Digital Commons Network^™

Reporting Of Results In Clinicaltrials.Gov And High-Impact Journals: A Cross-Sectional Study, Jessica Elizabeth Becker

Yale Medicine Thesis Digital Library

In 2007, the FDA Amendments Act expanded requirements for ClinicalTrials.gov, a public clinical trial registry maintained by the U.S. National Library of Medicine, mandating results reporting within 12 months of trial completion for all FDA regulated drugs. We compared clinical trial results reported on ClinicalTrials.gov with corresponding published articles. We conducted a cross-sectional analysis of clinical trials published from July 1, 2010 through June 30, 2011 in high impact journals (impact factor 10 or higher) that were registered and reported results on ClinicalTrials.gov. We compared trial results reported on ClinicalTrials.gov and within published articles for the following: cohort characteristics, trial …

Gender And Depression Among Veterans Of Operation Enduring Freedom, Iraqi Freedom, And New Dawn, Nkemka Esiobu

Yale Medicine Thesis Digital Library

The Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans utilizing Veterans Affairs (VA) services are medically and psychosocially complex, diverse, and rapidly growing. A significant portion of women Veterans seek out mental health services and they are more likely to be diagnosed with major depression than men, however the majority of prior studies informing Veteran mental health services have been done with predominantly male study populations (16,18,19). Our objectives were 1) to identify characteristics associated with a major depression diagnosis among OEF/OIF/OND men and women Veterans after stratifying by gender and 2) to identify gender differences in the nature …

Objective Outcomes Following Semi-Constrained Total Distal Radioulnar Joint Arthroplasty, Remy Sanga Bizimungu

Yale Medicine Thesis Digital Library

A dysfunctional distal radioulnar joint (DRUJ) can significantly compromise an individual's forearm rotation, grip, and weight bearing at the hand and wrist. This retrospective study reports surgeon and therapist collected objective wrist function and subjective pain scores of 10 patients who received the Scheker total DRUJ prosthesis. A review of these patients' medical records was performed to collect preoperative measurements of wrist range of motion, grip strength and pain scores (0-10 scale). The degree of pronation, supination, flexion, extension, radial deviation and ulnar deviation were the outcome measures used to evaluate wrist range of motion. Postoperative measurements were collected at …

Effects Of Degradation On Mechanical Properties Of Tissue-Engineering Poly(Glycolic Acid) Scaffolds, Yushane Celestine Shih

Yale Medicine Thesis Digital Library

Tissue-engineered vascular grafts (TEVGs) offer tremendous therapeutic potential for congenital cardiovascular malformations, and our computational model of growth and remodeling may help expedite TEVG design by identifying optimal scaffold parameters. To evaluate our model’s assumptions about scaffold physical properties, we measured the effects of in vitro hydrolytic degradation on the compressibility and mechanical behavior of poly(glycolic acid) (PGA) scaffolds. Degradation in neutral PBS at 37°C passed through two stages of first-order decay: the first 50 percent of PGA mass was lost from 5 to 40 days (~1 to 6 weeks) at a rate constant of 0.175/wk, after which the mass …

Non-Small Cell Lung Cancer In The National Cancer Database, Jacquelyn Gayle Hancock

Yale Medicine Thesis Digital Library

BACKGROUND

The National Cancer Database (NCDB) is the largest clinical database resource available. Using this remarkable tool, we completed two studies with the goal of answering two questions about non-small cell lung cancer (NSCLC) in the United States: 1) How is clinical stage IIIA-cN2 NSCLC managed? and 2) What is the survival and optimal treatment approach following incomplete resection of NSCLC?

Clinical stage IIIA (cStage IIIA) NSCLC that results from mediastinal lymph node disease (stage IIIA-cN2) represents a difficult lung cancer scenario. In addition to the disappointing prognosis, the accuracy of mediastinal staging is uncertain, the optimal treatment approach is …

Effect Of Therapeutic Interchange On Medication Errors At Hospital Admission And Discharge, Jessica S. Wang

Yale Medicine Thesis Digital Library

Since the landmark Institute of Medicine report brought patient safety to the forefront of public concern, there has been intense effort to reduce medication errors in the hospital setting. One such method, medication reconciliation during transitions in care, is now standard practice. While many studies have explored contributory factors and consequences of medication reconciliation errors at hospital admission and hospital discharge, the role of therapeutic interchange, or the substitution of a chemically different but therapeutically equivalent drug for the one originally prescribed, on patients' medication regimens has not been adequately investigated. In fact, no study has examined the extent to …

Spiciness, Trevor J. Mcdougall, Oliver A. Krzysik

Journal of Marine Research

We define and present algorithms for spiciness, which is an oceanographic variable whose isopycnal variations reflect isopycnal water-mass contrasts in density units. Discussion of spiciness in the oceanographic literature has often concentrated on its supposed orthogonality to isopycnals on the salinity-temperature diagram and how this orthogonal nature means that spiciness is a “passive” thermodynamic variable. Here we show that this “orthogonal” property is devoid of physical meaning. Moreover, it is emphasized that the notion of “orthogonality” on the salinity-temperature diagram does not give rise to a passive thermodynamic variable. Rather, the passive nature of variations of any thermodynamic variable is …

The Influence Of Anoxia And Substrate Availability On N2o Cycling By Denitrification In The Upper Boundary Of The Oxygen Minimum Zone Off Northern Chile, Maribeb Castro-González, Laura Farías

Journal of Marine Research

Strong accumulations of N₂O at oxyclines are some of the most conspicuous features of the world's oceans. However, the origin of these maxima, and the relative contribution of nitrification and denitrification in N₂O cycling, remains unclear. In order to gain insight into the importance of denitrification and factors regulating N₂O cycling at upper oxyclines in the eastern South Pacific, the production and consumption of N₂O by denitrification were measured using a classical acetylene method under induced anoxia with the addition of an electron acceptor (nitrite) and donors (sodium acetate and glucose). The …

Low-Frequency Variability Of The Separated Western Boundary Current In Response To A Seasonal Wind Stress In A 2.5-Layer Model With Outcropping, Jérôme Sirven, Sabine Férvrier, Christophe Herbaut

Journal of Marine Research

The response of the separated western boundary current to a seasonally varying wind stress is studied in a 2.5-layer model where the second layer outcrops. The model is eddy permitting with a resolution of one-sixth of a degree, and the geometry of the basin is idealized. The response is studied for two mean states: the first one is only wind driven, whereas the second one takes into account the existence of a meridional overturning circulation. The separation latitude and the mean path followed by the separated western boundary current are shifted northward of approximately 2° when the overturning circulation is …

The Wall-Layer Dynamics In A Weakly Stratified Tidal Bottom Boundary Layer, I. Lozovatsky, S. U. P. Jinadasa, H. J. S. Fernando, J.-H. Lee, Chang Su Hong

Journal of Marine Research

The application of the classical logarithmic layer model for wall-bounded shear flows to marine bottom boundary layer (BBL) usually leads to an overestimation of the friction velocity u_* due possibly to the influence of form drag, stratification, and rotation of the flow vector. To gain insights on the BBL velocity scaling, acoustic Doppler current profiler (ADCP) measurements taken in the East China Sea were analyzed (a total of 270 sixteen-minute averaged velocity profiles). Single and double log-layer models, a log-wake model, and a modified log-layer (MLL) model that accounts for stratification in the upper part of the BBL (Perlin, …

B Lymphocytes In The Brains Of Multiple Sclerosis Patients Mature In Peripheral Lymph Nodes, Bilal Siddiqui

Yale Medicine Thesis Digital Library

Multiple sclerosis is an autoimmune, demyelinating disorder of the central nervous system that afflicts nearly 2.5 million people worldwide and is among the most common causes of permanent disability in young adults. Although a number of treatments for multiple sclerosis have emerged in recent years, no cure currently exists. From a pathophysiological standpoint, murine models and human genomic studies have established the contribution of T-lymphocytes to multiple sclerosis. However, evidence suggests that B-lymphocytes are also involved in the development of this disease. Immunoglobulins (also known as oligoclonal bands) are routinely measured in the cerebrospinal fluid of patients at the time …

Thoracentesis In Cardiac Surgery Patients With Non-Specific Pleural Effusion: A Case-Control Study, David Russell Kull

Yale Medicine Thesis Digital Library

Non-specific pleural effusion is common in patients after cardiac surgery. Thoracentesis for non- specific pleural effusion is being used more frequently with informal observations of improved dyspnea, shorter length of inpatient stay (LOS), reduced need for escalation of care, and less postoperative atrial fibrillation (AF). Our hypothesis is that the majority of cardiac surgery patients who undergo thoracentesis for non-specific pleural effusion have improvements in dyspnea, reduced days in AF, and reduced escalation of care compared to similar patients who do not have procedural intervention.

Our study population includes patients with evidence of pleural effusion on chest x-ray during a …

Telepsychiatry And Mental Health Care For Syrian Refugees In Turkey, Moustafa Moustafa

Yale Medicine Thesis Digital Library

The Syrian conflict is now in its fourth year and has produced one of the largest humanitarian disasters since the Cold War. Violent fighting and aerial bombings in many of the country’s major cities have resulted in massive numbers of internally and externally displaced Syrians, many psychologically traumatized and in need of expert mental health attention. The influx of refugees into Syria’s neighboring countries of Lebanon, Jordan and Turkey has stressed already strained health systems. The ability to deliver mental health care is inextricably linked to the existing health care infrastructure—a dynamic and often unstable institution as refugees migrate from …

Effectiveness Of A Diabetic Ketoacidosis Prevention Intervention In Children With Type 1 Diabetes, Rebecca Joy Vitale

Yale Medicine Thesis Digital Library

Diabetic ketoacidosis (DKA) continues to be a common acute complication in youth with type 1 diabetes (T1D), with up to 10% of patients reporting at least 1 DKA event annually. Since many of these events should be preventable in known patients with diabetes, we developed a brief educational intervention that was easy to implement in a busy practice setting and tested its effectiveness in reducing emergency department usage due to DKA. Subjects aged > 13 years old or the parents of children aged ≤ 13 were first given a short pre-test about their knowledge of signs and symptoms of DKA and …

Lone Wolves And Stray Dogs: The Japanese Crime Film, 1931-1969, Aaron Gerow, Rea Amit, Samuel Malissa, Noriko Morisue, Hsin-Yuan Peng, Stephen Poland, Grace Ting, Takuya Tsunoda, Justine Wiesinger, Young Yi, Inuhiko Yomota, Jō Ōsawa, Phil Kaffen

Film Series Commentaries

“Lone Wolves and Stray Dogs: The Japanese Crime Film, 1931–1969” is a continuing collaboration between the Council on East Asian Studies at Yale University and the National Film Center of the National Museum of Modern Art, Tokyo. Ever since the success of the French crime film Zigomar in 1911, the Japanese film industry has produced numerous movies depicting criminals and the detectives who try to apprehend them. Chivalric yakuza, modern mobsters, knife-wielding molls, hardboiled gumshoes, samurai detectives, femme fatales, and private eyes populate Japanese cinema, from period films to contemporary dramas, from genre cinema to art film, from the …

Extensions Of Credit By Federal Reserve Banks, Federal Reserve System

Documents

Federal Reserve System Regulation A; Docket No. R-1476

Morrison And Foerster Llp Frequently Asked Questions About Covered Bonds, Morrison And Foerster Llp

Documents

No abstract provided.

Effects Of A Relationship Strengthening Intervention On Quality Of Life Of Young Low-Income, Minority Parents, Rongrong Wang

Public Health Theses

Partners in LIFE (PIL) is a 15-session relationship-based intervention delivered to young low-income minority parents (age 14-25). Fourty-nine parenting couples were recruited from urban pediatric clinics and randomized into PIL or a control group. PIL activities consisted of relationship strengthening (e.g., intimacy, empathy, communication, conflict resolution), parent education, and sexual health. The control group received only parent education. Participants were assessed at baselines and immediately after the intervention (4 months from baseline). Using within-groups analysis of variance (ANOVA) to account for the dependence of the data from time and dyad, we evaluated the effects of this intervention on physical and …

Neurocircuitry Of Suicidal Behavior In Adolescents And Young Adults With Bipolar And Major Depressive Disorder, Amanda Rose Wallace

Yale Medicine Thesis Digital Library

Suicide is one of the leading causes of death in the adolescent and young adult population. Furthermore, it is estimated that for every completed suicide there are many more attempters. The majority of suicide attempters have a mood disorder and neuroimaging research on the neural circuitry of suicidal behavior has primarily focused on these individuals. However, few studies have been designed to compare suicidal behavior across diagnoses. We used diffusion tensor imaging (DTI) to investigate white matter (WM) integrity in Bipolar Disorder (BD) and Major Depressive Disorder (MDD) in adolescents and young adults with a history of suicide attempt. Participants …

Medicine@Yale June 2015 Volume 11, 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.

Real-Time Rt-Pcr Assays To Detect West Nile Virus In Mosquito Pools, Nicole Marie Herman

Public Health Theses

Introduction: West Nile virus (WNV) is a mosquito-borne flavivirus that was first reported in North America in 1999. Human infections with West Nile are often mild or asymptomatic, but some infections progress to life-threatening encephalitis. The Connecticut Agricultural Experiment Station performs viral cell culture screening on mosquito pools collected throughout the state each summer to detect viruses circulating in mosquito populations. Three different real-time RT-PCR assays are used to identify WNV in positive cell cultures. Many surveillance programs do not use cell culture and only use real-time PCR to screen pools. Although this can provide for faster analyses, some positive …

Widespread Dissemination Of Diarrhea Due To Rotavirus Serotype G9p8 In The Solomon Islands After A Focal Flood-Related Outbreak, Forrest Kirby Jones

Public Health Theses

Background

Extreme weather events can precipitate epidemic transmission of diarrhea. We describe a large nationwide epidemic in the Solomon Islands following a focal flash flood disaster on April 3-5, 2015 in the capital city of Honiara.

Methods

The Early Warning Alert and Response Network surveillance system (EWARN) detected an outbreak of diarrhea in Honiara. We identified cases from EWARN and retrospective review of outpatient registries in Honiara prior to and during the outbreak. We reviewed data from the public adverse event system to identify diarrhea-related deaths. Rapid diagnostic testing for rotavirus was performed on stool samples from cases. RT-PCR analysis …

Pirna Sequence Variants Associated With Prostate Cancer In African Americans And Caucasians, Michael Cameron Lerro

Public Health Theses

Background: Prostate cancer is the most common cancer among men, and the incidence is 1.65 times higher in African Americans than Caucasians. The newly discovered PIWI/piRNA pathway, which regulates transposon and gene expression via small non-coding RNAs, has been implicated in certain aspects of cancer etiology. We hypothesize a novel involvement of the pathway via aberrant gene regulation due to sequence variants within piRNAs and test this hypothesis in relation to prostate cancer in both an African American and Caucasian sample. Methods: To interrogate SNPs embedded in piRNA sequences, we utilized genome-wide genotype data to impute 1,000 Genomes SNPs falling …

Usage Data And Humanities Collections: What Is The Data Telling Us?, Sarah Tudesco

Library as Laboratory: A Symposium on Humanities Collections and Research

No abstract provided.

What Do Longitudinal Data On Millions Of Hospital Visits Tell Us About The Value Of Public Health Insurance As A Safety Net For The Young And Privately Insured?, Amanda E. Kowalski

Cowles Foundation Discussion Papers

Young people with private health insurance sometimes transition to the public health insurance safety net after they get sick, but popular sources of cross-sectional data obscure how frequently these transitions occur. We use longitudinal data on almost all hospital visits in New York from 1995 to 2011. We show that young privately insured individuals with diagnoses that require more hospital visits in subsequent years are more likely to transition to public insurance. If we ignore the longitudinal transitions in our data, we obscure over 80% of the value of public health insurance to the young and privately insured.

Hydroxychloroquine Prevents Antiphospholipid Antibody-Induced Inhibition Of Trophoblast Migration, Caroline Albert

Yale Medicine Thesis Digital Library

HYDROXYCHLOROQUINE PREVENTS ANTIPHOSPHOLIPID ANTIBODY- INDUCED INHIBITION OF TROPHOBLAST MIGRATION

Women with antiphospholipid syndrome (APS) are at high risk of recurrent pregnancy complications. Antiphospholipid antibodies (aPL) target the trophoblast by binding beta2-glycoprotein I (b2GPI) and alter human first trimester trophoblast function by: triggering a pro-inflammatory cytokine response; modulating angiogenic factor secretion; and inhibiting cell migration. While patients with APS are often treated with hydroxychloroquine (HCQ), and it is safe to use during pregnancy, little is known about the effects of HCQ on aPL-associated adverse pregnancy outcomes. Therefore, the objective of this study was to test the hypothesis that HCQ prevents the …

Hearts With Cardiac Arrest History Safe For Transplant In The Context Of Donor And Recipient Factors, Aditi Balakrishna

Yale Medicine Thesis Digital Library

Background: Cardiac arrest, or downtime, can result in ischemic damage to myocardial tissue, which prompts caution in accepting hearts with such a history for transplant. Our aim is to provide guidance about whether these hearts are suitable and which among them confer optimal outcome.

Methods: We analyzed all first-time adult cardiac transplantations in the United States between 1988 and 2010 as reported in the United Network of Organ Sharing (UNOS) database. Stratification was between donors with downtime history prior to brain death versus those without such a history for univariate and multivariate analyses.

Results: Of 17,941 donors that met inclusion …

Exploring Femoroacetabular Impingement: An Examination Of The Evolution Of The Disease And Implications For The Development Of Osteoarthritis, Raghav Badrinath

Yale Medicine Thesis Digital Library

EXPLORING FEMOROACETABULAR IMPINGEMENT AND ITS IMPLICATIONS FOR THE DEVELOPMENT OF OSTEOARTHRITIS. Raghav Badrinath, Daniel R. Cooperman. Section of Pediatric Orthopedics, Department of Orthopedics and Rehabilitation, Yale University, School of Medicine, New Haven, CT

Femoroacetabular impingement (FAI) has been recently elucidated as an explanation for cases of hip osteoarthritis (OA) that were previously categorized as "idiopathic". We examine three questions related to FAI - the antiquity of the cam deformity, the role of overcoverage in hip osteoarthritis and the mechanism of impingement with acetabular retroversion.

To examine the antiquity of the cam deformity, we performed proximal femoral measurements on 175 femora …

Medicare And Medicaid Enrollment And Utilization Among Hiv-Infected And Uninfected Veterans In Va Care, Harry Chang

Yale Medicine Thesis Digital Library

Many veterans engaged in care with the Veterans Administration (VA) health system are also enrolled in Medicare and/or Medicaid and may receive care both inside and outside of the VA. Use of dual health systems has been associated with worse outcomes. Veterans with human immunodeficiency virus (HIV) may have different rates of Medicare and Medicaid enrollment, and may be at greater risk of poor outcomes related to non-VA use. This study compares the frequency of Medicare and/or Medicaid enrollment and factors associated non-VA use in an HIV-infected and uninfected population of veterans.

We used data from the VA and Center …

Autophagy Over The Lifespan: Using Fetal, Stem Cell, And Adult Retinal Pigment Epithelium (Rpe) Cultures To Model Amd Pathogenesis, Katherine Jean Davis

Yale Medicine Thesis Digital Library

Purpose: Dysfunctional autophagy in the retinal pigment epithelium (RPE) has been implicated as a therapeutic target in age-related macular degeneration (AMD). To explore how RPE autophagy changes over the lifespan and in response to phagocytosis of photoreceptor outer segments (POS), we compared stem cell-derived RPE (hESC-RPE, iPS-RPE), human fetal RPE (hfRPE), the ARPE-19 cell line, and adult RPE (ad-RPE).

Methods: RPE was cultured from 16-week human fetuses and cadaveric eyes. Stem cell- derived RPE was prepared from human embryonic stem cells (hESC-RPE) and induced pluripotent stem cells (iPS-RPE). LC3 conversion (immunoblotting) and changes in autophagy-related gene expression (qRT2-PCR) were used …