bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey
Authors: Prozesky Detlef Richard , Molwantwa Mmoloki Cornelius , Kebaetse Masego Baitseng , Nkomazana Oathokwa 
Published: June 2019

Abstract
Abstract
Background
The purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship.
Methods
The authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency. To determine the direction of differences between intern and supervisor ratings for tasks Likert scale ratings were treated as interval data and average scores calculated. Rating frequencies for each role were compared using the χ2 statistic. Reasons for differences between intern and supervisor ratings were explored by determining correlations between scores using the Pearson r statistic.
Results
Preparedness for all seven roles and the majority of tasks was found to be between ‘Fairly well prepared’ and ‘Well prepared’. The ratings for four roles (Medical expert, Communicator, Collaborator, Professional) differed statistically, but not for the three others (Leader, Health advocate, Scholar). Interns rated their proficiency higher than their supervisors for the tasks in six roles; for the ‘Professional’ role intern ratings were mostly lower. Correlations between intern and supervisors scores were only statistically significant for three roles (Medical expert, Communicator, Collaborator).
Conclusions
Intern preparedness for tasks and roles varied but was generally satisfactory. Based on the analysis of the data seeming discrepancies in between interns and supervisor ratings were investigated and explanations are offered. For three roles the data indicate that their component tasks are understood in the same way by interns and supervisors, but not for the other roles. The Dunning-Kruger effect offers a plausible explanation for higher intern scores for tasks in six of the roles. For the ‘Professional’ role differences between interns’ internal, individual understanding and supervisors’ external, group understanding may explain lower intern scores. The fact that respondents may understand the tasks they rate differently has implications for all research of this nature.
BMI, Weight Change, and Dementia Risk in Patients With New-Onset Type 2 Diabetes: A Nationwide Cohort Study
Authors: Nam Ga Eun , Park Yong Gyu , Han Kyungdo , Kim Mee Kyoung , Koh Eun Sil , Kim Eun Sook , Lee Min-Kyung , Kim Bongsung , Hong Oak-Kee , Kwon Hyuk-Sang 
Published: June 2019

OBJECTIVE
This study examined the association between baseline BMI, percentage weight change, and the risk of dementia in patients newly diagnosed with type 2 diabetes.

RESEARCH DESIGN AND METHODS
Using the South Korean National Health Insurance Service-National Health Screening Cohort database, we identified 167,876 subjects aged ≥40 years diagnosed with new-onset type 2 diabetes between 2007 and 2012. Their weight changes were monitored for ∼2 years after diagnosis, with follow-up assessments occurring for an average of 3.5 years. The hazard ratios (HRs) and Bonferroni-adjusted 95% CIs of all-cause dementia, Alzheimer disease (AD), and vascular dementia were estimated using multivariable Cox proportional hazards regression models.

RESULTS
We identified 2,563 incident dementia cases during follow-up. Baseline BMI among patients with new-onset type 2 diabetes was inversely associated with the risk of all-cause dementia and AD, independent of confounding variables (P for trend &lt;0.001). The percentage weight change during the 2 years after a diagnosis of type 2 diabetes showed significant U-shaped associations with the risk of all-cause dementia development (P &lt; 0.001); the HRs of the disease increased significantly when weight loss or gain was &gt;10% (1.34 [95% CI 1.11–1.63] and 1.38 [1.08–1.76], respectively). Additionally, weight loss &gt;10% was associated with an increased risk of AD (HR 1.26 [95% CI 1.01–1.59]).

CONCLUSIONS
A lower baseline BMI was associated with increased risks of all-cause dementia and AD in patients with new-onset type 2 diabetes. Weight loss or weight gain after the diagnosis of diabetes was associated with an increased risk of all-cause dementia. Weight loss was associated with an increased risk of AD.
Regression to Normal Glucose Regulation in American Indians and Alaska Natives of a Diabetes Prevention Program
Authors: Pratte Katherine A. , Johnson Ann , Beals Janette , Bullock Ann , Manson Spero M. , Jiang Luohua ,   and the Special Diabetes Program for Indians Diabetes Prevention Program
Published: June 2019

OBJECTIVE
This study evaluated whether regression from impaired glucose regulation (IGR) to normal glucose regulation (NGR) after 1 year of a lifestyle intervention reduces diabetes risk in American Indians and Alaska Natives (AI/ANs). In addition, we sought to identify predictors for regression to NGR and understand possible mechanisms for the association between NGR and future diabetes risk.

RESEARCH DESIGN AND METHODS
Data from participants enrolled from 2006 to 2009 in the Special Diabetes Program for Indians Diabetes Prevention Program with IGR at baseline and an oral glucose tolerance test at year 1 were analyzed (N = 1,443). Cox regression models were used to estimate the subsequent diabetes risk (year 1 to year 3) by year 1 glucose status. Mediation analysis was used to estimate the proportions of the association between year 1 glycemic status and diabetes risk explained by specific factors.

RESULTS
Those who reverted to NGR at year 1 (38%) had lower diabetes risk than those with sustained IGR (adjusted hazard ratio 0.28, 95% CI 0.12–0.67). The lower risk associated with regression to NGR was explained by both baseline risk factors and differences in weight loss. Metformin use, weight loss, and an increase in exercise were modifiable risk factors associated with higher odds of regression to NGR.

CONCLUSIONS
Patients with prediabetes who reverted to NGR had a reduced risk of developing type 2 diabetes over the next 2 years. Both baseline and modifiable risk factors explained the risk reduction associated with NGR.
Exploring Patient Preferences for Adjunct-to-Insulin Therapy in Type 1 Diabetes
Authors: Perkins Bruce A. , Rosenstock Julio , Skyler Jay S. , Laffel Lori M. , Cherney David Z. , Mathieu Chantal , Pang Christianne , Wood Richard , Kinduryte Ona , George Jyothis T. , Marquard Jan , Soleymanlou Nima 
Published: June 2019

OBJECTIVE
While sodium–glucose cotransporter inhibitor (SGLTi) therapy has been evaluated in type 1 diabetes (T1D) trials, patient reactions to benefits and risks are unknown. Using established methodology, we evaluated patient preferences for different adjunct-to-insulin therapy options in T1D.

RESEARCH DESIGN AND METHODS
An online survey, completed by 701 respondents with T1D (231 U.S., 242 Canada, and 228 Germany), used conjoint analysis to present six hypothetical, masked, pairwise drug profile choices composed of different benefit-risk attributes and effect ranges. Data used in analyses were derived from actual phase 3 trials of a low-dose SGLTi (comparable to oral empagliflozin 2.5 mg q.d.), a high-dose SGLTi (comparable to oral sotagliflozin 400 mg q.d.), and an available adjunct-to-insulin therapy (comparable to subcutaneous pramlintide 60 μg t.i.d.).

RESULTS
Conjoint analysis identified diabetic ketoacidosis risk as most important to patients (23% relative score; z test, P &lt; 0.05); ranked second were HbA1c reduction (14%), risk of severe hypoglycemia (13%), oral versus injectable treatment (12%), and risk of genital infection (12%). Next was risk of nausea (11%), followed by weight reduction (8%) and the risk of diarrhea (7%). A low-dose SGLTi drug profile was identified by conjoint analysis as the top patient preference (83% of participants; z test, P &lt; 0.05) versus high-dose SGLTi (8%) or pramlintide (9%). Separate from conjoint analysis, when respondents were asked to choose their preferred adjunct-to-insulin therapy (masked to drug name/dose), 69%, 17%, 6%, and 9% of respondents chose low-dose SGLTi, high-dose SGLTi, pramlintide, and insulin therapy alone, respectively.

CONCLUSIONS
Low-dose SGLTi profile was the favored adjunct-to-insulin therapy by persons with T1D.
Kualitas Fisik dan Kimia Buah Jambu ‘Kristal’ pada Letak Cabang yang Berbeda
Authors: Rustani Dona , Susanto Slamet 
Published: June 2019

Jambu biji kultivar kristal merupakan salah satu buah yang memiliki nilai ekonomi yang tinggi di Indonesia. Kualitas buah dipengaruhi posisi buah dalam kanopi. Penelititan ini bertujuan untuk mempelajari kualitas fisik dan kimia buah pada tunas yang muncul pada cabang primer, sekunder dan tersier. Percobaan berlokasi di Kebun Percobaan Cikabayan, IPB Dramaga, Bogor, Jawa Barat dan Laboratorium Pascapanen Departemen Agronomi dan Hortikultura dari bulan Februari hingga Juli 2017 menggunakan tanaman jambu ‘Kristal’ berumur 4 tahun. Percobaan ini menggunakan metode Rancangan Acak Lengkap (RAL) dengan satu faktor yaitu letak buah pada tunas dari cabang primer (C1), cabang sekunder (C2) dan cabang tersier (C3) dengan 5 ulangan. Hasil penelitian menunjukkan bahwa letak cabang tidak berpengaruh terhadap semua parameter pengamatan kualitas fisik dan kimia (diameter buah, bobot buah, kelunakan buah, kemulusan buah, PTT dan TAT). Terdapat kecenderungan pada buah yang muncul pada tunas yang muncul dari cabang primer dan cabang sekunder memiliki bobot dan diameter yang lebih tinggi dibandingkan dengan cabang tersier.
Pengendalian Gulma pada Perkebunan Karet (Hevea brasiliensis Muell Arg.) di Gurach Batu Estate, Asahan, Sumatera Utara
Authors: Nugraha Parid Ridwan , Zaman Sofyan 
Published: June 2019

Kegiatan penelitian ini bertujuan untuk mendokumentasikan jenis gulma yang tumbuh di bawah tegakan tanaman karet yang berbeda umur dan bagaimana manajemen pengendalian yang efektif. Kegiatan berlangsung dari Februari – Mei 2015 di Gurach Batu Estate, Asahan, Sumatera Utara. Pengamatan vegetasi gulma dilakukan dengan analisis vegetasi pada 13 blok dengan 13 tahun tanam yang berbeda untuk mendapatkan nisbah jumlah dominan (NJD) dan koefisien komunitas. Pengamatan lain adalah teknik pengendalian gulma, serta efektifitas dan efisisensi pengendaliannya. Data gulma dianalisis menggunakan nisbah jumlah dominan (NJD), sedangkan pengamatan lain dianalisis secara deskriftif. Hasil pengamatan menun jukan bahwa gulma yang dominan di GBE adalah Mucuna bracteata, Diplazium asperum, Selaginella deoderleinii, Nephrolepis bisserata. Manejemen pengendalian gulma dilakukan secara manual, kimiawi dan kultur teknis.
An Attributalistic Theory of Truth
Authors: Koch T M 
Published: June 2019

The Attributalistic Theory of Truth defines truth as being absolute, arithmetic, and axiomatic. Truth is consistent universally as it is tied to existence itself. This existence provides a system of reasoning through three innate principles: the Law of Commonality, the Concept of Infinity, which together allow for the Function of Comparability. Truth is metaphysically founded in the attribute of being. This truth is the absolute truth that meets the criteria of being the independent, prevalent element of reality.
Análise do ensino e aprendizagem de transformações químicas em publicações nacionais
Authors: Kraisig Ângela Renata , Braibante Mara Elisa Fortes 
Published: June 2019

O objetivo desta pesquisa é apresentar uma análise realizada nos anais do Encontro Nacional de Ensino de Química (ENEQ) e nas edições da Revista Química Nova na Escola (QNEsc), entre o período de 2008 e 2018, sobre o tópico de transformações químicas. Para a análise, foi realizada uma pesquisa bibliográfica nos anais e nas edições da revista com o intuito de detectar como vem ocorrendo o ensino e aprendizagem do tópico de transformações químicas na Educação Básica e Superior. A pesquisa bibliográfica foi realizada em quatro etapas: 1) Seleção dos anais do ENEQ e edições da revista QNEsc para estudo; 2) Coleta dos dados por meio do levantamento de trabalhos completos, resumos e artigos que abordam o tópico de transformações químicas; 3) Escolha dos trabalhos completos, resumos e artigos a partir de sua leitura integral, e eliminação dos que não apresentavam relação com o tópico pesquisado; 4) Análise dos trabalhos completos, resumos e artigos selecionados a partir de três dimensões. Ao total resultaram 82 publicações nas fontes investigadas e os resultados apontam que: o número de publicações encontradas não foi expressivo, pois de um total de 5.169 publicações, apenas 6,49% corresponde ao assunto investigado; a maior parte das publicações apresentam natureza empírica, com abordagem qualitativa, centrada nos aspectos macroscópicos das transformações químicas e são destinadas a Educação Básica (Ensino Médio); a base teórica mais utilizada pelos autores foi a teoria sobre transformações químicas, com ênfase em conteúdos específicos relacionados ao tema investigado; os principais resultados das pesquisas apresentam propostas de ensino diferenciadas, visto que grande parte das publicações apresentavam atividades com este viés em sala de aula, neste manuscrito descreveremos algumas e suas principais contribuições. Por meio do estudo realizado, conclui-se que ainda é insuficiente o número de publicações sobre este assunto, sendo necessário a realização de mais pesquisas sobre o tópico de transformações químicas, principalmente contemplando os três níveis de representação da matéria.
Shevchenko Studies School of S. Smal-Stotskyi: Figures and Concepts (Kitsman-Kolomyia Center)
Authors: Melenchuk Olha 
Published: June 2019

The paper offers an overview of the achievements of S. Smal-Stotskyi’s students in Shevchenko studies, which continued, to a greater or lesser extent, to explore and popularize the works of T. Shevchenko in the cultural space of Bukovyna and Pokuttia. The main accent is made on the Kitsman-Kolomyia center, where the early 20th century graduates of the Chernivtsi University lived and worked, O. Tsisyk, D. Nykolyshyn, M. Ravliuk, M. Kharzhevskyi, O. Kovbuz, B. Levytskyi being among them. They continued to develop the traditions originating from the seminar on Shevchenko studies conducted by S. Smal-Stotskyi.
Modern scholars recognize that in the second half of the 19th and early 20th centuries the Chernivtsi University was the leading educational institution in terms of contribution to Shevchenko studies. Students picked up the instructions of the professor S. Smal-Stotskyi and not only showed interest in the works by T. Shevchenko but also expressed their views in public, actively engaging in activities of the national movement that took place outside the university. The work within the circles continued profound reading of the Kobzar’s works, initiated at the university. The Circle of Kobzar Studies was one of them; it united university graduates who became teachers of Kitsman high school – Mykola Ravliuk, Omelian Tsisyk, Pavlo Diakiv, Oleksa Kovbuz, etc. The members of the circle continued collecting and analyzing the scholarly and critical material that might help in making comprehensive analysis of Shevchenko’s works. Such activity formed a good basis for teaching and inspiring students to explore Shevchenko’s legacy that was fundamental for shaping the national outlook and national consciousness of contemporary Ukrainians. However, the regular research of the works by T. Shevchenko also played an important role in the Kitsman-Kolomyia center. This direction was represented mainly by the works of D. Nykolyshyn and O. Tsisyk.
Authors of Ukrainian Travel Essays of 1920s – 1930s as Secret Agents and Spies
Authors: Vaskiv Mykola 
Published: June 2019

The article deals with the engagement of the Ukrainian authors of travel essays about foreign life to the intelligence and spy activities in different forms, usually for performing the special tasks alongside with observation and making literary notes. Various textual ‘footprints’ in their travel writings prove this fact. In two interwar decades Ukrainian travel writings had a period of rise and rapid development; they were generously financed by publishing houses, editorial boards of the magazines, different state institutions and labor unions. Numerous books by amateur and experienced professional writers, predominantly about their trips around Ukrainian and other Soviet lands, were published in large numbers. Very often the travelers were professional military men, secret agents or followed out the instructions of the special service, openly recognizing it in their books.
Not so many, but still a lot of travel writings described what had been seen, heard and read abroad. Crossing the border of the USSR required essential expenses in foreign currency and special permissions; therefore only selected representatives of literature could visit European and Asian countries. This fact makes one suspect them of cooperation with different intelligence institutions. The textual analysis of the books written by S. Holovanivskyi, O. Dosvitnii, K. Kotko, L. Nedolia, V. Polishchuk and others proves that these suspicions are well-grounded. It is evidenced by numerous slips, omissions, reports on rather strange travel routes, repeated meetings abroad with Soviet consular and embassy employees, political emigrants, illegal immigrants and left-wing artists. It is obvious that the essayists were the transmitters of secret information in oral form addressed both abroad and backwards, so that it could not be found by any customs officers or counterintelligence agents. It seems that such a secret mission influenced the texts of travel writings, intensifying their anti-Western, ‘anti-capitalist’ orientation and class bias.
Efficacy of splint theraphy on Pain in the Treatment of Internal Derangement of TMJ-A clinical study
Authors: Malik Altaf , Majeed Shabnum 
Published: June 2019

Purpose: This study was designed to investigate the efficacy of splint theraphy on pain in the treatment of temporomandibular joint (TMJ) internal derangement patients.
Materials and Methods: 15 males and 25 females aged between 18 to 37 years comprised the study material in the Dental Implant and Faciomaxillary centre at Bandipore (India). The patients’ complaints were limited mouth opening and TMJ pain . Splints were given to the patients suffering from internal derangement. Clinical evaluation of the patients was done before the procedure, and 1 week and 3 months after postoperatively. Intensity of TMJ pain was recorded at each follow-up visit.
Results: There was significant reduction in pain scores in the post-operative period.
Conclusions: Splint therapy is simple and safe procedure for the patients of internal derangement with closed lock for improving mouth opening and decreasing pain.
Transformation of Relapsed Membranous Nephropathy to Proliferative Lupus Nephritis. A Case Report:
Authors: Sofi Fayaz Ahmad , Ahmad Mushtaq , Rather Bilal Ahmad 
Published: June 2019

SSLE is a dynamic disease. Lupus nephritis occurs in 40%-70% of patients. Renal biopsy is performed to know various classes of lupus nephritis. In several studies of lupus nephritis, type IV nephritis is the most common [approximately 40%] whereas type III and type V follow with an approximate frequency of 25% and 15%. The transformation from one class to another can occur, spontaneously and as a result of treatment. Prognosis is worse when membranous andproliferative changes coexist. In Pub Med search from 1999-2015, 9 patients of class V have changed to mixed ( IV+V) and none out of 6 patients in the study by Narveiz et al: to class ( IV + V), though in one case transformation to class ( 111/1V+V) was reported.Our case report transformed from relapsed class V to mixed class( IV+V)
Colorectal Cancer in Young Adult Population in Kashmir Valley: Tertiary Care Centre Experience
Authors: Baba Peerzada Umar Farooq , Malik Ajaz Ahmad , Hassan Yaqoob , Wani Khurshid Alam , Lone Abdul Rashid 
Published: June 2019

Background: Colorectal cancer has been defined and discussed as a disease of middle or late life. However, no age-group is exempt, and adenocarcinoma of the colon has been reported in young age. Malignant disease is frequently found in young adults in our Kashmir valley.
Objective (s): This aim was to study the clinic pathological features, diagnosis, management and outcome of colorectal cancer in young adults under the age of 40.
Material and Methods: This combined Retrospective (January 2002 to May, 2004) Prospective (June 2004 to September 2006) Observational Study was conducted in the department of General and Minimal Access Surgery, SKIMS,. Total of 62 young colorectal carcinoma patients were studied. The case records of all the patients of colorectal cancer less than 40years of age admitted in the department of General Surgery were reviewed retrospectively. In the prospective study all the patients less than 40 years of age with colorectal carcinoma admitted in our department were registered. Following the confirmation of diagnosis, the patients were subjected to exploratory laparotomy. The nature of the surgical procedure depended upon the intra-operative findings. All the patients were subjected to postoperative chemotherapy and in selected cases to postoperative chemo-radiation. The patients were followed for a period of five years .The patients were thoroughly examined and investigated on follow up to rule out any recurrence or metastasis.
Results: Most of our patients (83.9%) were admitted through outpatient department (OPD) and only 10 patients (16.1%) were admitted through emergency. In our study, the male: female ratio was 1.58: 1.The mean age in our study was 30.2 years. Bleeding per rectum was the most common (74.2%) presenting symptom followed by altered bowel habits (72.6%). Carcinoembryonic antigen (CEA) levels show significant decline after surgery/adjuvant therapy. Colonoscopy detected synchronous growths in 5.3% of patients. Rectum was the most common site of lesion (32.2%) while combined rectum and sigmoid colon (including recto sigmoid) accounted for 62.7% of lesions. Resection with intention of cure was performed in 68.3% of patients, palliative procedure in 26.7% and biopsy in 5% of patients. Postoperative complications were recorded and managed accordingly. Typical adenocarcinoma was seen in 80.6% of patients. None of our patients had Dukes stage A presentation. 13.6% of patients had local recurrence and 25.4% had metastasis on follow up.
Conclusion: Colorectal cancers in young adults are quite common in Kashmir valley. Outcome of CRC in young patients is significantly related to the procedure - whether done with curative intention or for palliation. Henceforth, surgical treatment should be radical and optimized with adjuvant therapy where possible to achieve the best prognosis. The diagnosis of colorectal cancer should be done at the early and curable stage for better outcome.