Kornimate/medical-research-clean huggingface dataset:
cpap titration using an artificial neural network: a randomized controlled study

Conditions: Obstructive Sleep Apnea

Summary: the purpose of the study is to determine the validity of the prediction model in reducing the rate of cpap titration failure and in achieving a shorter time to optimal pressure

in order to derive the most effective pressure, cpap titration is performed in the sleep laboratory during which the pressure is gradually increased until apneas and hypopneas are abolished in all sleep stages and in all body positions. the technique is however time consuming and labor intensive. furthermore, the duration of the study may not be sufficient to attain this goal because of patient's poor ability to sleep in this environment or due to difficulty in attaining an appropriate pressure. a predictive algorithm based on demographic, anthropometric, and polysomnographic data was developed to facilitate the selection of a starting pressure during the overnight titration study. yet, the performance of this model was inconsistent when validated by other centers. one of the potential reasons for the lack of reproducibility is the complex relation of behavioral processes with nonlinear attributes. in areas of complex interactions, the artificial neural network (ann) has been found to be a more appropriate alternative to linear, parametric statistical tools due to its inherent property of seeking information embedded in relations among variables thought to be independent. comparison: time to achieve optimal pressure in the conventional technique versus the intervention model

Eligibility criteria:
inclusion criteria: 1. patients 18 years of age and older, 2. documented osa by sleep study defined as ahi \> 5/hr exclusion criteria: 1. previously treated osa, 2. unwilling to undergo a titration study, 3. unable or unwilling to sign an informed consent.

Keywords: sleep apnea, titration, cpap, neural network
lps flex porous femoral components

Conditions: Osteoarthritis; Rheumatoid Arthritis; Traumatic Arthritis; Poly Arthritis; Collagen Disorders; Avascular Necrosis of Femoral Condyle

Summary: this is a prospective multicenter study of the lps-flex porous femoral components when used in primary total knee arthroplasty. the purpose of the study is to obtain short-, mid-, and long-term clinical outcomes and implant survivorship data for the nexgen lps-flex porous femoral components.

survival and outcome data on the nexgen lps-flex porous femoral components will be done by an analysis of standard scoring system, radiographs and adverse event records. survivorship will be evaluated by monitoring the frequency and incidence of adverse events, serious adverse events, adverse device effects, serious adverse device effects, and unanticipated adverse device effects. outcomes will be measured by comparing the overall pain and function performances (based on the knee society scoring system), survivorship, subject quality of life and radiographic parameters of study subjects receiving the lps-flex porous femoral components.

Eligibility criteria:
inclusion criteria: * patient 18-75 years of age, inclusive; * patient qualifies for a total knee arthroplasty based on physical exam and medical history including at least one of the following: rheumatoid arthritis, osteoarthritis, traumatic arthritis, polyarthritis, collagen disorders, avascular necrosis of the femoral condyle; * post-traumatic loss of joint configuration, particularly when there is patellofemoral erosion, dysfunction or prior patellectomy; * moderate valgus, varus, or flexion deformities; * patient has undergone a study related informed consent process; * patient is willing and able to provide written consent; * patient is willing and able to cooperate in the required post-operative therapy; * patient is willing and able to complete scheduled follow-up evaluations. exclusion criteria: * patient has previous history of infection in the affected joint and/or a local or systemic infection that could affect the prosthetic joint; * insufficient bone stock on femoral or tibial surfaces; * skeletal immaturity; * neuropathic arthropathy; * osteoporosis or any loss of musculature or neuromuscular disease that compromises the affected limb; * stable, painless arthrodesis in a satisfactory functional position; * severe instability secondary to the absence of collateral ligament integrity; * patient has rheumatoid arthritis and an ulcer of the skin or a history of recurrent breakdown of the skin because of their risk of postoperative infection is greater; * patient has a known sensitivity or allergy to one or more of the implanted materials; * patient is pregnant or considered a member of a protected population (e.g., prisoner, mental incompetence, unable to understand what clinical trial participation entails, etc.)

Keywords: arthritis
evaluation of fetal cardiac function and vascular hemodynamics in intrauterine growth restriction

Conditions: Fetal Hypoxia

Summary: intrauterine growth restriction (iugr) is one of the major contributors to perinatal mortality and morbidity and is characterized by complex hemodynamic changes involving placental and fetal arterial, cardiac and venous circulations .however, the temporal sequence of these modifications in relation to other hemodynamic changes of the fetal arterial and venous circulations is unknown. the aim of this study was to evaluate cardiac function and other hemodynamic changes in a group of fetuses with iugr and clinical impact on perinatal outcome .


Eligibility criteria:
inclusion criteria: * singleton fetus with normal fetal anatomy documented a detailed sonogram. * fetal abdominal circumference \<5th percentile for gestational age. * evidence of placental insufficiency documented by an elevated umbilical artery pulsatility index (ua-pi) by reference ranges. exclusion criteria: * evidence of fetal infection * chorioamnionitis * fetal anomalies * abnormal fetal karyotype * patient withdrawal from the study and/or unavailability for follow-up.
effect of standardized nutrient management on clinical outcomes of hematopoientic stem cell transportation patients

Conditions: Nutrition Related Cancer

Summary: to analysis a standardized stepped nutritional treatment process for patients with hematopoietic stem cell transportation, including nutritional risk screening and assessment, standardized nutritional treatment implementation, therapeutic effect follow-up and monitoring, family nutritional treatment follow-up, etc

standardized nutrition therapy for patients with hematopoietic stem cell transportation should follow the principle of sequential treatment of nutrition, which is the preferred scheme with individualized dietary advice or oral nutritional supplement, if their energy intake will not reach 60% of the goal level during the transplanting, then supplementary parenteral nutrition or total parenteral nutrition is needed. the standardized nutrition therapy aims to improve quality of life and long-term survival rate of patients, reduce the complications and social burden of disease.

Eligibility criteria:
inclusion criteria: * • patients treated with hsct exclusion criteria: * nothing

Keywords: hsct; nutrtion
the impact of polynuclear neutrophils' intra-tumoral rate and the mutational status in pulmonary adenocarcinomas on survival

Conditions: Pulmonary Adenocarcinoma

Summary: lung cancer is one of the most frequent cancer concerning human beings and it represents, worldwide, one of the first cause of death. most of patients with this cancer are males and 85% of lung cancers are non-small cells type (nsclc) with adenocarcinoma being the most common histologic subtype. patients with pulmonary cancer have a poor long-term prognosis with an overall 5 years of survival which is less than 25% for all stages. the natural immune system, with polynuclear neutrophils (pnn) is involved in carcinogenesis. the impact of pnn localized within the tumor as a prognostic biomarker has not been really studied in non-small cells lung cancers. according to some studies, an increase in the number of pnn (labelled by the cd66b antibody) within the tumor is associated to a greater risk of relapse and a poor overall survival rate. the intra-tumoral ratio pnn over lymphocytes t cd8 + (intr) is an independent factor of the poor prognosis concerning the overall survival rate and concerning risk of relapse with patients who went through a first surgery for a non-small cells lung cancer. with this study we will initially concentrate on lung adenocarcinoma and attempt to evaluate the pnn's rate within the tumor and its impact on an overall survival rate and progression-free survival. secondly, we will explore the role of intr and the mutational profile of tumors concerning this survival.


Eligibility criteria:
inclusion criteria: * patients with stages i to iii lung adenocarcinoma (tnm uicc 8ème édition) * patients who went through a first surgery with a lymph node dissection at the chru of nancy between 01/01/2010 and 01/01/2012 * patients included in the crb chru-inserm bronchial collection exclusion criteria: * patients who received neoadjuvant therapy. * stage iv patients (tnm uicc 8ème édition) * patients whose surgical resection was incomplete
short segment fixation in thoracolumbar osteoporotic fracture

Conditions: Spinal Fractures

Summary: although long-segment posterior spinal fixation might provide more rigid fixation, the procedure increases perioperative morbidities in the elderly. the present study reviews the results of short-segment decompression and reconstruction in thoracolumbar fragile fractures.

this study included 20 elderly patients with osteoporotic thoracolumbar burst fractures and neurological compromise. the participants were followed-up for a period of 40.6 (24-68) months. a visual analog scale (vas) and the oswestry disability index (odi) were used to measure back pain and disability. radiologic assessment and neurological status were also analyzed.

Eligibility criteria:
inclusion criteria * osteoporotic burst fracture at a single level of the thoracolumbar region * dual-energy x-ray absorptiometry and t-score value less than -2.5 exclusion criteria * translational displacement at the fracture site (fracture-dislocation) * loss of structural integrity within the posterior osteoligamentous complex (such as flexion-distraction ligament disruption) * spondylolisthesis of the adjacent vertebrae * malignancy * chronic steroid administration * previous spinal surgery * prior vertebroplasty and infection
isokinetic performance and function after total hip arthroplasty

Conditions: Hip Osteoarthritis

Summary: there are ongoing debates on the effects of the surgical approach on outcome after total hip arthroplasty. it was hypothesized that with the anterolateral approach, trauma to the abductor arm can be occured and related detrimental effects can diminish the post-operative outcomes. in this first randomized controlled trial in the literature on this subject, isokinetic performance and patient-reported functional outcomes were evaluated in patients undergoing total hip arthroplasty. with a posterior approach (pa) and a anterolateral approach (ala), at 6 and 12 months postoperatively.

patients undergoing total hip arthroplasty are randomized to posterior approach (pa) and anterolateral approach (ala) groups. the patients are evaluated preoperatively and at 6 and 12 months postoperatively, with flexion, extension and abduction strength measurements and the harris hip score (hhs). the physiatrist performing isokinetic tests and the patients are blinded to the study groups.all data are calculated as mean and standard deviation values. the student's t-test is used for statistical analysis of the patient data. statistical calculations are performed using spss vn.22.0 software (ibm spss statistics for windows, version 22.0. armonk, ny, usa).

Eligibility criteria:
inclusion criteria: patients aged 55 to 80 years unilateral primary hip osteoarthritis - exclusion criteria: bilateral osteoarthritis inflammatory arthritis post-traumatic osteoarthritis previous hip surgery neuromuscular diseases

Keywords: anterolateral approach posterior approach isokinetic test
basivertebral nerve ablation with the intracept procedure

Conditions: Low Back Pain

Summary: this is an independent prospective, noninterventional, single arm post market data collection of the patient-reported effectiveness, ongoing safety, and satisfaction outcomes for patients treated with intraosseous basivertebral nerve ablation using the intracept procedure at a single study site.

participants in the study will have three study visits over a period of one-year (one prior to procedure and 2 post their procedure). study visits will be conducted in person by the principal investigator and/or authorized and trained clinical research coordinators at the study site. participants will be consented and evaluated for inclusion/exclusion criteria and a baseline collect at the initial visit (prior to procedure). participants will be followed post intraosseous basivertebral nerve ablation at 1, 3, 6, and 12, and 24 months. primary and secondary objectives are based on patient reported outcomes for functional improvement (oswestry disability index), low back pain reduction (visual analog scale), and physical and mental health pre and post procedure (eq-5d-5l and sf-36).

Eligibility criteria:
inclusion criteria: * adult patients ≥18 years of age * patients who have experienced chronic low back pain for ≥6 months. * patients who have not responded to at least 6 months of conservative care. * patients with modic type 1 or 2 changes. exclusion criteria: * patients with severe cardiac or pulmonary disease. * patients with active systemic infection or localized infection in the treatment area.

Keywords: basivertebral nerve radiofrequency ablation chronic low back pain vertebrogenic pain
expanded access to velmanase alfa

Conditions: Alpha-Mannosidosis

Summary: individual patient expanded access requests may be considered for patients who have no other treatment options.

expanded access may provide access for treatment prior to approval by the local regulatory agency.

Eligibility criteria:
inclusion criteria: - exclusion criteria: -
a study to evaluate the efficacy and safety of sintilimab in combination with ibi305 (anti-vegf monoclonal antibody) compared to sorafenib as the first-line treatment for advanced hepatocellular carcinoma.

Conditions: Hepatocellular Carcinoma

Summary: the purpose of the study is to assess the safety, tolerability and effectiveness of sintilimab in combination with ibi305 in patients with hcc as the first-line treatment compared with sorafenib. this study is a randomised, open-label，multi-center study. the primary endpoint is overall survival.


Eligibility criteria:
inclusion criteria: 1. hepatocellular carcinoma confirmed by histology/cytology. cirrhosis meets the clinical diagnostic criteria for hepatocellular carcinoma of the american association for the diagnosis of liver diseases (aasld). 2. ecog performance status between 0 and 1 3. no systematic anti-tumor treatment has been performed.(end of postoperative adjuvant chemotherapy for more than 6 months allowed). 4. barcelona clinic liver cancer stage c. bclc stage b, not suitable for radical surgery and/or local treatment. 5. at least 1 lesion with measurable disease at baseline by recist v1.1. 6. child-pugh: \<=7 7. adequate organ and bone marrow function. exclusion criteria: 1. with fibrous lamellar hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma, cholangiocarcinoma components in tumor tissues. 2. have a history of hepatic encephalopathy or have a history of liver transplantation. 3. with clinical symptoms requires drainage of pleural effusion, ascites or pericardial effusion. 4. central nervous system (cns) metastasis. 5. uncontrolled high blood pressure, systolic blood pressure \>140mmhg or diastolic blood pressure \>90mmhg after optimal medical treatment. 6. local treatment for liver lesions within 4 weeks.
guided self-help treatment for binge eating disorder

Conditions: Eating Disorders; Bulimia

Summary: this study will determine the effectiveness of guided self-help treatment in treating individuals with binge eating disorder (bed).

binge eating disorder (bed) is a serious condition characterized by compulsive overeating and feelings of powerlessness. the condition often has a negative impact on both physical and emotional health. this study will examine ways to help people determine whether they have bed and will test whether guided self-help (gsh) treatment is effective in treating bed. participants will be randomly assigned to receive either gsh treatment or usual clinical care (which may include general support and talk therapy) for 3 months. the gsh treatment is a cognitive behavioral therapy-based program that will be administered over 8 sessions. participants receiving gsh will be given a book that focuses on dealing with bed; they will also meet with a therapist regularly to have their progress monitored. the eating disorders examination (ede), self-reports, questionnaires, and surveys will be used to assess participants. assessments will be conducted at study entry, at weeks 2 and 4 of the treatment, at the end of the treatment, and at 6 and 12 months post-treatment.

Eligibility criteria:
inclusion criteria: * diagnosis of binge eating disorder (bed) bulimia nervosa (bn), or spectrum bn, defined as recurrent binge eating at least once a week for 3 months * body mass index (bmi) between 18 and 45 * continuous membership in the kaiser permanente northwest division for at least 12 months prior to study entry exclusion criteria: * diagnosis of anorexia nervosa or psychotic disorder * significant organic brain syndromes, retardation, pervasive developmental disorder, or autism * at risk for suicide * pregnancy

Keywords: binge eating overeating compulsive eating hyperphagia
botulinum toxin in the treatment of idiopathic detrusor overactivity

Conditions: Overactive Detrusor

Summary: overactive bladder (oab) is a chronic condition caused by instability of the detrusor or bladder muscle, which gives rise to symptoms of urinary urgency and often urinary incontinence. idiopathic detrusor overactivity (ido) is a subset of oab where the cause for the bladder muscle instability is unknown. oab is usually treated by conservative measures or with oral medications eg. anticholinergics. injection of onabotulinum toxin a (onabont-a) into the bladder wall is licenced in the treatment of refractory ido where oral medications fail. the injected toxin paralyses the bladder by blocking the ability of certain (motor) nerves to communicate with the bladder muscle. as these nerves are mainly concentrated in what is known as the "body" of the bladder this is traditionally where the injections are given. in addition to its action on motor nerves, onabont-a also affects sensory nerve pathways. recent studies show that ido is caused by both motor and sensory nerve dysfunction, therefore injecting the "trigone", a part of the bladder where sensory nerves are particularly dense, may be of clinical benefit. three studies comparing trigone versus trigone-sparing injection of botulinum toxin in the treatment of ido have been carried out. one of these indicated a significant benefit in targeting the trigone and the other two did not show any difference. our study aims to examine if injection of onabont-a into the trigone alone will provide symptom and functional improvement in patients with ido by comparing peritrigonal injection of onabont-a with the traditional method of injection which spares the trigone.


Eligibility criteria:
inclusion criteria: * fulfil ics criteria for oab * urodynamically proven detrusor instability * symptoms lasting \>6/12 * patients must discontinue anticholinergic medication \>14 days prior to randomisation and withhold the use of anticholinergics for the duration of the study. * patients with mixed incontinence are eligible if their urge symptoms are predominant. these will be instruced to record only episodes of urge urinary incontinence. * providing informed consent to participate in the study * at least 18 years of age exclusion criteria: * previous bont-a injection within 9 months of randomisation * history of any neurological condition e.g. ms, parkinsons, cva * contraindication to bont e.g. myaesthenia gravis * urinary tract infection in previous 6/12 * antimicrobial therapy in previous 6/12 * previous or current diagnosis of prostate or bladder cancer * history of treatment with cyclophosphamide * radiation cystitis * urethral dilatation, cystometrogram, bladder cystoscopy under anaesthetic or a bladder biopsy in previous 3/12 * augmentation cystoplasty, cystectomy or neurectomy * urethral stricture of \<12ch * pregnancy * sexually active women of childbearing potential who are unwilling to use contraceptive measures for the duration of the trial.
long acting gnrh antagonist in pcos women undergoing ivf

Conditions: Polycystic Ovarian Syndrome; Ovarian Hyperstimulation Syndrome; Invitro Fertilization

Summary: pcos is a common endocrinopathy affecting 5-10% of women in their reproductive age characterized by hyperandrogenism, chronic anovulation and polycystic ovaries. this syndrome is a serious problem in ivf since there is a high risk of developing ovarian hyperstimulation syndrome (ohss) during ovarian stimulation with gonadotropins. the introduction of gnrh antagonist in ivf has reduced the incidence of severe ohss, still maintaining a good ovarian response and pregnancy rate. recently, a long acting gnrh antagonist, degarelix, was introduced for prostatic cancer treatment. furthermore a recent paper reported its use also for the induction of multiple follicular growth in a program of oocyte donation. the aim of this study is to evaluate the feasibility of gnrh antagonist depot use in a protocol of controlled ovarian hyperstimulation in pcos women at risk of developing ohss in ivf cycles.


Eligibility criteria:
inclusion criteria: * regular menstrual cycle (26-39 days) * primary infertility * bmi \< 30 exclusion criteria: * women with diabetes and other metabolic disease * women with heart disease * women with inflammatory or autoimmune disease

Keywords: pcos ohss gnrh antagonist ivf coh
virtual reality avatar therapy for people hearing voices

Conditions: Psychosis; Schizophrenia; Schizo Affective Disorder; Hearing Voices When No One is Talking (Symptom)

Summary: hearing voices is probably the worst form of acoustic hallucinations; which can be experienced as severely disturbing and is influenced by diverse factors including the ability of the individual to influence and control the hallucinatory experience itself. in recent years virtual reality has become a treatment option. in the so-called avatar therapy, patients with schizophrenia and acoustic hallucinations design a visual and auditory recreation (avatar) of the entity to which they attribute their hallucinations. working with a therapist over the course of several sessions, participants change the avatar from controlling to benevolent. avatar therapy involves similar processes to learning and cognitive restructuring, comparable to other psychotherapeutic interventions. the investigators plan to conduct an interventional study using a cross-over design, to compare the feasibility and efficacy of virtual reality avatar therapy for patients with acoustic hallucinations (independent of psychiatric diagnosis) with a cognitive behavioural group therapy aimed to improve social competence.


Eligibility criteria:
inclusion criteria: * consistent acoustic hallucinations, with the presence of voices for at least two months. * participants are competent to give informed consent, as determined by the referring physician or psychiatrist. * german language proficiency as a native speaker or level b1 common european framework of reference for languages (cefrl) exclusion criteria: * current neurological disorder. * current substance use or withdrawal. * concomitant group psychotherapeutic intervention.

Keywords: hearing voices, virtual reality avatar therapy, cognitive behavioural therapy