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Clinical And Pathologic Factors Associated With Poor Outcomes In Cutaneous Sarcomas, Jennifer Rodriguez

Yale Medicine Thesis Digital Library

Background:Cutaneous sarcomas exhibit a broad spectrum of clinical behavior, ranging from indolent tumors to lesions with significant metastatic potential. In atypical fibroxanthoma, pleomorphic dermal sarcoma, and cutaneous leiomyosarcoma predictors of recurrence and metastasis are not always apparent at initial diagnosis. Improved understanding of clinicopathologic features associated with adverse outcomes is needed to guide risk stratification and management.

Objectives:To identify clinical and pathologic factors associated with poor outcomes in AFX, PDS, and cutaneous leiomyosarcoma and to evaluate the relationship between initial biopsy, definitive excision findings, and clinical outcomes.

Methods:This thesis comprises three retrospective cohort studies conducted at a single academic institution. …

The Spectrum Of Cutaneous And Systemic Manifestations Associated With Anti-Pm/Scl, Sabrina Maariyah Saeed

Yale Medicine Thesis Digital Library

Anti-PM/Scl is a rare anti-nuclear autoantibody first identified in patients with polymyositis and the scleroderma/myositis overlap syndrome. Due to its low prevalence, the clinical manifestations associated with anti-PM/Scl remain incompletely understood. This study aims to further delineate the phenotype associated with anti-PM/Scl. Anti-PM/Scl positive patients treated at Yale New Haven Health Systems between 2012 and 2024 were retrospectively identified. Chart review was conducted to characterize demographics, skin findings, and extracutaneous manifestations associated with the antibody. Anti-PM/Scl was detected in 64 of the 2867 patients tested. Fifty-seven of these patients met inclusion criteria (i.e. sufficient availability of medical records and age …

Vascular Identity And Remodeling: Sox17 Mediates Arteriovenous Fistula Maturation, Andrew William Schwartz

Yale Medicine Thesis Digital Library

Background/Scientific Premise Mature arteriovenous fistulae (AVF) are the gold standard vascular access allowing hemodialysis for patients with end-stage kidney disease. The rate of AVF failure remains high, reflecting an incomplete understanding of the biology of AVF maturation and failure. Sox17 is a transcription factor indispensable for the acquisition and maintenance of endothelial arterial identity. Because endothelial cells (EC) acquire dual arteriovenous identity after AVF creation, we determined whether Sox17 mediates venous remodeling in AVF. Research Aims This study aims to characterize the degree of Sox17 expression within the venous outflow tract after AVF creation in humans and in a mouse …

Association Between Baseline Prostate Mri Pi-Rads And Risk Of Gleason Upgrade During Active Surveillance, Shayan Smani

Yale Medicine Thesis Digital Library

Background: Active surveillance (AS) is the preferred management strategy for men with favorable-risk prostate cancer, aiming to avoid overtreatment while preserving oncologic safety. However, a meaningful proportion of patients experience Gleason Grade Group (GG) upgrading during follow-up, reflecting either biological progression or baseline misclassification. Multiparametric prostate magnetic resonance imaging (MRI), interpreted using the Prostate Imaging–Reporting and Data System (PI-RADS), is well established for detecting clinically significant prostate cancer at diagnosis, yet its prognostic role during AS remains incompletely defined. Specifically, whether baseline PI-RADS scores independently predict the risk of GG upgrading among men managed with AS has not been systematically …

“Treatment Not Tents:" The Medicalization Of Homelessness In California’S 2022-2025 Legislative Agenda, Elana R. Straus

Yale Medicine Thesis Digital Library

Modern homelessness emerged in the 1980s due to political choices that cut the social safety net and decreased the availability of affordable housing. Medicalized views of homelessness that frame homelessness as driven by individual pathology, particularly mental illness and addiction, emerged in research, media, and politics at this time. Homelessness has persisted since and remains particularly high in regions, including California, where the housing markets are most constrained. In this context, California advanced multiple legislative changes between 2022 and 2025 that increased pathways to involuntary treatment and criminal-legal control over people experiencing homelessness. In this thesis, I demonstrate how legislators …

Discoid Lupus: Retrospective Analysis Of Epidemiology, Clinical Features, Autoimmunity Profiles, And Treatment Patterns, Aster Workineh

Yale Medicine Thesis Digital Library

Cutaneous lupus erythematosus (CLE) produces lifelong morbidity through visible, functionally consequential skin disease and accrued damage. In discoid lupus erythematosus (DLE), alopecia and dyspigmentation at hair-bearing and cosmetically sensitive sites are frequently cited as major drivers of reduced quality of life1,2. Despite this burden and the risk of progression to systemic lupus erythematosus (SLE), CLE has no FDA-approved therapy, and treatment evidence remains limited by the small number of CLE-specific datasets and trials focused on CLE-trials. Many therapeutic decisions for CLE are extrapolated from SLE despite the fact that CLE subtypes differ in morphology, histopathology, and reported immune signatures3,4. We …

The Strength Of Association Between Surrogate Markers And Clinical Outcomes Used By The Fda For Chronic Disease Indications, Samuel Yoon

Yale Medicine Thesis Digital Library

The U.S. Food and Drug Administration (FDA) has traditionally required the use of clinical outcome measures as clinical trial endpoints to support the approval of new drugs. However, clinical outcome trials are typically large, lengthy, and expensive. To expedite this process, Congress has enacted several regulatory programs to facilitate FDA approval of new drugs on the basis of surrogate markers, endpoints that are reasonably likely to predict clinical benefit, as trial endpoints. However, the evidence demonstrating the validity and reliability is mixed, creating uncertainty for patients and physicians about the true clinical benefits of new drugs approved on the basis …

Neighborhood Embeddings And Scalable Learning For Optimal Transport And Unbalanced Optimal Transport, Muhammad S. Rana

Mathematics Dissertations - Archive

Dimensionality reduction techniques are developed from the assumption that high-dimensional data often arises from low-dimensional structures embedded into the high-dimensional ambient space. Classical dimensionality reduction methods rely on the Euclidean distance, which may fail to capture the geometric structures of the datasets. This dissertation includes alternative metrics for dimensionality reduction techniques and challenges in applying these techniques.

First, we investigate the Wasserstein distance based neighbor embeddings for dimensionality reduction methods and compare the classification and clustering performance with the classical Euclidean based methods. The Wasserstein distance models the data as probability distributions and compares two distributions applying optimal transport (OT) …

School Of Biological Sciences News, 2026, School Of Biological Sciences, Illinois State University

School of Biological Sciences News

Alumni newsletter of Illinois State University's School of Biological Sciences.

A Questionnaire Assessing Attitudes And Readiness For Hiv Pre-Exposure Prophylaxis Therapy For Community Members At-Risk For Hiv Acquisition In Liberia, Yishak Bedaso

Yale Medicine Thesis Digital Library

AbstractA Questionnaire Assessing Attitudes And Readiness For HIV Pre-Exposure Prophylaxis Therapy For Community Members At-Risk For HIV Acquisition In Liberia Yishak Bedaso;1 Jessica Tuan, MD, MS;2 Yassah M. Barclay-Korboi;3 Onyema Ogbuagu MBBCh, FACP, FIDSA4 Affiliation: 1. Yale School of Medicine, New Haven, CT, USA 2. Columbia University Vagelos College of Physicians and Surgeons, Department of Infectious Diseases, New York, NY, USA 3. JFK Memorial Hospital, Monrovia, Liberia. 4.Yale Antivirals & Vaccines Research Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA; Despite how effective Pre-exposure prophylaxis (PrEP) is in preventing HIV, uptake among women in sub-Saharan …

Estimating Prep And Voluntary Medical Male Circumcision Prevalence In Three High Hiv Burden Countries, Rose Grace Bender

Yale Medicine Thesis Digital Library

Understanding the impact of specific biomedical interventions is crucial for optimizing HIV prevention strategies. In this study, we estimate of the prevalence of voluntary medical male circumcision (VMMC) and lay out a framework for estimating preexposure prophylaxis (PrEP) in the three high-burden sub-Saharan African countries of Malawi, South Africa, and Zimbabwe. For VMMC, we use a cohort-based simulation framework to model circumcision prevalence in all males over time, allocating VMMC count data to cohorts over time. Model outputs are compared with survey and campaign data, and two parameters, the initial background circumcision prevalence and the age distribution of VMMC procedures, …

Epidermal Differentiation Disorders Across The Lifespan: Growth, Ophthalmologic, And Perinatal Manifestations, Caroline Echeandia-Francis

Yale Medicine Thesis Digital Library

Epidermal differentiation disorders (EDDs) are a heterogeneous group of inherited skin diseases characterized by impaired epidermal barrier function, scaling, and erythema. Although substantial progress has been made in identifying the genetic causes of EDD, long-standing clinical observations—including impaired growth, ectropion, and increased rates of preterm birth—remain poorly characterized across genotypes. The prevalence, severity, and clinical significance of these manifestations have not been systematically evaluated in large, genotype-stratified cohorts, limiting the ability to provide anticipatory guidance and tailored clinical care. This thesis seeks to (1) characterize growth trajectories in children with EDD and determine genotype-specific patterns of growth impairment; (2) assess …

Regional Inequities In Colon Cancer Surgical Care: Treatment Delay Patterns Across U.S. Facilities, Rushabh Hemang Doshi

Yale Medicine Thesis Digital Library

AbstractBackground/Scientific Premise: Colon cancer represents a significant public health burden in the United States, ranking as the third most common and second deadliest cancer. Timely surgical resection is critical for optimal survival in non-metastatic disease, yet persistent racial, insurance, and geographic disparities in access to care may contribute to treatment delays. While treatment delay has been established as a critical quality metric, regional variation in surgical delays for colon cancer and how patient-level disparities manifest across different U.S. regions remain poorly understood. Understanding these geographic patterns is essential, as healthcare systems, patient populations, access barriers, and state-level policies differ substantially …

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 …

Repurposing Ezetimibe As A Therapeutic For Parkinson's Disease: Evaluating The Therapeutic Potential And Probing For A Mechanism, Brian Hilton

Yale Medicine Thesis Digital Library

Neurologic disease is the leading cause of disability globally and Parkinson’s disease (PD) has been the fastest growing neurologic brain disease over the last several decades. Despite the immense burden of PD on patients and society, there has yet to be an efficacious disease-modifying therapy. Investigation of candidate pharmaceuticals that have already been approved by the FDA for other conditions might provide an expedited path to the advent of disease-modifying therapy. There is a rich history of drug repurposing for symptomatic therapy for PD, with amantadine as the preeminent example. In order to identify candidate therapeutics for possible repurposing, an …

Rns-Based Early Prediction Of Antiseizure Medication Efficacy, Joshua Hobbs

Yale Medicine Thesis Digital Library

Drug-resistant focal epilepsy accounts for a significant portion of patients with epilepsy. These patients many times experience persistent seizures despite several ASM (anti-seizure medication) trials. RNS (Responsive neurostimulation) has demonstrated efficacy in reducing seizure frequency in patients that are resistant to drug trials, and provide continuous intracranial electroencephalographic monitoring. This longitudinal data may offer an opportunity to identify potential early biomarkers of ASM trial effectiveness, which could lead to quicker optimization of pharmacological therapy. This study in particular evaluated whether early changes in RNS-detection of seizure activity can predict a clinical response to ASMs in patients with drug-resistant focal epilepsy. …

Associating Inflammatory Dermatoses And Gynecological Disorders Using The National Institutes Of Health’S All Of Us Research Program, Christine Myriam Hodelin

Yale Medicine Thesis Digital Library

There remains a gap in the knowledge about the relationship between inflammatory disorders and common gynecological disorders, despite significant quality of life concerns for both. We examined the association between hidradenitis suppurativa (HS) and endometriosis, and the association between atopic dermatitis (AD) and uterine leiomyomas, both with a cross-sectional study using electronic health record and survey data from the National Institutes of Health’s All of Us Research Program.

The All of Us Research Program has a large United States-based cohort and focuses on traditionally underrepresented populations in research. We compared cases and controls, all assigned female at birth, using Pearson’s …

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 …

Trends, Predictors, And Cerebrovascular Outcomes Of Vertebral Artery Injury In Cervical Fractures, Rahul Jayaram

Yale Medicine Thesis Digital Library

Background and Scientific Premise: Cervical spine trauma is a common emergencydepartment presentation, and vertebral artery injury (VAI) is a potentially occult but serious complication associated with posterior circulation stroke. Identification of patients at risk remains challenging due to subtle presentations, variable screening practices, and limited prior data. Research Aims: The aims of this study were to characterize temporal trends in VAI detection among adult patients presenting to the emergency department with cervical spine fractures between 2010 and 2022, identify independent demographic, clinical, and injury-related predictors of VAI, and evaluate the association between VAI and ischemic stroke within ninety days of …

Prevalence, Predictors, And Consequences Of Postoperative Dysphagia After Aortic Surgery, Andrew Joseph Johnson

Yale Medicine Thesis Digital Library

Prevalence, Predictors, and Consequences of Postoperative Dysphagia After Aortic SurgeryAndrew Johnson and Ronny Munoz-Acuna, M.D., Department of Anesthesiology, Yale School of Medicine, New Haven, CT 06510. Abstract Background: Postoperative dysphagia is an underrecognized complication following cardiothoracic surgery and is associated with aspiration, prolonged hospitalization, and adverse clinical outcomes. Patients undergoing complex aortic surgery may be at particularly high risk due to prolonged mechanical ventilation, extensive airway instrumentation, and neurologic vulnerability. Data describing the prevalence, predictors, and clinical consequences of postoperative dysphagia in this population remain limited. Research Aim: This study consisted of three aims: first, to determine the prevalence and …

Frailty And Functional Decline After Elective Endovascular Abdominal Aortic Aneurysm Repair, Judy Li

Yale Medicine Thesis Digital Library

Background: Frailty can be used to estimate perioperative and long-term mortality risk in octogenarians undergoing elective endovascular abdominal aortic aneurysm repair (EVAR). Its association with functional decline, an important surrogate of quality of life in older adults, has not been well studied in this population. We aimed to evaluate whether preoperative factors such as frailty are associated with one-year functional decline after elective EVAR in octogenarians and to compare the performance of three different frailty assessments.

Methods: The Vascular Quality Initiative (VQI) database was queried for octogenarians who underwent elective EVAR for an asymptomatic infrarenal abdominal aortic aneurysm (AAA) (2014 …

The New Transgender Tipping Point: Trumpism, Medical Necessity & Gender-Affirming Care, Molly J. Nunn

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

Following the rise and eventual triumph of Trumpism 2024, President Donald J. Trump and his administration have sought to discredit the internationally recognized standards of effective health care practice for gender-affirming care. Now, ten years after Time Magazine published “The Transgender Tipping Point,” the political discourse of transgender identity is tipping again. Under the second Trump Administration, transgender identity sits at the edge of an abyss. Trumpism seeks to eradicate or significantly limit access to gender-affirming care through executive actions and the judiciary, despite the plethora of medical associations stating that that care is medically necessary. Public policies that widely …

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 …

Sauce For The Gander: The False Symmetry Of Myths And Stereotypes Against The Accused In Sexual Assault Trials, Janine Benedet

Dalhousie Law Journal

As sexual assault laws evolved to be expressed in sex-neutral language, so too have arguments relating to myths and stereotypes in the context of sexual offences. This article evaluates the argument that myths and stereotypes, traditionally a reflection of systemic discrimination against female complainants in rape trials, also operate against male accused. Understood correctly, this trend repackages anti-feminist backlash to early equality reform efforts, ultimately working to revive the belief that women’s accusations of sexual assault are often false. The Supreme Court of Canada’s decision in R v Kruk affirms that this historical context matters when it comes to claims …

Chapter 6 - Interviewing The Client, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The first interview with a criminal client is probably the most important exchange that counsel will have with the client. It largely shapes the client’s judgment of the lawyer. Any initial impressions counsel makes may be indelible. At the least, this interview will strongly affect all future dealings between the two. The lawyer’s primary objective in the initial interview is to establish an attorney-client relationship grounded on mutual confidence, trust, and respect.

Public Utilities Commission, Azad Hassan Khanzadeh Faal, Kelly Downes, Annika Kjos, Marcus Friedman

California Regulatory Law Reporter

No abstract provided.

The Role Of Parenting In Mitigating Epigenetic Cardiometabolic Risk In Predominantly Latino Preschoolers, Adamari López

Open Access Master's Theses

Background: Childhood obesity is a highly prevalent public health concern with significant consequences for health and development across the lifespan. Risk is disproportionately elevated among children from marginalized racial and ethnic groups and socioeconomically disadvantaged backgrounds, highlighting persistent disparities in long-term health outcomes. Epigenomic mechanisms, including DNA methylation (DNAm), have emerged as a promising approach for understanding the biological embedding of metabolic risk; however, prior research has largely emphasized deficit-based models, with limited attention to protective family-level factors. The present study examined whether participation in a positive parenting intervention was associated with epigenetic cardiometabolic risk among preschool-aged children. Methods …

“For Rescuing His Horse”: An Anthrozoological Approach To Dissent In Seventeenth-Century New England, Richard Mcgee

Open Access Master's Theses

The seventeenth-century colonization of New England entailed varying social, political, economic, cultural, and religious processes that were driven by and impacted several peoples. However, the presence of animals is undermentioned. This thesis forms an animal history of seventeenth-century New England, explains how different peoples understood human-animal relations, and evaluates how human-animal connectivity impacted how people conceptualized and conducted settler-colonialism. This thesis especially interrogates why some Puritan colonists limited different understandings of human-animal relations in the 1600s, namely from Indigenous Peoples, Quakers, and dissenting colonists deemed criminals. This thesis proposes that some Puritans restricted different concepts of human-animal relations because those …

Exploratory Investigation Of Greenhouse Gas Emissions In A Natural And Restored Salt Marsh, Sophia Motta

Open Access Master's Theses

Coastal wetlands are typically considered greenhouse sinks, specifically playing an important role in the global carbon cycle (Chmura et al., 2003), but new studies have pointed to anthropogenic interference leading to the understanding that altered tidal salt marshes may also be producers of methane to the atmosphere, contributing to the greenhouse effect. Hydrologic alteration including due to sea level rise (SLR), peat subsidence, impounded water, and decreased accretion rate disruption can have negative effects on marsh biochemistry leading to potential changes in electron acceptor availability, redox gradient shifts, and microbial community structure within the environment. This research is intended to …