bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
A three‐dimensional high Mach number asymmetric magnetopause model from global MHD simulation
Authors: Liu Z.‐Q. , Lu J. Y. , Wang C. , Kabin K. , Zhao J. S. , Wang M. , Han J. P. , Wang J. Y. , Zhao M. X. 
Published: June 2015

AbstractThe numerical results from a physics‐based global magnetohydrodynamic (MHD) model are used to examine the effect of the interplanetary magnetic field (IMF), solar wind dynamic pressure, and dipole tilt angle on the size and shape of the magnetopause. The subsolar magnetopause is identified using the plasma velocity and density, the cusps are identified using the thermal pressure, and the whole shape of the magnetopause is determined with the three‐dimensional streamlines traced through the simulation domain. The magnetopause surface obtained from the simulations is fitted with a three‐dimensional surface function controlled by ten configuration parameters, which provide a description of the subsolar magnetopause, the cusp geometry, the flaring angle, the azimuthal asymmetry, the north‐south asymmetry, and the twisting angle of the magnetopause. Effects of the IMF, solar wind dynamic pressure, and dipole tilt angle on the configuration parameters are analyzed and fitted by relatively simple functions. It is found that the solar wind dynamic pressure mainly affects the magnetopause size; the IMF mainly controls the magnetopause flaring angle, azimuthal asymmetry, and twisting angle; and the dipole tilt angle mainly affects the magnetopause north‐south asymmetry and the cusp geometry. The model is validated by comparing with available empirical models and observational results, and it is demonstrated that the new model can describe the magnetopause for typical solar wind conditions.