Digital Commons Network^™

The Impact Of Peer Education On Coronary Artery Bypass Surgery Readmission Rates, Melissa Ling

Yale School of Medicine Physician Associate Program Theses

Coronary artery bypass surgery is the most common cardiovascular operation performed in the United States. Coronary artery bypass surgery lowers rates of cardiovascular death by restoring circulation to cardiac tissue in patients with coronary artery disease. However, this surgery is associated with unacceptably high readmission rates, posing both health risks for the patient and a substantial financial burden on the healthcare system. Our objective is to investigate whether peer education can improve 30-day readmission rates of patients after coronary artery bypass surgery. Adult patients undergoing a coronary artery bypass surgery will either receive the usual standard of care or four …

Platelet-Rich Plasma For Grade Ii And Iii Medial Collateral Ligament Tears In Patients Aged 18-45, Madeline Kratz

Yale School of Medicine Physician Associate Program Theses

Medial collateral ligament tears are the most common knee ligament injury. Extent of injury is graded on a three-point scale. The mainstay of treatment for isolated tears is physical therapy; however, grade II and III tears require more intensive therapy. Platelet-rich plasma therapy is an autologous concentration of platelets prepared as an injection to augment the healing process. We propose a randomized controlled trial investigating the efficacy of platelet-rich plasma injection for patients with acute grade II or III medial collateral ligament tears. Results will be quantified by mean decrease in Visual Analog Scale scores at two, four, and six …

Recursive Preferences, The Value Of Life, And Household Finance, Antoine Bommier, Daniel Harenberg, François Le Grand, Cormac O'Dea

Cowles Foundation Discussion Papers

We analyze lifecycle saving strategies using a recursive utility model calibrated to match empirical estimates for the value of a statistical life. We show that, with a positive value of life, risk aversion reduces savings and annuity purchase. Risk averse agents are willing to make an early death a not-so-adverse outcome by enjoying greater consumption when young and bequeathing wealth in case of death. We also find that greater risk aversion lowers stock market participation. We show that this model can rationalize low annuity demand while also matching empirically documented levels of wealth and private investments in stocks. Our findings …

Recursive Preferences, The Value Of Life, And Household Finance, Antoine Bommier, Daniel Harenberg, François Le Grand, Cormac O'Dea

Cowles Foundation Discussion Papers

We analyze lifecycle saving strategies using a recursive utility model calibrated to match empirical estimates of the value of a statistical life. The novelty of our approach is that we require preferences to be monotone with respect to first order stochastic dominance. The framework we use can disentangle risk aversion and the intertemporal elasticity and can feature a positive value of life without placing constraints on the value of the risk aversion parameter or the intertemporal elasticity of substitution. We show that, with a positive value of life, risk aversion reduces savings, decreases stock market participation and decreases annuity purchase. …

The Elucidation Of Novel Small Molecule Metabolites In Escherichia Coli, Alexandra Marie Gatsios

Yale Graduate School of Arts and Sciences Dissertations

The human body is colonized by complex communities of microorganisms known as the human microbiota. These communities play an essential role in human health by modulating basic biological processes such as metabolism and immune, gastrointestinal, and cardiovascular development and homeostasis. Countless correlations have been made between specific microorganisms and host physiology/disease. However, the molecular mechanisms driving these phenotypes are largely undefined. This is in part due to our incomplete understanding of the microbiota metabolome. The members of the human gut microbiota express hundreds of diverse metabolic pathways that produce countless metabolites, many shared among diverse strains and the majority of …

Adaptive Rationality In Strategic Interaction: Do Emotions Regulate Thinking About Others?, Timo Ehrig, Jaison Manjaly, Aditya Singh, Shyam Sunder

Cowles Foundation Discussion Papers

Forming beliefs or expectations about others’ behavior is fundamental to strategy, as it co-determines the outcomes of interactions in and across organizations. In the game theoretic conception of rationality, agents reason iteratively about each other to form expectations about behavior. According to prior scholarship, actual strategists fall short of this ideal, and attempts to understand the underlying cognitive processes of forming expectations about others are in their infancy. We propose that emotions help regulate iterative reasoning, that is, their tendency to not only reflect on what others think, but also on what others think about their thinking. Drawing on a …

It Takes A Village: The Economics Of Parenting With Neighborhood And Peer Effects, Francesco Agostinelli, Matthias Doepke, Giuseppe Sorrenti, Fabrizio Zilibotti

Cowles Foundation Discussion Papers

As children reach adolescence, peer interactions become increasingly central to their development, whereas the direct influence of parents wanes. Nevertheless, parents may continue to exert leverage by shaping their children’s peer groups. We study interactions of parenting style and peer effects in a model where children’s skill accumulation depends on both parental inputs and peers, and where parents can affect the peer group by restricting who their children can interact with. We estimate the model and show that it can capture empirical patterns regarding the interaction of peer characteristics, parental behavior, and skill accumulation among US high school students. We …

Adaptive Rationality In Strategic Interaction: Do Emotions Regulate Thinking About Others?, Timo Ehrig, Jaison Manjaly, Aditya Singh, Shyam Sunder

Cowles Foundation Discussion Papers

Forming beliefs or expectations about others’ behavior is fundamental to strategy, as it co-determines the outcomes of interactions in and across organizations. In the game theoretic conception of rationality, agents reason iteratively about each other to form expectations about behavior. According to prior scholarship, actual strategists fall short of this ideal, and attempts to understand the underlying cognitive processes of forming expectations about others are in their infancy. We propose that emotions help regulate iterative reasoning, that is, their tendency to not only reflect on what others think, but also on what others think about their thinking. Drawing on a …

Optimal Control Of An Epidemic Through Social Distancing, Thomas Kruse, Philipp Strack

Cowles Foundation Discussion Papers

We analyze how to optimally engage in social distancing (SD) in order to minimize the spread of an infectious disease. We identify conditions under which the optimal policy is single-peaked, i.e., first engages in increasingly more social distancing and subsequently decreases its intensity. We show that the optimal policy might delay measures that decrease the transmission rate substantially to create “herd-immunity” and that engaging in social distancing sub-optimally early can increase the number of fatalities. Finally, we find that optimal social distancing can be an effective measure in substantially reducing the death rate of a disease.

Is Fish Brain Food Or Brain Poison? Sea Surface Temperature, Methyl-Mercury And Child Cognitive Development, Mark R. Rosenzweig, Rafael J. Santos

Discussion Papers

We exploit variation in the composition of local fish catches around the time of birth using largescale administrative and census data on adult cognitive test scores, schooling attainment, and occupation among coastal populations in Colombia to estimate the distinct causal effects of methylmercury (MeHg) and DHA, elements contained in fish, on cognitive development. Using an IV strategy based on an equilibrium model of fish supply that exploits time-series variation in oceanic SST anomalies on both coasts of Colombia from 1950 to 2014 as instruments, we find that net of cohort and municipality fixed effects increases in high-MeHg fish catches around …

Ecojustice, Religious Folklife And A Sound Ecology, Jeff Todd Titon

Yale Journal of Music & Religion

Folk, traditional, and indigenous ecological knowledges have a significant role to play in ecojustice. A case study in the traditional ecological knowledge among one of the religious communities with whom I have spent several decades illustrates how they embody the main principle and three fields of an ecological rationality: the community of inter-related beings; the ways the beings participate in that community or place; and the relations of nature and the nonhuman world to humans and human nature. Ecological rationality stands in contrast to economic rationality, a branch of instrumental reason exemplified by what economists call rational choice theory. An …

"No Human Ever Made A Cathedral Such As This": Scoping The Ecology Of The Carols By Candlelight Effect In Australia's Open-Air Environments, Robin Ryan

Yale Journal of Music & Religion

During Australia’s dry December, traditional and popular forms of caroling shape the sight and sound of the key Christian festival of Christmas. Creative connections between belief, place, and music are characteristically manifest in focused open-air environments of beach, bushland or park. Reasoning from gospel belief that the very first “Christmas carol” emanated from a heavenly host of angels singing to an audience of shepherds in a field, caroling alfresco is an appropriate activity. How, then, do Australian caroling venues become conducive to environmental spheres of sound and influence? While the annual mass Carols by Candlelight concerts televised from Melbourne and …

On The Mutual Adjustment Of Pressure And Velocity Distributions In Certain Simple Current Systems, C.-G. Rossby

Journal of Marine Research

The writer (Rossby 1936) recently advanced the hypothesis that the horizontal pressure gradients observed in the current systems of the atmosphere and the ocean to a large extent must be interpreted as reactions to the Coriolis’ forces impressed upon these systems by the rotation of the earth. Observational support for this point of view was found in the fact that both the temperature-salinity and oxygen-salinity correlation curves obtained from stations on both sides of the Gulf Stream in the region between Nova Scotia and Bermuda are very nearly identical, even though the individual isotherms may drop as much as 700 …

Editor's Commentary: Relation Between Variations In The Intensity Of The Zonal Circulation Of The Atmosphere And The Displacements Of The Semi Permanent Centers Of Action, C.-G. Rossby

Journal of Marine Research

Rossby waves! Beta-plane! Here Carl-Gustav Rossby, motivated by observations of weather patterns that move upstream relative to the dominant mid-latitude eastward wind flow, formulates a com-pletely novel linearized theory to account for the tendency for large-scale disturbances to move westward and smaller-scale disturbances to move eastward relative to the winds.

Classic Article: On The Oxidation Of Organic Matter In Marine Sediments By Bacteria, Selman A. Waksman, Margaret Hotchkiss

Journal of Marine Research

The question as to whether the organic matter in the sea bottom is inert or is available as a nutrient for the bottom fauna and bottom-inhabiting bacteria is a problem of special interest in the cycle of life in the sea. A number of marine animals, making up the benthos or the bottom fauna, must depend upon this organic matter for their nutrition while the sea bottom also harbors an extensive bacterial population which require the energy to be derived from various nutrient elements for cell synthesis and respiration...

Editor's Commentary: The Influence Of Deposit-Feeding Organisms On Sediment Stability And Community Trophic Structure, Robert C. Aller, David K. Young

Journal of Marine Research

This seminal paper by Donald Rhoads and David Young was a highly creative, interdisciplinary break from the standards of the time. It brought a new focus onto how benthic organisms modify sediment properties, potentially mediating interactions with other species, structuring community distributions, and governing coupling between sedimentary deposits and overlying waters...

Editor's Commentary: Effect Of Coriolis Force On Edge Waves (I) Investigation Of The Normal Modes, Kenneth H. Brink

Journal of Marine Research

In the oceanographic literature, there are not too many publications so clearly ahead of their time as is this one. Reid starts out by asking about the effect of Earth’s rotation on edge waves. Edge waves are essentially long gravity waves found over the continental shelf and up onto the beach. They are topographically constrained to propagate strictly alongshore, but in either direction. By the mid-1950s, interest in this was growing as people realized that edge waves are more than a mathematical curiosity. Rotation was expected to be important for long, low frequency (periods of tens of minutes, out to …

Classic Article: The Influence Of Deposit-Feeding Organisms On Sediment Stability And Community Trophic Structure, Donald C. Rhoads, David K. Young

Journal of Marine Research

Deposit-feeding and suspension-feeding benthos in Buzzards Bay, Massachusetts, show marked spatial separation; suspension feeders are largely confined to sandy or firm mud bottoms while deposit feeders attain high densities on soft muddy substrata. Food source and bottom stability have been investigated as potential factors effecting this trophic-group separation. Between October 4, 1967 and August 22, 1969, observations were made at 11 stations in Buzzards Bay, Massachusetts, along two widely separated transects over bottoms ranging in texture from silt to fine and medium sand. Water depths at these stations ranged from 3 m to 20 m. Scuba divers made many of …

Identification Of A Novel Disorder With Cholestasis, Liver Fibrosis And Congenital Diarrhea Due To Organic Solute Transporter Alpha Deficiency, Emily Gao

Yale Medicine Thesis Digital Library

BACKGROUND: Much of our understanding of normal liver pathophysiology comes from studying patients with liver disease who remain undiagnosed after a comprehensive workup. Searching for diagnoses among such cohorts has benefits both for the underserved patients with idiopathic liver disease, but also for science as a whole. Unbiased genomic analysis of patients with undiagnosed disease has yielded remarkable results, including clinically actionable diagnoses in children and adults, as well as the discovery of novel genetic diseases. Thus, we posit that among pediatric patients with undiagnosed liver disease, there may be previously unrecognized Mendelian causes.

METHODS: We report a 2.5 year …

Identifying Rare Genetic Variation In Obsessive-Compulsive Disorder, Sarah Abdallah

Yale Medicine Thesis Digital Library

Obsessive-compulsive disorder (OCD) is a neuropsychiatric developmental disorder with known heritability (estimates ranging from 27%-80%) but poorly understood etiology. Current treatments are not fully effective in addressing chronic functional impairments and distress caused by the disorder, providing an impetus to study the genetic basis of OCD in the hopes of identifying new therapeutic targets. We previously demonstrated a significant contribution to OCD risk from likely damaging de novo germline DNA sequence variants, which arise spontaneously in the parental germ cells or zygote instead of being inherited from a parent, and we successfully used these identified variants to implicate new OCD …

The Pharmacokinetics Of A Novel Anti-Renalase Antibody Used For The Treatment Of Melanoma In A Congenic Mouse Species, Oriyomi Alimi

Yale Medicine Thesis Digital Library

The pharmacokinetics of a humanized anti-RNLS monoclonal antibody used for the treatment of melanoma in a congenic mouse species

Authors: Oriyomi Alimi1, Gary Desir1

1Department of Internal Medicine, Yale School of Medicine, New Haven, CT

Cancer cells can overcome signaling that restrains their growth and promotes senescence and cell death. Renalase (RNLS) is a secreted flavoprotein that functions as a survival factor after ischemic and toxic injury, signaling through the plasma calcium channel PMCA4b to activate the PI3K/AKT and MAPK pathways. In addition, recent studies, indicate that dysregulated RNLS signaling promotes survival of melanoma cells due to its capacity to …

Developing The Language And Tools To Address Food Insecurity, Sarah Candace Desilvey

Yale School of Nursing Digital Theses

There is vast literature indicating associations of food insecurity with concerning health outcomes, and clinic and community settings now regularly partner to address food insecurity as it is assessed. However, there is scarce health terminology to use in the care of patients experiencing food insecurity. This presents challenges as clinicians seek to define food insecurity as a risk for their patients, order interventions to address it, and study the effect of interventions in individual and population settings. Furthermore, there is no published food insecurity diagnostic criteria to employ as clinicians listen to the histories of their patients and try to …

Factors Influencing The Receipt Of Diabetic Retinopathy Screening In A High-Risk Population, Elizabeth Ann Fairless

Yale Medicine Thesis Digital Library

Diabetic retinopathy (DR) is among the leading causes of vision loss in the US,

yet an estimated 50% of patients with diabetes do not receive recommended annual

screening eye exams for reasons that are incompletely understood. Patients with diabetes

and low socioeconomic status or who are racial/ethnic minorities are at increased risk for

vision loss. Qualitative interviews were conducted with 30 patients with diabetes at a

federally qualified community health center and a primary care clinic in New Haven, CT

regarding factors influencing their use of screening exams. The interviews were recorded,

transcribed, and analyzed line by line to identify …

Human Amniotic Membrane Improves Healing In A Chronic, Massive Rotator Cuff Repair Model, Maarouf Saad

Yale Medicine Thesis Digital Library

Rotator cuff tendon heals by fibrovascular scar that is weaker than native tissue leading to repairs that are prone to failure. To investigate the utility of an amniotic-membrane-derived human allograft in improving tendon-bone healing and skeletal muscle architecture, a rotator cuff repair model in Sprague-Dawley rats was established, tendon biomechanical testing, single muscle fiber biomechanical testing, microcomputed tomography analysis, tendon and muscle histological analysis, and gene expression analysis were performed. Our findings demonstrated single muscle-fibers with larger cross-sectional area and greater maximum isometric and specific force in the augmented experimental repair (ER) group. Additionally, microcomputed tomography revealed a larger volume …

Meat Consumption, Cooking Practices, And Blood Harmane Concentrations In Essential Tremor: A Population-Based, Environmental Study In The Faroe Islands, Monica Ferrer Socorro

Yale Medicine Thesis Digital Library

Background: Essential tremor (ET) is among the most prevalent neurological disease, yet potential modifiable environmental factors contributing to its etiology are poorly understood. Harmane [1-methyl-9H-pyrido(3,4-b)indole], is a potent neurotoxin, of which elevated levels may be linked to ET. Possible etiologies for this elevation include increased dietary consumption, impaired metabolism, or increased endogenous production. Harmane is particularly abundant in meats and long cooking times can increase its concentrations. One previous study provided preliminary data of a dietary difference between male ET cases and controls. To clarify the relationship between ET and harmane we conducted a population-based, case-control study, in the Faroe …

Immunologic Analysis Of Non-Small Cell Lung Cancer In People Living With Hiv, Ramsey Yusuf

Yale Medicine Thesis Digital Library

Among people living with HIV (PLWH), non-small cell lung cancer (NSCLC) has emerged as the most common non-AIDS defining cancer and a leading cause of death. PLWH with NSCLC are diagnosed at younger ages and demonstrate worse outcomes compared to the general population. Global immune dysregulation in the setting of HIV infection may account for these disparities, however little is known about the immunobiology of HIV-associated NSCLC. The goal of this study was to investigate the clinical and pathology of NSCLC in PLWH. This retrospective cohort study examined HIV-associated and uninfected NSCLC cases within Yale-New Haven Hospital between 2000-2016. Medical …

Editor's Commentary: On The Mutual Adjustment Of Pressure And Velocity Distributions In Certain Simple Current Systems, C.-G. Rossby

Journal of Marine Research

These are the original geostrophic adjustment papers. Rossby starts out by asking what,if anything, limits the ability for a flow to be in geostrophic balance (to precisely follow pressure contours on a rotating planet). This topic is now a classroom standard, but we often forget how insightful the original articles are...

Relation Between Variations In The Intensity Of The Zonal Circulation Of The Atmosphere And The Displacements Of The Semi-Permanent Centers Of Action, C.-G. Rossby

Journal of Marine Research

This paper attempts to interpret, from a single point of view, several at first sight independent phenomena brought into focus through the synoptic investigations carried on at the Massachusetts Institute of Technology during the last few years. Since this interpretation is very largely based on a consideration of the changes in vorticity which must occur in vertical air columns which are displaced from one latitude to another and since such vorticity changes play a fundamental role also in Ekman’s general ocean current theory (Ekman 1932), the results would appear to be of enough interest to physical oceanographers to warrrant their …

Editor's Commentary: On The Oxidation Of Organic Matter In Marine Sediments By Bacteria, Robert C. Aller, Margaret Hotchkiss

Journal of Marine Research

Selman Waksman is best known for his work on natural antibiotics, for which he originated the term and received a Nobel Prize. However, he and co-workers also extensively investigated soil microbes and their interactions with biogeochemical processes and elemental cycling...

Import, Export, And Recycling Of Dissolved Nutrients In The Ogeechee River Estuary (Georgia, Usa), William B. Savidge, Kathryn R. Doyle, Brock Woodson

Journal of Marine Research

We constructed an empirical mass balance model of nutrient fluxes in the Ogeechee River estuary (Georgia, USA) from eight surveys of seasonal estuarine nutrient concentrations during 2015 and 2016. The model results indicated a net removal of dissolved phosphorus and a net production of dissolved nitrogen (N) within the estuary over an annual cycle. During summer and autumn low flow periods, much of the dissolved N discharged to the ocean seems to be recycled into the estuary in the form of phytoplankton biomass. As a result, the outwelled N is not new nitrogen fueling coastal production but is nitrogen trapped …