle & Authors: Merrill Amy Merrill Faculty advisor: Background: Craniosynosto sis, or premature suture fusion, is one of the most common craniofacial defects and can be linked to a number of syndromic genetic disorders. One more recently characterized disorder, Bent Bone Dysplasia Syndrome (BBDS), is caused by mutations to Fibroblast Growth Receptor 2 The pattern (FGFR2). Purpose: of suture fusion in BBDS is distinct from other well-charac terized FGFR2 gain-of-function mutations and our recently de veloped Cre driven mouse mod el for it provides an excellent platform to study this unique as pect of Fgfr2 signaling on suture development and maintenance. Methods/Results: Using the Wnt1-Cre driver mouse, we in duced the Fgfr2 the neural crest cell population of the anterior skull, producing a multi-suture craniosynostosis This was especially phenotype. - in - - - - - Fgfr2 ratio Methods: Immor- Results: My prelimi- : The overall goalThe overall Methods: le: Investigating ameloblas confocal SP8. Aspect confocal SP8. of this proposal, therefore, is toof this proposal, genetics to identifyuse mouse of Fgfr2 in thethe dual roles and eventualestablishment of skeletallineage commitment progenitor cells contributing andAF to the formation of the PFS. thatnary studies demonstrate of conditional knockout neural crest cell (NCC)-derived the Wnt1- mesenchyme using AF closure Cre driver delays of theand blocks formation Conclu- PFS suture cartilage. studysion: Completion of this thatwill reveal a mechanism controls development of the anterior fontanelle and poste rior frontal suture, as well as advance our understanding of cell fate choice during calvarial patterning. Poster #21 Tit tin-ameloblast interactions using a novel 3D cell culture model Authors: Gayathri Visakan, Jingtan Su, & Janet Moradi an-Oldak Faculty advisor: Janet Mora- dian-Oldak Ameloblastin Background: is the second most abundant enamel matrix protein. Its silencing results in a loss of and ameloblast cell polarity, attachment to the developing devel To matrix. Purpose: op an in vitro 3D cell culture model to examine the role of recombinant ameloblas tors. tin (rAmbn) in modulating ameloblast morphology and polarization. Ameloblast Lineage talized Cells (ALC) were cultured in 3D using either Growth Factor I Type Reduced Geltrex or Collagen substrates for 24-72 The 96 well plates were hours. pre-coated with heat denatured (control), rAmbn and BSA rAmbn, rAmbn ∆5 and recombinant amelogenin rAmel (test samples). Cells were labeled and visualized in 3D using Keyence BZX810, and Leica tiation of SOM-derived Scx+/ of SOM-derived tiation EMM-derivedRunx2+ and skeletal progeni Scx+/Sox9+ Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------Con- muta- : Xenophobia has been le: Fgfr2 regulates estab- to COVID-19 to define xeno to to COVID-19 phobia and recommendationsphobia and The Results: to the problem. yield 75 articles, 46initial search relationship with thewith a direct pandemic, and 31COVID-19 information aboutwith focused and specif populations affected pomelic dysplasia, and frontal suture craniosynostosis can distort calvarial growth and alter intracranial pressure. Fibroblast Growth Factor Receptor-2 (FGFR2) is a key regulator of This is calvarial development. underscored by human diseas es caused by FGFR2 tions, which often feature both fontanelle and suture defects. This proposal will Purpose: test the hypothesis that Fgfr2 regulates development of the AF and PFS by dually regulat ing specification and differen Poster #20 Tit lishment and commitment of fontanelle progenitor cells Authors: Lauren Bobzin & Amy Merrill Amy Merrill Faculty advisor: anterior fon- The Background: tanelle (AF) is the fibrous soft spot in the front of an infant’s head, which forms at the intersection of the frontal (metopic), coronal, and sagittal sutures. During postnatal development of the calvaria, closure of the AF correlates with formation of the posterior frontal suture persistence (PFS). However, AF or premature fusion of the in congenital disorders, such cam dysplasia, cleidocranial as ic recommendations. Ethnicityic recommendations. reason foris the most common xenophobia (58%), followed the disease (16%)by suffering (13%).and the migratory status addressRecommendations to xenophobia are to support education and communication pro (41%), develop specific andgrams and policies (32%), understandcollect more data to the phenomena (19%). clusion shown to have negative health consequences. It is imperative to create educational programs and policies to address this relevant issue. Further research is suggested. 44

letion mice were examined by tions to control its activity and Ali Savas, Tingyu Wang, Jun metabolic pathways such skeletal preparation, microCT expression. Our lab revealed Zhao, Natalia Tjokro, Chao as lipid metabolism, and cell scanning, immunofluorescence novel methylation of Runx2 by Qin, Shu Zhang, & Pinghui cycle at G2/M phase, thereby staining, RNAScope, Proximity protein arginine methyltrans- Feng decreasing the mitotic events Ligation Assay, DiI-labeled ferases (PRMTs). Preliminary in infected cells. Conclusion: calvaria culture and RNA-se- data shows that PRMT3 and Faculty advisor: Pinghui Feng Future experiments will directly quencing analysis. Protein 4 are highly expressed in the investigate the molecular methylation assays were per- osteoblast lineages and cata- Background: Periodontitis is events that underpin patho- formed in 293T cells. Migration lyze Runx2 methylation at four a multifactorial and inflamma- genesis of bacteria-herpesvi- assay and ChIP-qPCR were specific arginine (R) residues, tory disease that rises from a rus co-infection in oral inflam- conducted using MC3T3-E1 which lie within the transac- complex interaction between a matory diseases. cells. Results: We identified tivation/repression (TD) do- broad spectrum of pathogens that PRMT4 methylated Runx2 main. Purpose: My project is and host immune‐inflammatory at four arginine residues and response. It is characterized centered around understand- Poster #26 revealed their co-expression ing the role of Runx2 arginine by bone destruction, irrevers- and Runx2 methylation in ible damage of the periodontal methylation in osteogenesis. Title: KSHV reprograms osteoprogenitors at the osteo- ligaments, and eventually Methods: Cell culture osteo- central carbon metabolism via genic fronts (OF) of posterior tooth loss. Herpes simplex genic differentiation models protein deamidation during frontal (PF) suture. NCC-spe- virus 1 (HSV-1) is a large DNA were used to assess Runx2 lytic replication cific Prmt4 deletion caused methylation during differentia- virus that replicates in the patent PF suture. We further tion. I developed dox-inducible oral epithelium and causes Authors: Mao Tian, Junhua observed delayed osteopro- C2C12 stable cell lines ex- cold sore. Approximately 70% Li, Tingyu Wang, Chao Qin, genitor migration at the OF pressing Runx2 WT and meth- are infected with HSV-1 in Dominique Pope, Christopher without changing cell prolifer- ylation-deficient mutants to the general population and it Wong, Karsten Stouffer, Deng ation or apoptosis. In addition, characterize the role of Runx2 reaches to 100% in individuals Pan, Alireza Delfarah, Nicholas PRMT4 depletion and methyl- arginine methylation in osteo- of 65-year and older. Recent A. Graham ation-deficient Runx2 impaired genesis. I performed qRT- clinical studies implicate her- migration of mouse calvarial PCR, Alp staining and RNA- pesviruses in oral inflammatory Faculty advisor: Pinghui Feng preosteoblasts. We observed seq analysis using stable cell diseases such as periodontitis, a significant downregulation lines. I also conducted co-IP yet molecular mechanism by Background: Though report- of ECM-related genes with assays to assess interactions which herpesviruses contrib- ed more than half-century enrichment in cell migration between methyl-Runx2 and ute to oral inflammation is ago, protein deamidation is genes, and reduced Runx2 multiple known transcriptional not understood. Purpose: A. poorly characterized for its enrichment in migration gene co-factors. Results: Runx2 ar- actinomycetemcomitans is roles in fundamental biological promoters by Prmt4 deletion. ginine methylation was found a gram-negative facultative processes. Cellular glutamine We also noted downregulation to increase during osteogen- anaerobic bacterium that is aminotransferase (GATs), of Sp7 and a subset of bone esis model. qRT-PCR and Alp known to be associated with known metabolic enzymes, are matrix genes, but the number staining revealed that Runx2 localized aggressive periodon- capable of deamidating proof Runx2+ or Sp7+ cells at the WT promoted osteogenic titis and plays an imperative teins. Utilizing KSHV infection OF did not decline. Conclu- differentiation as compared to role in plaque formation and as a model system, we probed sion: PRMT4-methylated the mutants. Runx2-depen- pathogenic bacterial aggre- the roles of deamidation in Runx2 at the OF is essential dent-methylation-dependent gation. Bearing this in mind, biological processes, specif- for the migration of osteo- genes determined through we hypothesized HSV1-A.a ically metabolic reprogram- progenitors during PF suture RNA-seq were associated with bacterium synergism would ming. Purpose: We employed closure. skeletal development as the contribute to the progression proteomics and metabolom- top GO pathway. Co-IP results of gingivitis further to periodon- ics to determine the role of showed that C/EBPβ binds titis development. Methods: protein deamidation and GATs Poster #24 more strongly to methylated To tackle this hypothesis, we in metabolic reprogramming Runx2. Conclusion: Runx2 performed an in vitro coinfec- during KSHV lytic replication. Title: Role of Runx2 arginine arginine methylation is import- tion experiment using normal Methods: To probe the role of methylation in functional inter- ant for driving osteogenesis oral keratinocytes (NOK) cells. deamidation in metabolism, we action with its transcriptional by modulating its interaction The co-infection of HSV-1 profiled the deamidation-pro- co-factors with C/EBPβ. Findings from and A.a. resulted in loss of teomics and metabolomics of this study will uncover new cell-cell junction and more KSHV-infected oral keratino- Authors: Prerna Sehgal, regulatory mechanism for cell death compared to HSV-1 cytes that support lytic repli- Yongchao Gou, Abhijit Shinde, Runx2 and potentially identify or A.a bacterium infection cation. Multi-omics analyses Baruch Frenkel, & Jian Xu new therapeutic approaches individually. To understand identified pathways and targets for skeletal disease. the underlying mechanism of that were significantly altered Faculty advisor: Jian Xu these phenotypes, we pro- by KSHV infection. Biochemi- filed protein phosphorylation cal analyses, including protein Background: Runx2 is the via phosphopeptide enrich- interaction, deamidation, master transcription factor for Poster #25 ment with high-resolution and enzyme activity, were bone formation. Loss of Runx2 mass spectrometry followed applied to delineate protein Title: Interplay between causes embryonic lethality by bioinformatics analyses. interactions. Results: A robust Herpes Simplex Virus 1 and by impaired mineralization Results: Interestingly through activation in central carbon Aggregatibacter actinomyce- of the skeleton. Because combining our results with metabolism and paralleled temcomitans in oral inflamma- of its importance, Runx2 is whole cell lysate proteomics, deamidation of key central car- tion tightly regulated by various we found that HSV1 infection, bon metabolism enzymes was post-translational modifica- Authors: Mehrnaz Zarinfar, significantly altered several observed upon KSHV infection.

The Explorer Journal 2021 Abstracts

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Conclu- Results: core and : The Methods: CCMB FELLOWS DENTISTRY/ POST-DOCTORAL sion. Lrp6 phosphorylation oc sion. Lrp6 membrane domains curs in raft internalization with subsequent vesi into signaling-competent potentiation of PA-mediated canonical Wnt signaling was abolished by the inhibition of The four caveolae formation. lipophilic with different PAs on tails have distinctive effects caveolae formation. mycetemcomitans translocation of beta-catenin to beta-catenin of translocation gene expres activate target that are essen cles (caveolae) activation. tial for Wnt pathway The requirement of Purpose: caveolae was characterized potentiation of in PA-mediated PA canonical Wnt signaling. to opti lipophilicity was tuned specific ic inhibitor or siRNA with for caveolin-1. Four PAs lipophilic tails were different synthesized and their poten tial to enhance Wnt signaling was characterized. sions: Caveolae formation is required for the potentiation of canonical Wnt signaling by PA nanofibers. Lipophilicity and conformation determine the signaling of PA-mediated effect potentiation. Poster #30 : Aggregatibacter actino Title accessory genes: what do they do? Tjokro, Authors: Natalia O. Kittichotirat, Roger Weerayuth & Casey Chen E. Bumgarner, mize their membrane-partition maximal ing phenomenon for signaling enhancement of Wnt on bone marrow mesenchymal The stem cell differentiation. activat ability to modulate Wnt signifi ed osteogenesis has cant potential for therapeutic application. caveolin-mediated endocyto sis was inhibited to block the formation of caveolae with two approaches, metabol different ------Conclu- : 51 faculty, Results: 51 faculty, writing skills. Method: Applicants skills. Method: writing a specific time were given the platform.frame to access they receivedOnce on-line, questionsspecific scenarios, perceptual ability, to evaluate essay to evaluateand a written wereApplicants writing skills. videotaped verbally answering scenariosquestions about the of Videos and perceptual skills. the essay, their responses, and were reviewed by calibrated evaluators. from the 6 dental divisions, as were calibrated and 5 staff applicantMMI evaluators. Each 2was given 7 case scenarios, andperceptual ability questions, evalua Two 1 essay question. eachtors independently rated scenario response using a 1-5 minimize subjectivity, To scale. one evaluator scored all percep tual ability questions and one evaluator scored all essays. By early March 2021, 777 appli cants were evaluated. virtual MMI was easilyThe sion: incorporated into the virtual and was well-received interview, by evaluators. Further compar ison of virtual interviews with traditional in-person interviews will be undertaken. Poster #29 : Lipophilicity of peptide Title amphiphile nanofibers opti mizes caveolae-mediated Wnt signaling Zhou, Erin Hsu, Yan Authors: Samuel I. Stupp, & Malcolm L. Snead Background: Peptide amphi nanofiber designed phile (PA) to include bioactive domains that are instructional to cells undergo self-assembly in aqueous fluids into nanoscale filaments to mimic natural extracellular matrices. These molecules create supra PA molecular nanofibers with a core-shell morphology built by collapsed hydrophobic segments and beta-sheets. Membrane-partitioning PA potentiates canonical Wnt signaling, which is initiated by the interaction of Wnt ligands with the Frizzled receptor and Phosphor- Lrp5/6 co-receptor. ylation of Lrp5/6 leads to cyto solic accumulation and nuclear ------Purpose: Results: : The pattern of findingsThe : An asynchronous virtual MMI initiated in October 2020 to eval uate applicants’ empathy, integ empathy, uate applicants’ rity and ethical decision-making, plus their perceptual ability and applicant interviews. 2019 inclusive of PBL facilitator PBL inclusive of 2019 scores (N= 53,301,evaluation and female=82, andmale=104 evaluationtheir corresponding =28,084 andnumbers, male Jump Triple and female=25,217) (N=15,368, male(T3) evaluation and their= 68 and female=70, num corresponding evaluation bers, male =7,157 and femalebers, male =7,157 and were used. =8,211) two-sample t-test assuming A unequal variances statistical test ifanalysis was used to student’sgender plays a role in evaluations. Men facilitators significantreceived statistically scores for case higher (p<0.011) In con facilitation than women. T3 facilitator’strast, the scores differentwere not significantly (p<0.49) comparing men to women facilitators. However, when evaluating the p-value male gender, students’ on based facili student evaluation of PBL tators (p<0.013) shows a signifi tion between the facilitator’s gender and performance scores To generated by male students. further enhance these findings, we are currently exploring the role of additional factors such as faculty ethnicity in the evaluation process. Poster #28 : Learner-centered dental Title admissions: 3. Implementation of an asynchronous multiple mini-interview Robin Tourah, Anita Authors: Fox, & Mahvash Navazesh The DentalBackground: Admissions Office uses the Multi Mini-Interview (MMI) to evaluate DDS applicants on ethical integrity, their empathy, decision-making, communica tion, and leadership skills. Due to COVID-19 pandemic, in-per son interviews could not be held. Instead, a “virtual MMI”, Platform©, Talent using the Kira was developed for 2020-2021 cant difference rating in contrastcant difference evaluation of to female students’ facilitators (p<0.082). Con- PBL clusion indicates a possible associa Herman Ostrow School of Dentistry USC School of of Ostrow Herman - : - - - - - Purpose: To Conclusion : Two sets Two Methods: FACULTY DENTISTRY DENTISTRY sis, to deamidate and activatesis, to deamidate and As such, CAD-medi G6PD. The central carbon metabolic carbon The central were funneled intopathways synthesisde novo nucleotide controlledthat is primarily by the glucose-6-phosphate (G6PD) of thedehydrogenase pathwaypentose phosphate cellular(PPP). KSHV exploits synthe carbomyl-phosphate tase, aspartate transcarbo mylase and dihydroorotase enzyme(CAD), the rate-limiting synthe of de novo pyrimidine isated G6PD deamidation KSHVrequired for efficient lytic replication. Poster #27 : Comparative analysis of Title student evaluation of facilitator performance Authors: Mahvash Navazesh, Larry Eisenberg, & Nasrin Bahari Chopiuk Background: Literature suggests that in traditional lecture-based teaching many factors such as race, gender, sexual orientation, ethnicity, stereotypes, and representa of data ranging from 2009- Here, we characterized aHere, we characterized new mechanism of metabolic viareprogramming achieved deamidation of key metabolic CAD enzymes. Specifically, deamidates G6PD to fuel the de novo nucleotide synthesis, thus uncovering new function beyond an of CAD as a driver, of metabolic repro executor, gramming. rating tions influence students’ of their instructor’s performance. These ratings are commonly perceived as indicators of the of an instructor’seffectiveness teaching, and a key component in the promotion process. Less is known about the impact of the above-mentioned factors in the Problem Based Learning (PBL) pedagogy. investigate retrospectively if gender played a role in student calibrated evaluation of PBL facilitators. 46

Faculty advisor: Casey Chen dian-Oldak multitargeting domain encoded to adhere cell membranes to within exon 5 the enamel matrix. Background: Gram negative Background: Amelogenin periodontal pathogen Aggregat- (Amel) and Ameloblastin (Ambn) Authors: Natalie C. Kegulian, ibacter actinomycetemcomitans are two primary extracellular Ralf Langen, & Janet Moradi- (Aa) exhibits a high degree of matrix proteins and play critical an-Oldak Poster #33 genetic variation among strains. roles in enamel formation from Title: Amphipathic helix on Each Aa genome consists of secretory to maturation stage. Faculty advisor: Janet Mora- dian-Oldak ameloblastin is associated with core genes found in all strains, We have shown that Amel and prismatic enamel microstruc- and accessory genes (14-23% Ambn bind together in vitro and ture of the genome) found in some co-localize in vivo. Purpose: Background: Amelogen- in (Amel) and ameloblastin but not all strains. Accessory To systematically investigate the Authors: Jingtan Su, Rucha genes are further grouped into co-assembly of Amel and Ambn (Ambn) secretion by ameloblasts into the extracellular Arun Bapat, & Janet Moradi- genomic islands and non-is- and examine their cooperative an-Oldak land accessory genes. The effect on nucleation of calcium enamel space is necessary for functions of accessory genes phosphate (CaP) in solution. correct formation of enam- Faculty advisor: Janet Mora- remain to be elucidated. We Methods: Recombinant Ambn el. We reported that Ambn dian-Oldak hypothesized that accessory and Amel expressed in E. coli interacts with both Amel and genes confer critical functions were used. We applied Atomic membranes via a region Purpose: To investigate the in vivo that allow Aa to survive Force Microscopy, Dynamic encoded by Ambn exon 5. link between the evolution of during unfavorable conditions. Light Scattering, and Trans- Objectives: To investigate enamel prismatic microstruc- Objective: To investigate the mission Electron Microscopy to the interactions of the exon ture and the presence of an expression patterns of Aa investigate their co-assembly. 5-encoded region of ameloblas- amphipathic helix (AH) domain accessory and core genes Nucleation of CaP was studied tin (Ambn) with membranes, within ameloblastin (Ambn). in distinct growth conditions. by monitoring the pH changes with amelogenin (Amel), and Methods: We utilized bioin- Methods: Aa strain D7S-1 was in bulk mineralization solu- with itself, and to probe its formatics methods to analyze grown in 4 different conditions: tion following addition of the localized structure. Methods: the presence of an AH within as planktonic cells or biofilms proteins. Results: The height of We used AB2 peptide, com- the sequence encoded by in an enriched medium, and Amel particles measured in-air prising the 37-amino-acid exon 5 of Ambn from species as biofilms in two nutrient-poor and in-fluid onto mica was 4.31 sequence encoded by Ambn with prismatic, non-prismatic media RPMI and Keratinocyte ± 1.04 nm and 5.46 ± 0.97 nm, exon 5, recombinant Amel, and poor prismatic enamel medium. The levels of tran- respectively. For Ambn particles, and liposomes. AB2-AB2, structure. Synthetic peptides scripts were determined by those values were 1.79 ± 0.28 AB2-liposome membrane, and presenting potential AH and RNA sequencing. Results: nm and 2.62 ± 0.29 nm. The AB2-Amel interactions were its corresponding sequences The expression patterns of the height of co-assemblies of Amel measured using various spec- from different species were island and non-island accesso- and Ambn was decreased from troscopic techniques, culminat- used and their interactions with ry genes were similar, with me- 5.08 ± 0.79 nm to 3.93 ± 0.94 ing in electron paramagnetic liposomes and cell membranes dian expression values ~2 fold nm in fluid following increasing resonance (EPR) with site-di- were investigated. ALC and lower than core genes. Both ratio of Ambn to Amel, which rected spin labeling (SDSL) LS8 ameloblast-like cells island and non-island acces- demonstrated that Ambn and to identify residue-by-residue were used to examine gene sory genes were activated to a Amel co-assemble near physical structural changes in AB2. expression, cell morphology greater extent than core genes conditions. Time-dependent pH Results: Wavelength shifts in and polarization following in nutrient-poor media. Notably, changes following amorphous tryptophan fluorescence peaks interactions with Ambn and several virulence genes of Aa calcium phosphate (ACP) and in AB2 showed interactions with peptides. Results: Fluorescent were activated in nutrient-lim- hydroxyapatite (HAP) formation liposomes and Amel separately spectroscopy showed that the ited conditions. Conclusion: showed that Amel stabilized and when both were added to peptides from mammals with/ Aa accessory and core gene ACP for 20 minutes when Ambn AB2 simultaneously. AB2-AB2 without prismatic structure pools exhibit distinct expression stabilized ACP for 14 minutes. interactions were also observed had blue shift in the presence profiles. Activation of genomic Low concentrations of Ambn did but not when liposomes were of liposome indicating strong islands, non-island accessory not affect mineral nucleation. present. Adding increasing con- interaction. Circular dichroism genes and selected core genes Increasing Ambn to Amel ratio centrations of AB2 to liposomes revealed that the peptides may help Aa cope with the in the mineralization solution led to a linear rather than expo- from prismatic species showed stress of nutrients limitation and (1:100 to 1:5) promoted the nential decrease in AB2-mem- increased helical content with to acquire nutrients via eliciting kinetics of ACP to HAP transfor- brane interaction, indicating liposomes. In contrast, the host inflammatory response, mation. Conclusion: Ambn and independence from AB2-AB2 peptides from non-prismatic probably a novel strategy of Aa Amel co-assemble and syner- interaction. EPR on spin-la- species didn’t show such to survive in its host. gically regulate transformation beled AB2 showed a marked structural change following of ACP to HAP crystalline. structural gain at residues 5, addition of liposomes. Mem- We suggest that HAP crystal 10, 12, 19, and 24 of the pep- brane leakage showed that the tide upon addition of liposomes peptides from prismatic spe- Poster #31 nucleation and phase transformation kinetics are not merely but not at residue 35. Addition cies leaked the liposome. Cell of unlabeled AB2 or Amel to Title: Ameloblastin and amelo- controlled by amelogenin but by spreading assay revealed that cooperative effects with other labeled AB2 only led to slight the peptides from prismatic genin co-assembly and their immobilization. Conclusions: role in mineralization enamel proteins. species inhibited ALC and LS8 These experiments reveal cells spreading on Ambn-coat- Authors: Changyu Shao, localized structural changes in ed plate. Addition of Ambn to Ambn upon interaction with dif- LS8 cells resulted in upreg- Rucha Arun Bapat, Jingtan Su, Poster #32 & Janet Moradian-Oldak ferent targets, which may have ulation of genes associated implications for its cooperative Title: Ameloblastin contains a with cell polarization, distal Faculty advisor: Janet Mora- function with Amel and its ability

The Explorer Journal 2021 Abstracts - 47 - - - - - (Ift88, (Cds1, : Our re- knockout are associated - Osr2-Cre;β-cat Rab39b ). Conclusion RAB39b mice, in contrast to mice, in contrast fl/f ) had decreasedMyog, Myod1 ed with muscle developmented with muscle ( in expression enin ders. However, the mechanism ders. However, underlying this dysregulation, particularly in human cells, remains poorly understood. Mutations in the small GTPase gene Pde8b ofsults highlight the importance soft palateWnt signaling during thedevelopment and suggest significance of the interaction between the CNC-derived mesenchyme and myogenic resultsprogenitor cells. Our of mes also highlight the roles lipogen lated ciliogenesis and esis, which when disrupted softultimately lead to defective palatal muscle development. These results may contribute to improved treatment of cleft soft palate. Poster #37 : Cerebral organoid Title and mouse models reveal a path- RAB39b–PI3K–mTOR way-dependent dysregulation of cortical development leading to macrocephaly/autism Li Ma, Zhang, Authors: Wei Qiang Shao, Jian Yang, Mei Xu, Zhipeng Lu, Zhen Zhao, Chai & Yang Rong Chen, Jian-Fu Chen Faculty advisor: Jian-Fu Chen Dysregulation of early neuro development is implicated in macrocephaly/autism disor increased expression of genesincreased to ciliogenesis connected Ttll6) and lipogenesis enchymal Wnt signaling-regu tism spectrum disorder (ASD), The and intellectual disability. in vivo roles of RAB39b in the brain remain unknown. We generated (KO) mice and found that they exhibited cortical neurogenesis and impairment, macrocephaly, ASD behaviors, which hallmark resembled patient phenotypes. also produced mutant We human cerebral organoids that were substantially enlarged due to the overproliferation of and impaired differentiation with X-linked macrocephaly, au with X-linked macrocephaly, ------

- fl/f fl/f : This : β-catenin- , fl/f Results: : To an- To Purpose: Conclusion Osr2-Cre;β-catenin Osr2-Cre;β-catenin , LacZ reporter mice. RNA-sequencing and qPCR analyses were conducted. Using mice were significantly reduced in size, indicating the necessity of Wnt signaling for CNC-de rived mesenchymal cells to regulate soft palate myogene sis. RNA-sequencing analysis revealed that genes associat cles of fl/fl mice, we revealed the function al significance of canonical Wnt signaling in soft palate muscle development. Soft palatal mus its cell type/spatial functional its cell type/spatial Furthermore, loss specificity. to increased Arid1a leads of which is Arid1b, of expression for odonto also indispensable not but is blast differentiation regulation of Hh involved in signaling. study expands our knowledge study expands our knowledge of the intricate interactions remodel between chromatin and ers, transcription factors, during signaling molecules progenitor cell fate determina tion and lineage commitment. Poster #36 : Canonical Wnt signal Title ing is essential for soft palate muscle development Authors: Eva Janečková, Guo, & Tingwei Jifan Feng, Chai Yang Chai Yang Faculty advisor: Background: Major physiolog ical functions such as swallow ing, breathing, hearing, and speech are governed by the soft palate, and are disrupt ed when cleft palate occurs. Surgical correction of cleft soft palate is very challenging as it involves extensive repair of musculature. alyze canonical Wnt signaling during embryonic soft palate development, its role in regu lating the interactions between cranial neural crest (CNC) and mesoderm-derived cells during this process, as well as the regulation of other organelles such as cilia, and metabolic processes such as lipogenesis. Methods: Histologic analyses, RNAscope, and immunofluo rescence were performed on Osr2-Cre;β-catenin - - fl/ ------Conclu- overactivates overactivates Gli1-CreER;Arid1a mutant mice and analyzed ing analysis to investigate the functional mechanism of show Arid1a. Results: We Arid1a impairs that loss of the differentiation-associat ed cell cycle arrest of tooth root progenitors through Hh signaling regulation, leading to shortened roots. Plagl1, as a Arid1a with endows cofactor, ing. We traced the cell fate ing. We of Gli1+ cells using tdTomato as a reporter and conducted - ATAC-se RNA-sequencing, quencing and ChIP-sequenc their tooth root phenotype us stain H&E and analysis CT ing Loss of Arid1a Arid1a Loss of axis, leading Aurka-Cdk1 the TAC mitotic the of expansion to but compromising population ability. their differentiation the defective ho Furthermore, Arid1a after loss of meostasis of ultimately leads to reduction the MSC population. These findings reveal sion: of the functional significance the fate Arid1a in regulating interaction and their TACs of tissue with MSCs to maintain homeostasis. Poster #35 Arid1a regulates mouse : Title molar root development Authors: Jiahui Du, Junjun Jifan Feng, & Yuan, Yuan Jing, Chai Yang Chai Yang Faculty advisor: Background: Epigenetic remodelers often show broad expression patterns in mul tiple cell types yet can elicit in cell-type-specific effects development and diseases. and regu- Arid1a binds DNA lates gene expression during tissue development. Howev Arid1a it is unclear how er, achieves its functional speci ficity in regulating progenitor used have cells. Purpose: We the tooth root as a model to Arid1a investigate the role of in the fate commitment and of progenitor differentiation cells during postnatal devel opment. Methods: First, we examined the expression pat Arid1a in mouse molars tern of Then, we by immunostaining. generated fl Herman Ostrow School of Dentistry USC School of of Ostrow Herman - - - - - : - mice fl/fl blasts after loss of Arid1a. blasts after loss of Then, we performed RNA-se quencing, luciferase reporter assays and ChIP-qPCR anal and analyzed their incisor phe notype using notch movement analysis and H&E staining. We examined the proliferation and activity of Gli1+ differentiation TACs MSCs and the ability of into odonto to differentiate ysis to investigate the func- Arid1a. tional mechanism of Arid1a show that Results: We maintains tissue homeostasis through limiting proliferation while promoting cell cycle exit by TACs of and differentiation Aurka-Cdk1 axis. inhibiting the Poster #34 Arid1a regulates mouse : Title incisor homeostasis Authors: Jiahui Du, Junjun Jifan Feng, & Yuan, Yuan Jing, Chai Yang Chai Yang Faculty advisor: Background: Stem cells self-renew or give rise to transit-amplifying cells (TACs) into specific that differentiate functional cell types to main Arid1a tain tissue homeostasis. performs epigenetic regulation of stage- and tissue-specific the func- genes. However, tional mechanism by which Arid1a influences the fate commitment of mesenchymal stem cells (MSCs) is not clear. used the have Purpose: We continuously growing adult mouse incisor as a model to in Arid1a investigate the role of the fate commitment of mesenchymal stem cells (MSCs) Methods: and their progeny. evaluated the expression We Arid1a in the incisor pattern of gener by immunostaining. We ated Gli1-CreER;Arid1a associated with the emergence with the emergence associated structure. of enamel prismatic of suggest that interaction We cell affects AH with cells Ambn polarization and morphology enamel and hence controlling microstructure. junction and Tomes’ processes processes Tomes’ junction and ROCK2, including ROCK1, PRICKLE1, VANGL1, PAR3, Conclusion and VANGL2. The presence of AH on AH on of The presence is closely Ambn sequence 48

neural progenitor cells (NPCs), We also identified that siR- uneven osteoblastic differ- sis as a model, we revealed which resemble neurodevel- NA-mediated knock-down of entiation. RNA-seq analysis the functional significance of opmental deficits in KO mice. PRMT1 altered histone meth- and in vivo validation revealed Kdm6b, a H3K27me3 demeth- Mechanistic studies reveal that ylations in TGFb-stimulated hedgehog (HH)-Gli1 signaling ylase, in regulating embryonic RAB39b interacts with PI3K cardiac fibroblasts, suggesting was upregulated in the sub- development. Kdm6b played components and its deletion a possible role of PRMT1 in chondral bone of TMJOA mice. an essential role in neural promotes PI3K–AKT–mTOR fibroblasts fate transition. Fur- Inhibition of HH signaling in crest development, and loss signaling in NPCs of mouse thermore, injection of PRMT1 Gli1+ cells alleviated abnormal of Kdm6b resulted in complete cortex and cerebral organoids. inhibitor MS023 successfully subchondral bone remodeling cleft palate and soft palatal The mTOR activity is robustly rescued TAC-induced cardiac and articular cartilage degen- muscle defects. Cell prolifer- enhanced in mutant outer radial failure in wild type mice, com- eration. Conclusions: Gli1+ ation and differentiation were glia cells (oRGs), a subtype paring with vehicles, indicat- cells are osteogenic progenitors abnormal in Wnt1-Cre;Kdm6bfl/ of NPCs barely detectable in ing PRMT1 as a promising for condylar subchondral bone fl mice. Importantly, the antag- rodents but abundant in human target in chronic heart failure formation and homeostasis onistic interaction between brains. Inhibition of AKT signal- treatment. in the mouse mandible. In Kdm6b and Ezh2 in regulating rescued enlarged organoid PD-induced TMJOA model, ex- ing H3K27me3 was crucial sizes and NPC overproliferation pansion of Gli1 progeny due to for p53 expression in cranial caused by RAB39b mutations. Poster #39 HH signaling upregulation may neural crest cells during Therefore, RAB39b mutation negatively affect subchondral embryogenesis. Furthermore, promotes PI3K–AKT–mTOR Title: Inhibition of hedgehog bone remodeling. Furthermore, the transcription factor Tfdp1 activity and alters cortical signaling in Gli1+ osteogenic inhibition of HH signaling in was recruited to the promot- neurogenesis, leading to progenitors alleviates osteo- Gli1+ osteogenic progeni- er of p53 along with Kdm6b macrocephaly and autistic-like arthritis tors could alleviate TMJOA, to specifically activate p53 behaviors. Our studies provide suggesting a potential cellular expression during palatogen- new insights into neurodevel- Authors: Jie Lei, Shuo Chen, target for future therapeutics in esis. Conclusions: Our study opmental dysregulation and Junjun Jing, Jifan Feng, Ting- treating patients with TMJOA. highlights the important role common pathways associated wei Guo, Yuan Yuan, Xia Han, of the epigenetic regulator with ASD across species. Thach-Vu Ho, & Yang Chai Kdm6b and how it cooperates Poster #40 with Tfdp1 to achieve its func- Faculty advisor: Yang Chai tional specificity in regulating Title: Kdm6b and Ezh2 antag- p53 expression, and provides Poster #38 Background: Recent stud- onistically regulate p53 signal- mechanistic insights into the ies suggest that committed Title: Deletion of PRMT1 ling to control palatogenesis epigenetic regulatory network osteoblastic lineage of bone Protects against TAC-Induced during organogenesis. marrow mesenchymal stem cardiac ventricular dysfunction Authors: Tingwei Guo, Xia cells (BMMSCs) in the sub- Han, Jizhi He, Jifan Feng, chondral bone may involve in Authors: Jiang Qian, Nicha Junjun Jing, Eva Janeckova, Poster #41 Ungvijanpunya, Prerna Seh- the development of OA, but Thach-Vu Ho, Jian Xu & Yang the exact mechanism remains gal, & Jian Xu Chai Title: Mapping mouse molar to be elucidated. In this study, development at single cell we identified Gli1+ cells as Faculty advisor: Jian Xu Faculty advisor: Yang Chai resolution unique osteogenic progenitors Cardiac fibroblast and its pro- in mandibular condyle and Background: Epigenetic Authors: Junjun Jing, Yuan grammed activation into my- further investigated the role of regulation plays a crucial role Yuan, Jifan Feng, Yang Chai ofibroblasts critically regulate Gli1+ cells in OA. Purpose: in development and diseas- myocardial extracellular matrix To investigate the role of Gli1+ es. Disruption of epigenetic Faculty advisor: Yang Chai (ECM) homeostasis. Our lab osteogenic progenitors in TM- regulation not only increases recently identified PRMT1 as JOA. Methods: We generated the risk of cancer, but can also Objectives: We aim to identify a new regulator for cardiac Gli1-CreERT2;tdTomato for cause developmental defects. the heterogeneity among odon- fibroblasts differentiation to lineage tracing experiments However, it is still unclear how togenic cell populations during myofibroblasts in cardiac and Gli1-CreERT2;Smofl/ epigenetic regulators coor- mouse molar development remodeling. We generated a fl;tdTomato, in which Smo was dinate with a transcriptional and elucidate their differenti- Prmt1 knockout mouse model deleted in the Gli1+ lineage. network to regulate the mor- ation trajectories. Methods: using a myofibroblast-specific A mouse model with OA-like phogenesis of specific organs. Molars of wildtype mice at inducible Cre-line, PnMC- changes in the TMJ was Purpose: To investigate the E14.5, E16.5 and PN3.5 were M/+:Prmt1flox/flox:R26RYFP/YFP induced by partial discectomy potential roles of Kdm6b as an dissected and homogenized (experimental group) and (PD). Micro-CT, HE staining, epigenetic regulator in organo- into single-cell suspension. Sin- Prmt1flox/flox:R26RYFP/YFP (control immunofluorescence staining genesis. Methods: The trans- gle-cell RNA sequencing was group) mice, and performed and RNA-seq were conducted genic mouse model used in performed with a Nextseq500 TAC surgery to induce cardiac for analyses. Results: Lineage this study is Wnt1-Cre;Kdm6bfl/ system and the reads were injury and remodeling. We tracing results showed that fl, in which Kdm6b was deleted aligned with Cell Ranger. We found that deletion of PRMT1 Gli1+ cells in the subchondral in cranial neural crest-derived used Seurat package imple- in cardiac fibroblasts prevent- bone were osteogenic progen- cells. Cellular and molecular mented in R to identify major ed the myofibroblasts differ- itors in mandibular condyle. In experiments used in this study cell types and differentiation entiation, decreased cardiac PD-induced TMJOA model, we included immunohistochem- trajectories. Immunostaining fibrosis, increased the vessel observed abnormal subchon- istry, in situ hybridization and RNAscope were performed density, and preserved the dral bone remodeling through (RNAscope), CoIP, RNA-seq, to validate the gene expres- ventricular function after 8w expansion of Gli1+tdTomato+ ATAC-seq and ChIP-qPCR. sion profiles. Lineage tracing TAC, comparing with controls. cells along with increased but Results: Using palatogene- analyses were conducted to

The Explorer Journal 2021 Abstracts 49 ------mice were generated to f/f explore how FGF1 secreted from the sensory nerve regu neurocognitive complications neurocognitive quality of that compromise ani- However, life later on. predicting and mal models these cognitive recapitulating are lacking, and phenotypes mechanism underly the circuit vironment with sensory nerves. the mechanism by However, which sensory nerves regulate adult stem cell homeostasis Methods: is still unclear. and Advillin-CreER;tdTomato mice were Advillin-CreER;DTA used to explore the role of sensory nerve. ScRNAseq of the trigeminal ganglion was performed to analyze the secreted ligands of sensory further explain how To nerve. the sensory nerve regulates MSCs, expression of different FGF receptors were analyzed Gli1-CreER;F- in the incisor. gfr1 ing behavioral abnormalities is ing behavioral abnormalities that unknown. Here we found mouse ZIKV infection during autistic-like pregnancy leads to repetitive behaviors including self-grooming and impaired We social memory in offspring. in found structure alteration and the synaptic connections of innervation pattern of vHIP to hy mPFC neurons, leading perconnectivity of vHIP-mPFC Decreasing the ac pathway. tivity of mPFC-projecting vHIP neurons with a chemogenetic strategy rescued social mem ory deficits in ZIKV offspring mice. Our studies developed a new mouse model of neuro cognitive abnormalities and identified hyperconnectivity to mPFC projections of vHIP driving social memory deficits with maternal ZIKV in offspring infection. Poster #45 : Sensory nerves support Title adult stem cell homeostasis via FGF signaling Chai Yang Authors: Fei Pei & Chai Yang Faculty advisor: Background: Stem cell niche provides a microenvironment to support the self-renewal and of multi-lineage differentiation The mouse incisor stem cells. is a highly innervated microen ------Con- Methods: Results: ;tdT and ER ;tdT incisors and ;tdT ER then differentiate into different into different then differentiate aim to iden We cell types. and how MSCs tify whether to regulate TACs interact with tissue homeostasis. - wildtype and differ Incisors of mice at adult stage ent mutant histolog were harvested and ical analysis was conducted. by RNA Laser capture followed sequencing was performed from Axin2-Cre bioinformatics analysis was bioinformatics analysis enriched utilized to identify the TACs. signaling in MSCs and combined RNAscope staining were with immunostaining the gene performed to confirm expression pattern. TACs have revealed that We and MSCs have distinct ge netic programs and engage in reciprocal signaling cross talk to maintain tissue homeosta an IGF-WNT sis. Specifically, signaling cascade is involved in the feedforward from MSCs are regulated TACs TACs. to by tissue-autonomous ca signaling and nonical WNT can feedback to MSCs and regulate MSC maintenance via Wnt5a/Ror2-mediated non-ca signaling. nonical WNT clusions: Our study highlight the importance of coordinated bidirectional signaling interac TACs tion between MSCs and in instructing mesenchymal tissue homeostasis, and the mechanisms identified here have important implications for interaction in other MSC-TAC organs. Poster #44 : Reversing social mem Title ory deficit in mice exposed to maternal Zika virus infection Authors: Li Ma, Jianlong Ge, & Jian-Fu Chen Wang, Yuan Faculty advisor: Jian-Fu Chen Zika virus (ZIKV) infection during pregnancy is causative ly linked to a wide range of developmental brain disorders. Related structural defects in the brain such as microceph aly have been characterized. Emerging evidence suggests that infants who are asymp tomatic at birth might have Gli1-Cre ------: - - - - formation in Conclusions lm-mediated infections. fi MIC profiles. bio This class of conjugates using drugs as biochemical BP vectors for the delivery of antibiotic agents to bone could represent an advantageous approach to the treatment of osteomyelitis because it improves bone pharmacokinet inhibiting biofilm impedance assays. Sitafloxa cin and nemonoxacin demon strated the lowest MIC values. The conjugate with the lowest and most favorable MIC profile was BCN, followed by BCS, with the etidronate conjugates demonstrating the highest ics while minimizing systemic exposure. Poster #43 : Reciprocal interaction Title reg- TACs between MSCs and ulates tissue homeostasis Authors: Junjun Jing, Jifan Chai Yang & Yuan, Yuan Feng, Chai Yang Faculty advisor: Objectives: In multiple organs, mesenchymal stem cells (MSCs) give rise to transit which amplifying cells (TACs), floxacin (ECC), and etidro floxacin (ECC), and inhibition was performed with inhibition was based real-time an impedance following The cell analyzer. were tested: cipro antibiotics moxifloxacin (X), floxacin (C), (S), and nemonox sitafloxacin The following novel acin (N). were experimental conjugates bis synthesized and tested: phosphonate-carbamate-sita floxacin, bisphosphonate-car (BCN), bamate-nemonoxacin etidronate-carbamate-cipro nate-carbamate-moxifloxacin (ECX). MIC and biofilm were preventative assays was performed, and HPLC used to assess hydroxyapatite binding affinity of conjugates. Results: HPLC results indicate that conjugates have high binding affinity and retention to in comparison to uncon HA jugated antibiotics. Parent antibiotics and the tested in conjugates were effective ising tool to evaluate antibiotic susceptibility and efficacy in Results show that real-time biofilm analysis can be a prom Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------Staph Purpose: lm-associated Methods: Moni- fi : We have Results: We is a predominant Our study provides biofilms with novel cause of bio infections, including serious in aureus bone-targeting antimicrobial conjugates. toring of biofilm formation and fections such as osteomyelitis. address issues with current To antimicrobial therapeutics in osteomyelitis treatment, we have designed, synthesized, and tested novel BP-fluoro quinolone antibiotic conjugates for activity against Staph aureus bone biofilms. study the real-time devel To opment and inhibition of Poster #42 : Real-time monitoring of Title osteomyelitis biofilm patho demonstrate the differentiation the differentiation demonstrate trajectories. new cell typesrevealed several mesenchyme ofin the dental Our resultsmouse molars. there were distinctshowed that within thecellular domains develop mouse molar during comprehensive information about the cellular heterogeneity of dental cell and differentiation populations in mouse molars and the findings in this study may lead to new strategies for tooth regeneration in the future. ment. We found that dental ment. We startpapilla and follicle lineages - to appear at E14.5. Odonto asblast lineage was observed early as E16.5. Interestingly, cellwe found that two distinct dentalpopulations within the canfollicle at PN3.5, which both contribute into periodontal our data tissue. Surprisingly, cyclingsuggested that Ki67+ ascells at PN3.5 may serve progenitor cells contributing to root complex formation. Con- clusions: gens with novel bisphospho nate-antibiotic conjugates Sedghiza- Authors: Parish P. Natalia deh, Esmat Sodagar, Adam F. Tjokro, Shuting Sun, Junka, Philip Cherian, Jeffrey Neighbors, R. Graham G. Russell, Charles E. McKenna, & Frank H. Ebetino Faculty advisor: Parish P. Sedghizadeh Background: Staphylococ cus aureus 50

lates stem cells in adult mouse a variety of structures with- with myogenic cells in multiple Faculty advisor: Stephen Yen incisor tissue homeostasis. in the craniofacial complex. craniofacial myogenic sites, Results: Advillin is expressed Methods: In this study, we we hypothesized that CNC-de- Background: Over the past in the trigeminal ganglion, infe- investigated cellular hetero- rived cells regulate soft palate few decades, the surgery-first rior alveolar nerve and nerves geneity during early mandible myogenesis through tissue-tis- approach has become a in the incisor, as shown by Ad- development and refined and sue interaction. Purpose: The popular method in orthognathic villin-CreER;tdTomato tracing. mapped patterning domains aim of this study is to under- surgery. With the surgery-first There was abnormal dentin with distinct differentiation stand molecular mechanisms approach, there is a change formation and a reduced potential back into the FPA in controlling soft palate muscle in treatment sequence. The incisor growth rate following fine detail. We also transcrip- formation for better repair of occlusion immediately after the induced defect in sensory tionally profiled single cells soft palate defects. Methods: surgery is not in an ideal nerve in Advillin-CreER;DTA from critical developmental Osr2-Cre;Alk5fl/flmice were position, and clinicians have mice. Furthermore, there was stages, closely tracked CNC generated to specifically target to determine what this tem- a compromised label-retain- cells within the FPA. Results: the TGF-β signaling pathway porary malocclusion, which is ing cells and cell proliferation Our investigations demon- in CNC-derived cells in the called transitional occlusion, in Advillin-CreER;DTA mice. strate notable heterogeneity soft palate. Single-cell RNA should look like during the Sc-RNAseq revealed different within the CNC cells, refine the sequencing analysis was planning process. The proper clusters of cells and indicated patterning domains, and iden- performed to compare cell- transitional occlusion is the that sensory nerve secretes tify progenitor cells within the type specific gene expression key to successful postsurgical FGF1, which exhibits high FPA. These progenitor cells profiles in E14.5 Osr2-Cre;Alk- orthodontic treatment as it en- expression in the proximal undergo fate bifurcation that 5fl/fl and control soft palates. sures an ideal final occlusion. region of the incisor. Fgfr1 separates them into common Results: TGF-β signaling Purpose: Finding the best was detected in Gli1+ mesen- progenitors and mesenchymal is specifically activated in way to determine the proper chymal stem cells both in vivo cells, which are characterized CNC-derived cells surrounding transitional occlusion for the and in vitro. Loss of Fgfr1 in by Cdk1 and Spry2/Notch2 myogenic cells in the develop- surgery-first cases using virtual Gli1+ cells showed a similar expression, respectively. The ing soft palate. Loss of TGF-β planning. Methods: For pre- phenotype to that of Advil- common progenitors undergo signaling in the these CNC-de- diction of orthognathic surgery lin-CreER;DTA mice. Conclu- further bifurcations to restrict rived cells in Osr2-Cre;Alk5fl/ and postsurgical orthodontic sions: Sensory nerves secrete them into osteogenic/odon- fl mice leads to defective soft treatment, 3D virtual treat- FGF1 ligand, which interacts togenic and chondrogenic/ palate formation including ment planning was performed with MSCs in the incisor by fibroblast lineages. Disruption disrupted soft palatal myo- using virtual planning software binding with specific receptor of a patterning domain leads genesis. Single-cell analysis (Nemotec). The treatment FGFR1 to regulate tissue to specific mandible and tooth further identified significantly planning consisted of 3 steps. homeostasis in adult mouse defects, validating the binary altered cell type composition in For step 1, teeth were virtual- incisor. cell fate restriction process. CNC-derived cells in the E14.5 ly setup to achieve the ideal Conclusion: Different from Osr2-Cre;Alk5fl/fl mouse soft position. In step 2, maxilla and the compartment model of palate, particularly a reduction mandible with setup dentition mandibular morphogenesis, of Tbx15+ cell clusters which were virtually repositioned. In Poster #46 our data redefine hetero- express FGf18. RNAscope step 3, setup dentition was switched back to the original Title: Spatiotemporal cellular geneous cellular domains expression confirmed that dentition while maintaining movement and fate decisions within the FPA, reveal dynamic Tbx15+Fgf18+ CNC-derived the skeletal positions. The during mandibular arch mor- cellular movement in time, and cells are in close contact with ideal position of transitional phogenesis describe a sequential series of myogenic cells in vivo, and binary cell fate decision-mak- that this population is reduced occlusion was determined Authors: Yuan Yuan, Yong- ing process. in the absence of Tgf-β signal- through this process. Results: hwee Eddie Loh, Xia Han, Jif- ing in Osr2-Cre;Alk5fl/fl mice. Two surgery first cases were an Feng, Thach-Vu Ho, Jinzhi Conclusions: Specific acti- planned with described virtual treatment planning method. He, Junjun Jing, Kimberly Poster #47 vation of the TGF-β signaling Groff, Alan Wu, & Yang Chai pathway in CNC-derived cells Both of them were successfully Title: TGF-β signaling regu- in close proximity to myogenic treated as planned. Conclu- Faculty advisor: Yang Chai lates soft palate development cells may determine the fate of sion: A multiplatform software via mediating cell-cell interac- these CNC-derived cells and can be a powerful tool for Background: Cranial neural tion instruct them to produce key analyzing problems in finishing crest (CNC) cells contribute signaling molecules to regulate a surgery-first case, predicting to different cell types during Authors: Jifan Feng, Xia Han, soft palate muscle formation. outcomes and improving the embryonic development. It Yuan Yuan, Courtney Kyeong accuracy in planning sur- is unknown whether postmi- Cho, Eva Janeckova, Tingwei gery-first approach. gratory CNC cells undergo Guo, Jing Bi, Mingyi Zhang, Poster #48 dynamic cellular movement Thach-Vu Ho, & Yang Chai and how the process of cell Title: Virtual treatment plan- Poster #49 fate decision occurs within the Faculty advisor: Yang Chai ning of surgery-first orthog- first pharyngeal arch (FPA). nathic approach using reverse Title: Runx2 maintains the Background: Coordinated Purpose: From a devel- engineering mouse incisor mesenchymal opmental perspective, it is movements of the soft palate stem cell niche fascinating to investigate the and pharyngeal muscles are Authors: Jaemin Ko, Lamia dynamic processes through crucial for speech, swallowing, Alhuwaishel, Xuanyu Lu, Mark Authors: Shuo Chen, Junjun which postmigratory CNC breathing, and hearing. Since M. Urata, Jeffrey A. Hammou- Jing, Thach-Vu Ho, & Yang cells commit to different fates cranial neural crest (CNC)-de- deh, & Stephen L.-K. Yen Chai and subsequently give rise to rived cells are in close contact

The Explorer Journal 2021 Abstracts 51 - - +/- - - - - mice. - - +/- mice. Final- +/- Twist1 mice. Con- +/- mice, we deliv +/- mice. Significantly, mice. Significantly, +/- ered Gli1+ cells mixed with a GelMa-based biomaterial into the resulting gap between the then eval calvarial bones. We uated the regenerated suture and neurocognitive function after 6 months. Results: Our results showed that there is a specific correlation between the dimin ished number of Gli1+ cells in a suture and its premature fusion in both humans and Twist1 ly, regeneration of the coronal ly, suture generated improvement in neurocognitive behavior in these Twist1 leviated the calvarial deformity typically seen in we showed that Gli1+ MSCs combined with modified GelMa were able to support coronal The newly suture regeneration. regenerated suture partially al mouse model, which shows increased intracranial pressure and dysmorphology of the craniofacial skeletal complex as the result of cranial suture fusion. Following the removal of the fused coronal suture in Twist1 : Mengfei Yu, Li Ma, Yu, : Mengfei Authors & Jian-fu Chen, Yuan, Yuan Chai Yang Chai Yang : Faculty advisor : Craniosyn Background tions to relieve the constriction The : on the brain. Purpose present study was designed to establish the rationale for employing biomaterials together with stem cells for cranial suture regeneration to provide a novel treatment for patients with craniosynostosis. we Methods: In this study, took advantage of the Twist1 ostosis is characterized by ostosis is fu premature cranial suture function. paired neurocognitive Surgery is the only treatment After surgery, option currently. re-fuse calvarial bones may opera and require repeated sion, which can cause severe sion, which can cause abnormal outcomes including increased growth of the skull, retarded intracranial pressure, im brain development and In parallel, we found for the first time that craniosynostosis of the coronal suture is associated with neurocognitive defects in Twist1 : ------fl/ - - -

- - fl/fl and fl/fl - fl/fl Methods: Conclusion mice. Doxycy- fl/fl Osr2-cre;Ror2 Osr2-cre;Ror2 every day from E14.5. fl/fl mice. However, there was mice. However, no change in cell apoptosis. At PN3.5, the expression of Nfatc4 and Cdk2 was de creased in mice at PN5.5. At PN3.5 and mice at PN5.5. PN5.5, cell proliferation in the apical region was significantly decreased in cline rodent diet was adminis - tered to K14-rtTA;Teto-cre;Ror 2 Results: Epithelial-specific deletion of Ror2 at E14.5 had on root formation. no effects den loss of Ror2 in However, tal mesenchyme led to retard ed root elongation at PN9.5 and severely shortened roots at 3 weeks after kidney cap sule transplantation of tooth germ from Osr2-cre;Ror2 mice. At PN5.5, Axin2 expres At PN5.5, mice. sion was also decreased in the apical region. Loss of Ror2 in dental mesen chyme decreases cell prolifer ation via Nfatc4 in the apical region and inhibits postnatal The inhibi root development. tion of canonical Wnt signaling pathway may also contribute. Poster #52 : Cranial suture regener Title ation and cognitive improve ment in a craniosynostosis model nonical Wnt signaling in tooth nonical Wnt signaling root development. generated epithelial- and/ We or mesenchymal-specific loss-of-function of non-ca nonical Wnt signaling using K14-rtTA;Teto-cre;Ror2 Li, & Yang Chai Yang Li, & Chai Yang : Faculty advisor : Mammali- Background development an tooth root the completion of begins after Canonical crown formation. plays Wnt/β-catenin signaling root important roles in tooth one formation. Wnt5a ligand, component of the non-canon is ical Wnt signaling pathway, devel associated with tooth its function opment. However, root and that of Ror2 during formation remain unknown. investigate the To Purpose: and roles of mesenchyme- epithelium-derived non-ca fl Osr2-cre;Ror2 ------, . - ER ER -tdTomato, -tdTomato, signaling. patterning Lhx6-Cre : Mesenchymal oxP-STOP-loxP : Yang Chai Yang : advisor Faculty : Mammali- Background has an tooth development as a model for long served questions of studying basic Crown biology. developmental inten development has been the sively explored. However, regulation of root development, deter especially root number mination, is largely unknown. investigate the To Purpose: in the potential roles of Lhx6 furcation, development of the the a structure that controls Methods: Mouse root number. lines used in the present study included tance of dental mesenchyme regulation in root and development, and it has important implications for tooth root regeneration. Poster #51 : Ror2-mediated non-ca Title nonical Wnt signaling regu lates tooth root development Ma, Jun Yuanyuan Authors: Jingyuan jun Jing, Quan Wen, Wnt/beta catenin Conclusion Lhx6 is a key regulator for root furcation formation and root number determination. Our study highlights the impor Gli1-LacZ, and Gli1-Cre ed to odontoblasts, alveolar osteoblasts, and periodontal ligament cells closely associat ed with root furcation develop ment. Loss of Lhx6 resulted in a lack of furcation formation as well as root number defects in the molars but left the Moreover, crown unaffected. Lhx6 mutation compromised mesenchymal proliferation via increasing cell cycle inhibitor Cdkn1c, as well as disrupting of odontogenic differentiation dental mesenchyme by via increasing Wnt antagonist Sfrp2, thereby downregulating MicroCT, HE staining, immu- MicroCT, nofluorescence, RNAscope and bulk-RNAseq were used. Results: Lhx6, an in vivo mak- er for a subpopulation of Gli1+ progenitor cells, is consistently and exclusively expressed in the apical dental mesenchyme. Lineage tracing showed that Lhx6+ cells mainly contribut ROSA26l Herman Ostrow School of Dentistry USC School of of Ostrow Herman - - - - l/ - ;Runx2f : Yang Chai Yang : ERT2 Loss of Runx2 mice, in which Runx2 was ed by TUNEL assay 1 week assay 1 TUNEL ed by after induction in the mutant The expression of dentin mice. sialophosphoprotein (Dspp) was shifted to an earlier stage. Gli1+ stem cells decreased significantly 2 weeks after induction, which may result from a lack of feedback from RNA-seq data showed TACs. that Igfbp3 was downregulat lost in the Gli1+ lineage. The lost in the Gli1+ lineage. mice were euthanized 1, 2, or The 4 weeks after induction. mandibles were collected and H&E staining, fixed. MicroCT, and immunofluorescence staining were carried out for The number analysis. Results: of transit-amplifying cells decreased significantly (TACs) while there were no apparent changes in apoptosis detect ed in the mutant mice, which was confirmed by RNA-scope. immunofluorescence Further, showed that p-Igf1r was down Poster #50 : Lhx6 is required for Title mouse root patterning Authors: Jinzhi He, Jifan Yuan Guo, Tingwei Feng, Chai Yang & Yuan, regulated in the mutant mice, suggesting the IGF signaling pathway was downregulated. Conclusions: the IGF in Gli1+ cells affects which regu signaling pathway, proliferation as well TAC lates as differentiation. fl Faculty advisor Faculty : The mouse : Background excellent model incisor is an mesenchymal for studying (MSCs). Previously, stem cells that quiescent Gli1+ we found cells near the neurovascular bundle are typical MSCs. we identified Runx2 Recently, cells using expression in Gli1+ single-cell RNA-sequence the function analysis. However, the of Runx2 in regulating mouse fate of MSCs in adult incisors is still unknown. investigate the To Purpose: role of Runx2 in maintain and ing tissue homeostasis MSC regulating the incisor gen- niche. Methods: We erated Gli1-Cre 52

clusions: Modified GelMa ment in Runx2 mutant molars. ciated genes in CNC-derived protein ISG15 (interferon-stim- loaded with Gli1+ cells is an Collectively, our study elucidates cells. Haploinsufficiency of ulated gene 15), a protein ideal biomaterial to support how Runx2 achieves function- Twist1 in Osr2-KIcre; Runx2fl/ potentially conjugated to functional suture regeneration al specificity in regulating the fl rescues multiple soft palate substrate proteins to regulate in Twist1+/- mice, and this study development of diverse organs defects associated with loss of their biological functions. This lays the groundwork for a nov- and yields new insights into the Runx2. Conclusion: Our re- post-translational modification el regenerative treatment for regulatory network of tooth root sults suggest that Runx2 may is known as protein ISGylation. patients with craniosynostosis. development. regulate the differentiation Our data showed that co-in- and fate decisions of distinct fection of MHV68 and A.a. CNC-derived cell populations elevated protein ISGylation in Poster #53 Poster #54 that play diverse roles during mouse embryonic fibroblasts soft palate development. (MEFs) compared with MHV68 Title: Runx2 regulates tooth Title: Runx2 Regulates Soft Thus, Runx2 may fine-tune or A.a. infection alone. We root development via activation Palate Development through soft palate morphogenesis further showed that MHV68 of Notum Patterning Neural Crest-de- via orchestrating CNC-de- lytic replication was reduced rived Cells rived mesenchymal cell fate, in ISG15 knockout MEFs com- Authors: Quan Wen, Junjun particularly of the perimysial pared to WT MEFs, indicating Jing, Xia Han, Jifan Feng, Authors: Summer Xia Han, and palatal stromal cells, in that ISG15 and ISGylation Yuan Yuan, Yuanyuan Ma, Jifan Feng, Tingwei Guo, Yuan a spatiotemporally specific stimulated by MHV68 and A.a. Shuo Chen, Jinzhi He, Thach- Yuan, Thach-Vu Ho, Jing manner through tissue-tissue co-infection promote MHV68 Vu Ho, & Yang Chai Bi, Brian Song, Jingyuan Li, interactions. lytic replication. Conclusion: Junjun Jing, Eva Janečková, & Collectively, A.a. positively reg- Faculty advisor: Yang Chai Yang Chai ulates MHV68 lytic replication Poster #55 via enhancing the expression Progenitor cells are crucial in Faculty advisor: Yang Chai of ISG15 and ISGylation. controlling organ morphogen- Title: Aggregatibacter actino- esis. Tooth development is a Background: The soft palate mycetemcomitans activates well-established model to inves- is crucial for essential physio- MHV68 lytic replication via tigate the molecular and cellular logical functions. Cranial neu- Poster #56 synergistically stimulating regulatory mechanisms in reg- ral crest (CNC) cells give rise ISG15 expression Title: Viral glutamine amido- ulating organogenesis. Despite to soft palate mesenchyme transferase (vGAT) activates advances in our understanding and guide craniofacial muscle Authors: Jianglin Zhang, Ca- phosphoribosyl-formylglycina- of the regulatory mechanism of development. Purpose: To sey Chen, & Pinghui Feng midine synthetase (PFAS) to tooth crown formation, we have investigate the regulatory fuel de novo purine synthesis limited understanding about mechanisms of soft palate Faculty advisor: Pinghui Feng and tumorigenesis tooth root development. Runx2 development. Methods: We & Casey Chen is a well-known transcription fac- performed single-cell RNA- Authors: Ting-Yu Wang, Xia- tor of osteogenic differentiation seq analysis of soft palate Background: Advanced oxi Lin, Junhua Li, Simin Xu, & and early tooth development. at E13.5-E15.5. Immunoflu- periodontitis (deep periodontal Pinghui Feng However, the function of Runx2 orescent staining and in situ pockets ≥6 mm) affects 10% during tooth root formation hybridization were performed to 15% of adults worldwide, Faculty advisor: Pinghui Feng remains unknown. In this study, to analyze the expression contributing significantly to the & Casey Chen we discovered that Runx2 is patterns of specific genes. We global burden of oral diseases. specifically expressed in a generated Osr2-KIcre; Runx2fl/ Clinical association studies Background: Kaposi’s sar- subpopulation of root progen- fl mice to delete Runx2 in a show that ongoing herpesvirus coma-associated herpesvirus itor cells and loss of Runx2 in subset of CNC-derived cells. infection is associated with (KSHV) is a tumorigenic DNA these progenitor cells and their We performed microCT, histol- severe forms of oral diseases, virus linked to several ma- progeny results in root devel- ogy, and single-cell RNA-seq such as severe periodontitis. lignancies such as Kaposi’s opmental defects. Our results analysis to identify regulating How herpesviruses contribute sarcoma and pleural effusion provide the first in vivo evidence mechanisms of Runx2 in soft to oral inflammatory diseases lymphoma. Recent studies that Runx2 plays a crucial role palate development. Results: is not understood. Purpose: have reported that viruses can in tooth root development and We demonstrated heterogene- The goal of this study is to activate cellular metabolism determining the differentiation ity in the soft palate mesen- characterize bacteria-virus to promote lytic replication of root progenitor cells. Further- chyme associated with distinct interaction in the oral inflam- and tumorigenesis. Howev- more, we identified that Gli1, cell fates: perimysial, stromal matory diseases using gamma er, the molecular mchanism Pcp4, Sfrp2, and Notum are and osteogenic lineages. herpesvirus 68 (MHV68) concerning such virus-induced downstream targets of Runx2 Runx2 is closely associated and Aggregatibacter acti- metabolic reprograming is still by using an integration analysis with multiple subpopulations nomycetemcomitans (A.a.) not well understood. Purpose: of bulk RNA sequencing and of CNC-derived mesenchyme, as a model. Methods: Here This study aims to delineate single-cell RNA sequencing. and loss of Runx2 in CNC-de- we used oral keratinocytes the molecular mechanism by Specifically, ablation of Runx2 rived cells results in bone, to determine the interaction which a viral pseudoenzyme results in downregulation of Wnt palate and muscle defects between MHV68 and A.a. in activates the de novo purine inhibitor Notum and upregula- in the soft palate of Osr2-KI- host response and microbial synthesis to promote tumori- tion of canonical Wnt signaling cre; Runx2fl/fl mice. We also infection. Results: Co-infection genesis. Methods: Methods in the odontoblastic site, which revealed that loss of Runx2 of MHV68 and A.a. enhanced for this study include: 1) Cell disturbs normal odontoblastic leads to ectopic expression of the production of CXCL10, culture and transfection, 2) differentiation. Significantly, Twist1 in perimysial CNC-de- a chemokine biomarker of Immunoblotting and immuno- exogenous Notum partially res- rived cells and reduced periodontitis development, and precipitation, 3) Metabolites cues the impaired root develop- expression of myogenic-asso- the expression of ubiquitin-like extraction and liquid chro-

The Explorer Journal 2021 Abstracts - 53 - - - : Our nucleotides in SARS-CoV-2- nucleotides is Ongoing study infected cells. of the antiviral effect examining on SARS- the small molecule in infection and disease CoV-2 results uncover These mice. strategy whereby an intricate couples inhibition SARS-CoV-2 pro of inflammatory cytokine duction to activated nucleotide duction to activated synthesis. Conclusion work reveals that SARS-CoV-2 NF-kB can hijack CAD to block PPP activation and upregulate RelA through deamidating Our and G6PD respectively. 2-TCPA new-designed drug can target CAD to diminish replication SARS-CoV-2 a is 2-TCPA dramatically. promising antiviral drug for the therapy of COVID-19 patients. Poster #59 Nsp5 tar- : SARS-CoV-2 Title to inhibit gets RIG-I and MAVS IFN induction Liu, Yongzhen Authors: Rao, Chao Qin, Chau Youliang Ngo, Jun Zhao, Shu Zhang, Ali Tian, Mao Wang, Ting-Yu Can Savas, Mehrnaz Zarinfar, Ca- A Julio Yang, Hanging marero Palao, Xiaojiang Chen, Chao Zhang, & Pinghui Feng Faculty advisor: Pinghui Feng Background: Caused by the newly emerged SARS-CoV-2, the COVID-19 pandemic claimed more than 132 million known infections and 2.8 million deaths, leaving many The high unknown infections. replication and transmission of are remarkably SARS-CoV-2 distinct to previous closely re lated coronaviruses and under pinning molecular mechanisms Innate immune remain unclear. defense is a physical barrier to restrict viral replication. Purpose: Previous studies on SARS-CoV and MERS-CoV have identified diverse viral factors that modulate host innate immune response. By comparing the SARS-CoV-2 genome sequence to those of a SARS-CoV and MERS-CoV, number of viral proteins were predicted to exert similar func tion to meddle cellular innate signaling events. However, the actual viral proteins and ------Pur- - Methods: In duces SARS-CoV-2 infection, duces SARS-CoV-2 are emerging mutant viruses pressure of neu under the calling for tralizing antibodies, strategies. Here, new antiviral we report the development inhibitor of a small molecule that targets the rate-limiting de novo enzyme, CAD, of the pathway pyrimidine synthesis and to restore inflammation SARS- deplete pyrimidine in cells, thus CoV-2-infected impeding viral replication. The goal of this study pose: novel viral is to characterize a that immune evasion strategy hi- the emerging SARS-CoV-2 jacks CAD to deamidate RelA, thereby shutting down NF-kB activation and inflammatory cytokine production. Inhibition of CAD is expected to restore cytokine production and de plete pyrimidine in SARS-CoV- 2-infected cells, thus impeding viral replication. we used real-time this study, PCR, western blot, liquid chromatograph-mass spec viral titer determina trometry, tion, co-immunoprecipitation, gene expression analysis, and protein charge analysis by two-dimensional gel electro To phoresis (2DGE). Results: test our central hypothesis, we discovered that SARS- infection induced weak CoV-2 expression of inflammatory cytokines and that it hijacks to in- CAD to deamidate RelA hibit NF-kB activation. Indeed, activated CAD SARS-CoV-2 and depletion of CAD restored NF-kB activation. Screening expression a SARS-CoV-2 we identified Nsp9 library, that interacted with CAD and inhibited NF-kB activation. activated CAD Conversely, upregulated the pentose phos phate pathway (PPP), the de novo synthesis of nucleotides and Nsp9 upregulated the PPP in a CAD-dependent manner. Biochemical and metabolites analysis indicated that CAD, when activated, deamidated and activated glucose-6-phos phate dehydrogenease (G6PD), the first rate-limiting to fuel de enzyme of PPP, novo nucleotide synthesis. De novo synthesis of a small mol ecule inhibitor of CAD enabled the restoration of inflammato ry cytokine and depletion of : Although ongo : Background drastically re ing vaccination - - : - - - Pur- - Conclusion : We per- Methods: We matography coupled with Results: mass spectrometry. found that SARS-CoV-2 We exploits CTPS1 to promote synthesis and suppressCTP IFN induction. Screening a expression library SARS-CoV-2 identified ORF7b and ORF8 that suppressed IFN induction via inducing the deamidation of interferon regulatory factor 3 (IRF3). Deamidated IRF3 fails to bind the promoters of classic IRF3-responsible genes, thus muting IFN induction. ORF7b and ORF8 also activate CTPS1 synthesis. Deto promote CTP novo synthesis of small-mol ecule inhibitors of CTPS1 depletion and IFNenabled CTP induction upon SARS-CoV-2 infection, thus impeding SARS- replication. CoV-2 resis, innate immune responseresis, innate immune ELISA,by real-time PCR and viral replication by real-time and me PCR and plaque assay, tabolite profiling by liquid-chro fuel viral replication. However, However, fuel viral replication. interacts how SARS-CoV-2 immune system andwith innate cellular metabolismmodulates understood. remains poorly of this studyThe purpose pose: the mecha was to investigate evades nism that SARS-CoV-2 defense,host innate immune while promoting macromolecule synthesis. toformed biochemical analyses bydefine virus-host interactions assays,co-immunoprecipitation electropho two-dimensional gel Our work uncovers a strategy that a viral pathogen couples immune evasion to metabolic activation to fuel viral replication. Inhibition of the cellular CTPS1 an attractive means foroffers developing antiviral therapy that would be resistant to SARS- mutation. CoV-2 Poster #58 a pyrimidine Targeting : Title synthesis enzyme to restore inflammatory cytokine produc tion and deplete pyrimidine in infection SARS-CoV-2 Authors: Chao Qin, Hao Ting-yu Rao, Youliang Yuan, Ali Savas, Jun Zhao, Wang, Bianca Espinosa, Chao Zhang, & Pinghui Feng Faculty advisor: Pinghui Feng Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------: Our findings Poster #57 synthe - CTP Targeting : Title tase 1 to restore interferon induction and deplete nucleo thesis enzymes, including thesis enzymes, including phosphoribosyl pyrophosphate and amidotransferase (PPAT) suggesting that vGAT PFAS, may alter their enzyme activity in purine synthesis. 3. Nude mice injected with NIH3T3/ developed visible tumors vGAT in three weeks, suggesting contributes potentially vGAT to virally associated malignan cies. Conclusion support the hypothesis that pseudoenzyme KSHV vGAT can boost the de novo purine biosynthesis by interacting and and PFAS, with PPAT also imply that elevated purine synthesis, perhaps with other metabolic pathways, can drive tumorigenesis. This hypothesis will be further investigated. infection tides in SARS-CoV-2 Ting- Rao, Youliang Authors: Qizhi Liu, Bianca Wang, Yu Espinosa, Chao Qin, Jun Ali Arunika Ekanayake, Zhao, Can Savas, Shu Zhang, Meh Liu, Yongzhen rnaz Zarinfar, Zhu, Nicholas Graham, Wenjie Jiang, Chao Zhang, & Taijiao Pinghui Feng Faculty advisor: Pinghui Feng The newlyBackground: caused emerged SARS-CoV-2 a global pandemic with aston olites such as IMP, inosine, olites such as IMP, hypoxathine and guanosine in human oral keratinocytes that (HOK) cells, indicating expand nucleotide vGAT cell metabolim pool to fuel stimulat proliferation through ing de novo purine synthesis. binds to purine-syn 2. vGAT ishing mortality and morbidity. propagate in infected cells, To viruses evolved strategies to evade host innate immune system and exploit cellular machinery to synthesize mac romolecules and biomaterials to etry (LC-MS) analysis, 4) In etry (LC-MS) formation, and 5) vivo tumor and statistical Quantification The vrial : 1. analysis. Results increases vGAT pseudoenzym, of purine metab production matography-mass spectrom matography-mass 54

their mechanisms of action old visiting our dental school in cells maintain incisor homeo- design to engineer bifunctional of SARS-CoV-2 remain to be 2012 or 2017. This data was stasis. These processes are peptides to combat bacte- defined. Methods: A screen then compared to the National crucially regulated by the stem rial colonization and biofilm utilizing the SARS-CoV-2 Health and Nutrition Examina- cell niche microenvironment. formation on implants. This expression library identified tion Survey (NHANES) data Purpose: To explore the large- bifunctional peptide contains Nsp5 as a potent inhibitor of for 2011-2012 and 2017-18. ly unknown signaling network a titanium-binding domain that IFN induction and that Nsp5 Results: In our sample there that guides the fate of MSCs recognizes and binds titani- targets both RIG-I and MAVS was a significant increase in as well as their niche in the um implant surfaces, fused for destruction. Results: Spe- the prevalence of self-reported mouse incisor. Methods: RNA- through a rigid spacer domain cifically, Nsp5 cleaves off the opioid use between 2017 (6.5%) scope, immunofluorescence, with an antimicrobial domain. very N-terminal 10 amino acids and 2012 (4.5%; p<0.01) and in and histological analysis were The antimicrobial activity of from RIG-I and deprives it to all ages, female gender, and Af- performed on Gli-CreER;T- these peptides to common oral activate MAVS. Furthermore, rican Americans (all at p≤0.05). gfbr2fl/fl and Gli-CreER;Smofl/ pathogens and commensals Nsp5 promotes the ubiquitina- For the NHANES population fl conditional knockout mice remains to be determined. tion and proteosome-mediated opioid usage also increased and Gli1-LacZ reporter mice. Objective: To determine the degradation of MAVS. As between 2012 to 2017 in all Results: Both Gli-CreER;Smofl/ effectiveness of antimicrobial such, Nsp5 potently inhibits ages, females and Caucasians fl and Gli-CreER;Tgfbr2fl/fmice peptides (AMPs) in the eradi- IFN induction by dsRNA in an (no significant differences) but display impaired odontogene- cation of common periodontal enzyme-dependent manner. decreased significantly in His- sis two months after tamoxifen pathogens and reduction of A synthetic small molecule in- panics (p≤0.05) with a decreas- injection; their dentinogen- biofilm formation. Methods: hibitor blunted Nsp5-mediated ing trend in African Americans. esis and amelogenesis are Bacterial suspensions at 107 destruction of RIG-I and MAVS When compared, older adults increased. The proliferation CFU/ml were treated with 100 and restored antiviral IFN at our clinic reported less opioid activity in the area of the µM of AMPs, and bacterial induction, thereby impeding use than the NHANES popula- cervical loop, where TACs are viability were determined at SARS-CoV-2 replication. Con- tion in both periods no matter located, is impaired both in the different time points by CFU clusion: This work offers new the gender, with the exception of mesenchyme and epithelium, counts. AMPs were also added insight into the immune eva- those aged >80 and Hispanics resulting in premature differen- to 24-hour single-species sion strategy of SARS-CoV-2 in 2017 (both having non-signifi- tiation of odontoblasts and am- and poly-microbial biofilms, and provides an antiviral agent cant differences). Conclusions: eloblasts that in Gli-CreER;Smo- and biofilms were quantified for treating COVID-19 patients. The prevalence of older adults fl/flcan already be observed through crystal violet staining. taking opioids in our dental two weeks after tamoxifen Results: Our preliminary UNDERGRADUATE school clinic increased signifi- induction. Of particular interest results showed that AMPs can cantly in 2017 when compared is the impaired expression of be categorized into three cate- & DDS STUDENTS - to 2012. Practicing dentists Axin2, Dspp and Pax9 repre- gories, highly effective, margin- should be aware of the risks as- senting individual cellular iden- ally effective, and ineffective, BASIC SCIENCES sociated with opioid use in older tities in the incisors. Conclu- depending on their efficacies adult patients and consider pre- sion: Tgf-β and Shh signalling in the killing of the various

scribing alternative analgesics play crucial roles in stem cell periodontal pathogens and following the CDC guidelines niche regulation, homeosta- clearance of biofilm. Conclu- and ADA policy. sis of the mouse incisor and sion: These novel bifunctional consequently odontogenesis. peptides have the potential Poster #60 Further functional experiments to deliver AMPs directly to Poster #61 are necessary to reveal the implant surface. They have the Title: Opioid usage prevalence exact role of these signalling potential to improve oral health in older adults in a dental pathways in the regulation of by controlling oral dysgenesis, population Title: Regulation of the mesenchymal stem cell niche in MSC fate and the incisor stem reducing peri-implant disease Authors: Maile Osborne, mouse incisor cell niche. progression, and decreasing Piedad Suarez-Durrall, Reyes the cases of implant failures. Enciso, & Roseann Mulligan Authors: Aileen Ghobadi, This strategy could be the Katerine Scheker, Ilan Kaboud, Poster #62 basis for next-generation Faculty advisors: Piedad Eva Janečková, & Yang Chai therapeutics and will have a Suarez-Durall, Reyes Enciso, Title: Targeted delivery of an- significant impact on public & Roseann Mulligan Faculty advisor: Yang Chai timicrobial peptides in peri-im- health. plantitis Background: Over 40% of Background: Mesenchymal stem cells (MSCs) located in older adults have chronic pain Authors: Natalia O. Tjokro, Poster #63 that is usually treated with long- the proximal end of mouse in- Christie Shen, Candan Tamerl- cisors enable continual growth term opioid use, risking drug er, Malcolm L. Snead, & Casey Title: IKKβ and TBK1 nega- of these teeth throughout the dependence, increased risk of Chen tively regulate the CAD-medi- entire lifespan of the animal. injury, and emergency depart- ated metabolic reprogramming ment visits or death. Purpose: MSCs are important in tissue Faculty advisor: Casey Chen To examine opioid prevalence in regeneration and adult tissue Authors: Chi Liang, Hansong patients >65 years of age within homeostasis. The progeny of Background: Peri-implantitis Xia, Anjie Lu, Jun Zhao, Ting- a dental school clinic, compared MSCs are transient amplifying is a host-mediated inflam- Yu Wang, & Pinghui Feng to national data. Methods: cells (TACs). The rate of MSC matory response to dysbiotic Self-reported opioid use was to TAC transition and subse- biofilms on the implants that Faculty advisor: Pinghui Feng extracted from the medical quent rates of TAC prolifer- leads to bone loss and implant records for patients >65 years ation and differentiation into failures. Here we used a Background: Cellular immune odontoblasts and dental pulp predictive approach to peptide response is a metabolically

The Explorer Journal 2021 Abstracts 55 ------Pur- Methods: Results: Previous studies ticipate obtaining a significantly score among thehigher DMFT underserved population of Skid Row compared to the general population. Poster #67 : FaceBase3: Craniofacial Title ty scoresshowed that the DMFT of people without housing were scores ofhigher than the DMFT an the general population. We This retrospective study is being conducted from existing patient The number of de records. scoresing X-rays and DMFT are calculated using an Excel As part of the project, the sheet. scores will be comparedDMFT categories based onin different and ethnici age, gender,race clinics in the Skid Row area in Angeles with downtown Los national databases. cayed, missing, and filled teeth are being extracted from each dental record includ patient’s nity oral health experiences to experiences to nity oral health oral students and addressing health needs of families. Poster #66 index of people : DMFT Title experiencing homelessness data compared to national bases Andia Ezzati, Reneih Authors: Azita Ezzati Abdelhafez, & Faculty advisor: Mehdi Mo- hammadi Background: Decayed, ( Teeth Missing, and Filled DMFT) index is one of the most used epidemiologic indices in People experiencing dentistry. homelessness face significant oral health challenges besides other chronic conditions; ac nity oral health programs are nity oral health physical outreach able to shift address oral health activities to that con- of the community with program tinues to align providing commu goals, while cording to recent studies, they from poor oral health thansuffer the general population. study compares theThis pose: score of patients seekingDMFT dental care at the USC dental ------Re- : Commu- : Dental education Five reviews found that trainingFive reviews are instrumental inprograms dental providers’ increasing and confidenceknowledge and reportingin recognizing cases of elder abusesuspected encounters.in their patient Conclusion to ensureon elder abuse needs that the curriculum provides future and current dental trainingpractitioners adequate andin identifying, reporting cases.managing suspected Poster #65 : COVID-19 pandemic Title “Safer at Home” community oral health activities Authors: Kristine D. Parungao & Roseann Mulligan Faculty advisor: Roseann Mulligan Os- Herman The Background: trow School of Dentistry of Uni versity of Southern California (USC) in partnership with the Angeles California State of Los began a community oral health promotion program in 2017 to address the oral health of chil dren, youth and young adults The (ages 0 to 20). Purpose: program was based on phys ical field outreach activities until the middle of March 2021 when the COVID-19 pandemic Angeles County and hit Los The pro- the rest of the world. gram transformed its physical outreach activities to a virtual model that continues to align with program goals. Method: The program developed “Safer at Home” activities which included virtual oral health presentations, development of oral health materials involving dental, dental hygiene and social work students, distribu tion of oral hygiene kits and telehealth consultations. The program resulted in sults: servicing 62 community sites, providing 1815 non-oral health community members with virtual oral health education, developing 14 oral health edu cation presentations or videos, involving 22 dental and dental hygiene students, distributing 10,104 oral hygiene kits, and conducting 697 telehealth ses sions. Conclusion ------CCMB Results: 199 records AFFILIATES : An electronic Methods: DENTISTRY & DENTISTRY ed approaches and suggest interventions for future educa tion. search in PubMed, EMBASE, of Science and Cochrane Web was performed on 9/30/2020 to identify studies pertaining to elder abuse education/training found in DDS and Dental Hy Poster #64 review of elder abuse A : Title edu curriculum in US dental cation Authors: Nechama Citrin, Reyes Enciso, & Roseann Mulligan Faculty advisors: Reyes En- ciso & Roseann Mulligan Background: Elder abuse is an evolving public health concern. Elder abuse is defined as actions or inaction by a caregiver or trusted individ ual that results in harm to a person aged 65 years or older. As mandated reporters of elder abuse in many states, den tal providers require training in identifying, reporting and managing suspected cases. review aims toThis Purpose: identify elder abuse curriculum models found in the literature, compare and contrast report giene (DH) programs and con downstream innate immunedownstream forging adefense, thereby link between cellularmolecular and innate immunemetabolism defense. tinuing education for practicing dentists. were retrieved and analyzed by Of those, 22 stud- one author. ies on dental curricula and 10 editorials on the subject were gathered. Published curricula included mailed or in-person surveys as well as in-person or on-line didactic session(s) with pre- and post-session assess ments. Survey results indicate that DDS/DH students as well as practicing dentists have limited knowledge and confi dence in reporting elder abuse. Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------: Our find- : The goal Purpose: Results: Biochemical Conclusion dates the RelA subunit of NF-ºB subunit dates the RelA in cancer cells to promote fuel cellaerobic glycolysis and proliferation in tumorigenesis. CAD catalyzes the rate-limiting step of the de novo pyrimidine pos synthesis, raising the cansibility that metabolism immunedownregulate innate response. lism was defined by metabolite profiling with liquid-chromatog raphy coupled with mass spec trometry. assays demonstrate that IKKβ TBK1 interact with and and directly phosphorylate CAD. Mass spectrometry analysis identified S147, S1827 and S1828 of CAD as the phos phorylation sites by IKKβ and TBK1-me- TBK1. IKKβ- and diated CAD phosphorylation inhibits the de novo pyrimidine synthesis and metabolic repro gramming, aerobic glycolysis installed by deamidated RelA. With knockout cell lines, we showed that innate immune activation, relayed by activated TBK1, suppresses IKKβ and cellular metabolism, thereby restricting viral replication. Furthermore, phosphoryla tion-resistant CAD renders cells more refractory to suppression imposed by innate immune activation. Current experiments are assessing the metabolic enzymes that are regulated by TBK1 via phosphor IKKβ and demanding biological process.demanding (IKK) ² andThe IkB kinase TBK1 kinases the IKK-related roles in innatehave essential activation ofimmunity through interferon regula NF-kB and of this study is to test whether innate immune response can regulate metabolism, specifi tory factors (IRFs). Carbam- tory factors 2,oyl-phosphate synthetase aspartate transcarbamoylase, deami dihydroorotatase (CAD) cally whether innate immune kinases can phosphorylate and modulate metabolic enzymes. Methods: Protein interaction and kinase phosphorylation were defined by biochemical assays, including co-immuno precipitation, in vitro kinase, tandem mass spectrometry analysis and mutation analysis. Innate immune response was characterized by real-time PCR and ELISA, whereas metabo ylation. ings place metabolic pathways 56

Development and Dysmorphol- through ensuring that contrib- of physical activities should clusion: Citalopram exposure ogy Data Management and uted datasets are findable, have strong consideration. in utero leads to an increased Integration Hub accessible, interoperable, and Further review of the topic is frequency of craniosynostosis reusable. FaceBase promotes suggested. both in WT and Twist1+/-mice. Authors: Thach-Vu Ho, Brid- multidisciplinary collaboration Our preliminary data suggest a get Samuels, Yuan Yuan, Carl and research in craniofacial combinatorial effect of genetic Kesselman, Robert Schuler, mutations and environment in development, molecular ge- Poster #69 Alejandro Bugacov, Cristina netics and genomics. the development of craniosyn- Williams, & Yang Chai Title: Pharmacological expo- ostosis. Faculty advisor: Yang Chai sure interplays with Twist1 Poster #68 mutations in exacerbating Background: The major goal craniosynostosis Poster #70 of the FaceBase Consortium Title: Impact of the COVID-19 is to advance research by pandemic on health and health Authors: Eloise Stanton, Yuan Title: Center for Dental, Oral creating a comprehensive behaviors Yuan, & Yang Chai & Craniofacial Tissue & Organ Regeneration (C-DOCTOR) repository of datasets on Faculty advisor: Yang Chai craniofacial development Authors: Khola Ahmed Khan & Chuong Thien Tran Author: Bridget Samuels and dysmorphologies, and Background: Craniosynos- on behalf of the C-DOCTOR disseminating these datasets Faculty advisors: Joyce Sumi tosis, the premature closure Consortium to the research community. & Mariela Padilla of calvarial sutures, leads to Purpose: The FaceBase3 debilitating neurologic dys- Faculty advisor: Yang Chai Data Management and Background: New regula- function through increased Integration Hub builds on tions were enforced during intracranial pressure. TWIST1 Background: The Center for the existing and successful the COVID-19 pandemic to mutation leads to Saeth- Dental, Oral, & Craniofacial scientific and technical team limit exposure and spread re-Chotzen syndrome, charac- Tissue & Organ Regeneration that has led the development, of the Coronavirus. Phys- terized by unilateral or bilateral (C-DOCTOR) is a public-pri- deployment, operation and ical distancing strategies coronal synostosis. A recent vate consortium focused on community engagement of the resulted in long-term home study showed that in utero ex- accelerating promising tissue FaceBase2 data hub. Looking confinement and isolation posure to a serotonin selective engineering/regenerative med- forward to the future impact for the majority population. reuptake inhibitor, citalopram, icine therapies for dental, oral, of the FaceBase Consor- A resultant of these mea- increases the incidence of cra- and craniofacial (DOC) tissue tium, we face major chal- sures impacted the behav- niosynostosis in mice coupled and organ regeneration to lenges that include (1) how iors affecting mental and with depletion of Gli1+ mes- human clinical trials. Purpose: to annotate large datasets physical health. Purpose: enchymal stem cells (MSCs), Our overall vision for C-DOC- to empower the biomedical To provide an insight about suggesting environmental risk TOR is to be a comprehensive research community; (2) how how the COVID-19 pandemic factors interplay with genetic national resource center for the to improve data integration affected mental and physical mutations in craniosynostosis clinical translation of innovative and facilitate data search health behaviors. Methods: etiology. Purpose: We would regenerative technologies to and retrieval from the hub; A topical literature search of like to determine how Twist1 replace DOC tissues or organs (3) how to use the data from published articles in Pubmed interacts with maternal usage lost to congenital disorders, FaceBase to design studies using keywords of COVID-19 of citalopram to disrupt cranial traumatic injuries, diseases, and otherwise inform our and lifestyle changes dated suture MSCs, leading to cra- and medical procedures. future research; and (4) how from the initial pandemic niosynostosis. Methods: Co- Methods: We have recruited to translate our knowledge lockdown of March 2020 horts of mice with or without in interdisciplinary teams with from animal model studies to to March 2021. Thirteen utero citalopram exposure (20 promising DOC regeneration improve human craniofacial articles were hand-selected mg/kg/day) were generated, therapies and developed the health. Methods: FaceBase individually by the authors including (1) wild-type (WT) comprehensive, customized provides innovative tools for as appropriate in addressing (n=14), (2) Twist1+/- (n=150), infrastructure through which the identification, retrieval, the focused topic. Physical (3) WT/citalopram (n=9), we provide these teams the display, curation, and analysis and mental health behaviors and (4) Twist1+/-/citalopram necessary clinical, scientific, of data on human and animal from the publications were (n=13). MicroCT analysis was technical, regulatory, financial, models of craniofacial devel- extracted and categorized performed on postnatal day business-oriented, and man- opment and disease. Results: by domains. Results: The (P)14 to examine the extent of agerial resources to facilitate FaceBase currently includes physical health behaviors calvarial suture fusion, since their IND/IDE-enabling activ- over 950 datasets from hu- related with COVID-19 were the coronal suture typically ities. Results: We direct the man, zebrafish, mouse, and more frequent noting de- completes fusion from P9-13 Center’s resources to advance chimpanzee. Alongside these creased hygiene habits, lack in Twist1+/- mice. Results: In technologies that optimally models, chick and xenopus of motivation for physical ac- utero exposure to citalopram in align with unmet clinical needs, data represent priorities. tivity, and nutritional changes. Twist1+/- mice led to increased market potential, anticipat- We are also expanding our The mental health behaviors aberrant suture fusion. No WT ed patient value, and high data repository to include included increased stress mice exhibited cranial suture probability of clinical adoption. morphological and functional levels, isolation and sleeping fusion. Untreated Twist1+/- We will continue to provide data on tooth development. patterns. Conclusion: Iden- mice had 70-80% suture fusion teams with fully customized Conclusion: FaceBase seeks tifying and understanding the penetrance. WT/citalopram support from expert scientists, to provide a comprehensive, pandemic impact on mental group showed 22.2% suture clinicians, commercialization trustworthy data repository and physical health can guide fusion. Importantly, Twist1+/- strategists and regulatory and educational resource on the design of strategies to mice with in utero exposure to advisors as the teams refine craniofacial development, improve health behaviors. citalopram had the highest rate their products, complete their Findings indicate promotion of suture fusion, 92%. Con- IND/IDE-enabling preclinical

The Explorer Journal 2021 Abstracts 57 ------

Findings

These studies include: These studies

: Each year, over Background: Each year, jectivity, and belonging. jectivity, Poster #74 timeline for tendon A Title: healing post-surgical repair using sonographic biomarkers & Takata Authors: Sandy C. Shawn C. Roll Faculty advisor: Shawn C. Roll 100,000 people experience a traumatic hand tendon injury that typically takes several months to fully heal. Current we lack precise measures ly, or methods to evaluate and individualize rehabilitation pro tocols for tendon repairs, lead ing to suboptimal outcomes. Musculoskeletal sonography is the ideal modality to evaluate and generate insights related related insights and generate of our to a reconceptualization of social and understandings connectedness for emotional will draw We autistic people. of ethnographic on a series phenomenolog and narrative with children and ical studies adults adolescents and young ASD and their with (AYA) that families to present findings counter prevailing assumptions enriched and provide a more of depiction of expressions this pop grief and empathy in ulation. Link Autism in Urban Context: and their families. include how: 1) grief expe riences comingle amongst family members; 2) children demon ASD with AYA and ing Heterogeneity with Health ing Heterogeneity with NIMH, and Service Disparities, NIH, (# R01 MH089474); Adult Collective Narratives; and Community Engagement. Data collected from clinicians will only be incorporated as it helps to situate the primary ASD data from people with strate empathy through actions and social communication; 3) parental understandings of social and emotional capaci ties are transformed; 4) grief experiences are layered over time and across developmen tal periods; and 5) grief and empathy interrelate. Findings will be contextualized within a discussion of contemporary intersub- theories of empathy, - - - - -

Although

& : Overall, infants Results: Participants SCIENCE THERAPY STUDENTS

DOCTORAL OCCUPATIONAL OCCUPATIONAL OCCUPATIONAL OCCUPATIONAL Poster #73 “Will you be okay?”: em Title: pathy and grief experiences Elisa Turnbull, Authors: David AlShalaan, Zack Apra, Linah Pinto, Patrick Harding, & Mary C. Lawlor Faculty advisor: Mary C. Lawlor There have been many misunderstandings and mis conceptions about the social and emotional capacities of ASD. people with there has been some recent attention to grief and empathy, ASD many descriptions of populations in research and educational literature convey a constrained, deficit driven, and inadequate portrayal of soci ality and emotional capacities. The purpose of this paper is to provide research findings across three studies that challenge current portrayals The CDC Milestone Checklist Milestone The CDC Armenian into was translated to assureand back-translated and cultural reliability, validity, Participants (n=98)relevance. from the ruralwere recruited Sisian and Kapan,villages of consented,Armenia. Once to com caregivers were asked plete the translated checklist fromand provided feedback an occupational therapist devel regarding their child’s opment. delayspresented with general andin cognitive and language Out ofcommunication areas. childrenthe 98 participants, 3 delaysdisplayed significant passed).(<50% of milestones Conclusion Armenia and children in rural displayed developmental trends similar to those of their U.S. peers. ------con- Methods: , a larger thickness FACULTY THERAPY SCIENCE & OCCUPATIONAL OCCUPATIONAL OCCUPATIONAL Poster #72 Investigating develop Title: tra occlusal veneers survived survived veneers tra occlusal both Cerasmart better than the control group groups and Failure modes were (p<0.05). with thin Cerasmart different the control show veneers and percentage of ing the highest failures (40% and reparable 46% respectively). In clusion did not of the same material Thick improve its resistance. best fatigue Celtra duo showed simple direct The survival rate. yielded composite restoration the highest rate of reparable failure. mental norms of infants and Armenia children in rural Allison Q. Phillips & Authors: Grace Baranek health ofThe Background: Armenia infants and children in by a variety has been affected of socioeconomic, environmen tal, educational, and behav ioral factors, displaying trends typical for both developed and developing countries. Prior independence Armenia’s to from the Soviet Union in 1991, children with disabilities were perceived as “defective” and kept hidden in the home. Due to the lasting shame and fear of stigmatization, develop mental disorders and disability are relatively new issues in Armenia. Low birth weight, young age of mothers, living in a rural area, and the presence of other sick children in the family have been identified as risk factors for developmental region of Tavush delay in the better To Armenia. Purpose: understand the development of infants and children living in the Arme southern regions of rural nia utilizing an adapted version Developmental of the CDC’s Milestone Checklist. Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------Conclu- cally treated molars Authors: Mayara dos Santos Noronha, Camila Heitor Cam Ahn Quynh Do, Marco pos, Aurélio de Carvalho, Marcelo Giannini, & Pascal Magne Faculty advisor: Pascal Magne Occlusal veneer (OV) resto rations can be indicated to restore endodontically-treated teeth (ETT) without removing unnecessary dental tissue. - Their resistance may be affect ed by the type of the material This study and thickness. aimed to evaluate the influ studies, transition to current to current transition studies, good laboratory/manufacturing scale-up, develop practices for protocols, form clinical study and strategic partnerships, of ahead the FDA interact with trials. Phase I clinical Poster #71 of occlusal ve- : Effect Title neers thickness of endodonti : C-DOCTOR is acceler- sion: C-DOCTOR of DOC ating the development and can regenerative medicine resource serve as a model for goals. centers with similar ence of thickness and type of CAD/CAM material on fatigue behavior and failure mode of Seven- with OV. restored ETT were used. ty-five (N=75) ETT After the endodontic treatment, teeth were restored with For the control Herculite XRV. group, no occlusal veneers were added. Experimental occlu- groups with two different sal reductions (thin 0.6-0.7 mm and thick 1.4-1.6 mm) were re stored with two materials (zir conia-reinforced lithium-silicate LS/Celtra Duo; and composite resin C/Cerasmart), result After ing in 5 groups (n=15). thermo-modified adhesive luting, the restorations were submitted to cyclic fatigue at a frequency of 5Hz, with a load starting at 200 N until 1800 The Kaplan Meier survival N. analysis was applied to the number of cycles data with a 95% level of significance (log rank test for post-hoc pairwise comparisons). No differences were found between thick nesses of the same CAD/CAM Thick Cel- material (p>0.001). 58

tendon healing with precision an RCT of a physical activity Faculty advisor: Shawn C. Poster #77 in real-time, ensuring a suc- app intervention, Moving Up Roll cessful, efficient recovery. Pur- (MU), for older adults during Title: Associations between pose: To develop a timeline for COVID-19; 2) Describe study Background: Recent physical child sensory reactivity pat- tendon healing after surgical participation following adapta- rehabilitation and hand therapy terns and caregiver respon- repair that can be monitored tions. Methods: The Moving literature has advocated for siveness using sonography. Methods: Up Study is a Multiphase Op- a more holistic and collabo- An extensive literature review timization Strategy RCT of the rative approach to treatment Authors: Emily Campi, John was conducted in PubMed and MU app for underactive older planning and patient care. Sideris, Alicia McConnell CINAHL around three main adults. Original study methods Although patient factors and Hatch, Ashley Masuda, Eliza- areas: 1) The tendon heal- comprised in-person group therapeutic approaches have beth Crais, Linda R. Watson, & ing process, 2) sonographic sessions at community venues been identified as crucial Grace T. Baranek biomarkers associated with for testing (questionnaires, elements, the therapist-patient Faculty advisor: Grace T. tendon injury, healing, and walk test, activity monitor relationship itself has not been Baranek recovery, and 3) the sensitivity application) and orientation widely researched. Purpose: To explore the perspectives of and reliability of these bio- (app setup, didactic presenta- Background: Caregiver therapists working at an outpa- markers for tendons. Results: tion, video tutorial). The study responsiveness (CR) predicts tient hand therapy clinic with We developed a detailed halted in-person activities fol- outcomes for children with the goal of identifying factors timeline of the tendon healing lowing COVID mandates, and and at elevated likelihood within this relationship that process that includes: 1) The resumed after protocol chang- for autism spectrum disorder impact the provision of holistic initial phase of healing imme- es, staff training, and adminis- (ASD). Children’s sensory and collaborative services. diately after surgery, 2) The trative approvals. Results: Key and communicative behav- Specifically, we examine the intermediate phase of healing adaptations facilitated project iors influence CR. Caregivers interaction between thera- when outpatient rehabilitation restart including: re-screening talk less and use more play pist and patient roles within is typically received, and 3) previously eligible individuals; actions when children demon- the therapeutic and greater The long-term phase of heal- administering eConsents and strate sensory hyporeactivity medical environment, including ing that occurs several months e-questionnaires via RED- and limited communication. balances of power and barriers after surgery. During the Cap; mailing activity monitors There is limited research on or facilitators to therapeutic healing and recovery process, with detailed instructions; CR to children’s sensory re- engagement. Methods: Princi- six sonographic biomarkers conducting orientations via activity (SR) cues and factors ples of grounded theory were were identified: echogenicity, Zoom screen share and that influence that respon- used to analyze data gathered edema, hypervascularization; remote control features; and siveness. Purpose: Examine in 2016 through thirteen group tendon excursion, thinning, adding posttest questions on associations between infant interviews with four occupa- and gapping. Furthermore, COVID-related activity chang- SR and CR to SR cues. tional therapists working in a most of these biomarkers es and app relevance. The Methods: Participants were hospital-based outpatient hand were reliable and sensitive to primary recruitment source a community sample (n=63) therapy clinic. Results: Analy- change. Conclusion: Using pre-/post-COVID was emailing of 11-16-month-olds (M=13 sis of this data is ongoing, and this information, we can begin senior organization members. months; 63.5% elevated likeli- several themes have emerged to establish a reliable and Enrollment grew post-COVID hood for ASD [EL-ASD]; 68% thus far. The therapist-patient sensitive sonographic proto- (47% vs 65%). Participants male; 87% White) and their relationship is intimate and col to evaluate post-surgical pre- vs post-COVID onset caregivers (68% mothers; dynamic, extending beyond tendon healing with precision were slightly older (72.9±4.9 70% with at least a college education and application of and across time. We hope that vs 69.9±10.8y) and more likely degree). SR patterns were physical intervention. Sur- our research can help sup- to be female (81% vs 64%). measured via the Sensory prisingly, power within this port clinical decision-making The proportion of Whites and Processing Assessment, a relationship seems to be more to individualize care, thereby Asians rose (49% vs 72%; 5% semi-structured observational fluid than anticipated, often optimizing outcomes for this vs 20%); proportion of Blacks tool. CR was measured with impacted by patient prefer- population. markedly decreased (46% vs a behavioral rating scheme ence and personal contexts. 8%). Conclusion: The Moving (1, unresponsive-7, highly Additionally, engagement in Up study was successfully responsive) during caregiv- the therapeutic process is adapted for remote implemen- er-child interaction in four dai- Poster #75 co-constructed through this tation as older adults complet- ly routines. CR scores across relationship rather than being Title: Adaptating an ongo- ed electronic forms, managed all routines were averaged an isolated patient experience. ing clinical trial amidst the activity monitors, and learned to compute a mean score. Therapists’ ability to navigate COVID-19 pandemic a smartphone app. Opportuni- Hierarchical linear regression the flow of this relationship and ties for more inclusive tech- was performed to analyze the the emotional states within Authors: Stacey Schepens nology-based studies for older associations between SR and seems to be crucial to facilitat- Niemiec, Rafael Wagas, people should be explored. CR. Results: The EL-ASD ing adherence. Conclusion: Jeanine Blanchard, Matthew group differed from controls Further investigation into the Niemiec, & Alana Schoenhals on hyporeactivity, seeking, dynamic and complex ele- and CR (p<.05). Interactions Poster #76 ments of this relationship may Faculty advisor: Stacy between risk group and SR better inform strategies aimed Schepens Niemiec Title: An exploration of ther- and differences in correla- at promoting collaborative care apist-patient relationships in tions across risk groups were Background: The COVID-19 and ultimately facilitating ad- hand therapy non-significant. Hyporeactivity pandemic has disrupted ongo- herence and successful patient was negatively associated ing clinical trials, requiring rap- Authors: Katherine J. Loomis, outcomes. id changes to study protocols. with CR. Conclusion: The Mark E. Hardison, & Shawn association between hypore- Purpose: 1) Describe dynamic C. Roll adaptations made to resume activity and CR may be due

The Explorer Journal 2021 Abstracts 59 ------Purpose:

gories in each. A preliminary A gories in each. for dental average COSI score Conclu- scaling tasks is 7.8. have developed a sion: We valid method for examining dental physical exposure in hygiene work, with preliminary analyses indicating moderate risk of injury. gories for hand scaling as light, hand scaling as light, gories for and heavy with moderate, ratings of 2.3, average exertion on a Borg scale. 3.2, and 4.2 angles were categorized Wrist (0°- as flexion (<0°), neutral (>30°). 30°), and extension for The final RSI modifiers were, 3.0, exertion and angles 1.0, and 4.0, and 5.5, and 1.2, cate 1.1 respectively across ing capacities of infants were behaviorally coded for duration and responsiveness of moth ers was rated during two min utes of mother-infant play at 2, 6, 9, 12 and 18 months. Latent growth curve models obtained looking capacity trajecto ysis of 5 videos to identify a to identify 5 videos ysis of Index (COSI) Strain Composite : video. Results score for each 3 exertion cate identified We Poster #81 Developmental trajecto Title: aimed to a) model devel We opmental trajectories of the looked amount of time infants’ at their mother or objects the mothers were holding from 2 to 18 months of age and b) determine the extent maternal responsiveness at 2 months predicts development of look community A ing. Methods: sample of 56 infant-mother dyads were recruited. Look ries of infant looking capacities during maternal-infant co-oc cupation Authors: Cristin M. Holland, John Sideris, Pat Levitt, Bar- T. Thompson, & Grace bara L. Baranek T. Faculty advisor: Grace Baranek Background: Infant looking capacities, which undergo are rapid shifts in the first year, important to social interactions, but limited research exists that considers longitudinal develop these capacities during ment of co-occupations between care givers and infants. - - - -

: Parents

Despite the over Despite the

Dentists discussed their Dentists discussed

lap in dentist and parent iden lap in dentist and supports, tified barriers experience and knowledge; knowledge; and experience of dental outcomes and (6) techniques. also differed. perceptions the role Parents emphasized members and of other family dental difficulty accessing care. and subjective experiences dental the influence of the environment on treatment tolerance. Conclusion Promoting hands-on-learning, mentorship, and communities and of practice among general likely to pediatric dentists, is and expand treatment access quality for CSHCNs. in the were eager to participate a need dental team but cited for more education and for dentists with experience and knowledge to treat children with DS. Poster #80 Developing a method Title: to measure strain in dental hygiene work Fang, Kryzto- Yiyang Authors: & Shawn C. Roll Tung, pher D. Faculty advisor: Shawn C. Roll is no cur- There Background: rent method to easily measure physical strain to the hand The in dental hygiene work. Revised Strain Index (RSI) is a commonly used tool that may be useful to examine the risk of work-related injury of dental - The pur hygienists. Purpose: pose of this study is to modify the RSI to validly measure exposure risk in dental hygiene practitioners. Methods: We conducted 36 live and video observations of dental hygiene patient visits and obtained self-reported ratings of exer tion during scaling tasks on a Borg CR-10 scale. Using software, we Observer XT identified patterns of scaling and validated the categories with a group of dental hygiene Through an iterative experts. process, we tested exertions and wrist postures to identify the RSI multipliers that were the most valid representation have of physical strain. We conducted a preliminary anal - : - -

Methods:

treating children with

DS were conducted to explore perceptions of oral care barriers and supports. Descrip tive and thematic analysis, informed by grounded theory, was performed for each group. Results: Six overlapping themes emerged from the two groups: (1) characteristics of the dental team; (2) treatment barriers/facilitators related to child-specific qualities; (3) family and dentist flexibility; (4) the need for a positive, patient-centered environment; CSHCN-specific (5) dentists’ ties in dental care persist. For example, many parents of children with Down Syndrome (DS) report difficulty finding and accessing dental care for their child. Purpose: Examine barriers and supports for the provision of dental care, as reported by parents of children with DS and dentists treating children with DS. Focus groups or interviews of and of dentists parents (n=11) ( n=9) Poster #79 Dental care for children Title: with down syndrome: multiple perspectives Authors: Elizabeth Isralowitz, Melissa Marinthea Richter, & Martinez, Leah Stein Duker, Sharon Cermak Faculty advisor: Sharon Cermak Background: Despite state and national initiatives to promote care for children with special healthcare needs (CSHCN), significant dispari like to learn additional ways ways learn additional like to oral child’s their to improve online being the health, with method of delivery preferred Conclusions (65.3%; n=66). caregivers African-American additional op report seeking to obtain knowledge portunities oral to improve their child’s that health. Research shows literacy improved oral health can lead to better outcomes, oral health including improved Thus, attitudes and behaviors. tailored oral health education online may programs provided mitigate be an opportunity to Afri- for oral health disparities can-American families. Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------

: Nearly Nearly Results: Methods: Data were ber of participants (87.5%; n=91) reported they would part of a larger mixed-methods study to determine barriers and facilitators to oral care for A African-American children. culturally-tailored survey examining oral health-related knowl 70% of respondents reported previously trying to find infor tors known to impact health outcomes, including required frequency of preventative visits and comprehensiveness of patient-provider communi identify To cations. Purpose: African-American care how givers prefer to receive oral health information for their children. edge, attitudes, and practices was completed electronically African-American caregiv by ers with children aged 4-14 (n=104). years mation to improve their child’s oral health; of these, the most frequent sources included: the internet (51.4%; n=37), dental practitioners (45.8%; n=33), friends/family (22.2%; n=16), and other health professionals (i.e., pediatricians) (12.5%; An overwhelming num n=9). Poster #78 oral Caregiver-reported Title: for health education needs african-american children Authors: Dominique H. Como, I. Lucía I. Floríndez, Leah A. & Sharon Stein Duker, Cermak A. Faculty advisor: Sharon Cermak Background: Children from medically underserved or minority populations, such African-Americans, expe as rience significant oral health disparities. Some healthcare providers have reported that African-American parents exhibit limited knowledge about oral health risk fac ation with hyporeactivity after hyporeactivity after ation with of seeking could the addition of a shared effect be due to hypo seeking behaviors and reactivity on CR. to caregivers having difficulty difficulty having to caregivers to and responding noticing presents which hyporeactivity, than other SR more subtly loss of associ The patterns. 60

ries and determined if these of uncertainty and fear, and 4 closed-ended questions, 6 models were used to adjust were predicted by maternal as their illnesses progressed, open-ended questions, and the clustering of data. Results: responsiveness at 2 months. they were unable to continue 13 statements on a 5-point Among all students, PCS Results: Person looking model fulfilling their roles as they Likert scale. Content includes remained the same across indicated an intercept of 9.83 always had. Occupational parent coaching, information time while MCS significantly seconds (p<0.01) and a slope therapy’s main role was to distribution, and overall experi- decreased (p<0.05). Within the of -0.02 seconds (p=0.52). facilitate quality of life through ence. These domains capture DH students, PCS increased Object-looking model had an occupational engagement, the caregiver perspective over time, and MCS decreased intercept of 86.25 seconds focusing on participation rather regarding study processes, (both p<0.01), while PCS and (p<0.01) and a slope of -1.46 than performance. Conclu- acceptability and feasibility. MCS remained similar across seconds (p<0.001). Respon- sion: Understanding the Results: Descriptive statistics time in the OT students. Among siveness trended toward unique needs of patients who and qualitative themes will be both groups, the average time prediction of person looking are dying will allow occupation- presented. Preliminary data spent in sports, fitness, social, intercept (b=1.18, p=0.08), but al therapists to provide better indicate caregivers strongly and work/volunteer activities was not associated with either client-centered care. Clearly agreed that the examiner gave decreased across time (p<0.05). slope (person or object) or defining occupational therapy’s clear directions, somewhat DH students participated in object intercept. Conclusion: role may encourage greater in- agreed that emails were easy fewer social activities than OT Person looking remains stable, terest in this practice area and to follow, and endorsed an students (p<0.001). Starting to while object looking decreases may contribute to improved overall positive experience. participate in work/volunteer across 2 to 18 months. During advocacy for the profession in Conclusion: The shift to activities was associated with co-occupation at 2 months, end of life care. remote assessments in the a decrease in PCS and an mothers with higher respon- research context has been fea- increase in MCS (both p<0.05). siveness had infants who sible. Understanding caregiver Conclusion: The deterioration looked at them more. Care- Poster #83 experience for quality improve- of mental health in DHS along giver responsiveness should ment can inform processes their academic years warrants be considered when aiming Title: Evaluating parent expe- of future studies that utilize attention. Engaging in work/ to promote infants’ looking at riences with research using telehealth approaches for child volunteer activities improved caregivers during play in early remote child assessments assessment. students’ mental health though infancy. impeded physical health. Authors: Daniela R. Valle, Allison Q. Phillips, & Grace T. Poster #84 Poster #82 Baranek Poster #85 Title: Extracurricular activity Title: End of life care and Faculty advisor: Grace T. impacts dental hygiene and Title: Feasibility of psycho- occupational therapy Baranek occupational therapy students’ physiological measure of health parental stress in the NICU Authors: Nina Wakayama, & Background: Telehealth Stacey Schepens Niemiec programs were created and Authors: Buwen Yao, Sandy Authors: Marinthea Richter, experimented with in response C. Takata, & Shawn C. Roll Leah Stein Duker, Jenny Faculty advisor: Stacey to the pandemic (Taddei & Kwon, & Bobbi Pineda Schepens Niemiec Bulgheroni, 2020), and remote Faculty advisor: Shawn C. methods of assessments show Roll Faculty advisor: Bobbi Background: Although oc- preliminary feasibility (Talbott Pineda cupational therapy services et al., 2019). Research, such Background: Participation in are available in end of life as our lab’s Longitudinal Study certain extracurricular activi- Background: Preterm birth care, these services are often of Development of Social ties can help college students and admission to a neonatal underutilized. Purpose: The Communication and Sensory adjust to university life; howev- intensive care unit (NICU) has purpose of this review was to Regulation in Infants and Tod- er, the impact of participation been linked to parental stress, explore the needs of patients dlers (SASI) adapted the origin extracurricular activities on which impacts parent-infant receiving end of life care, inal in-person study protocol health after this initial transition interaction and parental roles. as well as the role of occu- and processes to a telehealth remains unknown. Purpose: Electrodermal activity (EDA) pational therapy in meeting format in order to comply with To model extracurricular activity is a non-invasive measure of patients’ needs in this context. COVID-19 restrictions. The participation relative to physical activation of the sympathetic Methods: A literature review remote format increased the and mental health among dental “fight or flight” nervous system, of peer-reviewed journal expectations and demands hygiene (DH) and occupational which increases due to stress. articles was conducted using of caregivers compared to therapy (OT) students. Meth- EDA has not previously been PubMed and Google Schol- that of the in-person version, ods: Data was collected from used to understand the stress ar and by hand-searching where researchers conducted 85 DH students and 51 OT parents experience when inter- reference lists from January child assessments. Purpose: students at the beginning of acting with their infants in the 18, 2021 to March 26, 2021. The purpose of this investiga- their program and at the end of NICU. Purpose: To examine Sample search terms included tion was to develop a Parent the first and second academic the acceptability and feasibility “needs,” “role,” and “end of Feedback Survey to collect years. Students reported the of using wearable sensors to life.” Results: Twelve studies, data about caregiver experi- total hours of participation over describe the stress of parents publication dates ranging from ences with the remote format the past six months across 62 in the NICU while providing 2000 to 2020, were identified of SASI and to inform quality activities within eight categories. sensory experiences to their as relevant. At the end of life, improvement to better serve Physical and mental health infants. Methods: A prospec- people’s greatest needs fell families during the research was measured by SF-36, as a tive observational study with into two primary categories: experience. Methods: The Physical Component Summary seventeen parent-infant dyads emotional and relational. They Parent Feedback Survey is (PCS) and Mental Component (born <32 weeks gestation) needed to cope with feelings a brief, 5-minute survey with Summary (MCS). Mixed-effect took place in a level IV NICU.

The Explorer Journal 2021 Abstracts 61 ------: - - - - Pur-

: Initial IA Results: Initial IA Methods: Students

ary view of how infants engage with their caregivers. givers) and clarify coding crite secutive weeks. Conclusion Coders reported a newfound understanding of ways infants communicate as well as how determinedbe can intentionality even in young infants, support ing a broadened, interdisciplin T. Faculty advisor: Grace Baranek Background: Clinical Global Impressions (CGI) is a 2-item scale developed in psychiatry that efficiently captures clinician impressions of symptom sever nication. videocoded behaviors from recordings of caregiver-child snack, interactions during play, They and clean-up activities. to codewere considered ready ≥independently after reaching .70 inter-observer agreement by a(IA) with master codes speech-language pathologist. Coders met weekly to discuss coding disagreements and questions. across five weeks was low (M=.55). Feedback at this stage aimed to solidify understanding of intentionality (i.e., evidence of directedness towards care ria. Re-coding led to improved (M=.66). In the second IA training phase lasting three M=.64), feedback weeks (IA emphasized coding conser vatively (e.g., requiring strong evidence of directedness) and confirming each code with the manual. Re-coding led to great ≥ .70 (M=.75). IA ly improved IA on codes before feedback was then achieved across two con Poster #89 Considering clinical Title: global impressions for pediatric occupational therapy Authors: Elizabeth M. Phelps, T. Emily Sopkin, & Grace Baranek Such cross-training can pushSuch cross-training therapy studentsoccupational comfort zonesbeyond their their perspectivesand expand receive formalas they rarely this domain. training in codeapy students to reliably intentional commu infants’ : We present the process present the pose: We ther of training occupational

------: By adapt- Poster #88 Interdisciplinary training Title: to reliably code intentional communication in caregiv er-child interactions Authors: Elizabeth Choi, Cristin Holland, Elizabeth M. Phelps, Chloe Rey-Talley, Stephen Morrison, Linda R. Baranek T. & Grace Watson, T. Faculty advisor: Grace Baranek Background: Interdisci- plinary research promotes integrating knowledge across domains, enhancing the study of complex phenomena. For example, examining infants’ communication skills (an area of focus in speech-language pathology) can provide addi tional insight into the study of caregiver-infant engagement in daily routines (an area of focus in occupational therapy). self-efficacy, and decreases decreases and self-efficacy, barriers. patient reported this The purpose of Purpose: is to adapt the research study toolkit for women’s AASPIRE access/utilization healthcare it at Rancho and implement Rehabil Amigos National Los Methods: (1) itation Center. of will compare frequency We cancer screenings women’s autistic and STI testing among recom patients vs. national mendations, using electronic will (2) We health record data. conduct qualitative interviews to iden with autistic women to tify barriers and facilitators healthcare access. women’s with will collaborate (3) We autistic and healthcare provid er stakeholders to adapt the Toolkit AASPIRE Healthcare healthcare navi for women’s will pilot test the gation. (4) We toolkit at Rancho, measuring implementation outcomes of adoption, and acceptability, Results: N/A sustainability. are starting phases 1-2 (We using current funding and will then seek funding for phases 3-4.) Conclusion ing and implementing an evidence-based healthcare toolkit, this project will improve healthcare access women’s and utilization, and thus health outcomes, for autistic women. ------Conclu-

: To date, 94 To Results: : Autistic females Background: ied, underserved group. Autis- ied, underserved group. tic women may face disparities healthcare access in women’s and utilization compared to This is the general population. particularly alarming because autistic women may be at increased risk for numerous health conditions, women’s including ovarian and breast and sexually trans cancer, The mitted infections (STIs). Autism Spectrum Academic Partnership in Research and Education (AASPIRE) created an evidence-based healthcare toolkit to improve primary care navigation for autistic adults. The toolkit has strong content improves healthcare validity, Poster #87 Healthcare toolkit to Title: healthcare improve women’s utilization for autistic women Helen Authors: Shona Maher, Angell Amber & Tran, Angell Amber Faculty advisor: are identified as an understud vantages to continuing remote study procedures including the ability to reach participants over a wider geographical area and greater ease of scheduling digital appointments relative to in-person ones. along with 14 days of intensivealong with data collection us longitudinal continuous glucoseing blinded (CGM), ecologicalmonitoring assessment (EMA)momentary cognitive tasks,surveys and All study and accelerometers. procedures are conducted remotely. inparticipants have enrolled Nearly the FEEL-T1D study. concurrent80% have provided CGM, EMA, and accelerometer the 14data for at least 10 of anddays of data collection, surveys nearly 90% of EMA withhave been completed, minimal missing data. sion: Overall, our reconfigura protocoltion of the FEEL-T1D to be fully remote has been a success. Without transitioning to remote procedures, con ducting the study during the COVID-19 era would not have been possible. Even when in-person research becomes possible, there are several ad Herman Ostrow School of Dentistry USC School of of Ostrow Herman ------Con-

: Adults Methods: : To present To Purpose: : The use of wearableThe : Background: While short- iological response to possibly stressful encounters, with 82% of parents experiencing a stressful disruption during the parent-infant interaction. clusion sensors during parent-in EDA ual rise throughout intervention, toor (3) plateau from baseline data Additionally, intervention. evidenced a clear psychophys fant sensory interaction is feasible in the NICU. ning of intervention, followed byning of intervention, (2) grad a decrease or plateau; patica E4 wristband to recordpatica E4 stress be psychophysiological and after engagingfore, during sensory experi in a 10-minute : their infant. Results ence with reported the use ofAll parents accept wireless sensors to be EDA, 12fants; of the collected usable.recordings (71%) were of EDA Three distinct patterns (1)responses were identified: at begin temporary increase able in the NICU environment their in while engaging with ships are poorly understood. The Function and Emotion T1D in Everyday Life with (FEEL-T1D) study focuses on investigating these short-term dynamic relationships among BG, function, and emotional T1D. well-being in adults with The COVID-19 pandemic forced reconfiguration of the FEEL-T1D protocol to be fully remote. the FEEL-T1D study design, methods, and study progress to date, including adaptations necessitated by the COVID-19 pandemic. T1D complete a 18-75 with comprehensive survey battery, term blood glucose (BG) levels and variability are thought to underlie diminished function and emotional well-being in T1D, these relation people with Poster #86 Function and emotion Title: in everyday life with type 1 diabetes Authors: Loree Pham, Raymond Hernandez, Khatira Mehdiyeva, & Elizabeth Pyatak Faculty advisor: Elizabeth Pyatak Parents wore the wireless Em Parents wore 62

ity and degree of improvement. Faculty advisor: Sharon A. Poster #91 Poster #92 Given its brevity and sensitivity Cermak to change, a CGI scale could Title: Occupational science in Title: Optimizing inclusivity and be useful in occupational thera- Background: The COVID-19 community participation for occupational therapy practice: py (OT) practice and research, pandemic has caused abrupt an exploratory qualitative study people with autism but currently none are used. changes in the lives of many. Purpose: To understand the One specific group who has Authors: Nicole Yoon, & Tessa Authors: Kelly Chang, development and use of CGI experienced many changes is Milman Mariamme Ibrahim, Linah scales, and to draw conclusions college students, as a result of AlShalaan, Zack Pinto, Erna about possible applications disrupted living environments, Faculty advisor: Tessa Mil- Blanche, Mary C. Lawlor, & in pediatric OT for assessing limited social supports, and man Emily Ochi sensory processing. Methods: shifts in educational experienc- Faculty advisors: Mary C. A preliminary literature search es. These types of changes With occupational science be- Lawlor & Emily Ochi was conducted in PubMed of pattern in daily occupations ing acknowledged as providing and occupational balance the “essential foundations of and Google Scholar using the Despite increasing pressure to have been shown to be closely occupational curricula”, it has following search terms: pediat- ensure that all Autistic people related to both physical and been established that a focus rics, clinical global impression, have opportunities to freely emotional well-being (Wagman on occupational science has development or creation, ben- engage in communities and & Hakansson, 2014). Pur- provided a more theoretical efits or support, use or imple- participate in desired activi- pose: This study examines the and innovative understand- mentation or adoption, and/or ties, there continues to be a relationship between college ing to occupational therapy history. To date, we reviewed significant gap between current students’ occupational balance practice (WFOT, 2012). In her 11 publications; target is 20. forms and extent of engage- and satisfaction with partici- editorial letter, Dr. Laliberte Results: We found that CGI ment and optimal engagement pation in activities during the Rudman (2015) discusses scales were used in a variety of in inclusive communities. COVID-19 pandemic, and the how occupational science settings with diverse popula- Although there are many inter- effects on perceived psycholog- and occupational therapy can tions. Several diagnosis-spe- woven contributors to this un- ical well-being as manifested intersect and inform each other cific CGIs (i.e. CGI-Angelman acceptable gap, we believe the by depression, anxiety, fatigue, to “advance knowledge and Syndrome) were developed. capacity of people and commu- and stress. Methods: Partic- practice relevant to occupation, Intervention studies often used nities to flexibly provide devel- ipants were 152 undergrad- participation, and health”. This Severity scores as inclusion opmental, learning, and social uates (37 male, 109 female, intersectionality provides a rich- criteria, and Improvement scaffolds to facilitate optimal 4 non-binary, 1 transgender, er understanding of occupation, scores as outcome measures. experiences in natural environ- 1 gender-fluid), ages 18-25, helps occupational therapists In practice, diagnosis-specific ments, is a major and remedi- who were recruited through understand people’s subjective scales offer clinical presenta- able impediment. Throughout social media and Research experiences, and addresses tion descriptions for assigning the literature, researchers use Match, registry. Participants population, participation, and CGI ratings. These scaffolded inconsistent criteria to define completed an online survey health needs at an individual clinical reasoning and guided community participation for about their well-being during and societal level furthering clinicians to consider multi- autistic individuals (Simplican, COVID-19. Instruments includ- the reach of occupational ple domains of the client’s Leader, Kosciulek, & Leahy, ed the Occupational Balance therapy (WFOT, 2012). Using a condition to inform an overall 2015). Notably, given the social Questionnaire-11 (OBQ-11), narrative inquiry methodology, judgement of symptom severity. nature of community settings, General Anxiety Disorder we aim to interview occupa- Conclusion: Its versatility and the construct of social engage- (GAD-7), PROMIS Depression tional therapists to explore how ease of use indicate the CGI ment as a critical component to Short-Form-6a, Perceived they have used occupational would be a good fit for OT successful community partic- Stress Scale-10 (PSS-10), and science in their practice. We clinical and research settings. ipation for autistic individuals PROMIS Fatigue Short-Form- would like to understand how Current pediatric assessments has been remarkedly under- 6a. Occupational balance and it contributes, if at all, to their for sensory processing are theorized. Moreover, a limited self-ratings of psychological clinical reasoning and connec- time-consuming and rely heavi- understanding of the facilita- well-being were examined tion with clients in practice and ly on parent-report. A CGI scale tors and barriers to community using Spearman’s rank cor- through the analysis, identify specific to sensory processing participation may contribute relation. Results: The OBQ-11 recurring occupational science could be used to comprehen- to the lack of literature related (p<.01) and measures of per- concepts surrounding their sively yet concisely document to the effective implementa- ceived psychological well-being experiences. We hope that the gestalt client performance at tion of interventions designed were significantly correlated preliminary analysis will yield both evaluation and throughout to improve community par- (p<.01). Time use and activity the impact, if any, a background intervention. ticipation outcomes for this participation satisfaction are in occupational science has population. This paper aims to strongly associated with less had on their overall roles as expand the conceptualization anxiety, r=-.465; depression, occupational therapists. The of community participation for Poster #90 r=-.465; stress, r= -.525, and understanding and implications autistic individuals by drawing fatigue, r=-.529. Conclusion: of these narrative experiences Title: Occupational balance on several narrative phenom- This study demonstrates that can acknowledge the growing of college students during a enological and ethnographic occupational balance and value of occupational science pandemic research studies to explore the participation during COVID-19 theory to occupational therapy varied forms in which autistic may protect against negative in order to support develop- Authors: Nikki T. Nguyen, individuals participate in their psychological health outcomes ments, both domestic and Maggie Young, Valerie Tapia, communities. Data exemplars and may be a successful way international, in education and Kelly Deng, Elizabeth Is- from research with autistic in- to treat symptoms of anxiety in practice. ralowitz, Dominique H. Como, dividuals, family members, and and depression. Melissa Martinez, & Sharon A. clinicians and providers will be Cermak provided. Examples highlight

The Explorer Journal 2021 Abstracts - 63 - - -

- -

In research and

ing autism. media, “high-functioning” has been typically used to de scribe individuals with higher IQ; milder cognitive, social, and behavioral symptoms; and strengths in language, These (Alvarez, et al., 2019). characteristics do not neces our system of care has left the has left of care our system autistic children with parents of that their odds the impression the lottery are better of winning quality ser than of finding Poster #96 of The damaging effects Title: on subjective categorizations autistic individuals Authors: Kelly Chang, Mary Emily Ochi, & David C. Lawlor, Turnbull Faculty advisor: Mary C. Lawlor & Emily Ochi Over time, categorizations to have emerged in an effort better understand individuals with autism; a task made more complex by the heterogeneity - the sub of autism. However, jective and restrictive nature of these terms, namely the subgroups of “high-functioning” and “low-functioning,” can be detrimental to understand sarily correlate with long-term success (Magiati, et al., 2014). Therefore, the use of these simplistic terms can limit the resources and opportunities of vices or support in adulthood. in adulthood. vices or support services should not Adequate Scholars require a miracle. must do more to investigate and implement the support desired by autistic adults. fered and be overall damaging to autistic individuals and lead to misunderstandings related to strengths and capacities as well as needed supports Although there and scaffolds. is a need and call to come up with better and more inclusive language to encompass all autistic individuals and their experiences, solutions have draw from been elusive. We narrative phenomenological and ethnographic data to identify themes that problema tize the use of these catego- The collective narratives ries. from parents and caregivers demonstrate that 1) categories

- - - : - - - USC ed risk in a large community community in a large ed risk four subgroups sample, with and in demographics differing outcomes. later developmental the importance These indicate assessments in of dimensional of early parsing heterogeneity and the need ASD risk profiles for better tailored interventions. Poster #95 Supports for autistic Title: perspectives adults: mothers’ on insufficient services & Turnbull, Authors: David Mary Lawlor Faculty advisor: Mary Lawlor Background: Health and quality of life outcomes for autistic adults have remained remarkably poor despite growth in research and service spending. Few services exist for autistic adults; those that do are often unaligned with priorities of the autistic com sought Purpose: We munity. to enhance the understand ing of the lived experience of autistic adolescents and Barriers young adults (AYA). and facilitators to community engagement and participa tion were identified through a series of narrative phenom enological and ethnographic Autistic studies. Methods: individuals, family members, and clinicians participated in semi-structured narrative interviews and “Collective Nar rative” group-based interviews on topics related to community. Data was transcribed verba tim and coded thematically. of informants, Triangulation methods, and researchers Examples from enhance rigor. interviews of parents of autistic will be given to represent AYA themes related to service Results: Families availability. in our sample were universally unsatisfied with services and Par- AYA. support for autistic ents expressed anxiety about the future and had little hope for current systems of care. When asked to think about a program that could support their child, parents would often start their answer with, “if I won or “If God granted the lottery,” me a miracle.” Conclusion The experience of navigating ------

: These findings : Poster #94 Profiles of early au Title: cation, sensory reactivity and Assessing motor coordination. the early risk manifestations in these domains is critical to ASD heterogeneity. parsing aimed to This study Purpose: identify homogeneous profiles based on the three domain Inven- Years scores of the First tory (FYI) – Social Communi cation (SC), Sensory-Regula mentorship program to DSP at to DSP program mentorship planning to launchUSC and are this Fall. Furtherthe program needed to measureresearch is of the programthe effectiveness once implemented. tism-related behavioral age-3 markers and associated outcomes Chen, John Yun-Ju Authors: Eliza- Sideris, Linda Watson, Baranek beth Crais, & Grace Faculty advisor: Grace Baranek Autism spectrum Background: disorder (ASD) is a complex condition that encompasses difficulties in social communi tory Functions (SR), and Motor Development (MD), as well as their associations with age-3 com- A outcomes. Methods: munity sample of 6,386 par ents completed the FYI when their child aged 6-16 months, and 2,215 of them completed surveys about their child’s developmental outcomes two Latent profile anal years later. ysis was performed to identify the FYI profiles. Demographics and age-3 outcomes were compared across the profiles and equivalence ANOVA with tests for odds ratios. Results: The best‐fitting model was a four-profile solution. Profile-1 (84.5%) had the lowest risk levels across all domains. Profile-2 (10.8%) and Profile-3 (1.5%) scored high on SC and MD, while Profile-3 showed higher overall risk. Profile-4 (3.2%) scored particularly high on SR. Children in Profile-3 and 4 were more likely to have ASD or a later outcome of sensory processing disorder. Conclusion revealed heterogeneous man ASD-relat- ifestations of early Herman Ostrow School of Dentistry School of of Ostrow Herman ------:

Conclusions cy, adaptive skills, navigation of cy, system, and emotionalthe DSP successful mentor A regulation. ship program needs sufficient mentor training, appropriate mentor-mentee matching, and plans for consistency, sustainability. ed higher needs of self-advoca tered with DSP. After conducting tered with DSP. our literature analysis and stake holder interviews, we created a proposal for a peer mentorship program called Balancing L.I.F.E (Learning, Independence, Friendship, Empowerment) to DSP. be housed through USC’s Through our research,Results: we discovered the needs of college students with disabilities and the needs of a successful mentorship program. College students with disabilities report Poster #93 role in building OT’s Title: a peer mentorship program Services & through Disabilities Programs Authors: Nora Dixon & Beth ized nature of participation for of participation for ized nature while illustrating this population shape identi how experiences learning. ty and social rese Padini Jalaba Tracy Faculty advisor: - Background: Student men collegestorship is common in to promote student wellness, but there is limited research on a mentorship model in which both mentors and mentees are students with disabilities (SWD). The purpose of this poster is to propose a peer mentorship model for college students with disabilities in order to promote life balance and self-efficacy. conducted aMethods: We literature review to assess the needs of college students with disabilities and analyze best practices for mentorship mod vices & Programs (DSP), one supervisor of a peer mentorship program, and one student regis the complexity and personal the complexity els. Additionally, we interviewed Additionally, els. four stakeholders--two repre sentatives from Disabilities Ser By utilizing the criteria for a successful mentorship program, it is our hope that the needs of college students with disabilities proposed ourwill be met. We 64

do not accurately reflect their the TLX-6 and TLX-4v2 in the ing needs/wants. However, portive policies and resources children’s abilities; 2) cate- whole day repeated mea- further research still needs were available. Conclusion: gories diminish opportunities sures context. TLX-6 appears to be conducted in order to This study highlights how infor their children to engage in to capture multiple factors generate quantitative results. tersections of work and home community and social partic- contributing to task load, while Conclusion: There is some affected WFH experiences ipation; and 3) the subjective TLX-4v2 assesses the single positive effect of using a pet and worker well-being. The usage of “high-functioning” factor of “mental strain.” The over telehealth in order to widespread implementation and “low-functioning” verbiage TLX may be particularly useful “check-in” with a client at the of WFH will likely accelerate creates assumptions and for investigating how daily task beginning of a session. the pre-existing trend towards hurtful stigmas which can be load covaries with day level increase of WFH and other damaging to autistic individu- well-being measures (e.g. nontraditional work arrange-

als and their families. Possible headache severity, etc.) Poster #99 ments. There is a need to alternative taxonomies are rethink worker needs in the considered. Title: Work from home during WFH context to better support

Poster #98 COVID-19 as negotiating time worker health and well-being. and space Poster #97 Title: What’s up dog? Friend- ships with furry friends through Authors: Yoko E. Fukumu- Poster #100 Title: Validation of a repeated telehealth ra, Joseph Schott, Gale M. measure of daily task load Lucas, Burcin Becerik-Gerber, Title: Balancing Everyday Life Authors: Kellie C. Miyashima, & Shawn C. Roll (BEL) versus occupational Authors: Raymond Hernan- & Shelby Surfas therapy in mental health pop- dez, & Elizabeth Pyatak Faculty advisor: Shawn C. ulations Faculty advisor: Shelby Roll Faculty advisor: Elizabeth Surfas Authors: Skyler Lin, Mona Pyatak Background: COVID-19 Eklund, Carina Tjörnstrand, Background: Trauma leads led to major shifts in daily Mikael Sandlund, & Elisabeth Background: Task load is to symptoms synonymous to lives around the world. Many Argentzell the cost (e.g. fatigue, stress, ADHD such as inattention and workers had to suddenly tran- illness) of performing tasks. impulsivity, or lead to an ADHD sition to working from home Faculty advisor: Myka Winder The National Aeronautics and diagnosis. It can also lead to to follow social distancing Space Administration Task depressive symptoms, and measures. Work from home Mental health diagnoses often Load Index (NASA-TLX) has anxious, defiant, and tantrum (WFH) offers many benefits, decrease quality of life and di- been validated to measure behaviors. Dogs help promote from saving operation costs to minish meaningful occupations task load of particular tasks social interaction and increase supporting worker wellness; which affect health and mor- and load of whole workdays. comfortability and authentic- however, when poorly man- tality. No single intervention TLX-6 is the multidimensional ity (Fine, 2015). Therapies aged, WFH can negatively im- can address all symptoms, and full version of the TLX with all including animals help reduce pact worker health and quality while interventions like lifestyle six items, while TLX-4 is an symptoms of mental illness of life. Purpose: We aimed to redesign have been proven to abbreviated version with four (Koukourikos et al., 2019). understand lived experiences be effective with other popu- items found to load onto a Using dogs as part of sessions of workers transitioning to lations, there is significantly single factor in a prior study. over telehealth help clients feel WFH during COVID-19. Meth- less literature on interventions Purpose: Investigate the comfortable with answering ods: A national survey was focusing on daily lifestyle and/ validity of TLX-6 and TLX-4 questions about their needs/ conducted and comments or improving quality of life. for measuring task load over wants, and/or projecting those from two free-response ques- The Balancing Everyday Life a whole day in the repeated requirements onto the dog. tions regarding experiences (BEL) program was created measures context. Methods: Purpose: The goal was to of WFH (N=648, N=366) were for specialized and communi- We analyzed data on 51 create a telehealth protocol analyzed using inductive ty-based psychiatric settings to people with type 1 diabetes as utilizing a practitioner’s dog to qualitative content analysis. address everyday life broadly part of a larger study collecting decrease symptoms of ADHD Results: Two primary themes, and assist individuals with ecological momentary as- and increase the ability to the temporal and spatial mental health diagnoses to sessment and daily diary data identify basic needs thereby aspects of WFH, were framed obtain a good and stable way over 14 days. The NASA-TLX assisting with emotional and by an overarching construct of life. The BEL program was was administered at the last behavioral regulation. Meth- of intersections of work and administered over 16 weeks survey of every day. Results: ods: The outcome measure home. The positive aspects with one session a week at Confirmatory factor analysis fit utilized in this study combines of WFH, such as increased specialized and communi- metrics indicated that neither questions from the Vanderbilt flexibility and autonomy, were ty-based programs. The BEL the TLX-6 or TLX-4 were unidi- and Devereux Early Childhood juxtaposed with the challenge program could be administered mensional. In exploratory anal- Assessment. This will be a pre- of setting boundaries between to the adult population with yses, another set of TLX items post test study with outcomes work and home life. Individ- any mental health diagnosis we refer to as TLX-4v2 was analyzed at 0, 6, and 12 week uals’ experiences of WFH barring substance abuse, found to be unidimensional. marks. Qualitative data from were heavily influenced by developmental disorders, and Raw sum scores from the TLX- parents and practitioners will the role demands of work and dementia to increase function- 6 and TLX-4v2 generally had also contribute. Each outcome home, as well as the amount al occupational participation. plausible relationships with is paired with its own question of environmental and organi- The study has indicated that other measures as evidenced to the pediatric client about the zational supports. While the the BEL program is time-ef- by within-person correlations dog and about themselves. context of a global pandemic fective in improving patient and mixed modeling tests. Results: Qualitatively, other was an added stressor, many quality of life and functional Conclusion: We found evi- practitioners have reported individuals hoped to continue engagement with meaningful dence supporting the validity of improvements with identify- to WFH providing that sup- occupations, indicating this

The Explorer Journal 2021 Abstracts 65 ------: This This :

: The present present The Purpose: inform the development and and the development inform of inclusive implementation for health programming an intellectual people with disability. Poster #104 Psychedelics and occu Title: & Telles, Authors: Justin Samia Rafeedie Faculty advisor: Samia Rafeedie The value of Background: as a psychedelic compounds dis treatment for psychiatric pational therapy orders is a rapidly developing a field of study emerging from backdrop of formerly restricted Although a resur research. gence of scientific studies is their safety and underway, thera efficacy as an effective peutic intervention continue to be determined in clinical trial to date research. Moreover, there has been no published research discussing the intersection of psychedelics and with occupational therapy, this synthesis represents a development of this relation ship. research synthesis aims to analyze this resurgence of interpret the scientific inquiry, various clinical conclusions, and discuss the potential practical implications for the field of occupational therapy. Methods: Systematic search of PubMed, USC Health Sciences Catalog, and USC Library for English language quantitative research studies on psychedelics published after 2010. Results: Seven research articles including 151 participants were selected based on their peer-reviewed design and study of psilocybin or lysergic acid diethylamide (LSD). Conclusion review synthesizes the results of seven clinical trials exam ining the therapeutic value of psychedelic substances and provides scientifically estab lished support for their safety and efficacy as treatment for various psychiatric disorders. given the imme Additionally, of diate and enduring effects these compounds on study participants, occupational ------USC : Partici-

: The The Purpose: : Ten Ten Methods: Conclusion the autistic community, the autistic community,

objective of this study is to objective of this study is to understand how people with intellectual disability partic ipate in and access health promotion. disabil intellectual with adults ity engaged in an adapted Results: photovoice study. Health emerged: themes Four Are; Health is Is Who We Do; Health Is Our What We Mind, and Place; and Body, Barriers and Facilitators. Participants communicated an understanding of health, a strong identity of themselves and diverse as being healthy, participation in health promo participants Additionally, tion. identified specific resources and support necessary to pursue health. Participants’ broad description of health aligns with understandings of the social determinants of health. encounters and inclusion of of inclusion and encounters voice. Program the autistic was analyzed to feedback acquired, identify knowledge and potential for satisfaction, future practices. influencing officers should argue that We understanding have a basic with ASD and how to work of autistic people. Collabora tions among professionals thera such as occupational pists, potential and police has the encoun to positively impact persons ters between autistic and police officers. Poster #103 Participation in health Title: promoting occupations for individuals with intellectual disability Authors: Brittany St. John, Amanda Malz Megan Gray, Libby Hladik, Savanna acher, Ausderau Lurie, & Karla Aus- Faculty advisor: Karla derau Background: Understanding the daily health experiences of people with intellectual disability is necessary to illuminate factors that may be influencing health and health disparities. pant’s holistic view of health holistic view of health pant’s and experienced factors of health promotion should - - - -

- : Ghana, a former a former : Ghana, Poster #102 Engagements of police Title: strategies and autistic people: to optimize outcomes Authors: Monica Caris, David Riley McGuire, & Turnbull, Mary C. Lawlor Faculty advisor: Mary C. Lawlor Autism Spectrum Disor- der (ASD) is increasing in prevalence. Despite research showing that autistic individu als are more likely than their neurotypical peers to come in contact with the police, most police officers in the U.S. do not receive training on how to work with autistic people or identify behaviors that are commonly misinterpreted, such as running from police. Misinterpretation has led to an increased likelihood of The purpose of this harm. abstract is to synthesize literature to provide a greater understanding of autism, identify characteristics of police and autistic people’s interactions, discuss an inno There lem solving in the field. are few recommendations on how and when to administer this training and what types of training are most effective given the complicated nature An innovative ap of policing. rated by drawing on video clusion many is still in British colony, with major ways “colonized” in access to power, disparities and being (Dirette, knowledge decolonizing 2018). Hence therapy in Ghana occupational challenging than may be more world in other places in the of Ghanaian despite the efforts In therapists to push back. still many ways, westerners in control the power dynamics therapy. field of occupational vative training module, and provide an evaluation of this training approach. Research suggests that many police officers lack basic training, are unaware of the common ASD, and characteristics of feel underprepared for prob proach to preparing officers for more positive experiences in the field was incorpo Herman Ostrow School of Dentistry School of of Ostrow Herman ------Initial

Con-

analyses of data indicated that because occupational therapy was made by westerners for westerners, its foundation is laced with western ideologies. Ghanaian occupa However, tional therapists reported that limited practical training during their education may have led them to individually contextu alize westernized theories in their practice. Whilst Ghanaian therapists generally demon strate occupational conscious ness (Ramugondo, 2015), they lack sufficient power to decolonize, and find effectively that in their quest to decolo nize, they have to rely on aid from the very westernizers who colonized them. tional therapists and thematic analysis was used to ana lyze the data. Results: tional therapy education and descrip- A practice. Methods: tive qualitative study was conducted. Semi-structured interviews were administered with four Ghanaian occupa Poster #101 Decolonization of occu Title: py is in its formative years, making Ghana a ripe target for the decolonization agen of The purpose da. Purpose: this study was to determine how western ideologies have influenced Ghanaian occupa pational therapy: A Ghanaian A pational therapy: perspective Authors: Joana Nana Serwaa & Akrofi, Stefanie Bodison, Milman Tessa Faculty advisors: Stefanie Milman Tessa Bodison & Background: Decolonization is an emerging term in Occu ple (Dirette, 2018). Being rela tively new in Ghana, one may say that occupational thera intervention could be beneficial be beneficial could intervention health settings in adult mental along when implemented side standard care. Further side standard to be needs analysis, however, regarding care done on factors further strengthen context to findings. the study’s pational Science literature that has dominated several global discourses. Decolonialism is a political movement aimed at liberating ex-colonialized peo 66

therapy practitioners may be challenges with oral care expe- nity level risk. Methods: Infants average hip/knee extensor uniquely suited to provide riences in the home and dental will engage in a contingency moment ratio (HKR) during therapy preparation care, settings. However, some learning paradigm where right athletic movements. Methods: integration services, and other significant between-group leg movements will be rein- Thirty-nine healthy athletes (15 outpatient specialty treatment differences were reported: forced by activating a robot to males, 24 females) participat- associated with the healing more parents reported that clap and laugh (robot reward). ed. Lower-extremity kinematics process. their SOR child’s behavioral For all infants, we will detect and kinetics (3D) and sagittal difficulties and sensory sensi- leg movements using wearable plane video (2D) were collect- tivities make dental appoint- sensors (Opal) and timing of vi- ed simultaneously while sub- OCCUPATIONAL ments challenging, that their sual gazes directed at the robot jects performed 6 tasks (Step SOR child would be extremely using head-mounted eye track- Down, Drop Jump, Lateral SCIENCE & afraid to go to the dentist and ing (Positive Science). Infants Shuffle, Deceleration, Triple that their child disliked senso- will wear Opal sensors on their Hop, and Side-Step-Cut). OCCUPATIONAL ry-related stimuli at the dental ankles to detect leg movements Linear regression analysis was office (e.g., lights, sounds); in and a Positive Science eye performed to determine if the THERAPY the home, more SOR children tracking system on their head 2D trunk-tibia angle at peak AFFILIATES required complete assistance to record visual gaze. A 50% knee flexion predicted the for toothbrushing. Conclusion: increase in right leg movement average HKR during the de- Children with DS experience from baseline will be defined as celeration phase of each task. many challenges with oral learning during the contingency. Results: For each task, an Poster #105 care in the home and dental Timing of gaze onset directed increase in the 2D trunk-tibia office environments; sensory to the robot will be used to angle at peak knee flexion pre- Title: Oral care and sensory processing challenges may identify predictive gaze behav- dicted an increase in the av- over-responsivity in children play a role in some of these ior, defined as gaze directed to erage HKR when adjusted for with Down syndrome difficulties. the robot’s arms or face after leg body mass (all p < 0.013, R2: movement but before onset of 0.17 to 0.77). The 2D trunk-tib- Authors: Melissa Martinez, the robot reward. ia angle cut-offs necessary to Sharon Cermak, & Leah Stein achieve a hip extensor biased Duker BIOKINESIOLOGY Results: We hypothesize movement strategy (average & that infants at ER-ASD will be HKR > 1.0) ranged from -2° Faculty advisor: Leah Stein less likely to learn the contin- for the step down and 31° for Duker PHYSICAL gency and will exhibit fewer the triple hop. Conclusion: instances of predictive gaze. The 2D trunk-tibia angle at Background: Sensory over- THERAPY Conclusion: Results from the peak knee flexion represents responsivity (SOR) has been PHD CANDIDATES proposed study will provide a practical method to char- linked to oral care challenges foundational information about acterize movement behavior in multiple clinical populations. infant motor learning in those that may expose individuals to However, despite reports at ER-ASD. knee injury. of both oral care and SOR in children with Down syn- Poster #106 drome (DS), no literature has Title: Assessing contingency examined this relationship. Poster #107 Poster #108 learning in infants at elevat- Purpose: To investigate the ed risk of autism spectrum Title: Clinical estimation of association between SOR Title: Flexible reversal of disorder hip and knee extensors during and oral care challenges in responsibility assignment for athletic movements bimanual errors after stroke children with DS. Methods: Authors: Marcelo R. Rosales, Participants included 367 Nina S. Bradley, & Beth A. Authors: Rachel K. Straub, Authors: Rini Varghese, English-speaking parents of Smith Alex Horgan, Adam J. Barrack, James Gordon, Nicolas Sch- children with DS ages 5-14 Leana Mosesian, & Christo- weighofer, & Carolee Winstein throughout the U.S. who com- Faculty advisor: Beth A. pher M. Powers pleted a 48-item online survey Smith Faculty advisor: Carolee about oral care and sensory Faculty advisor: Christopher Winstein processing. Chi-square analy- Abstract type: Study protocol Powers ses tested for associations be- Abstract type: Research tween sensory-related and oral Background: Infants at ele- Abstract type: Research care variables. Results: Based vated risk of autism spectrum Skilled human action is seldom on cut-scores using responses disorder (ER-ASD) are charac- Background: Previous studies unimanual and often involves by parents of typical children, terized as having atypical gaze have indicated that increased coordination of both hands. parents who reported that their behavior, delayed achievement use of the knee extensors A critical aspect of bimanual child experienced “moder- of motor milestones, and lower relative to the hip extensors coordination is responsibil- ate-to-extreme” over-sensitiv- executive function performance. may contribute to various knee ity assignment. How does ity on three or more of eight However, these descriptive injuries. There is a need for a the nervous system assign sensory modalities were cat- characteristics do not ex- clinic friendly method to char- responsibility when an error egorized as “sensory over-re- plain the processes engaged acterize movement behavior occurs? The optimal feedback sponders” (SORs; n=142); in acquiring motor skills for that may expose individuals to control theory suggests that those reporting two or fewer infants at ER-ASD. Purpose: knee injury. Purpose: To deter- responsibility assignment is were categorized as “sensory Hence, we propose to describe mine whether the difference a flexible process such that not-over responders” (SNOR; differences in visual behavior between sagittal plane trunk errors are assigned to and n=225). Overall, parents of during a contingency learning and tibia orientations obtained corrected for by the limb that children with DS in both sen- paradigm in infants at ER-ASD from 2D video (2D trunk-tibia) is most likely to produce those sory groups reported similar compared to infants at commu- could be used to predict the errors. In right-handed adults,

The Explorer Journal 2021 Abstracts 67

- - - - - resting-state

ing the relationship between We chronic pain and PAF. tested three progressively more complex pipelines: 1) Pipeline 2) Pipeline 1 notch filtering only, and data re-referencing, and 3) Pipeline 2 and automatic artifact removal. Data for all three pipelines were then processed by the center-of-gravity (COG) method to determine peak frequency at each electrode. For all pipelines, a single principal component, well-represented across by the average rs-PAF all electrodes (global rs-PAF), explained <95% of the variance alsoacross participants. We found that the global rs-PAF was highly correlated among the analytic pipelines (<0.95); re-referencing was the analytic step with greatest impact. We additionally found interindividual in global rs-PAF differences were significantly correlated with in fMRI-estimateddifferences Theseactivity in the thalamus. is results suggest that rs-PAF a stable marker with respect to analysis method and reflects ininterindividual differences brain function. graphic (EEG) from 48 healthygraphic (EEG) from 48 identified importantmen. We variations in EEG preprocess from a ing pipelines for rs-PAF review of 10 papers investigat Poster #112 Compensation for Title: interaction torques during single-joint movement in stroke survivors. - Darmon,Vic Yannick Authors: tor Barradas, & Nicolas Sch weighofer Several studies have found studies Several resting-state of slowed evidence frequency (rs-PAF) peak alpha pain populations.in chronic stability of rs-PAF the However, pipe analytic from different collected We PAF. functional magnetic resonance andimaging (rs-fMRI) data subsequently 64 channel resting-state electroencephalo lines used in the pain literaturelines used determined andhas not been neural correlates ofunderlying not been sufficiently have PAF Heresubstantiated in humans. of analyticwe examine a range ofpipelines and the relationship in the thalamus, to activity PAF ofa hypothesized generator ------, p= - - 2 USC and

: Infants Results: & : Research : Ten Ten Methods: THERAPY PHD & MS PHYSICAL PHYSICAL STUDENTS . If infants increased leg . If infants increased to 4.312 ± 2.091 m/s 2 2 BIOKINESIOLOGY accelerations in this band, they accelerations in this perform were categorized as peak The magnitude of leg ers. right/left acceleration, ratio of Poster #111 Analytic stability and Title: neural correlates of peak alpha frequency Authors: Natalie J. McLain, & Jason J. Yani, Moheb S. Kutch Faculty advisor: Jason J. Kutch Abstract type 0.03) and proportion of target acceleration (from 6.61% ± 7.53% to 17.56% ± 11.56%, p= 0.03) for right leg, and ratio of right/left leg acceleration peaks within the target range (from 0.87 ± 0.52 to 2.32±1.88, p= 0.04). Conclusion specifically adjusted their right leg acceleration in response to a reward. Further study is needed to understand how control of lower limb move ment may influence develop mental trajectories. relative to a specified target target to a specified relative learn in a contingency range ing paradigm. typically-de 6 to 8-month-old participated veloping infants robot provid A in the study. when the ed reinforcement right leg acceleration infant’s of 9 to 20 fell within the range m/s leg acceleration peaks, accel distribution of leg peak eration data were compared con between baseline and tingency conditions. Six infants were categorized as performers. Comparing baseline to the contingency condition, the performer group increased the magnitude of ac celeration (from 2.687 ± 1.135 m/s ------: Our pre- Results: Hip : Research

Poster #110 Infants learn to adjust Title: leg movements in an accelera tion range Deng, Bar Authors: Weiyang bara Sargent, Nina Bradley, Marcelo Rosales, José Carlos Pulido, Maja Matarić, & Beth A. Smith Faculty advisor: Beth Smith Abstract type Background: Learning move ment control is a fundamental process integral to infant it is development. However, still unclear how infants learn to control leg movement. Pur- determine if infants To pose: can adjust leg acceleration determine if targeted gluteal gluteal if targeted determine during activation muscle can reduce impinge squatting and peak ment kinematics contact pressure. acetabular with a Methods: One male participated of FAIS diagnosis Kinematic, study. in this pilot surface EMG of kinetic, and collected 6 hip muscles were squat during two bodyweight one with tasks, one with and out gluteal activation cues. A A cues. out gluteal activation model 3D finite element (FE) of the hip joint was developed input with participant-specific hip joint parameters including kinematics, bone-on-bone contact forces (estimated model), from an EMG-driven (obtained and bony geometry contact scans). Peak via CT pressure was analyzed at peak hip flexion during each of the squat conditions. flexion and abduction were similar between squat condi tions, however internal rotation was reduced by 7° during the trials with the gluteal activation cues. In the cued trials, peak acetabular contact pressure decreased from 8.49 to 3.84 MPa. Conclusions liminary results suggest that gluteal activation cueing during squatting reduces hip internal rotation which in turn reduc es peak acetabular contact This highlights the pressure. importance of the gluteal mus culature’s ability to minimize culature’s impingement and associated loading during squatting in FAIS. Herman Ostrow School of Dentistry School of of Ostrow Herman ------

: To To Purpose: : Research Poster #109 Gluteal activation reduc Title: es acetabular contact pressure in femoroacetabular impinge ment syndrome Authors: Jordan Cannon & Christopher M. Powers Faculty advisor: Christopher Powers Abstract type Background: Symptomatic impingement between the aspherical femoral head and acetabular rim in persons with femoroacetabular impinge ment syndrome (FAIS) occurs ment syndrome (FAIS) with the motions of internal rotation and adduction when the hip is in a flexed position. The gluteus maximus and gluteus medius may protect against impingement given their ability to produce hip external rotation and abduction motion during tasks requiring deep hip flexion. this is often the less-skilled, less-skilled, often the this is limb. More left non-dominant of the flexibility interestingly, can be probed by this process corrections made examining after they have by each limb use-de acquired alternative pendent experiences, e.g., pendent experiences, more if the left limb became fewer er skilled, experiencing resis who not only corrected more with their paretic right limb within a trial, but also corrected less with their now They more skilled left limb. also systematically adapted to these errors in a feedforward The extent manner over trials. of correction and adaptation in stroke survivors varied with the degree of motor impairment of the paretic extremity. rors or if the right limb became rors or if the right limb more less skilled, experiencing is the frequent errors. Such the case of stroke affecting wherein right side of the body, the left we would predict that the limb corrects less while more paretic right limb corrects study, In this for task error. in we tested this prediction intact 20 individuals with an as well sensorimotor system, as 23 chronic stroke survivors (12 right hemiparesis). Our data supported our predictions for those with right hemipa 68

Faculty advisor: Nicholas cases annually. ACL recon- Background: Feedforward activity intervention for breast Schweighofer struction (ACLR) is the gold control represents attempts cancer survivors? standard treatment approach, of the nervous system to Abstract type: Research however, approximately 36% predict upcoming demands Authors: Guanrong Cai & of individuals that undergo and is integral to preparing for George Salem Background: Flexion and ACLR will be diagnosed with transitions between swing/flight extension of the elbow generate early-onset patellofemoral and ground contact phases. Faculty advisor: George torques at the shoulder and joint (PFJ) osteoarthritis. It There is limited research on Salem other proximal and distal joints. is conceivable that elevated how continuous athletic activity Abstract type: Theoretical These forces generated are PFJ loading during the first affects feedforward control. model or novel technique called interaction torques and year post-ACLR may be The requirements of dancers arise from the acceleration and contributory to early-onset to maintain aesthetics makes velocity of the limb about its Background: Breast cancer cartilage changes. Purpose: them an exemplar for this survivors (BCS) face declines joint. To maintain accuracy, the To compare PFJ stress during research. Purpose: To inves- central nervous system learns in numerous physical, psycho- walking, running, and jump- tigate the influence of contin- social, and cognitive outcomes to compensate for these torques ing between females who uous activity on feedforward by activating compensatory and an increase in comorbid have undergone ACLR and a control. Methods: We collected conditions, which are exacer- muscles concurrently with the healthy control group. Meth- surface EMG on the medial prime movers of the movement. bated by sedentary behaviors. ods: Twenty female athletes gastrocnemius (GasMed), per- Evidence demonstrates that The pre-programmed muscle who have undergone ACLR oneus longus (PL), and soleus activity involves feedforward traditional and non-traditional within 4 months and 20 healthy (Sol) as 12 dancers performed physical activities are beneficial controllers that are thought to females will undergo magnetic rate-controlled sauté jumps be updated by the cerebellum. to health outcomes in BCS. resonance imaging (MRI) and interspersed with choreogra- Two recent studies (GIVE and However, in stroke survivors, biomechanical evaluation. phy. Muscle variables: pre-ac- the death of neurons occurring GHA) from our research team Lower extremity kinematics, tivation(flight phase) median found that golf is a multimodal in motor cortical areas may kinetics, and EMG of the knee frequency, amplitude, onset indirectly provoke the death activity that is safe, feasible, and flexors will be obtained during latency. Kinematic variables: contributes to improved health of cells in the cerebellum by a walking, running, and a drop ankle sagittal plane angle at phenomenon call diaschisis. outcomes in healthy older adults jump. Axial plane MR images initial ground contact, maximum (OAS, age range: 59-80), an Damage in the cerebro-cerebel- (loaded, 20% bwt) will be ob- excursion into dorsiflexion lum pathways may, therefore, age group where BC diagnoses tained 0°,20°,40°,60° of knee during ground contact. Linear are prevalent. However, golf has precludes stroke survivors from flexion to acquire patellofemo- mixed effects models assessed updating their feedforward con- never been formally investigated ral contact area. A previously relations between accumulated in BCS. Purpose: This report trollers. Purpose: In this exper- described biomechanical mod- activity, EMG, and kinematics. iment, we investigate whether aims to propose that a compre- el will be used to calculate PFJ Results: The median frequen- hensive golf training program stroke survivors still compensate stress (force per unit area). cies decreased significantly for interaction torques during (CGTP) be considered as a nov- Peak PFJ stress will be com- (slopes: -3.0 to -1.2 Hz over 30 el activity intervention for BCS. single-joint movements. Meth- pared between groups across sautés). The ankle plantar flex- ods: We recruit stroke survi- Methods: GIVE (12 weeks) tasks using 2-factor ANOVA. ion angle at initial contact and and GHA (10 weeks) compared vors and healthy age-matched Results: Compared to the dorsiflexion excursion during control. During both single-joint within-subjects physical and healthy control group, females ground contact decreased sig- cognitive measures in healthy elbow flexion and extension, following ACLR will exhibit nificantly (slopes: 0.14°, -0.08° we explore the relationships be- OAS (novel to golf), before greater PFJ stress across all over 30 sautés; + = dorsiflex- and after a CGTP. The CGTP tween the generated interaction tasks. Increased PFJ stress ion). The initial contact angle torques and the electromyo- consisted of warm-up exercises, in the ACLR group will be the was negatively correlated with driving range practice, and golf graphic (EMG) activity of the result of elevated PFJ reaction PL and Sol amplitude (slopes: shoulder and elbow muscles. play twice/week for 90 minutes. forces and diminished PFJ 0.6°, 0.9°/10% MVIC amplitude Both studies had high atten- Results: Pending. Conclu- contact area. Conclusion: The increase). Dorsiflexion excur- sions: Pending. dance rates and no golf-related results of the current study will sion was positively correlated adverse events, demonstrated support the premise that ear- with GasMed pre-activation on- improvements in outcomes of ly-onset PFJ OA may be due set latency(slope: 1.3°/10% in- physical tests, balance, cognitive Poster #113 to elevated PFJ loading during crease in onset latency). Con- batteries, and social wellbeing.

the post-operative period. clusion: Dancers displayed Results: A large portion of Title: Do females exhibit altered pre-landing muscle BCS is also considered OAS, elevated patellofemoral stress activity and minor changes in therefore, the benefits observed following ACL reconstruction? Poster #114 ankle kinematics. The mild drop in our previous studies may in muscle frequency indicates Authors: Thomas Demirjian & translate to BCS. Investigating Title: Effects of continuous some alteration in muscle coor- Christopher Powers the efficacy of a CGTP in BCS athletic activity on feedforward dination, and it is possible this would provide clinicians with control of jumping coordination change prevented evidence regarding the feasibili- Faculty advisor: Christopher early task cessation. The minor Powers ty, safety, and efficacy of a novel Authors: David Ortiz-Weiss- changes in kinematics indicate activity designed to combat sed- Abstract type: Study protocol berg, Christopher Laine, Hai- the dancers maintained their entary behaviors and potentially Jung (Steffi) Shih, Amanda C. aesthetics even with this low provide a solution to long-term

Background: Tears of the an- Yamaguchi, & Kornelia Kulig level of muscle fatigue. lifestyle modification, which is terior cruciate ligament (ACL) key to high quality of life among are among the most com- Faculty advisor: Kornelia BCS. Kulig mon traumatic knee injuries Poster #115 in the United States with an Abstract type: Research incidence of 100,000-200,000 Title: Golf – The next novel

The Explorer Journal 2021 Abstracts 69 - - - - protocol

: Study : Peak power : This workPurpose: cant difference between peak between cant difference and 30% power output at 20% 1RM of the barbell back squat 50%, compared to loads at F(3,75) = 5.74, p <0.05. Conclusion occurs for output in the MTPC 20-30% of loads equivalent to with no the barbell squat 1RM between significant difference These men and women. additional findings suggest no benefit of training for power at greater intensities. Background: High-intensity in terval training (HIIT) is becoming more common as an exercise modality due to the ability to feasibly and safely train at high intensity in a short amount of time. Many studies have been done to examine inflammatory and muscle damage responses to endurance training; however, that methodology is difficult to perform without high level athletes. will showcase the use of heart rate maximum (HRmax) testing to determine treadmill speed and cycle ergometer resistance These protocols will be for HIIT. used to elicit training at specific heart rate ranges to study the inflammatory and muscle dam age biomarkers associated with acute exercise. Methods: HR- max testing will be performed young (18-30 years) by healthy, participants on a treadmill and The heart rate cycle ergometer. values measured will be used protocols atto produce 4x4 HIIT 85-95% HRmax for active inter (3,625±1,326 W) occurs for occurs W) (3,625±1,326 the 20-30% of equal to loads squat 1RM. Peak barbell back occurs when power output (3,522±1,285 N) neither force bar velocity nor peak vertical m∙sec-1) (2.19 m∙sec-1±0.38 one-way A is at its peak. analysis of repeated-measures signifi variance revealed a Poster #119 Producing high-intensity Title: interval training protocols from heart rate maximum testing Authors: Jared Moore, Garry Cai & George Salem Faculty advisor: George Salem Abstract type - - - - USC

- Results: : Research ences between interventions. interventions. between ences not mass did leg, lean Single change with either significantly was, how There intervention. mus significant acute ever, with BFR-ELET cle swelling that has been linked (p<0.001) con- synthesis. We to protein BFR train clude that low-load ing is a successful alternative optimal modality for effecting strength eccentric hamstring of gains. With the prevalence sports, hamstring injury across may be use- BFR eccentric RT ful since it can be implemented of during the early phases high-load rehabilitation when training is contraindicated. Poster #118 Maximal power produc Title: tion in the mid-thigh power clean Antonio Squillante, Authors: Brady McCormick, Lorena Martin, Susan Sigward, & E. Schroeder Todd Todd Faculty advisor: E. Schroeder Abstract type Background: Evidence suggests the importance of prescribing optimal load to maximize peak power output in explosive strength training conflict- for sports. However, ing results exist on the effect of loading on peak power output in the mid-thigh power To clean (MTPC). Purpose: determine the optimal load to maximize peak power output in the MTPC. Methods: 26 male and female weightlift ers (age 25.5±3.8, height 168.2±4.6 cm, body mass 76.7±4.6 kg) were tested in the MTPC for incremental loads of 20%, 30%, 40%, and 50% of the barbell back squat 1RM. Participants performed 4 sets of 3 repetitions standing on a force platform sampling at 1000Hz (AccuPower, - Tech Advanced Mechanical MA). Inc., Watertown, nology, Peak vertical bar velocity was measured using a wearable accelerometer placed on the barbell (Push 2.0). Findings with p-value set to p≤0.05 reveal that peak power output in the MTPC - - - -

: Research gated in the hamstring. We gated in the hamstring. We sought to determine the effect on of longitudinal BFR RT eccentric hamstring strength, endurance, hypertrophy, and power while assessing muscle soreness and acute muscle swell. Healthy adults mean±SD; (n=40; 19F,21M; age:24.3±2.6 years) participat ed to compare the outcomes of low-load (30% 1RM) eccentric lower extremity training with BFR (BFR-ELET) to traditional high-load (80% 1RM) eccentric lower extremity training (CON- ELET) without BFR biweekly for 6 weeks. Outcomes were tested pre/post intervention with significance at α=0.05. Both interventions elicited gains (p<0.001) in concentric 7.7±4.3%; (BFR-ELET strength 12.2±4.2%) and CON-ELET eccentric strength (BFR- 7.1±4.3 %; CON-ELET ELET 9.9±4.3%), with no differences between interventions. There were also improvements in muscle endurance and leg - power without significant differ Poster #117 vs Low-load with BFR Title: eccen high-load without BFR oping high eccentric force capability through resistance serious However, training (RT). hamstring injuries can take is months before high-load RT appropriate. Low-load blood has RT flow restriction (BFR) been identified as an effective alternative when high-load is contraindicated but RT has been scarcely investi tric hamstring training Authors: Malcolm J Jones, Clarizzah Dominguez, Jesus F. Coleman, Macatugal, Keairez Schroeder Todd & E. Todd Faculty advisor: E. Schroeder Abstract type key principle of hamstring A injury rehabilitation is devel ences in pKF became larger larger in pKF became ences with people speeds at faster exhibiting smaller post-stroke suggests that pKF This pKF. be may not deficits post-stroke addressed by fast adequately may need to be walking, and targeted. specifically Herman Ostrow School of Dentistry School of of Ostrow Herman - - - - -

: Research ics: comparing age-matched ics: comparing gait and post-stroke Kettlety, A. Authors: Sarah G. Broderick, James Catherine Darcy S. Reisman, M. Finley, A. Leech & Kristan Faculty advisor: Kristan Leech Abstract type creasing compensatory move ing at faster speeds changes the magnitude of kinematic between people differences post-stroke and age-matched hypothesize that controls. We will increase as this difference per- speed increases. We formed a secondary analysis After combining of 3 datasets. datasets, we had 28 people post-stroke and 26 age- matched controls that walked on a treadmill at 4 different speeds. Linear mixed-effects models were used to evaluate of speed and group the effect on circumduction, hip hiking (HH), trailing limb angle (TLA), and peak knee flexion angle (pKF). People post-stroke had greater circumduction(p=0.02) of than controls with no effect speed(speed: p=0.41, speed x group: p=0.54). People post- stroke also had greater HH (p<0.001) than controls, and post-stroke HH increased with faster speeds (speed x group: p=0.005). Controls had greater (p<0.001) and pKF TLA (p<0.001) than people post- found that controls stroke. We increased pKF at a faster rate with increased speeds than people post-stroke (speed x group: p<0.001). Conversely, people post-stroke increased at a faster rate than con- TLA trols(speed x group: p=0.001). at faster speeds Walking How- and pKF. TLA increased - between-group differ ever, Clinical practice guidelines Clinical practice guidelines recommend high-intensity to training at fast speeds in address activity limitations at Walking people post-stroke. fast speeds can also improve kinematic metrics without in Poster #116 Poster speed-de Investigating Title: in kinemat pendent changes if it is unclear ments. However, these improvements result in kinematics similar to controls. aimed to determine if walk We 70

vals and 60-70% HRmax for ac- the greatest thickening of Methods:Professional baseball Purpose: Compare develop- tive recovery intervals. Results: the supraspinatus tendon players (N=242, N=135 Pitch- mental trajectories of visuo- There will be no adverse events [0.7mm (95%CI:0.4,0.9mm)]. ers, N=162 NA) participated. motor planning and execution from the HRmax and HIIT proto- The change in supraspinatus Players completed two trials in infants at elevated and low cols. Treadmill speed and cycle thickness of DH-pain was of maximal isometric ER and risk for ASD. Methods: We resistance will be effectively greater than both DH-no pain IR strength (at 0° arm abduc- will measure motor planning transitioned from HRmax test to [0.4mm (95%CI:0.1,0.8mm)] tion) using a handheld dyna- and execution using a reach- the HIIT protocols. Participants and OT students [0.9mm mometer. Strength data were to-grasp task with an object of will reach anticipated heart rate (95%CI:0.5,1.2mm)]. At 12 normalized to body weight. changing orientation (vertical intervals with these HRmax test months, greater supraspina- Results: Position players were and horizontal) at 6, 7.5, and 9 values. Conclusion: HRmax tus thickness was related to significantly stronger in ER months of age. We will use 3-D testing in healthy, young adults greater shoulder pain (r=0.29; [MD=0.28N/kg; p<0.001] and motion capture to measure the will be safe and feasible. These p<0.01). DH students with IR [MD=0.29N/kg; p<0.001] following variables for motor measurements will allow the increased tendon thickness with higher ER:IR strength planning: latency to move- accurate production of HIIT indicating tendinopathy ratios [0.77±0.17 vs. 0.73±0.14; ment onset, reach trajectory protocols for each individual to (>0.8mm) were likely to de- p<0.043] compared to pitchers. error, hand orientation error, reach specific heart rate ranges. velop shoulder pain [relative LA athletes were stronger in ER and motor execution: move- This data will be used to build risk=1.9 (95%CI=1.0,3.6)]. [MD=0.3N/kg; p<0.001) and IR ment duration, post-contact an effective protocol for eliciting Conclusions: DH students [MD=0.2N/kg; p<0.001] com- hand orientation adjustment, high intensity exercise for mea- are at higher risk of developing pared to NA athletes. Specifi- movement units. We will surement of the inflammatory shoulder pain after 12 months cally, LA pitchers were stronger test for a group effect and a and muscle damage responses of training. The development in ER [MD=0.4N/kg; p=0.002] group-by-time interaction. Re- to acute exercise. of shoulder pain is associated and IR [MD=0.2N/kg; p=0.006] sults: Infants at elevated risk with an 18% thickening of the compared to NA pitchers. demonstrate significantly lower supraspinatus tendon. These Conclusion: Player position performance on all motor plan- Poster #120 morphological changes in the and geographic origin influence ning and execution measures supraspinatus are compatible shoulder rotational strength compared to infants at low risk Title: Repetitive occupational with signs of supraspinatus values in professional baseball (group effect), and that group tasks: effects on shoulder pain tendinopathy. players. Position players have differences will widen over and tendon morphology 14 –20% higher rotational time between 6 and 9 months strength than pitchers. More- of age (group-by-time inter- Authors: Daniel Awokuse, Poster #121 over, Latin American pitchers action). Conclusion: Infants Federico Pozzi, Catarina O. have 12.5% ER and 14.3% IR at elevated risk demonstrate Sousa, Hillary A. Plummer, Title: Shoulder rotational higher throwing arm strength impaired motor planning and Brittany Andrade, Naoko Kono, strength profiles in profession- than their North American execution starting at 6 months Wendy J. Mack, Shawn C. al baseball players counterparts. These normative of age. These results support Roll, & Lori A. Michener values can be used to deter- that early motor control inter- Authors: Adam J. Barrack, mine player deficits, declines in vention should be considered Faculty advisor: Lori Michen- Bernard Y. Liebeskind, Ryan performance, targets for return beginning at 6 months of age er J. Zerega, Jonathan C. Sum, to play after injury, and advance for infants at elevated risk for Ryan L. Crotin, Hillary A. Plum- strength and conditioning ASD. Ultimately, this may help Abstract type: Research mer, Christopher M. Powers, & practices. minimize cascading motor Lori A. Michener deficits which can exacerbate Repetitive upper extremity the social, communicative and tasks are a risk factor for de- Faculty advisors: Lori Mi- Poster #122 cognitive symptoms of ASD. veloping shoulder pain. Dental chener & Christopher Powers hygienists have repetitive Title: Visuomotor control in job-related tasks and report Abstract type: Research BIOKINESIOLOGY a high incidence of shoul- infants at elevated risk for der pain. Here we assess Background: Musculature of autism & the association between the the shoulder acts to accelerate, Authors: Judy Zhou, Carolee incidence of shoulder pain decelerate and stabilize the J. Winstein, Rujuta B. Wilson, PHYSICAL and tendon morphology. arm during throwing. Shoulder & Beth A. Smith Methods: Dental hygienist strength measures can be THERAPY (DH,n=45) and occupational leveraged to identify deficits Faculty advisor: Beth Smith therapist (OT,n=52) students that may explain changes in POSTDOCS & PT were recruited. Collected performance and injury risk. Abstract type: Study protocol RESIDENTS at baseline and 12-months: Previous studies of profession- shoulder pain with a visual al baseball players have not Background: Motor defi- analog scale (VAS), ultra- distinguished strength across cits are common in children sound images of supraspi- geographic areas of origin, and with and at elevated risk for natus thickness. The VAS often only consider pitchers. autism spectrum disorder Poster #123 minimal detectable change Purpose: To characterize (ASD). Studies in 4-5-year-old identified participants that the effects of player position children and adults with ASD Title: Motor intervention developed shoulder pain after (Pitcher, Position Player) and show both motor planning and forinfants with cerebral palsy: a 12 months(DH-pain). Results: geographic origin (North Amer- motor execution deficits. Al- systematic review Shoulder pain incidence was ican (NA), Latin American (LA)) though there is some evidence Authors: Aubrey Baker, Na- higher in DH students [relative on shoulder external (ER) and of motor deficits in infants at talie Niles, Lynn Kysh, MLIS, & risk=4.0 (95%CI:1.4,11.4)]. internal (IR) rotation strength in elevated risk, deficits in motor Barbara Sargent After 1 year, DH-pain had professional baseball players. control are not well identified.

The Explorer Journal 2021 Abstracts 71 including pitching mechanics pitching including physical factorsand modifiable strength andsuch as muscle range of motion. ------(p 2 - Con- = 0.15 2 : Research Purpose: Ball = 0.17; Beta= 0.009; 2 (range= 0.001-0.33), p > 0.05]. Pitchers with a significant torque-velocity relationship had a significantly larger R < 0.001) and slope (p= 0.01) compared to those without a significant relationship, with the intercept approaching significance (p= 0.055). The torque-velocity clusions: relationship was significant across pitchers, however this relationship appears to be Thirteen largely pitcher-specific. pitchers had a significant torque-velocity relationship with 72% of the variance explained, which was 57% higher than those 14 pitchers without a significant torque-velocity rela There are a number of tionship. potential factors that influence the torque-velocity relationship, and elbow valgus torque valgus and elbow Lobb NJ, Authors: Garcia NS, Yasen AJ, Zerega RJ, Barrack HB, Karim R, A, Rittenberry LA AR, & Michener Karduna : Lori Michen Faculty advisor er Abstract type Background/ ofvelocity and the prevalence (UCL)ulnar collateral ligament increasedreconstruction have Baseballamong Major League the UCL pitchers. Given that provides 54% of resistance duringto elbow valgus torque be usedpitching, torque can UCL as a surrogate to quantify The between-subject injury risk. relationship between ball ve locity and elbow valgus torque is low and highly variable when looking at individual pitchers, indicating that the torque-veloc ity relationship may be pitch er-specific. Here we analyze the between and within-pitcher relationship between torque Across Results: and velocity. pitchers, velocity was signifi cantly related to elbow varus torque (R p= 0.034). For within-sub jects, 13 (48%) pitchers had a significant torque-velocity relationship [average R2= 0.72 (range= 0.47-0.90); average (range= 0.005- Beta= 0.011 The remaining 0.017); p<0.05]. 14 (52%) pitchers did not have a significant torque-velocity relationship [average R -

- - - - : The : & THERAPY PHYSICAL PHYSICAL AFFILIATES sures and gold-standards for locomotion (APDM sensors) and arm/hand actions (video annotation). Usability was assessed through end-user Agreement feedback. Results: between the gold-standards and MiGo ranged from 68.5- 75.2% for step counts, 99% for stance time symmetry and UL active movement time. Social acceptability and perceived usability were high, with 95% of participants indicating a willingness to use all 5 sensors 10% of partic- However, daily. ipants experienced difficulty the to independently don/doff sensors. Conclusion wearable system accurately movement measured active UL time and stance time symmetry with high perceived usability. APDM sen- The choice of the sors as the gold-standard may have contributed to the lower accuracy for step counts and requires further investigation. Poster #125 The pitcher-specific rela Title: tionship between pitch velocity sors (MiGo; wrists, ankles and sors (MiGo; wrists, ankles Participants hip). affected more Arm performed the Chedoke Activity Invento- and Hand ry (CAHAI) and a 2-minute the walk test (2MWT). For the CAHAI, MiGo measured For the active movement time. MiGo measured step 2MWT, counts and stance time sym- we deter- For validity, metry. mined the agreement between the wearable system mea able, multi-sensor system that system that able, multi-sensor and measures UL accurately while leveraging activity, LL optimize end-user feedback to Twenty Methods: usability. were chronic stroke survivors sen outfitted with 5 wearable uals with motor impairments. uals with motor a wear develop To Purpose: measuring upper (UL) and (UL) and upper measuring (LL) activity in an lower limb community unsupervised for individ setting, especially BIOKINESIOLOGY Herman Ostrow School of Dentistry USC School of of Ostrow Herman -

Pur- Results: : CIMT and and : CIMT : Research : Research Background: One of the most impenetrable problems after stroke is the gap between motor capacity and the amount of motor activity performed in Few wearable the community. systems exist for accurately tion: validity and usability Authors: Demers Marika, Bishop Lauri, Rowe Justin, Zondervan Daniel, & Winstein Carolee Faculty advisor: Carolee Winstein Abstract type Poster #124 multi-sensor Wearable Title: system for stroke rehabilita : This systematic review’s This systematic review’s pose: the objective is to evaluate on of motor intervention effect motor outcomes of children aged CP with or at high risk of : Nine 0 to 3 years. Methods databases were searched trials for randomized control on motor outcomes of (RCTs) for children motor interventions CP. with or at high risk of risk of Level of evidence and bias were assessed. included 811 RCTs Twenty-five children with or at high risk Interventions included: of CP. Constraint-Induced Movement n=5), motor Therapy (CIMT, learning approaches (n=14), - Treat Neuro-Developmental n=3), and lower ment (NDT, extremity activities (LE, n=2). Results support that CIMT improved hand function of the hand (small more-affected size) and to moderate effect motor learning improved fine and gross motor function size). No ef- (moderate effect and fects were found for NDT LE. Conclusion motor learning approaches are recommended to improve motor function of infants with Further or at high risk of CP. research is recommended. : Barbara : Barbara advisor Faculty Sargent type Abstract palsy : Cerebral Background movement (CP) is a lifelong by damage to disorder caused the developing brain. 72

To our fellow students, faculty, and staff:

It is our honor and privilege to present to you the Thirteenth Edition of The Explorer Journal of USC Student Research. In this edition, our talented student authors have brought you to the FROM forefront of some of the innovative and game-changing research being conducted within the numerous programs at the Herman Ostrow School of Dentistry of USC, including the Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy and the Division of Biokine- THE siology and Physical Therapy, all of which are proud members of the Ostrow family. EDITORS We would like to acknowledge the wonderful discoveries of all our fellow classmates and faculty that are engaged in research and those who continue to make meaningful breakthroughs for our profession. Despite the limitations imposed by the COVID-19 pandemic, we want to recognize the hard work and dedication that our classmates, faculty, and staff demonstrated during this time. Our keynote speakers truly showcase the efforts our community is making towards advancing science. Now, more than ever we highly encourage all our fellow students to pursue research. There are so many exciting opportunities available here at USC - whether it may be from restorative dentistry to occupational therapy or to biokinesiology to name a few, we hope the projects presented in this journal will spark curiosity and interest in pursuing research.

Lastly, we would like to thank everyone who has helped in organizing Research Day. The success of Research Day would not be possible without the immense support we have received from our faculty advisors Dr. Yang Chai, Dr. Parish Sedghizadeh, and the entire Research Day planning committee that have worked tirelessly behind the curtains in order to host Research Day virtually and make today a success. We are also very fortunate to have an amazing group of writers, photographers and leaders in Student Research Group without whom this journal would not be possible. We hope you enjoy this issue of The Explorer!

Thank you so much for all the support, and Fight On! Teresa Nguyen & Chenxin Li Presidents / Editors in Chief

Faculty Advisors Editors: Yang Chai, DDS, PhD Andrea Diaz 2020-2021 Parish Sedghizadeh, DDS, MS Bridget Samuels

Vice President Student Research Involvement Directors Design Editors Secretary Photographer Mahboobeh Mirzaei Evi Sipola & Mirza Baig Caroline Fukawa & Jaime Huh Victoria Tran Natalie Black

The Explorer Journal 2021 73 STUDENT RESEARCH GROUP (SRG) Authors THE EXPLORER JOURNAL OF USC STUDENT RESEARCH VOLUME 13 Group

In alphabetical order: Scott Barlow, William Chakar, Sumi Chung, Michael Debourg II, Parinaz Esteghamat Tehrani, Catherine Frusetta, Abigail Heleba, Emilie Hsu, Ilan Kaboud, Yoo Jin Kim, Jessica Kim, Isatu Malekani, Antranig Mesrobian, Danielle Min, Greg Park, Brandon Pham, Ava Pournejad, Christie Shen, Sam Sheridan, George Simonyan, Sarina Taylor, Fan Xu, Iris Yu, Abraham Zilberstein

Herman Ostrow School of Dentistry of USC 74

RESEARCH DAY RESEARCH DAY PLANNING 2021 COMMITTEE

Yang Chai Parish Sedghizadeh Mary Lawlor Lori Michener Donna Castillo Jaime Gonzalez Patty Gutierrez Linda Hattemer Thach-Vu Ho Lynn Matsumoto Jacqueline Cordova Bridget Samuels Andrea Diaz Eva Janeckova Lauren Bobzin MAY 26, 2021 MAY

The Explorer Journal 2021 75

Front cover photo: Courtesy of Amanda Frataccia - “Cranial suture regeneration mitigates skull and neurocognitive defects in craniosynostosis.”

The Explorer Journal of Student Research is published annually by members of the student body from the Herman Ostrow School of Dentistry of USC.

All views are of the authors and do not necessarily represent those of the student body of the Herman Ostrow School of Dentistry of USC nor of the editors of the Ex- plorer Journal, unless such statements have been officially adopted by the Universi- ty. The Explorer Journal editorial board reserves the right to reduce, revise or reject any material submitted for publication. Articles and photos published in the Explorer Journal are the property of the Explorer Journal and may be reproduced or reprinted only after written permission has been granted. The editors and founder reserve the right to accept, reject, discontinue or edit any article, letter, or abstract submitted for publication.

Herman Ostrow School of Dentistry of USC