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Assessing The Causes Of Preterm Births And The Effectiveness Of Interventions For Reducing Preterm Birth Rates, Creagan Mee

Renée Crown University Honors Thesis Projects - All

No abstract provided.

Behavioral Outcomes In Patients With Metopic Craniosynostosis: Relationship With Radiographic Severity, Mariana Almeida

Yale Medicine Thesis Digital Library

Children with metopic nonsyndromic craniosynostosis have been found to have more neurocognitive and behavioral difficulties, when compared to other types of nonsyndromic craniosynostosis. These neurocognitive and behavioral difficulties can be apparent later in life even following surgical correction of the cranial dysmorphology at infancy. The factors that may be contributing to these difficulties have not been fully elucidated. In metopic craniosynostosis, radiographic severity can be measured using computed tomography imaging. Pre-operative radiographic severity has been demonstrated to be associated with worse reading abilities at school age. However, these studies have had limited sample sizes. Furthermore, the impact of radiographic severity …

Predictors Of Adverse Outcomes Following Surgical Intervention For Cervical Spondylotic Myelopathy, Samuel Craft

Yale Medicine Thesis Digital Library

As hospital costs associated with spine surgeries continue to climb, length of stay(LOS) and discharge disposition have been utilized as proxies through which these increasing costs can be assessed. Cervical spondylotic myelopathy (CSM) is the most common spinal pathology among older adults. As a result, studies assessing drivers of increased costs, LOS, and discharge disposition following surgery for CSM are needed. Two factors of interest are psychiatric comorbidities and safety net hospital (SNH) status. Psychiatric disorders are common and can have a profound impact on health, while SNHs serve a large proportion of patients with Medicaid or without insurance. However, …

Bringing Large Language Models To Ophthalmology: Domain-Specific Ontologies And Evidence Attribution, Aidan Gilson

Yale Medicine Thesis Digital Library

Background: In the landscape of medical innovation, Large Language Models (LLMs) represent a groundbreaking advancement, holding substantial promise for reshaping healthcare practices. These models demonstrate remarkable proficiency in assimilating and processing extensive medical literature, facilitating rapid information retrieval. Nevertheless, when applied to the specialized domain of ophthalmology, LLMs encounter significant hurdles owing to the intricacies inherent in this field. Ophthalmology, characterized by the intricate interplay of ocular anatomy, diverse disease manifestations, and nuanced diagnostic subtleties, poses considerable challenges for these generalized models. Compounding these challenges is the inherent limitation of the ophthalmological corpus itself, which remains notably narrower compared to …

Janus Kinase Inhibition In Granuloma Annulare: Two Single-Arm, Open-Label Clinical Trials, Erica Hwang

Yale Medicine Thesis Digital Library

Granuloma annulare (GA) is an inflammatory cutaneous granulomatous diseasethat lacks satisfying and effective targeted therapies. Janus kinase (JAK) inhibitors are of interest as they inhibit upregulated cytokines in GA including IFN-γ, IL-4, IL-13, IL-15, IL-21, and oncostatin M. Further investigation is needed to establish the safety profile, optimal route or formulation, and efficacy of JAK inhibitors for GA. We conducted single-arm, open-label clinical trials of abrocitinib, a JAK1-specific inhibitor, and AC- 1101, a topically applied JAK inhibitor, in patients with GA and hypothesized that each medication would be safe, tolerable, and effective at treating GA. In the first study, adult …

Population Attributable Fraction Of Reproductive Factors In Triple Negative Breast Cancer By Race, Rachel Jaber Chehayeb

Yale Medicine Thesis Digital Library

Age-adjusted incidence rates of triple negative breast cancer (TNBC) are higher in Black women than in non-Hispanic White (White) women. The disproportionate incidence of TNBC in Black women partially drives the 40% higher mortality rate from breast cancer in Black women compared to White women. Several studies have identified lack of breastfeeding and younger age at first birth as risk factors for TNBC. There are large differences in breastfeeding uptake, breastfeeding duration, and the distribution of age at first birth across racial groups in the US: only 44% of Black women breastfeed for 6 months or longer, compared to 60% …

Colonoscopy Withdrawal Time And Dysplasia Detection In Patients With Inflammatory Bowel Disease, Chandler Julianne Mcmillan

Yale Medicine Thesis Digital Library

Compared to the general population, patients with inflammatory bowel disease (IBD) are more at risk for developing colorectal dysplasia and neoplasia in their lifetime. Given this increased risk, current guidelines recommend that patients with IBD involving at least one-third of the colon undergo routine surveillance colonoscopy exams every one to five years to monitor disease activity and severity. Colonoscopy withdrawal time (CWT) is considered an important predictor of adenoma detection and a quality metric of colonoscopy within the general population. Society organizations including the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology have proposed a minimum average …

Regulation And Payment Of New Medical Technologies, Osman Waseem Moneer

Yale Medicine Thesis Digital Library

Our health care system should promote the development and useof innovative medical products, while simultaneously discouraging the marketing and adoption of unsafe or unnecessary products. In the United States, two federal agencies within the Department of Health and Human Services are responsible for administering policies directed toward these aims. The Food and Drug Administration (FDA) evaluates safety and effectiveness for market authorization of medical technologies while the Centers for Medicare & Medicaid Services (CMS) determines whether coverage is “reasonable and necessary” for its beneficiaries. Through a series of three investigations, this thesis evaluates federal policies for the regulation and payment …

Volumetric Assessment Of Imaging Response In The Pnoc Pediatric Glioma Clinical Trials, Divya Ramakrishnan

Yale Medicine Thesis Digital Library

Response assessment in neuro-oncology relies on radiographic assessment of tumor burden on magnetic resonance (MR) imaging. The most widely used criteria were developed by the Response Assessment in Neuro-Oncology (RANO) group. The RANO criteria rely on bidimensional (2D) measurements of tumor on MR images. The RANO criteria were originally developed to assess response in adult high-grade glioma. However, the heterogeneous appearance of pediatric low-grade gliomas make application of RANO criteria challenging. Volumetric assessment of pediatric gliomas may offer a more comprehensive method for characterizing response.

The goal of this thesis was to compare 2D and volumetric assessment methods in two …

Outcomes Following Hypofractionated Radiotherapy For Patients With Thoracic Tumors In Predominantly Central Locations, Alexander Sasse

Yale Medicine Thesis Digital Library

Hypofractionated radiation therapy (HFRT) is emerging as a preferred treatment for lung cancer patients ineligible for stereotactic body radiotherapy (SBRT). Normally, a standard-dose (SD-HFRT) hypofractionation regimen administers 60 Gy across 15 fractions, equating to a biologically effective dose (BED10) of 84.0, which is less than that of ablative SBRT. The first part of this thesis contrasts the clinical outcomes of patients receiving a high-dose (HD-HFRT) protocol, delivering 72 Gy in 18 fractions with a BED10 of 100.8, against those on SD-HFRT. Our research examines whether HD-HFRT enhances local control (LC) and overall survival (OS) rates while maintaining comparable rates of …

Probing Ligands To Reaction Centers To Limit The Photocycle In Photosynthetic Bacterium Rubrivivax Gelatinosus, Mariann Kis, James L. Smart, Péter Maróti

Faculty Publications - Department of Biological & Molecular Science

Light-induced electron flow between reaction center and cytochrome bc1 complexes is mediated by quinones and electron donors in purple photosynthetic bacteria. Upon high-intensity excitation, the contribution of the cytochrome bc1 complex is limited kinetically and the electron supply should be provided by the pool of reduced electron donors. The kinetic limitation of electron shuttle between reaction center and cytochrome bc1 complex and its consequences on the photocycle were studied by tracking the redox changes of the primary electron donor (BChl dimer) via absorption change and the opening of the closed reaction center via relaxation of the bacteriochlorophyll fluorescence in intact …

A Critical Assessment Of Tiny Urban Forest Methodologies And Their Regional Adaptation For North Central Texas, Michael E. Moore

Landscape Architecture Masters & Design Theses - Archive

Urbanization has led to significant environmental and social challenges, including biodiversity loss, resource depletion, and climate concerns (McDonald et al., 2008). In response to these issues, innovative methods such as Tiny Urban Forest Systems (TUFS) have gained attention. TUFS are densely planted clusters of trees and shrubs designed to emulate the structure and ecological functions of natural early successional forests (Lewis, 2021). For this study, TUFS are defined as small, high-density green spaces incorporating multi-layered native woody trees and shrub species within rapidly urbanizing areas, offering both environmental and social benefits (SUGi, 2023). This research examines the feasibility of implementing …

Improving Heart Health In African Americans Using A Cardiovascular Disease Bundle, Loretta N. Bennam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Cardiovascular disease (CVD) is a significant cause of mortality in the United States of America. Risk factors include abnormal low-density lipoprotein (LDL) cholesterol, physical inactivity, and unhealthy diets. African American (AA) adults have higher mortality rates from CVD than other demographics. In Houston, Texas, age-adjusted death rates for CVD per 100,000 population by race in AAs were 111, 85.0 in Whites, 62.9 in Hispanics, and 49.5 in Asians. This project evaluated the impact of using a CVD bundle over an eight-week period on cholesterol medication adherence, physical activity, and heart disease knowledge and was titled Improving Heart Health in African …

Guideline For Screening Of Trichomonas Vaginalis Infections In The Correctional Setting, Nahirobi J. Madrid Antunez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Objective: This guideline project focused on creating a screening guideline for T. vaginalis that would benefit healthcare providers in a correctional healthcare setting for incarcerated females entering the facility.

Methods: A literature review was conducted. The PubMed and MEDLINE search engines, were used to obtain medical, biomedical and life sciences literature, and CINAHL for nursing and allied health resources, Governmental agency sites, such as the Centers for Disease Control and Prevention (CDC), were also explored. Guideline recommendations were extrapolated from the literature review, and then rated by, stakeholders.

Results: Several overarching themes were identified. Screening of asymptomatic women for T. …

Glutamate Optimization As A Treatment For Depression: A Clinical Guideline, Luisa Angeles Collins Villares

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Based on the use of drugs to treat hypertension and tuberculosis for depression, the monoamine hypothesis led to the development of antidepressants in 1952. Serotonin was recognized as a deficiency associated with depression in 1967. As a fine-tuning orchestration of neurotransmitters and neuromodulators, the glutamate system became known using Spravato in 2019 and Auvelity in 2022. In this pilot study, mental health experts rated the importance of 24 science-based recommendations to optimize glutamatergic therapy in depression for a proposed guideline on a Likert scale from zero to four. The results were analyzed using a non-parametric predictive modeling method called Chi-Square …

Student Performance In Modern Physics In An Active, Partially-Flipped Classroom, Scott Yarbrough

Physics Dissertations - Archive

The effectiveness of the flipped classroom and hybrid-flipped (partially flipped, partially lecture-based) method of instruction has been extensively studied for high school and introductory undergraduate physics courses, and it has been shown to increase student understanding and performance. However, few studies have been done for upper-level undergraduate courses, and even fewer have been done for virtual courses. In Spring 2021 and Fall 2023, a fully virtual, hybrid-flipped Modern Physics course was taught, primarily to a class of primarily juniors and seniors, with some sophomores. All were STEM majors. The same course, with a similar enrolment and demographic of students, was …

Soil Biogeochemistry In Riparian And Restored Tidal Wetlands: Monitoring And Method Evaluation, Joseph Anthony Loffredo

Open Access Master's Theses

Although soils are essential for sustaining ecosystems, they are often overlooked in routine monitoring efforts during restoration projects. This thesis tries to address the interest in and challenges of measuring and monitoring soil biogeochemical properties and processes to evaluate restoration trajectories. In the first part of this thesis (Chapter 1), I monitored tidal marsh vegetation and soil biogeochemical responses to restoration by thin-layer placement (TLP) of dredged sediments in a greenhouse mesocosm study and a parallel field study at an active restoration site in southern RI. In the greenhouse, aboveground plant biomass in mesocosms treated with +5 cm and +10 …

Markerless Motion Capture For Dual-Handed Teleportation Of Industrial Robots, Michael F. Vallaro

Open Access Master's Theses

The advancement of teleoperation systems has predominantly focused on single-robot or humanoid systems, leaving a gap in efficient control methods for dual-robot setups. Existing solutions lack the ability to integrate synchronized operations of two robots with intuitive and precise human inputs. This limitation limits the execution of tasks requiring simultaneous coordination, multitasking, and safety measures, particularly in environments that demand precision, such as hazardous material handling, industrial assembly, and automation workflows. To address this issue, a dual-robot teleoperation system is proposed, enabling a single operator to control two Niryo Ned 2 robotic arms using hand motion tracking via Leap Motion …

Developing A Cross-Platform Remotely Operated Toolset For In Situ Deep Sea Coral Propagation, Luke Richard Millen

Open Access Master's Theses

When disasters such as the Deepwater Horizon oil spill strike remote ecosystems including the fragile deep ocean, recovery can be a long and arduous process. Deep water corals are especially susceptible to being critically damaged, as colonies have been known to grow for thousands of years. The National Oceanic and Atmospheric Administration, in partnership with various other federal and state agencies, is leading the effort to restore these open ocean ecosystems that were damaged in the 2010 Deepwater Horizon oil spill through the Mesophotic and Deep Benthic Communities - Coral Propagation Techniques Development project suite. In line with this program, …

The Moderating Role Of Trait Impulsivity On Sensitivity To Reward And Alcohol Craving, Anna Sherman

Open Access Master's Theses

Alcohol use is associated with an increased risk of negative consequences such as poor physical and mental health outcomes (e.g., alcohol-related severe injury, depression, anxiety) in addition to financial and relational difficulties, particularly for young adults (i.e., individuals ages 18 to 25) due to their disproportionately high rates of alcohol use. Alcohol craving (i.e., the strong desire to consume alcohol) is a key factor related to increased use for clinical populations, but scant research has examined craving and its associated factors among young adults. Reward sensitivity (i.e., the desire to obtain appetitive stimuli) and impulsivity (i.e., rash action without consideration …

Exploring Elementary Teachers’ Self-Efficacy And Propensity For Teaching Stem, Ashley Wilkirson

Theses and Dissertations--Science, Technology, Engineering, and Mathematics (STEM) Education

The following research is conducted in the interest in exploring self-efficacy (or the lack of) in pre- and in-service elementary school teachers when it comes to teaching STEM. In order to explore the issue of self-efficacy for STEM in elementary schools, it comes to defining what STEM education is and what self-efficacy is. These definitions guide research collected in building these future and current teachers’ self-efficacy, with factors ranging from resources available, pre-service training, professional development, content area knowledge, pedagogical knowledge, perceptions of teaching STEM, and opportunities to collaborate with other teachers were listed as some of the reasons. These …

Exploring Teachers’ Views Of The Nature Of Science And Their Beliefs And Understanding About Viruses And Covid-19: A Multiple Case Study Of Three Secondary Science Teachers At A Rural High School In The Southeastern United States, Jeffrey Chalfant

Theses and Dissertations--Science, Technology, Engineering, and Mathematics (STEM) Education

Over the past several decades, science education reforms have called for students to develop appropriate views of the nature of science and have a comprehensive understanding of subject matter. Additionally, education research has demonstrated that teachers must have appropriate views of the nature of science and strong content knowledge as necessary conditions for appropriate instruction on the nature of science. However, research has consistently shown that teachers hold naïve or inadequate views of the nature of science. This is problematic as teachers are tasked with teaching science to students that is aligned with current education standards. Therefore, teachers need to …

Effects Of Unilateral Lower Limb Suspension On Quadriceps’ Structure And Contractile Function, Eve N. Elmore

Theses and Dissertations--Kinesiology and Health Promotion

BACKGROUND: Muscle unloading such as bed rest or space flight decreases strength and cross-sectional area concomitant with a slow-to-fast fiber type shift, of anti-gravitational muscles such as the quadriceps. Diffusion tensor imaging (DTI) quantifies tissue anisotropic properties such as Fractional Anisotropy, Mean Diffusivity, Axial Diffusivity, and Radial Diffusivity, as well as muscle volume, fascicle length, and physiological cross-sectional area, and has recently been adapted to assess skeletal muscle structure. In skeletal muscle, anisotropic properties correlate with muscle fiber type and contractile function and may be responsive to unloading-induced atrophy.

PURPOSE: To assess the changes in quadriceps’ size, anisotropy, and contractile …

Developing An Immunomodulatory Strategy Using Biophysical Cues To Modulate Macrophage Phenotype For Fracture Healing And Bone Regeneration, Harshini Suresh Kumar

Theses and Dissertations--Biomedical Engineering

Chronic inflammation is a major cause of the pathogenesis of musculoskeletal diseases such as fragility, fracture, and nonunion. Studies have shown that modulating the immune phenotype of macrophages from proinflammatory to pro-healing can heal recalcitrant bone defects. Current therapeutic strategies predominantly apply biochemical cues, which often lack target specificity, and controlling their release kinetics in vivo is challenging spatially and temporally. We have developed a magnetic iron-oxide nanocomplexes (MNC)-based therapy for resolving chronic inflammation in the context of promoting fracture healing. Here, we show that MNC internalized macrophages, when coupled with an external magnetic field, can exert an intracellular magnetic …

Relating Temperature, Sleep, And Pathology In Mouse Models Of Alzheimer's Disease, Jun Wang

Theses and Dissertations--Biomedical Engineering

It is well established that sleep plays an important role in Alzheimer’s disease (AD) pathology. There is growing evidence that sleep issues may accelerate AD pathology by interrupting the physiological clearance of amyloid‐β (Aβ) from the brain, which mainly occurs in normal sleep. As the over-accumulation of amyloid‐β (Aβ) is believed to lead the cascade effect that eventually causes neurodegeneration in AD patients, development of therapeutic strategies for improving sleep quality may help slow disease progression. It is well documented that the composition and dynamics of sleep are sensitive to changes in ambient temperature. We therefore developed a sleep enhancement …

Development Of Iron Oxide Nanozyme For Cancer Therapy, Zhongchao Yi

Theses and Dissertations--Biomedical Engineering

Cancer therapies that leverage reactive oxygen species (ROS) have shown potential for cancer inhibition due to their ability to induce oxidative stress in tumor cells. Iron oxide nanoparticles (IONPs) have garnered significant attention as a promising platform for ROS-dependent disease treatment, owing to their remarkable biocompatibility and Fenton catalytic activity. However, the low catalytic activity of IONPs has been a major hurdle in their clinical translation. To overcome this challenge, IONPs of different compositions are examined for their Fenton reaction under pharmacologically relevant conditions in this work. The results show that wüstite (Fe_1-xO) nanoparticles exhibit higher catalytic activity …

Language Models For Rare Disease Information Extraction: Empirical Insights And Model Comparisons, Shashank Gupta

Theses and Dissertations--Computer Science

End-to-end relation extraction (E2ERE) is a crucial task in natural language processing (NLP) that involves identifying and classifying semantic relationships between entities in text. This thesis compares three paradigms for end-to-end relation extraction (E2ERE) in biomedicine, focusing on rare diseases with discontinuous and nested entities. We evaluate Named Entity Recognition (NER) to Relation Extraction (RE) pipelines, sequence-to-sequence models, and generative pre-trained transformer (GPT) models using the RareDis information extraction dataset. Our findings indicate that pipeline models are the most effective, followed closely by sequence-to-sequence models. GPT models, despite having eight times as many parameters, perform worse than sequence-to-sequence models and …

The Aesthetics Of Environmental Risk In Paolo Bacigalupi’S The Windup Girl And The Water Knife, David Schwartz

Theses and Dissertations--English

Any work of environmentally oriented fiction that seeks to represent the wide-reaching effects of climate change is faced with the problem of scale. These texts must render visible change which is at once ubiquitous and microscopic, along with the cascade of side-effects generated in the wake of rising temperature, rising sea levels, and winnowing biodiversity. In short order, these texts must fully imagine what it means to live within the modern global risk society. Borrowing this sociological model from the late Ulrich Beck, I analyze the literary work of Paolo Bacigalupi, one of the foremost authors in the growing genre …

Functional Analyses Of The Polycomb-Group Genes In Sea Lamprey Embryos Undergoing Programmed Dna Loss, Cody Saraceno

Theses and Dissertations--Biology

During early embryonic development, the sea lamprey (Petromyzon marinus) undergoes programmatic elimination of DNA from somatic progenitor cells in a process termed programmed genome rearrangement (PGR). Eliminated DNA eventually becomes condensed into micronuclei, which are then physically degraded and permanently lost from the cell. Previous studies indicated that many of the genes eliminated during PGR have mammalian homologs that are bound by polycomb repressive complex (PRC) in embryonic stem cells. To test whether PRC components play a role in the faithful elimination of germline-specific sequences, we used a combination of CRISPR/Cas9 and lightsheet microscopy to investigate the impact …

Effects Of Neonatal Estradiol Treatment On Regulating Sexual Differentiation Of Daily Rhythms Underlying Diet-Induced Obesity In Female Mice, Samuel Nwadialo

Theses and Dissertations--Biology

Sex differences of the brain and behavior often require the combination of organizational and activational effects of sex hormones. The activational effects of estrogens in adult female mice protect daily eating and activity rhythms from disruption by high-fat diet feeding and inhibit diet-induced obesity. However, male mice have disrupted eating rhythms when fed high-fat diet and this causes obesity. Treatment of adult male mice with estradiol does not protect rhythms from disruption by high-fat diet, as it does in females. In this study, we sought to determine whether the organizational effects of estradiol masculinize the daily eating and activity rhythms …