Kornimate/medical-research-clean huggingface dataset:
mean systemic filling pressure and heart performance predicting fluid responsiveness in aortic valve replacement

Conditions: Cardiac Output, High

Summary: the purpose of this study is to determine fluid responsiveness in critically ill patients by measuring mean systemic filling pressure on the intensive care unit.

the assessment of the cardiovascular state in critically ill patients is subject to difficulties in terms of the fact that several hemodynamic parameters, for example mean arterial blood pressure (map) and cardiac output (co) supply insufficient information about the circulating volume and cardiac performance. there is a clinical need to adequate determination of intravascular volume status and therefore reliable predictors of fluid responsiveness are highly relevant. however, in determining the fluid status of a patient, the lack of appreciation of the venous side of the circulation persists today, which is greatly due to the inability to appropriately assess the venous side of the circulation. the importance of the venous part of the circulation is moreover reflected by the fact that an increase in venous resistance does reduce co many times more than a similar increase in arterial resistance. mean systemic filling pressure (pms), which is defined as the pressure equal to the pressure which would be measured if the heart should suddenly stop pumping and all (arterial and venous) the pressures in the entire circulatory system should be brought to equilibrium instantaneously, is a good, complete and reliable reflection of the total intravascular fluid compartment. passive leg raising (plr) represents a "self-volume challenge" that predicts preload responsiveness and the transient hemodynamic changes on venous return can be directly monitored in ventilated patients, provided that there is an intact circulation, in order to test the amount of volume responsiveness.

Eligibility criteria:
inclusion criteria: * patients must be older than 18 years, and must be equipped with a pulse-contour cardiac output system with a central venous catheter. * patients will be subsequently connected to the hemodynamic monitoring device navigator™. * in those patients with clinical signs of inadequate tissue perfusion, passive leg raising and standardized fluid challenge will be performed. exclusion criteria: * patients with assist devices (e.g. intra aortic balloon pump, impella®, ecmo), patients with arrhythmias (either atrial of ventricular) will be excluded from the study. * also, patients with inguinal impairment or contraindications for a passive leg raising will be excluded (such as deep venous thrombosis or elastic compression stocking), head trauma, an increase intra-abdominal pressure suspected by clinical context and examination as well as patients with absolute contraindications for fluid challenge.

Keywords: volume responsiveness mean systemic filling pressure
feasibility study of the aliya system in the treatment of early stage non-small cell lung cancer

Conditions: Non Small Cell Lung Cancer

Summary: a prospective, two-arm, non-randomized, concurrently controlled, multi-center, open-label, treat and resect study following patients to 1 year. the study is designed to evaluate the safety and feasibility of the aliya system for the ablation of solid tumors using pulsed electric field (pef) energy delivery. the study is intended for adult patients with suspected or confirmed nsclc 8th ed. stage ia2, ia3 or ib (\>1 to ≤4 cm solitary lesion) who are surgical candidates and have not received treatment for the index tumor in the last two years.

this study is to evaluate the safety and initial feasibility of pulsed electric field (pef) treatment of nsclc tumors prior to surgical resection. treatment may be delivered via either an endoluminal (bronchoscopic) or percutaneous approach at the discretion of the clinical investigator utilizing two available device configurations: * endoluminal: galvanize aliya system with commercially available tbna needle (e.g., periview flex) and rf probe electrode * percutaneous: galvanize aliya system with compatible commercially available rf needle and rf probe electrode the study will enroll and treat up to 30 adult patients with early stage nsclc at up to 5 clinical sites. patients meeting all eligibility criteria who elect not to undergo the pef treatment will be offered the opportunity to participate in a concurrent control arm. up to 10 patients will be included in the control group. a total of up to 40 patients will be included in the study.

Eligibility criteria:
inclusion criteria: * presence of solitary nsclc nodule 8th ed. stage ia2, ia3 or ib * nodule measuring \> 1 cm and ≤4 cm diameter by ct size estimate (e.g. t1b, t1c, t2a), with a minimum 1 cm solid component * high pre-procedure probability of malignancy as determined by the investigator * patient has been evaluated by a thoracic surgeon and deemed a candidate for definitive lung tissue resection * patient is, in the opinion of the principal investigator, able to adhere to and undergo bronchoscopy, surgical procedure and post-treatment care exclusion criteria: * additional pulmonary nodules requiring intervention * patient is receiving concurrent cancer treatment (e.g. external beam radiation therapy, brachytherapy, chemotherapy, targeted therapy, immunotherapy, other focal therapy) or has received treatment for the index tumor in the last two years * patient has implanted lung devices or electronic devices * patient has n1 disease * patient is immune compromised or receiving immune modulating medication * recurrent nsclc within 2 years of initial definitive treatment * previous checkpoint inhibitor treatment for another cancer
burn-out among chinese anaesthesiologist after covid-19 pandemic peak and its protective factor： a national survey

Conditions: Burnout

Summary: the investigators proposed a national representative survey to collect data of socio-demographic characteristics, level of exposure to covid-19, depression，anxiety， ptsd， burnout and resilience of working anaesthesiologists across mainland china for the following purpose 1. explore the current burn-out rate of chinese anaesthesiologists and compared it with data acquired in 2015； 2. explore the perceived covid-19 exposure of covid-19 among chinese anaesthesiologist. 3. explore rate of burnout, anxiety, depression, ptsd symptoms experienced by the participants 4. explore the protective psychosocial characteristics of burnout. (resilience) 5. see whether covid-19 exposure contribute to higher burn out rate.


Eligibility criteria:
inclusion criteria: working anaesthesiologist in mainland china exclusion criteria: -
is there a relationship between hyperlipidemia and periodontitis?

Conditions: Hyperlipidemia, Periodontal Disease

Summary: the aim of present study is to investigate any relationship between hyperlipidemia and periodontal disease regarding the periodontal parameters and plasma lipid parameters, along with age, gender, brushing habit, body mass index, dietary habit, physical activity, alcohol consumption. in this cross sectional study, a total of 160 individuals were divided into two groups based on their metabolic status: hyperlipidemic group (n=97) and normolipidemic group (n=63). plaque index, gingival index, bleeding on probing (bop), probing depth (pd), clinical attachment level (cal) clinical parameters and community periodontal index of treatment needs (cpitn) scores were measured. triglyceride (tg), total cholesterol (tc), low density lipoprotein-cholesterol (ldl-c) and high density lipoprotein-cholesterol (hdl-c) levels had been determined previously during individuals routine systemic examinations. daily brushing habits and interdental cleaning together with dietary habits, alcohol consumption and physical activity levels were also recorded.


Eligibility criteria:
inclusion criteria: * subjects having no periodontal treatment within previous 6 months, * number of natural teeth ≥ 10, * no history of cancer and systemic disease that affects lipid levels or periodontium, * no history of medical treatment for hyperlipidemia, bmi\< 30 kg/m2, * no pregnancy, * no history of systemic antibiotic treatment within previous 3 months, * no smoking. exclusion criteria: * patients with history of systemic disease that affects lipid metabolism or periodontal disease * history of medical treatment for hyperlipidemia * pregnancy, lactation or hormone replacement therapy at the time of study * use of any other drug known to affect lipid metabolism or periodontal disease * systemic infection or any history of systemic antibiotic treatment in previous 3 months * smokers as well as ex-smokers

Keywords: hdl cholesterol hyperlipidemia ldl cholesterol periodontal disease triglyceride
study of myopia acquisition and prevention

Conditions: Myopia

Summary: purpose: to determine whether the use of reading glasses blocks the near work mediated increased incidence of myopia in healthy school children. methods: smart enrolled 115 emmetropic children (ages 7-9 years). the children were recruited in the principality of liechtenstein. they were randomly assigned to either the control group (n=52) or to receive reading glasses with a lens power of +2.0 dioptres (n=63). the primary outcome measure was progression towards myopia as determined by autorefraction after cycloplegia. the secondary outcome measure was change in biometry measurements of corneal curvature, axial length, anterior chamber depth, crystalline lens thickness, and vitreous chamber depth using partial coherence interferometry.


Eligibility criteria:
inclusion criteria: * emmetropia exclusion criteria: * ametropia

Keywords: myopia prevention
regulation of sterol homeostasis

Conditions: Hypertriglyceridemia

Summary: the purpose of this study is to determine how people with high triglycerides metabolize and absorb bile acids, compounds made in the body from cholesterol. this project has two objectives: a) to define the mechanism of impaired bile acid absorption in hypertriglyceridemia (specifically we will determine if the active or passive component of absorption is abnormal) and b) to determine the contribution of an alternative pathway of bile acid synthesis which begins with 27-hydroxylation of cholesterol. because 27-hydroxylase is present in endothelial cells as well as liver, this pathway may play a role in removal of cholesterol from incipient atherosclerotic plaque.


Eligibility criteria:
hypertriglyceridemia and normal controls with normal lipids

Keywords: triglyceride bile acids cholelithias
self - breathe for chronic breathlessness

Conditions: COPD; Cancer; Heart Failure; Interstitial Disease; Dyspnea

Summary: semi-structured qualitative interviews will be conducted to understand key factors that would enable / facilitate patients with chronic breathlessness to potentially use an online breathlessness intervention (self-breathe).

study overview full title: a self -guided, internet -based intervention for patients with chronic breathlessness (self-breathe): an interview study. objective: to understand the key factors that would enable / facilitate patients with chronic breathlessness to use an online breathlessness support intervention (self-breathe). study type: qualitative interview study methods: semi-structured qualitative interviews will be conducted to achieve maximum variation in approx 20 patients with chronic breathlessness (a purposive sample: age sex, diagnoses, and presence of caregiver). the interview will explore and identify: patients' views/experiences of internet-based activities, e.g. digital apps, shopping online; patients' understanding, preferences, values and motivations that would influence uptake of self-breathe; potential barriers to the development and use of self-breathe; facilitators to usage of self-breathe, such as the ability to self-monitor progress etc... these topics cover areas of uncertainty in order to optimise the self - breathe intervention. inclusion criteria: adult patients \>18 years of age, with the ability to read, converse in english and able to provide informed consent chronic breathlessness on exertion and or rest (mrc dysponea score \>2) advanced disease such as cancer, chronic obstructive pulmonary disease (copd), chronic heart failure (chf) or interstitial lung disease (ild), where the underlying disease is deemed to be optimally medically managed by the referring clinician / allied health professional / clinical nurse specialist exclusion criteria: breathlessness of unknown cause a primary diagnosis of chronic hyperventilation syndrome

Eligibility criteria:
inclusion criteria: * adult patients \>18 years of age, with the ability to read, converse in english and able to provide informed consent * chronic breathlessness on exertion and or rest (mrc dyspnea score \>2) * advanced disease such as cancer, chronic obstructive pulmonary disease (copd), chronic heart failure (chf) or interstitial lung disease (ild), where the underlying disease is deemed to be optimally medically managed by the referring clinician / allied health professional / clinical nurse specialist exclusion criteria: * breathlessness of unknown cause * a primary diagnosis of chronic hyperventilation syndrome
intrapleural administration of bevacizumab versus endostar for pleural effusions in nsclc

Conditions: Non Small Cell Lung Cancer

Summary: malignant pleural effusion (mpe) is a common complication of advanced non-small cell lung cancer (nsclc). bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (vegf), has been shown to be efficient in suppressing the accumulation of pleural fluid. the other widely used treatment for mpe is recombinant human endostatin.

we designed this clinical trial to determine the efficacy and safety of intrapleural bevacizumab versus recombinant human endostatin as a treatment for malignant pleural effusions (mpe) in patients with non-small cell lung cancer (nsclc).

Eligibility criteria:
inclusion criteria: patient who was confirmed stage iv nsclc with malignant pleural effusion confirmed by cytology. males or females aged ≥18 years, \< 75 years. eastern cooperative oncology group (ecog) performance status 0-3. life expectancy ≥12 weeks. ability to maintain a drainage catheter. previous intrapleural administration of chemotherapeutic drugs (preferred bleomycin) males and females should be contraceptive during the period of the trial until 8 weeks after the last administration of the drug. adequate bone marrow, renal, and liver function are required. able to comply with the required protocol and follow-up procedures, and able to receive oral medications. institutional review board-approved informed consent will be obtained for every patient before initiation of any trial-specific procedure or treatment. exclusion criteria: any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the previous year, serious cardiac arrhythmia requiring medication, hepatic, renal, or metabolic disease). active thoracic cavity or systemic bleeding. major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to day 0. female subjects should not be pregnant or breast-feeding. known sensitivity to bevacizumab or endostar. patients must not be on therapeutic anticoagulation with warfarin, heparin or low molecular weight heparin. adequate hematological function: absolute neutrophil count (anc) ≥1.5 x 109/l, and platelet count ≥100 x 109/l. adequate renal function: serum creatinine ≤ 1.5 x uln, or ≥ 50 ml/min. adequate liver function :total bilirubin £ 1.5 x upper limit of normal (uln) and alanine aminotransferase (alt) and aspartate aminotransferase (ast) \< 2.5 x uln in the absence of liver metastases, or \< 5 x uln in case of liver metastases. patient assessed by the investigator to be unable or unwilling to comply with the requirements of the protocol.
yh001 plus envafolimab with or without doxorubicin in patients with advanced or metastatic sarcoma

Conditions: Advanced Sarcoma; Metastatic Sarcoma; Soft Tissue Sarcoma

Summary: this is a multicenter, open label, phase 1/2 study of yh001 initially given in combination with envafolimab, and then given in combination with envafolimab plus doxorubicin in patients with advanced or metastatic sarcoma, followed by phase 2 cohorts of patients with select histologies of advanced or metastatic sarcoma.


Eligibility criteria:
inclusion criteria: 1. histologically confirmed advanced or metastatic sarcoma patients without ups or mfs who are refractory to or intolerant to standard treatments for their disease. 2. histologically confirmed advanced or metastatic sarcoma patients without ups or mfs who have not received any immune checkpoint inhibitors or doxorubicin, and with histology for which doxorubicin is considered a reasonable treatment option (for cohort 1b, 2b and expanded cohort 1b and/or 2b) 3. measurable disease by recist 1.1 4. age ≥ 18 years 5. adequate organ function 6. left ventricular ejection fraction (lvef) as measured by echo or multigated acquisition scan of \> 50% (for patients to receive doxorubicin) 7. willingness and ability to consent for self to participate in study 8. willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures 9. men who are sterile or agree to use a condom with spermicide . 10. women of non-child bearing potential due to surgical sterilization or medically-documented ovarian failure confirmed by medical history, or women of child bearing potential who test negative for pregnancy at time of enrollment and agree to use at least 2 acceptable methods of birth control exclusion criteria: 1. gastrointestinal stromal tumor (gist) or desmoid tumors 2. condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days prior to enrollment 3. known allergy to any component of any study drug that the patient would receive if enrolled into this study 4. prior t-cell or nk-cell therapy 5. prior pericardial or mediastinal radiation (for patients to receive doxorubicin) 6. acute coronary syndromes within 6 months of enrollment 7. women who are pregnant or breast feeding 8. other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for this study

Keywords: tracon sts lms ddls asps envafolimab yh001 ctla-4 pd-l1 chondrosarcoma
decision making in multiple sclerosis care under uncertainty

Conditions: Multiple Sclerosis

Summary: the main objectives of this study are: i) to determine patient-level, physician-level and health system factors influencing therapeutic decisions in multiple sclerosis (ms) care by applying conjoint discrete experiments. ii) to determine the prevalence of therapeutic inertia among participating neurologists. iii) to compare clinical judgement vs. a qualitative or quantitative approach when assessing for a given case-scenario. iv) to evaluate the influence of decision fatigue in treatment decisions.

the landscape of ms care is changing. currently, there are over 15 disease modifying agents (dmts) available to treat ms, with varying availability around the world. significant heterogeneity exists in the efficacy and risks associated with these therapies. neurologists caring for ms patients face important choices in each medical encounter: 1) continue with the same management, 2) initiate or escalate therapy for a more effective or safer agent, or 3) consider a reassessment within months under the uncertainty of the current status of the patient. limited information on how physicians weigh in different factors when making therapeutic decisions. physicians (cognitive biases affecting decision making) and health system (e.g. access to an infusion center) factors are the most responsible causes of practice gaps in ms care. the physician's component is the least studied. therapeutic inertia (ti) is a common phenomenon in ms care defined as lack of treatment initiation or escalation (e.g. switch interferons or glatiramer to fingolimod /alemtuzumab /natalizumab/ocrelizumab/ etc.) when recommended by guidelines or evidence of disease progression. this phenomenon leads to poorer patient's outcomes, greater disability, and diminished quality of life. goals of the study: i) to determine what are the most relevant factors influencing therapeutic decisions among neurologists with expertise in ms care; ii) to asses whether physicians rely on medical information provided in a case scenario versus a quantitative or qualitative estimation of disease progression based on hypothetical models.

Eligibility criteria:
inclusion criteria: * actively practicing neurologist * expertise in treating patients with multiple sclerosis (at least 12 per year) * clinical setting: academic or community institutions, private practice or outpatient clinic * certified physicians in their specialty * online consent to participate in the study

Keywords: decision making therapeutic disease modifying agents monoclonal antobodies physicians neurologists uncertainty neuroeconomics
effects of nonlinear signal processing algorithms on speech perception

Conditions: Speech; Hearing Loss, Sensorineural; Hearing Aids

Summary: the purpose of this study is to investigate the effect of nonlinear signal processing algorithms on speech perception.

in this study, we are interested in how nonlinear algorithms influence speech perception. nonlinear algorithms are used within hearing aids and personal sound amplifiers to provide comfort to the listener. one of these algorithms provides amplification (gain) in a manner that depends on the level of the input sound.: low-level sounds are amplified much more than high-level sounds. this type of amplification makes sounds more comfortable for listeners, but also distorts incoming sounds. to determine the effect of these algorithms on speech understanding, we will evaluate the following factors on speech perception, within the context of these algorithms: * the input signal-to-noise ratio (snr) to the algorithm (3 different snrs) * the type of background noise (20 people talking or 2 people talking) * algorithm settings (slow and fast - whether changes to gain applied to fluctuating input sounds occurs quickly or slowly) to address our questions, we are using a wearable processor (tympan) that allows for real-time processing of audio signals. the tympan itself contains microphones, a processor, and small earpieces that include speakers. a listener can wear the earpieces, like headphones, and listen to sounds processed by the tympan in real time. the tympan allows us access to the algorithms and to the sounds processed by the algorithms so that we cannot algorithm behavior to speech perception. our study will complement existing work on speech perception and nonlinear algorithms, but our study will be the first to use a wearable processor in which the specific algorithm is known, tailored to an individual's hearing levels, and which allows for direct calculation of the output snr. most studies also have not measured speech perception, and this will be one of only a handful of studies with that objective.

Eligibility criteria:
inclusion criteria: * between the ages of 18 and 65 * native speaker of english * have bilateral, symmetric sensorineural hearing loss that is less than 75 decibels (db) hearing level (hl) at 1000 hz and below. exclusion criteria: * subjects with normal hearing, mixed hearing loss, or asymmetric sensorineural hearing loss. * subjects who younger than 18 or older than 65. * subjects who are not native speakers of english. * subjects with thresholds more than 70 db hl at 2000 hz and below

Keywords: speech perception, hearing aids