Kornimate/medical-research-clean huggingface dataset:
the role of tumor-associated macrophages in colorectal liver metastases

Conditions: Colorectal Liver Metastases; Colorectal Cancer; Liver Metastases; Immunotherapy

Summary: colorectal cancer is a major cause of mortality worldwide. most patients develop colorectal liver metastases (clm), and for such patients hepatectomy combined with chemotherapy may be curative. nevertheless, in the era of precision medicine there is a critical need of prognostic markers to cope with the heterogeneity of clm patients. tumor-associated macrophages (tams) pave the way to tissue invasion and intravasation providing a nurturing microenvironment formetastases. the quantification of immune landscape of tumors has provided novel prognostic indicators of cancer progression, and the quantification of tams might explain the heterogeneity of clm patients. here, we will investigate the development of a new diagnostic tool based on tams with the aim to define the causative role of tams in clm patients. this will open new clinical scenarios both for the diagnosis, therapy and prognosis, leading to the refinement of the therapeutic output in a personalized medicine perspective.

some preliminary data produced by the research team from humanitas clinical and research center in milan (italy) have shown that tams in clm are heterogeneous and that their diversity can be distinguished based on their morphology and functionality. therefore, tams may represent an additional tool in the definition of the biology and prognosis of clm patients. this preliminary finding provides us with the rationale to undertake a prospective study on a large series of clm patients surgically resected by our unit aimed at validating the promisingcorrelation between different tams phenotypes and patients prognosis. the characterization of the diversity of tams in clm will be refined using state of the art technology, including multi-parametric flow cytometry, single cell rna sequencing (scrna-seq) transcriptional profiling, metabolomic, and proteomic analyses. the expected findings will allow us to develop a new diagnostic tool based on tams features, which will open the way to new criteria for patient stratification and for the design of new targeted therapies in a personalized medicine perspective.

Eligibility criteria:
inclusion criteria: * patients with colorectal liver metastases undergoing hepatectomy * full clinical, surgical, pathological and follow-up data * availability of tissues for the analysis exclusion criteria: * missing (any) data * combination of radiofrequency or microwave ablation plus surgery
comparison of monitors of fluid therapy

Conditions: Hypovolemia

Summary: the investigators want to correlate different methods to guide fluid therapy. the investigators know that guidance by esophagus doppler technique has improved outcome and want to correlate other already used techniques to esophagus doppler.

fluid therapy before and under surgery can be guided by measurement of the hearts ability to eject blood (cardiac output). by doing this it has been shown that the occurrence of nausea,vomiting and complications generally can be reduced. the function of the heart has been measured with a probe in the esophagus in in earlier studies. we want to correlate these results with other techniques by which fluid therapy also is guided in daily practice. these are: svo2, modelflow (finapres)and nirs. these methods are noninvasive except svo2 measurement which requires a central venous catheter (cvk). therefore we have chosen a population in which cvk is standard in our institution. we thereby don´t apply any further risks than daily practice and the project is considered as a quality assessment of used standards.

Eligibility criteria:
inclusion criteria: * age 18 years or older * elective urological surgery in which a central venous catheter is routinely administered * informed consent exclusion criteria: * age 70 years or older * no informed consent * pathology in the esophagus that contraindicates use off gastric tube and esophagus doppler * asa iii or above

Keywords: fluid therapy monitoring
extent of lymph node dissection for advanced right-sided colon cance

Conditions: Advanced Right-sided Colon Cancer; the Extent of Lymph Node Dissection

Summary: this is a prospective multicenter randomized controlled clinical study to explore the extent of lymph node dissection in progressive right hemicolon cancer and to elucidate the pattern of lymphatic drainage in the right hemicolon.


Eligibility criteria:
inclusion criteria: 1. age: 18-75 years 2. preoperative pathologic confirmation of adenocarcinoma 3. tumor located in the region from the ileocecal valve to the right one-third of the transverse colon 4. american society of anesthesiologists (asa) physical status classification i to iii 5. patients who have not received preoperative radiotherapy, chemotherapy, or immunotherapy 6. preoperative imaging staging ct4n0m0 or ct3-4n+m0 7. willing to participate in the study and sign the informed consent form exclusion criteria: 1. past medical history of malignant tumor 2. patients with multiple primary tumors 3. patients with a history of inflammatory bowel disease or familial adenomatous polyposis 4. patients with distant metastasis 5. pregnant or breastfeeding women 6. history of other previous major abdominal surgery 7. patients requiring emergency surgery (including tumor perforation, obstruction, hemorrhage, etc.) 8. those with other clinical and laboratory conditions deemed by the investigator to be inappropriate for participation in the trial
radiotherapy treatments for neoplasms in the abdominal-pelvic region

Conditions: Abdominal Cancer; Pelvic Cancer

Summary: evaluation of clinical and dosimetric aspects, tolerance, and effectiveness of abdominal-pelvic region radiotherapy treatments in patients undergoing radiotherapy for primary or secondary neoplasms localized in the abdominal-pelvic region.

approximately 60% of patients with neoplasms receive radiotherapy as part of their oncological treatment. various primary tumors as well as metastases of various origins can be localized in the abdominal-pelvic anatomical region. patients with such neoplastic localizations will therefore receive radiotherapy treatment possibly associated with other systemic or surgical treatments. treatment choice is usually established following multidisciplinary discussions, based on disease characteristics and stage, concurrent pathologies and pharmacological treatments, patient preferences, and functional aspects. data collection related to radiotherapy plays a crucial role in understanding various clinical aspects of the treatment itself. the availability of data from an increasing number of patients will allow the identification of clinical situations or technical parameters of radiotherapy correlated with treatment tolerance and effectiveness, aiming to identify the best treatment for these oncological pathologies. this project aims to collect data related to radiotherapy treatments for primary or secondary neoplasms of the abdominal-pelvic region for scientific dissemination with the goal of establishing the basis for evaluating achieved results over time, and deriving from these elements useful for guiding the most effective treatment strategies and appropriate operational protocols.

Eligibility criteria:
inclusion criteria: 1. patients treated with radiotherapy for curative, palliative, neo-adjuvant, and adjuvant purposes in the abdominal-pelvic region for: primary tumors of the gastrointestinal tract, primary tumors of the male and female reproductive systems, primary tumors of the urinary system, primary tumors of the cardio-circulatory system, primary tumors of the lymphatic system, primary tumors of the nervous system, skin tumors, secondary abdominal-pelvic localizations of various origins, primary or secondary bone or soft tissue lesions of the lumbosacral spine and pelvis. 2. signed informed consent exclusion criteria: 1. radiotherapy in districts other than the abdominal-pelvic region
assessing risk factors for radiological complications after transforaminal lumbar interbody fusion

Conditions: Degenerative Lumbar Spine Diseases

Summary: this retrospective study is to determine whether age is a risk factor for postoperative complications in patients undergoing transforaminal lumbar interbody fusion; specifically whether the risk (odds) of implant failure and the need for revision surgery increases with age.

spinal fusion is one of the most commonly performed surgical procedures for the treatment of degenerative spinal disease. interbody fusion with cages reconstructs the anterior column through disc removal, allowing to maintain proper disc height despite weight bearing, while providing firm fixation of the spinal segments. transforaminal lumbar interbody fusion (tlif) has fewer complications and less intraoperative bleeding than posterior lumbar interbody fusion (plif). elderly patients are at high risk for perioperative and postoperative complications after lumbar fusion. this retrospective study is to determine whether age is a risk factor for postoperative complications in patients undergoing transforaminal lumbar interbody fusion; specifically whether the risk (odds) of implant failure and the need for revision surgery increases with age.

Eligibility criteria:
inclusion criteria: * indications for tlif surgery (e.g., degenerative disc disease, spondylolisthesis) * existing preoperative upright standing sagittal plane x-ray of lumbar spine with clear visibility of pelvis, sacrum and femoral head * existing preoperative mri of the lumbar region with clear visibility of different fatty infiltration grade and stenosis degree * complete follow-up at 3 months and 1 year postoperatively, including clinical and radiographic data exclusion criteria: * neuromuscular diseases such as parkinson's disease or multiple sclerosis according to our records * preoperative infection and/or malignancy tumor with involvement of the bony or soft tissue structures of the lumbar spine * presence of a documented consent dissent

Keywords: posterior lumbar interbody fusion (plif) transforaminal lumbar interbody fusion (tlif) implant failure revision surgery
progressive muscle relaxation and nature sounds in nursing students

Conditions: Anxiety

Summary: background: the aim of this study was to determine the effect of pmr and nature sounds on nursing students' bpm skills, and anxiety levels and vital signs. methods: this was a randomized controlled experimental study conducted at the nursing department of the faculty of health sciences of a university. pmr participants rested for ten minutes between the sessions and then practiced pmr for 15 minutes. pmr+ns participants practiced pmr accompanied by nature sounds.

background: the aim of this study was to determine the effect of pmr and nature sounds on nursing students' bpm skills, and anxiety levels and vital signs. methods: this was a randomized controlled experimental study conducted at the nursing department of the faculty of health sciences of a university. pmr participants rested for ten minutes between the sessions and then practiced pmr for 15 minutes. pmr consisted of taking a deep breath five times and then clenching fists, raising the shoulders, bringing the forearms towards the body, stretching the triceps muscle, and tensing and relaxing the forehead, eye, chin, neck, chest, abdomen, back, hips, thigh, and feet muscles. the investigators made a video of exercises in a certain order and uploaded it to the television in the lab prior to the intervention. the investigators turned on the video during the intervention and asked the participants to follow the instructions for pmr exercises. pmr+ns participants practiced pmr accompanied by nature sounds.

Eligibility criteria:
inclusion criteria: 1. being a first-year nursing student 2. voluntary 3. participating in the theoretical part of the "pulse and blood pressure measurement" course and in lab practice. exclusion criteria: * not participating in the theoretical part of the "pulse and blood pressure measurement" course and in lab practice.

Keywords: skill training nursing students anxiety blood pressure measurement skills
a smart sleep apnea self-management support programme(4s) for subjects with sleep apnea

Conditions: Obstructive Sleep Apnea

Summary: osa is a chronic disease with high prevalence that parallels with increasing obesity. self-management programmes are perceived to be cost-effective in long-term osa patient care and can supplement regular medical treatments. the current study attempt to examine the effectiveness of 4s on improving apnea severity, cardiovascular health and quality of life in 4s intervention (4s) group, compared to the general hygiene (gh) control group.

osa is a chronic disease with high prevalence that parallels with increasing obesity. osa affects around 12% and 24% of adults in hong kong and china mainland, respectively. chronic intermittent hypoxia and sleep fragmentation of osa leads to cardiometabolic and neurocognitive sequelae (e.g. hypertension, diabetes, daytime sleepiness and depression). long-term, multidisciplinary management involving patients in decision-making of treatment strategies, shifting from positive airway pressure (pap) device-focused to the patient-centered chronic care model has been suggested. mobile instant messaging (such as whatsapp/wechat) are popular and inexpensive for interactive messaging. smartphone-based self-management interventions were reported improved self-efficacy and clinical outcomes in patients with chronic diseases. the investigator only found one mobile health application to support cpap therapy for osa and one ongoing trial of osa self-management telematic support to improve cpap adherence. there is underutilization of mobile technology in patient-centered self-management programmes to improve pap treatment and lifestyle modifications in osa. the current study attempt to examine the effectiveness of 4s on improving apnea severity, cardiovascular health and quality of life in 4s intervention (4s) group, compared to the general hygiene (gh) control group. questionnaire and simple fitness assessment will be used to assess the effectivness of the intervention at 4-month and 12-month follow-up. focus group interview will be conducted to collect qualiatative feedback on the intervention.

Eligibility criteria:
inclusion criteria: * aged 18 years and above; * diagnosis of moderate to severe obstructive sleep apnea (ahi≥15); * physically inactive (self-reported moderate physical activity per week of \<150 minutes); * overweight (bmi≥23 kg/m2); * mentally, cognitively and physically fit to join the trial as determined by the doctor in-charge and responsible clinical investigators; * able to speak and read chinese; * willing to complete the questionnaires and assessments; * has a smartphone with instant messaging function (eg. whatsapp/wechat); and * willing to give informed consent. exclusion criteria: * sleep disorder other than osa; * clinically significant psychiatric, neurological, or medical disorder other than osa; and * use of prescription drugs or clinically significant drugs affecting sleep.
perioperative pharmacogenomic testing

Conditions: Pharmacogenetics; Anesthesia

Summary: this is a single centre, prospective feasibility study and pilot randomised controlled trial of patients scheduled for elective intermediate or major non-cardiac surgery. the investigators plan to randomise up to 200 patients who meet the inclusion criteria to standard care or to personalised perioperative care based on pharmacogenomic testing for drugs commonly used in anaesthesia and postoperative pain management e.g., opioids - morphine, oxycodone and tramadol; anti-emetics - metoclopramide and ondansetron; and non-steroidal drugs - celecoxib and ibuprofen. the investigators hypothesise that pharmacogenomic testing is feasible prior to elective surgery and through 'personalised prescribing' for precision tailored perioperative care the investigators will improve patient's postoperative quality of recovery, including pain management.


Eligibility criteria:
inclusion criteria: 1. able to provide written informed consent 2. age greater than 18 years 3. elective surgery scheduled greater than 1 week from preoperative assessment and date of pharmacogenomic testing 4. moderate-major surgery expecting to last two or more hours with anticipated admission of at least 1 night including: breast, melanoma, colorectal (laparoscopic or open), prostate, or other major surgery (e.g. oesophagectomy, head and neck cancer, retroperitoneal sarcoma, etc.) exclusion criteria: 1. day case surgery 2. expected surgery duration of \< 2 hours 3. urgent surgery expected within 1 week of pre-operative assessment 4. emergency surgery

Keywords: drug metabolism pharmacogenomics individualised care postoperative pain quality of recovery
homocysteine after laparoscopic roux-eny gastric bypass

Conditions: Obesity, Morbid; Homocystine; Metabolic Disorder; Bariatric Surgery Candidate; Folate Deficiency; Vitamin B 12 Deficiency

Summary: changes in homocysteine values after bariatric surgery remain controversially discussed. this is the first comprehensive summary to depict timeline changes in homocysteine levels following laparoscopic roux-en-y gastric bypass.

homocysteine is an independent risk factor for cardiovascular disease. changes in homocysteine levels following bariatric surgery remain controversially discussed. 708 consecutive patients underwent laparoscopic roux-en-y gastric bypass over a 6 year period. throughout their routine follow-up, demographic data as well as homocysteine, folate and vitamin b12 were retrospectively collected at the timepoints: preoperatively, at 3, 6, 9, 12, 18, 24, 36, 48, 60, 72, 84, and 96 months postoperatively. in order to reveal clinical relevance of the results, patients were sent a special questionnaire accompanied by an informed consent form for participation and asked for cardiovascular disease events (myocardial infarction, stroke, deep venous thrombosis) or any other hospital stay after the surgery and cross checked with two region wide databases which account for approx. 80% of all hospital contacts in the region. additionally, the database was networked with the statewide death registry in order to reveal deceased subjects and data about their demise through the beforementioned databases was collected.

Eligibility criteria:
inclusion criteria: * bmi \> 40kg/m2 or bmi \> 35 kg/m2 including relevant comorbidities * age between 18 to 75 years * suitable for operation, consent * no contraindications for the operation exclusion criteria: * bmi \< 35 kg/m2 * age below 18 or above 75 years * not able to consent to the operation * severe medical conditions not applicable for general anaesthesia * non compliance

Keywords: bariatric surgery gastric bypass homocysteine folate vitamin b12
learning mri and histology image mappings for cancer diagnosis and prognosis.

Conditions: Prostate Cancer; Prostate Neoplasm

Summary: multiparametric magnetic resonance imaging (mpmri) is now widely used to risk stratify men with a suspicion of prostate cancer and identify suspicious regions for biopsy. advanced mri techniques have emerged which seek to improve this characterisation and could predict biopsy results non-invasively before men undergo biopsy. before these techniques are translated clinically, robust histological and clinical validation is required. this study aims to clinically validate advanced mri techniques in a cohort of men suspected with prostate cancer. histological analysis of men undergoing biopsy, +/- prostatectomy will be used for biological validation of verdict; vascular and extracellular restricted diffusion for cytometry in tumours and luminal water imaging (lwi). in particular, prostatectomy specimens will be processed using 3-d printed patient-specific moulds to allow for accurate mri and histology mapping.


Eligibility criteria:
inclusion criteria: * men aged 18-90 with a clinical suspicion of prostate cancer * no contraindication to mri exclusion criteria * men unable to have a mri scan, or in whom artefact would reduce quality of mri * men unable to given informed consent * previous treatment (prostatectomy, radiotherapy, brachytherapy) of prostate cancer * ongoing hormonal treatment for prostate cancer
infant chest compression

Conditions: Cardiac Arrest; Infant; Simulation

Summary: our aim was to quantitatively compare the quality of chest-compression of the new two thumb chest compression (nttt) versus the current standard techniques: two finger technique (tft), two thumb technique (ttht) as defined by systolic-, diastolic-, mean arterial- and pulse-pressures. our hypothesis is that nttt generates higher arterial blood pressures compared to the established tft and ttht in an infant manikin model.

to simulate the scenario of infant cpr, an als baby trainer manikin (laerdal medical, stavanger, norway) simulating a 3-month-old infant. the manikin was connected with a fixed-volume arterial system attached to a monitor (draeger infinity® delta; draegerwerk ag \& co. kgaa, luebeck, germany) via an arterial pressure transducer (edward lifesciences: truwave disposable pressure transducer; irvine, ca, usa). the arterial circuit composed of a 50-ml bag of normal saline solution (air removed) attached to the manikin chest plate and connected to the transducer with a 20-gauge intravenous catheter and tubing. the manikin was placed on a high adjustable hospital stretcher. the bed was leveled to the iliac crest of each rescuer for standardization. the manikin was previously intubated and ventilation was performed using a resuscitator bag.

Eligibility criteria:
inclusion criteria: * nurses * give voluntary consent to participate in the study exclusion criteria: * not meet the above criteria * wrist or low back diseases

Keywords: cardiopulmonary resuscitation chest compression medical simulation randomization quality
modeling of the hemoglobin drop in the uncomplicated postoperative course

Conditions: Surgical Blood Loss; Surgery; Perioperative/Postoperative Complications

Summary: transfusion-related decisions in the perioperative setting are often complex due to acute variations in the hemoglobin levels, which typically experience a progressive decrease within days. this process, commonly referred to as "hemoglobin drop" or "hemoglobin drift", has been observed to be highly variable among patients and reliant on several variables, such as the volemic status, fluid balance and blood loss. although it has been investigated and some predictors have been identified, postoperative hemoglobin drop remains unpredictable and is not fully clarified. in consequence, hemoglobin levels' variations are frequently misunderstood, hindering the decision to transfuse.


Eligibility criteria:
inclusion criteria: * adult patients electively scheduled for laparoscopic urologic and gynecologic surgery. exclusion criteria: * suspected or confirmed coagulopathy (including current treatment with anticoagulants or antiplatelet agents). * requirement for surgical gauzes during surgery, including conversion to open surgical techniques. * transfusion of red blood cells (rbcs) or use of blood recovery systems during the perioperative period. * significant postoperative bleeding (\> 50 ml in surgical drains, gross hematuria, or any other type of significant blood loss). * postoperative hemodynamic instability (defined as requirement of vasoactive drugs). * other major postoperative complications during the observable period.

Keywords: hemoglobin hemoglobin drop surgical blood loss