Kornimate/medical-research-clean huggingface dataset:
the diagnostic and prognostic utility of procalcitonin (proct) for ventilator-associated pneumonia (vap)

Conditions: Ventilator Associated Pneumonia

Summary: our aim in this study is to investigate the potential role of serum proct as an early diagnostic marker and later prognostic indicator for vap.

ventilator-associated pneumonia (vap), a bacterial infection that develops after 48 hours or more of intubation, is associated with high morbidity and mortality. rapid identification of vap is required to improve survival and to reduce avoidable treatment-associated side effects. procalcitonin (proct), a blood test, is a reasonably specific marker of bacterial infection and its level increases early in sepsis. in this study, a proct serum level will be measured in 50 patients with clinically suspected vap. we aim to show that the proct level will be high early in vap and will stay high in patients with poor prognosis. this will help to address the potential role of proct as part of early diagnosis and management of vap.

Eligibility criteria:
inclusion criteria: in the preceding 24 h, the appearance of a new opacity or opacities on chest x-ray when compared to previous, and two of the following: 1. white blood cell count \> 12 or \< 5 x 10\^9 cells/l, 2. temperature \> 38°c or \< 35°c, or 3. purulent secretions.endotracheal samples must be collected by bronchoscope/bronchoalveolar lavage with quantitative culture or endotracheal aspiration with quantitative culture (when available) or qualitative culture from each patient to be enrolled in the study. this is a routine procedure done in every case of suspected vap and is considered to be the standard of care. exclusion criteria: 1. known underlying chronic inflammatory condition of the lung (e.g., sarcoidosis, vasculitis) 2. thyroid cancer patients 3. neutropenia (neutrophils \< 0.5 x 10\^9 cells/l 4. concomitant aids 5. solid organ transplantation with severe immunosuppression 6. new antibiotic use for more than 18 hrs before blood sample collection 7. severe pancreatitis 8. attending physician does not agree with enrollment into the study.

Keywords: ventilator associated pneumonia. procalcitonin.
child development and genetic biomarkers(ii): gene verification and data integration

Conditions: Developmental Disabilities

Summary: the aims of the study include (1) identifying genes associated with child development and developmental delay in taiwan (2) comparing the differences and similarities between genetic biomarkers of development and developmental delay for children in taiwan and children from other countries (3) employing precision medicine as the method for genetic screening or test and (4) tracking children's biological, psychological and social adjustment, especially for those who have early-onset developmental delay.

the aims of the study include (1) identifying genes associated with child development and developmental delay in taiwan (2) comparing the differences and similarities between genetic biomarkers of development and developmental delay for children in taiwan and children from other countries (3) employing precision medicine as the method for genetic screening or test and (4) tracking children's biological, psychological and social adjustment, especially for those who have early-onset developmental delay. the study will be completed in two phases over three years and will enroll a total of 475 0\~40-year-old participants. in the first phase, we will recruit 380 participants. including 50 participants with typical development, 300 participants with developmental delay and 30 parents to whom have children with severe dd. then, their genetic data will be compared with genetic data of chang gung hospital and the national center for genome medicine, expect to preliminary find genes associated with child language development. at the same time, 20-30 children with severe developmental delay or have family history of developmental delay will be selected as a pilot study, using whole-exome sequencing (wes) to find other genes associated with development. if the gene deficiency was found in the children, we will invite his or her parents to do wes. in the second phase, we will establish a gene panel according to the genes identified in the previous stage and recruit 95 children with developmental delay to test the gene panel prospectively. the long-term goal of this study is to establish a pioneer study for children

Eligibility criteria:
inclusion criteria: * consent signing * 0-40 years old * typical development or developmental disabilities exclusion criteria: * central nervous disease * neuromuscular disease * congenital disease * sensory disorder such as blindness or hearing impairment
anaerobic exercise and mental acuity

Conditions: Depression; LPS; Mood

Summary: this is a randomized controlled trial to examine the effect of anaerobic activity (e.g., weight training) on gut microbiome metabolism and neurological health in healthy sedentary men.

the human gut microbiome, which houses over 2,000 distinct bacterial species, has recently been characterized as a highly influential force on the health and longevity of its host. by way of several distinct pathways comprising the "microbiome-gut-brain axis", this diverse population is known to communicate with the human brain in a bidirectional manner and is implicated in the pathophysiology of several metabolic and psychological disease states. the ability to support a healthy, diverse microbiome through modifiable behavioral interventions - such as diet and exercise - is a topic of growing interest. most of the evidence pertaining to the relationship between physical activity and the gut-brain axis at this time, however, investigates the influence of aerobic exercise providing limited insight to how other modalities of physical activity may differ. specifically, this study will examine the impact of an 8-week weight training protocol on gut microbiome metabolism and neurological health in healthy sedentary men. participants will be randomly assigned to the intervention group or the waitlist control group.

Eligibility criteria:
inclusion criteria: * free of any existing medical diagnoses * willing and able to participate in moderate to vigorous exercise as determined by the acsm health/fitness facility preparticipation screening questionnaire * sedentary (defined as a score \<14 on the godin-shepard leisure time physical activity questionnaire (gsltq)) * equipped with access to a complete gym exclusion criteria: * antibiotic use within the past six months * prebiotic, probiotic, or high-dose antioxidant supplementation within the past 6 months * smoker (cigarettes and/or marijuana) * regular laxative use * blood pressure \>129/80 at baseline
wound catheter vs la bolus in renal transplant: rct

Conditions: Wound

Summary: pain control is an important part of patients' care after a kidney transplant. currently patients receive a one off injection of local anaesthetic (la) in the wound at the end of the operation followed by intravenous morphine through a patient controlled analgesia system (pcas), a button pressed to provide a calculated dose with lock out times for safety. through this study the aim to test the efficiency of continuous local anaesthetic infiltration via wound catheter (lawc) which is a method to deliver local anaesthetic over a longer period of time after the operation. lawc are currently in use in a variety of surgical specialities including liver surgery. patients participating in this study will be allocated randomly to one of 2 groups; one will receive la at the end of the operation as per current practice and one will receive lawc. it then compare outcomes such as the the dose of morphine required in the pcas, quality of pain control and improvement in recovery.


Eligibility criteria:
inclusion criteria: * primary kidney transplantation * single kidney transplantation * signed informed consent exclusion criteria: * midline laparotomy * dual kidney transplantation * kidney re-transplantation * multi-organ transplantation * patients on long term opiates * patients with psychiatric illness
eradication efficacy and safety of two rescue treatments for helicobacter pylori infection

Conditions: H. Pylori Infection

Summary: the aim of this study was to evaluate the efficacy and safety of high-dose dual therapy compared with furazolidone-based quadruple therapy as a rescue treatment for helicobacter pylori infection.

helicobacter pylori (h. pylori) infection is common worldwide and is strongly associated with peptic ulcer and gastric cancer. the eradication rate of h. pylori treatment is limited in the recent years although standard first-line therapy is used. there is a growing antibiotic resistance due to antibiotic consumption for other infections. the failure of first-line therapy for h. pylori can significantly limit the efficacy of the subsequent rescue therapies. h. pylori resistance to amoxicillin (amo), both primary and acquired, have been reported to be uncommon. the bactericidal effect of amo against h. pylori is ph- and time- dependent with a sustaining higher intragastric ph. thus, the therapy consisting of high-dose ppi and amo may have advantage over the currently recommended furazolidone-based quadruple therapy.

Eligibility criteria:
inclusion criteria: * the patients who were diagnosed with persistent h. pylori infection and had previously failed one or more courses of eradication therapies that included amoxicillin, clarithromycin, or nitroimidazole. exclusion criteria: * age \< 18 years old. * the time frame was less than 6 months from the previous eradication therapy. * the previous eradication therapy included furazolidone. * allergic to the medication. * pregnant or lactating women. * comorbidities of severe conditions like hepatic, renal or cardiorespiratory diseases or malignancy. * administration of antibiotics, bismuth or ppi in the preceding 4 weeks.
the impact of robot-assisted digital education on prenatal women's health literacy

Conditions: Gestational Diabetes Mellitus (GDM)

Summary: this randomized controlled trial evaluates the effectiveness of a robot-assisted digital education program for pregnant women diagnosed with gestational diabetes mellitus (gdm). the intervention aims to reduce anxiety, improve health literacy, and increase satisfaction and acceptance of digital health technologies. participants are randomly assigned to either a robot-assisted education group or a conventional tablet-based video education group. outcome measures include anxiety scores, health literacy scores, and educational satisfaction.

this study implemented a robot-assisted digital education method for teaching about gestational diabetes mellitus (gdm) that was intended to reduce anxiety and encourage healthy behaviors among pregnant women. a randomized controlled trial was conducted to assess the effectiveness of the intervention, where 66 pregnant women from a single hospital were randomly assigned to either the experimental group (n = 32) or the control group (n = 34). the experimental group received health education about gdm using a robot, while the control group received the same health education through video presentations on a tablet. the results showed that the implemented robot-assisted digital education method not only reduced anxiety levels among pregnant women, but also influences their health education satisfaction, health literacy, and acceptance of technology. in the global information age, this study can serve as a reference for educators and researchers at medical institutions interested in tracking long-term health education through technological tools.

Eligibility criteria:
inclusion criteria: * pregnant women aged ≥21 years * diagnosed with gestational diabetes mellitus (gdm) * normal first prenatal ultrasound * taiwanese nationality * provided informed consent exclusion criteria: * non-taiwanese nationality * chronic disease history * cognitive impairment or psychiatric disorder * declined participation
compare sacrospinous fixation versus high uterosacral ligament fixation for uterus vaginal prolapse iii/iv

Conditions: Uterovaginal Prolapse; Prolapse of Vaginal Vault After Hysterectomy; Complete Tear, Sacrospinous Ligament; Uterosacral Ligament; Rupture

Summary: the purpose of this study is to compare the vaginal sacrospinous colpopexy and high uterosacral colpopexy in the treatment of genital prolapse grade iii/iv in women with uterus.

hysterectomy is often the traditional approach for women with uterovaginal prolapse. however, hysterectomy alone does not address the underlying problem of deficient apical support. surgical options for patients with apical prolapse include transvaginal suspension procedures using pelvic structures for fixation, such as the sacrospinous ligament or uterosacral ligaments.the objective of this study is to compare the sacrospinous fixation with high uterosacral in the treatment of uterine prolapse pop-q stage 3 or 4 in terms of recurrence of prolapse,quality of life,complications,post-operative recovery, hospital stay.

Eligibility criteria:
inclusion criteria: * pelvic prolapse iii/iv * counselling and informed consent exclusion criteria: * abnormal cervical smears * abnormal ultrasound findings of uterus or ovaries or abnormal uterine bleeding * pelvic radiotherapy

Keywords: vaginal colpopexy sacrospinous vaginal colpopexy uterosacral
sutureless closure for primary total anomalous pulmonary venous connection

Conditions: Total Anomalous Pulmonary Venous Connection; Pulmonary Venous Stenosis; Sutureless Closure

Summary: the purpose of this study is to assess the percentage of pulmonary venous stenosis after tapvc repair with sutureless closure.

parents of patients with tapvc after repairing by sutureless technique will be informed about the study. if parents agree to participant in the study and sign the informed consent, the investigators will collect information of patients and echocardiography results at 1 month, 6 month, 12 month and 18 month after the operation.

Eligibility criteria:
inclusion criteria: * all patients with tapvc operated with sutureless closure and be agreed to join this study by parents from 01/2019 to 06/2024. exclusion criteria: * tapvc operated with sutureless closure have single ventricle, isomerism or heterotaxy, congenital pulmonary venous stenosis. * tapvc enrolled to study but cannot the obtain the echocardiography at the time of 1 month, 6 month, 12 month and 18 month.

Keywords: tapvc sutureless pulmonary venous stenosis
prediction of cerebral hyperperfusion syndrome after carotid revascularization using deep learning

Conditions: Carotid Artery Diseases; Carotid Atherosclerosis; Carotid Artery Stenosis; Cerebral Hyperperfusion Syndrome

Summary: cerebral hyperperfusion syndrome (chs) was initially described as a clinical syndrome following carotid endarterectomy (cea), but it may present in both cea and carotid artery stenting, and is characterised by throbbing ipsilateral frontotemporal or periorbital headache, and sometimes diffuse headache, eye and face pain, vomiting, confusion, macular oedema, and visual disturbances, focal motor seizures with frequent secondary generalisation, focal neurological deficits, and intracerebral or subarachnoid haemorrhage. knowledge of chs among physicians is limited. most studies report incidences of chs of 1-3% after carotid endarterectomy. chs is most common in patients with increases of more than 100% in perfusion compared with baseline after carotid revascularization procedures and is rare in patients with increases in perfusion less than 100% compared with baseline. the pathophysiological mechanism of chs remains only partially understood. the chronic lowflow state induced by severe carotid disease results in a compensatory dilation of cerebral vessels distal to the stenosis, as part of the normal autoregulatory response, to maintain adequate cerebral blood flow (cbf). in this chronically dilated state, the vessels lose their ability to autoregulate vascular resistance in response to changes in blood pressure. in fact, it has been shown that this dysautoregulation is proportional to the duration and severity of chronic hypoperfusion. after revascularization and reperfusion, the impaired cerebral autoregulation could then contribute to a cascade of intracranial microcirculatory changes, as explained above, with an inability of reaction toward the augmentation of the cbf after the carotid recanalization. although most patients have mild symptoms and signs, progression to severe and life-threatening symptoms can occur if chs is not recognised and treated adequately. because chs is a diagnosis based on several non-specific signs and symptoms, patients may be misdiagnosed as having one of the better-known causes of perioperative complications like thromboembolism.


Eligibility criteria:
inclusion criteria: 1. age from 30 to 80 years 2. has a symptomatic (more than 60%) or a asymptomatic (more than 70%) carotid stenosis 3. permanent residence in the republic of belarus exclusion criteria: 1. patient's unwillingness to continue participating in the study 2. absence of a temporal window for transcranial dopplerography

Keywords: cerebral hyperperfusion syndrome carotid stenosis stroke deep learning
testing informed decision making in lung cancer screening

Conditions: Lung Cancer

Summary: lung cancer screening rates are very low despite the fact that lung cancer screening could save many lives. people need to understand the risks and benefits to screening as well as their own beliefs about screening. this study builds an intervention in real world primary care that will help people make the right decision for them as well as help people to quit smoking. interventions like this are needed to improve the screening rate and reduce death from lung cancer, which is the leading cancer killer.

lung cancer screening rates in the united states are very low- just 3.3% in 2010 and 3.9% in 2015. there is a critical need to develop and implement effective strategies to engage high-risk patients in a coordinated program of lung cancer screening, which includes shared-decision making. the investigators proposed to modify and expand a shared decision- counseling intervention previously developed in one primary care practice. the investigators measured lung cancer screening in our intervention group compared to a propensity-matched usual care cohort. the investigators compared patients recruited to patients who are not in order to identify potential sources of disparity in future work and the investigators developed a more intense smoking cessation component. model interventions for shared-decision making in clinical practice are needed across a wide range of diseases and decisions.

Eligibility criteria:
inclusion criteria: * current or former smoker * greater than or equal to 30 pack years smoking exclusion criteria: * prior ct in last year * quit smoking greater than 15 years ago * current diagnosis of lung cancer
stop ovarian cancer; implementation of the opportunistic salpingectomy in the netherlands

Conditions: Risk Reduction; Ovarian Cancer

Summary: the aim of this study is to optimize implementation of the opportunistic salpingectomy throughout the netherlands.

the investigators aim to optimize implementation of opportunistic salpingectomy throughout the netherlands. the investigators will evaluate the implementation by enrolling patients in a database to evaluate healthcare experiences and to register eoc diagnosis and vital status through yearly palga (the nationwide network and registry of histopathology and cytopathology in the netherlands) and municipal administration searches. in addition, the investigators will perform medical record check to assess which percentage of eligible women have been offered os. the investigators expect that a decision aid will be a necessary tool for the decision whether women opt for an os or not, based on their personal values. after development of the tool(s), the investigators will evaluate the implementation process.

Eligibility criteria:
inclusion criteria: * age from 30 years * undergoing gynaecological surgery in which currently both ovaries and fallopian tubes would be preserved * childbearing completed * able to understand the written or spoken dutch language * consent for enrolment in database * consent for yearly checks of palga database and municipal administration exclusion criteria: * age under 30 years * undergoing surgery without residual ovarian tissue * child wish * unable to understand the written or spoken dutch language * previous bilateral salpingectomy * previous bilateral salpingo-oophorectomy

Keywords: ovarian cancer opportunistic salpingectomy prevention female sterilization risk reduction implementation
effects of interrupting sedentary time on glycemic control in older overweight and obese adults

Conditions: Metabolic Syndrome; Diabetes; Aging

Summary: increasing physical activity in older adults has important implications for treating obesity related metabolic conditions, however the interaction of aging- and obesity-related declines in physical function may make adding structured exercise particularly challenging for this group. given these challenges, an alternative prescription to traditional structured exercise, may be short bouts of intermittent walking scattered throughout the day - this may be an effective strategy to increase physical activity, reduce sedentary behavior, and improve glycemic control in overweight/obese older adults. the purpose of this project is to determine how interrupting sedentary time with short bouts of moderate intensity walking affects important metabolic outcomes in older, overweight adults. it would also be of interest to compare the effects of short, frequent interruptions in sedentary behavior to a traditional exercise prescription (continuous 30 min walking bout) on metabolic outcomes (e.g., glycemic control, insulin sensitivity, and 24 h fat oxidation). thus, the overall aims of the proposed research are to 1) determine the effect of performing short bouts of moderate-intensity intermittent walking (iw) on glucose and insulin metabolism compared to uninterrupted sitting (us) in older overweight and obese adults. 2) to compare the effects of interrupting sedentary time (iw) vs. a traditional exercise prescription (continuous 30 m walk (cw)) on metabolism. the investigators hypothesize that interrupting sedentary time with intermittent walking will improve glucose and insulin metabolism compared to uninterrupted sitting and it will be as effective at improving metabolism as a single continuous 30 min walk.


Eligibility criteria:
inclusion criteria: * aged 60-85 yr • bmi 25-35 kg.m-2 * non-exercisers (\<150 m/wk of moderate intensity exercise) * sedentary (\>60% of waking day sedentary) * able to walk on a treadmill for 36 continuous minutes at a pace of at least 2.0 mph exclusion criteria: * self-reported acute or chronic disease (e.g. diabetes, heart disease, thyroid disease) * fasting plasma glucose ≥ 126 mg/dl - participants will not be excluded if they an abnormal post prandial glucose levels (e.g. glucose ≥ 200 mg/dl) following the mtt's. * tobacco use (cigarettes, cigars, or chewing tobacco) within the past 6 months * females who previously used (\> 6 months) or are currently using any formulation of estrogen-based hormone therapy (e.g., oral premarin, transdermal 17-estradiol, selective estrogen receptor modulators). * resting diastolic blood pressure \> 100 mm mercury or resting systolic blood pressure \> 160 mm mercury * contra-indications to exercise (e.g. orthopedic limitations) * unable to walk on a treadmill for 36 continuous minutes at a pace of at least 2.0 mph

Keywords: sedentary behavior physical activity older adults