Digital Commons Network^™

Association Between Fine Particulate Matter And Eczema: A Cross-Sectional Study Of The All Of Us Research Program And The Center For Air, Climate, And Energy Solutions, Gloria Chen

Yale Medicine Thesis Digital Library

A chronic inflammatory skin disease characterized by disruption of the epidermal barrier, eczema has increased in prevalence in tandem with industrialization. Ambient air pollution is a ubiquitous exposure resulting from industrial processes that includes fine particulate matter with aerodynamic diameter measuring less than 2.5 µm (PM2.5). Studies on the potential association between PM2.5 and eczema have produced conflicting results. The objective of this study was to determine the risk of eczema with exposure to PM2.5 in a diverse national cohort of American adults.

In this cross-sectional study, eczema cases were identified via electronic health records (EHR) in the All of …

Implications Of Acute Brain Injury Following Transcatheter Aortic Valve Replacement, Daniel Grubman

Yale Medicine Thesis Digital Library

Stroke is a feared complication of transcatheter aortic valve replacement (TAVR), affecting 2–8% of patients at 30 days. Beyond clinically evident stroke, covert brain injury (CBI) defined as clinically silent evidence of brain injury on imaging is strikingly prevalent: 70–100% of patients have evidence of new infarcts on diffusion-weighted magnetic resonance imaging (DW-MRI). The clinical significance of these lesions is unknown. Recent guidance has highlighted the importance of imaging in the assessment of cerebral embolic protection (CEP) devices that aim to counter the debris generated during TAVR. This work aims to a) determine the clinical significance of new ischemic lesions, …

Latent Health Status Trajectory Modelling In Patients With Symptomatic Peripheral Artery Disease, Scott Grubman

Yale Medicine Thesis Digital Library

For patients with peripheral artery disease (PAD) and symptoms of intermittent claudication, treatment is geared towards maximizing health status and minimizing disease progression. We aimed to phenotype health status trajectories over the first 12 months of specialty care and examine factors associated with nonresponsiveness to treatment. Adults with new or worsening exertional leg symptoms presenting to vascular clinics in the United States, Australia, and Netherlands 2011-2015 were included. Patients with non-compressible ankle-brachial index, critical limb ischemia, barriers to consent, or lacking at least one follow-up interview were excluded. The Peripheral Artery Questionnaire (PAQ; range 0-100, higher = better) was used …

Cerebral Arachnoid Cysts Are Radiographic Harbingers Of Epigenetics Defects In Neurodevelopment, Kedous Mekbib

Yale Medicine Thesis Digital Library

Cerebral arachnoid cysts (ACs) are the most common space-occupying lesion of thehuman brain but we know very little about its pathogenesis and association with other neurological phenotypes complicating clinical management.

To better understand AC pathogenesis and clinical presentation, we conducted wholeexomesequencing of 617 patient-parent trios, analysis of human brain and mouse meningeal single-cell RNA sequencing and natural language processing of patient medical records, the largest and only integrative genomic study of ACs to date.

We found seven genes: ADNP, ARID1B, KDM5C, PURA, FOXP1, MAP2K1 andSCN2A, had an exome-wide statistically significant burden of de novo variants. Our AC candidate genes were …

Racial And Sex Disparities In Adult Reconstructive Airway Surgery Outcomes: An Acs Nsqip Analysis, Tagan Rohrbaugh

Yale Medicine Thesis Digital Library

Racial and Sex Disparities in Adult Reconstructive Airway Surgery Outcomes: An ACS NSQIP Analysis Tagan Rohrbaugh and Nikita Kohli. Department of Otolaryngology, Yale University, School of Medicine, New Haven, CT.

Previous studies demonstrated postoperative adverse events associated with pediatric airway reconstruction surgery using the National Surgery Quality Improvement Program-Pediatric (NSQIP-P) database. However, postoperative adverse events using the NSQIP database has not yet been described in adults. This study uses the NSQIP database to examine postoperative complications of airway reconstruction surgery in the setting of racial and sex disparities. Current procedural terminology (CPT) codes were used to identify 260 patients 18 …

Illness Perception And The Impact Of A Definitive Diagnosis On Women With Ischemia And No Obstructive Coronary Artery Disease: A Qualitative Study, Leslie Yingzhijie Tseng

Yale Medicine Thesis Digital Library

Background: Ischemia and no obstructive coronary artery disease (INOCA) disproportionately impacts women, yet the underlying pathologies are often not distinguished, contributing to adverse health care experiences and poor quality of life. Coronary function testing at the time of invasive coronary angiography allows for improved diagnostic accuracy. Despite increased recognition of INOCA and expanding access to testing, data lack on first-person perspectives and the impact of receiving a diagnosis in women with INOCA.Methods: From 2020 to 2021, we conducted structured telephone interviews with 2 groups of women with INOCA who underwent invasive coronary angiography (n=29) at Yale New Haven Hospital, New …

Survival Outcomes In T3 Laryngeal Cancer Based On Staging Features At Diagnosis, Vickie Jiaying Wang

Yale Medicine Thesis Digital Library

Stage T3 laryngeal cancer is defined by the presence of vocal cord fixation and/or invasion into any of the following: pre-epiglottic space, paraglottic fat, post-cricoid space, or inner cortex of the thyroid cartilage. These cancers are usually treated with chemoradiation rather than upfront total laryngectomy. To our knowledge, no studies have directly compared differences in survival among the varied features within the T3 staging category. This study aims to determine how the presence of each of these staging features impacts overall and laryngectomy-free survival.Patients with clinically-diagnosed T3 laryngeal squamous cell carcinoma seen at our institution between 2010-2021 were retrospectively identified. …

H.R. 133: Consolidated Appropriations Act, 2021, United States: Congress: House Of Representatives

Documents

No abstract provided.

Yale Medicine Magazine Autumn 2024, Issue 173, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the Autumn 2024 issue of Yale Medicine Magazine, issue 173. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes include 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).

Yale Medicine Magazine Spring 2024, Issue 172, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the Spring 2024 issue of Yale Medicine Magazine, issue 172. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes include 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).

The Struggle For Eudaemonia: The Eugenics Movement In Psychology And Community Resistance In Connecticut, Eve Galanis

Academic Articles

Throughout the twentieth century, the eugenics movement dominated medical discourses in the state of Connecticut. From deportations, coerced institutionalizations and sterilizations, to proposed executions of people with mental illness, eugenic policies were deployed in an attempt to control and direct populations. The state collaborated with academic institutions like Yale University, and agencies like The Eugenics Record Office at Cold Spring Harbor, to endorse pseudo-scientific techniques of surveilling and administering bodies across intersecting lines of race, ability, gender, sexuality, class, and citizenship status. This research examines the biopolitics of eugenics and the contest for economic, geographic, social, and ideological space. Using …

Annual Report 2023, Federal Deposit Insurance Corporation (Fdic)

Documents

No abstract provided.

Federal Home Loan Banks: Investor Presentation, Federal Home Loan Banks

Documents

No abstract provided.

Consolidated Financial Statements 2023, Landsbankinn (Nbi)

Documents

No abstract provided.

The Crisis In The Banking Sector, International Monetary Fund (Imf)

Documents

No abstract provided.

Overview: Special Drawing Rights (Sdrs), International Monetary Fund (Imf)

Documents

No abstract provided.

Federal Deposit Insurance Corporation Quarterly Banking Profile: First Quarter 2024, Federal Deposit Insurance Corporation (Fdic)

Documents

No abstract provided.

Partial And Total Tonsillectomy For Pediatric Sleep-Disordered Breathing: The Role Of The Cas-15, Jacob Garn Mabey

Yale Medicine Thesis Digital Library

The Clinical Assessment Score-15 (CAS-15) is an office-based tool for assessing the riskof sleep disordered breathing (SDB), a relatively common condition in the pediatric population. Change in CAS-15 following total tonsillectomy (TT) has been shown to have a large effect size, but it is unclear how it varies following partial intracapsular tonsillectomy (PIT). Thus, the objective of the present study is to evaluate the utility of the CAS-15 score in assessing the effectiveness of PIT and how this compares to change after TT. Children ages 2-18 undergoing PIT (N=16) or TT (N=8) with or without adenoidectomy for SDB completed the …

Ship Shaping: How Congress And Industry Influenced U.S. Naval Acquisitions From 1933-1938, Henry H. Carroll

Harvey M. Applebaum ’59 Award

Studying shipbuilding politics across time can yield key insights into present-day shipbuilding acquisition reform issues, such as the effects of naval industry consolidation and potential “ally-shoring” of warship production on domestic political support for future naval funding. Past studies of naval acquisitions during the late interwar period often focus on how President Franklin Delano Roosevelt and the Navy Department prepared the nation for the beginning of World War II. However, Congress and the shipbuilding industry played an often-overlooked role in creating the political support needed to expand the Navy during the tumultuous late interwar period. Self-interested domestic interest groups were …

Surveyor: Scratching For A Wild Moon, Nina Grigg

Harvey M. Applebaum ’59 Award

At the dawn of the space race, neither the moon as a destination nor man’s physical presence there were foregone conclusions. In order to get to that all important "first step," NASA had to dissect the Moon as a romantic symbol into concrete ground that space boots could tread on. Identifying these sites on a terrain so uniquely hostile to human habitation required remote exploration mediated by totally encapsulating technology. However, in the attempts of scientists and engineers to objectively explore the lunar wilderness, they unintentionally transformed it into an extension of the urban landscape. Once only conceivable as a …

Reducing 30-Day Hospital Readmission In The Older Homebound Population: Using An Interprofessional Communication Protocol Within A Multidisciplinary Hospital At Home Program, Pamela Ann Alvey

Yale School of Nursing Digital Theses

Home-bound patients aged 65 and older are at the highest risk for avoidable 30-day hospital readmission: a factor contributing to rising healthcare costs and comprising over 30% of Medicare’s spending. The Hospital Readmission Reduction Program (HRRP) deemed that one in five patients that were discharged from the hospital were readmitted within 30 days, resulting in an annual waste of $17 billion. The increase in homebound older patients, coupled with ongoing avoidable 30-day readmissions, resulting in poorer quality of life, makes this a critical issue for the U.S. healthcare system. A key gap identified in the prevalence of avoidable 30-day readmissions …

Improving Outpatient Medication Reconciliation And Reducing Adverse Drug Events: Development Of A New Process, Marisa Kristine Blake-Raut

Yale School of Nursing Digital Theses

AbstractImportance: Prescribed medications can pose risks to patient safety. In the United States, persons aged over 65 account for nearly 450,000 annual emergency department (ED) visits, and they are seven times more likely to require hospital admission than younger persons (Centers for Disease Control and Prevention, 2022). Medication reconciliation (MR) errors are more likely to affect those older than 65, but can be prevented by using standardized MR criteria that identify medications with higher risks for adverse drug events (ADEs) (O’Mahoney, 2020). Objective: The DNP project goal was to create and implement a risk stratified medication reconciliation (RSMR) intervention process …

Implementation And Evaluation Of Perinatal Educational Video Series – Postpartum Hemorrhage, Daileann Lamara Hemmings

Yale School of Nursing Digital Theses

Abstract

Implementation and Evaluation of Perinatal Educational Video Series –Postpartum Hemorrhage Per the Centers for Disease Control and Prevention (2021), 700 women die each year due to pregnancy related complications in the United States. Black women (Erickson, 2020) have a 26.6% higher risk for morbidity resulting from postpartum hemorrhage (PPH) and a five times higher risk of mortality. Education can serve as a tool to increase knowledge, promote a mother’s ability to identify the onset of a risk and report signs and symptoms of PPH that could otherwise lead to complications or death. ​ This DNP pilot project developed and …

The California Bridge Model For Emergency Department-Initiated Medication-Assisted Treatment For Opioid Use Disorder: Adaptations For Perinatal Hospital Services, Devin C. Thomas

Yale School of Nursing Digital Theses

Background: Poor access to gender-specific, pregnancy-focused medication-assisted treatment for perinatal opioid use disorder greatly contributes to adverse outcomes for pregnant patients, infants, and society, at large. It is well established that Emergency Department-initiated pharmacotherapy for opioid use disorder is safe, effective, and can be rapidly adopted by hospital systems to improve access to care for people who misuse opioids. Like the Emergency Department, perinatal hospital services are well positioned to serve as critical access points in the treatment of perinatal opioid use disorder. However, concerns such as lack of training, workflow inefficiencies, and bias act as barriers to co-located, integrated …

Unveiling Chagas Disease: An In-Depth Analysis Of Epidemiological Patterns In High Burden Latin American Nations, Nicole Del Castillo

Public Health Theses

Background: Chagas Disease, endemic to 21 countries in Latin America, is transmitted by triatominae insects infected with parasites known as Trypanosoma cruzi.1–3 It is the most prevalent tropical disease in Latin America, affecting about 6 million individuals across the Americas.1 This literature review aims to summarize unique epidemiological patterns over a 9-year time period from 2010 to 2019 across three nations in South America that experienced the highest Chagas Disease burden in 2019: Bolivia, Venezuela, and Argentina.4

Methods: For this rapid literature review, one independent reviewer extracted all data for publications reviewed within a 9-year time period: 2010 to 2019. …

Examining Factors Associated With Covid-19 Disruptions To Tuberculosis Services, Tejaswini Dharmapuri Vachaspathi

Public Health Theses

Background: The COVID-19 pandemic posed unprecedented challenges to global health systems, significantly impacting the delivery of essential health services, including tuberculosis (TB) care. It is important to analyze the factors associated with the reductions in TB notifications during the pandemic, with a focus on high TB burden countries, to inform strategies for making TB programs more resilient to health system shocks.

Methods: Amongst 98 selected high-burden countries, a GLM analysis was employed to examine the association between ‘missed’ TB case notifications from 2020 to 2021, and various country-level factors including: COVID-19 mortality estimates, lockdown stringency index, GDP per capita, health …

Evaluation Of One Health Education Materials: A Scoping Review And Quality Assessment, Sydney Jones

Public Health Theses

The increasing risk of zoonotic spillover, driven by climate change and evolving human behaviors, requires a systematic shift in pandemic prevention strategies towards a One Health approach. Central to this approach is effective health communication intended to translate knowledge into actionable recommendations for the most vulnerable populations. This thesis aims to systematically evaluate the quantity and quality of existing One Health communication materials through a scoping review and two distinct methods of quality evaluation: the CDC Clear Communication Index and content analysis. Among 82 communication materials identified in the scoping review, the median overall CDC Clear Communication Index score was …

Light At Night And Cancer Incidence: A Gis-Based Study In The Us, Linshuoshuo Lyu

Public Health Theses

Aims: Light at night (LAN) can cause circadian disruption and was found to be a potential risk factor for several cancers. This study aims to confirm the adverse effect of LAN on hormone-related cancers and explore the association between LAN and the prevalence of various cancer types under an ecological study design. Methods: County-level age-adjusted cancer incidence data was obtained from the CDC Cancer Statistics (2016 to 2020), while LAN data (1996 to 2000) was obtained from the satellite imagery of Version 4 Defense Meteorological Satellite Program. Linear mixed effect regression models (LMMs) were performed to assess the relationship of …

Evaluating Knowledge And Attitudes Towards Dengue Fever And Its Vaccination Among Medical Staff In China: A Questionnaire-Based Study, Ip Man Lam

Public Health Theses

Dengue, a mosquito-borne tropical disease caused by the dengue virus, has seen a significant increase in global incidence in recent decades. China has experienced a rapid rise in dengue cases since 2013, posing a serious threat to population health and increased economic burden. This study aimed to evaluate the knowledge and attitudes towards dengue fever and dengue vaccination among medical staff in China. A cross-sectional study was conducted using an online questionnaire survey targeting medical professionals in Zhejiang, Yunnan, and Hainan provinces, which are known endemic areas for dengue virus infection in China. The questionnaire assessed participants' understanding of dengue …

Analysis Of Mercury Exposures In The United States Reported To The National Response Center (2018-2022), Abigail E. Mcdonald

Public Health Theses

Introduction

The frequency and extent of environmental elemental mercury exposures in the U.S. are unknown. Due to its marked toxicity, elemental mercury has been phased out of many newer commercial products. However, mercury-containing products are still available, and a variety of religious, cultural, decorative, cosmetic, and illicit uses have been reported in the community. Small quantities of mercury can be highly toxic, and mercury toxicity can present nonspecifically and multi-systemically with the potential to be easily missed. Therefore, it is important to characterize the settings where mercury exposures occur and the extent of such exposures. The overall aim of this …