Digital Commons Network^™

Data Integration And Targeted Anticancer Drug Synergies Prediction, Xiaoting Gao

Public Health Theses

In the past decades, targeted cancer therapies have made considerable achievements in inhibiting cancer progression by modulating specific molecular targets. However, targeted cancer therapies have reached a plateau of efficacy as the primary therapy since tumor cells can achieve adaptability through functional redundancies and activation of compensatory signaling pathways. Therapies using drug combinations have been developed to overcome the bottleneck. Accurate predictions of synergies effect can help prioritize biological experiments to identify effective combination therapies. Data integration can give us a deeper insight into the mechanism of cancer and drug synergies and help to address the challenge in prediction of …

Genomic Characterization Of Sarcomatoid Transformation In Clear Cell Renal Cell Carcinoma, Xiao Bi

Yale Medicine Thesis Digital Library

The presence of sarcomatoid features in renal cell carcinoma (ccRCC) confers a poor prognosis. The mechanisms that account for these sarcomatoid features are unknown. We performed whole exome sequencing of matched normal-carcinomatous-sarcomatoid specimens from 21 subjects. Two tumors had hypermutation and a mutational signature consistent with mismatch repair deficiency. In the remaining 19 tumors, sarcomatoid and carcinomatous elements shared a mean of 45/108 (41.7%) somatic single nucleotide variants (SSNVs). Sarcomatoid elements had a higher overall SSNV burden (mean 90 vs 63 SSNVs, p=4.0x10-4), increased frequency of non-synonymous SSNVs in Pan-Cancer genes (mean 1.4 vs 0.26, p=0.002), and increased frequency of …

Salivary Cortisol As A Measure Of Stress Reactivity In Adolescents With Psychiatric Disorders, Cortlyn Wilhelmina Brown

Yale Medicine Thesis Digital Library

Objective: The aims of this study were to 1) examine salivary cortisol distributions in a nationally representative sample of U.S. adolescents; and to 2) evaluate whether youth with mood and anxiety disorders are associated with differential salivary cortisol response to an acute mild stressor.

Background: An association between mood disorders and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, as indicated by elevated levels of cortisol, has been well established [1, 2]. Although studies have suggested that these differences emerge early in the development of mood disorders in children and adolescents [3] the samples have generally been very small and primarily derived from clinical …

Transitioning Of Hiv-Infected Children From Pediatric To Adult Care: A Jamaican Case Study, Flavia De Souza

Yale Medicine Thesis Digital Library

Successful public access to antiretroviral therapy in resource-limited settings (RLS) has resulted in survival of HIV perinatally infected children into adulthood. There are few studies on transition of care in RLS, where 90% of HIV-infected children reside. We aimed to characterize the current landscape of the transfer process of HIV-infected adolescents in one such RLS, Jamaica. We conducted in-depth interviews of 18 HIV-infected adolescents in pediatric care and 21 health care providers. We analyzed the data using the grounded theory approach. Five themes emerged: 1. Pediatric clinics were like families who provided care-taking and developmental support in addition to HIV …

Language In Schizophrenia: What We Can Learn From Quantitative Text Analysis, Sasha Deutsch-Link

Yale Medicine Thesis Digital Library

LANGUAGE IN SCHIZOPHRENIA: WHAT WE CAN LEARN FROM QUANTITATIVE TEXT ANALYSIS

Sasha Deutsch-Link, Sarah Fineberg, Philip R. Corlett. Department of Psychiatry, Yale University School of Medicine, New Haven, CT.

Background: People living with schizophrenia demonstrate broad language and communication deficits. Prior research has focused on qualitative changes in thought, speech production, and language comprehension. In this thesis I expand upon our understanding of language in schizophrenia, by using a novel, quantitative method for language analysis, Linguistic Inquiry Word Count (LIWC).

Methods: I examined essays by four groups of authors: people with schizophrenia (n=77), family history of schizophrenia (n=25), psychiatric controls …

Viral Causes Of Gastroenteritis In The Era Of Widespread Rotavirus Vaccination, Dame Idossa

Yale Medicine Thesis Digital Library

Background: It is unknown if widespread use of Rotavirus (RV) vaccine will impact the primary causative agent of viral gastroenteritis (VGE).

Objective: To identify changes in epidemiology of VGE affected by vaccination, determine factors associated with higher severity of illness, and assess agreeability between two clinical severity-grading scales; Clark and Vesikari.

Methods: We analyzed fecal samples of children, 6 months-5 years of age, evaluated at YNHH for VGE. Fecal samples were tested using a real-time PCR assay. Primer and probe sequences targeted conserved regions of the genome for RV, Norovirus GI/GII, Adenovirus, Astrovirus, and Sapovirus. Data were analyzed using SPSS. …

Outcomes Following Heart Transplantation In A National Cohort: An Analysis Of The Organ Procurement And Transplantation Network’S Database, Oliver Kayden Jawitz

Yale Medicine Thesis Digital Library

In this analysis, we examine a large national cohort within the Organ Procurement and Transplantation Network’s (OPTN) United Network for Organ Sharing (UNOS) database for the purpose of determining the impact of a recipient history of myocarditis as well as donor/recipient ABO compatibility on outcomes following heart transplantation. We used a nationwide sample with primary stratification between ABO identical and compatible heart transplantations or transplant recipients diagnosed with myocarditis and those diagnosed with ischemic or idiopathic cardiomyopathy. The primary end-point was graft failure from all causes. Post-transplant survival was compared between groups using univariate Kaplan-Meier as well as multivariate Cox …

Student Perspectives On Interprofessional Education: Implications For Curriculum Development, Jacob Alan Weatherly

Yale Medicine Thesis Digital Library

Background

The Yale Schools of Medicine and Nursing and the Yale Physician Associate (PA) Program are collaborating to implement an interprofessional curriculum. Although healthcare organizations have called for interprofessional education (IPE), such initiatives have been difficult to implement. Per the Kern framework of curriculum development, design and implementation is likely to be more successful if a needs assessment is done as the first step.

Objective

To better understand healthcare professional students’ perspectives about IPE as part of a needs assessment for developing an IPE curriculum.

Methods

Because little is known about stakeholder perceptions of IPE, we used a qualitative, content …

A Comparison Of Superomedial Versus Inferior Pedicle Reduction Mammoplasty Using Three-Dimensional Analysis, Victor Zhang Zhu

Yale Medicine Thesis Digital Library

A COMPARISON OF SUPEROMEDIAL VERSUS INFERIOR PEDICLE REDUCTION MAMMOPLASTY USING THREE-DIMENSIONAL ANALYSIS.

Victor Z. Zhu, Ajul Shah, Rachel Lentz, Tracy Sturrock, Alexander F. Au, Stephanie L. Kwei.

Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT.

Reduction mammoplasty using the inferior pedicle (IP) technique continues to be more commonly performed than the superomedial pedicle (SMP). This study uses three-dimensional (3D) imaging to compare postoperative linear and volumetric changes in SMP and IP breast reductions.

Reduction mammoplasty was performed using either a SMP or IP, with a Wise-pattern skin incision. Patients in each …

“For The Safety Of Our Health”: A Qualitative Analysis Of Pre-Exposure Prophylaxis (Prep) Acceptability Among Female Sex Workers In Malaysia, Shaylen Susalla Foley

Public Health Theses

Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population. Daily oral pre-exposure prophylaxis (PrEP) offers a novel way to prevent HIV transmission in this population. This research aims to inform culturally relevant implementation of PrEP through a qualitative exploration of the factors that determine FSW willingness to use PrEP. In-depth, semi-structured interviews (n=30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach. FSW expressed positive interest in PrEP but preferred it as a supplement to condoms, not a …

Livestock Prevalence Of Brucellosis And Q Fever In Thailand, Soledad Colombe

Public Health Theses

Background

Brucellosis and Q fever may impart high morbidity in humans and economic losses among livestock. Yet, a systematic investigation has not been performed in Thailand, where a significant proportion of the rural population may be vulnerable to these zoonotic diseases.

Objectives

We surveyed the seroprevalence of brucellosis and Q fever in livestock from Thai communities at the border with Cambodia, evaluated risk factors for seropositivity, and performed a risk assessment for potential transmission to farmers.

Methods

We selected herds of beef and dairy cattle and small ruminants (sheep and goats) for Sa Kaeo province in 2015 using a two-stage …

Associations Of Depression With End-Of-Life Cancer Care Intensity, Kathy Cao Doan

Public Health Theses

Background: Depression has adverse effects on health outcomes and the quality of end-of-life care among cancer patients. However, overly aggressive EOL care can result in high costs and may not be consistent with patient preferences or linked to better health. As such, there is rising interest in identifying the associations between depression and care quality for cancer patients. This study investigates whether depression is associated with EOL care intensity among elderly individuals with cancer.

Methods: Utilizing the Surveillance, Epidemiology, and End Results-Medicare linked database, we identified decedents aged 66 years or older either with pre-cancer depression, post-cancer depression, or no …

Yale Medicine : Alumni Bulletin Of The School Of Medicine, Winter 2016, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the Winter 2016 issue of Yale Medicine: alumni bulletin of the School of Medicine, v. 50, 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).

Molecular And Genetic Properties Of Breast Cancer Associated With Local Immune Activity, Anton Safonov

Yale Medicine Thesis Digital Library

The causes of high versus low, or absent, immune cell infiltration in breast cancer is unknown. The goals of this analysis were to examine if total mutation load, neoantigen load, copy number variations (CNV), gene-level or pathway level somatic mutations or germline polymorphisms (SNP) are associated with the level of immune infiltration measured by immune metagene expression levels. We used RNA-Seq, DNA copy number, mutation and germline SNP data from the TCGA representing n=627 ER+, n=207 HER2+ and n=191 TNBC cancers. 13 published immune metagenes were used in correlation and multivariate linear regression analyses performed separately for the 3 major …

Wind-Driven Flow Over Topography, Michael A. Spall

Journal of Marine Research

The space and time scales over which wind forcing can directly drive flows over regions of closed topographic contours are explored using an idealized numerical model and theory. It is shown that stratification limits the vertical scale of the mean flow but also results in an enhanced recirculation strength in shallow water by distorting the isopycnals in the bottom boundary layer. Time-dependent forcing can drive flows that extend deeper than the mean flow because the initial response is primarily barotropic. This response is limited at low frequencies by baroclinic Rossby wave propagation. It is expected that these wind-driven flows might …

Medicine@Yale September/October 2016 Volume 12, Issue 2, Yale School Of Medicine Department Of Surgery

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.

Bulletin Of Yale University School Of Nursing 2016-2017, Yale School Of Nursing

Yale School of Nursing Bulletins and Catalogues

Series 112, Number 15

September 5, 2016

Adverse Childhood Experiences And Their Relation To Parenting Stress And Parenting Practices, Brittany Lange

Public Health Theses

Introduction: Trauma represents a significant public health issue that has been associated with a number of adverse physical and mental health outcomes. Additionally, parenting practices have been found to be affected by trauma. Adverse childhood experiences (ACEs), one conceptualization of trauma, are also associated with adverse outcomes. However, limited research has been done on ACEs and their association to parenting stress and practices. As such, this study aims to understand this relationship. Methods: Surveys (n=1985) were administered to a population of low-income, parenting women to determine community needs and eligibility for a mental health intervention. At the baseline visit, measures …

Yale School Of Medicine Facts & Figures 2016-2017, 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.

Species Distribution Modeling Of North American Odonates, Rebecca Beilinson

Library Map Prize

Species distribution modeling, which uses species-environment relationships to predict species’ geographic ranges, is a powerful technique for biogeographical and ecological analysis as well as for conservation planning. However, it has typically been underutilized for invertebrates and for freshwater species, as modeling these groups can pose unique challenges. Here I present methods for modeling odonate distributions and demonstrate these methods for four North American species. I show that incorporating expert-derived range maps as spatial priors can significantly improve model performance as compared to MaxEnt models. I also introduce a new distance to freshwater layer as an environmental variable, and show that …

Treading The Path Of Least Resistance: Fda's Regulation Of The Subtherapeutic Use Of Antibiotics In Animal Agriculture, 1970-2015, Colleen Flynn

Harvey M. Applebaum ’59 Award

No abstract provided.

Broadly Neutralizing Human Antibodies Inhibit Dengue Virus Infection In Aedes Mosquitoes, Colette Jolynn Matysiak

Public Health Theses

Introduction

Dengue virus is the leading cause of morbidity and mortality among mosquito-borne viruses globally. There are four Dengue serotypes; immunity to one serotype provides protective immunity to that serotype but increases the risk of severe disease upon infection with a second serotype. Dengue virus, like all Flaviviruses, utilizes class II fusion proteins to gain entry into the host cytoplasm. The fusion loop, which is responsible for viral-host fusion, lies within the envelope (E) glycoprotein and has nearly 100% amino acid identity among all Flaviviruses. Two anti-Dengue virus human monoclonal antibodies (hMAbs), 1.6D and D11C, were isolated from Dengue infected …

Hcv And Drug Transition In Ct Nonurban Injection Drug Users, Maria Ma

Public Health Theses

Aims: We sought to determine if age of first substance initiation (alcohol intoxication, marijuana use, pharmaceutical opioid use, polysubstance) was associated with faster rates of transition to injection drug use or heroin use. Subsequently, we examined if transition time was a predictor for hepatitis C infection.

Methods: From 2008-2012, 462 active injection drug users were recruited using respondent-driven sampling. Participants were interviewed about their injection-associated risk, and serological testing of HIV, HCV and HBV was performed. Kaplan-Meier analyses were used to examine the rate of transition from first substance event to initiation of heroin use or first injection. A Cox …

Conflict-Affected Youth Livelihoods Programming: Bridging The Gap Between Research & Practice, Chanel M. Marin

Public Health Theses

The current thesis project consists of a programmatic mapping of existing policy and programming related to conflict-affected youth livelihoods and a Rapid Evidence Assessment (REA) of the literature to identify the evidence base for effective interventions. The programmatic mapping identified key actors in the field and existing policy and programming, revealing a need for: data regarding evidence-based interventions; demand-driven intervention strategies; cross-sectoral partnerships providing holistic programming approaches; increased outreach to vulnerable sub-populations; and increased youth participation in program design, implementation, management, and evaluation. The REA revealed a severe shortage of evidence-based practice in this area, but sheds light on the …

Spatial And Temporal Dynamics Of Glossina Pallidipes In Nguruman National Park (Kenya)., Michael Frederic Mengual

Public Health Theses

Abstract:

Background: Glossina pallidipes is a significant vector of trypanosomiasis for humans and livestock across Sub-Saharan Africa. Nguruman national park in Kenya is regarded as a potential location for targeted vector control activity. We screened flies from three locations in Nguruman in 2003, 2009, and 2015 using 13 microsatellite loci to assess population structures of G. pallidipes.

Methods: We acquired Tsetse samples from three sites across Nguruman in Kenya at three time points. We then performed genetic analyses on 267 flies using 13 microsatellite loci and evaluated genetic structure of Tsetses across a geographic distance of about 22 km and …

Exposure To Pesticides And Food Packaging Materials And Bmi In Samoan Mothers And Children, Jennifer Park

Public Health Theses

Background: Growing evidence suggests that environmental chemicals, including certain pesticides and bisphenol A (BPA), may be linked to obesity because of their ability to disrupt metabolic functions. Methods: We conducted a community-based, cross-sectional survey of 319 non-pregnant mothers, ≥18 years old, with a child aged 2-Samoa, a country with high obesity prevalence, understudied agricultural and residential pesticide use and BPA consumption from canned and packaged goods. We measured weight and height of the mother-child pair and interviewed mothers about their potential environmental exposures. Using multivariable logistic regression, we evaluated the association between pesticide and BPA exposure surrogates and weight status. …

“You Want To Go Home”: Search For Home Among Young Trans Women Of Color, Rebecca Suzanne Pepe

Public Health Theses

A wealth of literature explains the existence of barriers to accessible housing for the trans community. However, none have elucidated the story of how young trans women manage and navigate these barriers as they experience finding not only a housing structure, but also a place to call home. The aim of this work is to describe the experience finding home for a group of young, trans, women of color. This is done via qualitative analysis of semi-structured interviews of 17 trans women associated with the Ruth Ellis Center in Detroit, Michigan. Utilizing a grounded theory approach and coding with Dedoose …

Patterns Of Drug Use And Correlates Of Active Amphetamine-Type Substance Use Among Sex Workers In Kuala Lumpur, Malaysia, Courtney Jo Pedersen

Public Health Theses

Objective: To describe the female and transgender sex worker population in Kuala Lumpur, Malaysia, understand their patterns of substance use, and examine the correlates of active amphetamine-type substance (ATS) use.

Methods: We administered a cross-sectional survey and performed biological testing on 492 sex workers to assess lifetime and active substance use history and frequency, criminal justice involvement, alcohol and substance abuse disorders, sexual risk behaviors, experience of childhood and adulthood physical and sexual abuse, depression, and prevalence of HIV, syphilis, chlamydia, and gonorrhea. We performed descriptive statistics to describe demographics and lifetime and active drug use patterns and employed bivariate …

Evaluating Substance Use In A Network Of Emerging Adult Males Via Analysis Of Text Messages Sent And Received, Lia Pizzicato

Public Health Theses

Introduction: With the ubiquity of mobile phones, mobile health (mHealth) has the ability to transform healthcare specifically in regard to substance use interventions. Current mHealth interventions targeting substance use are limited as they require self-monitoring and user input.

Objectives: The objective of this study was to determine if text message content can predict substance use attitudes and behaviors. The aims were three-fold: (1) To assess the prevalence of discussion of substance use in text messages (2) To evaluate the relationship between text message content and substance use attitudes and behaviors; and (3) To examine social network structure using texting interactions …

Likelihood Of Achieving Who Leprosy Goals: An Expert Survey, Alex Rittel

Public Health Theses

Much progress has been made in the global fight against leprosy, as evidenced by dramatic declines in prevalence rates in recent years. However, leprosy has proven elusive. New case detection rates have remained fairly stable, particularly in countries with remaining pockets of high endemicity such as India, Brazil, and Indonesia. In 2012, the World Health Organization spearheaded the London Declaration, which in part aimed for the goal of interruption of transmission of global leprosy by 2020. Aggregating the opinions of experts can supplement existing data to help determine the feasibility of reaching the WHO goals. To obtain the opinions of …