bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eccentric Neutron Star Disk Driven Type II Outburst Pairs in Be/X-ray Binaries
Authors: Franchini Alessia , Martin Rebecca G. 
Published: December 2021

Abstract
Be star X-ray binaries are transient systems that show two different types of outbursts. Type I outbursts occur each orbital period while type II outbursts have a period and duration that are not related to any periodicity of the binary system. Type II outbursts may be caused by mass transfer to the neutron star from a highly eccentric Be star disk. A sufficiently misaligned Be star decretion disk undergoes secular Von Zeipel–Lidov–Kozai (ZLK) oscillations of eccentricity and inclination. Observations show that in some systems the type II outbursts come in pairs with the second being of lower luminosity. We use numerical hydrodynamical simulations to explore the dynamics of the highly misaligned disk that forms around the neutron star as a consequence of mass transfer from the Be star disk. We show that the neutron star disk may also be ZLK unstable and that the eccentricity growth leads to an enhancement in the accretion rate onto the neutron star that lasts for several orbital periods, resembling a type II outburst. We suggest that in a type II outburst pair, the first outburst is caused by mass transfer from the eccentric Be star disk while the second and smaller outburst is caused by the eccentric neutron star disk. We find that the timescale between outbursts in a pair may be compatible with the observed estimates.
Health Insurance Literacy and Medical Debt in Middle-Age Americans
Authors: Wiltshire Jacqueline , Liu Echu , Dean Caress A. , Colato Edlin Garcia , Elder Keith 
Published: December 2021

Background:
Health insurance literacy (HIL) may influence medical financial burden among people who are sick and the most vulnerable.

Objective:
This study examined the relationships between HIL, health insurance factors, and medical debt among middle-age Americans, a population with an increasing prevalence of illnesses.

Methods:
Linear and generalized linear regression analyses were conducted on data drawn from the 2015–2016 waves of the Health Reform Monitoring Survey, a national, internet-based sample of Americans age 18 to 64 years. The analytical sample included 8,042 people age 50 to 64 years.

Key Results:
Adjusted mean HIL scores did not differ by private versus public insurance or by out-of-pocket costs. Mean HIL scores were lower with higher deductibles; however, differences in mean scores were small. Higher HIL was associated with lower medical debt (odds ratio = 0.97; 95% confidence interval [0.96, 0.98]), but at the highest HIL score, the risk of having medical debt was still 13.8%. Public coverage, higher annual deductibles, and out-of-pocket costs were associated with higher risks of having medical debt.

Conclusions:

The findings suggest that HIL plays an important role in medical debt burden. However, with the shift toward high cost-sharing insurance plans, addressing health care affordability issues along with HIL are critical to eliminate medical debt problems.

[
HLRP: Health Literacy Research and Practice
. 2021;5(4):e319–e332.]

Plain Language Summary:
Understanding and using health insurance (also defined as health insurance literacy) may influence the ability to pay medical bills among people who are sick and vulnerable. This study examined the relationships among health insurance literacy, health insurance factors, and difficulty paying medical bills (i.e., medical debt) in Americans age 50 to 64 years using data from the Health Reform Monitoring Survey. People with higher health insurance literacy reported lower medical debt. Type of insurance coverage did not influence medical debt. Those with annual deductibles and out-of-pocket health care costs were more likely to report having medical debt.
Efeitos das Práticas Meditativas nos Níveis de Cortisol Induzidos por Estresse Agudo: uma revisão sistemática
Authors: Alfonsi José , Troncoso Ana Cristina , Conde Erick 
Published: December 2021

As práticas meditativas são reconhecidas pelo potencial na redução do estresse. Estas possuem ampla variedade de técnicas e estilos e quando inseridas na multidisciplinariedade do campo do estresse, sua linha de pesquisa adquire características metodológicas peculiares com diversificação investigativa. Neste contexto, esta revisão sistemática qualitativa tem como objetivo revisar os principais aspectos metodológicos das pesquisas que investigaram o potencial da meditação na regulação do cortisol induzido por tarefas de reatividade de estresse agudo, bem como as características das práticas meditativas utilizadas que, segundo autores, são diferenciais no manejo do estresse e considerados relevantes a esta linha de pesquisa. A pesquisa foi realizada nas plataformas PubMed e Web of Science. Foram incluídos sete estudos originais que utilizaram uma tarefa de reatividade ao estresse agudo e o cortisol como o principal marcador biológico. As intervenções com ênfase em habilidades cognitivas sociais e regulação emocional tiveram melhores resultados na redução do cortisol do que as práticas somente focadas no desenvolvimento cognitivo. Na discussão, foram destacados aspectos como tempo de prática, o aprimoramento de competências e a regulação emocional. Esta revisão contribui para elucidar os mecanismos psicológicos subjacentes às práticas meditativas tal como os aspectos metodológicos relevantes.
Outcomes From a Novel Graduate Medical Education Leadership Program in Advancing Diversity, Equity, and Inclusion
Authors: Powell Carmin , Yemane Lahia , Brooks Michelle , Johnson Carrie , Alvarez Al'ai , Bandstra Belinda , Caceres Wendy , Dierickx Quynh , Thomas Reena , Blankenburg Rebecca 
Published: December 2021

ABSTRACT

Background
Academic medicine needs more diverse leadership from racial/ethnic minorities, women, people with disabilities, and LGBTQIA+ physicians. Longitudinal structural support programs that bring together underrepresented in medicine (UiM) and non-UiM trainees are one approach to build leadership and scholarship capacity in diversity, equity, and inclusion (DEI).

Objective
To describe the creation, satisfaction with, and feasibility of a Leadership Education in Advancing Diversity (LEAD) Program and evaluate scholars' changes in self-efficacy, intended and actual behavior change, and outputs in leadership and DEI scholarship.

Methods
In 2017, we created the LEAD Program, a 10-month longitudinal, single institution program that provides residents and fellows (“scholars”) across graduate medical education (GME) with leadership training and mentorship in creating DEI-focused scholarship. In the first 3 cohorts (2017–2020), we assessed scholars' self-efficacy, actual and planned behavior change, and program satisfaction using IRB-approved, de-identified retrospective pre-/post-surveys. We measured scholarship as the number of workshops presented and publications developed by the LEAD scholars. We used descriptive statistics and paired 2-tailed t tests to analyze the data.

Results
Seventy-five trainees completed LEAD; 99% (74 of 75) completed the retrospective pre-/post-surveys. There was statistically significant improvement in scholars' self-efficacy for all learning objectives. All trainees thought LEAD should continue. LEAD scholars have created workshops and presented at local, regional, and national conferences, as well published their findings. Scholars identified the greatest benefits as mentorship, developing friendships with UiM and ally peers outside of their subspecialty, and confidence in public speaking.

Conclusions
LEAD is an innovative, feasible GME-wide model to improve resident and fellow self-efficacy and behaviors in DEI scholarship and leadership.
A Document Analysis of Nationally Available Faculty Assessment Forms of Resident Performance
Authors: French Judith C. , Pien Lily C. 
Published: December 2021

ABSTRACT

Background
Written feedback by faculty of resident performance is valuable when it includes components based on assessment for learning. However, it is not clear how often assessment forms include these components for summative and formative feedback.

Objective
To analyze prompts used in forms for faculty assessment of resident performance, guided by best practices in survey research methodology, self-regulation theory, and competency-based assessment.

Methods
A document analysis, which is a qualitative approach used to analyze content and structure of texts, was completed on assessment forms nationally available in MedHub. Due to the number of forms available, only internal medicine and surgery specialties were included. A document summary form was created to analyze the assessments. The summary form guided researchers through the analysis.

Results
Forty-eight forms were reviewed, each from a unique residency program. All forms provided a textbox for comments, and 54% made this textbox required for assessment completion. Eighty-three percent of assessments placed the open textbox at the end of the form. One-third of forms contained a simple prompt, “Comments,” for the narrative section. Fifteen percent of forms included a box to check if the information on the form had been discussed with the resident. Fifty percent of the assessments were unclear if they were meant to be formative or summative in nature.

Conclusions
Our document analysis of assessment forms revealed they do not always follow best practices in survey design for narrative sections, nor do they universally address elements deemed important for promotion of self-regulation and competency-based assessment.
Interdisciplinary Ethics Certificate Program for Graduate Medical Education Trainees
Authors: Thomas Harrison C. , Meador Keith , Payne Kate , Drolet Brian C. 
Published: December 2021

ABSTRACT

Background
Ethics education is an essential component of developing physician competency and professionalism. Although prior studies have shown both a wide interest and a need for ethics education during residency, structured learning opportunities are not widely available at the graduate medical education (GME) level.

Objective
Through the Vanderbilt Center for Biomedical Ethics and Society, we developed a 1-year certificate program offering a Distinction in Biomedical Ethics, open to all active trainees in GME programs at the Vanderbilt University Medical Center. This certificate program provides advanced education in biomedical ethics and can be completed without additional cost to the trainee or time away from training.

Methods
This certificate program has been offered each academic year since 2017–2018. The program curriculum includes case-based seminars, a rotation on the Ethics Consultation Service, participation on the hospital ethics committee, and a capstone project. Outcomes were assessed using a post-course evaluation.

Results
During the first 4 years of the program, 65 trainees participated from 19 different specialties. Course evaluations were obtained from 58 participants (89.4% response rate) and were strongly favorable in most domains. All participants agreed that this program enhanced their knowledge of biomedical ethics and they would use something they learned in their future practice. Most participants (57 of 58, 98.3%) would recommend this course to a friend.

Conclusions
We designed and implemented a Distinction in Biomedical Ethics program to provide advanced training in clinical Bioethics, which has been favorably received by participants.
Disseminating the knowledge on the complex interactions between humans and volcanoes: the geological section of the Villa Arbusto archaeological museum at Lacco Ameno (Ischia, Naples - Italy)
Authors: Sandro de Vita  , Mauro Antonio Di Vito  , Diana Barra  , Giuseppe Aiello  , Costanza Gialanella  
Published: December 2021

A room in the Archaeological Museum of Villa Arbusto (Lacco Ameno, Ischia) was set up to house rocks and fossils collected by the renowned archaeologist Giorgio Buchner during his excavation activity on the Island of Ischia. The collection is witness to a long multidisciplinary research activity that saw archaeological studies at the center of volcanological, pedological and palaeoenvironmental researches, aimed at reconstructing the archaeological contexts in the complex geological dynamics of the island. In fact, during the different phases of colonization recorded on the island, the Ischia volcanoes were very active and produced explosive and effusive eruptions, accompanied by a strong geological dynamics that included earthquakes, landslides (even gigantic ones), rapid ground uplift and strong hydrothermal activity. In the room, the samples on display “tell” the evolution of the island and its dynamics in four windows and a chest of drawers, where there is an exposition of the products of the various eruptions, from the oldest to the most recent, sedimentary rocks and the collection of macro and microfossils found in marine sediments, displaced at variable altitudes by the rapid volcano-tectonic deformations that characterize the island. A series of panels and monitors accompany the visitor along a path that, starting from the geological evolution of the island, passes through the relationship between humans and the volcano, the main volcanic phenomena and the reconstruction of an archaeological excavation of exceptional value, where it is possible to see the strong interaction between primary and secondary volcanic phenomena and a human settlement of the first Greek colony in the west: Pithecusae. The exhibition was designed with the purpose of educating the visitors and the local population about the natural history of the island and its volcanoes, and their impact on the human life through time.
A Postmodern Cultural Study of Media Manipulation and Capital Market Expansion
Authors: Afrin Sadia 
Published: December 2021

Media manipulation is rampant in the present postmodern culture since people are constantly monitored by screens due to the advancement of technology. In the postmodern world, the media have become an inseparable part of everyday life, where there is hardly any scope to spend a single moment without the screen and media. Thus, the current researcher got the impetus to unravel the media's simulated world, which uses images, advertisements, and signs to expand global capitalism. The objective of the study is to explore inquisitively the power and influence of the media and the way these are used to manipulate people. This is a qualitative study that delves into media politics and media economy in an investigative way to uncover the covert targets of the media. The study's major finding is that the media play a vital role in attracting consumers and expanding world commercialism in today’s globalized world. Several modern and postmodern writings were extensively studied to scrutinize the manifold facets of media manipulation through different presentations of print and visual formats.
Tastes and volatiles of tropical-type sweet potatoes
Authors: Dumas José A. , Ortiz Carlos E. , Soler Sheila 
Published: December 2021

For fresh market sweet potato [Ipomea batatas (L.) Lam] quality is defined in terms of attractiveness, sweetness, texture, and flavor composed of taste and odor after cooking. There is a scarcity of information regarding taste and volatiles of tropical type sweet potatoes. The first objective of this research was to provide a robust set of data for carbohydrate type and levels, alcohol insoluble solids (AIS) and volatile organic compounds (VOC) from six cultivars of sweet potato, data which will allow us to have a quantitative selection tool besides crop yield, tuber size and appearance. The second objective was to relate VOC differences among sweet potato cultivars that can be attributed to chemical and physical differences of the pulp before and after cooking. A three harvest study was conducted to identify and determine major carbohydrate content, AIS, starch granule diameter and form, and tastes and odors of six cultivars of sweet potato, which were very sweet ('Gem'), sweet ('Miguela' and Travis'), moderately sweet ('Viola' and 'Martina') and non-sweet ('Ninetynine'). The average AIS contents were 81, 77, 79, 85, 66, and 76% for 'Martina', 'Miguela', 'Ninety-nine', 'Viola', 'Gem' and 'Travis', respectively. Scanning electron micrograph (SEM) indicated that the average starch granule diameters were 12.9, 15.3, 16.9 and 25.2 |jm for 'Martina', 'Miguela', 'Ninety-nine' and 'Viola', respectively. In addition, all of the sweet potato starch granules had both spherical and polygonal granules. The cultivars with greatest change in AIS and maltose content (raw vs. baked) were 'Gem', the sweetest, and 'Travis'. Correlation between sucrose index (SI) and AIS for baked samples was 0.956; for AIS and sweetness, correlation was -0.823. A similar correlation between the AIS and maltose was obtained for the data from the three harvests (-0.8493). Fifty volatile organic compounds of baked sweet potatoes were trapped in cold methylene chloride. The predominant volátiles were hexanal, 3-pente-2-ol, and isoledene. Other sweet aromas detected were 2,4-decadienal, 2-pentyl furan, benzaldehyde, 4-methyl-4-hydroxy-2-pentanone, and benzene acetaldehyde. The great differences in relative concentrations of volátiles among cultivars seem to be related to the synthesis of maltose and the content of AIS.
COVID 19 Pandemic and the Library Online Services
Authors: Narca Josiah Ramuel 
Published: December 2021

The purpose of this study is to describe the experiences of St. Scholastica's College Manila High School librarians in implementing library online services during the COVID-19 Pandemic. The researcher used a descriptive research design and employed Document Analysis and Thematic Analysis vis-a-vis the respondents' answers on the electronic questionnaires. It was revealed, through this study, that the roles and responsibilities of the SSC Manila HS librarians were technologists, online learning support professionals, instructional partners, and game-based learning developers. On the other hand, they experienced challenges such as having limited transactions and time constraints in delivering library online services and the opportunities of having proactive team culture and providing appropriate and innovative services to their clientele. With these findings, the following are recommended for better library online services of the school libraries and librarians. First, librarians and staff's technical competencies and skills must continuously be honed. Second, the library's online services must also be evaluated annually by the students and faculty members. Third, the librarians and staff must explore more technological applications or apps and learning management systems. Lastly, further research studies are recommended in relation also to delivering library online services that can be in the contexts of other types of libraries, most especially their experiences so that there will be a deeper and bigger understanding of the roles and responsibilities, and the challenges and opportunities of librarians during the COVID-19 Pandemic.
Association between CHA2DS2-VASc score and in-hospital death in ICU patients with COVID-19
Authors: Jha Mukesh , Balani Utkarsh Mukesh , Pandey Vimlesh , Balani Prachi , Patel Vipin , Mehta Abhishek 
Published: December 2021

Background: CHA2DS2-VASc score is a scientifically proven risk assessment score for patients with atrial fibrillation. It may be a good predictor of in-hospital death in COVID-19 patients. The present study aimed to evaluate the association between CHA2DS2-VASc score and in-hospital mortality in the prognosis of intensive care unit (ICU) patients with COVID-19.
Methods: Eighty-four COVID-19 patients who were hospitalized in the ICU were retrospectively analyzed in a tertiary health care center, and the CHA2DS2-VASc score was determined. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 20.0). A p-value <0.05 was considered statistically significant.
Results: The median age of patients was 60.0 years, and most were males (75.0%). Findings of the study showed that the CHA2DS2-VASc score was considerably higher among the hospitalized patients than discharged patients (3.08 ± 1.72 vs. 1.38 ± 1.16; p<0.001), and patients who required mechanical ventilation compared to those who did not require mechanical ventilation (3.03 ± 1.68 vs. 1.15 ± 0.97; P <0.001), respectively. Patients with CHA2DS2-VASc score of ≥3 had substantially higher age [67(45-87) vs. 58(19-75); P ˂0.001], computed tomography involvement score [67.5(20-90) vs. 35(15-90); P ˂0.001] and need for mechanical ventilation [29(90.6%) vs. 22(42.3%); P ˂0.001]. A significant difference was found in oxygen saturation on admission (P =0.001) between the two groups. In-hospital death was significantly higher among patients with a CHA2DS2-VASc score of ≥3 (P <0.001). The CHA2DS2-VASc score was positively correlated with white blood cells count (r=0.257, P =0.018) and negatively correlated with the number of days spent in the hospital (r=-0.184, P=0.130) due to higher in-hospital death in ICU patients with COVID-19.
Conclusion: CHA2DS2-VASc score may be an effective tool to estimate in-hospital death in COVID-19 patients who were hospitalized in the ICU.
Catastrophic health expenditure: the case of households with adults over 60 years of age in Peru – 2019
Authors: Villegas Yarleque Mario , Carrasco Choque Freddy , Hidalgo Armestar Ronald , Villegas Aguilar Gretel Fiorella 
Published: December 2021

Within the health sector, it is vitally important to analyze whether households incur catastrophic spending for using such services. In this sense, the study seeks to estimate catastrophic health spending for households with members over 60 years of age. To achieve the objective, the methodology of the World Health Organization was used to find the way in which the household incurs in catastrophic spending, using as an instrument the National Household Survey of Peru, for the year 2019. The main results found were: that families living in urban areas, who have health insurance, who have a higher academic degree, decrease the probability of incurring in catastrophic spending, while being over 60 years old, having a chronic disease, suffering some permanent limitation and not having hygienic services, help to incur in catastrophic spending, so it was concluded that the most vulnerable areas should be attended to achieve a better welfare for older adults.
Keywords: catastrophic expense, out-of-pocket expense, health insurance.
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