Digital Commons Network^™

Impact Of Pcv10 On Pediatric Pneumonia In Nepal, Katie Steimel

Public Health Theses

Pneumococcal conjugate vaccines have significantly reduced pneumonia cases, hospitalizations, and deaths worldwide. This study evaluates the impact of 10-valent pneumococcal conjugate vaccine (PCV10) eligibility on pediatric pneumonia hospitalizations in Nepal using administrative hospital data from three major geographically and administratively diverse hospitals. A controlled interrupted time series design was used comparing pneumonia hospitalizations with diarrhea hospitalizations, under the assumption that PCV10 would not influence diarrhea hospitalization rates. A secondary model stratified hospitalizations by age group, assessing differential trends based on vaccine eligibility. Generalized linear models with quasipoisson distributions were used, adjusting for hospital and seasonality.The primary model comparing pneumonia to …

Disparities In Clinical Trial Representation: Bioethical & Human Rights Violations Against The Global Burden Of Disease And Gender Equity, Kaustubha Reddy

Public Health Theses

This investigative thesis seeks to contribute to the understanding of how disparities in the planning, design, and placement of clinical trials perpetuate global health inequities. It will analyze the misalignment between the global burden of disease and research priorities, examining the systemic factors that determine which diseases are prioritized for trials. It will highlight the bioethical and human rights implications of gender exclusion, particularly the underrepresentation of women with HIV, in clinical research. By addressing both the upstream determinants of clinical trial planning and the downstream consequences of exclusionary practices, this work offers a comprehensive critique of the structural inequities …

Under-Five Malaria And Malnutrition Syndemic In Rajasthan, Nandini Sinha

Public Health Theses

Background: The syndemic of severe acute malnutrition (SAM) and malaria in under-five children in Rajasthan presents a critical public health challenge. Current SAM and malaria programs are implemented as siloed interventions despite the potential benefits of integrated approaches. A better understanding of the interactions between these factors is important to strengthen the delivery of integrated services.

Objective: This study investigates the relationship between under-five SAM and malaria infections at the block level in Rajasthan to inform targeted, integrated interventions. By running regression analysis, we will identify associations between these co-occurring health threats to guide state-level policy integration. To the best …

Social Networks Of Care: A Qualitative Study On The Role Of Social Support In Managing Diabetes While Facing Economic And Housing Insecurity, Shankeri Vijayakumar

Public Health Theses

Research has identified the particular significance of social support for individuals living with chronic health conditions such as Type 2 diabetes. Housing stability and economic security are just a few key determinants for good health-- factors shaped by structures and systems acting at various levels of influence. Without stability in these dimensions, social support is one of the most significant resources to promote and maintain health by serving as a buffer for adverse physical and mental health exposures. However, less is known about how vulnerabilities related to poverty, racism, and housing insecurity can impact an individual's ability to cultivate sources …

Integrating Rare Variant Association Studies With Embedding-Based Methods: Simiskato, Changheng Wang

Public Health Theses

Understanding the genetic basis of rare diseases remains a central challenge in human genomics, especially when conventional methods rely on case-control labels that may oversimplify complex clinical variation. In this thesis, we introduce SimiSKATO, a novel approach that integrates phenotype embeddings with rare variant association testing. Using PERADIGM-generated similarity scores to represent clinical resemblance between individuals, SimiSKATO treats these scores as continuous traits within the SKAT-O framework. By applying this method to rare diseases in the UK Biobank, we demonstrate that SimiSKATO not only replicates known gene-disease associations but also identifies biologically plausible novel candidates missed by other methods. This …

Expanding The Trypanosoma Brucei Parasite Detection Limit Through Tb177 Gene Detection In Qpcr, Yi Yan

Public Health Theses

Trypanosomiasis, caused by protozoan parasites of the Trypanosoma genus, remains a significant health and veterinary burden in sub-Saharan Africa, with Human African Trypanosomiasis (HAT) and Animal African Trypanosomiasis (AAT) posing ongoing threats to underserved populations. Despite advances in therapeutics, the lack of sensitive and scalable diagnostic tools continues to limit early detection, effective disease management, and evaluation of emerging vaccine candidates. Current diagnostic methods such as light microscopy and serological tests frequently fail to detect low levels of parasitemia during the early stages of infection, thereby delaying intervention and increasing the risk of disease progression and transmission.

Our study mainly …

Temporal Analysis In Connectivity Structure Of Human Disease Co-Occurance Network, Jingxuan Xu

Public Health Theses

Recent research on human disease networks (HDNs) has revealed the importance of jointly analyzing multiple diseasesand their interconnections, yet many existing approaches focus on molecular-based data and do not fully capture non-molecular relationships. Building on the concept of the phenotypical HDN, we leverage Medicare inpatient claims data to construct a comprehensive disease co-occurrence network. In our framework, two diseases are deemed interconnected if their observed probability of co-occurrence significantly deviates from that expected under independence. We adopt the weighted gene co-expression network analysis (WGCNA) framework to build our network, using a ϕ-correlation measure and a hard threshold to ensure a …

Occupational Choice And Social Mobility, Samuel Solomon

Yale Graduate School of Arts and Sciences Dissertations

This dissertation examines how individuals make occupational choices and how that shapes economic success, social mobility, and the labor market.

The first chapter uses population-wide administrative data from Finland to examine the underlying drivers and aggregate implications of occupational following—when children enter into their parent’s occupation—for the labor market, social mobility, and total output. I first document that occupational following is a widespread feature of the labor market. Second, I show that pre-labor market multidimensional skills and educational choice statistically explain 19% of following among all 43 two-digit occupations, and 53% among white collar ones. Third, I use an instrumental …

Data-Driven Functional Connectivity Investigations Into Neural Correlates Of Lateral Preferences, Link Tejavibulya

Yale Graduate School of Arts and Sciences Dissertations

Lateral preferences are ubiquitously present throughout the body despite its oversimplifications towards handedness. Studies on lateral preferences have therefore been simplified and binarized based on handedness preferences despite incongruencies and reduced proportions of right-preference as other limbs and measures are taken into consideration. In spite of this, studies on brain-laterality preferences that have been simplified and confined towards brain-handedness studies have demonstrated that handedness greatly affects how the brain is functionally organized and that these preferences are linked to high concurrences with other behavioral traits, both normative and psychiatric. For instance, males are more likely to be left-handed than females …

Development Of An Enantioselective Synthesis Of (–)-Euonyminol And Studies Towards The Total Synthesis Of (–)-Lomaiviticin A, Zhi Xu

Yale Graduate School of Arts and Sciences Dissertations

In the first chapter, I describe the development of the first enantioselective synthesis of (–)-euonyminol (1), a heavily oxidized sesquiterpenoid. Structurally, (–)-euonyminol (1) features a tricyclic framework containing an all-carbon quaternary center and nine free hydroxyl groups. Following the initial failed attempts to achieve a semi-pinacol rearrangement of an allylic silyl ether, we developed a novel oxyalkylation reaction to establish the C10 quaternary center of 1. From this intermediate, we investigated three distinct strategies to construct the tricyclic framework of 1 employing a reductive cyclization, an aldol–dehydration sequence, and a radical cyclization reaction, respectively. Finally, a series of stereoselective transformations …

Epigenetic Regulation Of Macrophage-Induced Inflammation By Glutamine During Tissue Repair, Yiting Xu

Yale Graduate School of Arts and Sciences Dissertations

Introduction:

Delayed wound healing is a major healthcare challenge, creating a significant financial burden and impacting patient quality of life by increasing risks of infections, chronic wounds, and impaired tissue regeneration. Macrophages are key mediators in wound healing, where they transition from a pro-inflammatory to an anti-inflammatory state, balancing inflammation resolution and tissue repair. Dysregulated macrophage function, as seen in chronic wounds, leads to persistent inflammation and poor healing outcomes. Recent studies indicate that glutamine metabolism in macrophages may be crucial for this phenotypic transition by influencing gene expression and epigenetic regulation. However, the specific role of glutamine metabolism in …

The Vagina Dentata: A Case For Unlocking Mouths, Loosing Hips, And Spreading The Gospel Of Healing Women's Sexual Performance Anxiety, Alisha Lola Jones

Yale Journal of Music & Religion

This article explores how vagina dentata folklore—stories and imagery about a mythical "toothed vagina"—connects to the ways Black religious communities often cultivate silence around women’s sexual lives, particularly within the “Worth the Wait” and Word of Faith movements. Ignited by womanist religious ethnographer Monique Moultrie’s scholarship on sexual silence in these movement, I take seriously the musicological chasm by exploring how these ministries influence Black women’s sexual agency and moral decision-making through inequitable theological procedures and discourses. The vagina dentata metaphor emerges as a symbol of constrained appetites—respiratory (larynx), digestive (intestine, anus), and reproductive (uterus, vagina)—reflecting broader sociocultural and religious …

Changes In Marital Sorting: Theory And Evidence From The Us, Pierre-André Chiappori, Monica Costa Dias, Costas Meghir, Hanzhe Zhang

Cowles Foundation Discussion Papers

Positive assortative matching refers to the tendency of individuals with similar characteristics to form partnerships. Measuring the extent to which assortative matching differs between two economies is challenging when the marginal distributions of the characteristic along which sorting takes place (e.g., education) change for either or both sexes. We show how the use of different measures can generate different conclusions. We provide axiomatic characterization for measures such as the odds ratio, normalized trace, and likelihood ratio, and provide a structural economic interpretation of the odds ratio. We then use our approach to consider how marital sorting by education changed between …

“Forget The Rest ...”: Notes On Magnetic Tape And Other Antiquated Media As Archives Of Afro-Atlantic Liturgy, David Font-Navarrete

Yale Journal of Music & Religion

The virtuosic complexity of Afro-Cuban orisha music has led scholars and artists to enshrine it as a “classical” tradition, and it has become one of most iconic and closely-studied sacred music traditions of the historical Afro-Atlantic. This essay traces the legacies of several analog-era multimedia technologies in orisha music traditions: reel-to-reel and cassette tapes; limited edition and out-of-print books and phonograph discs; ephemeral texts such as album liner notes; and photographic negatives, prints, and slides. The tapes and photos — along with a vast body of informal, unpublished, and out-of-print documents of Afro-Cuban orisha liturgy — are seldom archived by …

Economic Development, Undernutrition And Diabetes, Kaivan Munshi, Swapnil Singh, Nancy Luke, Anu Mary Oommen

Cowles Foundation Discussion Papers

This research connects two seemingly unrelated facts that have recently been documented in developing countries, with important consequences for global health: (i) the weak association between nutritional status and income, and (ii) the elevated risk of diabetes among normalweight individuals. The model that we develop to reconcile these facts is based on a set point for body size that is adapted to (low) pre-modern food supply, but subsequently fails to adjust to rapid economic change. During the process of development, some individuals thus remain at their low-BMI set point, despite the increase in their income (food consumption), while others who …

Physical Decline Rates: Men Versus Women, Ray C. Fair

Cowles Foundation Discussion Papers

This paper uses world records by age in running, swimming, and rowing to estimate a biological frontier of decline rates for both men and women. Decline rates are assumed to be linear in percent terms up to a certain age and then quadratic after that, where the transition age is estimated. The use of world records avoids the possible problem of survivor bias in a sample. The decline rates are smallest for rowing, followed by swimming and then running. Decline rates for women are roughly the same as those for men for the swimming events. They are slightly larger for …

Intermittent Fasting As An Adjuvant To Standard Drug Therapy For Drug Resistant Epilepsy, Jake Smiech

Yale School of Medicine Physician Associate Program Theses

Epilepsy affects about 70 million people worldwide, making it the world’s second most common neurological disease. The first line treatment for epilepsy are anti-seizure medications, but only two-thirds of patients respond to the first two medications given. We propose a randomized controlled study utilizing intermittent fasting as a therapeutic lifestyle modification as an adjuvant to standard drug therapy for those that experience drug-resistant epilepsy. We will assess the efficacy and safety of intermittent fasting for a period of six months, and statistically determine if there is a significant reduction in the mean frequency of seizures participants experience compared to a …

Effect Of Selective Head-Neck Cooling Therapy On Specific Brain Biomarkers After Concussive Injury, Mateusz Conrado

Yale School of Medicine Physician Associate Program Theses

Selective head-neck cooling therapy as novel treatment for concussion has been researched in pilot studies for several years using symptom severity as the primary outcome. As of 2018, brain biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) have been FDA approved as indicators of Traumatic Brain Injury (TBI). This study aims to investigate the effects of selective head-neck cooling therapy on the serum levels of the biomarkers, alongside patient symptom severity, in adults aged 18 years and older with mild Traumatic Brain Injury diagnosed in the last 72 hours. A randomized controlled trial will compare two intervention …

Domestic Exotic: Dispossession And Desire In South Florida 20th C Tourism, Emily Nelms

Masters of Environmental Design Theses

Domestic Exotic, considers the conditions that led to the rise of cultural tourism in Florida and examines Yale University’s involvement in this economic phenomenon. Cultural tourism is defined as site-seeing attractions where performers interact with visitors under fabricated conditions. At these sites, ‘the spectacle of the other’ was demarcated onto specific bodies, creating a collective imaginary that helped to shape the infrastructure and public thought of Florida as a travel destination for Euro-American audiences. This document supports an exhibition at the Yale Peabody Museum titled, The Resonance of Things Unseen: Indigenous Sovereignty, Institutional Accession, and Private Correspondence (March 26 - …

Diagnostic Disclosure Using Script-Driven Imagery In Borderline Personality Disorder, Michelle Rodriguez

Yale School of Medicine Physician Associate Program Theses

Borderline Personality Disorder is a widely underdiagnosed psychiatric disorder associated with stigma and misinformation, both in the general public and clinical settings. Current diagnostic disclosure methods do not consider borderline-specific challenges, such as interpersonal hypersensitivity and emotion dysregulation. This has led to discrepancies in patient-provider communication approaches, perpetuating underdiagnosis and negative diagnostic experiences, impacting recovery outcomes and attitudes toward the condition. We seek to determine the efficacy of using script-driven imagery as a method of diagnostic disclosure and psychoeducation versus current practice for individuals newly diagnosed with Borderline Personality Disorder. Our randomized controlled trial will assess efficacy as the proportion …

Memantine For Preservation Of Neurocognitive Function During Reirradiation Of Recurrent Glioblastoma, Yeun Hiroi

Yale School of Medicine Physician Associate Program Theses

Glioblastoma is the most common malignant primary brain tumor in adults. This disease has a dismal prognosis with a median overall survival between 12-18 months. Recent analyses of salvage therapies for recurrence suggest that reirradiation may improve survival. A possible adverse effect is radiation-induced neurocognitive decline. There is a dearth of literature investigating neuroprotective strategies, like using memantine. Our aim is to investigate whether memantine protects neurocognitive function in this population, with an additional goal to show that memantine does not reduce overall and progression free survival. Subjects were randomly assigned to reirradiation plus memantine or reirradiation alone, and the …

Prolonged Metformin For Managing Postpartum Weight Retention In Women With Gestational Diabetes, Ashley Manning

Yale School of Medicine Physician Associate Program Theses

Gestational diabetes is one of the most common obstetric complications and causes both intrapartum issues and increased long-term cardiometabolic risk of type 2 diabetes. Overweight and obese populations are more likely to develop gestational diabetes, which manifests as increased gestational weight gain and postpartum weight retention, perpetuating the cycle of obesity and diabetes in future pregnancies leading to further type 2 diabetes risk. Metformin has become more widely accepted for use during pregnancy and has been associated with decreased gestational weight gain; however, its long-term effects in the postpartum period remain poorly understood. This randomized controlled trial seeks to determine …

Pathological And Protective Immune Responses During Covid-19, Jonathan Klein

Yale Graduate School of Arts and Sciences Dissertations

Since its introduction into humans in late 2019, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally and resulted in the deaths of more than 6.5 million people in just 39 months. Infection with SARS-CoV-2 causes Coronavirus Disease 2019 (COVID-19), a clinically heterogenous viral illness that may alternatively manifest as asymptomatic infection or a life-threatening viral pneumonia. This dissertation examines the range of pathogenic and protective immune responses generated in humans with COVID-19, with specific focus on the contribution of various maladaptive immune responses to the development of severe disease. The investigations presented here are organized into 4 chapters, …

Malaria Parasite, Host, And Drug Dynamics In The Context Of Artemether-Lumefantrine Treatment And Hiv-Infection, Justin Goodwin

Yale Graduate School of Arts and Sciences Dissertations

Malaria is a leading cause of global morbidity and mortality with an estimated 249 million cases and 608,000 deaths in 2022, overwhelmingly in sub-Saharan Africa (SSA). Artemisinin-based combination therapies (ACTs) are the primary treatment for malaria and combine a potent short-acting artemisinin with a longer-acting partner drug. ACTs rapidly reduce the initial parasite burden, eliminate residual parasites, and provide post-treatment prophylaxis against new infections. Artemether-lumefantrine (AL) is the most widely prescribed ACT globally and in SSA. Unfortunately, ACT efficacy is threatened by widespread resistance in Southeast Asia, and by the emergence of partial artemisinin resistance in SSA. SSA also bears …

Social-Ecological Practice Theory And Human-Wildlife Interactions: People, Cattle, And Predators In Makgadikgadi, Botswana, Katherine Orrick

Yale Graduate School of Arts and Sciences Dissertations

2024My dissertation delves into the complex interplay between human activities and wildlife dynamics, focusing on understanding and mitigating human-wildlife interactions (HWI) for sustainable coexistence. Overseeing and managing HWI requires acknowledging that the behavior and actions toward humans and wildlife are made up of local variations across both ecological and social processes. This intertwinement of ecological and social processes is complex; hence, conservation projects aiming to overcome human-wildlife conflict may, in fact, risk exacerbating it whenever either process is only superficially addressed. Ecologists, social scientists, and policy makers are challenged with a lack of knowledge surrounding subject-specific theory and language to …

Harnessing Microbial Warfare To Identify Products Lethal To Pathogenic Free-Living Amoebae By Pseudomonas Aeruginosa, Carrie Anne Flynn

Yale Graduate School of Arts and Sciences Dissertations

Acanthamoeba castellanii is a free-living amoeba (FLA) that causes untreatable, fatal infections of the central nervous system. FLA are ubiquitous in the environment, where they graze upon bacteria such as Pseudomonas aeruginosa. We interrogated P. aeruginosa—under evolutionary pressure to defend against amoebal grazing—as a producer of amoebicidal compounds that could serve as leads for new and urgently needed drugs to treat amoeba infections in humans. To accomplish this, we developed novel methods to quantify killing of A. castellanii trophozoites, pseudocysts, and cysts. Together, these high throughput, reproducible, and extensively validated assays provide a robust platform to measure viability of all …

The Duality Of Neurons: Co-Transmission Of Serotonin And A Neuropeptide, Nlp-3, In The Caenorhabditis Elegans Egg-Laying Circuit, Allison Butt

Yale Graduate School of Arts and Sciences Dissertations

Neurons typically release both a neurotransmitter and one or more neuropeptides in a process known as co-transmission. While this process is a widely observed phenomenon, the logic of why a neuron releases these two or more different types of signals to accomplish its myriad of functions remains largely unclear. In this dissertation, I studied how two serotonergic neurons in the C. elegans egg-laying circuit—known as the Hermaphrodite Specific Neurons (HSNs)—release both the neurotransmitter serotonin and the neuropeptide NLP-3 to activate egg laying. Egg laying typically occurs in a temporal pattern with two-minute active phases, during which the HSNs are highly …

How Molecular Chaperones Promote Pathogen Survival, Carissa Chan

Yale Graduate School of Arts and Sciences Dissertations

All organisms require metal ions to help carry out biological processes. Mg2+ is the most abundant divalent cation in all living cells, where it neutralizes negative charges on DNA and RNA, acts as a cofactor for enzymatic reactions, stabilizes macromolecular complexes, and fulfills numerous other essential roles. Due to the critical nature of Mg2+ in all cellular compartments, cells have developed intricate mechanisms of sensing and responding to changes in intracellular and extracellular Mg2+. Inside the cell, Mg2+ concentration in the cytoplasm impacts the synthesis, maintenance, and degradation of proteins, which perform the vast majority of biochemical functions. First, because …

Microbial Controls On Globally Significant Methane Cycling In Wetlands And Forests, Wyatt Arnold

Yale Graduate School of Arts and Sciences Dissertations

Methane (CH4), like carbon dioxide (CO2), is a potent greenhouse gas that has played a critical role in the warming of the planet. Yet unlike CO2, virtually all of the methane emitted into the atmosphere is the product of biological activity. Specifically, it is the metabolic byproduct of a group of archaea that are collectively referred to as methanogens. These methanogens thrive in a diversity of habitats—from landfills, to ruminant guts, to the wood of trees—and excel at converting carbon into methane. Their vast presence and activity in natural environments, like wetlands and inland waters, accounts for more than half …

Nanopatterned Electrochemical Biosensor Electrodes With Enhanced Signal And Sensitivity, Emily R. Kinser

Yale Graduate School of Arts and Sciences Dissertations

Innovations in materials and process development in recent decades have enabled surface engineering at the nanoscale, which provides a pathway to improvement in the performance and longevity of biomedical implants and biosensors. One such novel class of materials is bulk metallic glass. As an amorphous metal, bulk metallic glass can be molded with after initial casting to produce high-precision features by elevating the material above the glass transition temperature, Tg, via the process of thermoplastic forming (TPF). Thus, BMGs enable a unique pathway to molding nano-scale structures in air at comparably low processing temperatures. Platinum-base BMG alloys (Pt-BMGs) are of …