Kornimate/medical-research-clean huggingface dataset:
first-trimester placental ultrasound study

Conditions: Fetal Growth Complications; Pregnancy Complications

Summary: an observational cohort study to assess the clinical utility of the oxnnet toolkit for the prediction of adverse pregnancy outcomes.

the first plus study is a single centre, prospective, observational study recruiting 4000 women from the harris birthright centre, which provides ultrasound scanning for all women who would attend king's college hospital nhs foundation trust for their pregnancy care. this study aims to develop a tool to provide reliable measurements of placental size and estimate the blood flow within the placenta during the first trimester of pregnancy. these metrics hope to develop a screening tool for fetal growth restriction (fgr), which is a condition in which a baby fails to grow to its full potential and can cause adverse pregnancy outcomes and is the single most common cause of stillbirth. this devastating outcome could potentially be reduced by stratifying pregnancies into high risk, allowing women to undergo additional monitoring and limiting clinician resource to those in need of it most. stillbirth is also a serious adverse pregnancy outcome that nhs england is looking to reduce the rate of as part of their long-term plan. women 18 years of age or older, attending their first trimester scan during 11-14 weeks of pregnancy, who has a viable pregnancy with no more than one baby with no major defects identified during the scan will be eligible to take part. the study will take place over 24 months and participants will undergo a single study visit in which their demographics and routine medical history will be recorded, an additional research ultrasound scan will be conducted alongside their routine scan, and blood from a sample taken as part of routine care will be used to assess the level of placental growth factor (plgf). participants will then be followed up until the completion of their pregnancy via their pregnancy records (remote follow up) and the outcome of their pregnancy will be recorded.

Eligibility criteria:
inclusion criteria: * pregnant * 18 years of age, or older * presenting for first-trimester combined test screening between 11+0 and 13+6 weeks of pregnancy * participant is willing and able to give informed consent for participation in the investigation. * able to understand written or verbal english and able to access methods of translation. * in the opinion of the investigator, the participant is not at risk or under stress or limited in their ability to participate in the study activities. exclusion criteria: * participant with a multiple pregnancy (more than one viable fetus) discovered at the scan * participant with a non-viable pregnancy discovered at the scan (no detectable heartbeat) * pregnancies with major defects identified during 11+0 to13+6 week scan * any pregnancy subsequently found to be chromosomally abnormal as a result of either prenatal or postnatal testing

Keywords: ultrasound fetal growth pregnancy
ibuprofen and renal function in premature infants

Conditions: Premature Infants; Patent Ductus Arteriosus

Summary: purpose of the study: 1. to evaluate renal function maturation within the first month of life in very premature infants. 2. to determine whether a treatment with ibuprofen for patent ductus arteriosus would alter renal function maturation at short term and up to 28 days of life.

ibuprofen has improved the prognosis of infants with patent ductus arteriosus. several studies showed that ibuprofen has significantly less side effects than indomethacin that was used for this indication. however, experimental studies and few clinical observations suggested that side effects on renal function could occur in very premature infants. purpose of the study: 1. to evaluate renal function maturation within the first month of life in very premature infants. 2. to determine whether a treatment with ibuprofen for patent ductus arteriosus would alter renal function maturation at short term and up to 28 days of life. population: at least 120 infants 27 to 31 weeks gestation will be studied. that number will allow to demonstrate a 30% difference in creatinine clearance on day 7 postnatally. careful recording of mother and child history, and associated therapies prone to alter renal function should allow to improve the use of this treatment.

Eligibility criteria:
inclusion criteria: * gestational age = 27 to 31 weeks * postnatal age \< 48 hours * parental consent obtained exclusion criteria: * renal malformation * urinary tract infection * renal failure * pulmonary hypertension at echocardiography

Keywords: premature infants patent ductus arteriosus renal function ibuprofen
evaluation of providing coffee to patients postoperatively to decrease length of stay in the pacu

Conditions: PACU Length of Stay; Postoperative Nausea; Postoperative Vomiting; Patient Satisfaction

Summary: the purpose of the study is to determine if providing coffee to patients who self-identify as coffee drinkers postoperatively will decrease the length of stay in the post-anesthesia care unit (pacu).

decreasing the length of stay in pacu for surgical patient is a pertinent outcome. the shorter length of stay can achieve higher patient engagement scores, while simultaneously increasing the productivity of the unit. this is achieved by making more beds available for new patients coming from the operating room (or). one thought was that coffee would benefit the investigator's patients experience through a number of pathways. initially, the stimulant effect of coffee would create a more alert patient. a more alert patient is more likely to comprehend home care instruction and be ready for discharge earlier. coffee is often used as a remedy for morning sickness. ideally the act of drinking coffee or even smelling the coffee may decrease the occurrence of post-operative nausea and vomiting (ponv) in investigator's patient population. finally, patients frequently state that the inability to drink their morning coffee is often more difficult than not being able to eat prior to surgery. by allowing those to drink coffee in pacu this would make the patient feel that they are being cared for on an emotional level, in addition to a physical level.

Eligibility criteria:
inclusion criteria: 1. 18 years old or older 2. admitted to bethesda north minimally invasive surgery center 3. reports to consume at least one cup of coffee a day for at least 5 days in a week exclusion criteria 1. history of ponv 2. pre-existing cardiac arrhythmias 3. history of seizure disorder 4. pregnant

Keywords: pacu length of stay coffee
comparative effectiveness of pregnancy failure management regimens

Conditions: Spontaneous Abortion

Summary: the purpose of the study is to compare the effectiveness of combination treatment (mifepristone premedication plus single-dose misoprostol) to single-dose misoprostol (standard of care) for the management of early pregnancy failure.


Eligibility criteria:
inclusion criteria: * between 5 and 12 completed weeks gestation * 18 years or older * hemodynamically stable * confirmed diagnosis of intrauterine embryonic/fetal demise or anembryonic gestation (ultrasound examination demonstrates a fetal pole without cardiac activity measuring between 5.3 and 40 mm or an abnormal growth pattern diagnostic of early pregnancy failure) * willing and able to give informed consent exclusion criteria: * diagnosis of incomplete or inevitable abortion (absent gestational sac and/or active bleeding, open cervical os) * contraindication to mifepristone (chronic corticosteroid administration, adrenal disease) * contraindication to misoprostol (glaucoma, mitral stenosis, sickle cell anemia, or known allergy to prostaglandin) * cardiovascular disease (angina, valvular disease, arrhythmia, or cardiac failure) * most recent hemoglobin \<9.5 g/dl * diagnosis of porphyria * known clotting defect or receiving anticoagulants * pregnancy with an intrauterine device (iud) in place * breastfeeding during the first 7 days of study participation * unwilling to comply with the study protocol and visit schedule * any evidence of viable pregnancy * possibility of ectopic pregnancy * known or suspected pelvic infection * concurrent participation in any other interventional trial

Keywords: spontaneous abortion early pregnancy failure mifepristone misoprostol
the alert-pilot study

Conditions: Myocardial Infarction, Acute; Artificial Intelligence; ECG Pattern

Summary: the algorithm of artificial intelligent to diagnose myocardial infarction through prior surgery electrocardiogram was established. the accuracy of using artificial intelligent to diagnose acute st-segment elevation myocardial infarction and judge criminal vascular was evaluated.


Eligibility criteria:
inclusion criteria: 1. age≥18 years old; 2. the admitting doctor's diagnosis is st-segment elevation myocardial infarction. exclusion criteria: 1. the admitting diagnosis is non-st-segment elevation myocardial infarction. 2. default data; 3. pregnancy, mental disorder, kidney failure; 4. except for criteria mention above, including some improper condition considered by investigators.

Keywords: myocardial infarction artificial intelligence 12 lead electrocardiogram
effects of pir and pfs on pain, rom, and disabilty in tight hamstring syndrome

Conditions: Hamstrings; Flexibility; Range of Motion; Disability

Summary: this randomized clinical trial aims to compare the effects of post-isometric relaxation (pir) and post-facilitation stretch (pfs) on pain, range of motion, and disability in individuals with tight hamstring syndrome. conducted at riphah rehabilitation clinic, lahore, participants aged 18-35 years with posterior thigh pain will be divided into two groups. both groups will receive hot pack therapy and core strengthening exercises, with group a receiving pir and group b receiving pfs. outcomes will be assessed at baseline and after 4 weeks using nprs, a disability questionnaire, and a goniometer, with data analyzed using spss version 25.

both pir and pfs are subtypes of muscle energy techniques (met) that have shown potential in improving muscle flexibility and reducing discomfort. this study aims to address the impacts of pir and pfs on pain, rom, and disability in patients with tight hamstrings syndrome, providing valuable insights for clinical practice and enhancing the understanding of effective interventions for this common musculoskeletal issue. the current literature on stretching techniques for musculoskeletal conditions reveals several gaps specifically relevant to the effects of post isometric relaxation (pir) and post facilitation stretch (pfs) on tight hamstrings syndrome. despite the high incidence of hamstring tightness and its association with conditions such as nonspecific low back pain, there is limited research directly comparing the effects of post isometric relaxation (pir) and post facilitation stretch (pfs) on this condition. while studies have explored various stretching methods such as muscle energy technique (met), static stretching, and myofascial release, there is a notable lack of direct comparative research between pir and pfs in patients with tight hamstrings. additionally, existing studies had often focused on immediate or short-term outcomes, with limited investigation into the long-term effects of these techniques on pain, range of motion (rom), and disability.

Eligibility criteria:
inclusion criteria: * both male and female * age between 18 to 35 years(45) * bilateral hamstring muscle tightness * individuals having lack of active knee extension more than 20 degrees(46) exclusion criteria: * low back pain radiating to the back of thigh * history of fracture, dislocation of hip(47) * acute or chronic hamstring injury * any neurological disease(48) * congenital deformity of the lower limb * inflammatory condition that affects motion * a history of a cervical whiplash injury(45)

Keywords: hamstrings flexibility muscle energy techniques range of motion post facilitation stretching post isometric relaxation
updating preventive and treatment guidelines for hypoglycemia in individuals living with type 1 diabetes

Conditions: Type 1 Diabetes

Summary: the remodal trial is a randomized crossover study aiming to update treatment guidelines for mild hypoglycemia in people with type 1 diabetes using continuous glucose monitoring (cgm) technology. the study will assess whether treating mild hypoglycemia proactively (at a glucose threshold of 5.0 mmol/l) with lower doses of carbohydrate (cho) is more effective than the traditional reactive approach (treatment at \< 4.0 mmol/l). the goal is to reduce hypoglycemia frequency and improve quality of life, while minimizing caloric intake and rebound hyperglycemia.

the remodal trial explores an individualized, proactive approach to treat mild hypoglycemia in individuals with type 1 diabetes (t1d) who use cgm. traditional guidelines, established in the 1980s, recommend the "15g/15min rule" - consuming 15g of cho every 15 minutes for glucose levels below 4.0 mmol/l. however, these guidelines may no longer be optimal with the advancements in insulin therapies and cgm, which provide real-time glucose data and predict glucose trends. in this study, 32 adult participants with t1d will receive three interventions to test different amounts and timing of cho intake under real-life conditions. these are as follows: 1. 8g of cho at a threshold of 5.0 mmol/l (proactive approach). 2. 16g of cho at a threshold of 5.0 mmol/l (proactive approach). 3. 16g of cho at a threshold of \< 4.0 mmol/l (traditional reactive approach). the primary outcome is the prevention rate of hypoglycemic episodes under each intervention, with additional measures on glucose levels, time spent in hypoglycemia, and rebound hyperglycemia. the study also considers differences in glucose management between multiple daily injections, continuous subcutaneous insulin infusion, and automated insulin delivery systems, which may affect cho needs. this study hopes to redefine effective hypoglycemia management in the modern era of diabetes care, providing personalized recommendations to improve glycemic control and overall quality of life.

Eligibility criteria:
inclusion criteria: * adults aged 18 years and older * clinical diagnosis of type 1 diabetes for at least 1 year * currently treated with multiple daily insulin injections (mdi), continuous subcutaneous insulin infusion (csii), or automated insulin delivery (aid) systems * hba1c level below 9.0% * equal distribution of male and female participants, as well as mdi/csii and aid users exclusion criteria: * gastroparesis * significant cardiac rhythm abnormalities * clinically significant microvascular complications such as nephropathy (egfr \< 40 ml/min) or severe proliferative retinopathy * diagnosis of epilepsy * pregnancy or currently breastfeeding * severe hypoglycemic episode within 1 month prior to inclusion * macrovascular events or uncorrected hypokalemia (k+ \< 3.5 mmol/l) within 3 months prior to inclusion * anticipated treatment changes during the trial period * inability to provide informed consent

Keywords: type 1 diabetes hypoglycemia
nanocytology test to evaluate skin cancer in high risk patients

Conditions: Actinic Keratosis; Squamous Cell Carcinoma

Summary: the purpose of this study is to correlate pathological features from specimens in order to determine if this new molecular diagnostic technique can be used to detect risk of skin cancer.

squamous cell carcinoma is the culmination of a multistep carcinogenesis process that is preceded by early stages referred as squamous dysplasia and actinic keratosis. squamous dysplasia (sd) also known as "field effect" is clinically characterized by xerosis (dry, scaly skin), lentigines and uneven pigmentation. while morphologically skin biopsies and cytology samples show only minimal changes, at the molecular level it is known that sd is characterized by small clone keratinocytes carrying mutations of the p53 gene. an optical technology called partial wave spectroscopy (pws) probes nanoscale structures in the order of tens to a few hundred nanometers. pws is a light back-scattering techniques that uses light reflected off of a tissue sample. the measured biomarker is sensitive to the cytosolic and nucleic architecture within the cell and quantifies the nanoscale disorder, which conventional light microscopy fails to appreciate. pws has allowed to identify various grades of structural disorder at the nanoscale level of colonic and pulmonary premalignant cell samples. using pws we aim to study the spectrum of cutaneous sd from patients at high risk for scc development. since squamous dysplasia is difficult to assess with routine histology and cytopathology and a grading system for squamous dysplasia by routine histology or cytology is not available, we propose to assess the value of pws as a new and more sensitive imaging technique. by identifying the degree of sd at the molecular level, we may be able to intervene with close surveillance, early treatment and chemoprevention strategies to achieve lower morbidity by means of fewer and smaller skin cancers.

Eligibility criteria:
inclusion criteria: * 18 to 89 years old, male and female, fitzpatrick skin phototype i - iii * photodamage skin grades 3 - 4 (global assessment) * medical history of precancerous lesions and or known history of scc or healthy volunteers exclusion criteria: * subjects under 18 years old * pregnant women or lactating mothers * treatment with systemic chemotherapy within 4 weeks period before consent * known hiv+ patients (self-reported)

Keywords: non melanoma skin cancer field of cancerization skin carcinogenesis
virtual 360°-tour in coronary computed tomography

Conditions: Coronary Artery Disease; Anxiety; Fear

Summary: the purpose of the study is to evaluate the effectiveness of the virtual 360° counselling environment in the anxiety and process time of the patients coming to ccta (coronary computed tomography angiography). the virtual, 360° environment 'virtual 360°-tour in coronary computed tomography' uses 360°- technology based on spherical panorama images and resembles the spaces of the hospital according to the patient's pathway in ct-examination and provides information to the patient at various stages of the pathway.

the purpose of the study is to evaluate the effectiveness of the virtual 360° counselling environment in the anxiety and process time of the patients coming to ccta (coronary computed tomography angiography). the virtual, 360° environment 'virtual 360°-tour in coronary computed tomography' uses 360°- technology based on spherical panorama images and resembles the spaces of the hospital according to the patient's pathway in ct-examination and provides information to the patient at various stages of the pathway. patients who have referred first time to the coronary computed tomography can access the virtual ct examination environment via link before entering the hospital. using the environment requires a network connection and is possible with a computer, tablet or phone. the environment has digital counselling materials in text, image, animation and video formats in three different virtual spaces/views, the environment and examination are presented via pathway of example 59-year female patient with arterial hypertension and exercise related chest pain (angina pectoris).

Eligibility criteria:
inclusion criteria: * coming to first coronary computed tomography examination * adult patient * able to independently fill in question forms exclusion criteria: * previous coronary computed tomography * mental illness

Keywords: counselling computed tomography coronary ct virtual 360 anxiety
a comparison of dfd01 spray versus comp01 lotion, vehicle spray and vehicle lotion in subjects with moderate psoriasis

Conditions: Psoriasis

Summary: the objectives of this study are to compare the safety of dfd01 spray to comp01 lotion for topical treatment of moderate plaque psoriasis and to compare the efficacy of dfd01 spray to placebo spray for topical treatment of moderate plaque psoriasis after 28 days of treatment.


Eligibility criteria:
inclusion criteria: * subjects must present with a clinical diagnosis of stable (at least 3 months) plaque-type psoriasis. * subjects with psoriasis involving 10 to 20% bsa, not including the face, scalp, groin, axillae and other intertriginous areas. * subjects must have an iga grade of 3 (moderate) at the baseline visit exclusion criteria: * current diagnosis of unstable forms of psoriasis including guttate, erythrodermic, exfoliative or pustular psoriasis. * other inflammatory skin disease that may confound the evaluation of the plaque psoriasis (e.g., atopic dermatitis, contact dermatitis, tinea corporis). * presence of pigmentation, extensive scarring, or pigmented lesions or sunburn which could interfere with the rating of efficacy parameters. * history of psoriasis unresponsive to topical treatments. * history of organ transplant requiring immunosuppression, hiv, or other immunocompromised state.
safety of romiplostim (nplate®) following ucbt

Conditions: Hematologic Malignancies

Summary: this is a single institution, phase i dose escalation study of weekly romiplostim post umbilical cord blood transplantation in patients who fail to achieve platelet engraftment by day +30. engraftment is defined as a platelet count ≥ 20 x 109/l on 3 consecutive measurements without transfusion for 7 days. romiplostim is administered at the assigned dose as 6 weekly injections beginning by day +42 post transplant. up to 4 dose levels (4, 6, 8, and 10 mcg/kg/dose) will be evaluated with the maximum tolerated dose (mtd) of romiplostim determined by using the continual reassessment method (crm). the goal of this crm will be to identify 1 of the 4 dose levels which corresponds to the desired maximum toxicity rate of 20% or less.


Eligibility criteria:
inclusion criteria: * any patient who has undergone a single or double umbilical cord blood transplant (ucbt) except those with primary myelofibrosis. * those with acute leukemia must be in remission at the time of transplant * must have achieved neutrophil engraftment (defined as an anc \>500 for three consecutive days) and be off daily g-csf prior to starting romiplostim. intermittent g-csf is allowed. * failure to achieve platelet engraftment (defined as platelet count ≥20x10\^9/l on 3 consecutive measurements without transfusion for 7 days) by day +28 post ucbt * between day +28 and day +42 status post myeloablative or nonmyeloablative ucbt (single or double cord blood transplant) * age ≥ 18 years * adequate organ function within 7 days of enrollment defined as: * creatinine: ≤ 2.0 mg/dl * hepatic: sgot and sgpt \< 5 x upper limit of institutional normal (uln) * women of child bearing potential agree to use effective contraception during therapy and for 4 months after completion of therapy * voluntary written consent exclusion criteria: * known pregnancy - pregnancy category c: there are no adequate and well-controlled studies of romiplostim in pregnancy * recurrence of aml or myelodysplastic syndrome on bone marrow evaluation done within 21 days of enrollment * presence of clinically significant bone marrow fibrosis on the bone marrow examination immediately prior to ucbt * patients requiring more than one platelet transfusion per day * history of an allergy to romiplostim

Keywords: umbilical cord transplant acute leukemia ucbt hodgkin's lymphoma lymphoid leukemia multiple myeloma myeloid and monocytic leukemia non-hodgkin's lymphoma hematopoietic malignancies