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Clinical Predictors Of Fluid-Responsive Acute Kidney Injury, Cindy Khanh Nguyen

Yale Medicine Thesis Digital Library

CLINICAL PREDICTORS OF FLUID-RESPONSIVE ACUTE KIDNEY INJURY

Cindy Khanh Nguyen, Abinet M. Aklilu, Yu Yamamoto, Bashar A. Kadhim, Claudia Coronel-Moreno, Francis P. Wilson. Section of Nephrology, Department of Internal Medicine, Yale University, School of Medicine, New Haven, CT.

Specific Aims: We aimed to explore and identify common clinical variables that may be helpful in selecting patients who will benefit from volume challenge when the fluid-responsiveness of AKI is unclear.

Methods: Our study is a retrospective secondary analysis of a clinical trial that prospectively enrolled adult patients at Yale-New Haven Hospital with AKI defined by the 2012 Kidney Disease: Improving Global …

Adopting America’S Future Citizens: The Children’S Bureau And The Plight Of East Asian War Orphans, 1950-1969, Caroline Chen

Harvey M. Applebaum ’59 Award

This essay considers the role of the Children’s Bureau in the transnational adoptions of East Asian war orphans from 1950-1969. World War II and other Cold War conflicts left hundreds of thousands of children in Japan, Hong Kong, and Korea orphaned and displaced. This essay argues that the Children’s Bureau played an important role in the transnational adoptions of East Asian war orphans. The Bureau was the only federal agency involved in these adoptions explicitly devoted to child welfare. Cold War geopolitics imbued the Bureau’s approach. Through transnational adoptions, the agency simultaneously responded to Cold War pressures to help children …

The Mirror Of Scripture: Historical Memory, Translation, And The Bible In Early Modernity, 1450-1660, Colin Glen Hoch

Yale Graduate School of Arts and Sciences Dissertations

Contributing to the latest thematic trends in early modern studies, this dissertation project maintains that contested historical memory, or the competing ways that European Christians envisioned themselves as part of an ancient and authoritative biblical tradition, constituted the creative engine at the heart of shaping the early modern Bible (c.1450- 1660). In an era when successful claims to custom and antiquity conferred the highest legitimacy, historical memory was a critical source of identity and authority, even if, as recent theorists of early modern memory assert, memory itself meant something different in the period. The Bible in myriad forms served as …

Molecular Mechanism Of Vibrio Cholerae Biofilm Adhesion, Xin Huang

Yale Graduate School of Arts and Sciences Dissertations

Bacterial biofilms are surface-attached communities of bacterial cells enclosed in an extracellular matrix formed on environmental surfaces and host tissues. Biofilm formation represents a common strategy in facilitating host colonization and infection by human pathogens, and the polymeric matrix provides a mechanism for drug and host immune resistance by acting as a barrier around biofilm-dwelling cells. Bacteria often express multiple adhesive proteins (adhesins), but it is often unclear whether adhesins have specialized or redundant roles. Here, we combine mutagenesis, biochemistry, single-cell imaging, and bioinformatics to show how Vibrio cholerae, the causal agent of pandemic cholera, uses two biofilm-specific adhesins …

Towards The Mathematical Intepretability Of Likelihood-Based Generative Models, Henry Li

Yale Graduate School of Arts and Sciences Dissertations

Probabilistic generative models have seen rapid adoption as algorithmic tools in a multitude of domains due to their unparalleled capacity to model and draw samples from complex high-dimensional data distributions in a wide range of modalities. At their core, these models are simply transformations that map a simple known distribution to an arbitrarily complex target distribution. As these algorithms essentially operate over measure spaces, they are inherently stochastic, and their implementational details allow their taxonomy as either explicit or implicit probabilistic models. Explicit models directly permit the evaluation of a likelihood function pθ(x), which is directly maximized with respect to …

Levitated Optomechanical Sensors For Fundamental Physics, Jiaxiang Wang

Yale Graduate School of Arts and Sciences Dissertations

This thesis focuses on utilizing more than 20 years of development of optomechanics to develop new measurement tools to solve open questions in fundamental physics. Optomechanical detectors offer a highly sensitive method for measuring weak forces. By optically trapping these systems in high vacuum, one can drastically reduce environmental noise and achieve exquisite control over the detector's center-of-mass motion, rotational degrees of freedom, and physical characteristics such as charge states. This level of isolation enables the detector's noise to reach the quantum measurement regime, where the dominant noise source is the measurement process itself. Such sensors are a powerful tool …

Computational Approaches To Understanding The Proton-Coupled Electron Transfer Reactions In Ribonucleotide Reductase, Jiayun Zhong

Yale Graduate School of Arts and Sciences Dissertations

Proton-coupled electron transfer (PCET) is a fundamental chemical process where both an electron and a proton are transferred simultaneously or sequentially, playing a key role in various biological and chemical systems, including enzymatic reactions and energy conversion. This thesis investigates the PCET reactions in ribonucleotide reductase (RNR), a critical enzyme responsible for DNA synthesis and repair in all living organisms. While significant progress has been made in understanding RNR's PCET pathway, several gaps remain, particularly regarding the specific mechanisms and energetics of individual PCET steps, the role of conformational dynamics, and the influence of water molecules. Through quantum mechanical/molecular mechanical …

The Richness Of Perception: Dynamic Visual Representations From Static Images, Kimberly Wong

Yale Graduate School of Arts and Sciences Dissertations

What is the purpose of visual perception? The most common explanations suggest that “seeing” is for answering the question ‘What’s out there?’ — giving us information about the features and objects in the current local environment. This dissertation, in contrast, suggests a different approach: seeing is also for answering the question ‘What’s happening?’ — and the related questions ‘What just Happened?’ and ‘What’s about to happen?’. The critical difference is that while the more common answer seems implicitly static, these newer answers are intrinsically dynamic. This dissertation proposes that visual processing represents even certain static images …

Abolition In Color: Written And Oral Narratives Of Struggle In Black Latin America, Karina Alexandra Lopez

Yale Graduate School of Arts and Sciences Dissertations

This dissertation examines the different types of anti-slavery narratives written by people of Afro-descended writers in Cuba and Brazil at the end of the nineteenth century. During this time, literature acted as propaganda to further the spread of abolitionist ideas and ultimately end the abhorrent institution. While scholarship has tended to focus on the texts written by white abolitionists, this study places particular focus on the short stories and novels written by writers of color and points out the ways in which these texts not only contributed to swaying public opinion towards abolition, but also looked towards both the past …

The Cotzumalhuapa Obsidian System: Economy Of Procurement, Production, And Provisioning In A Classic Mesoamerican Polity, David Rafael Mccormick Alcorta

Yale Graduate School of Arts and Sciences Dissertations

This dissertation expands scholarly modeling of pre-contact economic organization in Mesoamerica through an in-depth examination of obsidian systems of Cotzumalhuapa, an important polity during the Late-Terminal Classic (650-950 CE) in Escuintla, Guatemala. The exchange of obsidian into the region from several sources was critical because other types of tool-grade stone were locally unavailable. Overtime, sophisticated systems developed to mine, transform, and move obsidian in a variety of forms across the landscape. Technological changes in manufacturing processes led to universal adoption of prismatic blades and fomented the importance of lithic artisans specializing in core-blade reduction. Access to obsidian to produce tools …

Decoding Heterogeneity In Human Aging: Omic Biomarkers Of Age-Related Disorders, Yaroslav Markov

Yale Graduate School of Arts and Sciences Dissertations

Biological aging unfolds along multiple heterogeneous trajectories shaped by both acquired molecular drift and inherited genetic variation. This dissertation investigates two complementary axes of aging heterogeneity: (1) stochastic, individually acquired epigenomic deviations; and (2) genotype-defined risk exemplified by the APOEε4 allele, the strongest genetic determinant of late-onset Alzheimer’s disease (AD).

1) Stochastic Epigenetic Mutation Detection

We developed SEMdetectR, a robust R-based pipeline for identifying and quantifying stochastic epigenetic mutations (SEMs) -- rare, outlier CpG methylation events that accumulate idiosyncratically with age. Using technical replicates from three independent cohorts, we uncovered previous methodological flaws undermining SEM reliability and trained a machine …

Precision Bootstrap Studies Of Fermions And Stress Tensors In Conformal Field Theories, Matthew Stephen Mitchell

Yale Graduate School of Arts and Sciences Dissertations

Conformal field theories (CFTs) describe a wide variety of scale-invariant phenomena. As CFTs are tightly constrained by symmetry, unitarity, and self-consistency, it is possible to compute rigorous bounds on their observables by translating these constraints into a semidefinite programming problem. This approach, known as the numerical conformal bootstrap, has been used to great success in recent years, and has produced the tightest bounds to-date on the critical exponents of 3d Ising and O(N) models. In this work, we conduct bootstrap studies of spinning operators in several CFTs.

First, we present a numerical bootstrap analysis of the critical 3d Gross–Neveu–Yukawa models, …

Biomedical Privacy And Security: Histology Image Vulnerabilities And Blockchain Solutions, Eric Ni

Yale Graduate School of Arts and Sciences Dissertations

Biomedical research increasingly relies on vast datasets, such as genomic sequences, electronic health records, and histology images, to advance scientific knowledge and clinical applications. However, the sensitive nature of biomedical data poses significant privacy risks, particularly with emerging capabilities of artificial intelligence and machine learning technologies. This dissertation addresses two central challenges in biomedical data privacy and security: quantifying privacy risks associated with histology images and developing innovative blockchain-based methods to ensure secure data storage and sharing.

The first part of this work investigates the vulnerability of histology images—commonly perceived as safe for public sharing—to privacy breaches. Utilizing advanced computational …

Challenges In Modern Machine Learning: Generalization And Responsible Use, Grigoris Velegkas

Yale Graduate School of Arts and Sciences Dissertations

Modern machine learning (ML) systems operate in settings where classical theoretical analysis, which relies on worst-case bounds, often fails to provide meaningful guarantees. Neural networks and large language models are trained with significantly more parameters than training data, yet they generalize well in practice—contrary to theoretical results. Additionally, ML algorithms are increasingly deployed in high-stakes applications, raising concerns about replicability and, more broadly, their responsible use. This thesis makes progress on two fundamental challenges in modern ML: (i) developing generalization guarantees beyond worst-case analysis, and (ii) designing algorithms with provable replicability guarantees.

In the first part of the thesis, we …

Structural And Functional Analysis Of Translation Inhibition By Betacoronavirus Non-Structural Protein 1, Michael Brandon Vetick

Yale Graduate School of Arts and Sciences Dissertations

humans: SARS-CoV, SARS-CoV-2, and MERS-CoV. Key to their viral lifecycle is Non-structural protein 1 (Nsp1), an essential pathogenicity factor that potently restricts the cell’s antiviral response. Despite poor protein sequence conservation of Nsp1 between evolutionarily distant β-CoVs, these proteins have proven to be highly conserved both functionally and structurally. Nsp1 functions by inhibiting host gene expression through contacts made with two mRNA ribonucleoprotein (mRNP) complexes: the initiating ribosome and the Nxf1/Nxt1 mRNA nuclear export complex. It is believed that two Nsp1 functions occur on the ribosome: Nsp1 is able to coordinate cleavage of the host mRNA and Nsp1 is able …

Majority Dynamics On Random Graphs With Almost Balanced Initial Settings: The Power Of Few, Hoang Bao Linh Tran

Yale Graduate School of Arts and Sciences Dissertations

A community of n people participate in a parliamentary election with two major parties. Every person initially supports one side, and with each day, changes their opinion to match the majority among their friends. This process, commonly known as Majority Dynamics in literature, and similar processes, have been studied in many different contexts, including Statistical Physics, Computer Science, Economics and Ecology, as discussed in the influential survey by Mossel and Tamuz (2014).

Tran and Vu (2019) considered the process on a Erdös-Rényi G(n, p) random graph and discovered the "Power of Few" phenomenon: Starting from a …

Providing Safe Gastric Feedings In Pediatric Patients On High Flow Nasal Cannula Respiratory Support, Olivia Joyce Chan

Yale School of Nursing Digital Theses

Purpose: HFNC is used to manage pediatric respiratory distress, but concerns aboutgastric air insufflation and aspiration risk lead to delayed feedings. There is no standardized practice guiding gastric feedings in children on HFNC. This project developed and implemented a decision tree to guide clinical decision-making for gastric feedings for children on HFNC. Methods: A HFNC feeding safety decision tree was developed following literature review and implemented in a Pediatric Intensive Care Unit (PICU). The primary outcome evaluated HFNC flow rates when starting gastric feeds. Secondary outcomes include adverse events (AEs), physiologic distress, and PICU/hospital LOS. Data were analyzed using Chi-Square …

Transgender And Gender Diverse People – Inclusive Healthcare System Access, Dakota Denielle Lawtum

Yale School of Nursing Digital Theses

Transgender and Gender Diverse People – Inclusive Healthcare System AccessPurpose: This DNP project implemented a dual strategy to increase system-wide access to care and awareness of the needs of transgender and gender diverse people. Background: The 2015 U.S. Transgender Survey is the most recent and largest survey of its kind in the United States comprising a total of 27,715 responses. (National Center for Transgender Equality, 2015, U.S. Transgender Survey). The results of this survey are as follows: 1) 26% of the total national respondents experienced insurance issues for gender affirming healthcare or being denied coverage for routine care; 2) 32% …

Fabrication And Characterization Of Chalcogenide And Oxide Thin Films, Shuhang Pan

Yale Graduate School of Arts and Sciences Dissertations

This dissertation explores the fabrication, structural characterization, and quantum transport properties of chalcogenide and oxide thin films. High-quality SnTe films were synthesized via molecular beam epitaxy (MBE), demonstrating tunable topological surface states through nanoscale patterning. Magnetoconductivity measurements revealed weak antilocalization (WAL) effects across continuous and patterned films, with coherence lengths governed by boundary scattering in hole-patterned geometries. Advanced focused ion beam (FIB) protocols enabled atomic-resolution transmission electron microscopy (TEM) of monolayer ZrO2 on silicon, defect distribution in off-stoichiometric CaWO4 films and orientation analysis in YVO4 thin films. Josephson junctions fabricated on superconducting Nd1−xEuxNiO2 thin films exhibited …

Machine Learning And Cheminformatics Methods For Retrosynthetic Planning, Yu Shee

Yale Graduate School of Arts and Sciences Dissertations

Designing efficient synthetic routes automatically remains a central challenge in chemistry. This thesis presents machine learning and algorithmic strategies for retrosynthetic planning that aim to improve both efficiency and practical usability over previous approaches.

We first introduce the site-specific template (SST) generation framework (Chapter 2), which leverages transformer-based models for template generation and reaction center labeling to enable targeted single-step disconnections. We then develop DirectMultiStep (DMS) (Chapter 3), a multistep-first model that generates complete synthetic routes directly from product molecules, avoiding recursive search and achieving strong performance on benchmark datasets. In parallel, we propose FragmentRetro (Chapter 4), an efficient, stock-aware, …

Unveiling The Structure Of The Perfect Superfluid Using Correlation Functions, Ananya Rai

Yale Graduate School of Arts and Sciences Dissertations

The sequential clustering of particles into jets provides an algorithmic link between final-state hadrons and the partons from which they originated. Jet substructure techniques allow us to trace the radiation history of jets, offering a powerful framework to probe Quantum Chromodynamics (QCD) across different energy scales. Projected N-point Energy Correlators (ENCs) are a novel class of observables that explore the energy flow within hadronic jets. This thesis presents the first measurements of the two-point (EEC) and projected three-point correlators (E3C) as well as their ratio (E3C/EEC) at √ s = 13 TeV using Run 2 data from the ALICE experiment. …

Development Of Genome-Scale Technologies For Writing And Recoding Cyanobacteria, Laura Beth Quinto

Yale Graduate School of Arts and Sciences Dissertations

Diverse microorganisms have delivered unique solutions in medicine, food, energy, and nutrient cycling through atmospheric gas fixation. Yet despite tremendous progress in model organisms like E. coli and S. cerevisiae, tools for editing and predictably manipulating undomesticated species – which comprise the vast majority of microbes1 – remain scarce. Cyanobacteria, with their light- and CO₂-powered metabolism, hold particular promise for bioproduction, bioremediation, and in situ fertilization, but have been difficult to engineer. Furthermore, many of the most valuable applications of cyanobacteria would involve implementation in an open system. Such strains require two critical safeguards: biocontainment to ensure that their propagation …

Implementation Of Teamstepps® In A Peri-Operative Environment In An Urban Medical Center, Chris Chantler

Yale School of Nursing Digital Theses

Problem and Context: Preventable Patient Harm (PPH) continues to occur frequently in healthcare. Failures in communication, poorly functioning teams, and a lack of shared mental models (SMMs) continue to challenge healthcare organizations. The purpose of this PI project was to improve communication and teamwork, among team members in a Peri-Operative setting. TeamSTEPPS® was selected as the training curriculum. Multiple parameters, including perceptions of teamwork, and safety metrics were evaluated pre and post-intervention.

Intervention: TeamSTEPPS® was selected as the training curriculum. TeamSTEPPS® is a highly adaptable curriculum designed to address these gaps and to improve team function in the healthcare setting. …

Implementing A Screening Algorithm For Depression Diagnosis, Management And Referrals In Primary Care, Jorge Correia

Yale School of Nursing Digital Theses

Depression is a major cause of mortality, morbidity, disability, and economic costs in theUnited States. Everyday millions of Americans navigate our complex healthcare field to find the best solution to their problem. Due to a shortage of specialized psychiatric providers, often these people must rely on the primary care settings to get the help they need. However, the lack of knowledge in screening and management of mood disorders causes many of these patients to fall through the cracks or get substandard quality of mental health care. The goal of this quality improvement project was to develop and implement a screening …

A Systems Organizational Model Of Professional Role Development For New Apps: Building A Train The Trainer Program, Abigail H.B. Baugh

Yale School of Nursing Digital Theses

Most Advanced Practice Provider (APP) turnover occurs within the first year of practice. It is often linked to feelings of inadequacy caused by limited professional instruction and immediate expectations of full practice integration. These challenges are compounded further in systems with inconsistent onboarding processes and underprepared trainers, further exacerbating turnover rates. At East Carolina University (ECU) Health System, turnover rates for Physician Assistants and Nurse Practitioners reached 20% and 12%, respectively, surpassing national averages (ECU Health, 2024), highlighting the urgent need for a structured onboarding approach.A system-based Train-the-Trainer (TTT) program was developed to address these issues, focusing on essential areas …

Exergaming Physical Exercise Program Protocol For Older Adults With Mild Cognitive Impairment, Yushiu Lin

Yale School of Nursing Digital Theses

Physical inactivity is a risk factor for dementia and may accelerate the progression ofmild cognitive impairment (MCI). Older adults with MCI often engage in insufficient exercise, increasing their risk. This clinical intervention evaluated the effects of an exergaming physical exercise program on cognitive function and balance in older adults with MCI. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA), while balance was evaluated with the Romberg Test. The aims involved developing and implementing an eight-week exergaming physical exercise program, using a pre-packaged, non-immersive virtual reality (VR) application. Results indicated a significant improvement in cognitive function following increased physical …

Cultural Intelligence For Advanced Practice Providers: Moving A Contextually Based Model Forward For Workforce Training, René Padilla

Yale School of Nursing Digital Theses

Cultural Intelligence for Advanced Practice Providers: Moving a Contextually Based Model Forward for Workforce TrainingCultural Intelligence (CQ) among clinicians in primary care for the Hispanic population is inadequate (Da Costa, 2023). Cultural diversity training for patient care has been identified as a need to improve outcomes since the 1960s (Lin et al., 2017). In 2000, the Office of Minority Health (OMH) at the US Department of Health released the National Standards for Culturally and Linguistically Appropriate Services in Healthcare and updated those standards in 2013. Mainous et al. (2020) found that only 35% of primary care providers (PCPs) knew of …

Promoting Mental Health Awareness And Reducing Stigma In Spanish-Speaking Communities Through Educational Interventions, Kelly Medina Prado

Yale School of Nursing Digital Theses

Background: Spanish-speaking Latino populations in the U.S. experience significant disparities in mental health access driven by language barriers, low mental health literacy, and cultural stigma. These factors contribute to the underutilization of services, early treatment dropout, and poor outcomes.

Objective: This quality improvement project aimed to develop, implement, and evaluate a culturally and linguistically tailored mental health education intervention designed to increase mental health literacy and reduce stigma among Spanish-speaking Latino adults in a federally qualified health center.

Methods: A total of four group sessions were conducted over an eight-week period. The sessions were delivered in Spanish and included culturally …

Addressing Intergenerational Retention And Workplace Satisfaction Factors With A Workshop For Nurse Leaders, Elizabeth Labish

Yale School of Nursing Digital Theses

Nursing is a multigenerationally diverse workforce, with up to five generations (Traditionalists, Baby Boomers, Generation X, Millennials, and Generation Z) contributing simultaneously (Gerhardt et. al, 2022). Each generation holds varied work preferences and retention drivers, which manifest as unique drivers of preventable turnover. Leaders can reduce turnover and its associated costs by cultivating a multi-generationally preferred work environment (Koehler & Olds, 2022). The purpose of this project was to deliver a workshop for nurse leaders to improve their knowledge about leading multigenerational workforces. Following literature review, A 2.5 hour in-person workshop was created and delivered at a community hospital. The …

Factors Associated With Non-Transport For Ems Incidents Of Pediatric Head Injuries, Margaret Zhang

Public Health Theses

Background/Purpose:Emergency Medical Services (EMS) is a valuable resource for evaluating, treating, and coordinating care for individuals who have sustained a traumatic brain injury (TBI). Among adults with a TBI, there is frequent refusal of EMS transport. This raises a public health concern because it can put a burden on resource utilization and reveal misperceptions regarding risk following head injuries. Less is known about whether similar patterns of non-transport exist among children with TBIs. The purpose of this study is to describe the epidemiology of pediatric head injuries attended by EMS and to identify factors associated with non-transport for these patients. …