Digital Commons Network^™

Insights Into Medical Surveillance Among Engineered Stone Countertop Workers In The United States Of America, Tony Huy Nguyen

Public Health Theses

Background: An alarming rise in the number of cases of silicosis, a progressive and incurable lung disease, among engineered stone (ES) workers has prompted concern about the extent of the problem in the U.S. and whether ES can be used safely. Overexposure to high levels of respirable crystalline silica (RCS) during fabrication or installation of ES can increase the risk of developing a more severe case of silicosis. Medical surveillance studies on US ES workers are limited.Aim: The overall objective of this study was to better understand the state of medical surveillance for ES workers using employer surveys and employee …

Stage-Specific Disruption Of Cancer Cell Metabolism By Pfas: Connecting “Forever Chemicals” To The Growing Public Health Challenge Of Colorectal Cancer, Hannah O'Halloran

Public Health Theses

Per and polyfluoroalkyl substances (PFAS), termed “forever chemicals” for their persistence in the environment, are under investigation for their carcinogenic effects, but their specific impacts on colorectal cancer (CRC) progression remain largely unexplored. This study uses untargeted metabolomics to examine the effects of PFAS exposure on cells of CRC stages 2, 3, and 4, and identify state-specific alterations in important metabolic pathways. Later stage cells exhibit a greater response than early stage cells, suggesting increased susceptibility to PFAS effects in cells of more advanced cancer. PFOS had a greater effect on the metabolism of the cell lines compared to PFOA, …

Evaluating The Implications Of Class And Regional Stereotypes On Attributions Of Blame During Hurricane Helene: A Reflexive Content Analysis Of Tiktok, Abby Ong

Public Health Theses

Background and Objectives: Hurricane Helene devastated entire towns across the Southern and Appalachian U.S. Following the hurricane, people who lived in impacted regions were derided for their perceived failures in evacuating. Utilizing Bernard Weiner’s attribution theory of social motivation, this study sought to analyze potential implications of regional stereotypes on how people blamed or supported disaster victims. Primary objectives were to: (1) to analyze content regarding residents’ decisions to evacuate or not evacuate during the storm, (2) to document attributions of blame or support and how those experiencing the disaster and outside observers responded to these attributions, and (3) to …

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 …

Codecontext: Integrating External Context For Enhanced Source-Code Model Performance In Software Development, Mohammad Arjamand Ali

Senior Honors Theses and Projects

In the ever evolving field of software development, understanding and maintaining complex codebases is crucial. There exist machine learning models and algorithms that aid in this by specifically learning to ‘understand code’, allowing engineers to build applications that help develop and maintain these large codebases. Although existing source-code machine learning models often overlook an important factor: the code's context. Our research focuses on leveraging external contextual information to enhance source-code model performance. We’ve developed a data pipeline that utilizes CodeQL to extract contextual information from the CodeSearchNet benchmark dataset to extend and create an augmented version of the dataset. We …

Effects Of Imagined Gun Ownership Psychopathology On Fears And Estimates Of Crime, Joseph Brown

Senior Honors Theses and Projects

Firearm incidents, a leading cause of death among youth aged 12-17 (CDC, 2023), present a complex issue requiring urgent attention. While prior psychological research has examined the weapons effect and related phenomena, further investigation is needed to understand the breadth of issues related to concerns with firearms usage, and specifically implications for mental health discourse (Berkowitz & Lepage, 1967; Metzl et al., 2021). In a sample (n = 55) of college students, this study investigates the effects of imagined gun ownership and exposure to a firearm and psychopathology on fear of crime and victimization. Participants were recruited in person and …

Colorblind Racial Attitudes Mediates The Association Between The Internalization Of Model Minority Myth Attitudes And Tolerance, Talal Ali

Senior Honors Theses and Projects

The model minority myth is the belief that Asian Americans are generally more intelligent and more hardworking than other minority groups. Many studies have demonstrated the relationship between belief in the model minority myth and anti-Black sentiment in White Americans. However, there is little literature on the relationship between belief in the model minority myth and anti-Black sentiment in Asian Americans. With this in mind, we plan to determine whether the internalization of the model minority myth in Asian Americans has a relationship with anti- Black sentiment. This relationship is being measured by the IM-4 Scale (which measures the internalization …

Portfolio Construction Analysis, Liam Peoples

Senior Honors Theses and Projects

This project examines the construction and evaluation of a diversified equity portfolio designed to generate positive risk-adjusted alpha relative to the S&P 500 over a five-year investment horizon. The analysis is conducted within a macroeconomic environment characterized by structurally higher interest rates, slowing real GDP growth, and elevating geopolitical and political risks. A comprehensive top-down assessment of financial, economic, industrial, global, political, housing, and trade dynamics forms the foundation for establishing portfolio selection criteria. Emphasis is placed on balance sheet strength, durable cash flows, and pricing power, reflecting the higher cost of capital and increased volatility relative to the pre- …

Pilot Study: Development Of A Food Delay-Discounting Measure For Individuals With Neurodevelopmental Conditions, Aaron Daniel Schwieterman

Senior Honors Theses and Projects

Individuals with intellectual (NDD) and neurodevelopmental (NDD) conditions experience disproportionately higher rates of obesity (Hsieh et al., 2014; Ptomey et al., 2020). Yet their diet decision-making process has been left out of the current literature. Delay discounting, which reflects the decrease in the subjective value of a reward as the delay to its receipt increases, has been linked to obesity and unhealthy food intake in typically developing adults. However, most existing tasks rely on hypothetical rewards and verbal reasoning, which limit their use with individuals who have cognitive or communication differences. The present pilot study developed and evaluated a novel …

Fairness-Aware And Culturally Adaptive Machine Learning For Predicting Adolescent Substance Use, Stephanie Nworgu

Senior Honors Theses and Projects

Early initiation of substance use during adolescence poses significant risks to long-term health, educational attainment, and social outcomes, making early identification a critical public health priority. Machine learning models have increasingly been used to predict substance use risk; however, many such models do not explicitly examine whether predictive performance differs across demographic groups. This senior project examines the fairness of logistic regression models used to predict first-time alcohol use among adolescents. Using nationally representative survey data from the Youth Risk Behavior Surveillance System (YRBSS), pooled across the 2017, 2019, 2021, and 2023 survey cycles, this study develops logistic regression–based predictive …

Tips For Avoiding Contract Cheating, Dawn Atkinson

Writing

No abstract provided.