Kornimate/medical-research-clean huggingface dataset:
a learning algorithm for mdi individuals with type 1 diabetes to adjust recommendations for high fat meals and exercise management

Conditions: Type 1 Diabetes

Summary: mcgill artificial pancreas lab has developed a learning algorithm using a reinforcement learning approach to adjust basal and bolus recommendations for high-fat meals and exercise management for individuals with type 1 diabetes on multiple daily injections (mdi) therapy. the reinforcement learning algorithm is integrated with a mobile application that gathers insulin, meal information (carbs (if applicable) and high-fat content), mealtime glucose value, glucose trend at mealtime, and type and timing of postprandial exercise.

the objective of this study is to assess the feasibility of a reinforcement learning algorithm to adjust basal and bolus recommendations for high-fat meals and postprandial exercise management. the investigators hypothesize that the reinforcement learning algorithm will be safe, and participants will get the benefit of improved glucose outcomes and improved patient satisfaction from the start to the end of study. participants (aged ≥18) will undergo multiple daily injections (mdi) therapy for 4 months using a freestyle libre glucose sensor (abbott diabetes care) and a mobile data collection application integrated with the reinforcement learning algorithm.

Eligibility criteria:
inclusion criteria: 1. signed and dated informed consent form 2. females and males ≥ 18 years old 3. diagnosis of type 1 diabetes of ≥ 12 months based on the clinical investigator's judgement 4. undergoing mdi therapy 5. a self-reported diet that consists of at least 3 high-fat meals per week or participation in exercise for at least 30 minutes, two times per week exclusion criteria: 1. current use of any non-insulin antihyperglycemic medication (sglt2 inhibitors, glp 1 receptor agonists, metformin...) 2. current use of glucocorticoid medication, except inhaled and/or at low stable doses 3. pregnancy 4. use of isophane insulin (nph) or intermediate-acting insulin 5. significant clinical nephropathy, neuropathy, retinopathy as per the clinical investigator's judgement 6. acute macrovascular event (ex: acute coronary syndrome or cardiac surgery) within 6 months of admission 7. severe diabetes ketoacidosis and/or hypoglycemia within one month of admission 8. other severe medical illness that the clinical investigator considers may interfere with participation in or completion of the study 9. an inability or unwillingness to comply with study procedures as per the clinical investigator's judgement
tcms to treat ventricular tachycardia

Conditions: Ventricular Tachycardia

Summary: open label study of transcutaneous magnetic stimulation targeting the stellate ganglion in patients with ventricular tachycardia


Eligibility criteria:
inclusion criteria: * age \>18years * documented ventricular tachycardia within the preceding 72 hours exclusion criteria: * pregnancy * implanted ventricular assist device * metal implanted in heard or neck (except the mouth) * implanted medication pumps * cochlear implant * implanted brain stimulator * ocular implant * history of malignancy in the region of stimulation (neck)
aria to predict coronary artery disease in hiv-infected individuals

Conditions: Hiv; Coronary Artery Disease

Summary: with effective anti-retroviral therapy, non-communicable diseases, such as cardiovascular diseases, have become the major cause of morbidity and mortality for people living with hiv. there is only limited data evaluating the burden and risk factors of cardiovascular disease in the asian hiv-infected population. accurate non-invasive tools for prediction of cardiovascular disease, particularly in asian hiv-infected populations, are urgently needed. recently, more detailed evaluation of the complex retinal vasculature has been made feasible with advances in digitalized retinal imaging techniques. this study aims 1. to determine the prevalence of coronary atherosclerosis and obstructive coronary artery disease hiv-infected individuals with one or more cardiovascular disease risk factors in asia. 2. to determine the performance of automatic retinal image analysis (aria) in predicting the risk of coronary artery disease in hiv-infected individuals, as compared to traditional risk prediction tools. patients will undergo a coronary ct angiogram, followed by an automatic retinal image analysis within 4 weeks post completion of ct angiogram.


Eligibility criteria:
inclusion criteria: * positive anti-hiv antibody * age 30 or above * presence of one or more risk factors for cardiovascular disease exclusion criteria: * presence of overt coronary artery disease * impaired renal function * allergy to intravenous contrast * pregnancy
feasibility assessment of risk stratification and oral challenge in hospitalized children at low risk for antibiotic allergy

Conditions: Penicillin Allergy

Summary: children are often reported to have antibiotics allergies, with approximately 10% of the us population labeled as allergic to an antibiotic. recent studies have demonstrated that a large majority of children with a penicillin allergy label do not have a true ige-mediated allergy. appropriately delabeling antibiotic allergies has been shown to improve patient care outcomes and lower health care costs. however, efforts to implement these assessments in practice are lacking, particularly in the hospital setting. therefore, there is a need for hospital-based risk assessment and delabeling strategies for hospitalized children. the investigator's objective is to determine the feasibility of implementing a hospital-based approach to penicillin allergy risk stratification and evaluation of patients at low-risk for true allergy.


Eligibility criteria:
inclusion criteria: * patients admitted to vanderbilt children's hospital admitted to a pediatric hospital medicine service with a penicillin allergy reported in their chart who are medically stable exclusion criteria: * known pregnancy * patients without a primary care provider
stress ulcer prophylaxis in the intensive care unit

Conditions: Gastrointestinal Bleeding; Stress Ulcers

Summary: stress ulcer prophylaxis (sup) is standard of care in the intensive care unit (icu), however the quantity and quality of evidence is low and potential harm has been reported. the aim of the sup-icu trial is to asses the overall benefits and harms of sup with proton pump inhibitor in adult critically ill patients in the icu.

critically ill patients in the icu are at risk of stress related gastrointestinal (gi) bleeding, and sup is recommended. however, the quantity and quality of evidence supporting sup is low and has been questioned. furthermore studies have shown that proton pump inhibitors (ppis) may increase the risk of pneumonia, clostridium difficile infection and acute myocardial ischemia. the aim of the sup-icu trial is to assess the benefits and harms of sup with ppi in adult critically ill patients in the icu.

Eligibility criteria:
inclusion criteria: * acute admission to the icu * age ≥ 18 years * one or more of the following risk factors: * shock (continuous infusion with vasopressors or inotropes, systolic blood pressure \ 4 mmol/l) * acute or chronic intermittent or continuous renal replacement therapy * invasive mechanical ventilation which is expected to last \> 24 hours * coagulopathy (platelets \ 1.5 or prothrombin time (pt) \> 20 seconds) documented within the last 24 hours * ongoing treatment with anticoagulant drugs (prophylaxis doses excluded) * history of coagulopathy (platelets \ 1.5 or pt \> 20 seconds) within 6 months prior to hospital admission * history of chronic liver disease (portal hypertension, cirrhosis proven by biopsy, computed tomography (ct) scan or ultrasound, history of variceal bleeding or hepatic encephalopathy in the past medical history) exclusion criteria: * contraindications to ppi * ongoing treatment with ppi and/or h2ra on a daily basis * gi bleeding of any origin during current hospital admission * diagnosed with peptic ulcer during current hospital admission * organ transplant during current hospital admission * withdrawal from active therapy or brain death * fertile woman with positive urine human chorionic gonadotropin (hcg) or plasma-hcg * consent according to national regulations not obtainable

Keywords: stress ulcer prophylaxis proton pump inhibitor pneumonia clostridium difficile infection
a cross-sectional internet survey to estimate prevalence of lower urinary tract symptoms (luts)

Conditions: Lower Urinary Tract Symptoms

Summary: the purpose of the study is to determine prevalence of lower urinary tract symptoms in population aged 40 years or over, in china, taiwan and south korea using latest ics definition.

the research question for this study pertains to assessing prevalence and symptom specific bother of luts and its impact on hrql, work productivity, mental and sexual health across china, taiwan and south korea, using latest ics definition. the research is a cross sectional population-representative internet survey among general population of males and females aged 40 years or older. the research would be an internet-based self-administration survey across china, taiwan and south korea. the primary objective of the study is to determine the prevalence of lower urinary tract symptoms in population aged 40 years or over, in china, taiwan and south korea using latest ics definition. secondary objectives of the study are: * to examine the symptom-specific bother of luts * to evaluate impact of these symptoms on health-related quality of life, work productivity, mental and sexual health using standard survey instruments * to explore the differences in prevalence of luts across males and females, across age groups, across different socioeconomic strata and across china, taiwan and south korea * to examine the extent of overlap of voiding and storage symptoms among the study participants * to explore treatment seeking behavior and determine treatment rate and satisfaction with current treatment

Eligibility criteria:
inclusion criteria: * aged 40 years or older on the date of survey * able to read local language * able to access the internet and use a computer (with or without the help of an assisting person who may or may not be a family member) * provides of informed consent exclusion criteria: * is pregnant * diagnosed as having urinary tract infection by a physician in the past one month which may be cured or persisting
comparative effectiveness of tumor necrosis factor inhibitors and tofacitinib use in earlier lines of therapy and use as monotherapy.

Conditions: Arthritis Rheumatoid

Summary: this study is to investigate if there has been a shift in treatment with tofacitinib, assessing real world patient data and entered in the corrona registry between 2016 and 2020.


Eligibility criteria:
inclusion criteria: * ra patients in corrona initiating tofacitinib or a tnf biologic (adalimumab, etanercept, infliximab, golimumab, certolizumab pegol) after 06 november 2012 (market approval of tofacitinib) during follow-up in corrona with no prior use of tofacitinib. only the patient's first initiation after 06 november 2012 will be included in the analysis * have a 6 and / or 12-month follow-up visit (with +/- 2 month window) * have clinical disease activity index (cdai) measures at baseline and at the follow-up visit exclusion criteria: * patients who have not failed methotrexate (mtx) or another csdmard (ie 1st line initiators)
a safety and tolerability study of assisted and self-administered subcutaneous (sc) herceptin (trastuzumab) as adjuvant therapy in early human epidermal growth factor receptor 2 (her2)-positive breast cancer

Conditions: Breast Neoplasms

Summary: this multicenter, two-cohort, non-randomized, open-label study will evaluate the safety and tolerability of assisted and self-administered sc herceptin as adjuvant therapy in participants with early her2-positive breast cancer following tumor excision. participants will receive herceptin 600 milligrams (mg) sc every 3 weeks for 18 cycles, either by an assisted administration using a conventional syringe and needle/vial formulation (cohort a) or with assisted and self-administration using a single-use injection device (sid) in selected participants (cohort b).


Eligibility criteria:
inclusion criteria: * histologically confirmed early invasive her2-positive carcinoma of the breast with no evidence of residual, locally recurrent, or metastatic disease and defined as clinical stage i to iiic that is eligible for treatment with herceptin * eastern cooperative oncology group (ecog) performance status 0 or 1 * screening left ventricular ejection fraction (lvef) greater than or equal to (≥) 55% exclusion criteria: * previous neoadjuvant or adjuvant breast cancer treatment with an approved or investigational anti-her2 agent * history of other malignancy except for curatively treated carcinoma in situ of the cervix, basal cell carcinoma, or curatively treated malignancies (other than breast cancer) where the participant has been disease-free for at least 5 years * past history of ductal carcinoma in situ treated with any systemic therapy or with radiation therapy to the ipsilateral breast where invasive cancer subsequently developed * metastatic disease * inadequate bone marrow, hepatic, or renal function * serious cardiac or cardiovascular disease including uncontrolled hypertension or history of hypertensive crisis or hypertensive encephalopathy * history of severe allergic or immunological reactions, such as difficult-to-control asthma * pregnant or lactating women
a study of the safety and effectiveness of adx-n05 for excessive daytime sleepiness in subjects with narcolepsy

Conditions: Narcolepsy

Summary: this is a study to evaluate the safety and effectiveness of adx-n05 compared to placebo in the treatment of excessive daytime sleepiness in adults with narcolepsy.


Eligibility criteria:
inclusion criteria: * diagnosis of narcolepsy * good general health * willing and able to comply with the study design and schedule and other requirements exclusion criteria: * if female, pregnant or lactating * customary bedtime later than midnight * history of significant medical condition, behavioral, or psychiatric disorder (including suicidal ideation), or surgical history * any other clinically relevant medical, behavioral or psychiatric disorder other than narcolepsy that is associated with excessive sleepiness * history of significant cardiovascular disease * body mass index \> 34 * excessive caffeine use - \> 600 mg/day of caffeine or \> 6 cups of coffee/day * history of alcohol or drug abuse within the past 2 years * nicotine dependence that has an effect on sleep
effects of acleara needle insert on acne

Conditions: Acne Vulgaris

Summary: this prospective, open-label study will be conducted in 15 healthy subjects per clinical site ages 14 or older who meet the inclusion/exclusion criteria. each subject may have up to 5 lesions treated on the face, chest or back with the acleara insert. subjects will receive up to 3 follow up visits and evaluated for improvement in acne lesions and monitored for any adverse events.


Eligibility criteria:
inclusion criteria: * subjects \>14 years of age * subject has mild to moderate acne vulgaris on the face, chest or back. * subject has one or more inflammatory acne lesions on face, chest or back. * willingness to participate in the study * informed consent agreement signed by the subject * willingness to follow the treatment schedule and post treatment care requirements * willingness to remain on current acne therapy as directed by the investigator. exclusion criteria: * subject has an infection or other dermatologic condition (aside from acne) in the area to be treated * subject is immunosuppressed * subject is unable to comply with treatment or follow-up visits * any other condition or laboratory value that would, in the professional opinion of the investigator, potentially affect the subject's response or the integrity of the data or would pose an unacceptable risk to the subject.

Keywords: acne inflammatory acne intense pulsed light
restore-tavi pilot

Conditions: Frailty; Aortic Stenosis

Summary: this is a pilot randomised control study assessing the feasibility and effectiveness of a perioperative multi-component intervention aimed at reducing adverse hospital events and improving functional outcomes in patients with acute decompensated aortic stenosis undergoing urgent transcatheter aortic valve implantation compared to standard care. the intervention will consist of physical rehabilitation, delirium prevention, nutritional supplementation and anaemia correction (where indicated). the primary objective is to determine the feasibility and safety of delivering this intervention secondary objectives include investigating the impact on adverse hospital events such as hospital-acquired disability and post-tavi delirium, and on health-related quality of life and functional recovery following tavi.


Eligibility criteria:
inclusion criteria: 1. age \> 70 years 2. ability to provide written informed consent 3. ability to speak english exclusion criteria: 1. clinical instability defined as requiring use of inotropes/mechanical-circulatory support during admission or post-cardiac arrest 2. active delirium (4at score ≥ 4) at time of recruitment 3. parkinson's disease (hoehn \& yahr stage 3-5) 4. recent stroke (within 7 days preceding recruitment) 5. terminal condition (e.g. metastatic cancer) with life expectancy \< 12 months 6. clinical unsuitable for recruitment to trial according to the discretion of the research team
renal sympathetic modification in patients with essential hypertension

Conditions: Essential Hypertension

Summary: the purpose of this study is to observe the incident of composite cardiovascular events after renal sympathetic modification using thermocool® catheter in patients with essential hypertension, and evaluate safety and efficacy of the intervention.

hypertension is a common cardiovascular disease, and is also an important risk factor for heart-brain-renal diseases, with relatively low controlled rate. traditional pharmacological therapies are used in clinical practice without breakthrough for long time. previous studies confirmed that sympathetic nerves activity contributed to development and perpetuation of hypertension. renal ablation for sympathetic modification is a new method which is proved to be effective in decreasing sympathetic nerves activity. we assume that modifying renal sympathetic activity by ablation is effective and safe in treatment of hypertension. this trial is going to recruit 200 patients (ablation group vs control group = 1:1) with a follow-up duration of 3 years. patients in ablation group will receive additional necessary anti-hypertensive medications besides expectant intervention, and patients in control group will receive appropriate anti-hypertensive medications only. we aim to observe the incident of composite cardiovascular events after renal sympathetic modification using thermocool® catheter in patients with hypertension, and evaluate safety and efficacy of the intervention.

Eligibility criteria:
inclusion criteria: * ≥ 18 years old, and ≤ 75 years old of age * more than half a year history of hypertension, except for valvular heart disease * recently at least three times office blood pressure suggest systolic blood pressure of 140mmhg or more and/or a diastolic blood pressure of 90mmhg or more * estimated glomerular filtration rate (egfr) of ≥ 45ml/min * is competent and willing to provide written, informed consent to participate in this clinical study exclusion criteria: * secondary hypertension * isolated systolic hypertension * estimated glomerular filtration rate (egfr) of \< 45ml/min * has the history of renal restenosis or renal stents implantation * has experienced ami (old myocardial infarction is not excluded), unstable angina pectoris, cerebrovascular accidents, and alimentary tract hemorrhage within 3 months * patients with sick sinus syndrome * pregnant women * mental disorders * patients that have allergy to contrast agent * patients that do not go with follow-up * others such as researcher considers it is not appropriate to be included into the study

Keywords: renal artery sympathetic nerves modification essential hypertension primary hypertension
feasibility of the adapted h-grasp feedback program in the chronic phase post stroke.

Conditions: Stroke

Summary: in a recent cross-sectional study, it was shown that people with a good observed upper limb (ul) motor function but low perceived ul activity show a reduced daily-life ul activity. the investigators will now investigate the feasibility of a phone-monitored home exercise and feedback program for the ul following stroke and the preliminary effects on the perceived ul activity and actual daily-life ul activity for participants with good observed ul motor function but low perceived ul activity in the chronic phase post-stroke.


Eligibility criteria:
inclusion criteria: 1. voluntary written informed consent of the participant has been obtained prior to any screening procedures 2. first-ever unilateral, supratentorial stroke, as defined by the american heart association/american stroke association 3. minimum six months after stroke 4. living in the community 5. ≥18 years old 6. good observed ul motor function but low perceived ul activity. good observed ul motor function is defined as a score \>50/66 on the fugl-meyer assessment-upper extremity (fma-ue). low perceived ul activity is defined as a score ≤75/100 on the hand subscale of the stroke impact scale version 3.0 (sis-hand). exclusion criteria: 1. other neurological condition than stroke 2. musculoskeletal disorder that affects ul use 3. no informed consent 4. participation in an interventional study with an investigational medicinal product (imp) or device

Keywords: upper limb daily life activity home-based exercise program feedback perceived activity
app-guided training in efast ultrasound

Conditions: Learning Outcome; Training Efficiency

Summary: this study aims to investigate the cost-effectiveness of app-based self-directed ultrasound training compared to self-directed training with written handouts on subsequent performance on simulated patient cases and theoretical cases.


Eligibility criteria:
inclusion criteria: * first year medical doctor * provided written informed consent exclusion criteria: * prior practical ultrasonography experience such as performing independent ultrasonography scans, or participation in any post-graduate ultrasonography courses.