Comparing Scoring Consistency of Large Language Models with Faculty for Formative Assessments in Medical Education.

Background: The Liaison Committee on Medical Education requires that medical students receive individualized feedback on their self-directed learning skills. Pre-clinical students are asked to complete multiple spaced critical appraisal assignments. However, the individual feedback requires significant faculty time.

Assessing Between- and Within-Hospital Differences in Patient Safety Between Medicaid and Privately Insured Hospital Patients.

Objectives: The aims of the study are to investigate differences in rates of adverse safety events between nonelderly adult patients with Medicaid and those with private insurance and to assess whether differences are driven by differences in access to quality hospitals or differences in the quality of care delivered within hospitals.

Data Source: Inpatient records from 26 states in 2017 were collected from the Agency for Health Care Research and Quality's Hospital Cost and Utilization Project.

Study Design: This study measures differences in 11 patient safety indicators between patients with Medicaid coverage and patients with private insurance coverage.

How structural racism, neighborhood deprivation, and maternal characteristics contribute to inequities in birth outcomes.

Decades of disparities in health between infants born to Black and White mothers have persisted in recent years, despite policy initiatives to improve maternal and reproductive health for Black mothers. Although scholars have increasingly recognized the critical role that structural racism plays in driving health outcomes for Black people, measurement of this relationship remains challenging. This study examines trends in preterm birth and low birth weight between 2007 and 2018 separately for births to Black and White mothers.

Teaching foundational language equity concepts in the pre-clinical curriculum.

Background: Despite the prevalence of non-English languages in the US population, existing medical training to teach communication with linguistically diverse communities is limited to electives or solely focuses on medical interpreting. Language-appropriate communication skills are seldom comprehensively integrated in medical education. This study describes the development and evaluation of an intervention to teach foundational language equity concepts.

COVID-19 Provider Relief Fund Payments Were Appropriately Targeted And Did Not Boost Selected Hospitals' Profits.

To help mitigate the COVID-19 pandemic's financial effects on health care providers, Congress allocated $178 billion to the Provider Relief Fund (PRF) beginning in 2020. Using monthly data from January 2018 through June 2022 from a nationally representative sample of US hospitals, we used a difference-in-differences approach to examine whether hospitals receiving medium and high PRF support intensity had higher average monthly operating margins (measured separately with and without accounting for PRF payments) than those that received low PRF support intensity. We also assessed the impact of PRF payments by hospitals' prepandemic financial vulnerability status, measured by whether their average operating margins in 2018 and 2019 were above or below the national median.

Medicaid physician fees and the use of primary care services: evidence from before and after the ACA fee bump.

We examine whether fees paid by Medicaid for primary care affects the use of health care services among adults with Medicaid coverage who have a high school or less than high school degree. The analysis spans the large changes in Medicaid fees that occurred before and after the ACA-mandated fee increase for primary care services in 2013-2014. We use data from the Behavioral Risk Factors Surveillance System and a difference-in-differences approach to estimate the association between Medicaid fees and whether a person has a personal doctor; a routine check-up or flu shot in the past year; whether a woman had a pap test or a mammogram in the past year; whether a person has ever been diagnosed with asthma, diabetes, cardiovascular diseases, cancer, COPD, arthritis, depression, or kidney diseases; and, whether a person reports good-to-excellent health.

Assessing the difference in racial and ethnic disparities in access to and use of care between Traditional Medicare and Medicare Advantage.

Objective: Test whether racial-ethnic disparities in the access and use of care differ between Traditional Medicare (TM) and Medicare Advantage (MA).

Data Source: Secondary data from the 2015-2018 Medicare Current Beneficiary Survey (MCBS).

Study Design: Measure Black-White and Hispanic-White disparities in access to care and use of preventive services within TM, within MA, and assess the difference-in-disparities between the two programs with and without controls for factors that could influence enrollment, access, and use.

Credit where it is due: Investigating pathways from earned income tax credit expansion to maternal mental health.

While earned income tax credit (EITC) expansions are typically associated with improvements in maternal mental health, little is known about the mechanisms through which the program affects this outcome. The EITC could primarily affect mental health through changes in family financial resources, changes in labor supply or changes in health insurance coverage of participants. We attempt to disentangle these mechanisms by assessing the effects of state and federal EITC expansion on mental health, employment, and health insurance by maternal marital status.

How Workers Fared under the ACA.

Many politicians, policy makers, and analysts have debated whether the Affordable Care Act (ACA) would have negative effects on the labor market, such as reducing employment, earnings, or hours worked. Building on the existing literature, we investigated how workers' coverage changed under the ACA and whether coverage gains were associated with changes in labor market outcomes across occupations through 2017. We also examined whether occupations experiencing increased coverage through nonemployment sources (i.

Can Nonclinician Raters Be Trained to Assess Clinical Reasoning in Postencounter Patient Notes?

Purpose: Clinical reasoning is often assessed through patient notes (PNs) following standardized patient (SP) encounters. While nonclinicians can score PNs using analytic tools such as checklists, these do not sufficiently encompass the holistic judgments of clinician faculty. To better model faculty judgments, the authors developed checklists with faculty-specified scoring formulas embedded in spreadsheets and studied the resulting interrater reliability (IRR) of nonclinician raters (SPs and medics) and student pass/fail status.

Using Data From the Healthcare Cost and Utilization Project for State Health Policy Research.

Background: The Healthcare Cost and Utilization Project (HCUP), the nation's most complete source of all-payer hospital care data, supports analyses at the national, regional, state and community levels. However, national HCUP data are often used in inappropriate ways in studies of state-specific issues.

Objective: To describe the opportunities and challenges of using HCUP data to conduct state health policy research and to provide empirical examples of what can go wrong when using the national HCUP data inappropriately.

Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply.

We examined the effect of the expansion of Medicaid eligibility under the Affordable Care Act on health insurance coverage and labor supply of low-educated and low-income adults. We found that the Medicaid expansions were associated with large increases in Medicaid coverage, for example, 50 percent among childless adults, and corresponding decreases in the proportion uninsured. There was relatively little change in private insurance coverage, although the expansions tended to decrease such coverage slightly.

Generation of a complete set of additive shape-invariant potentials from an Euler equation.

In supersymmetric quantum mechanics, shape invariance is a sufficient condition for solvability. We show that all conventional additive shape-invariant superpotentials that are independent of ℏ can be generated from two partial differential equations. One of these is equivalent to the one-dimensional Euler equation expressing momentum conservation for inviscid fluid flow, and it is closed by the other.

Amyand's hernia in infant: a rare entity.

The chance of vermiform appendix lying with in a hernial sac is 1% or less and is known as Amyand's hernia and it is very rare in infant and neonate. Till date, only twenty cases had been reported in English literature. We are reporting a rare case of Amyand's hernia where appendix was present in right inguinal sac of non-obstructed inguinal hernia in a seven month old male infant during operation.

Juvenile polyposis syndrome.

Aim: Report of a series of 12 cases of juvenile polyposis coli.

Methods: The study period was from 1995 to 2005. All the patients were treated by total colectomy with rectal mucosectomy and endorectal ileoanal pullthrough with or without ileal pouch formation.

Esophageal achalasia of unknown etiology in infants.

Background: Achalasia cardia is an uncommon disease in children particularly in infants. We present 8 cases of achalasia who were encountered over a 12-year period. In infantile achalasia, respiratory symptoms predominate and vomiting may easily be mistaken for gastroesophageal reflux (GER).

Role of fibrin glue as a sealant to esophageal anastomosis in cases of congenital esophageal atresia with tracheoesophageal fistula.

Objective: The aim of this study was to characterize a successful approach for the management of infants with long-gap esophageal atresia (EA) with tracheoesophageal fistula (TEF). The goal was to preserve the native esophagus and minimize the incidence of esophageal anastomotic leaks using fibrin glue as a sealant over the esophageal anastomosis.

Method: A total of 52 patients were evaluated in this study.

Is ligation of azygos vein necessary in primary repair of tracheoesophageal fistula with esophageal atresia?

Introduction: Congenital tracheoesophageal fistula with esophageal atresia (TEF with EA) is not an uncommon disease of newborns. Classical approach for primary repair of TEF with EA is right thoracotomy with extrapleural approach, ligation of the azygos vein, identification and ligation of tracheoesophageal fistula, identification of upper esophageal pouch and end-to-end anastomosis. This study was conducted to evaluate if the ligation of the azygos vein is a must during primary repair of TEF with EA.

Spontaneous regression of patent omphalo-mesenteric duct.

We report a one-month-old male child with a patent omphalo-mesenteric duct that regressed spontaneously in the neonatal period and resulted in a Meckel's diverticulum.

Single stage repair of anovestibular fistula in neonate.

Anorectal malformations are one of the most common congenital defects. This study is conducted to evaluate the result of single stage anterior sagittal anorectovaginoplasty (ASARVP) in cases of vestibular anus (AVF) in neonatal age group without thorough gut preparation. All the patients of AVF admitted during 2003-2006 were included in this study.

Prognosis of congenital tracheoesophageal fistula with esophageal atresia on the basis of gap length.

Congenital tracheoesophageal fistula (TEF) with esophageal atresia (EA) is not an uncommon disease of newborns. Several classifications have been advocated for predicting the outcomes of these patients but all are physiological and concentrated on associated medical condition that influences survival. We emphasize a new classification on the basis of gap between two esophageal pouches to define the magnitude of surgical problems in the primary repair and correlate them with the outcomes in terms of anastomotic leak, esophageal stricture and mortality, keeping other prognostic factors constant.

Serotonin and 5-hydroxy indole acetic acid in infantile hydrocephalus.

The concentration of metabolites of neurohormones in cerebrospinal fluid (CSF) is an index of turnover of substances in brain parenchyma. The raised intracranial pressure in hydrocephalic children may cause alteration in the metabolism of neurohormones. Serotonin and its metabolite 5-HIAA have been studied extensively in CSF of patients with neuropsychiatric diseases.