Digital Commons Network^™

Prevalence, Management, And Outcomes Associated With Obstructive Sleep Apnea In The Medical Icu, Madeline Lilly Ehrenberg

Yale Medicine Thesis Digital Library

The prevalence of Obstructive Sleep Apnea (OSA) in the general adult population has been estimated to be between 9-17% in women and 25-30% in men. However, the prevalence of OSA among medical intensive care unit (MICU) patients is unknown. A 2015 systematic review by Knauert et al demonstrated the associations of OSA with many chronic diseases commonly seen in MICU patients (for instance, hypertension, type II diabetes mellitus, and congestive heart failure). This same review also shed light on the gaps in knowledge surrounding OSA, including underdiagnosis, undertreatment, and lack of research. Given the overall prevalence of OSA and the …

Predictors Of Adverse Outcomes In Adolescent Idiopathic Scoliosis And The Impact Of A Quality Improvement Initiative, Astrid C. Hengartner

Yale Medicine Thesis Digital Library

Posterior Spinal Fusion (PSF) is a common surgical intervention for severe cases of adolescent idiopathic scoliosis (AIS). However, prolonged hospital stays due to delayed ambulation and extended transition from intravenous (IV) to oral analgesics are significant concerns. In this study, we investigate the risk factors for delayed ambulation and prolonged transition to oral analgesics, and their respective impacts on hospital length of stay (LOS). Additionally, we explore the impact of a multidisciplinary Quality Improvement (QI) spine conference initiative on perioperative outcomes for patients undergoing PSF for AIS.This retrospective cohort analysis was carried out on 126 adolescents who underwent elective PSF …

Maternal Prenatal Anxiety And Child Epigenetic Aging: A Longitudinal Analysis From Childhood To Mid-Adolescence, Shashwat Kala

Yale Medicine Thesis Digital Library

The developmental origins of health and disease posits that in utero exposures and early life experiences increases susceptibility to a host of pathologies. Maternal psychopathology, specifically maternal prenatal anxiety, has been studied as an in utero stressor that can affect childhood development and epigenetic aging. In the current study, we analyzed the longitudinal effects of maternal prenatal anxiety on epigenetic aging, assessed sex-specific effects, and tested the contribution of cellular heterogeneity to these findings. Using the longitudinal Basal Influences on Baby Development (BIBO) cohort, we performed a mixed model for repeated measures to determine how prenatal and postnatal anxiety (State-Trait …

Exploring The Journey To Heart Failure Diagnosis In Uganda, Teimur Kayani

Yale Medicine Thesis Digital Library

This study sought to explore the healthcare journeys of patients recently diagnosed with heart failure (HF) in Uganda. Using a semi-structured guide developed in collaboration with Ugandan colleagues, we conducted in-depth interviews with 19 patients diagnosed with HF within the past three months across four regional referral hospitals in Uganda. Interviews were conducted in the participant’s preferred language (English, Luganda, Lugbara, Lugisu, or Swahili) using trained research assistants (RAs) and were recorded, transcribed verbatim, and thematically analyzed using the socioecological framework (SEM) to capture individual, interpersonal, community, and systemic-level barriers to HF care.Findings revealed a total of 11 themes spread …

Investigating The Cooccurrence Of Papillary Thyroid Carcinoma Among Patients With Oncocytic Pathology: Is There Evidence Of Causation?, Forest Seely Mahoney

Yale Medicine Thesis Digital Library

Thyroid neoplasms, both benign and malignant, significantly contribute to healthcare burden in the United States. Oncocytic neoplasms (ON), previously classified as Hürthle-cell neoplasms and comprising oncocytic adenoma (OA) and oncocytic carcinomas (OC), represent a rare subset of follicular cell-derived thyroid pathology, accounting for 3–7% of all thyroid malignancies. OC are considered more aggressive with worse prognosis due to higher rates of recurrence as well as inherent resistance to radioactive iodine, the first line of adjunct therapy for well-differentiated thyroid cancers. Conversely, papillary thyroid carcinoma (PTC), another follicular cell-derived thyroid cancer, constitutes over 90% of thyroid cancer cases and is characterized …

International Structural Magnetic Resonance Imaging Of Cortical Thickness In Older Adults With Bipolar Disorder, Rebecca Brynn Marks

Yale Medicine Thesis Digital Library

The presentation of bipolar disorder (BD) seems to change over the course of a lifetime. In older adults, BD seems to pose novel challenges including decreased cognitive functioning, psychiatric and medical comorbidities, increased susceptibility to medication side effects, and possibly even a shift toward more depressive symptoms. Despite these clinical findings, research into older adults with BD has lagged behind that of adolescents and young adults. As the global population ages, so too do individuals with BD. In fact, it is predicted that by 2030, 50% of patients with BD will be over the age of 60. This emphasizes why …

A Mechanical Etiology Of Lateral Patellofemoral Arthritis, Nancy Park

Yale Medicine Thesis Digital Library

The relationship between anatomic risk factors for patellar instability and patellofemoral cartilage loss in the general population remains unclear. This study aimed to determine whether common measures of patellar instability are associated with lateral patellofemoral cartilage loss. A secondary objective was to evaluate the inter- and intra-rater reliability of 21 anatomical landmarks, initially placed using an artificial intelligence algorithm and subsequently verified with human input. We analyzed 389 non-weight-bearing computed tomography scans of knee joints from participants enrolled in the Multicenter Osteoarthritis Study. Baseline and 2-year follow-up knee magnetic resonance images were scored for patellofemoral cartilage morphology using the magnetic …

Tigit And Gdf-15 As Biomarkers And Targets In Renal Cell Carcinoma Resistant To Immune Checkpoint Inhibitors, Oscar Norberto Perales

Yale Medicine Thesis Digital Library

Immune checkpoint inhibitors have become the standard of care treatment for local and systemic clear cell renal cell carcinoma (RCC). However, a subset of patients fail these therapies due to the development of disease refractory to such treatments. Therefore, it is imperative that we study the potential mechanisms of resistance to immune checkpoint inhibition within the tumor microenvironment. Likewise, establishing biomarkers indicative of treatment resistance may benefit clinicians and patients when it comes to the initial selection of treatment. Moreover, biomarkers of resistance might also serve as potential drug targets. In this study we analyzed expression of TIGIT and GDF-15, …

Cutaneous Fungal Infections In The United States: A Cross-Sectional Analysis Of National Surveys, Sarah Lee Spaulding

Yale Medicine Thesis Digital Library

Superficial cutaneous fungal infections (SCFIs), caused by yeasts, dermatophytes, and nondermatophyte molds, are prevalent skin conditions with substantial economic and quality-of-life implications. This study aimed to evaluate trends in the prevalence of SCFIs in the United States between 2005 and 2016, using data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS).We performed a cross-sectional analysis of outpatient visits with SCFIs diagnoses, identified through the International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification (ICD-9-CM and ICD-10-CM). Diagnoses included conditions such as tinea unguium, tinea pedis, and candidiasis of the skin …

Macrophage Migration Inhibitory Factor And D-Dopachrome Tautomerase As Biomarkers And Key Modulators Of Tumor Progression In Head And Neck Cancer And Melanoma, Caroline Naomi Valdez

Yale Medicine Thesis Digital Library

Macrophage Migration Inhibitory Factor (MIF) and its homolog D-dopachrome Tautomerase (DDT) are pro-inflammatory cytokines implicated in tumor progression across multiple cancers. Both MIF and DDT act through canonical CD74 and non-canonical CXCR2/4/7 signaling pathways, which contribute to immune suppression and tumor progression. Elevated MIF levels are associated with metastasis and poor prognosis in HNC and contribute to immune checkpoint inhibitor (ICI) resistance in melanoma. DDT’s role in cancer is not well understood. This study aims to evaluate the expression and therapeutic potential of MIF and DDT inhibition, focusing on their ability to modulate immune responses and improve survival outcomes as …

Portable Magnetic Resonance Imaging Safety, Comfort, And Compatibility With Mobile Vehicular Platforms, Jacob Howard

Yale Medicine Thesis Digital Library

Magnetic Resonance Imaging (MRI) has evolved rapidly since its early days of imaging vials of water and mice when it was known as “zeugmatography”. As advancements in semiconductors increase computational power and algorithmic techniques stretch what we can do with this power, MRI capability is advancing beyond the conventional restraints of room-bound scanners. Low-field magnetic resonance imaging (LF-MRI) that utilizes magnets typically 1/10th the size of traditional magnets has opened the door to mobilizing this imaging modality and increased flexibility in scanner design. With these developments, a new generation of portable MRI (pMRI) is beginning its use in the hospital …

Sharing Unexpected News After Traumatic Death: A Modified Delphi Study, Kirsten Lalli

Yale Medicine Thesis Digital Library

BackgroundGlobally, violence against healthcare workers in Emergency Departments (EDs) is alarmingly common and increasing in prevalence. While workplace violence is possible in any patient encounter, disclosure of traumatic deaths to family and friends may be uniquely high-risk.

Research AimsThe objective of this study is to establish consensus guidelines with multidisciplinary staff to improve safety in the emergency department of a large, urban, Level I trauma center when disclosing traumatic deaths.

HypothesisInterdisciplinary professionals in an emergency department can create consensus around best practices to improve safety in the ED when disclosing traumatic deaths.

MethodsWe conducted this study using a modified Delphi …

Yale Medicine Magazine December 2025, Issue 175, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the December 2025 issue of Yale Medicine Magazine, issue 175. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965) and Yale Medicine: alumni bulletin of the School of Medicine, v.1 (1965) through v. 52, no.1. (Autumn 2017).

From Clinic To Court: Feminist Organizing And The Fight For Birth Control In Griswold V. Connecticut, Lynn Q. Lee

Kaplan Senior Essay Prize for Use of Library Special Collections

In 1961, Planned Parenthood League of Connecticut (PPLC) Director Estelle Griswold and Yale School of Medicine Department of Obstetrics and Gynecology Chair Dr. Charles Lee Buxton were arrested. Charged with opening an illegal birth control clinic in New Haven, the two embarked on a four-year battle to overturn Connecticut’s decades-old anti-birth control law. The resulting Supreme Court case, Griswold v. Connecticut (1965), was the culmination of decades of advocacy, coalition building, and cultural conflict over reproductive rights in one of the nation’s most restrictive states.

Griswold v. Connecticut established the constitutional right to marital privacy, creating the protection needed for …

A Theory Of Economic Justice, Marshall Paul Forrester

Yale Graduate School of Arts and Sciences Dissertations

This dissertation develops a theory of economic justice. It begins with an economic state of nature, much like Hobbes's political state of nature. In the economic state of nature, there is no economic cooperation through the division of labor and specialization, and everyone is very poor. The purpose of the dissertation is to identify the conditions for just economic cooperation. I argue that each participant in economic cooperation should be rewarded according to their contributions. The first chapter draws on Henry George to argue that there is a fundamental difference between land and the other two factors of production, labor …

Language, Categorization, And Control: Examining Exclusion In Refugee Regimes Through The Shift From Muhājir To Lājiʾ, Cormac M. Thorpe

Harvey M. Applebaum ’59 Award

No abstract provided.

Essays On Political Violence And Democratic Competition In Western Democracies, Moritz Emanuel Bondeli

Yale Graduate School of Arts and Sciences Dissertations

This dissertation sheds new light on the causes of political violence as well as its consequences for democratic competition, focusing on Western democracies. My first essay examines the interplay of policing, political violence and democratic backsliding in Weimar Germany. It establishes that the preferences and incentives of law enforcement officials are central to understanding variation in political violence in this context. The essay combines original quantitative data on law enforcement staffing and party mobilization efforts with secondary data on incidents of lethal political violence and electoral outcomes to build an original county-level panel dataset for the German state of Prussia, …

Games In A High-Dimensional World: An Interplay Between Machine Learning And Game Theory, Anargyros Oikonomou

Yale Graduate School of Arts and Sciences Dissertations

Motivated by the growing number of applications at the intersection of game theory and machine learning, including alignment, AI agents like automated bidders, training generative models, and high-dimensional mechanism design, this dissertation explores the interplay between the two fields. Specifically, we show how machine learning can gain insights from game-theoretic multi-agent optimization techniques and how game theory can benefit from machine learning techniques. The first part of this work focuses on leveraging game-theoretic insights to improve optimization algorithms in multi-agent machine learning. Traditional methods, such as gradient descent, often fail to converge when training multi-agent systems with competing objectives. This …

Chk2 Sustains Mitotic Plk1 Activity To Promote Proper Chromosome Segregation, Elizabeth Maureen Black

Yale Graduate School of Arts and Sciences Dissertations

Polo-like kinase 1 (PLK1) protects against genome instability by ensuring timely and accurate mitotic cell division, and its activity is tightly regulated throughout the cell cycle. Although the pathways that initially activate PLK1 in G2 are well-characterized, the factors that directly regulate mitotic PLK1 remain poorly understood. Here, I identify that human PLK1 activity is sustained by the DNA damage response kinase Checkpoint kinase 2 (Chk2) in mitosis. Chk2 directly phosphorylates PLK1 T210, a residue on its T-loop whose phosphorylation is essential for full PLK1 kinase activity. Loss of Chk2-dependent PLK1 activity causes increased mitotic errors, including chromosome misalignment, chromosome …

Resource-Aware Distributed Machine Learning: Unified Approaches For Private And Efficient On-Device Intelligence, Yeshwanth Venkatesha

Yale Graduate School of Arts and Sciences Dissertations

The widespread integration of Artificial Intelligence (AI) into everyday life is driving a paradigm shift towards deploying machine learning models on a massive, distributed ecosystem of edge devices. While this decentralization offers opportunities for data-driven applications, it introduces a fundamental trilemma: the concurrent pursuit of high performance, operational efficiency, and stringent data privacy. State-of-the-art AI models, particularly Large Language Models (LLMs), demand computational and memory resources that far exceed the capabilities of typical edge devices, creating significant bottlenecks in training and inference. Furthermore, the distributed nature of data gives rise to challenges of statistical heterogeneity and communication overhead, while the …

Regulation Of Pre-Mrna Processing Through Nascent Rna Folding, Leonard Schaerfen

Yale Graduate School of Arts and Sciences Dissertations

RNA sequence determines the formation of intramolecular base pairs. Together with tertiary contacts, base pairs define every RNA's structure, or fold. The catalytic, regulatory, or coding potential of an RNA strongly depends on its folding pattern. Because base pairing occurs much faster than RNA synthesis (transcription) in cells, early structural states can govern RNA processing events and dictate the formation of functional conformations. These co-transcriptional structural states remained largely unknown. To address this gap, I developed CoSTseq, a chemical probing and enrichment method to measure nascent RNA base pairing upon exit from RNA polymerases (Pols) transcriptome-wide in living Saccharomyces cerevisiae …

Emotion Inferences: An Integrative And Dynamic Process, Srishti Goel

Yale Graduate School of Arts and Sciences Dissertations

Our understanding of what others around us feel, a process referred to as emotion inference, fundamentally shapes our behavior and social interactions. Early work largely focused on how people infer emotions from isolated, static, canonical facial expressions. Accumulating evidence and theoretical advancements suggest that emotion inference, instead, is a complex process that involves making meaning about a target’s experience by dynamically synthesizing information from multiple sources with existing knowledge. Yet, a comprehensive empirical account that captures this complexity is largely missing from the literature. In this dissertation, I propose and systematically test a research framework that addresses this complexity of …

Controlling And Protecting Quantum Information In Superconducting Oscillators, Aniket Maiti

Yale Graduate School of Arts and Sciences Dissertations

Modern quantum experiments allow the precise manipulation and measurement of many-body quantum states, pushing quantum mechanics from a testable theory to a utilizable technology. The central promise of these experiments is to process quantum information for exponential advantages in computing, sensing, and communication. An interesting way to achieve such a processor is to manipulate quantum information stored in the continuous-variable (bosonic) phase space of electromagnetic radiation. Since photons in free space do not interact, such an approach necessarily requires the introduction of nonlinearity through strong light-matter couplings. However, since all matter is lossy, this inevitably introduces a trade-off between the …

Framed Bundles, Abelianization, And The Ooguri-Vafa Space, Danny Nackan

Yale Graduate School of Arts and Sciences Dissertations

In this thesis we study the hyperkähler structure of a particular moduli space of Higgs bundles near the discriminant locus of the Hitchin fibration, which in this case consists of quadratic differentials with a double zero.

Gaiotto, Moore, and Neitzke predicted that the hyperkähler Ooguri-Vafa space Mov should provide a local model for Hitchin moduli spaces near the discriminant locus. To this end, Tulli identified Mov with a certain space of framed Higgs bundles with an irregular singularity.

We extend this result by identifying the Ooguri-Vafa holomorphic symplectic form with a regularized version of the Atiyah-Bott form on …

Characterizing The Photochemistry And Photophysics Of Benzoylbenzoate And Formylbenzoate Anions Using Cryogenic Ion Spectroscopy, Olivia Caroline Moss

Yale Graduate School of Arts and Sciences Dissertations

Marine chromophoric dissolved organic matter (mCDOM) is a large and complex class of material predominantly found at the air-water interface in bodies of water. While it is known to generate radicals and unwanted byproducts, such as HONO· and ·OH, the mechanism of formation for these products currently is unknown. In this dissertation, a bottom-up approach is utilized to investigate possible reaction pathways by scaling down to small-molecule models of mCDOM. Namely, this dissertation investigates the photochemistry and photophysics of benzoylbenzoates (BBA¯). Analysis of the UV spectrum of the deprotonated species reveals two dominant processes upon photoexcitation of 4BBA¯, tag loss …

Planets Are Not Points: The Profound Effect Of Planetary Structure On Exoplanet System Architectures, Tiger Chen Lu

Yale Graduate School of Arts and Sciences Dissertations

The quantity and quality of astronomical data has advanced to the point in which truly detailed and nuanced theoretical models are necessary. In the field of exoplanetary dynamics, it has become increasingly clear that we must account for the effects of planetary structure when considering the dynamics of the system. In other words, Planets are not Points. This dissertation details my contributions to the field of exoplanet dynamics, split into three subcategories:

• Part I (Chapters 2 - 3): Numerical Methods & the N-Body Problem. These chapters discusses the numerical methods I have developed to study the analytically unsolvable N-Body …

Computation And Estimation For Neural Networks Via Log-Concave Coupling, Curtis James Mcdonald

Yale Graduate School of Arts and Sciences Dissertations

In this work, we consider a Bayesian method to train single-hidden-layer neural networks with ℓ1 controlled weights by defining posterior distributions using different subsets of the training data, and combining posterior means to form our estimators. We consider both a joint Bayesian model for all parameters of the neural network at once, and a greedy Bayes model training the neurons one at a time based on the residuals of previous fits.

The log-likelihoods of the posterior distributions we define are multimodal and nonconcave, so sampling algorithms such as Markov Chain Monte Carlo (MCMC) will not be rapidly mixing to …

Quantum Computing In Discrete- And Continuous-Variable Architectures, Shraddha Singh

Yale Graduate School of Arts and Sciences Dissertations

This dissertation develops a theoretical framework for hybrid discrete-variable (DV) and continuous-variable (CV) quantum systems, focusing on control, state preparation, and error correction. Quantum computing holds the potential to surpass classical computation in tasks such as factorization, secure communication, and quantum simulation. Hybrid CV-DV systems offer a promising path by combining the stability and long coherence times of oscillators with the fast gate operations of qubits.

A central contribution of this work is the development of “non-abelian quantum signal processing” (NA-QSP), a generalization of quantum signal processing (QSP) [1] where the control parameters are non-commuting quantum operators, such as oscillator …

Sibling Rivalry In The Financial Safety Net: Governance Arrangements For Bank Resolution And Deposit Insurance (2025), Atilla Arda, Jan Nolte

Documents

No abstract provided.

The Development Of A Novel Large Language Model Method For Identification Of Incarceration History Via The Electronic Health Record And Evaluation Of Care Processes In The Emergency Department Setting, Thomas Huang

Yale Medicine Thesis Digital Library

Objective: Incarceration is a significant social driver of health and patients with a history of incarceration face systemic healthcare disparities, higher morbidity, mortality, and racialized health inequities. Incarceration status is largely invisible due to poor electronic health record (EHR) capture. In this thesis, we aim to develop, train, and validate a novel natural language processing technique to more effectively identify incarceration status in the EHR and apply this method in the emergency department setting to demonstrate proof of concept and elucidate care process disparities.Methods: The study population consisted of adult patients (≥ 18 y.o.) who presented to the emergency department …