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Clinical Studies Conducted Over The Total Product Life Cycle Of High-Risk Therapeutic Medical Devices Receiving Us Food And Drug Administration Premarket Approval In 2010 And 2011, Vinay Kumar Rathi

Yale Medicine Thesis Digital Library

The US Food and Drug Administration (FDA) approves high-risk medical devices, those that support or sustain human life or present potential unreasonable risk to patients, via the Premarket Approval (PMA) pathway. In recent years, the FDA has begun shifting premarket evidentiary requirements to the postmarket period as part of a broader effort to continually evaluate device safety and effectiveness throughout the total product life cycle. We therefore sought to characterize the clinical evidence generated for high-risk therapeutic devices over the total product life cycle. In October 2014, we identified all clinical studies of high-risk therapeutic devices receiving initial market approval …

Language At Rest: A Longitudinal Study Of Intrinsic Functional Connectivity In Preterm Children, Megan Alysse Rowlands

Yale Medicine Thesis Digital Library

Preterm (PT) children show early cognitive and language deficits and display altered cortical connectivity for language compared to term (T) children. Developmentally, functional connectivity networks become more segregated and integrated through the weakening of short-range and strengthening of long-range connections. The specific aims of this study are: (1) To use residual fMRI data to investigate intrinsic connectivity development from ages 8 to 16 years in PT vs. T controls; and (2) To correlate intrinsic connectivity to cognitive and language scores. Longitudinal intrinsic connectivity distribution (ICD) values were assessed in PT (n = 13) compared to T children (n = 12) …

Mri-Ultrasound Fusion Targeted Biopsy In Men With Prior Negative Prostate Biopsy For Prostate Cancer, Rollin Say

Yale Medicine Thesis Digital Library

A particularly challenging subpopulation of prostate cancer patients are those who present with a persistently elevated PSA and suspicion of prostate cancer despite having had one or more prior negative prostate biopsies. These patients may benefit from the improvements made in prostate imaging through multiparametric MRI (mpMRI) and MRI-guided prostate biopsy techniques. In this study, we evaluate mpMRI and MRI-US fusion biopsy as a means of detecting clinically significant cancer as well as a potential indicator for avoiding repeat biopsies. We performed a retrospective study of 374 men seen between 12/2012 and 06/2015. All patients underwent pre-biopsy mpMRI to identify …

Emergency Medical Services Utilization And Interventions By Paramedics During A Blizzard, Shalom Sokolow

Yale Medicine Thesis Digital Library

EMERGENCY MEDICAL SERVICES UTLIZATION AND INTERVENTIONS BY PARAMEDICS DURING A BLIZZARD.

Shalom Sokolow (Sponsored by Sandy Bogucki). Department of Emergency Medicine, Yale University, School of Medicine, New Haven, CT.

On February 8th, 2013, southern Connecticut was struck by a powerful blizzard. Emergency Medical Services (EMS) crews experienced significantly increased call volume along with increased response and transport times. This study examined which types of EMS calls increased or decreased during the storm and whether paramedics performed more or fewer advanced life support (ALS) interventions.

EMS calls were differentiated by call type and analyzed to determine which types increased or decreased …

Student Perspectives On Interprofessional Education: Implications For Curriculum Development, Jacob Alan Weatherly

Yale Medicine Thesis Digital Library

Background

The Yale Schools of Medicine and Nursing and the Yale Physician Associate (PA) Program are collaborating to implement an interprofessional curriculum. Although healthcare organizations have called for interprofessional education (IPE), such initiatives have been difficult to implement. Per the Kern framework of curriculum development, design and implementation is likely to be more successful if a needs assessment is done as the first step.

Objective

To better understand healthcare professional students’ perspectives about IPE as part of a needs assessment for developing an IPE curriculum.

Methods

Because little is known about stakeholder perceptions of IPE, we used a qualitative, content …

A Comparison Of Superomedial Versus Inferior Pedicle Reduction Mammoplasty Using Three-Dimensional Analysis, Victor Zhang Zhu

Yale Medicine Thesis Digital Library

A COMPARISON OF SUPEROMEDIAL VERSUS INFERIOR PEDICLE REDUCTION MAMMOPLASTY USING THREE-DIMENSIONAL ANALYSIS.

Victor Z. Zhu, Ajul Shah, Rachel Lentz, Tracy Sturrock, Alexander F. Au, Stephanie L. Kwei.

Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT.

Reduction mammoplasty using the inferior pedicle (IP) technique continues to be more commonly performed than the superomedial pedicle (SMP). This study uses three-dimensional (3D) imaging to compare postoperative linear and volumetric changes in SMP and IP breast reductions.

Reduction mammoplasty was performed using either a SMP or IP, with a Wise-pattern skin incision. Patients in each …

Information Design, Bayesian Persuasion And Bayes Correlated Equilibrium, Dirk Bergemann, Stephen Morris

Cowles Foundation Discussion Papers

A set of players have preferences over a set of outcomes. We consider the problem of an “information designer” who can choose an information structure for the players to serve his ends, but has no ability to change the mechanism (or force the players to make particular action choices). We describe a unifying perspective for information design. We consider a simple example of Bayesian persuasion with both an uninformed and informed receiver. We extend information design to many players and relate it to the literature on incomplete information correlated equilibrium.

How Fast Do Equilibrium Payoff Sets Converge In Repeated Games?, Johannes Hörner, Satoru Takahashi

Cowles Foundation Discussion Papers

We provide tight bounds on the rate of convergence of the equilibrium payoff sets for repeated games under both perfect and imperfect public monitoring. The distance between the equilibrium payoff set and its limit vanishes at rate (1 − δ) 1/2 under perfect monitoring, and at rate (1 − δ) 1/4 under imperfect monitoring. For strictly individually rational payoff vectors, these rates improve to 0 (i.e., all strictly individually rational payoff vectors are exactly achieved as equilibrium payoffs for delta high enough) and (1 − δ) 1/2 , respectively.

The Extensive Margin Of Exporting Products: A Firm-Level Analysis, Costas Arkolakis, Sharat Ganapati, Marc-Andreas Muendler

Cowles Foundation Discussion Papers

We examine multi-product exporters and use firm-product-destination data to quantify export entry barriers. Our general-equilibrium model of multi-product firms generalizes earlier models. To match main facts about multi-product exporters, we estimate our model with rich demand and access cost shocks for Brazilian firms. The estimates document that additional products farther from a firm’s core competency incur higher unit costs, but face lower market access costs. We find that these market access costs differ across destinations and evaluate a scenario that standardizes market access between countries. The resulting welfare gains are similar to eliminating all current tariffs.

Creation Of Novel Inducible Cell Line To Study Alveolar Rhabdomyosarcoma, Kaoru Takasaki

Yale Medicine Thesis Digital Library

CREATION OF NOVEL INDUCIBLE CELL LINE TO STUDY ALVEOLAR RHABDOMYOSARCOMA. Kaoru Takasaki, Ranjini K. Sundaram, Ranjit S. Bindra. Departments of Therapeutic Radiology and of Pathology, Yale University, School of Medicine, New Haven, CT.

Rhabdomyosarcoma (RMS) is a group of relatively rare mesenchymal malignancies classically associated with skeletal muscle and most frequently seen in the pediatric population. While chemotherapy, radiation, and surgical resection can confer long-term event-free survival rates of up to 85-95%, the prognosis for alveolar rhabdomyosarcoma (ARMS), particularly those positive for either the t(2;13) PAX3-FOXO1 or t(1;13) PAX7- FOXO1 translocation, is significantly worse. As such, the development of therapies …

Predictors Of Inadequate Follow-Up Of Screening Mammograms In Hispanic/Latinas In The Northeastern United States, Steven Parra

Public Health Theses

Abstract

Background: Breast cancer is the most common cause of cancer death among Hispanic/Latino patients. Similar to non-Hispanic Black women, Hispanic/Latino women are more likely to be diagnosed with later stage breast cancer and experience worse survival rates when compared to non-Hispanic White women. This study was focused on identifying predictors of inadequate follow-up of abnormal screening mammograms in this culturally diverse Hispanic/Latina population.

Methods: We studied 189 subjects with abnormal or inconclusive mammograms identified from a prospective cohort of Hispanic/Latino women (n=1570), aged 40-75, living in Connecticut and followed their cancer screening experience over a 2-4 year period. Using …

“For The Safety Of Our Health”: A Qualitative Analysis Of Pre-Exposure Prophylaxis (Prep) Acceptability Among Female Sex Workers In Malaysia, Shaylen Susalla Foley

Public Health Theses

Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population. Daily oral pre-exposure prophylaxis (PrEP) offers a novel way to prevent HIV transmission in this population. This research aims to inform culturally relevant implementation of PrEP through a qualitative exploration of the factors that determine FSW willingness to use PrEP. In-depth, semi-structured interviews (n=30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach. FSW expressed positive interest in PrEP but preferred it as a supplement to condoms, not a …

Community Mental Health Workers And Capacity Building: A Qualitative Evaluation From Ghana, Jurema Gobena

Public Health Theses

Background: Ghana is among countries facing human resource shortages for mental healthcare. Since 2011, the country has shifted to a community-based model of mental healthcare and has used task-shifting to fill the mental health professional gap.

Methods and Results: A qualitative study was conducted using in-depth interviews with 17 community mental health workers (16 psychology college graduates and 1 community psychiatric nurse) employed through the publically funded health system to explore their experiences in mental health promotion and service delivery on the ground. Several findings characterize the CMHWs experiences: limited mental health literacy, overwhelming stigma, performing duties outside of their …

Annual Report 2015, Dexia Group N.V./S.A.

Documents

No abstract provided.

Resolution And Insolvency Of Banks And Financial Institutions, Michael Schillig

Documents

No abstract provided.

The ‘Precautionary Recapitalization’ Of Banca Monte Dei Paschi Di Siena, Bank Of Italy

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No abstract provided.

2015 Annual Report, Bank Of Mongolia (Mongolbank)

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No abstract provided.

Artist' Studio Archives: Managing Personal Collections & Creative Legacies, Heather Gendron, Eumie Imm Stroukoff, Joan E. Beaudoin, Neal Ambrose-Smith

Library Staff Publications

A guide for artists, their assistants, and others managing and preserving an artist's studio archives.

The Influence Of Varying Cost Formats On Decision, Changchuan Jiang

Public Health Theses

Objectives. The objective of this study was to explore the impact of specific cost formats on individuals’ decision making.

Methods. Mechanical Turk workers completed a choice based conjoint (CBC) analysis survey designed to examine preferences for three second line agents used to treat diabetes: a sulfonylurea, exenatide, and insulin. Diabetes was chosen because the disease is familiar to the general public and people are generally aware of the importance of controlling blood sugar levels. The CBC survey included five attributes: route of administration, efficacy, risk of low blood sugar, frequency of checking blood sugar levels and cost. We developed seven …

Livestock Prevalence Of Brucellosis And Q Fever In Thailand, Soledad Colombe

Public Health Theses

Background

Brucellosis and Q fever may impart high morbidity in humans and economic losses among livestock. Yet, a systematic investigation has not been performed in Thailand, where a significant proportion of the rural population may be vulnerable to these zoonotic diseases.

Objectives

We surveyed the seroprevalence of brucellosis and Q fever in livestock from Thai communities at the border with Cambodia, evaluated risk factors for seropositivity, and performed a risk assessment for potential transmission to farmers.

Methods

We selected herds of beef and dairy cattle and small ruminants (sheep and goats) for Sa Kaeo province in 2015 using a two-stage …

Associations Of Depression With End-Of-Life Cancer Care Intensity, Kathy Cao Doan

Public Health Theses

Background: Depression has adverse effects on health outcomes and the quality of end-of-life care among cancer patients. However, overly aggressive EOL care can result in high costs and may not be consistent with patient preferences or linked to better health. As such, there is rising interest in identifying the associations between depression and care quality for cancer patients. This study investigates whether depression is associated with EOL care intensity among elderly individuals with cancer.

Methods: Utilizing the Surveillance, Epidemiology, and End Results-Medicare linked database, we identified decedents aged 66 years or older either with pre-cancer depression, post-cancer depression, or no …

Associations Between Diet Quality And Adiposity Measures In Us Children And Adolescents Ages 2 To 18 Years, Chasmine Nicole Flax

Public Health Theses

Abstract

Introduction: Childhood obesity is a growing problem in the United States. A good diet quality is essential to the health and well-being of children and adolescents. Little is known about the relationship between diet quality as measured by the 2010 Healthy Eating Index (HEI-2010) and adiposity measures in children and adolescents. The aim of this investigation is to determine if associations between diet quality and adiposity measures exist in United States children and adolescents. This investigation also aims to determine if these potential associations retain significance when accounting for sociodemographic characteristics know to be associated with diet quality.

Methods: …

Time-To-Detection Of M. Tuberculosis As A Predictor Of Infectivity, Lea Elizabeth Ghee Hamner

Public Health Theses

INTRODUCTION: Tuberculosis (TB) transmission continues to be problematic in the United States. Contact investigations are essential for identifying new infections and must prioritize limited resources by pursuing more infectious cases. Current infectivity measures like sputum smear grade, chest x-rays, and nucleic acid amplification tests (NAAT) are sub-optimal. Time-to-detection (TTD) of Mycobacterium tuberculosis in liquid culture has shown promising results.

OBJECTIVES: Our objective is to examine the relationship between TTD and TB transmission.

METHODS: This study examined a retrospective cohort of pulmonary TB cases with TTD data from 2009-2014 from the King County Laboratory, Seattle, WA. The primary outcome was transmission …

The Icelandic Financial Crisis: A Study Into The World's Smallest Currency Area And Its Recovery From Total Banking Collapse, Sgeir Jónsson, Hersir Sigurgeirsson

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No abstract provided.

The Demise Of Overend Gurney, Rhiannon Sowerbutts, Marco Schneebalg, Florence Hubert

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No abstract provided.

China Financial Stability Report 2016, People's Bank Of China: Shanghai Office: Financial Stability Analysis Group, People's Bank Of China: Steering Group

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No abstract provided.

Chrysler Bailout Tracker, Pro Publica

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No abstract provided.

Corporate Code, Section 221, Last Amended By Federal Law Gazette I No. 43/2016, Republic Of Austria

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No abstract provided.

Ecb Unconventional Monetary Policy: Market Impact And International Spillovers, Marcel Fratzscher, Marco Lo Duca, Roland Straub

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IMF research paper evaluating the effect of TROs on asset prices

Interbank Networks In The National Banking Era: Their Purpose And Their Role In The Panic Of 1893, Charles W. Calomiris, Mark Carlson

Documents

No abstract provided.