Digital Commons Network^™

Characterizing The Genetic Diversity Of Pfrh5 In Plasmodium Falciparum Clinical Isolates From Burkina Faso, Ghana, And Tanzania: A Next-Generation Sequencing Study To Inform Blood-Stage Malaria Vaccine Development, Manuel Emilio Perez

Public Health Theses

The development of a highly effective malaria vaccine is of global health priority, given the persistently high malaria burden in Sub-Saharan Africa (SSA) and growing resistance to antimalarial treatment and vector control measures. P. falciparum reticulocyte-binding protein homolog 5 (PfRH5) has emerged as a leading target among blood-stage malaria vaccine candidates due to its essential role in erythrocyte invasion and initial documentation of limited polymorphisms. However, recent studies have revealed greater PfRH5 genetic diversity than previously believed, raising concerns about potential parasite evasion of vaccine-induced immunity. This study utilized deep targeted amplicon next-generation sequencing to characterize PfRH5 genetic variation in …

From Success To Setbacks: A Case Study Of The Sex Wrap And The Impact Of Instagram's Evolving Policies On Sexual Health Education, Megan Piller

Public Health Theses

Due to the inconsistent and noncomprehensive nature of sexual health education across the United States, many adolescents and emerging adults are turning to digital platforms, specifically social media, for necessary information. The Sex Wrap (TSW), a podcast and Instagram-focused intervention, was established to fill critical knowledge gaps among these populations and empower them in their sexual decision-making. To serve as a case study, engagement metrics from TSW’s Instagram account between October 2020 and September 2021 were analyzed to determine which post types, tones, and thematic categories resonated most with users across the platform. However, Instagram, once a highly effective tool …

Global Comparison Of Children’S Exposomes, Inumidun Oyebode

Public Health Theses

Environmental influences impact health, often with enhanced susceptibility for theyoung. Understanding the sources of these environmental factors is critical for mitigating exposures. Globally, children are exposed to many sources that differ by policy, urbanization, and socioeconomic conditions. Specifically, urbanization creates variation in exposure sources that differ in rural (refuse combustion, cooking biomass combustion, indoor residual spray) and urban areas (vehicle combustion, industrial activity). Differences in policy further shape these exposure patterns by regulating pollution sources, chemical use, and environmental protections across countries. This thesis evaluated environmental exposures of children living in United States, South Africa, and Singapore contributing to a …

New Horizons In Hepatitis B Therapy: Antigen Reduction And Immune Modulation Approaches, Yiyun Pan

Public Health Theses

Chronic hepatitis B (CHB) remains a significant global health burden despite advances in antiviral therapy. Current treatments, including nucleoside analogs (NAs) and pegylated interferon (Peg-IFN), effectively suppress viral replication but rarely achieve functional cure, defined as sustained hepatitis B surface antigen (HBsAg) loss. Emerging therapeutic strategies focus on antigen reduction and immune modulation to overcome the limitations of existing therapies.

Antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs) offer promising approaches by directly targeting viral RNA to reduce HBsAg levels. Clinical trials of ASOs such as bepirovirsen and siRNAs such as JNJ-3989 and VIR-2218 have shown substantial HBsAg declines, but …

Liver Epigenetic Changes In Mice Exposed To 1,4-Dioxane In The Drinking Water: Implications For 1,4-Dioxane Liver Carcinogenicity, Shuya Qiao

Public Health Theses

1,4-Dioxane, a probable human carcinogen and widespread environmental contaminant, has been consistently associated with liver tumor development in rodents. However, limited research has addressed its role in epigenetic dysregulation. This study investigated epigenetic alterations in liver tissue following chronic exposure to 1,4-dioxane. Male mice of wild-type (WT) and glutamate-cysteine ligase modifier subunit knockout (Gclm-KO) genotypes were exposed to 0, 50, or 500 ppm of 1,4-dioxane in drinking water for six months. qPCR, Western blotting, and immunohistochemistry (IHC) were used to assess changes in DNA methylation-related enzyme gene expression, histone acetylation, and SAM (S-adenosylmethionine) distribution. qPCR results showed significant downregulation of …

Effectiveness Of Wolbachia Introgression On Dengue Incidence In A Complex Urban Environment, Karthika Satyanarayanan

Public Health Theses

Dengue is an arboviral disease of increasing global public health importance for which more than half the world’s population is at risk. The burden of dengue has increased greatly in the last decade; in 2024, over 14 million cases and 10,000 dengue-related deaths were reported, marking a historical milestone. The endosymbiotic bacterium Wolbachia (wMel strain) offers a promising alternative to traditional control methods through its reduction of Aedes aegypti vector competence and introgression into wild Ae. aegypti populations. This thesis evaluated the dynamics of Wolbachia introgression and its effect on reducing dengue incidence up to 31 months after the completion …

Quantifying Ambient And Occupational Pollutant Exposure In Urban Street Vendors: Evidence To Inform Electrification Transitions In New York City, Bryn Redal

Public Health Theses

Food cart vendors in New York City face significant environmental health risks from exposure to extreme heat and air pollution, compounded by their reliance on fossil fuel-powered generators. Despite growing interest in electrification as a cleaner alternative, limited research has explored vendors' experiences with generator use, health concerns, and attitudes toward electrification. This study, conducted in collaboration with the Yale School of Public Health and the New York City Mayor’s Office of Climate & Environmental Justice (MOCEJ), used a mixed-methods approach to assess vendor conditions and perspectives. Data were collected from 31 vendors across four NYC locations through structured interviews …

Assessing Environmental And Sociodemographic Risk Factors For Leptospira Infection In A Urban Informal Settlements: A Study In Salvador, Brazil, Sebastian Alonso Salazar

Public Health Theses

Background: Leptospirosis is a neglected zoonotic disease that disproportionately affects people living in areas with poor sanitation, water contamination and rodent infestation such as urban informal settlements. More than one billion people worldwide reside in such communities, and with increasing urbanization, coupled with environmental change, the risk of Leptospira transmission continues to increase. Despite its global burden, this disease is often underreported due to diagnostic challenges and limited healthcare access, particularly in urban informal settlements. Understanding the incidence and risk factors in these settings is essential for improving public health interventions. This study aims to estimate the annual incidence of …

The Impact Of California’S Behavioral Health Services Act (Bhsa) On The Need And Utilization Of Behavioral Health Services In California Counties, Lucia Shen

Public Health Theses

This thesis evaluates the impact of California’s Behavioral Health Services Act (BHSA) on behavioral health need and service utilization across 44 California counties from 2001 to 2023. Using data from the California Health Interview Survey and Department of Health Care Services expenditure reports, this study employs time-series visualizations and Ordinary Least Squares panel regressions to assess whether BHSA investments are associated with reduced behavioral health need and increased service use. Statewide trends show that while behavioral health needs rose steadily, utilization increased moremodestly, resulting in a persistent access gap. Some counties, such as Nevada, Monterey, and Mendocino, exhibited temporary convergence …

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 …

A Pilot Rct Of Mhealth & Chw Intervention For Art Adherence, Shivesh Shourya

Public Health Theses

Despite the availability of antiretroviral therapy (ART), only 66% of people with HIV in the U.S. achieve viral suppression, often due to suboptimal ART adherence. Barriers such as limited access to care and forgetfulness impact adherence, which must be ≥95% to prevent viral rebound. Combining community health worker (CHW) support with mobile health (mHealth) technologies may help address these barriers and improve outcomes. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of the remotely delivered Community Health Worker and mHealth to Improve Viral Suppression (CHAMPS) intervention, which combines the WiseApp, CHW support, and the CleverCap smart pill bottle. …

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 …

Epidemiological Changes In Shiga Toxin-Producing Escherichia Coli (Stec) Pre- And Post-Covid In Connecticut, 2018–2019 And 2023–2024, Brooke Thanh-Hang Tran

Public Health Theses

Background: Shiga toxin-producing Escherichia coli (STEC) causes over 265,000 infections, 3,600 hospitalizations, and 30 deaths annually in the U.S.. While STEC O157 is the most common serotype, the increased use of culture-independent diagnostic tests (CIDT) led to a rise in non-O157 serotypes detected. Nationally, STEC incidence declined during the COVID-19 pandemic but has since surpassed pre-pandemic levels. An analysis was conducted to determine the changes that occurred in STEC infections in Connecticut from pre-pandemic to post-pandemic and to identify differences between culture-confirmed cases and CIDT-only/untyped cases.Methods: A descriptive analysis using STEC surveillance data collected in Connecticut was performed to identify …

Mental Health Stigma As A Barrier To Mental Health Care For Black Youth & Young Adults: A Scoping Review, Sanaa Amaya Walker

Public Health Theses

Mental health stigma presents a significant barrier to mental health care access for Black youth and young adults, contributing to disparities in mental health service utilization in Black communities. This scoping review examines the current literature on mental health stigma as a barrier to care within Black communities, with specific focus on experiences of young Black people aged 25 and under. Review of twelve studies revealed multidimensional stigma manifestations: intrapersonal (characterized by self-reliance tendencies, shame, and secrecy), interpersonal (influenced by peer and caregiver attitudes), and structural manifestations of stigma, and stigma interventions. The findings highlight critical gaps in existing research …

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 …

Implementing A National Electronic Health Record In The United States Using Insights From Similar Nations, Alexandra Webster

Public Health Theses

This thesis explores how the United States can implement a national electronic health record (EHR) system by drawing lessons from three comparison countries (Germany, Italy, and Austria) that have implemented their own national EHRs. A national EHR, distinct from local electronic medical records (EMRs), is a centralized or linked platform that consolidates standardized patient health data across all care settings. While a national EHR offers significant benefits, such as improved patient safety, better clinical decision-making and care coordination, more efficient allocation of care, and expanded capacity for public health research, it also presents challenges related to data security, data quality …

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 …

Probing Non-Perturbative Qcd With Jet Substructure Measurements At Star, Youqi Song

Yale Graduate School of Arts and Sciences Dissertations

In high-energy particle collisions, when incoming quarks and gluons (partons) exchange a large momentum during scattering, the outgoing partons undergo parton showers by primarily radiating off gluons successively. Hadrons are formed when the parton energies are sufficiently low. The collimated sprays of particles created through this process are called jets. Studies of the internal structure of jets, known as jet substructure, can provide insight into Quantum Chromodynamics (QCD), the theory that governs the interaction between partons and their formation into hadrons. In this thesis, I present two sets of measurements of jet substructure observables that are sensitive to the theoretically …

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 …

Investigating Chronic Calcium Leak In The Aging Brain, Elizabeth K. Woo

Yale Graduate School of Arts and Sciences Dissertations

Alzheimer’s disease (AD) is a devastating, progressive neurodegenerative disease, characterized by amyloid plaques and tau tangles, with synapse loss, calcium dysregulation, and accumulation of advanced glycation end products (AGEs). These pathologies develop in a region-specific manner, targeting regions responsible for higher-order integrative processing, such as the prefrontal cortex (PFC) and entorhinal cortex. Calcium signaling, through cAMP-PKA-calcium signaling, is critical to support the persistent firing needed for working memory. However, under various conditions, e.g., aging, inflammation, chronic stress, these circuits lose regulation of cAMP-PKA-calcium signaling, leading to calcium leak from the smooth endoplasmic reticulum (SER) and chronically elevated levels of cytosolic …

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 …

Security And Privacy Of Quantum Computers, Chuanqi Xu

Yale Graduate School of Arts and Sciences Dissertations

Quantum computing promises to revolutionize the way we solve computationally intractable problems by harnessing quantum phenomena such as superposition, interference, and entanglement. Over the past two decades, the field has witnessed a dramatic evolution—from early devices with one or two qubits to modern machines featuring over a thousand qubits, with projections now foretelling error-corrected systems with millions of qubits and capable of executing millions of gates. Moreover, quantum computing is no longer a theoretical or experimental concept. Quantum computers have become widely accessible via cloud-based platforms with companies such as IBM, Amazon, and Microsoft. These services not only democratize access …

A (Great) Many Of Many Constructions, Jim Wood, Squid Tamar-Mattis

Yale Working Papers in Grammatical Diversity

In this paper, we discuss a series of constructions across various English dialects involving the word many, drawing examples from the Dictionary of American Regional English (DARE) and web searches. The constructions include both standard and colloquial forms, including formally singular and plural constructions, as well as those employing a lot of and a great many. We connect these constructions to existing linguistic analyses, particularly those proposed by Kayne (2002, 2006, 2007a,b, 2017).

Another One: On The Syntax Of ‘Alternative One’, Ester Luna

Yale Working Papers in Grammatical Diversity

This paper discusses the use of one as a disjunction marker occurring immediately after a DisjP, such as He was in Tennessee or Kentucky, one. Little research has been published on this construction, which is used predominantly by Southern American English speakers. My project aims to fill this gap in the literature by describing the distribution of one and examining various hypotheses for its syntactic derivation using data from Montgomery (2004) and the Yale Grammatical Diversity Project. Based on my descriptive analysis, I propose to treat this "alternative one" as a proform and matrix clause adjunct.

I compare …

Mapping The ‘Alternative One’ Construction In American English, Guilherme M. C. Pereira

Yale Working Papers in Grammatical Diversity

Alternative one is an understudied construction accepted by speakers of some American English dialects in sentences like (i), where the word one appears immediately after a disjunction.

(i) I need to talk to John or Malcolm, one.
'I need to talk to John or Malcolm, one or the other.'

(Montgomery 2006:152)

In this paper, I present maps of acceptability judgments of this construction in the U.S., using data from a survey administered by the Yale Grammatical Diversity Project in 2020 and 2021. The maps confirm the geographical distribution claimed for alternative one in the Dictionary of American Regional English (Cassidy …