The Yale School of Public Health (YSPH) was founded in 1915 by Charles-Edward Amory Winslow and is one of the oldest public health masters programs in the United States. It is consistently rated among the best schools of public health in the country, receiving recent rankings of 3rd for its doctoral program in epidemiology. YSPH has a unique hybrid existence with the Yale School of Medicine, as it is both a department (established in 1915) within the School of Medicine as well as an independent, CEPH-certified school of public health (established in 1946). According to the school's website, the community benefits greatly from the Yale School of Public Health's dual roles of providing a world–class education as an accredited, fully functioning school, and by conducting cutting–edge, interdisciplinary research through its collaborative departmental partnerships at the School of Medicine and across the Yale campus.
Background: The development of dedicated tibial artery stents has been challenging despite reports of successful use of coronary stents in the infrapopliteal circulation. This study compares the outcomes of tibial stenting and plain balloon angioplasty (POBA) prior to Food and Drug Administration (FDA) approval of a tibial scaffold. Methods: The Vascular Quality Initiative peripheral vascular intervention module was reviewed for patients treated for tibial peripheral arterial disease between 2011 and 2024. Trends in tibial interventions were derived, and patient characteristics undergoing stenting or POBA were compared. Propensity score matching was performed to evaluate outcomes, and Kaplan- Meier (KM) estimates of major adverse limb event-free (MALE-free) survival were compared. Results: Among 316,240 patients undergoing 460,584 procedures, 90,380 (28.6%) underwent tibial revascularization. Use of stenting declined (11.7%-3.0%), whereas use of special balloons increased (2.7%-14.3%). Before matching, patients undergoing stenting were more likely to be older, male, White, and had higher smoking rates but were less likely to have diabetes, congestive heart failure, and end-stage renal disease compared to patients undergoing POBA. They also more frequently underwent elective treatment of shorter lesions involving the tibioperoneal trunk with more fluoroscopy time. After matching, patients undergoing stenting had higher perioperative complications but achieved higher technical success compared to POBA. After a mean follow-up of 1.2 years, KM analysis demonstrated superior MALE-free survival among patients receiving stenting. Conclusion: Tibial stenting is associated with higher technical success than POBA and superior MALE-free survival. Dedicated tibial artery stents are needed in the endovascular armamentarium.
Climate change and its severe health impacts raise serious concerns about climate justice. To measure a population's vulnerability to climate change, researchers often apply indicator-based composite indices. In this work, we present a modeling framework for constructing a climate health vulnerability index (CHVI) and examine how methodological choices influence the identification of vulnerable communities. Using 44 indicators in New York State and two structural designs-inductive (principal component analysis) and deductive (indicator aggregation)-we conducted multiple sensitivity analyses to evaluate the robustness of CHVI outcomes. The deductive design was less sensitive to model inputs and specifications than the inductive design. Among the construction steps, principal component selection and indicator normalization were the most influential factors for the inductive and deductive designs, respectively. Quantification of climate-change-related vulnerability through transparent and reproducible index development can inform policy planning and resource allocation for the most disadvantaged populations.
Untargeted metabolomics provides a direct window into biochemical activities but faces critical challenges in determining metabolite origins and interpreting unannotated metabolic features. Here, we present TidyMass2, an enhanced computational framework for Liquid Chromatography-Mass Spectrometry (LC-MS) untargeted metabolomics that addresses these limitations. TidyMass2 introduces three major innovations compared to its predecessor, TidyMass: (1) a comprehensive metabolite origin inference capability that traces metabolites to human, microbial, dietary, pharmaceutical, and environmental sources through integration of 11 metabolite databases containing 532,488 metabolites with source information; (2) a metabolic feature-based functional module analysis approach that bypasses the annotation bottleneck by leveraging metabolic network topology to extract biological insights from unannotated metabolic features; and (3) a graphical interface that makes advanced metabolomics analyses accessible to researchers without programming expertise. Applied to longitudinal urine metabolomics data from human pregnancy, TidyMass2 identified diverse metabolites originating from human, microbiome, and environment, and uncovered 27 dysregulated metabolic modules. It increased the proportion of biologically interpretable metabolic features from 5.8
With the increasing accessibility of individual-level data from genome wide association studies, it is now common for researchers to have individual-level data of some traits in one specific population. For some traits, we can only access public released summary-level data due to privacy and safety concerns. The current methods to estimate genetic correlation can only be applied when the input data type of the two traits of interest is either both individual-level or both summary-level. When researchers have access to individual-level data for one trait and summary-level data for the other, they have to transform the individual-level data to summary-level data first and then apply summary data-based methods to estimate the genetic correlation. This procedure is computationally and statistically inefficient and introduces information loss. We introduce GENJI (Genetic correlation EstimatioN Jointly using Individual-level and summary data), a method that can estimate within-population or transethnic genetic correlation based on individual-level data for one trait and summary-level data for another trait. Through extensive simulations and analyses of real data on within-population and transethnic genetic correlation estimation, we show that GENJI produces more reliable and efficient estimation than summary data-based methods. Besides, when individual-level data are available for both traits, GENJI can achieve comparable performance than individual-level data-based methods. Downstream applications of genetic correlation can benefit from more accurate estimates. In particular, we show that more accurate genetic correlation estimation facilitates the predictability of cross-population polygenic risk scores.
Background We assessed the impact of pneumococcal conjugate vaccine (PCV) implementation on respiratory syncytial virus-positive, community-acquired alveolar pneumonia (RSV-CAAP) in young children in southern Israel. Methods This study was nested within a prospective population-based active surveillance system during 2004-2019. All children <60 months old residing in the region and served by the region's only hospital were included. A negative binomial regression model was used to evaluate the impact of PCV on the incidence of all-cause CAAP and RSV-CAAP and was the basis for estimating averted episodes. Results A total of 7640 all-cause CAAP episodes were observed; 50% were tested for RSV, of which 42% were positive. Shortly after PCV13 implementation, all-cause CAAP and RSV-CAAP rates markedly declined, stabilizing within 3-4 years. The mean annual hospitalization rates for all-cause CAAP and RSV-CAAP declined by 47% (95% CI: 40%-53%) and 29% (95% CI: -2% to 51%), respectively, during the late-PCV period, compared with the expected rates. This translated to a reduction in the mean annual incidence of 3.73 cases of all-cause CAAP/1000 children (95% CI: 2.98-4.58) and 0.50 cases of RSV-CAAP per 1000 children (95% CI: -.05 to 1.13). The highest incidences of averted cases occurred in children aged 12-23 months. Conclusions The observed dynamics of hospitalizations due to all-cause CAAP and RSV-CAAP following PCV implementation are consistent with the notion of a synergistic role of RSV and pneumococcus in CAAP in young children.
