Digital Commons Network^™

Influence Of Demographics On Research Participation In Female Patients Undergoing Ambulatory Surgery, Tiana Fernandez

Yale Medicine Thesis Digital Library

Background: Historically, research on women and minorities has consisted of unethical experimentation, human rights violations, and crimes against humanity. Numerous examples can be found throughout the past two centuries, including the exposure of pregnant women to radioactive iron in the Tennessee-Vanderbilt Nutrition Project (TVNP), failure to treat cervical carcinoma in situ in the Unfortunate Experiment, surgical experimentation on female slaves by Dr. J. Marion Sims, failure to treat syphilis in the Tuskegee Syphilis Study, intentional exposure to and subsequent failure to treat sexually transmitted diseases in Guatemala, collection of biospecimens from Henrietta Lacks, and nontherapeutic experimentation on minority children in …

Facial Harmony And Gender Congruence: Patient-Reported Outcomes Of Gender-Affirming Facial Surgery Using The Gender-Q And Gpsq, Helia Hosseini

Yale Medicine Thesis Digital Library

Background:Gender-affirming facial surgery (GAFS) addresses gender dysphoria by aligning facial features with gender identity, with historical emphasis on refining the upper facial third to render patients more attractive and feminine. The GENDER-Q, a novel patient-reported outcome measure (PROM), evaluates aesthetic, functional, and psychosocial outcomes, complementing the Gender Preoccupation and Stability Questionnaire (GPSQ) to assess effects of GAFS in this study. Methodology: Survey data from 86 patients was analyzed using GENDER-Q and GPSQ scores. Higher GENDER-Q scores indicated improved outcomes, whereas lower GPSQ scores reflected reduced gender dysphoria. Pre- and post-operative outcomes were compared using paired and unpaired t-tests. Spearman’s correlation …

A Spatial Transcriptomic Atlas And Cellular Lineage-Based Analysis Of Chondroblastoma, Will Jiang

Yale Medicine Thesis Digital Library

Chondroblastoma is a benign primary bone tumor with controversial cellular origin. Although bearing the name “chondroblastoma”, this musculoskeletal tumor has faced controversy as to whether chondroblasts are chondrocytes. Moreover, its cellular composition can make it difficult to distinguish amongst its mimics including giant cell tumor of bone, chondrosarcoma, and chondromyxoid fibromas.

This thesis aims to characterize the transcriptomic expression atlas of human chondroblastoma to better define the gene expression profile and diagnostic expression markers of chondroblastoma. Secondarily, this thesis aims to identify the lineage progression and cellular composition of chondroblastoma using spatial and temporal patterning analysis.

Histologically confirmed samples of …

Joint Venture: Curriculum Design, Implementation And Evaluation For A Novel Interdisciplinary Musculoskeletal Medicine Elective, Arielle Richey Levine

Yale Medicine Thesis Digital Library

Background / Scientific Premise: Musculoskeletal medicine is underrepresented in medical education in the United States and internationally; however, it represents an increasingly critical area of patient care. Educational initiatives targeting this area of medicine are complex given its interdisciplinary nature and the challenges faced when adding new material to medical curricula. The application of medical education principles to tackle this challenge remains an area open for further investigation in terms of efficacy and reported student experience.

Research Aims: This research aims to understand the needs for improved MSK education at Yale School of Medicine, design an intervention to address the …

Neurophysiologic Responses To Endovascular Interventions For Delayed Cerebral Ischemia Management, Rafael Seth Maarek

Yale Medicine Thesis Digital Library

Background/Scientific Premise: Delayed cerebral ischemia (DCI) continues to be a leading cause of poor outcomes in hospitalized aneurysmal subarachnoid hemorrhage (aSAH) patients. In addition to cerebral vasospasm, a growing constellation of pathophysiologic processes has been implicated in the development of DCI, including impaired autoregulation, micro-thrombosis, inflammation, and cortical spreading depolarizations. However, management options for patients showing signs of emerging DCI have largely remained spasmolytic in nature, and it remains unclear if reversing cerebral vasospasm in patients with signs of emerging DCI will reliably improve underlying neurophysiology. To our knowledge, no group has reliably shown postprocedural improvements in quantitative EEG metrics …

"It Made Me Want To Get Into Healthcare Even More": A Simulation-Based Healthcare Mentoring Program, Jack Mccarthy

Yale Medicine Thesis Digital Library

The healthcare industry in the United States continues to experience rapid growth, yet workforce shortages persist across a wide range of medical professions. In order to increase the pool of qualified individuals pursuing healthcare, innovative strategies are needed to increase interest in healthcare fields among youth. Prior research has identified that healthcare career interest is driven in part by motivational characteristics including interest in math and science, self-efficacy, and social factors like the expectations of parents and caregivers. Mentoring, career exploration, and informal learning have been identified as strategies that increase student interest in and commitment towards healthcare careers. This …

The Deepfake Dilemma: Fake Images, Real Victims, And The Legal Void In Addressing Non-Consensual Deepfake Pornography, Elizabeth A. Safaryn

William & Mary Journal of Race, Gender, and Social Justice

This Note evaluates the various legal remedies available to victims of non-consensual deepfake pornography. As deepfakes are a relatively new but rapidly advancing technology, it is difficult for the law to keep up with the mass creation and distribution of AI-generated images on the Internet. With the competing interest of constitutionally protected speech, current deepfake laws fail to address non-consensual intimate image sharing (NCII) explicitly and lack the necessary deterrent effect to curb their proliferation. With an initial background on deepfakes and machine learning, this Note then explores the strained relationship between the First Amendment and the available civil remedies …

Decreasing Work-Related Stress And Burnout In Advanced Practice Clinicians, Laura Vasquez

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

Advanced practice clinicians (APCs) face ongoing job-related stress and career burnout. Work-related stress and burnout affect healthcare quality, safety, and patient satisfaction, yet evidence specific to job-related stress and career burnout from outpatient medical facilities in the South Texas region remains limited.

Purpose

A quality improvement (QI) project was implemented to decrease work-related stress and burnout among APCs working in an outpatient medical facility in the South Texas region.

Methods

Project participants included family nurse practitioners (FNPs) (n=7) and physician assistants (PAs) (n=4). Data was collected between January 2026 and March 2026. An intervention was implemented which included engagement …

Export Controls As Intellectual Property Regulation, Doni Bloomfield

Faculty Scholarship

Export-control laws have long regulated information created outside of the U.S. government. Legal scholars have paid little attention to these national-security laws, and have not recognized that the government uses them specifically to assert a right to suppress information held in patent applications and trade secrets. In this Article, I present a new history of the relationship between export controls and intellectual property to show how the government regulates IP transfers, and how the state uses IP laws to national-security ends. Export-control laws regulate IP by controlling how people in the United States and beyond can share or use inventive …

Passive Communication Across Diverse Swarm Formations And Scales Utilizing Wake Signatures For Messaging And Object Inference, Bryan Varela

Open Access Master's Theses

Passive wake signatures in fluid flows can support perception and low-rate communication in swarms. In cluttered or contested underwater environments, conventional acoustic, radio, and optical links can be power-hungry, intermittent, or undesirable when low observability is required. Wake-mediated cues offer a local, directional channel that does not require line of sight because each agent naturally sheds coherent vortices that persist downstream and can be sampled by followers with only a small number of probes.

This study evaluates whether sparse downstream probes are sufficient to infer agent attributes and decode simple messages from wakes generated by established source shapes. Computational fluid …

Unseen Labour, Unmatched Impact: Struggles And Strategies Of Supervising Lawyers In Canadian Clinical Law Programs, Sarah Buhler, Gemma Smyth

Dalhousie Law Journal

Supervision has been described as the “beating heart” and the “core” of clinical legal education. Yet lawyers who supervise law students in clinical programs have challenging and poorly understood roles within Canadian legal education. This article analyzes interviews with lawyers who supervise students in Canadian law-school affiliated legal clinics. Supervising lawyers describe the tensions between their roles as lawyers, supervisors and mentors, university or non-profit employees, social justice advocates, members of law societies, and clinic team members. These tensions often exist within an environment of lower pay, poor job security, substandard treatment by colleagues, and inadequate training. Despite these challenges, …

Healthcare Discrimination Under The Canadian Charter Of Rights And Freedoms, Mélisande Charbonneau-Gravel, Sébastien Jodoin, Siobhan O’Connell

Dalhousie Law Journal

This paper explores the role that the Canadian Charter of Rights & Freedoms could and should play in addressing and redressing discrimination in the context of healthcare in Canada. Drawing on landmark as well as recent jurisprudence, we analyze how sections 7 and 15 of the Charter apply to three types of healthcare discrimination: (1) lack of access to healthcare and health services; (2) lower quality of services, and attitudes and biases faced in diagnosis and treatment; and (3) physical, verbal, psychological, and sexual abuse experienced by patients. Our analysis highlights the ongoing, problematic nature of the prevailing interpretations of …

Chapter 1 - Introduction And Overview, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

This Trial Manual is a how-to-do-it guidebook for handling criminal cases from beginning to end. It provides a compact guide through the stages of an ordinary criminal case, from arrest and investigation to appeal. Its focus is upon the key points at which defense counsel must make decisions and take actions. Options and factors to be considered in each decision, and steps that can be taken to assert a client’s rights and protect the client’s interests at each stage, are laid out.

Table Of Contents, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

TABLE OF CONTENTS
PART ONE: INTRODUCTION AND OVERVIEW (Chapters 1-2)
PART TWO: INITIAL STAGES OF THE CASE THROUGH ARRAIGNMENT (Chapters 3-16)
PART THREE: PROCEEDINGS BETWEEN ARRAIGNMENT AND TRIAL (Chapters 17-31)
PART FOUR: TRIAL (Chapters 32-46)
PART FIVE: POST-TRIAL (Chapters 47-49)

Chapter 3 - The Lawyer's Entrance Into The Case – First Steps, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Defense counsel may have occasion to enter a criminal case at almost any of the stages described in Chapter 2. In the early stages, at least, the crucial first steps to be taken are essentially the same. They are, in essence: (1) to make contact with the client, obtain the client’s authorization to represent him or her, warn the client against speaking with the police or others, and obtain information that counsel can use to seek the client’s release; (2) to speak to the investigating officer, find out whatever counsel can about the charges and the availability of release on …

Chapter 10 - Summary Of Things To Do Before First Court Appearance, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Contains "Checklist of Things to Do for an Arrested Client Between the Time of Arrest and the Client’s First Court Appearance" and "A Note on the Coroner’s Inquest and Similar Institutions."

Chapter 9 - Defense Investigation, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Investigation is counsel’s principal means for obtaining and vetting the information s/he needs. Although there are other fact-gathering tools – formal discovery proceedings (see Chapter 18); motions practice (see Chapter 19); plea-bargaining discussions (see Chapter 15); informal interchanges with a prosecutor (see § 7.2.2 supra) – they tend to be less reliable and comprehensive than independent defense spadework: meticulously searching the streets, paper and electronic files and records, and the internet. One key component of defense investigation, the interview with the client, is discussed in Chapter 6. The following aspects of investigation are discussed in the present chapter: locating and …

Chapter 13 - Defense Procedures After The Filing Of The Charging Paper And Before Arraignment, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Contains "Checklist of the Steps To Take During the Period Between the Filing of the Charging Paper and Arraignment", with further elaboration in subsequent sections.

Chapter 14 - Arraignment And Defensive Pleas, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Arraignment is the stage of proceedings when a misdemeanor or felony defendant ordinarily appears for the first time in the court that has jurisdiction to try the case. The defendant has been notified of the arraignment date as indicated in § 13.2 supra.

Chapter 15 - Guilty Pleas: Preparing For And Conducting Plea Negotiations; Counseling The Client About A Plea Offer, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

This chapter examines the processes by which counsel prepares for and conducts plea negotiations with the prosecutor and advises the client about a bargained plea. The chapter leads off with a discussion (in § 15.2) of the relative roles of counsel and client in deciding whether the client should plead guilty rather contesting a criminal charge. Part B (§§ 15.3-15.7) discusses the benefits and costs to a defendant of resolving a criminal charge by pleading guilty. It then reviews the factors that counsel should consider in developing an advantageous plea bargain to propose to the prosecutor or in assessing a …

Chapter 8 - Dealings With The Police And Prosecutor, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Counsel should usually establish contact with the investigating officers as early as possible in the course of a case. Thereafter, s/he should speak to them whenever the needs of the client dictate. Similarly, counsel should establish contact with the prosecuting attorney as soon as one is assigned to the case and should communicate with him or her periodically thereafter. The purposes of these contacts are (a) to learn as much as possible about the charges against the defendant (those already lodged and others that may later be lodged) and potential prosecution evidence; about the temperament of the prosecutor and of …

Chapter 22 - Change Of Venue Or For Disqualification Of The Judge, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The general principles governing initial venue in criminal cases are sketched in § 20.5 supra. As that section indicates, a charging paper filed in the wrong venue is usually subject to a motion to quash or to dismiss. In some jurisdictions, however, the defendant’s remedy may be merely a motion for transfer to the court of proper venue. Statutes, court rules, local practice, canons of judicial ethics, and opinions rendered by a jurisdiction’s professional-ethics committee or agency provide varying grounds and procedures for objecting to a particular judge’s presiding at trial or on pretrial matters.

Chapter 23 - Motions For Severance Or For Consolidation Of Counts Or Defendants, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Section 23.2 describes the strategic variables that counsel should consider in deciding whether to challenge joinder of counts. Sections 23.3 and 23.4 then examine the motions that counsel can file to obtain dismissal or a severance on grounds of misjoinder and to obtain a severance on the grounds that the joinder, although technically valid, is prejudicial to the defendant. Section 23.5 discusses motions for consolidation. The considerations that might lead defense counsel to favor or oppose a joint trial are listed in § 23.7 infra. As the discussion there indicates, it will usually be in the defendant’s interest to seek …

Chapter 24 - Suppression Hearings, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Suppression hearings may be used by the defense for several different purposes. To put a hearing to the most effective use, defense counsel needs to make a preliminary determination of which purposes s/he should be pursuing in this particular case. Often, a clear-cut choice between one purpose and another will be necessary, because the purposes or important means for achieving them are inconsistent. This is ordinarily not a choice that can be put off until the time of the evidentiary hearing: Both the content of the suppression motion and the nature of counsel’s pre-hearing preparation will vary considerably depending upon …

Chapter 17 - Defense Procedures And Considerations Between Arraignment And Trial, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Contains sections on: "Checklist of Matters for Counsel to Consider Between Arraignment and Trial", "Selecting and Drafting Pretrial Motions: Strategic and Practical Considerations" and "Resisting Prosecution Attempts to Freeze a Defendant’s Assets".

Chapter 16 - Representing Clients Who Are Mentally Ill Or Intellectually Disabled, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

There are, however, some clients who are not competent to make decisions affecting their own welfare; and counsel may need to take special measures in these cases. If counsel reasonably believes that mental illness or an intellectual disability has so severely “diminish[ed]” the client’s “capacity to make adequately considered decisions in connection with the representation . . . [that] a normal client-lawyer relationship with the client” cannot be maintained, and if counsel furthermore “reasonably believes” that the client “is at risk of substantial physical, financial or other harm unless action is taken and [that the client] cannot adequately act in …

Chapter 29 - Defense Trial Preparation, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Defense trial preparation culminates in the selection of the witnesses and evidence that will be presented at the trial (and, where applicable, at any pretrial evidentiary motions hearings such as suppression hearings (see Chapters 24-27 supra) and hearings on motions in limine (see § 17.5.3 supra)). Counsel must be wide-ranging in the search for sources of proof but highly selective in what s/he actually puts on at pretrial hearings and at trial. It is vital that s/he have an integrated theory of defense and that the evidence be tightly organized so that the defense theory will come across clearly in …

Chapter 18 - Pretrial Discovery; The Pretrial Conference, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

As a matter of practice, criminal discovery involves two processes or phases: informal and formal discovery. Most prosecutors are willing to hand over to the defense upon request certain categories of materials which it is clear that a court would order the prosecutor to divulge if the defense made a motion to discover them. Informal discovery devices (such as the discovery letter (see § 18.5 infra) and the discovery conference (see § 18.6 infra)) provide a quick route to obtaining this material. When the informal devices fail because the prosecutor refuses voluntarily to divulge information requested by the defense, counsel …

Chapter 26 - Motions To Suppress Confessions, Admissions, And Other Statements Of The Defendant, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The doctrines described in this chapter supply grounds for suppressing not only confessions but any statement by the defendant – “whether inculpatory or exculpatory – that the prosecution may seek to introduce at trial” (Rhode Island v. Innis, 446 U.S. 291, 301 n.5 (1980) (emphasis in original); see also Miranda v. Arizona, 384 U.S. 436, 476-77 (1966)).

Chapter 20 - Motions To Quash Or Dismiss The Charging Paper, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

There are numerous grounds for moving to quash or dismiss a charging paper or one or more of its counts. The chapter discusses a number of them.