Skip to main content
eScholarship
Open Access Publications from the University of California

Scholarly Works (7 results)

  • Article
Theses (1991)
    Cover page: Factors that Influence Medical Students' Choice of Specialty: A Composite Analysis of the LiteratureCreative Commons 'BY-NC-ND' version 4.0 license
    • Thesis
    • Peer Reviewed
    UC San Diego Electronic Theses and Dissertations (2019)

    Age-related macular degeneration (AMD) is a major cause of central vision loss among the elderly. Genome-wide association studies (GWAS) have implicated polymorphisms in complement factor H (CFH) and high-temperature requirement A1 (HTRA1) in progression to advanced AMD. The complement factor H plays a key regulator role in complement system of the innate immune defense. CFH is also found to have high affinity binding with oxidized phospholipids (oxPLs), which shields oxPLs from inducing inflammation in the eye. On the other hand, the HTRA1 is a serine protease that is identified to be an extracellular matrix homeostasis regulator and TGF-β1 pathway inhibitor. Despite the extensive studies on the two proteins’ respective properties and involved pathways, the mechanism between the genetic risk factors and AMD disease pathology remains to be explored. My research project investigates the cellular interactions and molecular mechanisms of CFH and HTRA1 in elevated oxidative stress environment. In this study, recombinant CFH and HTRA1 variants were produced for the experiments. The inhibitory effect of CFH and HTRA1 in modulating the uptake of oxidized low-density lipoprotein (oxLDL) into the retinal pigment epithelium cells (RPE) is demonstrated by Oil Red O staining. The CFH risk variant was identified to exhibit competitive binding against HTRA1 interaction with lipoproteins via competitive ELISA. Furthermore, CD36 mRNA expression is found to be significantly heightened with the administration of HTRA1 or oxidative stress. However, the CD36 protein level analysis via immunocytochemistry and western blot demonstrates reduction of CD36 protein expression by proteolytic active HTRA1. We also found that CD36 protein expression is either preserved or enhanced with the addition of CFH variants, which we speculate to protect CD36 against proteolytic cleavage by HTRA1. This preliminary evidence suggests that CFH and HTRA1 have an antagonistic effect on inhibiting oxidized phospholipids uptake in RPE cells. This finding provides a new aspect of complement independent role of CFH in lipid metabolism which may be explored as a therapeutic treatment to AMD.

      Cover page: CFH and HTRA1 exhibit antagonistic effect on inhibiting oxidized phospholipids uptake in human retinal pigment epithelial cells
      • Article
      • Peer Reviewed
      UCLA Previously Published Works (2020)

      Background

      Though patient-physician racial concordance correlates with better perceived shared decision-making, Chinese immigrants report low quality of care and have undertreated hypertension regardless of concordance.

      Objective

      To inform efforts to change physician behavior and improve quality of hypertension care, we used role theory to explore differences between Chinese American seniors' descriptions of current and desired physician roles in hypertension management.

      Design

      Qualitative interviews.

      Participants

      Immigrant Chinese Americans with hypertension age ≥ 65 years in Los Angeles County.

      Approach

      We recruited 15 participants from a senior wellness center for language-matched interviews and blood pressure (BP) checks. Participants described current and desired physician activities for hypertension management. Bilingual research assistants translated audio recordings. Using thematic analysis, a three-member team independently reviewed and coded transcripts to identify themes regarding physician roles in hypertension management; discrepancies were discussed to achieve consensus. Themes were checked for validity in four subsequent focus groups.

      Results

      We completed interviews in 2014. Interviewees' mean age was 70.6 years; seven were female and five had a systolic BP over 150 mmHg. All interviewees reported having race- and language-concordant primary care providers, were prescribed at least one BP medication, and had Medicare. Three major themes encompassed current and desired physician roles in hypertension management: technical expert, empathetic health steward, and health educator. Descriptions of current and desired physician roles differed for all themes, most prominently for empathetic health steward and health educator. Participants desired but did not consistently experience interpersonal engagement or receive hypertension lifestyle counseling, citing visit time pressures.

      Conclusions

      Among these Chinese American seniors, there remains a gap between current and desired physician roles in hypertension management, particularly interpersonal behaviors and education. Seniors deprioritized these roles in response to perceived physician role strain. Increased attention to the impact of perceived physician role strain might improve shared decision-making and hypertension management.
        Cover page: Differences Between Current and Desired Physician Hypertension Management Roles Among Chinese American Seniors: a Qualitative Study
        • Article
        • Peer Reviewed
        UC San Diego Previously Published Works (2019)

        Objectives

        To describe advertising tactics of cigarette, e-cigarette, little cigar/cigarillo and smokeless tobacco manufacturers.

        Methods

        We conducted a content analysis of tobacco 827 ads run in the US in 2016. Ads were double coded by trained coders across ten domains: promotions, web/social media presence, use cues, warnings and disclaimers, descriptors, claims, activities, setting, imagery, and themes.

        Results

        Cigarette ads relied on promotional tactics like discounts and sweepstakes and featured links to websites and mobile apps, all of which can increase brand loyalty and customer engagement. E-cigarette ads used tactics that appear to target new consumers, such as highlighting the product's qualities and modeling product use. Little cigar/cigarillo ads often positioned the product as social and featured music, urban and nightlife settings. Smokeless tobacco ads frequently featured themes, activities and settings stereotypically thought of as masculine.

        Conclusions

        The tactics used to advertise tobacco products can help generate new consumers, encourage product/brand switching, and escalate use among current users. Understanding how different products are advertised can inform the Food and Drug Administration's regulatory efforts, and tobacco counter-marketing campaigns.
          Cover page: Selling tobacco: A comprehensive analysis of the U.S. tobacco advertising landscape
          • Article
          • Peer Reviewed
          UC San Diego Previously Published Works (2019)

          Objectives

          To describe advertising tactics of cigarette, e-cigarette, little cigar/cigarillo and smokeless tobacco manufacturers.

          Methods

          We conducted a content analysis of tobacco 827 ads run in the US in 2016. Ads were double coded by trained coders across ten domains: promotions, web/social media presence, use cues, warnings and disclaimers, descriptors, claims, activities, setting, imagery, and themes.

          Results

          Cigarette ads relied on promotional tactics like discounts and sweepstakes and featured links to websites and mobile apps, all of which can increase brand loyalty and customer engagement. E-cigarette ads used tactics that appear to target new consumers, such as highlighting the product's qualities and modeling product use. Little cigar/cigarillo ads often positioned the product as social and featured music, urban and nightlife settings. Smokeless tobacco ads frequently featured themes, activities and settings stereotypically thought of as masculine.

          Conclusions

          The tactics used to advertise tobacco products can help generate new consumers, encourage product/brand switching, and escalate use among current users. Understanding how different products are advertised can inform the Food and Drug Administration's regulatory efforts, and tobacco counter-marketing campaigns.
            Cover page: Selling tobacco: A comprehensive analysis of the U.S. tobacco advertising landscape.
            • Article
            • Peer Reviewed
            UC San Diego Previously Published Works (2013)

            Objective

            To evaluate and compare the attitudes and preferences of younger and older adults regarding health information exchange with providers, and identify barriers and limitations to meaningful use.

            Study design

            Cross-sectional study.

            Methods

            Qualitative and quantitative data gathered from online surveys of younger and older adult patients enrolled in a freestanding, Internetbased patient-physician messaging system that requires an individual account. This messaging system is only a secure messaging center, and does not allow for direct access to personal medical records.

            Results

            Data were collected from 324 patients (or proxy users) who reported their age, with 55.2% of respondents under the age of 65 years (mean age 48.2 years) and 44.8% of respondents 65 years or older (mean age 74.9 years). Family and non-family caregivers (proxy users) (mean age 59.2 years) comprised 21.0% of respondents. Overall, 83.9% of all respondents preferred to communicate with the provider via e-mail, and 84.5% of users found the messaging system easy to use, with a majority utilizing the messaging system to communicate about health questions and/or medication requests. Finally, 83% of user respondents were satisfied with the messaging system. Results highlight several areas where improvement is needed to increase patient use and satisfaction including adequate patient education, user-friendly interface, and provider engagement. No significant differences between the younger and older adult populations were found.

            Conclusion

            Although a majority of enrolled older adult patients have positive attitudes about health information exchange, electronic communication platforms must address key issues in consumer education, physician commitment, and adoption of an accessible interface to ensure productive older adult consumer participation.
              • Article
              • Peer Reviewed
              UC San Diego Previously Published Works (2014)

              Objectives

              Evaluate safety of autogenous engineered septal neocartilage grafts.Compare properties of implanted grafts versus in vitro controls.

              Study design

              Prospective, basic science.

              Setting

              Research laboratory.

              Methods

              Constructs were fabricated from septal cartilage and serum harvested from adult rabbits and then cultured in vitro or implanted on the nasal dorsum as autogenous grafts for 30 or 60 days. Rabbits were monitored for local and systemic complications. Histological, biochemical and biomechanical properties of implanted and in vitro constructs were evaluated and compared.

              Results

              No systemic or serious local complications were observed. After 30 and 60 days, implanted constructs contained more DNA (p<0.01) and less sGAG per DNA (p<0.05) when compared with in vitro controls. Confined compressive aggregate moduli were also higher in implanted constructs when compared with in vitro controls (p<0.05) and increased with longer in vivo incubation time (p<0.01). Implanted constructs displayed resorption rates of 20-45 percent. Calcium deposition in implanted constructs was observed using alizarin red histochemistry and microtomographic analyses.

              Conclusion

              Autogenous engineered septal cartilage grafts were well tolerated. As seen in experiments with athymic mice, implanted constructs accumulated more DNA and less sGAG when compared with in vitro controls. Confined compressive aggregate moduli were also higher in implanted constructs. Implanted constructs displayed resorption rates similar to previously published studies using autogenous implants of native cartilage. The basis for observed calcification in implanted constructs and its effect on long-term graft efficacy is unknown at this time and will be a focus of future studies.
                Cover page: Evaluation of Autogenous Engineered Septal Cartilage Grafts in Rabbits: A Minimally Invasive Preclinical Model
                Top