bluuebunny/crossref_metadata_2025 huggingface dataset:
The Radiographic Effects of Lunotriquetral Coalition on Scapholunate Articulation
Authors: Court Tannor , Tsai Andrew , Joines Hannah , Kelly Christopher , Bouffard Antonio
Published: August 2024

Introduction: Radiographic widening in the scapholunate (SL) joint due to lunotriquetral (LT) coalition has historically been viewed as normal due to reported false positives of SL dissociation/widening in patients with LT coalition. Minimal further investigations have been reported on these findings.

Methods: Scapholunate interval, angle, third CMC joint space, and ligamentous measurements on CT, MRI, and X-ray imaging were compared for those with and without LT coalition. A multilevel one-way ANOVA was used to analyze CT SL angle versus X-ray SL angle and was compared to the control group. These comparisons were also performed for SL intervals and repeated for MRI imaging versus X-ray imaging. A t-test was completed to compare volar and dorsal ligament widths measured on MRI for the lunotriquetral and normal groups.

Results: On X-ray and CT, no difference was measured in SL interval, angle, and third CMC joint space between those with and without LT coalition, but SL angle was higher in those without LT coalition on CT. On MRI, no difference was measured in SL angle, but SL interval was smaller in those without LT coalition. SL interval compared to third CMC joint space was smaller for all cohorts on MRI and CT.

Conclusions: X-ray, CT, and MRI imaging of SL interval widening was not seen above normal radiographic parameters in the setting of LT coalition. Therefore, radiographic parameters of SL dissociation/widening should not change with LT coalition. The third CMC joint space was smaller compared to the SL interval and should not alone be used for radiographic diagnosis of SL dissociation.
Effects of Language Status and Interpreter Use on Inpatient Rehabilitation Outcomes
Authors: Hansen Kaitlyn , Roskos P Tyler , Fry Alexandra
Published: August 2024

Introduction: Non-English-speaking patients are at a disadvantage during inpatient rehabilitation due to language barriers and medical conditions including strokes and brain injuries. A qualified interpreter is not always used for various reasons depending on the setting. Studies have shown a lower functional independence and greater disability of minorities when discharged from rehabilitation. Further research is needed to investigate the communication barrier gaps in care. Question and Significance: Our goal was to determine if the use of interpreter services for non-English-speaking patients influences outcome measures from inpatient rehabilitation including CARE Tool scores, length of stay, and discharge disposition.

Methods: Our study was a retrospective chart review of patients admitted to the rehabilitation service at Corewell Taylor between 10/1/19-12/31/21, which included 2018 English-speaking patients and 105 non-English-speaking patients over 18 years old. We gathered information via UDSMR data set and chart review including demographic data, disposition factors, CARE Tool scores, language status, and if an interpreter was used. Data was examined via Fisher’s exact tests. Analyses were performed using R Statistical Software.

Results: Our data showed the proportion of non-English-speaking patients who used a professional interpreter was 0.73 (95% CI [0.64 – 0.82]). The proportion of non-English-speaking patients using any interpreter (professional or family) was 0.85 (95% CI [0.76 – 0.91]). There was a statistically significant association between language spoken (English vs non-English) and both gender (p=0.002) and race/ethnicity (p<0.001). No significant associations between interpreter use and any demographic characteristics/outcomes of interest were found.

Conclusions: Our data showed no statistically significant association between interpreter use and CARE Tool scores, length of stay, or discharge disposition. We found that most of those needing interpretation used professional interpreter services. Therefore, interpreters are likely beneficial to improve communication with patients in inpatient rehabilitation, but further research is warranted regarding its effect on outcome.
OBGYN Specialty Qualifying Exam Score Improvement from 2018-2023
Authors: Ayo-Olaniyan Oreoluwa , Younis Lana , Khan Ayesha , Maxwell Shari
Published: August 2024

Background: All US graduate OBGYN candidates must pass a Specialty Qualifying Exam, also known as the written board exam, before being able to take the Specialty Certifiying Exam, also known as the oral board exam. There has been emphasis on appropriate preparation.

Introduction: This study’s aim was to review the Specialty Qualifying Exam results from graduating residents between the years 2018 and 2023. There has been a notable change through an improved didactic schedule. This included incorporating a question bank and test preparation throughout the year.

Methods: The passage rate per graduating class year for Corewell Health East- Dearborn was compared in three-year windows. We compared the passage rate of 2018 to 2020 to the passage rate of 2021 to 2023. Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a gamified question bank, and test preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison.

Results: From 2018 to 2020, the three-trend noted overall 73.7% passage rate, with an 83.3% first time passage rate and a 57.1% repeat test passage rate. Compared to the three-year trend from 2021 to 2023 resulting in a 100% overall passage rate, 100% first time passage rate and 100% repeat test passage rate.

Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty, and as a result, there has been improvement in the Specialty Qualifying Exam by our graduating residents. We have maintained our commitment to recruit residents with diverse backgrounds who have come from US MD, US DO and foreign medical schools. Conclusion: The improvement in scores will continue to guide future changes in our didactic schedule.
Intern Mentor Program
Authors: Dougan Thomas , Khan Bakhta-Awar , Jafri Ali , Hasnain Amana , Mahoney Amanda , Raza Beebarg , Malatches Brock , Misra Preeti
Published: August 2024

Intern burnout, stress, and work life balance are abundant and normalized in residency in Livonia we challenge this statement. The intern mentor program was implemented as a way to combat the inevitable shock that comes between the transition from medical student to resident physician. Throughout the program, we had second and third year residents closely work with interns starting their rotations on medical floors. Observing their workflow, starting from chart review skills, providing tips in navigating the electronic medical record efficiently, to appropriate presentation of their patients using SOAP templates, supervising their signout with real time feedback, reviewing their notes, and addressing their concerns and fears. This was highly effective, especially in the transition of residents who experienced virtual rotations in their transition to Medical floors. The study outcomes revealed significant improvement among interns through the resident mentor program measured by a survey handed out to interns. Metrics, including patient care, medical decision-making, medical knowledge, understanding of the healthcare system, efficiency, and stress management were measured, and all interns reported significant improvement on a scale from 1-10, with average being 9. Future plans involve further strengthening mentorship through additional structured options and the assignment of mentors. Additionally, an extension of the intern mentor program duration will enhance both the breadth and depth of mentoring, and to increase the study power.
Surgical Site Infection Bundle for Babies – Preliminary Data
Authors: Ward Katelyn , Woodley Cullen , Nida John , Lonjin Alexis , Studzinski Diane , Novotny Nathan , Brahmamdam Pavan , Akay Begum
Published: August 2024

Introduction & Background: Perioperative care bundles reduce surgical site infections (SSIs) in adults but are not used regularly in infant surgery. Infections in babies after surgery are less common but carry significant morbidity in a fragile patient.

Question & Significance/Aim: We aim to evaluate the effects of a perioperative care bundle in patients less than 6 months old undergoing abdominal or thoracic surgeries.

Methods & Design: The perioperative bundle was developed in a multi-disciplinary fashion and addressed several areas of care: standardized bowel preparation when appropriate, preoperative skin cleansing, antibiotic choice and timing, temperature control, intraoperative skin preparation, and closing protocols. Patient characteristics and outcomes were compared pre- and post-implementation of the bundle. An SSI bundle checklist was used to help confirm bundle adherence.

Results: After 6 months, 44 cases were reviewed with 26 pre- and 18 post-implementation. The median estimated gestational age at birth was 36.6 weeks (IQR 30.8, 37.6). The median weight at surgery was 3.3 kg (IQR 2.3, 4.0). After bundle implementation, we saw statistically significant increases in appropriate antibiotic timing (42.3% vs 77.8%, p=0.03), pre-operative skin cleansing (0.0% vs 61.1%, p<0.001), Chloraprep™ use (3.8% vs 61.1%, p<0.001), and closing protocols (0.0% vs 33.3%, p=0.0026). No difference in SSI was appreciated (Table 1). The bundle was used appropriately 83% of the time.

Discussion: A perioperative SSI bundle in babies can change the approach to infection control during surgery. The rate of SSI in both groups was low. Adoption of our bundle was good, but we expect its use requires more patients to appreciate benefits.
Standardized Gastrografin Protocol for Small Bowel Obstructions in Community Hospital Setting
Authors: Korlewitz Ryan , Glover Mark , Linz Meghan , Braddock Amy
Published: August 2024

Introduction: Small bowel obstructions (SBO) are diagnosed and treated variously. The purpose of this study is to determine whether the use of Gastrografin oral hyperosmolar contrast and serial abdominal X-rays will lead to a decreased length of stay, readmission rate, and need for surgical intervention versus current management of patients with SBO.

Methods: A retrospective review of patients who presented to our hospital with the diagnosis of SBO over two years was performed. Patients were excluded if their clinical status led to emergent operative intervention, were admitted within 30 days of bowel surgery, or were <18 years old. The leading variable for analysis was patients undergoing Gastrografin protocol versus those that did not. The leading outcome was hospital length of stay. Secondary outcomes included number of CT scans during admission, progression to surgery and 30-day readmission rate. Analyses were performed using both unpaired T-tests and Chi-squared tests.

Results: A total of 55 patients with a SBO that met study criteria were reviewed. Total patients who underwent Gastrografin protocol were 24 versus 31 who did not. Gastrografin protocol patients had a decreased length of stay (mean, 2.2 days vs 3.9 days, p=0.0048) and decreased number of CT scans during admission (mean, 1.0 scans vs 1.35 scans, p=0.0027) compared to non-protocol patients. Both Gastrografin protocol and non-protocol groups had similar progression to surgical intervention (4.2% vs 16.1%, p =0.158) and 30-day readmission rate (12.5% vs 16.1%, p=0.70).

Conclusion: The Gastrografin protocol decreases length of stay and number of CT scans for patients admitted with SBO.
Do Hospitals Get EMS Patient Care Reports?
Authors: Shanley John , Marcero Joseph , Swor Robert
Published: August 2024

Background: EMS patient care reports (PCRs) are an important component of the EMS system and a foundational element of quality improvement. In many cases, PCRs provide hand-offs between providers, and may be the only context for patient presentation. Little data exists regarding the frequency and timeliness of PCR provision to Emergency Departments (ED).

Objective: To describe the frequency of missing PCRs following EMS transport and timing of receipt by EDs within a regional healthcare system.

Methods: We performed a retrospective study of EMS PCRs for patients transported to a single health system from 1/1/21 – 7/1/22. We stratified agencies by 911 response or interfacility transport. PCR receipt and time of EPIC upload were obtained from EPIC Crystal Report® query. Primary outcome was frequency of PCR receipt by EDs (in aggregate and by agency). Secondary outcome was interval from EMS ED arrival to EMR upload (greater or less than 120 minutes of arrival). We provide descriptive statistics reporting proportion of receipt of PCR (mean, range) by hospital and agency

Results: There were 106,496 patients transported by 62 agencies, 87.3% were 911 responders. Overall, receipt of PCRs varied substantially by hospital – 54.2% (13.5% - 80.1%). 30.7% (2.4% - 63.4%) were uploaded within 120 minutes of ED arrival. PCR submission rate varied substantially by agency, 45.8% (2.5% - 96.8%). Interfacility EMS services were far less likely to submit a PCR after ED transport (35.9% vs. 56.9%).

Conclusions: PCR’s are frequently missing after EMS transport within this large hospital system, and infrequently available for timely review. Interfacility transport agencies are less likely to submit compared to 911 responders. Although hospital manual upload of PCRs may impact time of their receipt, this does not explain the overall rate of missing PCRs. Further work is needed to identify obstacles to PCR delivery and assure their availability.
A Quality Initiative to Improve Breastfeeding Initiation Rates in a Resident Continuity Clinic Using Physician Directed Education
Authors: Magsam Cynthia , Menon Stephanie , Schechtman Jessica
Published: August 2024

Introduction: Known disparities exist in breastfeeding rates among marginalized populations. Direct patient counseling improves these rates. Non breastfed infants have increased risk of infections, obesity, and chronic disease. Mothers who do not breastfeed have increased incidence of breast and ovarian cancer. The aim of this quality initiative is to improve breastfeeding initiation rates in our resident OBGYN continuity clinic from the baseline rate of 74.9 % to 81.9%.

Methods: This project was a pragmatic quasi-experimental time series, utilizing PDSA cycles for an implementation framework. The outcome measure was monthly breastfeeding initiations rates of the Academic OB/GYN Center’s patients. This was determined by reviewing charts after birth from September 2021 through February 2022. This outcome was tracked and analyzed using a statistical control chart. We then designed three intervention cycles to improve breastfeeding rates. In September 2022, intervention one was implementation of an informational handout to guide residents on breastfeeding counseling. This was evaluated by tracking completion rates of documented counseling. In January 2023, intervention two was completed and consisted of a three-hour resident didactic on breastfeeding. The process measure for this intervention was recording attendance. May 2023, intervention three was the implementation of an informational handout directed to patients of color.

Results: A total of 496 patients were trended over 24 months. Statistical analysis on average initiation rates were completed with Welch’s t-tests. Average breastfeeding initiation rate increased from 74.9% to 76% (p-value 0.86) after intervention. After intervention two, breastfeeding initiation rates again increased to 82.8% (p value 0.22). There was a lower average breastfeeding initiation rate noted in non-Hispanic black patients compared to non-Hispanic white patients (70.8% vs 78%), prompting intervention three. After intervention three, overall breastfeeding initiation rates decreased to 72.8% (p-value 0.73), however, rates in non-Hispanic black patients increased to 72% (p-value 0.91).

Conclusion: Although physician directed patient education, resident didactics on breastfeeding, and directed breastfeeding resources appeared to positively impact breastfeeding initiation rates, control chart analysis shows no special cause variation indicating changes were associated with common causes. While the goal of increasing breastfeeding initiation rate to 81.9% was achieved, it was not sustained indicating additional interventions are needed.
Improving OBGYN resident CREOG scores
Authors: Zafar Naybar , Delancey Evan , Onyuike Ngozika , Khan Ayesha , Maxwell Shari
Published: August 2024

Background: OBGYN residents take an annual in-service training exam from the Council on Resident Education in Obstetrics and Gynecology (CREOG). The CREOG exam is used within the residency program to identify areas of improvement in education and to help residents prepare for passing the written boards.

Introduction: This study’s aim was to improve knowledge and preparation for the CREOG exam through an improved didactic schedule and more focused test preparation strategy. This included incorporating a question bank and CREOG preparation throughout the year.

Methods: The average standardized scores per resident class year for Corewell Health East- Dearborn were reviewed from 2019 to 2024.

Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a question bank gamified, and CREOG preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison.

Results: From 2019 to 2024, scores of each class year increased. In the PGY1 class year, the score increased from 54% in 2019 to 60% in 2024. In the PGY2 class year, the score increased from 57% in 2019 to 69% in 2024. In the PGY3 class year, the score increased from 55% in 2019 to 70% in 2024. In the PGY4 class year, the score increased from 58% in 2019 to 71% in 2024. The overall score has increased from 56% in 2019 to 67% in 2024.

Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty which resulted in improved scores in the CREOG exam.

Conclusion: The improvement in CREOG scores will continue to guide future changes in our didactic schedule.
Depression and Anxiety of At-Risk Patients in Antepartum Units: A Pilot Observational Study
Authors: Leppien Brittley , Shamoun Rachel , Nabati Sayeh , Naik Urva
Published: August 2024

Background

Perinatal depression is a common yet underdiagnosed and undertreated disorder that can occur in any trimester of pregnancy and can extend into the postpartum period. The aim of this study was to evaluate depression and anxiety in at-risk antepartum patients hospitalized due to pregnancy complications.

Methods

In this prospective observational study, we measured anxiety and depression using the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) and other contributing factors. Statistical analysis was performed using IBM SPSS Version 25.0 with significance set at a p-value <0.05.

Results and Discussion

While 78% had no prior history of treatment for depression (p=0.018), about 33% had a history of depression. Anxiety and depression scores increased from a mean score of 2.8 on PHQ-9 and 3.5 on GAD-7 on admission to 5.0 and 6.8 during antepartum hospitalization, respectively.

Conclusions

This pilot study showed that antepartum admission of at-risk patients was trending toward increased risk of anxiety and depression over time.
Impact of a Brief Educational Headache Osteopathic Manipulative Treatment Intervention for Allopathic and Osteopathic Family Medicine Residents: A Pilot Study
Authors: Naidu Janani , Li Elton , Soni Emily B , Leikert Eric P
Published: August 2024

Background

Headaches affect approximately 50% of all people. Osteopathic manipulative treatment (OMT) is a safe and effective treatment modality for headaches. Given the recent osteopathic and allopathic accreditation merger, there has been growing interest in OMT among allopathic physicians. The objective of this study was to determine the effect of a brief educational intervention on the confidence and knowledge of headache OMT for allopathic and osteopathic physicians.

Methods

Data from Postgraduate Year 1 and 2 Family Medicine resident physicians on their OMT rotation were collected via online surveys. Surveys were administered between August 2021 and June 2022; only residents who had seen patients 18 years and older and were referred to the OMT clinic for headache or neck pain treatment were included. Resident self-assessment was conducted before and after the educational intervention, which consisted of a prerecorded 20-minute lecture made available to the residents at the start of their OMT rotation. Wilcoxon Signed Rank Test was performed using IBM SPSS Version 25. Statistical significance was set at a p value<0.05.

Results

Three allopathic-trained and 4 osteopathic-trained residents participated in the study. Our results demonstrated a statistically significant increase in comfort with OMT billing (p=0.041) and completing an OMT visit within the allotted amount of time (p=0.025) post intervention but not in any other survey items.

Conclusions

The brief educational intervention resulted in an improvement in billing and timely completion of an OMT visit by osteopathic and allopathic residents.
A IMPORTÂNCIA DO PROFISSIONAL DE ENFERMAGEM NA PROMOÇÃO DA SAÚDE E PROFILAXIA DE NEOPLASIAS CERVICAIS: UMA REVISÃO NARRATIVA DA LITERATURA
Authors: Oliveira João Vitor da Silva , Lima Gizele Farias Valente , Bizerra Elizangela Fernandes da Silva , Leite Gabrielly Crescencio , da Silva Alsirley Rodrigues , Lima Jaqueline Oliveira , Dias Dhuliane Andreza Souza , Pessoa Elen Andrade de Araújo , de Sousa Francilene Inácio , Fagundes Natália Ribeiro
Published: August 2024

As neoplasias cervicais ocupam, no mundo, o segundo lugar no ranking dos cânceres femininos, só perdendo para a neoplasia mamária e a taxa de morbimortalidade por neoplasias no colo uterino, ajustada pela população mundial foi de 4,60 óbitos/100 mil mulheres. Este estudo constitui uma pesquisa bibliográfica, configurada como uma revisão narrativa da literatura relacionada ao suporte de enfermagem para câncer cervical, com o objetivo de sintetizar pesquisas publicadas sobre esse tema. Após a aplicação de todos os descritores, uma amostra inicial de 527 artigos foi obtida, após uma análise minuciosa e a aplicação dos critérios de inclusão e exclusão foi obtida uma amostra final de 8 artigos que compõem a revisão. De maneira unânime, destaca-se a importância de que o trabalho do enfermeiro seja baseado nas diretrizes e protocolos recomendados pela Organização Mundial da Saúde (OMS) no que se refere ao monitoramento de neoplasias cervicais. Em suma, o suporte da enfermagem na profilaxia é peça chave na promoção da saúde e no bem-estar das mulheres.
Information System for Financial Management and Human Resource Proficiency and Accountability for Financial Statements: An Indonesian Case Study
Authors: Soesiawan Tri Pangkat , Lestari Laraswati Puji , Supratikta Hadi
Published: August 2024

The purpose of this study is to investigate how organizational culture, human resource competency, and financial management information system variables affect the financial reporting responsibility of village governments. Using a straightforward random sample method, 65 villages from the two districts made up the sample. The data from this study were analyzed using multiple regression analysis. The outcomes demonstrated that Human resource competency, organizational culture, and financial management information systems—the three differentiators in the two districts—have a major positive impact on accountability when it comes to creating village government financial reports in Tabanan Regency. In Badung Regency, on the other hand, organizational culture has little bearing because work cultures vary throughout village governments. Local culture serves as the foundation for organizational culture in the Tabanan regency, whereas organizational culture in the Badung regency is examined and implemented differently, suggesting that no organizational culture type is better than any other. This implies that depending on how and when organizational goals are to be achieved, all types can work together and in tandem with one another.
The Use of Audio-Visual Media on Student Learning Interest in Explanatory Text Material
Authors: Bawamenewi Arozatulo , Lase Julita Hertawati , Zega Elsa Fitriana , Gea Lince Imerda
Published: August 2024

Background. The use of audio-visual media in education has gained increasing attention due to its potential to enhance student engagement and learning outcomes. In Indonesian language instruction, particularly in teaching explanatory text material, there is a need to explore innovative methods to improve student interest and comprehension.
Purpose. This study aims to evaluate the impact of using audio-visual media on students' interest in learning explanatory text material in class VII-A SMP Negeri 2 Hiliduho.
Method. A qualitative research method with a descriptive approach was employed. The study involved 20 students from class VII-A SMP Negeri 2 Hiliduho. Data were collected through observation, interviews, and documentation techniques.
Results. The use of audio-visual media significantly increased students' interest and understanding of explanatory text material. Students demonstrated improved ability in determining appropriate terms and adjusting explanatory texts to their proper structure and characteristics. Audio-visual media, such as PowerPoint presentations and videos, made the material more engaging and comprehensible, facilitating a more efficient learning process. Students using audio-visual media showed higher levels of engagement compared to those who did not, as they were able to follow the learning flow more effectively.
Conclusion. The findings suggest that audio-visual media play a crucial role in enhancing the learning experience for students studying explanatory text material. Teachers reported that these tools aided in more effective content delivery. The increased student engagement and improved understanding of the material highlight the potential of audio-visual media as a valuable instructional tool in Indonesian language education, particularly for explanatory text instruction.
The Utilization of Spotify Application to Improve English Listening Skill: Students’ experience
Authors: Yanti Dawi
Published: August 2024

Background. Listening is a complex skill involving attentive listening, understanding oral symbols, appreciation, content capture, and comprehension of communication through spoken language. It is a fundamental skill in language learning that supports other language abilities.
Purpose. This study aims to investigate the utilization of the Spotify application in improving English listening skills among sixth-semester English Tadris students at the Faculty of Tarbiyah and Keguruan, Universitas Islam Negeri Mahmud Yunus Batusangkar.
Method. The research employs a quantitative approach with a survey design. Data collection was conducted using a questionnaire comprising 24 statements, distributed to each student in the class. The population consisted of sixth-semester English Tadris students at the university, with a sample size of 37 participants. The questionnaire's reliability was established with an RPB for each item greater than the r table (0.325) and a Cronbach's alpha of 0.831.
Results. The assessment results indicate a positive response from students regarding the use of the Spotify application for improving their listening skills. Students reported that various features available on Spotify, along with its accessibility, contributed to enhancing their listening abilities.
Conclusion. The study concludes that the Spotify application is a valid and reliable tool for improving students' English listening skills. Its effectiveness is attributed to the diverse features offered by the application and its convenience of use. These findings suggest that Spotify can be a valuable resource for language learners seeking to enhance their listening proficiency.
Utilization of Quiz Kreator in Student Achievement Assessment in Elementary School
Authors: Chairuddin Chairuddin , Hidayat Rahmat , Nasruddin Nasruddin , Kadayloding Kamaruddeen , Toepak Erwin Prasetya
Published: August 2024

Background. The world of education is inseparable from various learning components. The utilization of technology cannot be separated from the world of education. One of them is the use of Quiz Kreator for student achievement assessment in elementary schools. Quiz Kreator is one of the online applications used to create quizzes, including multiple choice quizzes and true false quizzes.
Purpose. This study aims to determine how student achievement in elementary schools after using the Quiz Kreator application in the learning process.  
Method. The researcher used quantitative research methods, namely by distributing questionnaires to elementary school students. The questionnaire was distributed online.
Results. The results showed that the use of Quiz Kreator in assessing student achievement in elementary schools has a positive impact on students. The use of Quiz Kreator as an assessment tool that is well designed and relevant to the material being taught, can improve student achievement. Quiz Kreator can provide assessment results automatically and accurately. This can also help teachers in assessing student achievement more objectively.  
Conclusion. the use of Quiz Kreator in assessing student achievement in elementary schools can be utilized well. The use of this Quiz Kreator application can improve student achievement in the learning process.
The Effect of Mobile Learning on the Study Results of Arab Language Students of MTs-TI Pariangan
Authors: Ikhlas Rifki Zaitul , Abidin Munirul
Published: August 2024

Background. In today’s digital era, the use of technology in education is becoming increasingly important. Mobile learning in the form of Articulate Storyline application offers easy access and interactivity that can enrich students’ learning experience. However, not many studies have specifically investigated the impact of using the application on student learning outcomes at MTs-TI Pariangan.
Purpose. This study aims to evaluate the effect of using the Articulate Storyline application on students’ Arabic learning outcomes at MTs-TI Pariangan. Factors that influence the effectiveness of the app in improving academic achievement will be scrutinised to provide greater insight into the effectiveness of the app.
Method. The research method used is an experimental study with a pre-test and post-test design. The research sample was 8th grade students of MTs-TI Pariangan consisting of 20 students. Data was collected through an initial test before the use of the application and a final test after the period of application use.
Results. The results of this study showed a significant improvement in student learning outcomes after using the Articulate Storyline app. Students who actively used the application showed greater improvement in material understanding and academic achievement compared to those who did not use the application. The findings support the hypothesis that the use of the Articulate Storyline application has a positive effect on student learning outcomes at MTs-TI Pariangan.
Conclusion. This study shows that the use of Articulate Storyline mobile learning application significantly improves the Arabic learning outcomes of grade 8 students of MTs-TI Pariangan. Validity and reliability tests confirm that the instruments used have high consistency and reliability. The results of statistical analysis showed a significant difference between the pre-test and post-test scores, with an increase in the average score from 65.00 to 80.50.
Gas Store Data Analysis Using ERD Method and Constitutional Data Warehouse Model
Authors: Risaldi Fahmi , Terisia Vany , Arman Shevty Arbekti , Yusuf Diana
Published: August 2024

A data warehouse is a data storage system that plays a crucial role in business analysis. It collects, integrates, and stores data from multiple sources in a structured format, providing holistic insight into organizational performance. Entity-Relationship Model (ERD) is a visual tool for designing database structures. It uses entities to represent real-world objects and the relationships between them. ERD helps plan an efficient and coherent database design. A conceptual model is an abstract visual representation of information structures and relationships within a domain. It covers key concepts and business rules, assisting in building a solid foundation of understanding before technical designing begins. All three are interrelated in the development of successful information systems. Data warehouses use conceptual models to direct effective data storage design, while ERD helps describe the entities and relationships to be stored in the data warehouse. The combination of all three enables organizations to design, develop, and maintain adequate information systems, based on a deep understanding of data and its relationships. This results in better decision making, more efficient innovation, and optimal utilization of resources. The purpose of this study is to produce optimal data using the ERD method. The main objective is to explain how much data in an information system in the Company and how data management is crucial for effective decision making.
Augmented Reality-Based Computer Hardware Assembly Simulation Learning Media Design at SMK N 1 Bukittinggi
Authors: Mandiri Hari Okto
Published: August 2024

This research is based on the results of observations that the author did at SMK N 1 Bukittinggi. From the results of observations the authors know that in the subject of Basic Network Computers do not use learning media in the learning process. The learning process is carried out in the form of direct practice accompanied by an explanation from the subject teacher. This is seen as less effective in its implementation. Thus the purpose of this study is to design learning media for computer assembly using Augmented Reality technology in order to increase the effectiveness of the learning process. The research method used is the Research and Development (R&D) research method, which is a method used to produce products. The R&D model used is the 4D version, namely, define, design, develop, desseminate with the Luther Sutopo development model which consists of 6 stages, namely conceptualization (concept), design, material collection, manufacture (assembly), testing (testing), distribution (distribution). ). And the product test consists of 3 tests, namely validity test, practicality test, and effectiveness test. Based on the results, the author succeeded in designing Augmented Reality-based assembly learning media. This learning media can be used by teachers and students in Basic Computer Networking subjects. The form of this learning media is an application (apk) that is run using Android, while the validity results obtained from 3 validators are 0.86 which is declared valid, the practical results obtained from 2 examiners are 85.33 which are declared practical, and effectiveness was obtained from 10 students 0.87 which was declared effective.
O IMPACTO DA HEPATITE C NO SISTEMA PÚBLICO DE SAÚDE BRASILEIRO: REVISÃO BIBLIOGRÁFICA
Authors: Reis Beatriz Vinhaes dos , Honorato Nicole Falone Resende , Abrantes Lizanka Dias , Secundo Daniel Figueirêdo Macêdo , Sousa Carine Medeiros de , Teixeira Kaila Beatriz de Jesus , Leal Klysmann Douglas Nascimento , Santos Victor Hugo Pinheiro dos , Lemes Mônica Andrade , Lucena Júnior Francisco Furtado , Alencar Crincia Amorim Melo , Badini Rômulo Rodrigues , Pinho Victoria Alves , Silva Paulina Gomes da , Sousa Isabella dos Reis de , Mascarenhas Isabella Tempone , Costa Daniella Pineli Chaveiro , Lima Anna Priscylla Pinheiro Diógenes , Borges Mayara Rodrigues , Costa Fernanda Tâmy Alves Iseri , Carvalho Paulo Egildo Gomes de , Matos Roberta Priscila Baccili Castilho , Matos Roberta Priscila Baccili Castilho
Published: August 2024

Introdução: A hepatite C é uma doença crônica que representa um desafio significativo para o Sistema Público de Saúde Brasileiro (SUS) devido às suas complicações graves, como cirrose e carcinoma hepatocelular, e aos custos elevados de tratamento. O Brasil, por sua vez, tem implementado políticas públicas para ampliar o acesso a tratamentos modernos, como os antivirais de ação direta (DAAs), visando reduzir o impacto dessa doença. Objetivo: Este estudo tem como objetivo realizar uma revisão bibliográfica sobre o impacto da hepatite C no SUS, analisando aspectos como epidemiologia, impacto econômico, políticas públicas e os desafios enfrentados na gestão da doença. Metodologia: Foi realizada uma revisão bibliográfica narrativa, utilizando bases de dados como PubMed, SciELO, LILACS e Google Scholar. Foram incluídos artigos publicados entre 2011 e 2023, que abordassem o impacto da hepatite C no SUS, considerando fatores econômicos, epidemiológicos e de políticas públicas. Resultado: A análise dos dadosrevelou que a hepatite C exerce um impacto multifacetado sobre o SUS, com custos elevados tanto diretos quanto indiretos. Apesar da expansão do acesso aos DAAs, o sistema enfrenta desafios como a subnotificação de casos, desigualdades regionais no acesso ao tratamento e dificuldades de infraestrutura em determinadas regiões. Discussão: Os resultados indicam que, embora os avanços no tratamento com DAAs sejam promissores, há uma necessidade contínua de aprimorar estratégias de diagnóstico precoce e monitoramento, além de enfrentar as disparidades regionais. A sustentabilidade financeira do tratamento é uma preocupação, assim como o combate ao estigma relacionado à doença. Conclusão: O impacto da hepatite C no SUS é significativo e exige umaabordagem integrada, combinando avanços terapêuticos, políticas públicas eficazes e uma infraestrutura de saúde mais equitativa. Somente com esses esforços será possível reduzir o ônus da hepatite C sobre o sistema de saúde e melhorar a qualidade de vida dos pacientes no Brasil.
CATARATA CONGÊNITA: ASPECTOS DIAGNÓSTICOS, CLÍNICOS E CIRÚRGICOS: UMA REVISÃO DE LITERATURA
Authors: Simão Ana Letícia Corvisier Sad , Molinar Maria Paula Cury , Cova Maria Cecília Carvalho da , Vicente Apolyana Peres Martelleto , Goldfeld Eduarda Parrilha , Costa Handella Vitória Coelho Carneiro , Bezerra Lia Vitória Moura de Araujo , Rodrigues Alice Pontara Pazini , Borges Luana Dias , Paresqui Lara , Filho e Lira Carlos Vinicio Carvalho , Souza Natália Campos Vieira Freitas de , Lima Luan Cardoso Silva , Lima Cassio Vinicius Rodrigues de , Lima Julia Hammerschlag , Lopes Cristiano Torres , Nunes Caio Meireles , Monteiro Manoella Manhães , Vasconcelos Pablo Vinícius Silvino , Braga Roberta de Oliveira , Gomes Lucas de Souza , Silva Luane Godinho Carino da
Published: August 2024

Introdução: A catarata congênita, uma condição ocular que causa opacidade do cristalino desdeo nascimento, pode levar a comprometimento visual significativo se não for tratadaprecocemente. Suas causas incluem fatores genéticos, infecções congênitas e fatores ambientais.A detecção precoce, através de exames neonatais, e a cirurgia realizada idealmente antes das 8semanas de idade são cruciais para melhorar os resultados visuais a longo prazo e evitar aambliopia por privação. Apesar dos avanços na técnica cirúrgica, complicações como glaucomae opacificação da cápsula posterior podem ocorrer, exigindo monitoramento contínuo eacompanhamento rigoroso para garantir a melhor qualidade de vida possível para os pacientes.Objetivo: Avaliar o impacto do diagnóstico precoce e das intervenções cirúrgicas na cataratacongênita sobre os resultados clínicos e a qualidade de vida dos pacientes. Métodos: Umarevisão sistemática de literatura foi realizada nas bases de dados Pubmed e Scopus, com um filtrode 6 anos e estudos de alta qualidade metodológica em língua inglesa. Resultados e Discussão:Foram selecionados 7 artigos para compor essa pesquisa. O diagnóstico precoce e a intervençãocirúrgica na catarata congênita são cruciais para otimizar os resultados clínicos e a qualidade devida. A detecção precoce permite uma abordagem cirúrgica eficaz, e reduz a probabilidade decomplicações visuais. A escolha entre lentes intraoculares e afacia deve ser adaptada àsnecessidades individuais dos pacientes. O tratamento adequado pode melhorar significativamentea qualidade de vida das crianças afetadas, refletindo os avanços na prática clínica e nodiagnóstico. Conclusão: O diagnóstico precoce e o tratamento cirúrgico da catarata congênitasão fundamentais para melhorar os resultados clínicos e a qualidade de vida dos pacientes. Aescolha adequada do momento da cirurgia e a abordagem personalizada, incluindo a decisãosobre lentes intraoculares, são essenciais para o sucesso do tratamento. A evolução nas técnicasde diagnóstico e tratamento contribui para melhores desfechos e oportunidades para as criançasafetadas.
Diplômés internationaux en médecine : incertitude et complexité de la reconnaissance des compétences professionnelles au Québec (Canada)
Authors: Béguerie-Goddaert Corinne , Blain Marie-Jeanne
Published: August 2024

Choisies sur la base de leur capital humain, certaines personnes immigrantes hautement qualifiées se heurtent à la difficulté de faire reconnaître leurs compétences en lien avec la profession qu’elles exerçaient dans leur pays d’origine. L’intégration en emploi de ces professionnels est fondamentale pour l’activité économique de la province, qui a besoin d’une main-d’oeuvre spécialisée. Cet article se base sur deux recherches complémentaires sur les trajectoires de reconnaissance des compétences et d’intégration professionnelle de personnes immigrantes titulaires de diplômes internationaux en médecine (DIM) arrivés entre 1998 et 2009 (première recherche) et entre 2008 et 2018 (seconde recherche). Les deux recherches ont adopté une méthodologie qualitative, privilégiant des entretiens semi-dirigés avec 53 DIM. Cinquante acteurs-clé des milieux institutionnel, communautaire et associatif ont également été rencontrés, lors d’entrevues non dirigées ou semi-dirigées. Couplant des perspectives théoriques complémentaires, ces deux recherches ont en commun des analyses thématiques portant sur la typologie des trajectoires d’intégration et les expériences et vécu des médecins lors de leurs parcours. Le Collège des médecins est souvent accusé d’être un frein à la reconnaissance des compétences des médecins formés à l’étranger. Nous montrons dans cet article que la situation des DIM est plus complexe que cela. L’obligation pour ces personnes professionnelles formées à l’étranger de réussir plusieurs examens préalables à un retour aux études et de refaire une résidence en médecine peut également être une barrière et les mener à des trajectoires d’intégration professionnelle très variées. Les facultés de médecine qui doivent les accueillir exigent d’elles de faire la preuve de leurs compétences selon des critères qui les excluent parfois du parcours de formation en résidence.
One N-glycan regulates natural killer cell antibody-dependent cell-mediated cytotoxicity and modulates Fc γ receptor IIIa/CD16a structure
Authors: Kremer Paul G , Lampros Elizabeth A , Blocker Allison M , Barb Adam W
Published: August 2024

Both endogenous antibodies and a subset of antibody therapeutics engage Fc gamma receptor (FcγR)IIIa/CD16a to stimulate a protective immune response. Increasing the FcγRIIIa/IgG1 interaction improves the immune response and thus represents a strategy to improve therapeutic efficacy. FcγRIIIa is a heavily glycosylated receptor and glycan composition affects antibody-binding affinity. Though our laboratory previously demonstrated that natural killer (NK) cell N-glycan composition affected the potency of one key protective mechanism, antibody-dependent cell-mediated cytotoxicity (ADCC), it was unclear if this effect was due to FcγRIIIa glycosylation. Furthermore, the structural mechanism linking glycan composition to affinity and cellular activation remained undescribed. To define the role of individual amino acid and N-glycan residues, we measured affinity using multiple FcγRIIIa glycoforms. We observed stepwise affinity increases with each glycan truncation step, with the most severely truncated glycoform displaying the highest affinity. Removing the N162 glycan demonstrated its predominant role in regulating antibody-binding affinity, in contrast to four other FcγRIIIa N-glycans. We next evaluated the impact of the N162 glycan on NK cell ADCC. NK cells expressing the FcγRIIIa V158 allotype exhibited increased ADCC following kifunensine treatment to limit N-glycan processing. Notably, an increase was not observed with cells expressing the FcγRIIIa V158 S164A variant that lacks N162 glycosylation, indicating that the N162 glycan is required for increased NK cell ADCC. To gain structural insight into the mechanisms of N162 regulation, we applied a novel protein isotope labeling approach in combination with solution NMR spectroscopy. FG loop residues proximal to the N162 glycosylation site showed large chemical shift perturbations following glycan truncation. These data support a model for the regulation of FcγRIIIa affinity and NK cell ADCC whereby composition of the N162 glycan stabilizes the FG loop and thus the antibody-binding site.
One N-glycan regulates natural killer cell antibody-dependent cell-mediated cytotoxicity and modulates Fc γ receptor IIIa / CD16a structure
Authors: Kremer Paul G , Lampros Elizabeth A , Blocker Allison M , Barb Adam W
Published: August 2024

Both endogenous antibodies and a subset of antibody therapeutics engage Fc gamma receptor (FcγR)IIIa / CD16a to stimulate a protective immune response. Increasing the FcγRIIIa/IgG1 interaction improves the immune response and thus represents a strategy to improve therapeutic efficacy. FcγRIIIa is a heavily glycosylated receptor and glycan composition affects antibody-binding affinity. Though our laboratory previously demonstrated that natural killer (NK) cell N-glycan composition affected the potency of one key protective mechanism, antibody-dependent cell-mediated cytotoxicity (ADCC), it was unclear if this effect was due to FcγRIIIa glycosylation. Furthermore, the structural mechanism linking glycan composition to affinity and cellular activation remained undescribed. To define the role of individual amino acid and N-glycan residues we measured affinity using multiple FcγRIIIa glycoforms. We observed stepwise affinity increases with each glycan truncation step with the most severely truncated glycoform displaying the highest affinity. Removing the N162 glycan demonstrated its predominant role in regulating antibody-binding affinity, in contrast to four other FcγRIIIa N-glycans. We next evaluated the impact of the N162 glycan on NK cell ADCC. NK cells expressing the FcγRIIIa V158 allotype exhibited increased ADCC following kifunensine treatment to limit N-glycan processing. Notably, an increase was not observed with cells expressing the FcγRIIIa V158 S164A variant that lacks N162 glycosylation, indicating the N162 glycan is required for increased NK cell ADCC. To gain structural insight into the mechanisms of N162 regulation, we applied a novel protein isotope labeling approach in combination with solution NMR spectroscopy. FG loop residues proximal to the N162 glycosylation site showed large chemical shift perturbations following glycan truncation. These data support a model for the regulation of FcγRIIIa affinity and NK cell ADCC whereby composition of the N162 glycan stabilizes the FG loop and thus the antibody-binding site.