Miracle-dz/UniFAR-FTUs huggingface dataset:
The Mismatch of Nutrition and Lifestyle Beliefs and Actions Among Physicians: A Wake-Up Call

Background. There is a notable lack of education on nutrition and physical activity guidelines in medical schools and postgraduate training. The purpose of this study is to assess the nutrition and exercise knowledge and personal health behaviors of physicians in the Department of Medicine at a large academic center. Methods. We conducted a survey study in the Department of Medicine at the University of Florida in 2018. The survey instrument included questions on demographics, medical comorbidities, baseline perception of health and fitness, and knowledge of nutrition concepts. The Duke Activity Status Index assessed activity/functional capacity and the validated 14-point Mediterranean Diet Survey evaluated dietary preferences. Data were analyzed using descriptive statistics and the χ2 test was used to perform comparisons between groups. Statistical significance was determined at P < . 05. Results. Out of 331 eligible physicians, 303 (92%) participated in the study. While all respondents agreed that eating well is important for health, less than a fourth followed facets of a plant-based Mediterranean diet. Only 25% correctly identified the American Heart Association recommended number of fruit and vegetable servings per day and fewer still (20%) were aware of the recommended daily added sugar limit for adults. Forty-six percent knew the American Heart Association physical activity recommendations and 52% reported more than 3 hours of personal weekly exercise. Reported fruit and vegetable consumption correlated with perceived level of importance of nutrition as well as nutrition knowledge. Forty percent of physicians (102/253) who considered nutrition at least somewhat important reported a minimum of 2 vegetable and 3 fruit servings per day, compared with 7% (3/44) of those who considered nutrition less important (“neutral,” “not important,” or “important, but I don’t have the time to focus on it right now”; P < .0001). Conclusions. This study highlights the need for significant improvement in education of physicians about nutrition and physical activity and need for physicians to focus on good personal health behaviors, which may potentially improve with better education.
Comparison of Generic, Musculoskeletal-Specific, and Foot and Ankle–Specific Outcome Measures Over Time in Tibial Plafond Fractures

Background: This study performed a psychometric analysis assessing and comparing the responsiveness of the relevant components of a generic (Short Form–36 [SF36]), a musculoskeletal-specific (Short Musculoskeletal Functional Assessment [SMFA]), and a foot and ankle–specific (Foot and Ankle Outcome Score [FAOS]) outcome score when evaluating surgically treated tibial plafond fractures over time. Methods: Fifty-one patients were followed for 12 months after their tibial plafond fracture. Responsiveness, or the ability to detect clinical change in a disease, was evaluated through the standardized response mean (SRM), the proportion meeting a minimal clinically important difference (MCID), and floor and ceiling effects. Results: The SRM of the SF36–Physical Component Summary (PCS) was significantly greater than the SMFA–dysfunction index (DI) (P < .01) and FAOS–Activities of Daily Living (ADL) (P = .01) between baseline and 6 months, whereas the SRMs of only SF36-PCS and FAOS-ADL differed (P = .01) between 6 and 12 months. The proportion of patients achieving an MCID for SF36-PCS was higher than FAOS-ADL (P = .03) between baseline and 6 months and higher than SMFA-DI (P = .04) between 6 and 12 months. The FAOS-ADL showed substantial ceiling effects at baseline (88.2%) but much less at 6 months (5.9%) and 12 months (9.8%). Smaller ceiling effects were observed for the SMFA-DI (11.8%) at baseline, whereas none were observed for the SF36-PCS. Conclusions: This study found that the SF36-PCS had greater responsiveness in assessing tibial plafond fractures compared to the SMFA-DI and FAOS-ADL, particularly in the first 6 months after surgery. In addition, limitations were revealed in the SMFA-DI and FAOS-ADL. This study illustrates the necessary diligence required for selection of outcome measures, as musculoskeletal and anatomy specific scores are not necessarily superior. Level of Evidence: Level II, prospective cohort study.
A predictive model for prediction of heart surgery procedure

Coronary heart disease (CHD) is a disease in which plague in the form of waxy substance builds up inside the coronary arteries. Coronary artery bypass grafting (CABG) is used as treatment on CHD patients but the role of CABG has been challenged by percutaneous coronary intervention (PCI) when it was introduced in 1977. Drug eluting stents (DES) was introduced with the development of PCI. The purpose of this study was to find the potential risk factors that associated with the procedures (CABG and DES) and to model procedure (CABG vs DES) on coronary heart disease male patients aged 45 years old and below. The study sample was among male patients aged 45 years old and below who has undergone CABG or DES procedure at either IJN or HUKM from January 2007 until December 2010. Logistic regression was used to model treatment selection on coronary heart disease with 87.3% of the classification rate. Patient who i) smoke, ii) obese, or ii) had dyslipidemia was significantly associated with DES, and the other factors were prone to have CABG as their treatment.
Population Pharmacokinetic Modeling Of On-Demand And Surgical Use Of Nonacog Beta Pegol (N9-GP) And rFIXFc Based Upon The paradigm 7 Comparative Pharmacokinetic Study

Aim/objective Understanding pharmacokinetic (PK) differences between standard and extended half-life (EHL) products is important, particularly for factor IX (FIX), where differences are more significant than for factor VIII. Two single-dose PK trials showed N9-GP achieves higher FIX levels and greater area-under-the-curve than pdFIX, rFIX, and rFIXFc through higher recovery and longer terminal half-life. In paradigm 7, N9-GP demonstrated consistently favorable PK characteristics compared with rFIXFc. Collins et al explored population PK differences between N9-GP and pdFIX/rFIX based upon paradigm 1 data. This analysis uses population PK models based upon the paradigm 7 trial. Methods 15 patients (21–65 years) with hemophilia B received single 50-IU/kg doses of N9-GP and rFIXFc ≥21 days apart. A population PK model developed from single-dose PK profiles simulated plasma FIX activity following dosing for surgery and on-demand treatment of bleeds. Simulations explored doses and frequencies required to sustain target World Federation of Hemophilia (WFH) factor activity levels. Results PK profiles of N9-GP and rFIXFc were described by one- and three-compartment models, respectively. Simulations predicted significantly reduced dosing frequency and consumption for N9-GP than rFIXFc. For severe bleeds, a single N9-GP dose (80 IU/kg) is sufficient to maintain WFH-recommended FIX levels, whereas multiple rFIXFc doses are required. For surgery, redosing in the first week with N9-GP is modeled at day 6 vs rFIXFc dosing at 6, 30, 54, 78, and 126 hrs. For life-threatening bleeds, N9-GP is required at days 0, 3, 6, 13, and 18 vs rFIXFc redosing after 6 hrs with 10 additional doses at 24-, 48-, and 72 hr intervals. Conclusion PK modeling approaches based upon direct comparative studies offer insights into PK differences between EHL FIX products. Model simulations show N9-GP may allow on-demand treatment and perioperative management with 55–75% fewer injections and 65–74% lower overall factor concentrate consumption than rFIXFc.
CLINICAL EVALUATION AND MANAGEMENT OF SOLITARY NODULE OF
THYROID IN EUTHYROID PATIENTS

BACKGROUND: Solitary nodules of the thyroid have been the area of focus in research since Warren Colein 1949. It is an area of research with much potential because of its diverse clinicalpresentation and its wide-ranging etiology and often the risk of malignancy. But the studiesassessing the prevalence and clinical prole of solitary thyroid nodules are relatively scarcefrom India. Hence the current study was conducted with the objective of determining theprevalence of solitary nodule of thyroid in general Population and to determine the proportion of a solitary nodule of thyroid turning out to be multinodular goitre on subsequentevaluation. The study has also assessed the role of FNAC in the management of solitarynodule of the thyroid and estimatedincidence of carcinoma as a cause of solitary Noduleof the thyroid to determine the underlying cause of Solitary nodule of thyroid (SNT) by theHPE. MATERIALS & METHODS:This study was a prospective study conducted in the Department of General surgery inKATURI MEDICAL COLLEGE fromNovember 2016 to May 2018 for a period of 1.5years. The study population included Solitary Nodule of Thyroid admitted to theDepartment of General surgery at Katuri medical collegewere considered as thestudy population. The prevalence was computed against all the OPD attendees in thedened study period. The ndings of ultrasonography, FNAC and HPE were comparedusing cross tabulation. Since the study did not attempt to test any hypothesis, No statisticaltest of signicance was used. IBM SPSS statistical software version 21 was used for data/analysis. RESULTS: During the study period, the total number of subjects attending the Outpatient departmentwere 6485.Among all the outpatient attendees, the prevalence of solitary thyroid nodulewas 1.23% with 95% CI ranging from 0.96% to 1.5%. Out of 80 clinically diagnosed solitarythyroid nodule cases multi nodular goitrewas found in 7 (8.8%) subjects on subsequentevaluation. In USG, 51.3% had Hyper Echogenic Nodule while 23.8% had MixedEchogenic Nodule. In 8.8%, the nodule turned out to be a part of Multi Nodular Goiter while7.5% had Suspicious Multi Nodular Goiter. In FNAC, 86.2% of the nodules were benign onFNAC. The majority (32.50%) were Benign Colloid Nodules. 26% were colloid nodules inFNAC. 13.8% of the nodules were malignant in FNAC. Papillary thyroid carcinoma wasseen in 12.5% in FNCAC. In HPE, the majority (78.5%) were benign nodules. Only 21.5%were malignant. In HPE, 32.5% were a benign follicular adenoma. The proportion of Colloid Nodule was 31.3%, and nodular goitre was 5%. The proportion of Papillary Thyroid Carcinoma, Hashimoto's thyroiditis, Well-Differentiated PTC, Anaplastic ca. of Thyroid was 13.80%, 3.80%, 2.50% and 1.3% respectively. CONCLUSIONS: The current study had assessed the burden and clinic pathologicprole of solitary thyroid nodulecases. The study ndings is an important addition to the existing evidence and guide the clinicians at various levels in evidence based evaluation and management of the patients with solitary thyroid nodule.
Thyroid Surgery Throughout History

surgery, mainly due to the relatively late development of endocrinology as a separate domain of medical study. Even if modern procedures for endocrine pathologies be it malignant or benign, are nowadays more standardized, reproducible and fall into specific guidelines, the road to this point was not without its hardships. Certain notions regarding the role of the thyroid, parathyroid and adrenal glands have emerged in medical texts from ancient times, but surgery was considered troublesome and not worth the benefit, if the patient survived the procedure. This slow and exhausting trajectory saw an astonishing evolution during the end of the 19 century and positively bloomed in the beginning of the 20, with the significant contributions of outstanding pioneer surgeons in both Europe and the US. The predicament nowadays has shifted more from archaic issues such as postoperative morbidity and mortality in patients suffering from endocrine dysfunctions to whether minimally invasive surgery should become the gold standard, and if it should – would it be laparoscopic surgery or would the robot take the spotlight? The first literature mentions of goitre were reported in ancient China as early as 2700 BC, and even if the Chinese regarded such ailments as bygones and oddities, they did observe the positive effects of ingesting iodine-rich foods such as seaweed in treating these large neck masses (1). Many anatomists and great artists studied, described and illustrated the thyroid gland, Editorial
Optimizing Contrast Medium Injection for Coronary CT Angiography Using Myocardial CT Perfusion Data

Coronary CT angiography (CTA) is a widely used method to diagnose coronary artery disease [1]. Coronary arteries need to be within an optimal enhancement to maintain a good diagnostic performance [2-4]. Body habitus, especially body weight, is an important factor in determining the total amount of contrast medium required because more contrast medium is required to achieve an optimal enhancement in obese patients [5]. Even when the contrast medium is tailored to body weight, interpatient variability in coronary enhancement can still remain. Previous studies have attempted to tailor the contrast medium dose using other parameters, such as lean body weight [6], body surface area [7], and cardiac output [8,9]. Another approach for optimizing the dose of contrast medium to achieve the target enhancement is to use the test bolus data [10]. As the peak enhancement (PE) of the main bolus can cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/bync/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. CVIA Optimizing Contrast Medium Injection for Coronary CT Angiography Using Myocardial CT Perfusion Data
Is pain catastrophizing scale useful for predicting post-thoracotomy pain after lung cancer surgery?

Title Is pain catastrophizing scale useful for predicting post-thoracotomy pain after lung cancer surgery? Author(s) Miyazaki, Takuro; Sakai, Tetsuya; Sato, Shuntaro; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Hatachi, Go; Doi, Ryoichiro; Watanabe, Hironosuke; Nagayasu, Takeshi Citation Acta medica Nagasakiensia, 63(1), pp.41-48; 2019 Issue Date 2019-11 URL http://hdl.handle. net/10069/39546 Right NAOSITE: Nagasaki University's Academic Output SITE
Increasing HPV Vaccination Uptake among Adolescents: A Systematic Review

Human Papillomavirus (HPV) vaccination is a well-known fundamental strategy in the prevention of cervical cancer, as it is always caused by HPV infection. In fact, primary prevention of the infection corresponds to primary prevention of HPV-related cancers and other diseases. Since an effective prevention at the population level is the final goal, it is mandatory for healthcare systems to achieve a high HPV vaccination coverage among the adolescents to reduce the circulation of the virus and the burden of HPV-related diseases. This research identified, through a systematic literature review, 38 papers on strategies adopted to increase HPV vaccination coverage among adolescents. The evaluated strategies targeted adolescents/parents and/or healthcare providers and could be grouped in three main types: (1) reminder-based, (2) education, information, and communication activities, and (3) multicomponent strategies. Several types of strategy, such as those relied only on reminders and integrating different interventions, showed a positive impact on vaccination coverage. Nonetheless, the heterogeneity of the interventions suggests the importance to adapt such strategies to the specific national/local contexts to maximize vaccination coverage.
Ticagrelor-Induced Prolongation of the QTc Interval

Background Ticagrelor has been accepted as a class I antiplatelet agent in patients undergoing percutaneous coronary angioplasty (PTCA). There have been cases reported on ticagrelor being associated with various cardiac conduction defects. But there is no evidence of QTc prolongation associated with the drug as of yet. Case Presentation A 64-year-old male who underwent PTCA was given ticagrelor. A baseline electrocardiogram (ECG) showed a QTc of 402 ms. He returned after 1.5 months with complaints of shortness of breath. An ECG revealed a prolonged QTc of 468 ms. Ticagrelor was discontinued in view of ticagrelor-induced dyspnea and the patient was started on clopidogrel. The other medications were kept unchanged. The patient returned after a month without any complaints. A follow-up ECG showed a reduced QTc of 425 ms. Conclusion We present a case of ticagrelor-induced QTc prolongation. To our knowledge, this is the first case to be reported on the same. The Naranjo algorithm for causality assessment gave a total score of 6 indicating that the adverse drug reaction falls under the probable category.
Evidence-Based Diagnosis: Challenges for evidence-based diagnosis

1. Introduction: understanding diagnosis and diagnostic testing 2. Reliability and measurement error 3. Dichotomous tests 4. Multilevel and continuous tests 5. Critical appraisal of studies of diagnostic tests 6. Screening tests 7. Prognostic tests and studies 8. Multiple tests and multivariable decision rules 9. Quantifying treatment effects using randomized trials 10. Alternatives to randomized trials for estimating treatment effects 11. Understanding P-values and confidence intervals 12. Challenges for evidence-based diagnosis.
Traumerinnerungshäufigkeit und Alptraumhäufigkeit bei Patienten mit nächtlichen Atemregulationsstörungen

Question of the study. There are conflicting findings regarding dream recall frequency (DRF) in patients with sleep-disordered breathing: Various studies have reported less, equal, or higher DRF in comparison with healthy controls. Although more negatively toned dreams were found in these patients, nightmare frequency had not been found to be increased in a previous study. This study concerned whether DRF or nightmare frequency was altered in patients with sleep-disordered breathing without other comorbid diagnoses and whether disorder-related parameters, comorbidity, or drug intake was associated with DRF and nightmare frequency. Patients and methods. The present study assessed home DRF and nightmare frequency via two rating scales in 1,706 patients with sleep-disordered breathing. These data were compared with those of healthy control samples from other studies. Results. In comparison with the control group, a reduced DRF was found that was not associated with respiratory parameters or comorbidity. Similarly, nightmare frequency was reduced, and one might speculate whether these findings can be explained by cognitive dysfunction, which is often found in patients with sleep-disordered breathing. Use of antidepressants and psychiatric comorbidity were associated with heightened nightmare frequency. Conclusions. Future studies should include current medication intake, measures of cognitive functioning, and sleep parameters in order to explain reduced DRF and reduced nightmare frequency in patients with sleep-disordered breathing.
A Fixed-Dose Combination Of Gemigliptin And Rosuvastatin Exhibits Similar Pharmacokinetics, Pharmacodynamics, And Safety Compared To That Of A Loose Combination In Healthy Subjects

Purpose Fixed-dose combination (FDC) of gemigliptin and rosuvastatin may improve medication compliance of patients with comorbid type 2 diabetes and dyslipidemia. Pharmacokinetics (PK), pharmacodynamics (PD), and safety of gemigliptin/rosuvastatin 50/20 mg FDC was compared with a loose combination of individual tablets in healthy subjects. Patients and methods A randomized, open-label, single-dose, two-period, two-sequence, two-treatment crossover study was conducted. Subjects received FDC or a loose combination of gemigliptin (50 mg) and rosuvastatin (20 mg) during each period, with a 14-day washout. Serial blood samples were collected up to 72 hrs after dosing to measure plasma concentrations of gemigliptin, its active metabolite LC15-0636, and rosuvastatin for PK assessment, and DPP-4 activity for PD assessment. PK and PD parameters were calculated using a non-compartmental method. Safety profiles were evaluated throughout the study. Results Thirty-seven subjects completed the study. The concentration-time profiles of gemigliptin, LC15-0636, and rosuvastatin were similar between FDC and loose combination, respectively. For each of the three compounds, the geometric mean ratios (90% confidence interval) of FDC to loose combination for Cmax and AUClast fell within the bioequivalence range of 0.8–1.25. Inhibition of DPP-4 activity–time profiles after administration of FDC and loose combination was overlapping, and Imax and AUEClast were similar. Both FDC and the loose combination were well tolerated. Conclusion PK, PD, and safety profiles of gemigliptin, its metabolite, and rosuvastatin were similar between FDC and loose combination. The FDC of gemigliptin (50 mg) and rosuvastatin (20 mg) can be used as an alternative to a loose combination, which is expected to improve patient compliance.
The reliability and responsiveness of components of breathing pattern

Breathing pattern (BP) may have the potential to be used to monitor respiratory health and be used as an outcome measure for specific interventions designed to improve respiratory health. However, little published research has examined the reliability and responsiveness of BP. This research examines the reliability and responsiveness of specific components of BP in healthy adults and patients with asthma. It comprises three separate studies: The first study examines the test re-test reliability of BP at rest in both sitting and supine in 50 healthy individuals measured using Respiratory Inductive Plethysmography (RIP). The second study examines the responsiveness of BP before and during recovery from a 10minute moderate physical exercise stimulus in 43 healthy individuals recorded using Structured Light Plethysmography (SLP). The third study recorded BP in 5 participants with asthma using SLP before and after a breathing retraining intervention. Results were: 1) the BP components under examination demonstrated good relative reliability and no systematic bias with Bland-Altman analysis in both the sitting and supine positions. A slightly higher level of test re-test reliability was found for all components in the sitting position in comparison to the supine data. 2) thoracoabdominal motion (TAM) was not significantly changed post exercise in comparison to quiet breathing. Also, TAM responsiveness was not affected by gender. Moreover, there was low relationship between thoracoabdominal motion and timing components. 3) Breath-by-breath analysis did not find any consistency in changes in timing components or TAM following breathing retraining in all participants. Conclusion: This research has produced evidence that the studied components of BP are reliable in healthy adults. Regarding responsiveness, changes in TAM within individuals were observed, but the changes were not found to be significant and did not demonstrate any clear pattern in direction of change. However, the third study involved a small sample size. So, although the BP components were found to remain stable, it is too early to draw firm conclusions regarding the responsiveness.