Digital Commons Network^™

Marriage, Labor Supply And The Dynamics Of The Social Safety Net, Hamish Low, Costas Meghir, Luigi Pistaferri, Alessandra Voena

Cowles Foundation Discussion Papers

The 1996 US welfare reform introduced limits on years of welfare receipt. We show that this reduced program participation, raised employment for single mothers, and reduced divorce. A limited commitment, lifecycle model of labor supply, marriage and divorce, estimated on pre-reform data, replicates these effects. A large part of the responses occur in anticipation of benefit exhaustion, impacting primarily women with low potential earnings. The reform reduces lifetime utility of women, even allowing for the government savings, but has negligible effects on men. The expectation of marriage attenuates the losses for women and an increased probability of single-motherhood raises them.

Marriage, Labor Supply And The Dynamics Of The Social Safety Net, Hamish Low, Costas Meghir, Luigi Pistaferri, Alessandra Voena

Cowles Foundation Discussion Papers

The 1996 PRWORA reform introduced time limits on the receipt of welfare in the United States. We use variation by state and across demographic groups to provide reduced form evidence showing that such limits led to a fall in welfare claims (partly due to \banking” benefits for future use), a rise in employment, and a decline in divorce rates. We then specify and estimate a life-cycle model of marriage, labor supply and divorce under limited commitment to better understand the mechanisms behind these behavioral responses, carry out counterfactual analysis with longer run impacts and evaluate the welfare effects of the …

Retinal Stem Cell Culture On Planar Scaffold For Transplantation In Animal Models Of Retinal Degeneration, Tina Xia

Yale Medicine Thesis Digital Library

Successful differentiation of pluripotent stem cells into retinal cells and subsequent transplantation in animal models have made stem cell-based therapy a closer possibility for treating retinal degenerations. However, major limitations are low efficiency in deriving desired cell types and continued need for large animal studies to validate small animal studies. In this study, we modified a biopolymer scaffold with laminin-521 as a novel substrate to culture retinal progenitor cells (RPCs). We hypothesize that laminin-521 will increase cell retention and provide a developmental signal for RPCs to mature and self-organize. The RPC scaffold culture was transplanted into a RD10 mice, a …

Biodegradable Nanoparticles In The Treatment Of Cutaneous Malignancy, Emily Sara Yin

Yale Medicine Thesis Digital Library

Keratinocyte-derived carcinomas represent the most common type of malignancy worldwide, and while surgical removal is a first-line therapy, surgery may be impractical for certain patients and does not completely eliminate risk of recurrence. Previous studies have demonstrated the advantages of biodegradable poly(lactic acid)-hyperbranched polyglycerol non-bioadhesive nanoparticles (NNPs) and bioadhesive nanoparticles (BNPs) as chemotherapeutic drug delivery vehicles for the treatment of internal solid tumors. We are now investigating the use of this delivery system for the treatment of cutaneous malignancies, with the goal of maximizing drug efficacy while minimizing systemic effects and treatment-associated morbidity. After topical application of fluorescent dye-loaded NNPs …

Rectified Flow In A Stratified Coastal Ocean, K. H. Brink

Journal of Marine Research

An idealized numerical model is used to explore the generation of mean flows by oscillating wind forcing in a stratified coastal ocean with no alongshore variability, i.e., where neither barotropic nor baroclinic instability is a factor. On the inner shelf, where surface-to-bottom mixing occurs, a mean cross-shelf flow develops, as examined by Castelao et al. (2010), and the present results suggest that this flow can remain two-dimensional if there is a nonzero cross-shelf density gradient. Offshore of the inner shelf, where the water column is stratified, a mean alongshore flow develops in the direction opposite to coastal-trapped wave propagation. This …

Antarctic Mode Water, K. Speer, J.-B. Sallee, V. Pellichero

Journal of Marine Research

An estimate of Southern Ocean volume in temperature-salinity (T-S) classes is made with a focus on cold water masses south of the Polar Front, at depths shallower than 2,000 m. The volumetric diagram for waters below 5^° C shows a deficit at temperatures near 0^° C and 34.2 psu, surrounded by a ring of larger volumes, related to water mass formation near the Polar Front and near the continental margins as well as mixing effects. The cold, fresh extreme of the Antarctic Intermediate Water T-S relation shows a volumetric maximum, apparently distinct from the interior T-S relationship. We …

Multi-Decadal Trends And Variability In Temperature And Salinity In The Mid-Atlantic Bight, Georges Bank, And Gulf Of Maine, Elizabeth J. Wallace, Lev B. Looney, Donglai Gong

Journal of Marine Research

Increasing attention is being placed on the regional impact of climate change. This study focuses on the decadal scale variabilities of temperature and salinity in the Mid-Atlantic Bight (MAB), Georges Bank (GB), and Gulf of Maine (GOM) from 1977 to 2016 using hydrographic survey data from the National Oceanic and Atmospheric Administration (NOAA) Northeast Fisheries Science Center. The MAB (as defined by the shelf regions from Cape Hatteras to Cape Cod) experienced warming rates of 0.57 °C per decade during the Winter/Spring season (Jan–Apr) and 0.47 °C per decade during the Fall/Winter season (Sep–Dec). The GOM and GB, on the …

Simulation And Self-Assessment: A Medical-Simulation Based Exploration Of Medical Trainee Understanding Of Epa 6 (Oral Presentation) And Epa 8 (Handoff), Shuaib Raza

Yale Medicine Thesis Digital Library

Abstract

SIMULATION AND SELF-ASSESSMENT: A MEDICAL-SIMULATION BASED EXPLORATION OF TRAINEE UNDERSTANDING OF EPA 6 (ORAL PRESENTATION) AND EPA 8 (HANDOFF)

Shuaib Raza, Katherine Gielissen and Tiffany Moadel.

Department of Pediatrics, Yale University School of Medicine, New Haven, CT

Introduction:

Entrustable Professional Activities are clinical tasks that are observable, executable, and reflect one or more clinical competency. The goal of “entrustment” is that trainees perform their work safely and effectively without supervision once they have demonstrated sufficient competency. Simulation offers a unique opportunity to assess EPAs and objectively measure skills without threat to patient safety. Dr. Gielissen and Dr. Moadel chose …

Lag-3 Mediates Acute Rejection & Memory In Mouse Transplantation, Jeffrey Mark Erfe

Yale Medicine Thesis Digital Library

Lymphocyte Activation Gene-3 (LAG-3) is a soluble protein and transmembrane protein receptor expressed on lymphocytes such as immunosuppressive regulatory T cells. Our goal was to evaluate the effect of LAG-3 on transplantation outcomes, specifically rejection and cellular memory response to donor antigen, by comparing graft survival and IFN-l secretion to donor antigen in C57BL/6 LAG-3-/- versus wild-type mouse recipients of DBA/2 grafts. We found that LAG-3 deletion accelerates rejection time and enhances IFN-l secretion among heart or skin graft recipients. FACS analysis of memory T cells demonstrated disproportionate increases in effector T cell subsets, consistent with a heightened rejection response. …

Mitochondrial Calcium In Diabetic Platelets: Friend Or Foe?, Zainab O. Jaji

Yale Medicine Thesis Digital Library

The global burden of diabetes mellitus (DM) is projected to keep escalating with a burgeoning of the incidence and prevalence of cardiovascular disease sequalae, which are its major cause of morbidity and mortality. Current antiplatelet therapies used for risk factor reduction have limited efficacy, as such, further investigation into mechanisms provoking platelet dysfunction is warranted. Cytosolic calcium (Ca2+) excess in DM platelets is a well-documented phenomenon in the literature, and various mechanisms have been postulated. However, the ramification of this observation on mitochondrial health has not been explored. We hypothesize that the increase in cytosolic Ca2+ will be absorbed by …

Comparison Of Hematologic Effects Of Coronary Artery Bypass Grafting Surgery Performed With And Without Use Of Cardiopulmonary Bypass, Simon Kigwana

Yale Medicine Thesis Digital Library

Abstract: Coronary artery graft surgery (CABG) using a cardiopulmonary bypass (CPB)

pump to allow for stopping the heart, commonly designated as “on pump CABG” or

ONCAB, requires complete anticoagulation and is associated with significant

postoperative anemia. In addition, a reduction in postoperative platelet counts is relatively

common in large part due to heightened activation of hemostatic pathways and platelet

consumption secondary to blood passing through the CPB circuit. It has been

demonstrated that both anemia and nadir platelet counts after ONCAB are associated

with the incidence and severity of postoperative acute kidney injury (AKI). Over the past

several years, techniques …

Chemical And Phycological Structure Of Surface Microlayer And Subsurface Water In A Southern Baltic Sea Estuary, Józef Piotr Antonowicz, Anna Kozak

Journal of Marine Research

The surface microlayer of water (SML) is a unique ecotone found on all water bodies. It is an interphase for the exchange of matter between the hydrosphere and the atmosphere. This ecotone is capable of accumulating chemicals and microorganisms in amounts as high as 100-fold greater than those observed in the pelagic zone. Here we report on the accumulation of chemicals and phytoneuston in the SML of the estuarial Łebsko Lake located at the southern coast of the Baltic Sea in the unpolluted region of the World Biosphere Reserve: the Słowínski National Park in Poland. The physicochemical parameters and phytoplankton …

Yale Medicine Magazine, Winter 2018, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the Winter 2018 issue of Yale Medicine Magazine, v. 52, no. 2. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965) and Yale Medicine: alumni bulletin of the School of Medicine, v.1 (1965) through v. 52, no.1. (Autumn, 2017).

Lagrangian Dispersion Characteristics In The Western Mediterranean, Maher Bouzaiene, Milena Menna, Pierre-Marie Poulain, Dalila Elhmaidi

Journal of Marine Research

Dispersion characteristics in the Western Mediterranean are analyzed using data from Coastal Ocean Dynamics Experiment (CODE) and Surface Velocity Program (SVP) surface drifters deployed in the period 1986–2017. Results are presented in terms of absolute dispersion A² (mean-squared displacement of drifter individuals) and of relative dispersion (D²; mean square separation distance of drifter pairs). Moreover, the dispersion characteristics are estimated for different initial separation distances (D₀) between particles: smaller, larger, or comparable with the internal Rossby radius of deformation. Results show the presence of a quasiballistic regime for absolute dispersion at small time scales and …

Evidence Supporting Fda Approval And Cms National Coverage Determinations For Novel Medical Products, 2005 Through 2016: A Cross-Sectional Study, Aliya Cecilia Roginiel

Yale Medicine Thesis Digital Library

EVIDENCE SUPPORTING FDA APPROVAL AND CMS NATIONAL COVERAGE DETERMINATIONS FOR NOVEL MEDICAL PRODUCTS, 2005 THROUGH 2016: A CROSS-SECTIONAL STUDY

Aliya C. Roginiel, Sanket S. Dhruva, Joseph S. Ross

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

Abstract:

Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) rely on evidence from clinical trials when approving a therapeutic for marketing and insurance coverage in the US, respectively. No study has compared the quality and quantity of evidence examined by these agencies. Our purpose was to characterize evidence used by FDA and CMS to support …

Yale School Of Medicine Facts & Figures 2018-2019, 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 February/March 2018 Volume 14, 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.

Medicine@Yale June/July 2018 Volume 14, Issue 2, 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.

The Changing Fate Of Thailand's Elephants, But A Future Worth Fighting For: The Interplay Of Culture And Ecology For Conservation, Madeline Zimmerman

Library Map Prize

No abstract provided.

The Paradox Of Competition: Power, Markets, And Money - Who Gets What, When, How?, Martin Shubik

Cowles Foundation Discussion Papers

Money is a mystery and financial institutions are often regarded as guardians and promoters of the mystery. These sketches are designed to help any reader interested in, but not technically trained in economics, understand markets, money, credit and the evolution of a mass market system set in the rich context of its political environment and society. We all want a good society. What is a good society is given by our joint vision, mutual respect and social concern but the implementation of the vision calls for the use and understanding of money, markets and finance. The efficient functioning of a …

Who Gets What, When, How? Power, Organization, Markets, Money And The Allocation Of Resources, Martin Shubik

Cowles Foundation Discussion Papers

Money is a mystery and financial institutions are often regarded as guardians and promoters of the mystery. These sketches are designed to help an individual interested in, but not technically trained in economics, understand markets, money, credit and the evolution of a mass market system embedded in the rich context of its political environment and society. The efficient functioning of a dynamic economy requires the presence of money and financial institutions. The great variety of financial institutions in any advanced economy requires that a synthetic approach is used to understand what the whole looks like. Verbal description provides an overarching …

Bulletin Of Yale University School Of Nursing 2018-2019, Yale School Of Nursing

Yale School of Nursing Bulletins and Catalogues

Series 114, Number 15

September 5, 2018

Essential Evidence-Based Introductory Bioterrorism Content For Practicing Nurses, Manu Sharma

Yale School of Nursing Digital Theses

Bioterrorism content is too often absent from nursing education post-licensure. According to the Centers for Disease Control and Prevention (CDC), bioterrorism is defined as “the deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants.” A literature search and a review of available resources elucidated pertinent content items on bioterrorism and its associated precautions for nurses. Next, two rounds of expert panel consisting of five members rated the identified content and proffered comments to validate the curriculum. Finally, a four-hour in-person pilot educational session was implemented based on the results. …

Depersonalization In The Emergency Department, Damian Apollo

Yale Medicine Thesis Digital Library

DEPERSONALIZATION IN THE EMERGENCY DEPARTMENT. Damian Apollo, Karen Jubanyik. Department of Emergency Medicine, Yale University, School of Medicine, New Haven, CT.

Yale medical students have given feedback about the emergency medicine rotations via the end of clerkship feedback and the annual student mistreatment questionnaires collected by the medical school and stated that they felt distress and that patient depersonalization occurred during resuscitations. Accordingly, the objectives of this study were to assess medical students’ perspectives with regards to resuscitation exposure, depersonalization, utilization of support services, and support services that students thought would be helpful as well as the timeframe in which …

Inter-Rater Reliability Of Physical Abuse Determinations And Abusive Fracture Incidence At A Level 1 Pediatric Trauma Center, Kate Buesser

Yale Medicine Thesis Digital Library

As there is no “gold standard” in determining whether a fracture is caused by accident or abuse, agreement among medical providers is paramount. Using abstracted medical record data from children <36 months of age presenting to a level 1 pediatric emergency department (ED), we examined the extent of agreement between specialists who evaluate children with fractures for suspected abuse. To simulate clinical scenarios, two pediatric orthopaedists and two child abuse pediatricians (CAPs) reviewed the full abstraction and imaging, whereas the two pediatric radiologists reviewed a brief history and imaging.

Each physician independently rated each case using a 7-point ordinal scale designed to distinguish accidental from abusive injuries. For any discrepancy in independent ratings, the two specialists discussed the case and came to a joint rating. We analyzed 3 types of agreement: (1) within specialties using independent ratings, (2) between specialties using joint ratings, and (3) between clinicians (orthopaedists and CAPs) with more versus less experience. Agreement between pairs of …

Synergy Of Bcl2 And Histone Deacetylase Inhibition Against Leukemic Cells From Cutaneous T-Cell Lymphoma Patients, Benoit Cyrenne

Yale Medicine Thesis Digital Library

The presence and degree of peripheral blood involvement in patients with cutaneous T-cell lymphoma (CTCL) portend a worse clinical outcome. Available systemic therapies for CTCL may variably decrease tumor burden and improve quality of life, but offer limited effects on survival; thus, novel approaches to the treatment of advanced stages of this non-Hodgkin lymphoma are clearly warranted. Mutational analyses of CTCL patient peripheral blood malignant cell samples suggested the anti-apoptotic mediator BCL2 as a potential therapeutic target. To test this, we developed a screening assay for evaluating the sensitivity of CTCL cells to targeted molecular agents, and compared a novel …

A Novel Staining Method For Detecting Bloodborne Bacteria After Their Dielectrophoretic Isolation, John Gaudet

Yale Medicine Thesis Digital Library

Current methods to diagnose bacteremia typically require 18 to 36 hours to detect positive samples and five days to identify negative ones. This delay stems in part from the incubation time necessary for bacteria to multiply and achieve detectable concentrations. In recent years, microfluidic chips have been developed that isolate and concentrate bacteria from the blood on a time scale of minutes to hours (1). This research seeks to stain and visualize these bacteria after their microfluidic processing thereby significantly shortening the time required to diagnose bacteremia.

The traditional Gram stain is not sufficiently sensitive to detect bacteria in this …

Implementation Of New Definitions Of Labor Arrest Disorders And Failed Induction Can Decrease The Cesarean Rate, Jessica Tanzer Wright Greenberg

Yale Medicine Thesis Digital Library

Cesarean delivery for labor arrest currently makes up the largest proportion of

primary cesarean delivery in the United States. Because cesarean delivery is associated

with significant morbidity, it is important to limit its use to ensure the benefits outweigh

the risks. New diagnostic criteria to limit the diagnosis of labor arrest have the potential

to decrease the cesarean delivery rate. To investigate how cesarean delivery for arrest of

dilation or descent and failed induction contributed to the primary cesarean delivery rate,

we analyzed rates of primary cesarean for these indications among 17,864 live births at

our institution from 2010 through …

Arterial And Venous Impacts Of Transdermally Administered Vasodilators On The Local Microvasculature, George Guo

Yale Medicine Thesis Digital Library

Microcirculatory function is an important component of cardiovascular pharmacology as related to cardiovascular dysfunction. We used photoplethysmography (PPG) to compare the microcirculatory effects of transdermal patches of rivastigmine (Exelon, Novartis), nicotine, nitroglycerin (NTG) and topically applied EMLA (eutectic mixture of lidocaine/prilocaine). We anticipate that this initial pilot comparison of single doses of each medication will catalyze future multi-dose comparisons of the various vasodilatory features of these and other drugs.

Methods: With IRB approval, 10 healthy volunteers were monitored with PPG at the time each transdermal patch was applied and every 8 minutes afterwards for a total of 40 minutes. 1x1 …

Adherence To Prospective Registration Policy And Implications For Clinical Trial Endpoint Integrity, Anand Gopal

Yale Medicine Thesis Digital Library

Since implementation of the International Committee of Medical Journal Editors’ (ICMJE) prospective registration policy in 2005, trial registration has increased significantly. Registering clinical trials is critical in promoting transparency and integrity in medical research, however trials must be registered in an appropriate manner to deter unaccounted protocol modifications or selection of alternate endpoints that may enhance favorability of reported results. This thesis provides relevant background on clinical trial registration and appropriate reporting in addition to evaluating adherence with the ICMJE’s prospective trial registration policy and the implications of inappropriate adherence for the integrity of reported results. In a cross-sectional, retrospective …