Digital Commons Network^™

A Source-Specific Algorithm To Estimate Occupational (1→3)-Β-D-Glucan Exposure For Farmers In The Biomarkers Of Exposure And Effect In Agriculture Cohort, Felicia Hung

Public Health Theses

Background: (1→3)-β-D-glucans, or simply known as glucans, are components of fungal cell walls and are associated with mold. The adverse health effects due to glucan inhalation exposure has not been well studied, but it is known that upper respiratory inflammation has been seen with glucan exposure. Farmers, especially those who work with animals, are exposed to glucans on a daily basis; however, there is no occupational exposure limit to glucans and the full extent of glucan exposure in this population is unclear due to the lack of exposure assessment. This study will utilize decision-rules and a source-specific method to create …

Key Trends In Digital Health And The Future Of Clinical Trials In The Us, Jeannette Jiang

Public Health Theses

With the increasing burden of chronic diseases on the global population, many stakeholders see digital health technologies and devices as potential solutions to improve patient self-management of their disease and offer novel treatment methods. Digital health solutions including mobile apps, web-based programs, texting, and connected devices have been applied to a wide variety of diseases. In recent years, interest in digital health technologies has exploded with almost 200 digital health related articles published in PubMed in 2019 alone. In particular, digital health holds great potential in improving and enhancing the traditional clinical trial by increasing patient recruitment and retention and …

Psychosocial Mechanisms Of Historical Trauma Transmission In Native American Communities: A Rapid Scoping Review, Rucha Kandlur

Public Health Theses

For centuries Native American communities have been subjected to persistent oppression. The effects of the historical events of colonization have transcended generations and continue to affect the lives of the current generation, removed from direct exposure to the traumatic events. The intergenerational transmission of trauma has widely been studied in Holocaust survivors, with only recent explorations in other marginalized populations incurring similar forms of trauma. Additionally, explorations in intergenerational trauma transmission have largely focused on biological mechanisms rather than the psychosocial mechanisms. The purpose of this study is to examine existing evidence regarding psychosocial mechanisms of intergenerational transmission of historical …

Factors Associated With Early Childhood Development Outcomes For Children Of Adolescent And Young Adult Mothers In Brazil, Lily Benson Kofke

Public Health Theses

Objectives: A descriptive analysis to explore the risks for early childhood development (ECD) delays among children of adolescent and young adult mothers in Brazil. Methods: A secondary analysis of cross-sectional data of a representative sample of children under age 2 and their mothers from community health centers in Brasília, Brazil. The Denver Developmental Screening Test II was used to assess overall and domain-specific ECD (personal-social, fine motor, gross motor, and language). Mothers were subset into two groups based on age. Bivariate analyses and multivariable logistic regressions were used to examine the associations between maternal age and risk of ECD delay, …

The Associations Between Circadian Genetic Factors And Cancer Survival, Bingqing Li

Public Health Theses

The circadian rhythm controls a range of important biological behaviors with a 24-hour cycle. The mammalian biological clock is a layered network of vibrators with a master clock locating in the neurons of suprachiasmatic nucleus (SCN) in the hypothalamus and a set of core and related circadian genes. Several lines of evidence from previous studies suggested the relationships between tumorigenesis and circadian rhythm disruption. However, the effects of circadian genetic factors in cancer survival remains uncertain. Therefore, it is important to review and explore the circadian genetic factors which might be linked to cancer survival. This paper aimed to evaluate …

Gene-Gene Interactions Contributing To Asthma Susceptibility, An Exploration Using Uk Biobank Dataset, Yuyuan Lin

Public Health Theses

Background: Previous studies have attempted to identify gene-gene interactions for asthma. However, most of these studies suffered from lack of replication or insufficient statistical power. In this study, we aimed to explore the gene-gene interactions affecting asthma susceptibility and tried to replicate the results. Both the discovery and replication datasets were nested in UK Biobank data.

Methods: Nested case-control design was used. In the discovery analysis (N= 306,859, cases = 35,483, controls = 271,376), Univariate genome-wide association analysis was performed to prioritize loci for the interaction analysis. Pairwise search for epistasis was conducted among 5,389 SNPs. Replication of the top …

The Impact Of Ww’S Multi-City Fvrx Program On Children, Damaris Lopez Mercado

Public Health Theses

Introduction and background: Higher F&V intake are associated with healthier BMI in children, but cost of F&V has been found to be a barrier to access for some families. To mitigate this barrier, Wholesome Wave (WW) implemented a six-month F&V incentive program that included a $25 weekly financial incentive for families to spend on F&V in three U.S. cities. The primary objectives of this paper are to assess whether this program significantly impacted child F&V consumption and child anthropometry from baseline to end-of-program and to assess whether F&V intake and food insecurity and end-of-program are significant predictors of healthy child …

Determinants For Approval And Reimbursement Of Orphan Products In China, Wenlan Mao

Public Health Theses

Rare disease definition varies among countries/regions. China has published The First National List of Rare Diseases, including 121 kinds of rare diseases in 2018. It was the first time that China has defined rare diseases officially. China has also started releasing a range of encouraging regulations regarding orphan drug development and approval in recent years. Nevertheless, the FDA has introduced Orphan Drug Act in the 1980s, Japan has launched a government-led support initiative in the 1990s, and the European Parliament has adopted the Orphan Regulation in 2000. Among the 121 rare diseases, 58 of them have approved treatments in the …

Co-Distribution Of Ambient Light At Night And Incidence Of Human Cancers And Covid-19, Yidan Meng

Public Health Theses

Introduction and BackgroundThere are increasing concerns about the effects of artificial lights on human health, including hormone-related disease and immune functions. In January 2020, the outbreak of COVID-19 disrupted everyone’s life, and people who infected have various severity. Thus, we want to analyze whether people exposed to different ambient light at night (LAN) levels make them more susceptible to COVID-19 for our summer research. Besides the effects of LAN on immune functions, we also discussed the association of LAN and multiple cancers in seven states of Northeastern U.S. We used similar statistical and geographic analysis methods and separate them into …

Economic Evaluation Of The Preventing Childhood Obesity Through Mindfulness-Based Parent Stress Intervention, Jingyi Meng

Public Health Theses

This study analyzed the intervention cost of a novel early childhood obesity prevention program -- Preventing Childhood Obesity Through a Mindfulness-Based Parent Stress Intervention (PMH+N) conducted by Yale Stress Center. The randomized clinical trial started from 11/01/2018 and will enroll 240 participants in total. Parents were included in the trial if they had: a child in the 2- to 5-year age group, a body mass index (BMI) over 28 kg/m2, high levels of perceived stress as assessed by the Perceived Stress Scale (PSS) (score >25) and were able to read and write in English. For 12 weeks, about 13 parents …

The Role Of Histone Demethylase Kdm6a In Mouse Coronavirus Infection, Sonam Patel

Public Health Theses

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of acute respiratory coronavirus disease 2019 (COVID-19), a disease that erupted into a global pandemic in March of 2020.2 Recently, a genome wide CRISPR screen was performed on SARS-lineage coronaviruses and two additional recombinant viruses; the screen revealed host genes essential to coronavirus pathogenesis and entry.7 The screen identified KDM6A, a histone demethylase, as an important pro-viral gene.7 Building upon this observation, in this thesis, I explore the role of Kdm6a in murine hepatitis virus (MHV), a type of mouse coronavirus. MHV is the prototypical model for studying SARS-CoV-2 …

An Examination Of The Multilevel Determinants Of Homelessness, Ashley Brooke Roehrig

Public Health Theses

Objectives: This project aimed to explore factors contributing to homelessness within Fairfield County, Connecticut in order to understand how to develop prevention services that best match the population’s needs.

Methods: This project draws on data collected from a qualitative study done by Supportive Housing Works, where researchers conducted 2 focus groups and 44 semi-structured interviews with individuals experiencing homelessness or housing instability in Bridgeport, CT. Participants were recruited by posting flyers, as well as referrals from programs such as Prospect House, and other Opening Doors Fairfield County (ODFC) partner agencies. Eligible participants had to be registered with the Homeless Management …

An Agenda-Setting Report: Biome Monitoring For Human Health, Peter Roumeliotis

Public Health Theses

In light of the COVID-19 pandemic and the increasing frequency with which zoonotic diseases of pandemic potential have emerged in recent decades, it is vital to seek new methods of preventing disease outbreaks before they occur. Novel information age technologies have the potential to change the game for infectious disease outbreak monitoring. This paper addresses the overall opportunity that exists for biome surveillance as a means for health monitoring, particularly the way that the domains of technological and biological sciences can unite to prevent the next pandemic before it gets a chance to take hold. This report outlines the numerous …

Association Between Maternal Stress And Parental Responses To Child Development As Measured By Hpa Axis Biomarkers, Crystal Maureen Ruiz

Public Health Theses

Background. This study aims to assess the association between perceived stress and maternal responses to child developmental behavior, utilizing hypothalamic-pituitary-adrenal (HPA) axis biomarkers to measure maternal stress: cortisol, cortisone, DHEA and testosterone.

Methods. This study was conducted using data collected from a randomly selected sample of mother-infant dyads from the Bachpan cohort. This analysis focuses on data collected at baseline and 36 months postpartum. Of the women who screened positive for depressive symptoms at baseline (n=889) and provided responses to the 36-month questionnaire assessing perceived stress, a sub-sample (n=90) provided hair cortisol concentration (HCC) samples and completed a questionnaire concerning …

“We Are Left Alone”: A Qualitative Study Of Life Satisfaction Of Older Adults In Rural Nepal, Anna Elisabeth Schwartz

Public Health Theses

Considering that the aging population in the Southeast Asian region is rapidly growing, there is an increasing need to promote the subjective well-being of older adults. However, few studies have investigated mechanisms of life satisfaction in developing countries in the Southeast Asian region. This research gap needs to be addressed, since aging and life satisfaction are complex processes that are experienced differently in various sociocultural contexts. The purpose of this study is to understand meanings of life satisfaction and experiences of aging through the perspectives of older adults who live in Jumla, Nepal. We conducted semi-structured, in-depth interviews with twenty …

Sex Difference In Identification Of Predictive Tumor Tissue Metabolites Associated With Colorectal Cancer Prognosis, Xinyi Shen

Public Health Theses

Colorectal cancer (CRC) is the third major cause of cancer-related deaths in the United States in 2020. Sex-related differences in CRC stage, prognosis, and metabolism have become increasingly popular in cancer research. Males have poorer survival for CRC, but females with right-sided colon cancer (RCC) have aberrant metabolism correlated with poor survival. Delay in knowing the condition of CRC in female patients would result in poor prognosis, which could be avoided by predicting prognostic outcomes. Random Survival Forest (RSF) is ideal for exploration and making predictions using metabolomics data with high dimension, strong collinearity, and heterogeneity, which CPH models could …

Genetic Determinants For Cancer Risks With Racial Differences And Asthma, Yinqiao Wang

Public Health Theses

Over the past decade, many studies have found disproportionally higher prostate cancer among men of African ancestry, and testicular cancer incidences among men of European ancestry, compared with men from other ethnicity/race groups. However, genetic determinants that could potentially explain this observation are unclear. This study collected single nucleotide polymorphisms (SNPs) related to the two cancer types and compared the frequencies of each risk allele of SNPs among men of African or European ancestry from several genetic databases. When comparing the frequencies of risk alleles that are associated with prostate and testicular cancers, significant differences were found between those of …

Determining The Relationship Between Sars-Cov-2 Infection And Streptococcus Pneumoniae In Clinical Saliva Samples, Anne Watkins

Public Health Theses

Background. Streptococcus pneumoniae is a commonly found upper respiratory tract colonizer that can progress to more severe disease forms such as pneumonia. Interactions with respiratory viruses other than SARS-CoV-2 have been previously identified such that S. pneumoniae may sometimes enhance disease or occur as a secondary or co-infection. With the recent emergence of SARS-CoV-2 there is limited data available describing this specific pathogen relationship that could play a role in the breadth and severity of the pandemic. Methods. Inpatients and healthcare workers testing positive for SARS-CoV-2 March 2020-August 2020 were tested for S. pneumoniae through saliva culture enrichment and RT-qPCR …

Vector-Host Interactions Of Culex Pipiens Mosquitoes And Their Role In Arbovirus Transmission In The Mid-Atlantic United States, Karen Jane Yuan

Public Health Theses

As the primary vector for the West Nile virus in the United States, members of the Culex pipiens complex have caused illnesses and deaths in the human population since its discovery in 1937. The potential contribution of Cx. pipiens to transmission and enzootic amplification of WNV can be influenced by multiple aspects, including their interactions with various vertebrate hosts as an important factor. By using blood meal analysis and virus testing, this study further investigated the role of Cx. pipiens in WNV transmission and amplification. With 91% of blood meals identified from avian species, birds remain the most frequent source …

Associations Of Sars-Cov-2 Serum Igg With Occupation And Demographics Of Military Personnel, Joseph Zell

Public Health Theses

BACKGROUND: Countries across the globe have mobilized their armed forces in response to COVID-19, placing them at increased risk for viral exposure. Humoral responses to SARS-CoV-2 among military personnel serve as biomarkers of infection and provide a basis for disease surveillance and recognition of work-related risk factors.METHODS: Enzyme-linked immunosorbent assays (ELISA) were used to measure SARS-CoV-2 spike antigen-specific IgG in serum obtained from N-995 US Army and Air National Guard soldiers between April and June 2020. Occupational information, e.g. military operating specialty (MOS) codes, and demographic data were obtained via questionnaire. Plaque assays with live SARS-CoV-2 were used to assess …

Identification Of Genetic Factors For Metabolically Healthy Obese And Metabolically Obese Normal-Weight, Junli Zhu

Public Health Theses

Though obesity is typically associated with metabolic dysfunction and cardiometabolic diseases, there are both obese individuals who have favorable metabolic profiles (metabolically healthy obese; MHO) and individuals who present obesity alterations despite their normal weight (metabolically obese normal weight; MONW). Genetic studies suggest that there is a genetic component underlying these phenotypes. However, previous research has been restricted by the use of the candidate gene approach, limited choice of metabolic indicators, and low statistical power. A genome-wide association (GWA) study that examines both MHO and MONW in a single large-scale population cohort is necessary to uncover the genetic determinants of …

Htra1 Expression In Humanized Arms2 Knock-In Mouse Models, Yunfan Zhang

Public Health Theses

Age-related macular degeneration (AMD) is the most common cause of central vision loss in developed world. Two genes on chromosome 10q26, maculopathy susceptibility 2 (ARMS2) and HtrA serine peptidase 1 (HTRA1) were identified as candidate genetic factors of AMD. However, due to the high linkage disequilibrium across the locus as well as the inconsistent functional findings regarding the two genes, it is difficult to distinguish the causative gene that confer the risk of AMD. To provide insight of the functional roles of ARMS2 and HTRA1 in the pathogenesis of AMD, we investigated the regulation relationship between the two genes in …

Mothers’ Social Networks And Socioeconomic Gradients Of Isolation, Alison Andrew, Orazio P. Attanasio, Britta Augsburg, Jere Behrman, Monimalika Day, Pamela Jervis, Costas Meghir, Angus Phimister

Cowles Foundation Discussion Papers

Social connections are fundamental to human wellbeing. This paper examines the social networks of young married women in rural Odisha, India.. This is a group, for whom highly-gendered norms around marriage, mobility, and work are likely to shape opportunities to form and maintain meaningful ties with other women. We track the social networks of 2,170 mothers over four years, and find a high degree of isolation. Wealthier women and women more-advantaged castes have smaller social networks than their less-advantaged peers. These gradients are primarily driven by the fact that more-advantaged women are less likely to know other women within their …

The Concept Of Natureculture Document: A Conceptual Exploration Of Seeds, Embodied Information, And Unconventional Records, Marc Kosciejew

Journal of Contemporary Archival Studies

Seedbanks, or so-called archival arks of the apocalypse, are addressing accelerating anthropocentric alterations to the environment by collecting, storing, and preserving seeds. These are specialized archival repositories that approach, frame, and use seeds as documents for agricultural and scientific research, classification and preservation work, and various other archival and administrative purposes. Seedbanks indeed are archives of unconventional records.

This article introduces the concept of natureculture document as a framing device in which to help analyze the documentary status of objects that are not necessarily or usually considered as documents or having documentary characteristics. This concept, coupled with its interdisciplinary theoretical …

Utilizing Patient-Reported Outcome Measures In The Management Of Inflammatory Bowel Disease, Jennifer Elizabeth Farren

Yale School of Medicine Physician Associate Program Theses

Inflammatory bowel disease, a chronic relapsing-remitting disorder, affects three million adults in the United States. One of the main therapeutic goals in patients with inflammatory bowel disease is mucosal healing, measured by endoscopy, an invasive procedure that does not always reflect patient symptomatology. To address these limitations, clinicians have developed patient-reported outcome measures, questionnaires evaluating bowel symptoms and quality of life. However, the clinical utility of these patient-reported outcome measures and their correlation to objective markers of inflammation is unclear. We will determine the efficacy of using a patient-reported outcome measure to inform treatment for inflammatory bowel disease. In a …

Prenatal Marijuana Use And Potential Adverse Neonatal Outcomes, Tracy L. Buechele

Yale School of Medicine Physician Associate Program Theses

Marijuana use during pregnancy has dramatically increased in recent years, driven in part by the increasing legalization of marijuana for medicinal and recreational use. However, the impact of prenatal exposure to marijuana on a developing fetus is not clear. Previous studies examining this effect have been limited by polysubstance use during pregnancy and confounding factors that make data interpretation challenging. In this study, we propose a prospective cohort study that will address the limitations of prior studies and measure the association between prenatal marijuana exposure and adverse neonatal outcomes. Strict exclusion criteria will exclude women with tobacco, alcohol or other …

Consider Palliative Care: A Decision Aid To Improve Palliative Care Knowledge, Meg Schultheiss

Yale School of Medicine Physician Associate Program Theses

Palliative care enhances a patient’s quality of life by managing symptoms and psychosocial needs and facilitating advanced care planning. Engagement with palliative care improves satisfaction with care in patients and the informal caregivers identified by patients. However, palliative care is underutilized because many patients and their informal caregivers have limited knowledge about palliative care. Decision aids effectively educate patients and informal caregivers in a variety of clinical settings. We propose a randomized clinical trial that will test the effectiveness of a decision aid for informal caregivers considering palliative care. Specifically, we will match informal caregivers to a decision aid and …

Administration Of Canagliflozin For The Remission Of Metabolic Syndrome In Nondiabetic Adults, Corrie Asseo

Yale School of Medicine Physician Associate Program Theses

Metabolic syndrome is a critical risk factor for the development of type 2 diabetes mellitus and cardiovascular disease, two of the leading causes of death in the United States. With over one third of the adult population currently affected, this syndrome poses a serious health and economic burden. Lifestyle modification is the primary treatment, however only 50% maintain adherence. A single pharmacological therapy such as canagliflozin may overcome this lack of treatment adherence. Our purpose is to establish a difference between canagliflozin 300 milligrams daily plus lifestyle modification education and lifestyle modification education alone for the remission of metabolic syndrome …

Magnesium Exposure In Very Preterm Neonates And Adverse Gastrointestinal Outcomes, Giavanna G. Chirico

Yale School of Medicine Physician Associate Program Theses

Preterm birth is the leading cause of perinatal morbidity and mortality, especially among neonates born less than 32 weeks’ gestation. Magnesium sulfate is the standard treatment for seizure prevention in preeclampsia and for fetal neuroprotection in mothers at risk for preterm delivery. However, the consequences of antenatal magnesium exposure on the very preterm neonate’s gastrointestinal tract are not fully established. This study will determine whether elevated magnesium levels in very preterm neonates are associated with adverse gastrointestinal outcomes from birth to 4 months. Specifically, using a prospective cohort design, we will measure magnesium in umbilical cord blood of very preterm …

Vitamin D Supplementation In Fitzpatrick Skin Types Iv-Vi As Malignant Melanoma Adjuvant Treatment, Shikha Goyal

Yale School of Medicine Physician Associate Program Theses

Melanoma is the most lethal form of skin cancer and accounts for the majority of skin cancer deaths. Melanoma is prone to recurrence, and even with early surgical intervention relapse occurs in approximately one-third of patients. The current standard of care following excision is inconsistent and patients would benefit from adjuvant treatment to reduce recurrence rates. This randomized controlled study will investigate whether supplementation with vitamin D reduces risk of melanoma recurrence in adults with Fitzpatrick skin types IV-VI who have been diagnosed and treated for cutaneous melanoma. Outcomes will be measured by relapse-free survival rates over an 18-month period. …