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Financial Stability Review, Issue 36, Banco De Espana/Central Bank Of Spain

Documents

No abstract provided.

Crisis In Cyprus: 'No Negotiating Power, No Credibility', European Stability Mechanism

Documents

No abstract provided.

Framework For Valuation - Q&A, Single Resolution Board

Documents

No abstract provided.

Антикризисное Управление: Анализ Изменений Механизмов Финансового Оздоровления Кредитных Организаций В Национальной Экономике, Alina Kinash

Documents

No abstract provided.

Function Of Piwi-Interacting Rnas In Prostate Cancer, Shunjia Zhang

Public Health Theses

Abstract

Background: As the most common cancer in male, prostate cancer makes up 9.5% of new cancer cases and 4.8% of all cancer death in US in 2018. Though the 5-year survival of prostate cancer is high and multiple treatments are available, the death rate of prostate cancer was still more than 19.5 per 100,000 men per year. With more and more evidence suggested that piRNA may play a more important role in tumorigenesis, we want to find out if piRNAs can be a potential treatment for prostate cancer.

Method: Two Prostate cancer cell lines (PC3, LNCap) and a normal …

Geospatial Analysis Of High-Grade Cervical Lesions To Address Health Disparities, Savanah M. Russ

Public Health Theses

Introduction: Incidence of high-grade cervical lesions (HGCL) caused by human papillomavirus (HPV) has declined in the U.S following the introduction of the HPV vaccine in 2006. However, disparities in HPV cervical infection and subsequent sequelae by race, ethnicity and income continue to persist. The purpose of this analysis was to identify spatial areas with significantly elevated HGCL burden in Connecticut, and determine socioeconomic characteristics associated with high incidence clusters.

Methods: Data from statewide surveillance in Connecticut for cervical intraepithelial neoplasia grades 2, 2/3, 3 and adenocarcinoma in situ (CIN 2+) from 2008-2016 were used for this analysis. Spatial analyses were …

Connecticut Thrives: Reimagining Community Health Workers - A Gap Analysis For Pediatric Behavioral Health In Connecticut And Proposed Workforce Recommendations, Mary Katherine Preuschoff Montgomery

Public Health Theses

Children and families across the United States are facing incredible obstacles as they navigate siloed systems, like healthcare and education, to achieve overall health. This program projection analyzes current local and national trends in pediatric mental and behavioral health services in order to make a recommendation for the state of Connecticut to achieve more supportive and holistic care for children, with behavioral health needs, and their families. The program projected here is: Connecticut Thrives. This program is intended to work with existing state structures to utilize Community Health Workers for the intended purpose of ensuring seamless healthcare. Taking a social …

Exposure To 1,4-Dioxane Dysregulates Stool Metabolomic Network, Yensheng Wang

Public Health Theses

1,4-dioxane is an environmental toxin found in drinking water that is highly associated with liver cancer. The interactions between environmental toxins and the human body can result in the development of tumorigenesis, it can also result in changes to metabolism and thus metabolites that circulate within the body. Some of these metabolites can be procarcinogenic, or can reflect changes to host processes that control metabolism. Stool contains copious information on metabolism that can provide an overview of the well-being of our body, and metabolites in the stool can provide information regarding the pathogenesis of disease and the toxicokinetics of toxicants. …

The Association Between Access To Care And Blood Pressure Control Among Individuals With Hypertension: Evidence From The Coronary Artery Risk Development In Young Adults (Cardia) Cohort, Luming Yang

Public Health Theses

Background: Hypertension is a major risk factor for cardiovascular disease (CVD). Blood pressure control is important to reduce cardiac risk for individuals with hypertension. Reduced access to health care may be associated with and blood pressure control.

Methods: To address this issue, the study included participants with hypertension who were enrolled in The Coronary Artery Risk Development in Young Adults(CARDIA) cohort. Using a cross-sectional study design, we examined whether the main predictor---access to care, defined asa cumulative variable of four aspects—whether or not have health insurance; whether or not have regular care resources; whether or not have payment difficulties; whether …

Predictors Of Incomplete Evaluation Among Pediatric Household Contacts Of Pulmonary Tuberculosis Patients In Kampala, Uganda: A Secondary Analysis, Giyoung Lee

Public Health Theses

Background: Contact investigation is an active approach to identifying new TB cases by screening contacts of known patients for symptoms and risk factors. This is particularly important for child contacts of TB patients because young children are at higher risk of progressing to severe disease compared to adults. Moreover, children are unable or unlikely to travel to clinics for evaluation independently, so their access to TB evaluation may depend on the adults in their household.

Objective: To evaluate the association between individual- and household-level characteristics and completion of TB evaluation for children under 15 years.

Setting: Seven public tuberculosis (TB) …

Evaluating Clostridioides Difficile Infection (Cdi) Risk Factors By Comparing The Use Of Piperacillin/Tazobactam, Cefepime, And Ceftazidime, Shardul Rathod

Public Health Theses

Introduction: Over the past several years, Clostridioides difficile infection (CDI) incidence has been rising. The primary risk factor for CDI is antibiotic use. Many studies indicate that penicillin drugs are among the low-risk antibiotic classes associated with CDI whereas cephalosporin drugs are among the high-risk antibiotic classes. However, there is variation in studies evaluating the healthcare-associated CDI (HA-CDI) risk associated with antibiotics within a class and limited data comparing the use of penicillin versus cephalosporin drugs.

Methods: An observational cohort study was performed using patient data from BH and YNHH. Minitab (Version 18) was used to perform survival analysis and …

Single-Cell Transcriptomics In The Protozoan Parasite Trypanosoma Brucei During Acquisition Of Infectivity, Trisha Kaye Ramsdell

Public Health Theses

Single cell RNA-sequencing (scRNA-seq) is a recent innovation that allows sequencing of transcriptomes from a vast number of single cells, thus providing an unbiased view of cell-to-cell variability in gene expression within a population of cells. The Tschudi laboratory has previously established an in vitro differentiation system based on the inducible expression of the RNA-binding protein 6 (RBP6) in cultured non-infective procyclics, which recapitulates Trypanosoma brucei developmental stages that have been previously described in tsetse fly vector. Thus, I aimed to utilize scRNA-seq in this system to describe the potential heterogeneity in transcript abundance of known and suspected T. brucei …

Influenza Hospitalizations And Census Tract Ses In Ct 2013-2018, Nicole Elizabeth Torigian

Public Health Theses

Background: Influenza hospitalizations are a costly outcome of influenza infection. Socioeconomic status (SES) is not typically collected through routine public health surveillance methods, but understanding SES allows for targeted interventions.

Methods: Surveillance data from the CT Emerging Infections Program’s US Influenza Hospitalization Surveillance Network (FluSurv-Net) component was used to identify cases of laboratory confirmed influenza-associated hospitalizations in the 5 influenza seasons from 2013-2018. Case-patient home addresses were geocoded and linked to census tract level factors from the U.S. Census Bureau. Both census tract level poverty and crowding were broken into 4 categories: low, medium low, medium high, and high. Trends …

Differential Effects Of Medicaid Expansion On Racial/Ethnic Disparities In Primary Care Access, Janet Yim

Public Health Theses

By providing health insurance to low-income and disabled children and adults, the United States’ Medicaid program increases health care access and utilization by those with limited access to affordable private insurance. To increase coverage, the Affordable Care Act (ACA) helped fund state expansions of Medicaid’s eligibility criteria to include low-income adults with incomes up to 138% of the Federal Poverty level. This paper examines the differential effects of Medicaid expansion on racial/ethnic disparities in primary care access using a quasi-experimental differences-in-differences design. Regression analyses consider low income adults (defined as below 138% FPL) ages 19-64. When analyzing both short term …

Evaluation Of The Endocrine Disrupting Potential Of Chemicals Used In Crumb Rubber: A Multi-Factorial Approach, Alexia Sara Akbay

Public Health Theses

Crumb rubber, an infill substance made from repurposed tires, has been examined for its carcinogenic potential but no studies have looked at its endocrine disrupting potential to date. After prioritizing 306 chemical components of crumb rubber using computational models, four endocrine disrupting chemicals (EDCs) thought to possess estrogenic activity were chosen for further in vitro testing. In addition to these chemicals, a crumb rubber concentrated media (CRCM) was created for mixture analysis. Gene expression assays for estrogenic activity were conducted on Ishikawa, HepG2 and MCF-7 immortalized cell lines exposed to 4-tert-octylphenol, dibenz(a,h)anthracene, fluoranthene, chrysene and CRCM. Based on the findings …

Scaling Up Group Prenatal Care: Analysis Of The Current Situation And Recommendations For Future Research And Policy Actions, Allissa Anne Desloge

Public Health Theses

The United States consistently spends more on healthcare than other developed nations, but continues to suffer from inferior outcomes in maternal and infant morbidity and mortality. Innovation is needed within maternal and child healthcare to address these adverse outcomes. One identified innovative approach to tackle these issues is group prenatal care (GPNC). Women who participate in GPNC experience individual clinical care checks to monitor weight, blood pressure, and gestational age in addition to interactive learning and community-building activities and discussions. When compared to those who receive individual prenatal care, GPNC recipients have lower rates of preterm birth, fewer small for …

Yale School Of Medicine Facts & Figures 2019-2020, 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.

Fannie Mae And Freddie Mac, Rosalind Z. Wiggins

Resource Guides

No abstract provided.

Assessing Risk Factors For Sudden Infant Death Syndrome And Caregivers’ Perceptions Of The Cardboard Box For Infant Sleep, Nisha Dalvie

Yale Medicine Thesis Digital Library

Some US hospitals are giving out cardboard boxes as a way to address behaviors associated with Sudden Infant Death Syndrome (SIDS). Our goal was to evaluate the cardboard box for this purpose by quantifying current practices and qualitatively assessing caregivers’ perceptions of the cardboard box. Study participants were English or Spanish-speaking caregivers of 2-16 week old infants presenting to primary care clinics in New Haven, CT. Caregivers completed a survey asking about demographic data and SIDS risk factors, such as non-supine positioning and bed-sharing. Some caregivers also participated in a semi-structured interview about the cardboard box, created used a grounded …

Inhibition Of The Akt1-Mtorc1 Axis Alters Venous Remodeling To Improve Arteriovenous Fistula Patency, Arash Fereydooni

Yale Medicine Thesis Digital Library

Arteriovenous fistulae (AVF) are the most common access created for hemodialysis, but up to 60% do not sustain dialysis within a year, suggesting a need to improve AVF maturation and patency. In a mouse AVF model, Akt1 regulates fistula wall thickness and diameter. We hypothesized that inhibition of the Akt1-mTORC1 axis alters venous remodeling to improve AVF patency. Daily intraperitoneal injections of rapamycin reduced AVF wall thickness with no change in diameter. Rapamycin decreased smooth muscle cell (SMC) and macrophage proliferation; rapamycin also reduced both M1 and M2 type macrophages. AVF in mice treated with rapamycin had reduced Akt1 and …

Searching For Phenotypes Of Sepsis: An Application Of Machine Learning To Electronic Health Records, Michael Jarvis Boyle

Yale Medicine Thesis Digital Library

SEARCHING FOR PHENOTYPES OF SEPSIS: AN APPLICATION OF MACHINE LEARNING TO ELECTRONIC HEALTH RECORDS. Michael J. Boyle (Sponsored by R. Andrew Taylor). Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.

Sepsis has historically been categorized into discrete subsets based on expert consensus-driven definitions, but there is evidence to suggest it would be better described as a continuum. The goal of this study was to perform an exhaustive search for distinct phenotypes of sepsis using various unsupervised machine learning techniques applied to the electronic health record (EHR) data of 41,843 Yale New Haven Health System emergency department …

The Care Of The Sexual Assault Patient, Eun Sook Choi

Yale Medicine Thesis Digital Library

Survivors of sexual assault (SA) experience a range of physical and mental health consequences. Despite universal agreement that follow-up care improves outcomes, studies demonstrate only one-third of survivors receive assault related follow-up care. This study aims to describe the patient population presenting after SA, characteristics of their acute care, and rates of follow-up within one-year at two sites of the Yale New Haven Hospital, which includes an urban tertiary care hospital (York Street Campus, YSC), and its satellite community hospital (St Raphael Campus, SRC). A retrospective medical record review was conducted of patients older than 12 years presenting after sexual …

Social Integration And The Mental Health Needs Of Lgbtq Asylum Seekers In North America, Samara Danielle Fox

Yale Medicine Thesis Digital Library

This study examined the mental health burden of LGBTQ asylum seekers and associated psychosocial risk factors with a focus on barriers to social integration. This study also characterized LGBTQ asylum seekers’ interest in interventions aimed at alleviating mental distress and social isolation. Respondents (n = 308) completed an online survey which included the Refugee Health Screener (RHS-15), the NIH loneliness scale, and an adapted scale of sexual identity disclosure. Most respondents (80.20%) screened positive for mental distress. Loneliness (OR = 1.14, 95% CI = 1.09, 1.19) and LGBTQ identity disclosure (OR = 3.46, 95% CI = 1.01, 12.02) were associated …

Localized Hippocampal Glutamine Synthetase Knockout: A Novel Model Of Mesial Temporal Lobe Epilepsy, Maxwell Gerard Farina

Yale Medicine Thesis Digital Library

The purpose of this study was to create and optimize a model of mesial temporal lobe epilepsy through selective depletion of glutamine synthetase (GS) in the mouse hippocampus. Following validation of the model, preliminary studies attempted to characterize morphological astrocytic and synaptic changes that result from GS deficiency. Aim 1 established a novel mouse model of GS knockout in hippocampal astrocytes. Aim 2 tested whether localized hippocampal knockout of GS causes mice to exhibit an epilepsy-like phenotype. Aim 3 characterized the cellular effects of localized GS loss. To generate the knockout, Glul-floxed C57BL/6J mice were injected with four different adeno-associated …

Demographics, Mechanism Of Injury, Injury Severity, And Associated Injury Profiles Of Patients With Femoral And Tibial Shaft Fractures: A Study Of The National Trauma Databank, Nidharshan Anandasivam

Yale Medicine Thesis Digital Library

Introduction:

Traumatic injuries, such as fractures, are known for having defined associated

injury patterns. These can alter management and affect outcome if not promptly

recognized and managed. There are limited large-scale studies of demographics,

mechanism of injury, and injuries associated with femoral and tibial shaft fractures.

Objectives:

1. To determine the demographics, mechanism of injury, injury severity score, and

associated injuries in those with femoral and tibial shaft fractures in a large

national sample.

2. To determine the relationship between associated injuries and in-hospital

mortality.

Methods:

In two separate studies, patients in the 2011 and 2012 National Trauma Data Bank …

A Genomic Approach To Idiopathic Liver Disease In Adults, Aaron Hakim

Yale Medicine Thesis Digital Library

Adult patients suffering from liver disease of unknown cause represent an understudied and underserved population. Over the past 15 years, next-generation sequencing technologies have matured into an inexpensive, effective, and widely available set of tools to do genomic analysis. One of these technologies, whole-exome sequencing (WES), allows for high throughput sequencing of all of the genome’s protein coding regions (exons). In pediatric cohorts, WES combined with deep clinical phenotyping has been shown to be an effective and unbiased method of identifying rare protein-altering coding variants in individual genes. WES has also contributed to the diagnosis and individualization of medical care …

The Reproductive Health Needs Of Women At Risk Of Hiv Infection In Connecticut, Emily Hoff

Yale Medicine Thesis Digital Library

Background: The number of women involved in criminal justice systems (WICJ) and women who use opioids has been dramatically increasing in the United States. An often-overlooked aspect of healthcare for women at risk of HIV infection (either WICJ or women who use drugs) is reproductive health. We aim to provide a framework, informed by a systematic review and primary data, to guide future interventions addressing the sexual and reproductive health (SRH) needs of women at risk of HIV infection.

Methods: We completed a systematic literature review of the pregnancy prevention and planning needs of US WICJ published in English from …

The Worsening Trajectory Of Social Impairment In Preterm Born Young Adults And Its Association With Altered Amygdalar Functional Connectivity, Christina Johns

Yale Medicine Thesis Digital Library

Survivors of preterm birth experience long-lasting behavioral problems characterized by increased risk of depression, anxiety, and impaired social functioning. The amygdala is a key region for social functioning, and alterations in amygdalar structure and connectivity are thought to underlie social functioning deficits in many disorders, including preterm birth. However, the trajectory of social impairments in PT and their association with functional connectivity of the amygdala are not well-studied in former preterm born individuals (PTs).

It was hypothesized that PTs would show impaired social functioning compared to term controls beginning in early childhood and continuing to young adulthood. It was also …

Career Interests And Mentorship Experiences Of International And Minority Medical Students In Us Medical Schools, Lovemore Simbarashe Kuzomunhu

Yale Medicine Thesis Digital Library

Background: International medical students (IMS) represent a group of students with unique issues that have largely been ignored in the medical literature. This invisibility is because international students make up a very small percentage of the total number of students matriculating into medical school in the US and because most international students are grouped together with domestic underrepresented minority (URM) students and hence are treated as if they were domestic minority students.

Aim: We aim to determine what are the career interests of international and domestic underrepresented minority medical students and what factors influence their choices. We also aim to …

Csf Lymphocyte And Monocyte Activation And Trafficking In Primary Hiv Infection, Aveline Xiang Li

Yale Medicine Thesis Digital Library

Trafficking of immune cells to the central nervous system (CNS) is hypothesized to facilitate HIV entry and immune-induced neuronal injury, and is mediated by cell surface proteins such as chemokine receptors and integrins. We longitudinally assessed immune cell activation and surface marker expression in cerebrospinal fluid (CSF) and blood and their relationship with CSF HIV RNA during primary HIV infection (PHI) before and after combination antiretroviral therapy (ART). Longitudinal paired blood and CSF were obtained in initially ART-naïve PHI (infection) participants; some subjects independently initiated ART during follow up. Multiparameter flow cytometry was used to determine activation (% CD38+HLADR+) and …