Kornimate/medical-research-clean huggingface dataset:
spirometry interpretation performance of primary care clinicians with/without ai software

Conditions: Lung Disease

Summary: to evaluate whether an artificial intelligence decision support software (artiq.spiro) improves the diagnostic accuracy of spirometry interpreted by primary care clinicians, as measured by clinician diagnostic accuracy (vs reference standard).

this is a randomised controlled study to evaluate the effects of ai support software on the performance of primary care clinicians in the interpretation of spirometry. clinicians will be provided with a clinical dataset of 50 entirely anonymous, previously recorded real-world spirometry records to interpret and will be asked to complete specific questions about diagnosis and quality assessment. the records will be randomly selected from a database comprising spirometry records from 1122 patients undergoing spirometry in primary care and community -based respiratory clinics in hillingdon borough between 2015-2018. participating clinicians will be allocated at random to receive either spirometry records alone or spirometry records with the addition of an ai spirometry interpretation eport. the clinical spirometry records will be de-identified (name, date of birth, address, postcode, occupation, gp, medications data removed), by a member of the clinical care team. study participants (participating clinicians) will independently examine the same 50 spirometry records through an online platform. for each spirometry record, the primary care clinician participant will answer questions about technical quality, pattern interpretation, preferred diagnosis, differential diagnosis and self-rated confidence with these answers. the study statistician will be blinded to treatment allocation up to completion of analysis and interpretation. the reference standards for spirometry technical quality and pattern interpretation will be made by a senior experienced respiratory physiologist but without access to ai report. the reference standard for diagnosis will be made by a panel of three respiratory specialists from the clinical care team with access to medical notes and results of relevant investigations but without access to ai report.

Eligibility criteria:
inclusion criteria: 1. clinicians working in primary care (for at least 50% of their job plan) in the uk, who refer for or perform spirometry (typically gp, practice nurse) 2. able to access spirometry traces on study platform 3. provide written informed consent via study platform exclusion criteria: 1. clinicians who have completed specialist training in respiratory medicine and recognised by the general medical council with a right to practise as a nhs consultant in respiratory medicine
exercise training and testosterone replacement in heart failure patients

Conditions: Heart Failure

Summary: the purpose of this study is to determine if exercise training with or without testosterone replacement can improve cardiopathy in heart failure patients

in this study, we are evaluating: * hospital length of stay and readmission * muscle sympathetic nerve activity * functional capacity * body composition

Eligibility criteria:
inclusion criteria: * heart failure * hypogonadism * left ventricular fraction ejection \< 45% exclusion criteria: * chronic renal failure * normal testosterone * pace maker
navigated transcranial magnetic stimulation in monitoring stroke recovery

Conditions: Ischemic Stroke

Summary: the past 10 years of research in persons more than 6 months post stroke have shown certain types of rehabilitation can help "re-wire" the brain. transcranial magnetic stimulation (tms) can be used to monitor this re-wiring by mapping the brain's function (measuring brain activity). recent research suggests that tms can be used for both prognosis (determining future function) and to determine what type of rehabilitation therapy will work best after stroke. the purposes of this research study are to: 1) determine changes in brain activity during the first 6 months after stroke (to determine how the brain "re-wires"); 2) compare changes in recovery of motor function with changes in brain re-wiring; 3) determine the ability of tms to "predict" functional outcome in the first 6 months after stroke. the primary hypotheses are: 1) functional recovery will be correlated with tms changes (as measure motor threshold (mt), motor evoked potentials (meps) and recruitment curves; 2) baseline tms will predict future functional outcomes at 3 and 6 months.


Eligibility criteria:
inclusion criteria: * one sided ischemic stroke confirmed by radiology * 20-80 years old exclusion criteria: * hemorrhagic stroke * brainstem stroke * cerebellar stroke * thalamic stroke * seizure with the recent stroke * any history of uncontrolled seizure * history of epilepsy * pregnancy or planning on getting pregnant during the next year * mri incompatibility (e.g. metal implants in body) * recent history (past year) of alcohol and drug abuse (due to lack of follow up) other criteria include tms exclusions: aneurysm clips, previous surgery over motor cortex, open craniotomy
effect of dose fractionation of testosterone cypionate on transgender men with erythrocytosis

Conditions: Testosterone; Transsexualism; Hematologic Diseases

Summary: a transgender man is someone with a male identity who were born with a vulva and vagina. the acquisition of masculine characters can come from surgery or from the use of testosterone. despite the benefit of using this hormone in relation to hair development, muscle mass gain and changes in voice timbre, its use can cause an increase in the hematocrit (ht) level. when erythrocytosis occurs (ht ≥ 50%), the currently proposed conduct is the suspension of cross-hormonization for 3 months, which has negative effects on the affirmation process. this project aims to assess whether reducing the dose of testosterone cypionate by half (100mg/15d) can mitigate the negative outcomes caused by the suspension with the benefit of reducing the hematocrit level in trans patients who developed erythrocytosis using testosterone. this is a pilot study that will compare the intervention (testosterone cypionate 100 mg, fortnightly) to the suspension of the drug, both for 3 months, with the main outcome being the hematocrit level. hormonal and biochemical levels and the hospital anxiety and depression scale (had) will also be evaluated in patients treated at the gender incongruence outpatient clinic of the hospital das clínicas of the faculty of medicine of ribeirão preto.


Eligibility criteria:
inclusion criteria: * tm aged between 18 and 40 years in threatmeant with testosterone cypionate 200mg/2ml with a diagnosis of erythrocytosis (ht⩾50%). exclusion criteria: * tm with polycythemia vera or secondary to other pathologies (chronic kidney disease, severe lung disease, chronic myeloid leukemia, lymphoma, liver diseases and cushing's syndrome); * tm in use of hormonal contraceptives or copper iuds; * tm with psychiatric conditions such as severe psychotic disorders, severe personality disorders * patients with ht \> 54.
improving the breast cancer care delivery model for sex and gender minority survivors, intended for sgm study

Conditions: Breast Carcinoma

Summary: this study evaluates improving the breast cancer care delivery model for sex and gender minority (intended for sgm) in identifying the patient, support person and provider barriers to quality care in sgm breast/chest cancer survivors.

primary objective: i. to determine the important ways the icandecide breast cancer decision aid needs revised for sgm people, and how best to integrate a culturally-relevant tool into clinical practice. outline: this is an observational study. aim 1: interview transcripts from sangria study utilized to explore the values, preferences and key considerations for breast cancer treatment decision making in sgm individuals. aim 2: patients are assigned to 1 of 2 groups. group 1: cancer survivors participate in a focus group on study. group 2: breast cancer clinicians undergo a semi-structured interview on study.

Eligibility criteria:
inclusion criteria: * survivors: * self-identify as a member of the sex and gender minority community or partner with an individual of the same sex or gender * must be a breast cancer survivor, in active treatment or completed active treatment in the last 10 years (not including hormone therapy) * be over age 18 * english-speaking * received care in the us breast oncology clinicians: physicians, advanced practice providers, nurses, psychologists and social workers will be eligible if they: * provide care and/or surgical decision support to individuals diagnosed with early stage breast cancer in the us * are english-speaking
liver injury after covid-19 vaccination

Conditions: Subjects After COVID-19 Vaccination

Summary: the covid-19 pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (sars-cov-2), is still raging across the world and vaccination is expected to lead us out of this pandemic. although the efficacy of these vaccines is beyond doubt, safety still remains a concern. liver injury, such as autoimmune hepatitis (aih), has been reported after covid-19 vaccination. the aim of this prospective study is to investigate the spectrum and profile of liver injury after covid-19 vaccination in asia-pacific region and to explore the potential risk factors for the development of liver injury.


Eligibility criteria:
inclusion criteria: * subjects who have received at least one dose of approved covid-19 vaccine; * volunteer to participate in this study. exclusion criteria: * no valid consent.
evaluation of a simulation training tool to identify lesions requiring further screening for melanoma

Conditions: Skin Simulation Model; Mastery Learning Model to Simulation Training for Visual Screening for Melanoma and Skin Biopsy

Summary: the investigators will design a curriculum for visual screening for melanoma and skin biopsy procedure, based on the mastery learning model, using simulators and web-based didactic instruction for medical students and internal medicine residents. this requires having a skin simulation model that presents a range of lesions from benign nevus to atypical nevus to melanoma in a distribution and density that mimics the clinical findings of those with 2 skin tones: fair-skin non- hispanic white and hispanic.


Eligibility criteria:
inclusion criteria: * medical student in his primary care clerkship at northwestern university exclusion criteria: * not a medical student in his primary care clerkship at northwestern university

Keywords: melanoma simulation training medical students
effectiveness of ultrasound (us) guided supraclavicular block

Conditions: Analgesia; Pain

Summary: this research study is being done in order to find out if there is any difference in the effectiveness of ultrasound guided supraclavicular brachial plexus nerve block that can be achieved with 3 different amounts of ropivacaine 0.5% (20 ml, 30 ml, and 40 ml). the investigators want to show if you can have a successful nerve block with less amount of local anesthetic, thus potentially decreasing the risk of side effects.


Eligibility criteria:
inclusion criteria: * patients between the ages of 18-64, * patients who are asa i-iii, presenting for distal upper extremity surgery. surgeries to be considered are orif of distal upper extremity fractures such as orif radius, orif ulna, orif of any bones in the wrist or hand, and distal upper extremity surgery involving bones or tendons for which postoperative pain is to be expected. no emergency surgeries will be considered. exclusion criteria: * emergency surgery, * patient or surgeon refusal * patients for which peripheral nerve block or study medications are contraindicated, * patients on chronic analgesic therapy at home, * history of nerve injury, neuropathy, or known neurologic injury or illness, or inability to properly describe postoperative pain to investigators (language barrier, psychiatric disorder, dementia).

Keywords: anesthesia
impact of new anthropometric indices on outcomes after cardiac surgery

Conditions: Coronary Artery Disease; Cardiometabolic Risk Factors; Cardiac Anesthesia; Cardiac Surgery; Anthropometry

Summary: obesity is associated with a number of risk factors for cardiovascular disease. body mass index (bmi) is the most commonly recommended and used anthropometric measure to classify general obesity in clinical and epidemiological studies. it is widely accepted that obesity increases the risk of heart disease and is thought to be a risk factor for adverse outcomes after cardiac surgery. however, recent studies show paradoxical results, wherein obese patients can experience fewer adverse events and lower mortality than patients with normal-low body mass index(bmi) . the discriminative capacity of bmi has been criticized because it cannot distinguish muscle mass from fat mass, or reflect fat distribution . alternatively, abdominal obesity indices, such as waist circumference (wc) and waist-to-height ratio (whtr), have been suggested to be better predictor of cardiometabolic abnormalities because they modulate the limitation of bmi. however, they were insufficient in studies.for this reason, scientists turned to find a new anthropometric formula that could better detect obesity-related mortality and morbidity and they developed 2 new methods. body shape i̇ndex (absi) is calculated using waist circumference, bmi and height parameters. body roundness i̇ndex (bri) is calculated using waist circumference and height parameters. these new indices may reflect visceral adiposity and strongly predict cardiovascular risk, postsurgical outcomes and resource utilisation.


Eligibility criteria:
inclusion criteria: * open heart surgery * voluntary patients exclusion criteria: * emergency surgery * off-pump or robotic surgery * surgery requiring deep hypothermic circulatory arrest * reluctant patients
cognitive behavior therapy for anxiety-related asthma in adults.

Conditions: Asthma

Summary: this is a study to develop a protocol on cognitive behavior therapy (cbt) for asthma-related anxiety that in a consecutive study can be translated to internet-delivered cbt.

asthma is one of the most common chronic diseases around the world, with a high prevalence of anxiety disorders. cognitive behaviour therapy (cbt) has been shown to increase psychological well-being for anxiety-related asthma. our primary aim is to develop a standardized cbt protocol for asthma-related anxiety that can be transferred to internet-delivered cbt. ten participants will be included in a single-subject multiple baseline design. they will all receive 10-12 sessions of cbt.

Eligibility criteria:
inclusion criteria: * asthma diagnosed by a physician * anxiety or stress related to asthma exclusion criteria: * severe psychiatric disorder (e.g. psychotic disorder, addiction disorder, suicidal ideation).

Keywords: anxiety stress asthma
psilocybin for the treatment of veterans with post-traumatic stress disorder

Conditions: PTSD; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Trauma and Stressor Related Disorders; Mental Disorder

Summary: the primary aim of this study is to assess the safety and efficacy of psilocybin-assisted therapy in the treatment of post-traumatic stress disorder in united states military veterans.

the objective of this study is to determine the safety and efficacy of psilocybin assisted psychotherapy in the treatment of veterans with ptsd. this study will recruit 15 united states military veterans, age 21 to 64, primarily from the columbus and central ohio region who meet the criteria for ptsd. after enrollment and informed consent, participants will receive two separate doses of psilocybin in conjunction with preparatory and post-psilocybin therapy sessions. each psilocybin session will last approximately 8 hours and will be facilitated by two trained session facilitators. before the first psilocybin session, participants will meet with one or both of the session facilitators for a total of 6-8 hours of contact time (or up to 4 meetings) before the first psilocybin session day. two post psilocybin therapy session visits will follow psilocybin sessions 1 and 2. psilocybin sessions 1 and 2 will occur about two weeks apart. follow-up visits will occur 1 and 2 weeks and 1, 3, and 6 months after the final psilocybin session, with additional contact hours scheduled as needed. thus, the intervention and follow-up requires at least 13 visits over a period of about 8-10 months.

Eligibility criteria:
in order to be eligible to participate in this study, an individual must meet all of the following criteria: * a us military veteran * 21 to 64 years old * have at least a high-school level of education or equivalent. * have a current dsm-5 diagnosis of post-traumatic stress disorder * have a caps-5 total severity score of ≥35 at baseline * no antidepressant medications prior to enrollment * be judged by study team clinicians to be at low risk for suicidality * be medically stable * have limited lifetime use of hallucinogens general medical exclusion criteria: * women who are pregnant * cardiovascular conditions * epilepsy with history of seizures * insulin-dependent diabetes * currently taking psychoactive prescription medication * currently taking on a regular (e.g., daily) basis any medications having a primary centrally-acting serotonergic effect, including monoamine oxidase inhibitors.. psychiatric exclusion criteria: * current or past history of schizophrenia or other psychotic disorders or bipolar i or ii disorder * current or history within one year of a moderate or severe alcohol, tobacco, or other drug use disorder * have a first or second-degree relative with schizophrenia spectrum or other psychotic disorders or bipolar i or ii disorder * has a psychiatric condition which precludes the establishment of therapeutic rapport * history of a medically significant suicide attempt * current antidepressant use

Keywords: psilocybin psilocybin-assisted therapy psychedelics veterans
neuro-urological outcome after spinal cord injury

Conditions: Urinary Bladder Neurogenic Dysfunction

Summary: most patients with spinal cord injury suffer from bladder dysfunction which may - especially in the long-term - impair renal function. improved treatment during the last decades improved life expectancy and quality of life. this study evaluates the bladder function in the long-term after spinal cord injury.

bladder dysfunction is a common consequence of spinal cord injury and depends on the completeness and the level of the lesion. patients with suprasacral injury usually suffer from neurogenic detrusor overactivity mostly combined with detrusor sphincter dyssynergia. without adequate treatment, this adverse combination puts the upper urinary tract at risk due to high intravesical pressure often causing vesico-ureteral reflux. based on improved therapeutic options in the last decades, life expectancy and quality of life constantly increased in spinal cord injury patients. the investigators aim to evaluate the bladder function in the long-term after spinal cord injury.

Eligibility criteria:
inclusion criteria: * spinal cord injury for at least 5 years * neurogenic lower urinary tract dysfunction * written informed consent exclusion criteria: * lower urinary tract dysfunction due to other causes than spinal cord injury

Keywords: neurogenic detrusor overactivity detrusor sphincter dyssynergia compliance video urodynamic spinal cord injury
efficacy of volume ventilation in patients with acute respiratory failure at risk of obstructive apneas or obesity hypoventilation

Conditions: Acute Respiratory Failure; Hypercapnic Respiratory Failure; Respiratory Acidosis; Obesity; Hypoventilation Syndrome; Apnea, Obstructive

Summary: this study compares a volume targeted pressure support non-invasive ventilation with an automatic pep regulation (avaps-ae mode) to a pressure support non-invasive ventilation (s/t mode) in patients with acute hypercapnic respiratory failure with acidosis. this study focuses on patients at risk of obstructive apneas or obesity-hypoventilation syndrom (bmi≥30 kg/m²). half of participants (33 patients) will receive non invasive ventilation with avaps-ae mode, the other half will receive non-invasive ventilation with s/t mode.

so far, in respiratory intensive care units, the usual treatment of patients with acute hypercapnic respiratory failure with acidosis is non-invasive ventilation set with a pressure support mode (s/t or vs/ai mode depending on the ventilator manufacturer). avaps-ae mode is a volume targeted pressure support mode with an automatic pep. with the forced oscillations method, the ventilator is able to detect the obstruction and the resistances of upper airways. it allows the ventilator to change its pressure settings to keep the targeted volume and avoid apneas and hypoventilation. that is why in patients with a bmi \> 30 kg/m², at risk of obesity hypoventilation syndrom or obstructive apneas, this ventilation mode may be interesting. avaps-ae has been evaluated in the home ventilation showing it is as efficient as s/t mode in controlling paco2. however it has never been compared to s/t mode in acute respiratory failure care.

Eligibility criteria:
inclusion criteria: * patient of age * patient benefitting of social security * informed patient who signed the information note and the research enlighted consent form * admission in respiratory intensive care unit for an acid-hypercapnic exacerbation (defined by ph≤ 7,35) * bmi ≥ 30kg/m2 * paco2 \> 6.5 kpa on blood gases at icu admission exclusion criteria: * confirmed copd with a spirometry (vems/cvf \< 70%) * pregnant women, or breast-feeding women * patient with a judiciary or administrative liberty deprivation * patients under guardianship * contraindication to niv

Keywords: non-invasive ventilation respiratory failure obese obesity hypoventilation syndrome apnea hypercapnic acidosis avaps-ae vonivoo
personal music for disorders of consciousness

Conditions: Disorder of Consciousness

Summary: background: the evaluation and treatment of disorders of consciousness(doc) is a challenging undertaking. now many neuroimaging techniques were used to detect the level of consciousness and electroencephagram(eeg) was widely used because of its high temporal resolution. music would be an effective for doc, due to its highly arousal value. preferred music was near to persons, so that it would excite more range of cortical and increase the functional connectivity between cortices. methods: the exploratory study included 15 health controls and 30 doc, with 15 minimally conscious state(mcs) and 15 vegetative state(vs). after 5 minutes baseline silence, they listened to relaxing music(rm), preferred music(pm) and amplitude modulated sound(ams), with 5 minutes baseline silence in the end, meanwhile eeg recorded their cortical activity. each music was appropriately 5 minutes and separated by 3 minutes washout. discussion: the study would verify the effect of preferred music to the functional connectivity of doc. music would excite the networks related to consciousness by cross-modal.


Eligibility criteria:
inclusion criteria: 1. being doc less than 1 year and more than 28 days; 2. diagnosis of vs and mcs based on crs-r; 3. the auditory sub-scale of crs-r scoring more than 0, or auditory brainstem response showing no auditory injury at least one side; 4. stopping using sedatives more than 24 hours prior to study; 5. no history of neurological or psychiatric diseases. exclusion criteria: 1. auditory brainstem response showing completely injured auditory pathway(disappeared wave ⅴ); 2. having epilepsy or eeg showing alpha-coma; 3. widely range of injured scalp or bone.

Keywords: doc preferred music functional connectivity