Digital Commons Network^™

Sense-Able Hauntings: Ethics And Narratives In Ornithological Specimen Preservation At Yale's Peabody Museum, Elaina Foley

Kaplan Senior Essay Prize for Use of Library Special Collections

Until I was standing in between the rows of towering metal specimen cabinets, I didn’t understand how many birds the Yale Peabody Museum holds. Like most people, I had only experienced the display side of museums: its dioramas and glass cases. These displays, while made to embody a certain set of interests, priorities, and values, still serve an obscuring function—they vastly underrepresent the museum’s total collections. In their ornithology collection alone, the Peabody currently holds more than 152,000 bird skins, bones, eggs, nests, and other avian fragments. The Peabody staff members who maintain the ornithology specimen collections are distinct from …

Surgical Outcomes Following Posterior Spinal Fusion For Adolescent Idiopathic Scoliosis, Wyatt Benajmin David

Yale Medicine Thesis Digital Library

Surgical Outcomes Following Posterior Spinal Fusion for Adolescent Idiopathic ScoliosisWyatt B. David and Michael DiLuna. Section of Pediatric Neurosurgery, Department of Neurosurgery, Yale University, School of Medicine, New Haven, CT. Hospital size has previously been shown to impact outcomes in adult spine surgery. However, there is a paucity of studies assessing the impact of hospital size on outcomes in adolescent spine surgery. Furthermore, gender-based differences have been suggested in disease progression and outcomes of adolescent idiopathic scoliosis (AIS), though only a few studies have investigated these disparities. The aim of this study was to determine the impact of hospital size …

Improving Cancer Classification With Domain Adaptation Techniques, Juliana Veira

Yale Medicine Thesis Digital Library

Background: As the quantity and complexity of oncological data continue to increase, machine learning (ML) has become an important tool in helping clinicians better understand malignancies and provide personalized care. Diagnostic image analysis, in particular, has benefited from the advent of ML methods to improve image classification and generate prognostic information from imaging collected in routine clinical practice [1-3]. Deep learning, a subset of ML, has especially achieved remarkable performance in medical imaging, including segmentation [4, 5], object detection, classification [6], and diagnosis [7].

Despite the notable success of deep learning computer vision models on oncologic imaging data, recent studies …

Factors Influencing Decision For Contralateral Prophylactic Mastectomy Versus Unilateral Mastectomy, Julian Huang

Yale Medicine Thesis Digital Library

Background: Rates of contralateral prophylactic mastectomy (CPM) are increasing despite falling rates of contralateral breast cancer and controversy over survival benefit of the procedure. We investigated why and how patients choose to undergo CPM, with focus on the roles of financial burden, decision-making resources, and active participation in decision-making.

Methods:Female unilateral breast cancer patients older than 18 years old who had undergone mastectomy (with or without CPM) coming in to the Yale Breast Center for a follow-up or post-operative visit between June and August 2017 were approached with an opportunity to participate in this survey study. Chart review was completed …

"Come On. I Need An Answer." A Mixed-Methods Study Of Barriers And Disparities In Diagnostic Odysseys, Zeyu Tang

Yale Medicine Thesis Digital Library

Background: The boom of next generation DNA sequencing over the past decade has improved our ability to provide accurate genetic diagnoses for children with previously undiagnosed diseases, in turn leading to important advances in management and prognostication. Even given this progress, two areas of ongoing need are the accurate definition of further novel genetic diseases and to make genetic expertise and diagnostics widely available to children and families who have frequently endured grueling diagnostic odysseys. The Pediatric Genomics Discovery Program (PGDP) at Yale is an advanced genomics program focusing on both these areas, enrolling over 700 patients since its inception …

Severity And Operative Age In Metopic Synostosis: The Association With Neurocognitive Outcomes, Aaron Samuel Long

Yale Medicine Thesis Digital Library

The cranial morphology of single-suture metopic craniosynostosis is defined by trigonocephaly, hypotelorism, and bitemporal narrowing. The severity of deformity may be defined radiographically based on computed tomography imaging. The radiographic severity of metopic synostosis has been suggested as a possible predictor of long-term neurocognitive outcomes, making it a potentially useful variable in determining which patients will benefit from surgery. Artificial intelligence (AI) has recently been used to quantify severity of metopic synostosis. Furthermore, age at surgery has been shown predict long-term neurocognition in sagittal synostosis but has not been adequately explored in metopic synostosis. In sagittal synostosis, age at surgery …

Perspectives On Emergency Department-Initiated Buprenorphine Among Clinical Pharmacists, Marissa Justen

Yale Medicine Thesis Digital Library

Clinical pharmacists are well positioned to enhance efforts to promote Emergency Department (ED)-initiated buprenorphine to treat opioid use disorder (OUD). Among clinical pharmacists in urban EDs, we sought to characterize barriers and facilitators for ED-initiated buprenorphine to inform future implementation efforts and enhance access to this highly effective OUD treatment.

This study was conducted as a part of Project ED Health (CTN-0069, NCT03023930), a multisite effectiveness-implementation study aimed at promoting ED-initiated buprenorphine that was conducted between April 2017 and July 2020. Data collection and analysis were grounded in the Promoting Action on Research Implementation in Health Services (PARIHS) framework to …

Multi-Omic Differences Between Right And Left Sided Colorectal Cancer Liver Metastases, Montana Tremaine Morris

Yale Medicine Thesis Digital Library

Colorectal cancer (CRC) is the second leading cause of cancer-related death both in the United States and worldwide, making it an urgent area of investigation for the oncology community. The inferior survival of patients with right-sided colon cancer (RCC) compared to left (LCC), particularly in metastatic disease, as well as the resistance of RCC to certain targeted systemic therapies, represent clinically important features relevant to the development of improved targeted therapies for CRC. Given the high probability that there is a biological component underpinning the differing clinical behaviors of CRC across anatomic laterality, we conducted a multi-omic analysis on frozen …

Incarcerated Patients Have Higher Mortality After Trauma: An Unreported Healthcare Disparity, Harry Newmanplotnick

Yale Medicine Thesis Digital Library

While the U.S. has the highest incarceration rate in the world, at nearly 1% of the adult population, or over 2 million people, insight regarding health disparities in this population remains limited, particularly for traumatic injuries and surgical care. Our aims with this paper were two-fold. First, we sought to perform the largest national database analysis of criminal-justice system involved (CJI) trauma patients (specifically incarcerated patients). Second, we planned to investigate if incarceration status was associated with differences in a variety of outcomes after trauma for U.S. adults.To accomplish these aims we analyzed data from the National Trauma Data Bank …

Baseline Skin Cytokine Profiles Determined By Rna In Situ Hybridization Correlate With Response To Dupilumab In Patients With Eczematous Dermatitis, Katelyn Singh

Yale Medicine Thesis Digital Library

Dupilumab, a monoclonal antibody that inhibits IL4 and IL13, has revolutionized the treatment of atopic dermatitis (AD). However, not all patients respond optimally, and this may relate to underlying molecular heterogeneity. Yet, clinically useful and accessible methods to assess such heterogeneity have not been developed. Additionally, As the number of targeted medications continues to expand, the choice of which specific therapy to initiate in any individual patient will become increasingly difficult. Currently, there are no biomarkers that can be used to guide treatment selection in common inflammatory diseases such as atopic dermatitis (AD) and psoriasis. This study aims to determine …

Comparison Of Clinical Study Results Reported In Medrxiv Preprints Vs Peer-Reviewed Journal Articles, Guneet Singh Janda

Yale Medicine Thesis Digital Library

The aim of this project was to evaluate the concordance among study characteristics, results, and interpretations described in preprints of clinical studies that are subsequently published in peer-reviewed journals (preprint-journal article pairs).

In this cross-sectional analysis, preprints posted on medRxiv in September 2020 were identified. Four evaluators determined how many preprints were subsequently published in peer-reviewed journals as of September 2022, calculating the time from preprint posting to publication. For preprints with multiple versions, the most recent version prior to journal acceptance was selected. Preprints updated after journal acceptance were excluded. For preprint-journal article pairs describing clinical trials, observational studies, …

Wildfires And Their Impacts On Immigrant Farmworker Women Of Childbearing Age, Rosa Gonzalez Juarez

Public Health Theses

Wildfires have been increasing in recent years due to the climate change that has been affecting the nation and across the globe. The Western part of the United States has been greatly affected, especially California. In 2022 there were 68,988 wildfires reported which consumed 7,577,183 acres nationwide, this was strikingly higher than the 10-year average (National Interagency Coordination Center Wildland Fire Summary and Statistics Annual Report 2022, 2022). The California Wildfires have been detrimental to its residents; however, they have specifically disproportionately affected the Latino population either due to the location of their homes, citizenship status or socioeconomic status (Rosenthal …

Developing Gradient Boosting Machine Learning Model For Predicting Headaches Among Adult Headache Patients, Hye Sun Kim

Public Health Theses

Background – Headache is one of the significant public health threats in the world. Patients often face difficulties preparing for medications before headache attacks due to their unexpected nature. A headache diary was previously employed in studies to develop a machine-learning prediction model. However, previous research used variables related to a narrow range of topics or used ensemble methods where the decision trees were not added sequentially. Therefore, this study aimed to use a gradient-boosting approach to find factors from a headache diary with a broader range of factors with strong predictive values for headache prediction.Methods – The three-month headache …

Organizational Structure And Pricing: Evidence From A Large U.S. Airline, Ali Hortaçsu, Olivia R. Natan, Hayden Parsley, Timothy Schwieg, Kevin R. Williams

Cowles Foundation Discussion Papers

Firms facing complex objectives often decompose the problems they face, delegating different parts of the decision to distinct subordinates. Using comprehensive data and internal models from a large U.S. airline, we establish that airline pricing is inconsistent with canonical dynamic pricing models. However, we show that observed prices can be rationalized as an equilibrium of a game played by departments who each have decision rights for different inputs that are supplied to the observed pricing heuristic. Incorrectly assuming that the firm solves a standard profit maximization problem as a single entity understates overall welfare actually achieved but affects business and …

A Novel Smarcc1-Mutant Bafopathy Implicates Epigenetic Dysregulation Of Fetal Neural Progenitors In The Pathogenesis Of Congenital Hydrocephalus, Amrita K. Singh

Yale Medicine Thesis Digital Library

Congenital hydrocephalus (CH) is a common disorder requiring neurosurgery in children, however its pathogenesis is poorly understood. Recent studies have implicated SMARCC1 as a candidate CH gene but variants have not been conclusively linked with a human syndrome, nor functionally validated in vivo. This study aims to (i) assess the extent of CH risk associated with SMARCC1 variants; (ii) describe associated clinical and radiographic phenotypes; and (iii) assess the pathogenicity and mechanisms of SMARCC1 depletion in a novel animal model of CH. A genetic association study was conducted using whole-exome sequencing from a CH discovery cohort consisting of 492 neurosurgically-treated …

Single Neuronal Firing Dynamics In A Mouse Model For Absence Seizures, Waleed Khan

Yale Medicine Thesis Digital Library

SINGLE NEURONAL FIRING DYNAMICS IN A MOUSE MODEL FOR ABSENCE SEIZURES

Waleed Khan1, Samiksha Chopra1, Xinyuan Zheng2, Shixin Liu1, Marcus Valcarce-Aspegren1, Lim-Anna Sieu1, Sarah Mcgill3, Cian Mccafferty4, Hal Blumenfeld1.1 Department of Neurology, Yale University, School of Medicine, New Haven, CT. 2 Department of Biomedical Engineering, Yale University, School of Medicine, New Haven, CT. 3 Department of Neuroscience, Yale University, School of Medicine, New Haven, CT. 4 Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.

Background: Absence seizures are generalized seizures that occur mostly in children and often manifest as staring spells. Absence seizures can often occur hundreds of …

Does Environmental Testing Of C. Difficile Predict Whether A Patient Is Positive With C. Difficile?, David Caccese

Public Health Theses

Clostridioides difficile is a major public health threat and frequent cause of healthcare-associated infections. Hospitals have struggled to control C. difficile due in part to the challenge of identifying asymptomatic C. difficile carriers and because of C. difficile’s ability to survive on environmental surfaces for long periods. Asymptomatic carriers and environmental surfaces can contribute to C. difficile transmission. Screening of all patients for C. difficile upon hospital admission is not feasible and asymptomatic patients may not be accepting of surveillance testing. Thus, this study examines whether sampling the patient’s room environment once they have been admitted can indicate a patient …

Social Vulnerability And Viral Respiratory Infections In Connecticut (2018-2021): A Modeling Approach To Identify Salient Measures, Sarah C. Katsandres

Public Health Theses

The social vulnerability index (SVI) measure was developed by the Centers for Disease Control and Prevention to characterize a community’s vulnerability level. Recently, SVI has been used to predict risk of COVID-19, in order to understand which communities may be most vulnerable. This analysis aims to understand what factors are driving the relationship between census tract-level vulnerability and risk of hospitalization with a viral respiratory pathogen. A statistical analysis and modeling study of surveillance data was conducted, analyzing the incidence of hospitalization with influenza, respiratory syncytial virus (RSV), and COVID-19, by census tract, in two counties in Connecticut between 2018–2021. …

Improving Health Equity Through Residential Electrification And Energy Efficiency: State Of Practice In The Us, Alice Lu

Public Health Theses

Improving residential building efficiency and transitioning from fossil fuels for climate alignment has been a primary focus in climate change mitigation efforts. Energy efficiency is usually achieved through tightening buildings by sealing gaps that allow conditioned air to pass through. However, early research highlighted the potential for more efficient buildings to also limit the supply of outdoor air, leading to increased indoor concentrations of various air pollutants. Tightening buildings for efficiency must therefore be accompanied by supplemental ventilation to preserve indoor air quality. However, less is known about the effects of specific indoor pollutant sources. It is hypothesized that indoor …

Barriers And Care-Seeking Behavior Towards Breast And Cervical Cancer Screening Among Migrant Women In Casablanca, Morocco, Ala Mansour

Public Health Theses

Introduction: Over the past few decades, Morocco – a transit country for entry into Europe – has gradually evolved as a place of resettlement for migrants of sub-Saharan and West African origins. To combat inequities in healthcare utilization, the Moroccan government introduced a series of reforms designed to promote breast and cervical cancer screening and regularization of migrants. To date, few studies have explored the extent to which migrant residents in the country uptake these services or their awareness of cancer signs, symptoms, and risk factors relative to their native counterparts. The purpose of this study is to therefore delineate …

“I Was Reaching Out For Help And They Did Not Help Me”: Mental Healthcare In The Carceral State, Anna Grace Preston

Public Health Theses

Background: Despite the limitations the carceral environment may impose on mental wellness, mental healthcare is increasingly becoming a carceral endeavor. Over the course of the last several decades, prisons and jails have become the de facto mental healthcare provider for thousands of incarcerated individuals. Furthermore, practices like mandated mental healthcare for supervised individuals further broaden the population experiencing mental healthcare within the criminal legal system at large. This study examines the perspectives of nine individuals who experienced mental healthcare within the carceral state, whether in prison or on parole or probation, with a special focus on how attributes of the …

Association Between Sars-Cov-2 Reinfections And Anti-S Antibody Levels At The First Omicron Wave In Salvador, Brazil, Yiran Qin

Public Health Theses

Background: SARS-CoV-2, with its high transmissibility and rapid dissemination, has caused a global public health emergency. The emergence of new variants and mutations of SARSCoV-2 spike protein antigens has led to concerns about immune escape and the potential for reinfection, even in individuals who have been previously infected or vaccinated. Brazil has been severely affected by the pandemic, especially in its densely populated slum areas. Our study aimed to evaluate the association between anti-S IgG antibody levels and subsequent SARS-CoV-2 infection during the Omicron wave in a susceptible community in Salvador, Brazil, to provide insight into the antibody level necessary …

Developing And Using Cholera Models In Northwest Syria, Emily Rose Tobik

Public Health Theses

Researchers have utilized transmission dynamic modeling to determine interactions between hosts and pathogens in many humanitarian settings. However, modeling for the cholera outbreak in Northwest Syria (NWS) has yet to be completed. This thesis presents a path towards cholera model building in NWS by investigating the current cholera outbreak, outlining how to create a compartmental model in this region given its complexities, and determining ways potential cholera models could be utilized in NWS. Intricacies involving the region's ongoing civil war, significant internally displaced persons (IDP) population, and the February 2023 earthquake add complexities to modeling in this region. For the …

Radiomics: A Methodological Guide And Its Applications To Acute Ischemic Stroke, Emily Avery

Yale Medicine Thesis Digital Library

The field of radiomics provides a quantitative approach to medical imaging, wherein a large number of features extracted from medical images are used to detect clinically relevant information that is invisible to the naked eye. This increasingly prevalentmethodology has facilitated improvements in the speed and efficacy of clinical decision-making across specialties. One area where radiomics can make a particular impact is acute stroke imaging. As “time is brain” in acute stroke triage, automated tools for patient evaluation have significant potential to improve outcomes by providing timely, objective data. The present work aimed to create radiomics models from admission CT angiographic …

An Examination Of Honor Society Membership, Mistreatment, And Discrimination By Medical Student Demographics, Katherine Ann Hill

Yale Medicine Thesis Digital Library

Purpose: To determine whether the prevalence of honor society membership and self-reported mistreatment and discrimination differs by medical student demographic group.Methods: This cross-sectional study analyzed data from Association of American Medical Colleges data collection instruments and included all students who graduated from LCME-accredited US medical schools and completed the Graduation Questionnaire in 2016-2019 (for honor society membership) or 2016-2017 (for self-reported mistreatment and discrimination). Results: In a sample of 50,384 graduating medical students, membership disparities were found in both Alpha Omega Alpha (AOA) and Gold Humanism Honor Society (GHHS). However, disparities in AOA existed across more identities, were often larger, …

Diagnosis Of Polycystic Ovary Syndrome And Non-Hispanic Black Race Are Predictive Of Hypertension In Reproductive Age Women -Analysis Of Real World Electronic Medical Record Data, Nyerovwo Okifo

Yale Medicine Thesis Digital Library

Objective: The primary objective was to examine if blood pressure (BP) indices are higher and if the prevalence of hypertension (HTN), indices of metabolic syndrome (MetS) and severe obesity are greater in women diagnosed with polycystic ovary syndrome (PCOS) versus age comparable Controls without PCOS diagnosis. The secondary objective was to examine if Non-Hispanic Black (NHB) race and Hispanic ethnicity were relevant to the relationship between PCOS diagnosis and outcomes. Methods: This was a case-control study based on retrospective analysis of cross-sectional data available in the electronic health record (EHR) of an academic tertiary care health care system. Utilizing ICD-10 …

“I Was Reaching Out For Help And They Did Not Help Me”: Mental Healthcare In The Carceral State, Anna Grace Preston

Yale Medicine Thesis Digital Library

Background: Despite the limitations the carceral environment may impose on mental wellness, mental healthcare is increasingly becoming a carceral endeavor. Over the course of the last several decades, prisons and jails have become the de facto mental healthcare provider for thousands of incarcerated individuals. Furthermore, practices like mandated mental healthcare for supervised individuals further broaden the population experiencing mental healthcare within the criminal legal system at large. This study examines the perspectives of nine individuals who experienced mental healthcare within the carceral state, whether in prison or on parole or probation, with a special focus on how attributes of the …

Single-Cell Transcriptomic Atlas Reveals Molecular Drivers Of Human Inner Ear Development, Amar H. Sheth

Yale Medicine Thesis Digital Library

Introduction: Improving the therapeutic landscape for hearing loss necessitates an improved understanding of inner ear biology. Historically, our molecular understanding of inner ear physiology has lagged behind our knowledge of mechanistic understanding of signal transduction due to the rare, diverse, and fragile cell types of the inner ear. However, recent advances in high-throughput sequencing have allowed us to decode the molecular underpinnings of physiologic changes in the murine inner ear. Herein, we single-cell RNA sequence fetal tissue and present a comprehensive atlas of the developing human inner ear. Harnessing newer approaches in computational analysis, we delineate diversity of cell types …

“Have You Been Vaccinated For Hpv?” - Piloting A Novel Brief Educational Intervention In Otolaryngology Clinics To Improve Patient Knowledge Of Oropharyngeal Cancer And Promote Human Papilloma Virus Vaccination, Samipya Kafle

Yale Medicine Thesis Digital Library

Introduction; The incidence of HPV-associated oropharyngeal squamous cell carcinoma(OPSCC) has increased significantly over the past several decades, however public awareness of HPV’s role in head and neck cancer remains markedly low. There is evidence to suggest that addressing this knowledge gap through patient education initiatives may help increase HPV vaccination rates. To this end, we introduce a brief educational intervention into routine otolaryngology clinic visits to increase patient knowledge of the link between HPV and oropharyngeal cancer, and to encourage HPV vaccination. We aimed to test the feasibility of a simple, in- office intervention and to assess its efficacy in …

Proprietary Trading And Certain Interests In And Relationships With Covered Funds, United States: Federal Deposit Insurance Corporation (Fdic)

Documents

No abstract provided.