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Yale School Of Medicine Facts & Figures 2021-2022, Yale School Of Medicine Office Of Communications

Facts & Figures – annual Yale School of Medicine numbers

Provided by the Office of Communications, the Facts and Figures brochure is produced annually as a way to provide a snapshot of key facts and data related to the School of Medicine as well as the Medical Campus. This includes enrollment data, research activity, financial summaries, and more.

Medicine@Yale January/February 2021 Volume 16, Issue 1, Yale School Of Medicine Office Of Communications

Medicine@Yale - development newsletter

Medicine@Yale : advancing biomedical science, education and health care was a print and online newsletter which published news about academics, research and philanthropy for alumni, donors, faculty, students and the general public. It was initially published 6 times a year and then changed to a quarterly schedule. The first issue came out June/Jul. 2005. The final issue was published in May/June 2022, vol. 17, issue 1. Published by Yale School of Medicine, Office of Communications.

Was New York City A Source Of Global Sars-Cov-2 Spread?, Cole Jensen

Public Health Theses

Coronavirus disease 2019 (COVID-19) was first diagnosed in the United States on January 15, 2020, in the state of Washington. Shortly after that, on February 29, 2020, the first case of COVID-19 was reported in New York City. From January 2020 through July 2020, there were 223,107 cases of COVID-19 that led to 18,787 COVID-19 related deaths in New York City alone. During this time, many left New York City to avoid contracting the virus or to return home. This travel seeded much of the transmission within the United States. We aimed to identify any international transmission of severe acute …

Smoking And Early-Onset Basal Cell Carcinoma, Zhaopei Liu

Public Health Theses

Background – Smoking has been identified as a risk factor for many cancers. While many studies have investigated the association between smoking and basal cell carcinoma (BCC), the results have been inconsistent, and no study has evaluated this association among a young population.

Methods – Early-onset BCC cases (n=374) and controls with minor benign skin conditions (n=384) under age 40 were identified through Yale Dermatopathology. Participants over 18 years old were asked whether they ever smoked (defined as ever smoked at least 100 cigarettes) during an in-person interview. Those who responded affirmatively were then asked about their smoking history. We …

Discovery Of Genetic Pleiotropy For Obesity And Inflammation And Mediation In Identified Variants Through Obesity-Related Pathways, Yiqian Wenren

Public Health Theses

Genetic data suggest that obesity and inflammation shared a portion of their genetic architectures. Meanwhile, epidemiologic data suggest a causal link between obesity and inflammation. Therefore, we hypothesized that there are variants in the human genome that display pleiotropy for obesity and inflammation and that the effects of at least some of those variants could be mediated by obesity-related pathways. To test these hypotheses, we conducted univariate genome-wide association analyses of obesity-related traits (BMI and WHRadjBMI) and inflammation (CRP) in the UK Biobank (n= 291,396 Caucasian subjects), searched for overlapping signals, fine-mapped the regions to identify putative causal SNPs, and …

Bulletin Of Yale University School Of Nursing 2021-2022, Yale School Of Nursing

Yale School of Nursing Bulletins and Catalogues

Series 117, Number 15

September 5, 2021

The Utility Of A Maximum Entropy Species Distribution Model For Ixodes Scapularis In Predicting The Public Health Risk Of Lyme Disease In Ontario, Canada, Holly Alexandra Burrows

Public Health Theses

Introduction: Lyme disease is an emerging public health threat in Ontario, Canada due to the range expansion of the tick vector, Ixodes scapularis. Tick abundance and density are important predictors of human Lyme disease risk and are typically measured using active tick surveillance (dragging). New cost-effective tools are needed to augment current surveillance activities.Objective: The objective of this study was to evaluate the ability of a Maximum entropy species distribution model to predict I. scapularis density and abundance in three regions of Ontario – Ottawa, Kingston, and southern Ontario – in order to determine its utility in predicting the public …

Too Fast, Too Furious: Slaughterhouse Line Speeds In The Era Of Covid-19, Zoe Novic

Public Health Theses

Since 1998, the United States Department of Agriculture (USDA) has allowed meat companies to increase slaughter line speeds in order to increase production of meat and poultry. The USDA grants approvals known as “line speed waivers” that bypass the requirements of current speed and inspection regulations. During the Covid-19 pandemic, slaughterhouses became epicenters of Covid-19 outbreaks, which called into question safety regulations established at these facilities. The USDA continued to grant line speed waivers despite evidence that faster line speeds result in increased worker injuries, animal welfare violations, environmental protection violations, food safety violations, and higher risk of Covid-19.

In …

Utilizing Qualitative Methods To Inform Interventions For Addressing Alcohol Use During Pregnancy, Chaarushi Ahuja

Yale Medicine Thesis Digital Library

Background: In the United States, nearly 12% of women report alcohol use during pregnancy despite recommendations of complete abstinence by government agencies and professional medical organizations. Multiple public health and screening interventions are effective in promoting increased knowledge and abstinence amongst pregnant women. However, the interventions generally provide broad, non-specific content, and the messaging is not directly tailored to the specific motivations and barriers that women face when making decisions about alcohol use during pregnancy. Since tailoring content and messages can improve effectiveness of interventions, a deeper qualitative investigation into the context surrounding alcohol use during pregnancy is warranted. Methods: …

Physician Burnout: An Assessment Of Impact, Drivers And Design Of Prevention Programs, David Dupee

Yale Medicine Thesis Digital Library

Burnout merits close study, with particular attention paid to means of quantifying institutional impact, reducing provider burnout burden, and measuring said burden. This study utilized economic and qualitative analyses to indicate institutional impact. It modified and piloted an intervention for attending level physicians. It also proposes a novel wellness program for resident physicians based off of triumphs and gaps in literature. Lastly, it utilizes survey comparison to track overall changes in burnout rate at Yale New Haven Hospital (YNHH). Overall, the cost of physician burnout at YNHH was estimated to range between $171 and $233 million annually. Reducing physician burnout …

Preauthorizations In Orthopaedic Surgery: An Analysis Of A Single Institution’S Spine Center, Kareem Jamal Kebaish

Yale Medicine Thesis Digital Library

Introduction

Preauthorizations are frequently required by commercial insurers before patients can undergo magnetic resonance imaging (MRI) of the spine. In addition to the administrative burden, such processes can lead to delays in care. The current study assessed the rates and eventual disposition of preauthorizations required prior to spine MRIs ordered from an academic spine center.

Methods

Patients from a single academic institution’s spine center who were covered by commercial insurance and referred for a spine MRI between January 2013 and December 2019 were included in the analysis. The requirement for preauthorization and eventual disposition of each of these studies was …

Integrative Genomics Implicates Disruption Of Prenatal Neurogenesis In Congenital Hydrocephalus, Shreyas Panchagnula

Yale Medicine Thesis Digital Library

Congenital Hydrocephalus (CH) affects 1/1000 live births and costs the US healthcare system over $2 billion annually. Mainstay therapies, hinging on surgical cerebrospinal fluid diversion, exhibit high failure rates and substantial morbidity. Limited understanding of pathogenesis warrants identification of crucial genetic drivers underlying CH and their impact on brain development. This pioneering study integrates gene discovery from the largest whole-exome sequenced CH cohort with transcriptional networks (modules) and cell-type markers from the latest transcriptomic atlases of the mid-gestational human brain to uncover the genomic and molecular architecture of CH. Exome analysis of 381 radiographically-confirmed, neurosurgically-treated sporadic CH probands (including 232 …

Somatic Gja4 Mutation In Vascular Malformations Reveals A Novel Pathway For Vascular Neoplasia, Nelson C. Ugwu

Yale Medicine Thesis Digital Library

The term “cavernous hemangioma” has been used to describe vascular anomalies with histology featuring dilated vascular spaces, vessel walls consisting mainly of fibrous stromal bands lined by a single layer of flattened endothelial cells, and a variably irregular outer rim of interrupted smooth muscle cells. Hepatic hemangiomas (HH) and cutaneous venous malformations (cVM) share this histologic pattern, and we examined lesions in both tissues to identify genetic drivers. Paired WES of lesional tissue and normal liver in HH subjects revealed a recurrent GJA4 c.121G>T, p.Gly41Cys somatic mutation in four of five unrelated cases, and targeted sequencing in paired tissue …

Editor's Commentary: Gravitational Circulation In Straits And Estuaries, Kenneth H. Brink, Maurice Rattray Jr.

Journal of Marine Research

For decades, people understood the rudiments of how idealized estuaries work: fresh water flows outward above saltier water that intrudes into the estuary. At the same time, mixing smooths out contrasts, so that the ultimate shallow outflow water is much saltier that the upstream riverine inflow had been. But, this vision is qualitative, so that it is hard to predict or diagnose flow structures or the outflow salinity. Hansen and Rattray provided a major step forward in an age before any sophisticated numerical models could deal simultaneously with the many competing effects...

Vocal Fold Cover Replacement: Imaging Analysis Of Intermediate And Long-Term Outcomes, Kevin Osmond Juarez

Yale Medicine Thesis Digital Library

The voice is an important source of communication. Voice disorders, dysphonia, has an estimated 30 percent lifetime prevalence in the United States with a significant economic and social cost. Severe vocal fold scarring can lead to persistent dysphonia, has no optimal treatment and negatively impacts those affected by impairing their quality of life and general health. We propose a novel approach to treating sever vocal fold scarring by replacing the entirety of the vocal fold mucosa with a tissue engineered implant, the cell-based outer vocal fold replacement (COVR). We hypothesized that intermediate and long-term implantation of human stem-cell derived COVR …

Climate Niche Evolution In C4+Cam Portulaca And Closely Related C3+Cam Lineages, Nora M. Heaphy

Library Map Prize

With at least a hundred independent origins among land plants, the CAM and C4 photosynthetic pathways represent one of the most notable examples of global convergent evolution of a complex trait. While biochemically similar, CAM and C4 are generally understood to be two distinct ecological adaptations evolving along separate trajectories. However, the purslanes (Portulaca), a globally widespread clade of around 100 species of annual and perennial succulents, are able to operate both CAM and C4 cycles in the same leaf. Portulaca likely originated from a facultative CAM ancestor and then evolved a C4 system at least three times …

The Future Of Leadership Training: An Immersive Web-Based Program Enhancing Nurse’S Critical Soft Leadership Skills In New Healthcare Contexts, Nina Vaid Raoji

Yale School of Nursing Digital Theses

As the care of health shifts to a more decentralized model of care, it essential that the role of nursing facilitates new paths to meeting patients and communities where they are in the context of their lives, forging new partnerships outside of the traditional health care setting, and focusing on advocating for collective upstream solutions (Pittman, 2020). However, this shift requires a set of skills that are not a focus of current nurse leadership training. These are Soft Leadership Skills: networking, communication, teamwork, and innovation/creativity, but not in the traditional sense of the terms (Rao, 2017). The goal of this …

From Bedside To Mountainside: Preparing New Nurse Practitioners For Advanced Clinical Skills In Remote Settings Using A Novel Training Program, Benjamin Woodard

Yale School of Nursing Digital Theses

The purpose of this doctoral project was to develop and pilot an expert-panel validated training program specifically for nurse practitioners (NPs) in remote settings, and to evaluate how new remote NPs rate their self-efficacy (a measure of confidence) in performing specific advanced clinical skills and procedures (ACSPs) before and after completing this program. The practice of primary care in remote regions requires expanded clinical skills for high acuity scenarios given the isolation. With more new primary care NPs practicing in more remote locales, their preparation for performing ACSPs, (including in complex and high-acuity cases) is critical for safe and effective …

Classic Article: Control Of Salinity In An Estuary By A Transition, Henry Stommel, Harlow G. Farmer

Journal of Marine Research

A theoretical reason is developed to explain why the mouth of a vertically stratified estuary should act as a constraint on the amount of salt water available for mixing in the estuary. Flume experiments designed to test this idea are described. The effect of tides on the control action and application to various estuaries is discussed.

Prevalence And Health Burden Of Cardiovascular Disease In Older U.S. Veterans: Results From The 2019-2020 National Health And Resilience In Veterans Study, Cailin Arechiga

Public Health Theses

Importance. Cardiovascular disease (CVD) is one of the leading causes of death in the U.S. and is associated with a range of demographic, military, trauma, and clinical characteristics and physical and mental health conditions. Older military veterans may have an increased risk for CVD, given their advanced age and military experiences. However, the prevalence and health burden of CVD in population-based samples has not been well characterized. Objective. To characterize the current prevalence of CVD, and its association with sociodemographic, military, trauma, and clinical variables in a large, contemporary, and nationally representative sample of older U.S. veterans. Design. Cross-sectional study …

United States Long-Term Trends In Adult Bmi From 1959 To 2018 By Income, Education, And Race/Ethnicity, Julia Banas

Public Health Theses

Obesity prevalence has increased dramatically since the 1950s. While cross-sectional comparisons across racial, ethnic, and socioeconomic groups are abundant, there is less work on long-term trends. We assessed trends in average adult body mass index (BMI) in the United States by income, education, and racial/ethnic groups from 1959 to 2018 using the National Health and Nutrition Examination Survey, which assesses repeated cross-sectional, representative samples of the United States population. Height, weight, income, education, and race variables were extracted from raw data files; income data was converted to constant dollars prior to analysis. BMI was calculated from height and weight measurements. …

Healthcare Provider Perspectives On The Influence Of Cultural Beliefs On Infant And Young Child Feeding Practices Within Ghanaian Refugee Camps: A Qualitative Analysis, Morgan Nadene Veronica Buchanan

Public Health Theses

Adherence to breastfeeding and complementary feeding recommendations is a proven strategy for promoting the well-being of infants and young children and ensuring their proper development. Cultural beliefs inform caregivers’ likelihood to follow these guidelines as they influence caregivers’ thoughts about maternal behavior during the prenatal and lactation periods, child feeding behaviors, and health. Refugee camps or settlements are a unique space to study the coexistence of cultural beliefs held by residents and staff. Understanding the pathways by which cultural beliefs modulate caregiver infant and young child feeding (IYCF) behavior (and therefore impact child health) within these settings is of paramount …

Identifying Serum Metabolite Biomarkers Of Thyroid Cancer, Yihui Chen

Public Health Theses

Background: In recent years, the incidence rate of thyroid cancer is increasing rapidly, including a significant increase in young aged group people. Environmental chemical exposure is a significant driver. With untargeted metabolomics approach, this study will perform an untargeted metabolomics approach to identify serum metabolites biomarkers associated with thyroid cancer and tumor size.

Methods: Serum samples of 100 thyroid cancer patients (50 cases and 50 controls) diagnosed between 2010 and 2011, were extracted for metabolites and analyzed by reversed-phase liquid chromatography-mass spectrometry (LC-MS) based untargeted metabolomics. All the analysis were conducted in both positive and negative Electrospray ionization (ESI) modes. …

The Epidemiology Of Covid-19 Hospitalizations In Connecticut, July – December 2020, Geena Chiumento

Public Health Theses

Background. Hospitalizations due to COVID-19, caused by infection with SARS-CoV-2, have disproportionately impacted many throughout the United States, particularly elderly folks, communities of color, and individuals residing in low-income neighborhoods. Objective. This study aims to describe the epidemiology of COVID-19-related hospitalizations in Connecticut in order to elucidate trends in incidence as well as health disparities. Methods. All first-time hospitalizations due to laboratory-confirmed COVID-19 from July 1 to December 31, 2020, including patients’ geocoded residential addresses, were obtained from the Connecticut Department of Public Health. Patients residing in the community were compared to those residing in congregate settings. Community patients were …

Overseen And Overlooked: Knowledge Production And Care In Public Health Surveillance, Krzysztof Wojciech Chwala

Public Health Theses

At the beginning of the COVID-19 pandemic, contact tracing was implemented as a public health measure to prevent the further spread of disease. In this thesis, I analyze contact tracing as a case study of public health surveillance. I argue that public health does not sufficiently study the social components and consequences of its surveillant activities, and as a result is hyperopic; it sees health-related phenomena at a distance with clarity, but has not brought its own logics under view. To remedy this, I utilize perspectives from the field of surveillance studies, which studies surveillance as social and cultural phenomena. …

Determining Polymorphisms In Tnf Production As They Relate To Infection With Ebov, Nirvana K. Dominguez Singh

Public Health Theses

This is a theoretical proposal done as an intellectual exercise. The purpose of this project is to practice and familiarize oneself with the process of applying for a grant from the National Institute of Health to conduct research on human subjects. This proposed study plans to sequence blood samples from infected individuals, exposed and uninfected individuals, and unexposed individuals from the 2018 outbreak in the Democratic Republic of Congo to determine the presence of polymorphisms in TNF production as they relate to Ebolavirus infection. It is hypothesized that certain polymorphisms in the regulation and production of TNF that cause a …

Quantification Of Anesthetic And Analgesic Compounds In E-Liquids And Their Aerosols, Deyri Sugey Garcia

Public Health Theses

The unprecedented rise of vaping has resulted in gaps of scientific understanding of the health hazards this new phenomenon has created, as well as delayed regulations surrounding vape products, including coolants. Coolants are additives that create anesthetic, physical sense-reducing, and/or analgesic, properties that numbs the airways and add a minty flavor to vape products. However, it is unclear how much coolant is added to vape products electronic liquid (e-liquid), and how much of this content carries over into the aerosolized vaped form. To determine compositional analysis and carryover of common synthetic coolants, eugenol in 35 clove e-liquids and menthol, methone, …

How Knowledge, Perception, And Identity Influence Covid-19-Related Concerns In The Built Environment, Abigail Ginader

Public Health Theses

Background: There is increasing research exploring how different diverse and intersecting identities based on race, gender, ability/disability, sexual orientation, and age interact with space to influence an individual’s inclusiveness and comfort in a space. This is particularly salient in the context of COVID-19 which has shown large health inequities and increased risk for certain vulnerable subgroups (e.g., older individuals, individuals of color).Objective: To assess end users’ perception of COVID-19 safety in the built environment of museums. Methods: A cross-sectional study design was used. An electronic survey was distributed between January and February 2021. Repeated measures ANOVA, multivariate Poisson regression, and …

Exploring Toddler Sleep Disparities Using Spatial Analytic Methods, Jessica He

Public Health Theses

Introduction: Sleep health is a vital component of childhood health. However, sleep health disparities exist among toddlers from racially/ethnically diverse families living with socioeconomic adversity as early as 12 months of age. There is a gap in the current literature that includes environmental factors that may explain the factors contributing to these differences.Objective: To explore associations between toddler sleep health and environmental and societal factors at the neighborhood level using spatial analysis that may help elucidate factors which contribute to the race/ethnicity differences in toddlers unexplained by socioeconomic variables. Methods: A secondary analysis was performed on data collected from a …

Transcriptomic And Metabolomic Analyses Of Acetaminophen Exposure In Human Ipscs: Potential Mechanisms Explaining Epidemiological Associations Between Prenatal Acetaminophen Exposure And Increased Risk Of Autism Spectrum Disorder, Tristan Furnary

Public Health Theses

Acetaminophen (APAP) is the most common analgesic taken during pregnancy. Indeed, approximately 65% of pregnant women use the drug. Recent epidemiological studies suggest that prenatal exposure to APAP is associated with increased risk of autism spectrum disorder (ASD). Although this neurodevelopmental disorder affects 1 in 54 children in the U.S., no studies have investigated the molecular mechanism by which APAP may increase the risk of ASD. In vitro experiments in cell cultures have shown that high concentrations of APAP induces cell death. Through the use of a systems-level approach in human induced Pluripotent Stem Cells (iPSCs), the present study investigates …