Digital Commons Network^™

Infectious And Hemorrhagic Hydrocephalus Share Molecular Mechanism Sensitive To Immune Modulation, Benjamin Reeves

Yale Medicine Thesis Digital Library

Hydrocephalus, characterized by a pathologic dilation of the brain’s cerebrospinal fluid (CSF)-filled ventricles, may either be primary or acquired. Acquired hydrocephalus, most often caused by ventricular infection or hemorrhage, is currently treated by surgical CSF diversion with either a shunt or endoscopic third ventriculostomy – two procedures plagued by high failure and complication rates. The lack of pharmaceutical treatments is in part due to the obscure pathophysiology of the disease. We created novel rat models of post-infectious (PIH) and post-hemorrhagic hydrocephalus (PHH) and conducted a systems-level, multi-omics investigation of these animals to outline the cellular, molecular, and physiologic pathology of …

2023 Scrcog Hazard Mitigation Plan, City Of New Haven

Miscellaneous

No abstract provided.

The Synergy Between Physiologic Dendritic Cells And Mrna-Loaded Lipid Nanoparticles And Its Potential As A Cellular Immunotherapy, Brian Myles Wei

Yale Medicine Thesis Digital Library

Transimmunization (TI) is a dendritic cell (DC)-based immunotherapy derived from extracorporeal photochemotherapy (ECP), a widely used immunotherapy for cutaneous T cell lymphoma. TI builds upon the mechanistic understanding that ECP inducts large-scale monocyte-to-dendritic cell differentiation through physiologic platelet-monocyte interactions that occur during the passage of cells over a plastic plate. While TI and ECP have used apoptotic tumor cells treated with 8-methoxypsoralen (8-MOP) and ultraviolet-A (UVA) irradiation as the source of antigens by which to target its immunotherapeutic effects, there is investigational interest in alternative antigen sources, including mRNA-containing lipid nanoparticles (LNP). In this work, we developed a modified version …

Barriers To Identifying Learning Disabilities: A Qualitative Study Of Clinicians And Educators, Lauren Stone

Yale Medicine Thesis Digital Library

The estimated prevalence of learning disabilities (LDs) is nearly 8% of all children. Yet fewer than 5% of all children are diagnosed in public schools — jeopardizing remediation. The specific aims of this study were as follows: 1) To perform a qualitative study involving individual interviews with front-line child-facing professionals to identify barriers to detecting school-aged children with LDs and 2) To utilize results to suggest improvements to pediatric clinical care, as pediatricians are often initial responders for families when children experience academic difficulties.

We conducted a qualitative study with individual interviews of 40 professionals from different areas of the …

Central Bank Of Ireland Annual Report 2023 & Annual Performance Statement 2023 - 2024, Central Bank Of Ireland

Documents

No abstract provided.

How (In)Effective Was Bank Supervision During The 2022 Monetary Tightening?, Yadav Gopalan, Joao Granja

Documents

No abstract provided.

Latvian Privatization Agency 2022 Report, Latvian Privatization Agency

Documents

No abstract provided.

Form 10-K 2022 - Svb Financial Group, Silicon Valley Bank Financial Group

Documents

No abstract provided.

On The Subject Of Rpi, Royal Park Investments

Documents

No abstract provided.

Operating Circular No. 10 Lending, Federal Reserve System: Board Of Governors

Documents

No abstract provided.

On The Subject Of Rpi, Royal Park Investments

Documents

No abstract provided.

Applying Deep Learning To Identify Imaging Biomarkers To Predict Cardiac Outcomes In Cancer Patients, Aishwarya Kishore Nene

Yale Medicine Thesis Digital Library

Cancer patients are a unique population with increased mortality from cardiovascular disease, however only half of high-risk patients are medically optimized. Physicians ascertain cardiovascular risk from several risk predictors using demographic information, family history, and imaging data. The Agatston score, a measure of total calcium burden in coronary arteries on CT scans, is the current best predictor for major adverse cardiac events (MACE). Yet, the score is limited as it does not provide information on atherosclerotic plaque characteristics or distribution. In this study, we use deep learning techniques to develop an imaging-based biomarker that can robustly predict MACE in lung …

A Project To Improve Advanced Practice Provider Financial Metrics Through A Practice Management Program, Stefanie Anne Generao

Yale School of Nursing Digital Theses

A Project to Improve Advanced Practice Provider Financial Metrics Through a Practice Management Program

This DNP project developed a practice management program for ambulatory Advanced Practice Providers (APPs) practicing in a large academic healthcare system with the goal to improve financial metrics. In 2020, Centers for Medicare and Medicaid Services (CMS) reported $25.74 billion in incorrect payments citing documentation errors and insufficiency as the common cause. The growth of the APP workforce necessitates APP practice management knowledge to avoid significant revenue loss since APPs collectively report lack of healthcare business knowledge. Twenty ambulatory APPs participated in a 12-week practice management …

Evaluating The Use Of Reflective Practice Principles To Support Nurse Manager Well-Being During A Period Of Chronic Distress, Amy A. Martone

Yale School of Nursing Digital Theses

The COVID-19 pandemic brought forward a crisis that the current U.S. healthcare system was not prepared for. This increased the risk for burnout of teams and individuals, including the nurse leader. Nurse managers were selected as the target audience for support because they are key clinical leaders at the unit and staff level, yet they report feeling undervalued and are at higher risk for turnover than other leaders. This project developed a program that used reflective practice principles to support nurse manager well-being during periods of chronic distress.

The curriculum was guided by the Dimensions of Leadership as framework for …

Understanding Perceptions Of New-Onset Type 1 Diabetes Education In A Pediatric Tertiary Care Center, Gabriel Betancurvelez

Yale Medicine Thesis Digital Library

Background: Youth newly diagnosed with type 1 diabetes (T1D), and their families, require intensive education on the management of this chronic condition during this overwhelming period. Traditionally, our center conducts training in person during a hospital admission.

Methods: We studied family perceptions of our current patient education methods in an effort to elucidate strategies to augment education in the post-pandemic environment, where provider time in the room and visitation rules may limit face-to-face encounters.

Results: 25 families completed the survey (distributed to 156 in total, with approximately 21% response rate). The mean age at diagnosis was 9.52 ± 4.29 years …

2022 Condensed Interim Financial Statements, Hellenic Financial Stability Fund

Documents

No abstract provided.

Misinterpreting Yourself, Paul Heidhues, Botond Koszegi, Philipp Strack

Cowles Foundation Discussion Papers

We model an agent who stubbornly underestimates how much his behavior is driven by undesirable motives, and, attributing his behavior to other considerations, updates his views about those considerations. We study general properties of the model, and then apply the framework to identify novel implications of partially naive present bias. In many stable situations, the agent appears realistic in that he eventually predicts his behavior well. His unrealistic self-view does, however, manifest itself in several other ways. First, in basic settings he always comes to act in a more present-biased manner than a sophisticated agent. Second, he systematically mispredicts how …

Implementing Prediabetes Screening During Hospitalization In An Internal Medicine Unit, Roxana Bustamante

Yale School of Nursing Digital Theses

About 1 in 3 adults in the United States have prediabetes, yet 8 in 10 of people are unaware of having this condition. The gap in timely diagnosis of prediabetes hinders opportunities for awareness of risk for type 2 diabetes (T2DM), self-management, and referral to preventative interventions. Individuals with undiagnosed prediabetes have 1.3 times higher risk for hospitalization. Extending prediabetes screening to the inpatient hospital setting offers opportunity to identify undiagnosed prediabetes. The purpose of this DNP project was to implement a prediabetes screening algorithm in the hospital setting to identify undiagnosed prediabetes and initiate patient education on preventative lifestyle …

Increasing Transplant Medication Knowledge Through Implementation Of A Medication Education Intervention Algorithm, Colleen Chime Karkhang

Yale School of Nursing Digital Theses

Limited health literacy (LHL) has profound implications on measured transplant outcomes as it is associated with higher incidence of graft loss, organ rejection, decreased immunosuppression medication adherence, and increased hospital re-admissions. Identification of patients with limited health literacy allows for opportunities to provide targeted medication education that allows patients to become more active participants in their care while increasing their transplant medication education knowledge and self-efficacy. The aims of this DNP projects were to develop and implement a medication education intervention algorithm that incorporates health literacy scores and evidenced based educational interventions amongst kidney transplant recipients (initial transplants and re-admissions) …

Multimodal Opioid-Sparing Analgesia: Increasing Regimen Adherence In Minimally Invasive Abdominal Surgery, Panicha F. Kittipha

Yale School of Nursing Digital Theses

Multimodal Opioid-Sparing Analgesia: Increasing Regimen Adherence in Minimally Invasive Abdominal SurgeryIn 2016, the CDC estimated 11.5 million persons in the United States, aged 12 years and older, misused opioids in the past year. The opioid epidemic poses a challenge to the healthcare profession as it continues to care for, treat, and manage pain with associated complications from opioid dependence. Patients who primarily use opioids for pain control postoperatively and at discharge are at a 44% increased risk for opioid dependence after only five days of use. The incorporation of multimodal analgesia and opioid-sparing approaches has led to improved pain management …

Improving Treatment Outcomes For American Indians With Posttraumatic Stress Disorder Through The Use Of Telepsychaitry, Shaylice Meserole

Yale School of Nursing Digital Theses

The prevalence of PTSD has increased from 6.8% to 20% since the start of the Covid-19pandemic. For American Indians, the prevalence of PTSD ranged between 16 to 24% prior to the start of the pandemic. American Indians living in rural and tribal communities often experience significant barriers to accessing quality mental health treatment. For these reasons, telepsychiatry is a necessary tool to increase access to care. An entirely home based telepsychiatry program was developed and adapted for PTSD patients within a tribal community and implemented over 12 weeks. 40 patients were engaged at the initiation of the program and a …

The Adaptation And Implementation Of A Comprehensive Retirement Transition Program For Members Of Law Enforcement, Renee White

Yale School of Nursing Digital Theses

Due to job related PTSD and identification with their intense careers, police officers areat risk for substance use disorder and mental illness when they transition into retirement. This DNP project implemented a retirement transition program modeled from a successful federal program for military personnel that was structured as a five day, in-person experience designed to be efficient and cost effective. The aims of the project were to: 1) modify an existing comprehensive retirement transition program used by the US military for police officers in an unnamed state within 5 years of their projected retirement date; 2) implement and evaluate this …

Perceptions Of Adults With Type 1 Diabetes About Diabetes Management And Exercise, Meera Swaminath

Public Health Theses

This study was conducted to understand participants’ experiences with diabetes management and relationships with exercise for a sample of adults (27-65 years old) with Type 1 diabetes living in the United States and identify potential technological features for a digital health tool supporting physical exercise and diabetes management. The sample consisted of 12 participants living across the nation. Participants were recruited online, through social media and healthcare system platforms. Participant data was collected in the form of surveys and interviews and analyzed using a constructivist framework and thematic analysis. Findings were collapsed into four major themes: 1) making exercise decisions …

Associations Between Involvement In Shared Activities With Plwd, Relationship Closeness, And Loneliness Of Friends And Family, Marielle W. Quinn

Public Health Theses

Objectives. To examine the association between self-reported relationship closeness, loneliness, and engagement in shared activities with a person living with dementia (PLWD) in a community sample of family members and friends of PLWD. Methods. Using data from a Qualtrics-administered online survey, we examined involvement in shared activities of 51 respondents who have or had a family, friend, or intimate relationship with a PLWD. Outcome variables included relationship closeness, measured with the Inclusion of Other (IOS) scale, and loneliness, measured using a revised three-item questionnaire from the UCLA loneliness scale. Results. The main findings of the study were as follows: 1. …

Chagas Disease Screening: Awareness, Practices And Perceived Barriers Among Health Care Providers In Connecticut, Erica J. Rayack

Public Health Theses

Background: An estimated 288,000 people in the United States are infected with Chagas disease. Despite published recommendations for health care providers, the neglected nature of this disease persists, in part due to gaps in knowledge and low levels of Chagas disease awareness among health care providers. A survey was emailed to health care providers to assess knowledge, screening practices and provider-perceived barriers to screening for Chagas disease.

Methods: The survey link was emailed to healthcare providers and department heads. Providers answered a series of questions categorized either as knowledge (K), practice (P), or perceived barriers (B), which were then scored …

Evaluating The Direct Medication Costs Associated With Advanced Non-Small Cell Lung Cancer (Nsclc) Treatment By Biomarkers In The United States: A Coarsened Exact Matching Retrospective Cohort Study, Juanyi Tan

Public Health Theses

IMPORTANCE Most NSCLC patients are diagnosed at an advanced stage. Given recent advancements in immunotherapy and targeted therapies, identifying the biomarker status—such as targetable gene alterations and immune checkpoints—of patients becomes critical in selecting the appropriate treatment. Despite the substantial economic burden of lung cancer, little is known about the medication costs associated with advanced NSCLC treatment by different biomarkers.OBJECTIVE To investigate the association between biomarker status and first-year direct medication costs associated with advanced NSCLC treatment. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted using the Flatiron Health electronic health record (EHR)-derived de-identified database. The study population …

Detecting Disease-Related Changes In Intercellular Communications, Nating Wang

Public Health Theses

Diverse types of cells interact and communicate with each other to maintain tissue homeostasis and perform biological functions. Perturbations to these interactions can break the homeostasis of the tissue microenvironment, leading to disease. Understanding intercellular communication changes in disease is critical for therapeutic development. Cell-cell communication networks (CCCNs) inferred from single-cell RNA sequencing data are highly variable and only capture a snapshot of the dynamic intercellular communication system. We develop a graphical generative model to compare CCCNs between disease and control samples to identify disease associated perturbations to intercellular communications. The distribution of CCCNs is learned using variational graph autoencoder …

A Robust Bayesian Model Averaging Method For Basket Trials With Different Endpoints, Xueting Wang

Public Health Theses

Oncology drug research in the last few decades has been driven by the development of targeted agents. In the era of targeted therapies, basket trials are often used to test the antitumor activity of a novel treatment in multiple indications sharing the same genomic alteration. As patient population are further fragmented into biomarker-defined subgroups in basket trials, novel statistical methods are needed to facilitate cross-indication learning to improve the statistical power in basket trial design. Here we propose a robust Bayesian model averaging (rBMA) technique for the design and analysis of phase II basket trials. We consider the posterior distribution …

The Impact Of Climate Change On The Mental Health Of Native American Youth: A Qualitative Study Protocol, Xun Wang

Public Health Theses

Climate change can induce a significant mental health burden on youth, especially for those in Indigenous communities. Despite their vulnerability, little is known about the impact of climate change on the mental wellbeing of Native American children and adolescents. This qualitative study seeks to address this gap by exploring Native American youths’ perceptions and emotional and behavioral responses to climate change. The study is grounded in Indigenous methodologies, which prioritize Indigenous worldviews, values, and ways of interaction. We will utilize relational capital on campus to identify the collaborating tribe and ensure a respectful and reciprocal relationship is built before proceeding …

Redox Changes In The Livers Of Mice Exposed To Environmentally Relevant Doses Of 1,4-Dioxane In Drinking Water, Caroline Erickson

Public Health Theses

1,4-dioxane (DX) is designated as a probable human carcinogen (Group 2B) based on demonstrated liver carcinogenicity in animal models. DX was a widely-used stabilizer for organic solvents throughout the late 20th century. Today, DX is found in many public water supply systems as well as personal care products. A lack of data on the mechanisms of action (MOAs) of its toxicity has contributed to the absence of adequate regulation. As a result, no federal Maximum Contaminant Law (MCL) exists leaving states responsible for designing exposure guidance amidst the regulatory melee. This thesis seeks to investigate redox changes associated with DX …