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Characterization Of Temperature Curves In The Intensive Care Unit, Patricia Lourdes Valda Toro

Yale Medicine Thesis Digital Library

Fevers are extremely common in hospitalized patients, particularly in those admitted to the intensive care unit (ICU). Up to 50% of fevers in the ICU are non-infectious in origin. Yet, the development of a fever commonly prompts extensive, costly and invasive infectious workups. Patients with persistent fevers are usually treated with antimicrobials long after infectious workups prove unrevealing. While this is viewed as a ‘safe’ approach, inappropriate antibiotic use has shown to be harmful to patients – even effecting an increase in mortality – in addition to contributing to the spread of antibiotic resistance. The purpose of this study is …

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

Yale Medicine Thesis Digital Library

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

Meningitis In Infants ≤60 Days Of Age Diagnosis, Parent Experiences And Potential Improvements In Care And Communication, Eduardo Fleischer

Yale Medicine Thesis Digital Library

Objectives: The aims of this body of work are several fold. Aim 1: To describe the cerebrospinal fluid (CSF) profile of infants ≤60 days old with bacterial meningitis and characterize the clinical and laboratory features of infants with bacterial meningitis who present with no CSF abnormalities. Aim 2: To evaluate the performance characteristics of the BioFire® FilmArray® Meningitis/Encephalitis panel (ME panel), the only Food and Drug Administration (FDA)-cleared multiplexed panel for the evaluation of CSF samples. Aim 3: To identify themes to be included in a parent-reported outcome measure for febrile infants ≤60 days old and to describe the process …

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

Yale Medicine Thesis Digital Library

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

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

Journal of Marine Research

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

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

Journal of Marine Research

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

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

Journal of Marine Research

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

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

Journal of Marine Research

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

Classic Article: Steady Flow In A Frictionless Homogenous Ocean, N. P. Fofonoff

Journal of Marine Research

A mathematical model is developed to study the free (frictionless) steady horizontal flow which can occur in a homogeneous ocean of constant depth. The flow satisfies the dynamic constraint that the vertical component of absolute vorticity is constant along a streamline. The conclusion is reached that in an enclosed ocean a free steady circulation cannot have any slow broad eastward currents. The eastward currents must occur as narrow streams of high velocity and high relative vorticity. Intensified currents are present along the eastern and western coasts. The theory which is developed for the homogeneous ocean of constant depth can be …

Classic Article: Effect Of Coriolis Force On Edge Waves (I) Investigation Of The Normal Modes, Robert O. Reid

Journal of Marine Research

Essentially two classes of free edge waves can exist on a sloping continental shelf in the presence of Coriolis force. For small longshore wave length, fundamental waves of the first class behave like Stokes edge waves. However, for great wave lengths (of several hundred kilometers or more) the characteristics of the first class are significantly altered. In the northern hemisphere the phase speed for waves moving to the right (facing shore from the sea) exceeds the speed for waves which move to the left. Also, the group velocity for a given edge wave mode has a finite upper limit. Waves …

Maternal Anxiety And Neural Responses To Infant Cues, Emily Vancor

Yale Medicine Thesis Digital Library

Maternal anxiety is highly prevalent during pregnancy and the postpartum period and is associated with disruptions to children’s socioemotional development. These long-term outcomes are thought to be mediated in part by anxiety’s effects on parenting and parental sensitivity to infant cues. Recent event-related potential (ERP) studies have found a positive association between generalized anxiety symptoms during the perinatal time and enhanced sustained processing of neutral infant faces. It has been suggested that for perinatal women with anxiety, the uncertainty of how an infant with a neutral expression may be feeling could be experienced as distressing, leading to enhanced sustained neural …

Myrf Represses Nodal Signaling Via Furin During Left-Right Patterning And Gastrulation, Sarah Amalraj

Yale Medicine Thesis Digital Library

Congenital heart disease (CHD) is the most common major birth defect in children, affecting nearly 3% of children and is the leading cause of infant mortality. Heterotaxy (Htx) is a disorder of left-right (LR) patterning, in which organs, including the heart, are mispatterned relative to the LR axis. Htx is associated with severe forms of CHD, but its genetic causes remain largely undefined. Exome sequencing studies of large patient cohorts have recently revealed hundreds of CHD/Htx candidate disease genes, which now need to be validated in experimental systems for causality in order to better understand the causes and biological mechanisms …

Editor's Commentary: The Relationship Of Vertical Turbulence And Spring Diatom Flowerings, Peter Franks

Journal of Marine Research

The dynamics of spring blooms of phytoplankton in temperate waters are usually associated with H.U. Sverdrup’s 1953 “critical depth” model. However, more than a decade earlier, Gordon Riley published a statistical and mechanistic analysis of data he had gathered over two spring “flowerings” on Georges Bank...

Classic Article: The Relationship Of Vertical Turbulence And Spring Diatom Flowerings, Gordon A. Riley

Journal of Marine Research

The causes underlying the initiation of the spring diatom flowering have been a subject of vigorous discussion in recent years. With the gradual accumulation of records it has become quite clear that no one factor controls this peculiar phenomenon. The obvious prerequisite, an abundant supply of nutrient salts in the euphotic zone, is generally satisfied during the autumn and early winter, yet a flowering does not in most cases follow immediately. In a few localities, such as Cape Cod Bay and Ipswich Bay (Bigelow 1926), the Woods Hole region (Fish 1925), and Long Island Sound (Riley 1941a), diatom bursts have …

Assessing Trends In Industry Payments To Orthopaedic Surgeons: A Sub-Specialty Analysis, Neil Pathak

Yale Medicine Thesis Digital Library

Background: The Open Payments Database (OPD), mandated by the Sunshine Act, is a listing of physician-industry payments. With the growing scrutiny of such transactions, the present study aims to characterize and investigate trends in industry payments to orthopaedic surgeons using four full years of data available. The study assessed payments to four orthopaedic sub-specialties: (1) pediatric surgery, (2) foot and ankle (F&A) surgery, (3) spine surgery, (4) adult reconstructive surgery. As the majority of industry payments were classified as General (other categories are Research and Ownership), the present study primarily focused on General payments.

Methods: Industry payments were characterized by …

Writing The Gap: The Role Of Clinician-Authored Narratives In Building Structural Competence And Situated Knowledge In Service Of Marginalized Patient Populations, Anusha Singh

Yale Medicine Thesis Digital Library

This thesis analyzes clinician-authored narratives about mental illness. Through this lens, it argues that the writing and reading of medical narratives can facilitate the development of key clinical skills such as structural competence and situated knowledge – terms that this thesis will define and discuss at length. It will argue that clinicians who write about structural barriers to health do so to develop a deeper understanding about their vulnerable and marginalized patient populations. It will assert that clinicians who pursue situated knowledge can positively impact health outcomes. Ultimately, this thesis will compare what clinician-authored narratives can achieve with what patient …

Defining Psychological Resilience And Determining Long-Term Mental And Physical Health Outcomes In Male And Female West Point Graduates, Melissa Thomas

Yale Medicine Thesis Digital Library

We examined what defines psychological resilience in graduates of the United States Military Academy at West Point, a special population that was selected and trained to adapt and excel in the face of risk factors that can adversely affect mental and physical health. We also assessed self-reported mental and physical health in this population and compared these data to other veteran and civilian populations to lay the groundwork for further investigations into the relationship of resilience to health outcomes. The aims of this study were to: 1) employ a novel approach to operationalizing psychological resilience, defined as adapting well and …

Discipline, Diagnose & Punish: A Critical Analysis Of Ptsd Diagnostication Amongst Syrian Migrants In Jordan, Erik Kramer

Yale Medicine Thesis Digital Library

This qualitative project seeks to explore sociopolitical factors influencing post-traumatic stress disorder (PTSD) diagnostication in Syrian migrants living in Jordan. Interviews were performed with twenty-three key informants, comprised of clinicians, organizational staff, and scholars, using semi-structured techniques which were analyzed with grounded theory analytic approaches. The results illuminate the complex social forces governing the practice of PTSD diagnostication in the Syrian migrant population in Jordan, with a focus on the effects of financial pressures. This is the first study to report extensively on the financial pressures affecting PTSD diagnostication in this setting. These data served as rooted substrate for a …

The Financial Crisis 2008-2009, Algemene Rekenkamer

Documents

No abstract provided.

Commercial Paper Index, Thai Bond Market Association (Tbma)

Documents

compiled data summarizing movements in prices of Thai commercial paper

Bear Stearns Cioffi And Tannin Compensation Table, Bear Stearns Companies, Inc.

Documents

No abstract provided.

Bear Stearns High-Grade Structured Credit Strategies Marketing Presentation, Bear Stearns Companies, Inc.

Documents

No abstract provided.

Assessment Of Children’S Personal And Land Use Regression Model-Estimated Exposure To No2 In Springfield, Massachusetts, Sarah Esenther

Public Health Theses

Personal NO2 measurements were taken for a cohort of seventh-grade students (n=25) attending a magnet school in Springfield, MA with an elevated prevalence of pediatric asthma (17.2%). These personal measurements were compared with exposures predicted through a land use regression (LUR) model constructed from built environment and land use characteristics across the area to assess personal exposures in NO2 exposures within the cohort. Springfield, Massachusetts was chosen as the study location because of its elevated prevalence of pediatric asthma (19%) compared to the state average (11%) coupled with the recognized sensitivity of asthmatic children to traffic-related air pollutants. The exposure …

Eastern Equine Encephalitis Amplification And Spillover In New England, Aaron Hentoff

Public Health Theses

Introduction: Eastern Equine Encephalitis (EEE) is an alphavirus spread by the Culiseta melanura mosquitoe. While extremely rare, infection can lead to severe mental sequala and death, making it a public health concern for affected communities. Over the past two decades EEE outbreaks have become more frequent in occurrence and larger in size in the Northeast Region of the United States.

Objectives: The main objectives of this study are to 1) measure the association between mosquito abundance, infection rate, and disease incidence 2) characterize the relationship between seasonal climate variability in New England with Cs. melanura abundance, infection rates, and incidence …

Phylogeographic Insights Into Zika Virus In Puerto Rico, Chaney Christine Kalinich

Public Health Theses

During the larger epidemic in the Americas, Puerto Rico experienced an epidemic of Zika virus (ZIKV) between November 2015 and December 2016. During this period, 39,717 residents tested positive, or 1.1% of the population. Our team sequenced 84 ZIKV genomes directly from archived ZIKV-positive clinical samples from throughout the epidemic period, and from distinct regions of the island, in order to reconstruct the introduction(s) to and geographic spread of ZIKV in Puerto Rico. We found that ZIKV was circulating in the Greater Antilles by April (95% CI: February-June) of 2015, and was introduced to Puerto Rico by August (95% CI: …

Chlorpyrifos And The Gut Microbiome Of Animals: A Systematic Review, Danh Lai

Public Health Theses

This review found that chlorpyrifos exposure may be associated with negative impacts on the gut microbiome, especially obesity, diabetes, and compromised immune response. Perinatal exposure in rats was also linked to dysbiosis of intestinal microbes. Further research resulting in primary data would be needed to substantiate the relationships. Even with a clear understanding of the relationship, further research needs to be conducted to determine if the microbes are a product of health outcomes or vice versa. Species-level investigation would be critical in characterizing the true interactions of the gut. This information can be used to identify another possible component of …

Caregiver Support And The Mental Health Of Transgender And Gender Expansive Youth: Race-Specific Effects In A Clinic-Based Sample, Whitney Morgan Menary

Public Health Theses

Parental and caregiver support has been shown to be a protective factor against poor mental health in transgender and gender expansive (TGE) youth. However, little is known about how race and ethnicity might affect this relationship. This study extends the literature by examining whether the associations between parental support and mental health outcomes are moderated by race. A clinic-based sample of 81 TGE youth (mean age = 15.31, SD = 1.61) completed assessments of their anxiety and depression symptoms. Caregiver support scores were gathered from youth and the caregivers themselves. Results show that TGE youth of color have decreased odds …

Functional, Motivational And Emotional Support: A Qualitative Study Of Social Influences On Diabetes Management Among Low-Income Adults, Emily Helen Miron

Public Health Theses

Objective To understand how low-income adults living with type 2 diabetes conceptualize and utilize social support in their diabetes management.

Methods The data for this paper came from a larger qualitative study, conducted by the advisor and last author, exploring the intersection of housing access and diabetes management among 40 low-income adults diagnosed with type 2 diabetes in New Haven, Connecticut. This qualitative study utilized 58 of the previously collected semi-structured interviews (some participants were interviewed more than once). Excerpts from two broad parent codes from the original study were analyzed using a flexible and iterative coding process.

Results Participants …

Downstream Impacts Of Racial Discrimination In Us-Born And Foreign-Born Latinxs, Dominic Schnabel

Public Health Theses

Latinxs experience high levels of discrimination with potential negative downstream health impacts and there is question as to what extent nativity status moderates the relationship between discrimination and health. I utilized the National Epidemiologic Survey on Alcohol and Related Conditions Wave III to characterize the impact of self-reported instances of racial discrimination on anxiety as well as engagement with emergency department services in the Latinx population. I found that for Latinxs, each additional reported experience of racial discrimination was associated with 1.23 times odds of reporting generalized anxiety (95% CI: 1.16-1.30). Stratified analyses suggested no difference in the relationship between …

Antimicrobial Resistance And Molecular Epidemiology Of Escherichia Coli Isolated From Urban And Rural River Systems, Christopher Robert Jossart

Public Health Theses

Antimicrobial resistance (AMR) is an emerging public health issue that threatens the efficacy of antibiotic treatment for bacterial infections and human health. Sources of antimicrobial resistance genes (ARGs) in the environment include wastewater treatment plants and animal feeding operations that discharge waste into waterways, such as rivers and streams. This retrospective descriptive study describes the presence of AMR, and specific ARGs in Escherichia coli isolates from two distinct watersheds, rural and urban, with the use of antimicrobial susceptibility testing, whole-genome sequencing (WGS) to detect ARGs, and multi-locus sequence typing. Antimicrobial susceptibility testing was performed for 143 E. coli isolates, 73 …