Kornimate/medical-research-clean huggingface dataset:
efficacy of using large language model to assist in diabetic retinopathy detection

Conditions: Diagnosis; Diabetic Retinopathy

Summary: with the increase in population and the rising prevalence of various diseases, the workload of disease diagnosis has sharply increased. the accessibility of healthcare services and long waiting times have become common issues in the public health medical system, with many primary patients having to wait for extended periods to receive medical services. there is an urgent need for rapid, accurate, and low-cost diagnostic services.


Eligibility criteria:
inclusion criteria the study will include adults aged 18 years and above who have been diagnosed with type 2 diabetes but have not previously been screened for dr. participants must demonstrate good compliance with clinical examinations, and provide informed consent. exclusion criteria the study will exclude patients who have previously been diagnosed with dr, those who have recently undergone eye surgery, and those with other significant eye diseases that could potentially confound the results of dr screening. individuals with ocular, auditory, or cognitive impairments that prevent the use of mobile phones or reading will also be excluded.
contrast-enhanced ultrasound for the evaluation of changes in tumor blood flow surrounding hae

Conditions: Hepatocellular Carcinoma; Liver Cancer

Summary: the purpose of the study is to find out if a study agent called lumason® microbubbles may be helpful for people with lesions in the liver. it is possible it may help determine an early response to radioembolization and/or help demonstrate radiation toxicity to the surrounding liver.


Eligibility criteria:
inclusion criteria: * provision of signed and dated informed consent form * stated willingness to comply with all study procedures and availability for the duration of the study * men and women \>18 years of age. * histologically or cytologically confirmed hepatocellular carcinoma or meet imaging criteria for a diagnosis of hepatocellular carcinoma with tumor burden dominant in the liver. * participants must have measurable disease, by ct or mri per mrecist, not be a candidate for surgical resection based on unresectability, anatomy, anesthesia risk, patient preference. * serum bilirubin ≤ 2.0 * platelet count \> 50,000/ul (corrected if needed) * inr ≤ 1.5 (corrected if needed) 9. serum creatinine \< 2.0 mg/dl exclusion criteria: * participants must be at least one month beyond prior chemotherapy, ablation or surgery, and have recovered from all therapy-associated toxicities. * history of severe allergic reaction to intravenous contrast media (iodinated and gadoliniumbased) or any agents used during the embolization; participant cannot be medicated against allergic reaction prior to embolization or contrast enhanced ultrasound. * history of hypersensitivity reactions to sulfur hexafluoride lipid microsphere components or to any of the inactive ingredients in lumason® microbubbles * active infection * participants with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias) * pregnancy or lactation. women/men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method. * participants may not be receiving any other investigational agents

Keywords: hepatic artery embolization liver metastases radioembolization
safety and efficacy of insulin nph compared to a new insulin formulation in subjects with type 2 diabetes

Conditions: Diabetes; Diabetes Mellitus, Type 2

Summary: this trial is conducted in south america. this trial aims for a comparison of the safety and efficacy of insulin nph and a new insulin formulation on blood glucose control.


Eligibility criteria:
inclusion criteria: * type 2 diabetes for at least 12 months * current nph treatment for at least 3 months - alone or as the only insulin in combination with oads * body mass index (bmi) less than or equal to 40 kg/m2 * hba1c less than or equal to 9.5% * fpg less than or equal to 12 mmol/l exclusion criteria: * treatment with glucagon-like peptide 1 mimetics or dipeptityl peptidase iv inhibitors * treatment with more than 1 iu/kg nph insulin daily * known hypoglycaemia unawareness or recurrent major hypoglycaemia, as judged by the investigator * known or suspected allergy to trial products or related products * receipt of any investigational drug within one month prior to this trial * any other condition that the investigator feels would interfere with trial participation or evaluation of results, e.g. shiftworkers
glucose monitoring in treatment of postprandial hypoglycemia after gastric bypass surgery

Conditions: Hypoglycemia Non-Diabetic; Gastric Bypass Surgery

Summary: the goal of this clinical trial is to learn if continuous glucose monitoring works to treat postprandial hypoglycaemia in patients who have undergone gastric bypass surgery. the main question it aims to answer is: • is continuous glucose monitoring superior to usual care for prevention of postprandial hypoglycaemia in patients with verified postprandial hypoglycaemia after gastric bypass surgery? researchers will compare continuous glucose monitoring to usual care to see if continuous glucose monitoring works to treat postprandial hypoglycaemia. participants will: * use a continuous glucose monitor for 6 weeks or use no continuous glucose monitor for 5 weeks and wear a blinded continuous glucose monitor for 1 week. * visit the clinic 2-3 times and have 2-3 phone consultations. * register symptoms of hypoglycaemia, answer questionnaires, undergo a 24-hour dietary recall interview conducted by a registered dietitian, measure weight and body composition and take blood samples.


Eligibility criteria:
inclusion criteria: * gastric bypass surgery at least 1 year ago * age ≥18 years * symptomatic postprandial hypoglycaemia; capillary glucose level \<3.0 mmol/l 1-4 hours after meals exclusion criteria: * not able to give informed consent * reduced compliance due to severe mental and psychiatric conditions * use of insulin or sulfonylureas * use of systemic corticosteroids * primary or secondary adrenal insufficiency * insulinoma * severe heart-, lung, liver- or kidney disease, cancer, malnutrition and other medical conditions causing fragility * performed bariatric revisional surgery * drug- or alcohol abuse * pregnancy * use of acarbose or octreotide in the treatment of postprandial hypoglycemia * use of continuous glucose monitor
online cognitive behavioral therapy for rehabilitation after cardiac surgery

Conditions: Cardiac Surgery

Summary: the purpose of the present pilot study is to evaluate the feasibility and potential efficacy of a brief, internet-delivered cbt protocol provided early following cardiac surgery.

cardiac surgery is a major surgical procedure used to treat for example coronary artery disease (cad). the intervention increases survival rates and reduces cardiac symptom burden in cardiac patients. however, cardiac surgery is associated with elevated symptoms of psychological distress, which are related to several negative outcomes, such as poorer health-related quality of life (qol) and response to treatment. there is a clear need to develop a brief psychological intervention that can be provided early in the clinical course after cardiac surgery to reduce psychological distress. the purpose of this pilot study is to evaluate the feasibility and potential efficacy of a brief, exposure-based internet-delivered cbt protocol provided early after cardiac surgery. this is an uncontrolled pilot study with a pretest-posttest design. the study will include 30 participants. assessments will be conducted pre-treatment, post-treatment, one- and six months after treatment. the one-month follow-up is the primary endpoint. the treatment lasts for five weeks and will be provided as an early intervention following cardiac surgery ≥ eight weeks to nine months before assessment. it will include psychoeducation, behavioral activation to address post-operative fatigue and depression, interoceptive exposure to reduce fear of cardiac-related symptoms and in-vivo exposure to reduce avoided situations, and activities to enhance physical activity and wellbeing.

Eligibility criteria:
inclusion criteria: * (a) cardiac surgery (i.e., cabg, heart valve repair/replacement, aortic repair or combined cabg and valve repair/replacement) ≥ eight weeks to nine months before assessment * (b) age 18 years and above; * (c) endorses postoperative psychological distress and/or interference with daily life * (d) on medical treatment for the cardiac condition according to clinical guidelines; * (e) ability to read and write in swedish exclusion criteria: * (f) prior cardiac surgery with ventricular assist device or heart transplant; * (g) hospitalized or living in a care facility; * (h) any medical restriction to be physical active; * (i) severe medical illness i.e., terminal cancer ; * (j) severe psychiatric disorder or risk of suicide; * (k) alcohol dependency; * (l) ongoing psychological treatment.

Keywords: psychological distress cognitive behavioral therapy fatigue depression anxiety
pharmacokinetics of rfviiifc at two vial strengths

Conditions: Severe Hemophilia A

Summary: the primary objective of the study is to characterize the pharmacokinetics (pk) of rfviiifc administered at vial strengths of 1000 and 3000 iu in subjects with severe hemophilia a. the secondary objective of the study is to evaluate the safety of rfviiifc beyond the pk assessment for up to 6 months for a continued treatment period.

this is a randomized, open-label, crossover study during which each participant receives a single injection of rfviiifc from 2 different vial concentrations (pk assessment). after the pk assessment, participants are provided with rfviiifc for either prophylactic or episodic (on-demand) treatment for up to 6 months.

Eligibility criteria:
key inclusion criteria: * have severe hemophilia a * previously treated subject, defined as having at least 150 documented prior exposure days to any recombinant and/or plasma-derived fviii and/or cryoprecipitate products (other than any use of rfviiifc- study drug or commercial product) at day 1. fresh frozen plasma treatment must not be considered in the count for documented exposure days. * no history of a positive inhibitor test or clinical signs of decreased response to fviii administrations. family history of inhibitors will not exclude subjects. * no measurable inhibitor activity using the nijmegen-modified bethesda assay at screening. * platelet count ≥100,000 platelets/μl at screening * cd4 lymphocytes \>200 mm3 if known as hiv antibody positive at screening. * viral load of \<400 copies/ml if known hiv antibody positive at screening. key exclusion criteria: * subject is at high risk of bleeding during the 5-day period between the first and second injections for pk analyses, as per investigator discretion. * previous treatment with rfviiifc as study drug or commercial product. * other coagulation disorder(s) in addition to hemophilia a. * history of hypersensitivity or anaphylaxis associated with any fviii or iv immunoglobulin administration. * currently taking (or likely to require during the study) acetylsalicylic acid (asa), except for low-dose asa as prophylaxis (other nonsteroidal anti-inflammatory drugs are permitted). * concurrent systemic treatment with immunosuppressive drugs within 12 weeks prior to day 1. exceptions to this include: ribavirin for treatment of hepatitis c virus (hcv), and/or systemic steroids (a total of 2 courses of pulse treatments lasting no more than 7 days at a dose of ≤1 mg/kg within 12 weeks prior to day 1) and/or inhaled steroids. note: other protocol-defined inclusion/exclusion criteria may apply
robotic assisted early mobilization in ventilated icu patients with covid-19

Conditions: Covid19; Critical Illness; Critical Illness Polyneuromyopathy; Early Mobilization; Rehabilitation; Robotics

Summary: feasibility trial investigating the potential higher frequency of robotic assisted early mobilization in intubated covid19 patients on the icu.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * invasive mechanically ventilated and expected to be ventilated for another 24 hours * cardiovascular stability, allowing mobilization * respiratory stability, allowing mobilization exclusion criteria: * bed-bound before icu admission * bed-rest order or contraindication of weight load of the lower extremity or spine * severe skin lesions or fasciitis in the area of contact with the device or rhabdomyolysis * fresh sab, icb or elevated icp * status epilepticus * acute intoxication * shock with catecholamine doses \>0.3μg/kg/min or acute bleeding including organ ruptures * multiorgan failure with lactate \> 4 mmol/l * body height outside the range 150-195 cm * body weight outside the range 45-135 kg * pavk iv° * pacemakers or other electrical stimulators * implanted medical pumps * pregnancy * life expectancy below 7 days or acute palliative care situation * death inevitable or maximum therapy is not carried out by the treating physicians or due to patient's request * unable to understand the official language

Keywords: covid19 early mobilization robotics vemo
glycocalyx biomarkers in ards for clinical prognosis and pulmonary fibrosis

Conditions: ARDS, Human; Endothelial Dysfunction; Mechanical Ventilation Pressure High

Summary: ards is a severe disease in icu, and could induce high mortality. glycocalyx is an important matrix construction which covers endothelial cells, it could protect endothelial cells injury and the glycocalyx biomarkers could predict pulmonary injury. decorin is a member of the small leucine-rich proteoglycan (slrp) family, contains a single glycosaminoglycan (gag) chain and a core protein with 12 leucine-rich repeats. in the previous study, decorin is associated with cardiac and liver fibrosis, however, the effects of decorin on ards pulmonary fibrosis have not been clarified.


Eligibility criteria:
inclusion criteria: 1. age \> 18yrs and \<80yrs 2. meet ards berlin definition 3. with mechanical ventilation exclusion criteria: 1. have chronic pulmonary disease 2. have use heparin or low molecular heparin or chondroitin sulfuric acid

Keywords: ards endothelial dysfunction mechanical ventilation glycocalyx pulmonary fibrosis mortality
reducing heart failure re-admissions by enhancing sleep apnea treatment adherence

Conditions: Congestive Heart Failure; Sleep Apnea Syndromes

Summary: sleep apnea, characterized by abnormal breathing at night, is often untreated in patients with heart failure. helping patients to effectively use the most common form of treatment for sleep apnea, positive airway pressure therapy, can improve their heart function. this can reduce the likelihood that the patient will be re-admitted to the hospital. aircarelabs has developed an innovative solution that allows patients to communicate with health care providers 24 hours a day, thus allowing them to get the help they need to effectively use positive airway pressure and thereby reduce the risk of being re-admitted to the hospital.


Eligibility criteria:
inclusion criteria: * congestive heart failure and sleep apnea exclusion criteria: * cognitive impairment
a medication adherence intervention for hiv infected veterans

Conditions: HIV Infection

Summary: it is estimated that the vha is caring for nearly 40 percent of all hiv-infected veterans. to benefit from recent improvements in anti-hiv therapy, patients need to take their medications consistently.

background: it is estimated that the vha is caring for nearly 40 percent of all hiv-infected veterans. to benefit from recent improvements in anti-hiv therapy, patients need to take their medications consistently. objectives: optimizing health for hiv patients requires excellent adherence to antiretroviral medication regimens. however, its unclear how best to incorporate adherence education and support programs into va hiv outpatient care. we implemented and evaluated a pharmacist program (ace) and a pager reminder program to support adherence in veterans with hiv. methods: we used a quasi-experimental design with pre-post evaluation at four va centers. three treatment conditions (ace, pager, usual care) were rolled-in sequentially over two study phases, allowing for group comparisons between conditions. ace is a multi-component manualized 4-session, individual patient education and support program by trained pharmacists. the pager intervention used alphanumeric pagers to remind patients of dosing times. electronically-monitored medication adherence (mems), self-report questionnaires, and pharmacy refill records were collected. qualitative site interviews were collected before and after interventions to assist with program evaluation. multilevel mixed models were used to analyze main study outcomes over time. secondary analyses compared subgroup who actually received all ace sessions (�as treated�) to controls. status: project has been completed and final report submitted to hsr\&d co.

Eligibility criteria:
inclusion criteria: patients must be greater than or equal to 18 years old, must be enrolled in hiv primary care at one of 4 va study sites and be taking antiretroviral therapy. exclusion criteria:
positron emission tomography/computed tomography (pet/ct) for the diagnosis of recurrent cancer: a feasibility study

Conditions: Non-small Cell Lung Cancer; Breast Cancer; Head and Neck Cancer; Ovarian Cancer; Esophageal Cancer; Lymphoma

Summary: sometimes, cancer comes back after it has been successfully treated-a situation called recurrent cancer. when recurrent cancer is suspected, the standard approach to diagnosis is to perform a combination of imaging tests, such as x-rays, ultrasound, computed tomography (ct), magnetic resonance imaging (mri), and nuclear medicine scans. sometimes, however, after performing these tests it still may not be clear whether or not the cancer has come back. some studies have shown that a diagnostic imaging test called positron emission tomography/computed tomography (pet/ct) may be helpful in the diagnosis of recurrent lung, breast, head and neck, ovarian or esophageal cancer or lymphoma. however, it is not clear if pet/ct can offer better results than standard approaches to diagnosis. this feasibility study is needed to determine how common it is for a diagnosis of recurrent cancer to be unclear even after standard diagnostic imaging tests have been completed. if the enrollment goal is reached (\~60 patients enrolled in 18 months), a larger clinical trial is being planned to determine if pet/ct is helpful in making the diagnosis of recurrent cancer in situations where standard imaging tests have not been helpful. it is also expected that the results of this feasibility study will help to define exactly which patients should be enrolled in this larger clinical trial of pet/ct.


Eligibility criteria:
inclusion criteria: * patients with a previous history of non-small cell lung cancer, breast cancer, head and neck cancer (not thyroid cancer), ovarian cancer, esophageal cancer, or lymphoma (hodgkin's or non-hodgkin's) who have suspected recurrence on history and/or physical exam. * conventional imaging (e.g., x-ray, ultrasound, ct, mri, bone scan) is non-diagnostic. exclusion criteria: * age less than 18 years. * patient with established recurrence requiring staging of recurrent disease. * patients who, at the time of the initial evaluation, have already undergone pet/ct within 6 months prior to registration. * unable to lie supine for imaging with pet/ct. * pregnant or lactating female. * significant concurrent medical problems (e.g., uncontrolled diabetes, active cardiac disease, significant chronic obstructive pulmonary disease) making the patient unfit for further cancer therapy. * unable to give informed consent.

Keywords: recurrent cancer pet/ct fdg planned management actual treatment
perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis

Conditions: Acute Appendicitis

Summary: patients undergoing open appendectomy for acute appendicitis were enrolled in a randomized prospective study.


Eligibility criteria:
inclusion criteria: * consent was given * 15 years old or older * underwent acute appendicitis exclusion criteria: * lack of follow up * younger than 15 years * not eligible according to physician decision
effect of bariatric surgery on kidney function

Conditions: Obese Subjects Who Will Undergo Gastric By-pass Surgery

Summary: primary hypothesis: a large reduction in weight is not associated with a change in accurately measured glomerular filtration rate (gfr) (51chromium ethylenediaminetetraacetic acid plasma clearance (51cr-edta)). secondary hypothesis: a large reduction in weight is associated with a greater change in estimated gfr (the modification of diet in renal disease (mdrd-formula)) than in accurately measured gfr. other formulas for estimated gfr (cockcroft gault, chronic kidney disease epidemiology collaboration (ckd-epi), ckd-epi with cystatin c) are better correlated with accurately measured gfr.


Eligibility criteria:
inclusion criteria: * male or female, older than 18 years of age * appointed to gastric by-pass surgery on hvidovre hospital, denmark exclusion criteria: * withdrawal of surgical indication * severe oedema or ascites
the effect of the timing of postoperative mobilisation after locking plate osteosynthesis of fractures of the surgical neck of the humerus

Conditions: Humeral Fracture

Summary: open reduction and locking plate osteosynthesis is a commonly used and well-accepted treatment for displaced fractures of the proximal humerus. the shoulders tend to end stiff despite intensive rehabilitation, limiting the function of the upper extremity and decreasing the quality of life. the accepted postoperative mobilisation protocol includes passive exercises until six weeks postoperatively and active range of motion exercises after that. there is good evidence that conservatively treated fractures of the same site heal better and faster if mobilised immediately. the study compares "standard mobilisation" versus "immmediate mobilisation" in a prospective, randomized, controlled trial in order to find the optimal time-frame for physiotherapy to produce best possible results. outcome measures are assessed at specific time points after the operation and comparisons between groups are made to follow the rate of recovery and end results.


Eligibility criteria:
inclusion criteria: * age 18 years or older * surgery can be performed within 10 days of injury * a dislocated (\>1cm or 35 degrees) ao 11-a2, -a3, -b1 or -b2 fracture of the surgical neck of the proximal humerus with a possible fracture of the tuberculum majus exclusion criteria: * glenohumeral dislocation * fracture of the tuberculum minus * open fracture * additional fractures in the shoulder region * other injuries requiring surgical treatment * clinically significant injury of the brachial plexus or vasculature * pathological fracture associated with cancer * history of a fracture of the clavicle, scapula or humerus, or history of a very significant disease or trauma of the shoulder region (hemiparesis, tumour, osteomyelitis, grave arthrosis etc) * rheumatoid arthritis in the shoulder requiring active treatment * reduced co-operation or incapability for independent living (dementia, mental illness, drug- or alcohol abuse etc) * unwillingness to accept some of the treatment options.

Keywords: locking plate physiotherapy