Digital Commons Network^™

Maternal Anxiety And Neural Responses To Infant Cues, Emily Vancor

Yale Medicine Thesis Digital Library

Maternal anxiety is highly prevalent during pregnancy and the postpartum period and is associated with disruptions to children’s socioemotional development. These long-term outcomes are thought to be mediated in part by anxiety’s effects on parenting and parental sensitivity to infant cues. Recent event-related potential (ERP) studies have found a positive association between generalized anxiety symptoms during the perinatal time and enhanced sustained processing of neutral infant faces. It has been suggested that for perinatal women with anxiety, the uncertainty of how an infant with a neutral expression may be feeling could be experienced as distressing, leading to enhanced sustained neural …

Myrf Represses Nodal Signaling Via Furin During Left-Right Patterning And Gastrulation, Sarah Amalraj

Yale Medicine Thesis Digital Library

Congenital heart disease (CHD) is the most common major birth defect in children, affecting nearly 3% of children and is the leading cause of infant mortality. Heterotaxy (Htx) is a disorder of left-right (LR) patterning, in which organs, including the heart, are mispatterned relative to the LR axis. Htx is associated with severe forms of CHD, but its genetic causes remain largely undefined. Exome sequencing studies of large patient cohorts have recently revealed hundreds of CHD/Htx candidate disease genes, which now need to be validated in experimental systems for causality in order to better understand the causes and biological mechanisms …

Editor's Commentary: The Relationship Of Vertical Turbulence And Spring Diatom Flowerings, Peter Franks

Journal of Marine Research

The dynamics of spring blooms of phytoplankton in temperate waters are usually associated with H.U. Sverdrup’s 1953 “critical depth” model. However, more than a decade earlier, Gordon Riley published a statistical and mechanistic analysis of data he had gathered over two spring “flowerings” on Georges Bank...

Classic Article: The Relationship Of Vertical Turbulence And Spring Diatom Flowerings, Gordon A. Riley

Journal of Marine Research

The causes underlying the initiation of the spring diatom flowering have been a subject of vigorous discussion in recent years. With the gradual accumulation of records it has become quite clear that no one factor controls this peculiar phenomenon. The obvious prerequisite, an abundant supply of nutrient salts in the euphotic zone, is generally satisfied during the autumn and early winter, yet a flowering does not in most cases follow immediately. In a few localities, such as Cape Cod Bay and Ipswich Bay (Bigelow 1926), the Woods Hole region (Fish 1925), and Long Island Sound (Riley 1941a), diatom bursts have …

Assessing Trends In Industry Payments To Orthopaedic Surgeons: A Sub-Specialty Analysis, Neil Pathak

Yale Medicine Thesis Digital Library

Background: The Open Payments Database (OPD), mandated by the Sunshine Act, is a listing of physician-industry payments. With the growing scrutiny of such transactions, the present study aims to characterize and investigate trends in industry payments to orthopaedic surgeons using four full years of data available. The study assessed payments to four orthopaedic sub-specialties: (1) pediatric surgery, (2) foot and ankle (F&A) surgery, (3) spine surgery, (4) adult reconstructive surgery. As the majority of industry payments were classified as General (other categories are Research and Ownership), the present study primarily focused on General payments.

Methods: Industry payments were characterized by …

Discipline, Diagnose & Punish: A Critical Analysis Of Ptsd Diagnostication Amongst Syrian Migrants In Jordan, Erik Kramer

Yale Medicine Thesis Digital Library

This qualitative project seeks to explore sociopolitical factors influencing post-traumatic stress disorder (PTSD) diagnostication in Syrian migrants living in Jordan. Interviews were performed with twenty-three key informants, comprised of clinicians, organizational staff, and scholars, using semi-structured techniques which were analyzed with grounded theory analytic approaches. The results illuminate the complex social forces governing the practice of PTSD diagnostication in the Syrian migrant population in Jordan, with a focus on the effects of financial pressures. This is the first study to report extensively on the financial pressures affecting PTSD diagnostication in this setting. These data served as rooted substrate for a …

Assessment Of Children’S Personal And Land Use Regression Model-Estimated Exposure To No2 In Springfield, Massachusetts, Sarah Esenther

Public Health Theses

Personal NO2 measurements were taken for a cohort of seventh-grade students (n=25) attending a magnet school in Springfield, MA with an elevated prevalence of pediatric asthma (17.2%). These personal measurements were compared with exposures predicted through a land use regression (LUR) model constructed from built environment and land use characteristics across the area to assess personal exposures in NO2 exposures within the cohort. Springfield, Massachusetts was chosen as the study location because of its elevated prevalence of pediatric asthma (19%) compared to the state average (11%) coupled with the recognized sensitivity of asthmatic children to traffic-related air pollutants. The exposure …

Phylogeographic Insights Into Zika Virus In Puerto Rico, Chaney Christine Kalinich

Public Health Theses

During the larger epidemic in the Americas, Puerto Rico experienced an epidemic of Zika virus (ZIKV) between November 2015 and December 2016. During this period, 39,717 residents tested positive, or 1.1% of the population. Our team sequenced 84 ZIKV genomes directly from archived ZIKV-positive clinical samples from throughout the epidemic period, and from distinct regions of the island, in order to reconstruct the introduction(s) to and geographic spread of ZIKV in Puerto Rico. We found that ZIKV was circulating in the Greater Antilles by April (95% CI: February-June) of 2015, and was introduced to Puerto Rico by August (95% CI: …

Antimicrobial Resistance And Molecular Epidemiology Of Escherichia Coli Isolated From Urban And Rural River Systems, Christopher Robert Jossart

Public Health Theses

Antimicrobial resistance (AMR) is an emerging public health issue that threatens the efficacy of antibiotic treatment for bacterial infections and human health. Sources of antimicrobial resistance genes (ARGs) in the environment include wastewater treatment plants and animal feeding operations that discharge waste into waterways, such as rivers and streams. This retrospective descriptive study describes the presence of AMR, and specific ARGs in Escherichia coli isolates from two distinct watersheds, rural and urban, with the use of antimicrobial susceptibility testing, whole-genome sequencing (WGS) to detect ARGs, and multi-locus sequence typing. Antimicrobial susceptibility testing was performed for 143 E. coli isolates, 73 …

What Is Socialism Today? Conceptions Of A Cooperative Economy, John E. Roemer

Cowles Foundation Discussion Papers

Socialism is back on the political agenda in the United States. Politicians and some economists who identify as socialists, however, do not discuss property relations, a topic that was central in the intellectual history of socialism, but rather limit themselves to advocacy of economic reforms, funded through taxation, that would tilt the income distribution in favor of the disadvantaged in society. In the absence of a more precise discussion of property relations, the presumption must be that ownership of firms would remain private or corporate with privately owned shares. This formula is identified with the Nordic and other western European …

Decline In Medication Affordability Despite Closure Of The Medicare Part D Coverage Gap, Matthew Jordan Klebanoff

Yale Medicine Thesis Digital Library

The original Medicare Part D benefit included a gap in coverage, commonly known as the “doughnut hole,” where beneficiaries were responsible for 100% of drug costs. The Affordable Care Act included provisions to gradually close this gap, beginning in 2011, in order to reduce the financial burden of drug spending for Part D enrollees. Using a nationally representative survey of Medicare beneficiaries, we examined the effect of this policy on out-of-pocket drug spending and medication affordability. We found that the policy was associated with a decrease in out-of-pocket spending. However, this trend was limited to relatively healthy enrollees in stand-alone …

Differential Diagnosis Documentation In Emergency Medicine, Ruochen Zhang

Public Health Theses

Diagnosis is a central aspect of emergency medicine. Coming to the correct diagnosis impacts patient morbidity and mortality and also the healthcare expenditures. Medical decision making is driven by the path of figuring out the differential diagnosis. Once a decent Natural Language Processing (NLP) system is developed including general characterization of differential diagnose, associated with downstream testing, diagnostic error, etc., we could be able to automatically extract differential diagnoses within clinical notes, which would have a large impact on healthcare. The main purpose of our investigative study is the characterization of differential diagnosis documentation within emergency provider notes and the …

Annual Report 2019, Dexia Group N.V./S.A.

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No abstract provided.

Articles Of Agreement Of The International Monetary Fund, International Monetary Fund (Imf)

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No abstract provided.

The V Metric, Menopausal Hormone Therapy, And Breast Cancer Risk, Kevin Casey

Public Health Theses

Background and Aims. Long-term use of menopausal hormone therapy, typically in the form of estrogen or estrogen + progesterone, can increase the amount of dense breast tissue in women, which is associated with breast cancer. These changes are commonly measured using mammograms to calculate percent density; higher percent density is also associated with breast cancer. Newer methods of mammogram analysis look at spatial texture feature variation; these approaches are more sensitive than percent density, however the association between texture features and hormone therapy use is not well-documented. This study aims to analyze a specific texture feature, the V metric, which …

Fungal Community Characterization And Machine Learning Classification Of Building Mold Status Between Pre- And Post-Remediation, Truc T. Ly

Public Health Theses

As part of a larger sampling campaign with mold inspectors across the US, samples (dust and direct mold) from 11 New York homes during pre- and post-remediation were analyzed by sequencing the interspaced transcribed region of extracted DNA and bioinformatic methods. Overarching findings from this study include: 1) pre/post- remediation fungal communities exhibit subtle differences and 2) larger degrees of fungal community differences exist between direct mold and settled dust. Mainly known as environmentally derived fungal species, Cladosporium ramotenellum and Rhodosporidium diobovatum were the two main taxa to be abundant among post-remediation samples. The thermophilic fungi, Thielavia terrestris, was higher …

Contraception And Sexual Health Counseling In Adolescent And Young Adult Female Cancer Patients, Sarah Hadassah Abelman

Yale Medicine Thesis Digital Library

Introduction:

Adolescent and young adult women undergoing cancer treatment face unique reproductive health risks. The objectives of this study were to assess the prevalence of sexual health counseling and contraception use in the oncology setting, and to identify factors associated with these outcomes.

Methods:

After institutional review board approval, a retrospective chart review was conducted of female patients ages 15-25 receiving cancer treatment at Yale New Haven Hospital from 2013-2018. Univariate and multivariate analyses were used to assess the relationship between patient variables and the outcomes of counseling and contraception use. Additionally, with institutional review board approval, a cross-sectional survey …

Uncovering Intratumoral And Intertumoral Heterogeneity Among Single-Cell Cancer Specimens, William Shelton Chen

Yale Medicine Thesis Digital Library

While several tools have been developed to map axes of variation among individual cells, no analogous approaches exist for identifying axes of variation among multicellular biospecimens profiled at single-cell resolution. Developing such an approach is of great translational relevance and interest, as single-cell expression data are now often collected across numerous experimental conditions (e.g., representing different drug perturbation conditions, CRISPR knockdowns, or patients undergoing clinical trials) that need to be compared. In this work, “Phenotypic Earth Mover's Distance” (PhEMD) is presented as a solution to this problem. PhEMD is a general method for embedding a “manifold of manifolds,” in which …

Development And Validation Of A Predictive Model For Oncology Hospital-At-Home, Keval Niraj Desai

Yale Medicine Thesis Digital Library

Background:

Hospital-at-Home (HaH) is a unique care model that allows for the provision of inpatient level care in the patient’s home. HaH has been used to facilitate early discharge from inpatient care or to substitute entirely for an inpatient admission. Hospital-at-Home has been shown to have similar clinical outcomes to inpatient care, while reducing cost and complications associated with inpatient admission. Application of the HaH model to patients with oncologic disease is a promising avenue to reduce healthcare costs while improving patients’ quality of life by increasing time spent at home. A major challenge to implementing a Hospital-at-Home program for …

External Validation Of An Electronic Phenotyping Algorithm To Detect Attention To Elevated Bmi And Weight-Related Comorbidities In Pediatric Primary Care., Anya Golkowski Barron

Yale Medicine Thesis Digital Library

Pediatric obesity is a growing national and global concern with nearly 1 in 5 children in the U.S. affected [1].The American Academy of Pediatrics endorsed expert committee recommendations in 2007 to assist clinicians in pediatric weight management; however, adherence to these recommendations among primary care providers is suboptimal, and measuring adherence in feasible and pragmatic ways is challenging[2-4]. Commonly used quality measures that rely on billing data alone are an inadequate measure of provider attention to weight status in pediatric populations as they do not capture whether providers communicate about elevated body mass index (BMI) and associated medical risks with …

Acute And Chronic Liver Disease: Lessons Learned From Retrospective Cohort Studies, Ysabel C. Ilagan-Ying

Yale Medicine Thesis Digital Library

Current trends in liver disease are changing due to increased access to pharmacotherapies and the worsening burden of obesity. Large, observational cohort studies are a common tool in clinical and epidemiological research to determine risk for patients that may have experienced an exposure of interest. Past studies have largely examined risk factors for liver disease in patients with cirrhosis or fatty liver disease. We utilized retrospective cohort studies in a disease-agnostic approach and aimed to characterize risk for two increasingly prevalent populations: patients with severe acute liver injury and those with liver fibrosis progressing to hepatocellular carcinoma (HCC).

First, we …

Reversal Of Warfarin-Associated Coagulopathy: Prothrombin Complex Concentrates Versus Fresh Frozen Plasma In Elderly Patients Presenting With Intracranial Hemorrhage, Shunella Grace Lumas

Yale Medicine Thesis Digital Library

Background: Patients on warfarin with traumatic intracranial hemorrhage (ICH) often require pharmacological reversal of warfarin-induced coagulopathy. We compared outcomes among patients who received 4-factor prothrombin complex concentrate (PCC), fresh frozen plasma (FFP) or no reversal to assess the real-world impact of PCC on elderly patients with traumatic intracranial hemorrhage on warfarin.

Study Design: This was a retrospective analysis of 150 patients on preinjury warfarin. Data was abstracted from the electronic medical record (EMR) of an academic level 1 trauma center for patients age 65 years and greater on warfarin therapy admitted with a traumatic ICH between January 2013 and December …

How Exposure To Mass Incarceration Is Associated With The Wellbeing Of Individuals And Families, Ram Sundaresh

Yale Medicine Thesis Digital Library

Mass incarceration in America has far-reaching effects on individuals and their families. Although a large body of evidence has described the effects of incarceration on specific physical and social outcomes, there is almost no research on its effects on broader wellbeing, a more holistic measure of lived experience that can more sensitively reflect social welfare and structural vulnerability. The goal of this thesis is to assess the association between exposure to the American system of mass incarceration and wellbeing. We examine individual-level exposure to the broader criminal legal system (CLS), including police stops, arrests, and incarceration, and family-level exposure to …

Municipal Liquidity Facility Form Documents And Certifications, Federal Reserve System: Federal Reserve Bank Of New York

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No abstract provided.

The Effect Of Emergency Liquidity Assistance (Ela) On Bank Lending During The Euro Area Crisis, Heather Gibson, Stephen G. Hall, Pavlos Petroulas, Vassilis Spiliotopoulos, George S. Tavlas

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quantitative study examining the effect of ELA on bank lending in Greece, Cyprus, and Portugal

Contingent Term Repo Facility - Quick Reference Guide For Securities, Bank Of England/Central Bank Of The United Kingdom

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No abstract provided.

Contingent Term Repo Facility - Quick Reference Guide For Loans, Bank Of England/Central Bank Of The United Kingdom

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No abstract provided.

Rip Pbpp, Warren Lovely, Taylor Schleich

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No abstract provided.

Bad Bank Resolutions And Bank Lending, Michael Brei, Leonardo Gambacorta, Marcella Lucchetta, Bruno Maria Parigi

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No abstract provided.

Fannie Mae And Freddie Mac: What Happens When The Time-Out Is Over?, Sabrina Gardner

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No abstract provided.