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Lagrangian Dispersion Characteristics In The Western Mediterranean, Maher Bouzaiene, Milena Menna, Pierre-Marie Poulain, Dalila Elhmaidi

Journal of Marine Research

Dispersion characteristics in the Western Mediterranean are analyzed using data from Coastal Ocean Dynamics Experiment (CODE) and Surface Velocity Program (SVP) surface drifters deployed in the period 1986–2017. Results are presented in terms of absolute dispersion A² (mean-squared displacement of drifter individuals) and of relative dispersion (D²; mean square separation distance of drifter pairs). Moreover, the dispersion characteristics are estimated for different initial separation distances (D₀) between particles: smaller, larger, or comparable with the internal Rossby radius of deformation. Results show the presence of a quasiballistic regime for absolute dispersion at small time scales and …

Evidence Supporting Fda Approval And Cms National Coverage Determinations For Novel Medical Products, 2005 Through 2016: A Cross-Sectional Study, Aliya Cecilia Roginiel

Yale Medicine Thesis Digital Library

EVIDENCE SUPPORTING FDA APPROVAL AND CMS NATIONAL COVERAGE DETERMINATIONS FOR NOVEL MEDICAL PRODUCTS, 2005 THROUGH 2016: A CROSS-SECTIONAL STUDY

Aliya C. Roginiel, Sanket S. Dhruva, Joseph S. Ross

Department of Internal Medicine, Yale University School of Medicine, New Haven, CT

Abstract:

Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) rely on evidence from clinical trials when approving a therapeutic for marketing and insurance coverage in the US, respectively. No study has compared the quality and quantity of evidence examined by these agencies. Our purpose was to characterize evidence used by FDA and CMS to support …

Yale School Of Medicine Facts & Figures 2018-2019, 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.

Sareb Annual Activity Report 2018, Sareb

Documents

No abstract provided.

Mechanisms Of Decreased Brainstem Arousal In Limbic Seizures: In Vivo Whole-Cell Recordings, John Paul Andrews

Yale Medicine Thesis Digital Library

Seizures are commonly regarded as disorders of neuronal hyperactivity, but evidence shows that temporal lobe seizures also cause reduced activity in subcortical arousal nuclei, including cholinergic neurons in the pedunculopontine tegmental nucleus (PPT), a key node of the reticular activating system. The synaptic mechanisms underlying the reduced ictal activity of cholinergic neurons in the PPT are unknown. Whole-cell in vivo recordings were made from PPT neurons in head-fixed rats to distinguish active inhibition from withdrawal of excitatory input as the driver of reduced ictal neuronal firing. A subset of PPT neurons exhibited reduced firing and hyperpolarization during seizures and stained …

Medicine@Yale February/March 2018 Volume 14, 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.

Medicine@Yale June/July 2018 Volume 14, Issue 2, 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.

The Changing Fate Of Thailand's Elephants, But A Future Worth Fighting For: The Interplay Of Culture And Ecology For Conservation, Madeline Zimmerman

Library Map Prize

No abstract provided.

The Paradox Of Competition: Power, Markets, And Money - Who Gets What, When, How?, Martin Shubik

Cowles Foundation Discussion Papers

Money is a mystery and financial institutions are often regarded as guardians and promoters of the mystery. These sketches are designed to help any reader interested in, but not technically trained in economics, understand markets, money, credit and the evolution of a mass market system set in the rich context of its political environment and society. We all want a good society. What is a good society is given by our joint vision, mutual respect and social concern but the implementation of the vision calls for the use and understanding of money, markets and finance. The efficient functioning of a …

Who Gets What, When, How? Power, Organization, Markets, Money And The Allocation Of Resources, Martin Shubik

Cowles Foundation Discussion Papers

Money is a mystery and financial institutions are often regarded as guardians and promoters of the mystery. These sketches are designed to help an individual interested in, but not technically trained in economics, understand markets, money, credit and the evolution of a mass market system embedded in the rich context of its political environment and society. The efficient functioning of a dynamic economy requires the presence of money and financial institutions. The great variety of financial institutions in any advanced economy requires that a synthetic approach is used to understand what the whole looks like. Verbal description provides an overarching …

Regulating Mismeasured Pollution: Implications Of Firm Heterogeneity For Environmental Policy, Eva Lyubich, Joseph S. Shapiro, Reed Walker

Cowles Foundation Discussion Papers

This paper provides the first estimates of within-industry heterogeneity in energy and CO2 productivity for the entire U.S. manufacturing sector. We measure energy and CO2 productivity as output per dollar energy input or per ton CO2 emitted. Three findings emerge. First, within narrowly de ned industries, heterogeneity in energy and CO2 productivity across plants is enormous. Second, heterogeneity in energy and CO2 productivity exceeds heterogeneity in most other productivity measures, like labor or total factor productivity. Third, heterogeneity in energy and CO2 productivity has important implications for environmental policies targeting industries rather than plants, including technology standards and carbon border …

Regulating Mismeasured Pollution: Implications Of Firm Heterogeneity For Environmental Policy, Eva Lyubich, Joseph S. Shapiro, Reed Walker

Cowles Foundation Discussion Papers

This paper provides the first estimates of within-industry heterogeneity in energy and CO2 productivity for the entire U.S. manufacturing sector. We measure energy and CO2 productivity as output per dollar energy input or per ton CO2 emitted. Three findings emerge. First, within narrowly defined industries, heterogeneity in energy and CO2 productivity across plants is enormous. Second, heterogeneity in energy and CO2 productivity exceeds heterogeneity in most other productivity measures, like labor or total factor productivity. Third, heterogeneity in energy and CO2 productivity has important implications for environmental policies targeting industries rather than plants, including technology standards and carbon border adjustments.

Resolution Fund Annual Report, Hungary: Szanálási Alap

Documents

No abstract provided.

Annual Report 2017, Dexia Group N.V./S.A.

Documents

No abstract provided.

Kärntner Ausgleichszahlungs-Fonds Gebarungsbericht 2017, Carinthian Compensation Payment Fund

Documents

No abstract provided.

Bulletin Of Yale University School Of Nursing 2018-2019, Yale School Of Nursing

Yale School of Nursing Bulletins and Catalogues

Series 114, Number 15

September 5, 2018

Precision Medicine In Atrial Fibrillation: A Risk Model For Management With Dabigatran V. Warfarin, Jeremy Ader

Yale Medicine Thesis Digital Library

The Precision Medicine Initiative aims to advance Medicine from “one-size-fits-all” treatments to more individualized approaches. Clinical trials evaluate treatments by analyzing average outcomes, and thus risk overlooking potential differences in treatment effect among different subsets of the study population. The use of multivariate models has been proposed as a way to identify heterogeneity of treatment effect and to determine patients’ individualized treatment risks and benefits.

We analyzed the Randomized Evaluation of Long-Term Anticoagulation Therapy (RELY) trial of dabigatran versus warfarin in patients with atrial fibrillation, to determine if the application of multivariate predictive models could demonstrate heterogeneity of treatment effect …

"I Viewed Them Sick": Photography And Addiction Medicine As Activism During The "Speed Freak" Crisis Of The Long 1960s, Hannah Zornow Alter

Yale Medicine Thesis Digital Library

“Speed freak” was a pejorative term that emerged in the late 1960s to describe young people who binged on amphetamines, often by injection. The accessibility of amphetamines during the 1960s and early 1970s coupled with the emergence of a radical youth movement produced this distinctive subculture. This thesis will address responses to this drug crisis in two parts, from the perspective of two activists working in very different fields. In 1971, Larry Clark, a photographer, and David Smith, a physician, each published their seminal works on “speed freak” culture. Separated by half a country, they had enmeshed themselves in communities …

Measuring The Burden Of Childhood Cancer Treatment: Decrements In Bone Health And Financial Toxicity, Hadley Bloomhardt

Yale Medicine Thesis Digital Library

With research and clinical advances over the past several decades, survival rates for childhood cancer have improved to greater than 80%. However, the path to survivorship poses a substantial burden to patients and families, with lengthy treatment courses requiring frequent hospital visits, and with late complications of treatment that can present years after therapy ends. This thesis explores each of these areas: one study investigating bone health and morbidity in leukemia and lymphoma survivors, and another study examining the cost burden to families of children during treatment for average-risk acute lymphoblastic leukemia (ALL). We aimed to determine the utility of …

Synergy Of Bcl2 And Histone Deacetylase Inhibition Against Leukemic Cells From Cutaneous T-Cell Lymphoma Patients, Benoit Cyrenne

Yale Medicine Thesis Digital Library

The presence and degree of peripheral blood involvement in patients with cutaneous T-cell lymphoma (CTCL) portend a worse clinical outcome. Available systemic therapies for CTCL may variably decrease tumor burden and improve quality of life, but offer limited effects on survival; thus, novel approaches to the treatment of advanced stages of this non-Hodgkin lymphoma are clearly warranted. Mutational analyses of CTCL patient peripheral blood malignant cell samples suggested the anti-apoptotic mediator BCL2 as a potential therapeutic target. To test this, we developed a screening assay for evaluating the sensitivity of CTCL cells to targeted molecular agents, and compared a novel …

A Novel Staining Method For Detecting Bloodborne Bacteria After Their Dielectrophoretic Isolation, John Gaudet

Yale Medicine Thesis Digital Library

Current methods to diagnose bacteremia typically require 18 to 36 hours to detect positive samples and five days to identify negative ones. This delay stems in part from the incubation time necessary for bacteria to multiply and achieve detectable concentrations. In recent years, microfluidic chips have been developed that isolate and concentrate bacteria from the blood on a time scale of minutes to hours (1). This research seeks to stain and visualize these bacteria after their microfluidic processing thereby significantly shortening the time required to diagnose bacteremia.

The traditional Gram stain is not sufficiently sensitive to detect bacteria in this …

Point-Of-Care Echocardiography And Electrocardiography In Assessing Suspected Pulmonary Embolism, John Grotberg

Yale Medicine Thesis Digital Library

POINT-OF-CARE ECHOCARDIOGRAPHY AND ELECTROCARDIOGRAPHY IN ASSESSING SUSPECTED PULMONARY EMBLOSIM.

John Grotberg, James Daley, Richard A. Taylor, Chris L. Moore. Section of Ultrasound, Department of Emergency Medicine, Yale University, School of Medicine, New Haven, CT.

Daniels and TwiST electrocardiogram (ECG) scores have been proposed to detect right heart strain (RHS). Tricuspid Annular Plane Systolic Excursion (TAPSE) is a reliable indicator of RHS in patients with acute pulmonary embolism (PE). I aimed to investigate the relationship between these ECG scores, TAPSE, and the level of care required for patients with acute PE. This was a prospective observational study of 110 patients undergoing …

Implementation Of New Definitions Of Labor Arrest Disorders And Failed Induction Can Decrease The Cesarean Rate, Jessica Tanzer Wright Greenberg

Yale Medicine Thesis Digital Library

Cesarean delivery for labor arrest currently makes up the largest proportion of

primary cesarean delivery in the United States. Because cesarean delivery is associated

with significant morbidity, it is important to limit its use to ensure the benefits outweigh

the risks. New diagnostic criteria to limit the diagnosis of labor arrest have the potential

to decrease the cesarean delivery rate. To investigate how cesarean delivery for arrest of

dilation or descent and failed induction contributed to the primary cesarean delivery rate,

we analyzed rates of primary cesarean for these indications among 17,864 live births at

our institution from 2010 through …

Arterial And Venous Impacts Of Transdermally Administered Vasodilators On The Local Microvasculature, George Guo

Yale Medicine Thesis Digital Library

Microcirculatory function is an important component of cardiovascular pharmacology as related to cardiovascular dysfunction. We used photoplethysmography (PPG) to compare the microcirculatory effects of transdermal patches of rivastigmine (Exelon, Novartis), nicotine, nitroglycerin (NTG) and topically applied EMLA (eutectic mixture of lidocaine/prilocaine). We anticipate that this initial pilot comparison of single doses of each medication will catalyze future multi-dose comparisons of the various vasodilatory features of these and other drugs.

Methods: With IRB approval, 10 healthy volunteers were monitored with PPG at the time each transdermal patch was applied and every 8 minutes afterwards for a total of 40 minutes. 1x1 …

Adherence To Prospective Registration Policy And Implications For Clinical Trial Endpoint Integrity, Anand Gopal

Yale Medicine Thesis Digital Library

Since implementation of the International Committee of Medical Journal Editors’ (ICMJE) prospective registration policy in 2005, trial registration has increased significantly. Registering clinical trials is critical in promoting transparency and integrity in medical research, however trials must be registered in an appropriate manner to deter unaccounted protocol modifications or selection of alternate endpoints that may enhance favorability of reported results. This thesis provides relevant background on clinical trial registration and appropriate reporting in addition to evaluating adherence with the ICMJE’s prospective trial registration policy and the implications of inappropriate adherence for the integrity of reported results. In a cross-sectional, retrospective …

Evaluation Of Pulse Oximetry As A Screen For Critical Congenital Heart Disease In Newborns, Rachel Erin Klausner

Yale Medicine Thesis Digital Library

Evaluation of Pulse Oximetry as a Screen for Critical Congenital Heart Disease in Newborns. Rachel E. Klausner, Eugene D. Shapiro, Robert W. Elder, Eve Colson and Jaspreet Loyal. Department of Pediatrics, Yale University, School of Medicine, New Haven, CT.

The objective of this study was to report the results of and identify problems with a screening program using differential pulse oximetry (POx) to detect critical congenital heart disease (CCHD) in newborns. Charts of all infants born at four Yale New Haven Health hospitals in Connecticut between January 1 and December 31, 2014 were reviewed. Of 10,589 newborns, 171 (1.6%) underwent …

Parental Perspectives On Myopia In An Urban Chinese Population, Wendy Li

Yale Medicine Thesis Digital Library

In this study, we aimed to understand how Chinese parents view myopia, including causes, progression, and treatment. We performed a cross-sectional study from July 2016 to August 2016 at Peking University 3rd Hospital in Beijing, China. Parents of myopic children completed a questionnaire including sociodemographics and Likert-style questions assessing perspectives on myopia. We employed logistic regression models to analyze relationships between responses and demographic data/degree of myopia. 109 parents completed the survey. Of these, 97 responses were included in the analysis. Almost all parents surveyed (97.9%) found their child’s myopia concerning and believe myopia is dangerous to their child’s vision. …

Simulation-Based Nurse Mentoring To Promote Preeclampsia Care: What Is The Impact In Bihar, India?, Julia Haven Raney

Yale Medicine Thesis Digital Library

Background:

Inadequately treated, severe preeclampsia and eclampsia (PE/E) may rapidly lead to severe complications in both mothers and neonates and are estimated to cause 60,000 maternal deaths globally each year. Simulation-based training where health providers review basic emergency obstetric and newborn care through highly realistic cases have demonstrated promising results in low- and middle-income countries (LMIC). Two international simulation training programs, Helping Mothers Survive and PRONTO International, have demonstrated improved overall use of evidence-based practices (EBPs) in active management of third stage of labor and hemorrhage management, though individual skills varied. However, the impact of simulation training on use of …

Optimal Counseling And The Utility Of Imaging Parameters In Patients With Idiopathic Normal Pressure Hydrocephalus, Harry Eswar Subramanian

Yale Medicine Thesis Digital Library

It is very difficult to counsel patients who are suspected to have idiopathic normal pressure hydrocephalus (iNPH) due to the variability in diagnostic criteria and clinical presentations, as well as the difficulty in evaluating prognosis. This two part study was conducted in order to identify ways to improve the counseling of patients with iNPH. A qualitative analysis of patient experience with iNPH and shunting was initially performed. This was followed by an imaging analysis to identify predictors of outcome after shunt surgery.

A cohort of patients with iNPH who were shunted at a single institution were identified retrospectively and interviewed …

Disparities In Socioeconomic Context And Response To Antihypertensive Medication In The Antihypertensive And Lipid-Lowering Treatment To Prevent Heart Attack Trial (Allhat), Andi Shahu

Yale Medicine Thesis Digital Library

Where one lives affects one’s blood pressure. Observational studies demonstrate

that living in communities of low socioeconomic status is associated with higher blood

pressure and worse cardiovascular outcomes. In understanding the reasons for these

disparities, a key question is whether evidence-based antihypertensive medication therapy

is less effective in lowering blood pressure and improving cardiovascular outcomes in

lower socioeconomic communities. If so, then anti-hypertensive therapies derived from

randomized clinical trials (RCTs) may be suboptimal in achieving expected outcomes.

Despite standardized protocols and balancing of demographic and clinical characteristics

between study arms of RCTs, the socioeconomic environment in which people live is …