Kornimate/medical-research-clean huggingface dataset:
predicting the effect of laser peripheral iridotomy

Conditions: Glaucoma

Summary: this study will compare the angle parameters of patients with pacs before and after lpi. the investigators will analyze the results of patients with different angle closure mechanisms before and after lpi, and participants hope to find the structural parameters for predicting the effect of lpi.

primary angle-closure glaucoma is the leading cause of blindness worldwide. it is associated with increased intraocular pressure, which causes optic nerve damage and field defects if untreated. the aqueous humor leaves the anterior chamber through the trabecular meshwork and flows into the aqueous vein and the superior scleral vein through the collector channels and schlemm's canal. if the trabecular meshwork is not blocked, a wide angle allows enough aqueous humor to drain out. the iris corneal translocation may lead to angle-closure glaucoma. laser peripheral iridectomy is recognized as the best surgical method to relieve pupil block. previous studies have shown increased anterior chamber depth (acd), area (aca), and volume (acv), and increased angle open distance (aod) after lpi surgery. however, postoperative outcomes of lpi were not the same for patients with different angle closure mechanisms. postoperative outcomes for lpi were best for patients with pupillary block type, but were moderate for patients with plateau iris group and mixed group. the purpose of this study, conducted in chinese subjects, aims to use ubm to evaluate changes in the anterior segment parameters of lpi, and to propose methods to predict postoperative outcomes of lpi.

Eligibility criteria:
inclusion criteria: 1. patient was diagnosed of primary angle closure angle suspect; 2. received ultrasound biomicroscopy before and after laser peripheral iridotomy; 3. voluntary participation in this study; 4. have enough language comprehension ability; 5. patient or his legal representative has sign the informed consent. exclusion criteria: 1. severe health problems resulting in a life expectancy of less than 1 year; 2. previous intraocular surgery or penetrating eye injury; 3. media opacity preventing laser peripheral iridotomy; 4. researchers think not suitable to participate in this clinical trial subjects; 5. refused to sign the informed consent.; 6. there are important viscera function failure or other serious disease, including clinical related coronary artery disease, cardiovascular disease or myocardial infarction into the group of the first six months; serious neurological or psychiatric illness; serious infections; coagulant function abnormality; general active infectious diseases; malignant tumor; serious immune diseases.

Keywords: laser peripheral iridotomy primary angle closure suspect angle closure mechanism
role of ultrasound elastography in pleural effusion

Conditions: Pleural Effusion

Summary: diagnostic performance of u.s elastography in pleural effusion

pleural fluid is an extremely common problem however the diagnosis of pleural effusion remain challenging due its diverse aetiologies .transthoracic ultrasound is often the initial tool to help diagnosis of pleural effusion. ultrasound elastography is a novel ultrasound technology that can differentiate malignant disease from benign disease by quantitatively assses tissue stifness by measuring the degree of distortion under application of an external force (shear wave ) however, very limited studies are available evaluating the efficacy of this novel technique in diagnosis of malignant pleural effusion.

Eligibility criteria:
inclusion criteria: .patients with pleural effusion above18 year exclusion criteria: * patients who refuse to undergone further investigations to reach final diagnosis of cause of pleural effusion .patients with intercostal tube inserted in the effusion before enrollment in the study.
nano-hydroxyapatite and ozone - effect on approximal initial caries

Conditions: Caries,Dental

Summary: objectives: to assess the efficiency of three methods of enamel remineralization on initial approximal caries: 1. a nano-hydroxyapatite gel, 2. gaseous ozone therapy 3. combination of a nano-hydroxyapatite gel and ozone. materials and methods: patients (n=92, age 20-30y) with initial approximal enamel lesions on premolar and molar teeth (n=546) randomly allocated to three groups subjected to a 6-months treatment: group i: domestic nano-hydroxyapatite remineralizing gel, group ii: in-office ozone therapy, group iii: both remineralizing gel and ozone therapy. caries lesions assessed on bitewing radiographs at baseline, after 1 year and after 2 years.


Eligibility criteria:
inclusion criteria: -initial approximal enamel lesions on premolar and molar teeth exclusion criteria: * distal surface of the last tooth in arch, overlapping teeth * fillings on approximal surfaces of teeth of interest * ongoing orthodontic therapy with braces or other appliances
recovery improved in covert stroke with exercise

Conditions: Cerebral Small Vessel Diseases

Summary: silent ischemic, also known as "covert stroke vascular disease" (csvd), contributes to neurological deficits that are caused by damage to small blood vessels in the brain. csvd occurs six to ten times more often that an acute stroke. it is misleading to think, however, that csvd is an inevitable part of "getting old" because people with csvd are at high risk of developing an acute stroke or dementia. in fact, people with more csvd lesion volume are more likely to develop day to day problems in planning, decision-making and speed of thinking. unfortunately, there are no proven therapies designed to address csvd. we propose to test whether aerobic exercise is an intervention that can combat csvd because the disease is fundamentally a blood flow problem that may be improved by aerobic exercise. we will recruit csvd adults with moderate to severe lesion burden and use magnetic resonance imaging (mri) to study the brain in terms of structure, perfusion and function. participants will be randomly assigned to either our established aerobic exercise program or a control stretching program. both groups will take part in lab exercise sessions, which are designed to monitor progress and assess adherence to the program. the duration and intensity of their exercise will increase as participants progress. we will use activity log books, phone calls and extra "booster" exercise sessions, as needed, to maximize retention and adherence. we aim to show that aerobic exercise increases cerebral blood flow (cbf) in frontal-subcortical grey matter, supports regional tissue growth, and improves cognitive function in csvd adults with substantial risk of acute stroke and dementia. a positive outcome of this research will provide strong support for additional clinical trials aimed at sustaining cognition and maintaining independent living.


Eligibility criteria:
inclusion criteria: * covert stroke: white matter hyperintensities of presumed vascular origin * ability to walk for 10 minutes without assistance from another person * fluent in english * ability to consent exclusion criteria: * highly fit individuals exercising ≥ 150 minutes per week * dementia * multiple sclerosis * disabling stroke (ischemic or hemorrhagic) * major concurrent illness (e.g. chronic obstructive lung disorder, current or metastatic cancer, chronic kidney disease) * major psychiatric illness (e.g. bipolar, schizophrenia, major depression) * contraindications to mri scanning (e.g. claustrophobia, implants, prostheses, metallic fragments) * contraindications to exercise (participants must have medical clearance to exercise from their attending physician) * recent change in health status (e.g. hospitalization within past month)

Keywords: covert stroke cerebral blood flow grey matter attention executive function aerobic exercise
comparing the adenoma detection rate with air insufflation, water immersion and water exchange

Conditions: Adenoma

Summary: interval (missed) cancers and lower than expected mortality reduction of proximal colon cancers in the united states and elsewhere after screening colonoscopy drew attention to quality indicators. missed adenomas which are more likely to be in the proximal colon may be contributing factors. an independent predictor of the risk of interval cancers is adenoma detection rate. in pilot observations, the investigators showed that water exchange enhanced adenoma detection in the right colon (cecum to hepatic flexure). this prospective, randomized controlled trial will compare water exchange with water immersion and traditional air insufflation in patients undergoing colonoscopy. the investigators test the hypothesis that compared with air insufflation and water immersion, water exchange produces a significantly higher adenoma detection rate in the right colon.

all of the procedures will be recorded and stored as digital files.

Eligibility criteria:
inclusion criteria: * patients undergoing colonoscopy performed by the participating endoscopists exclusion criteria: * obstructive lesions of the colon known before colonoscopy * massive ascites * past history of partial colectomy * refusal to provide written informed consent

Keywords: adenoma detection rate colonoscopy water exchange
preoperative treatment with noninvasive intra-auricular vagus nerve stimulation pending bariatric surgery

Conditions: Obesity; Bariatric Surgery

Summary: faced with the current obesity epidemic, new avenues of research into effective weight loss must be developed. among the possible actions on obesity, vagus nerve stimulation has been shown in several studies to be effective in treating epilepsy or depression, at the same time inducing weight loss in those patients. vagus nerve stimulation has also shown to be effective on weight loss in experimental animal studies. vagus nerve stimulation has never been attempted in obese patients awaiting bariatric surgery.

the primary objective is to demonstrate the benefit of transcutaneous vagus nerve stimulation in obese subjects awaiting surgery. secondary objectives include, among others, the risk factors related to obesity, systemic micro-inflammation, insulin and lipid profile.

Eligibility criteria:
inclusion criteria: * any obese patient consulting for bariatric surgery with bmi ≥ 35 and comorbidities or with bmi ≥ 40 * consent form signed exclusion criteria: * permanent atrial fibrillation * patient on treatment that could influence measurement of autonomic nervus system (ans) activity (eg. anti-arrhythmics). * for patients previously operated (by any technique), an interval of at least 6 months since the surgery must be observed * pacemaker * serious cardiac pathology * history of myocardial infarction * history of stroke * severe respiratory insufficiency * allergy in the rhodium and in the gold * surgery of the vagus nerve * pregnant patient

Keywords: obesity bariatric surgery no invasive intra-auricular vagus nerve stimulation weight loss autonomic nervous system
outcomes that matter and questionnaires for older people with frailty

Conditions: Frailty

Summary: the goal of this qualitative study is to investigate what matters to older people living with frailty, and how this can be measured using questionnaires (patient reported outcome measures, or "proms"). the research questions are: 1. what outcomes matter to older adults living with frailty? 2. what are participants' perceptions of proms that could measure these outcomes? our estimated sample will be 15 older adults, approximately 5 people living with mild frailty, 5 living with moderate frailty and 5 living with severe frailty. participants will take part in one 90-minute interview.


Eligibility criteria:
inclusion criteria: * over the age of 65 * indication of frailty in one of the following ways: * clinical diagnosis of frailty * assessment of at least "4" on the clinical frailty scale by a healthcare professional * having mental capacity to consent to participate as defined under the mental capacity act (2005). this will be assessed in the telephone conversation prior to the interview by a researcher who has received mental capacity training * available to be interviewed by face-to-face interview at the national institute of health research (nihr) exeter clinical research facility or as a home visit, or as an online meeting exclusion criteria: * not able to participate in face-to-face interview or use video call technology * not assessed as frail * not able to express thoughts and opinions in sufficient depth for analysis, even with facilitation by a relative or carer. this will be assessed in the telephone conversation with the researcher prior to the interview. * lacking capacity to consent to participate as defined under the mental capacity act (2005). an individual would be unable to participate if they cannot: * understand the information relevant to the decision of participating * retain that information * use or weigh up that information as part of the process of deciding whether to participate * communicate their decision to other people

Keywords: patient reported outcome measures qualitative research frailty health priorities quality of life
effect of sleep deprivation on sensory integration of balance, fall risk and postural stability

Conditions: Sleep Deprivation

Summary: sleepiness caused by sleep deprivation may increase the risk of injuries and damages during physical activity. individual data so far indicates worsening of postural stability and control with females exhibiting better static postural stability regardless of sleeping conditions in comparison to men. however, the literature is deficient in terms of postural stability conditions with eyes open and eyes closed states, as well as fall risk and sensory integration of balance.


Eligibility criteria:
inclusion criteria: * age 19 to 24 * healthy young adults from rawalpindi/islamabad. * both males and females * participants should have normal sleep patterns without any signs or symptoms of insomnia or hypersomnia. * persons without any sleep disorders. * persons without any neurological disease. exclusion criteria: * persons with sleep disorders such as hypersomnia, insomnia, parasomnia etc. * elderly population. * persons with any sort of neurological deficits. * covid positive and those with any suspected signs and symptoms of covid-19. * alcoholics * pregnant females * a participant with the history of or active diagnosed conditions of any of the following, which renders individual's performance will be excluded: * neurological. * musculoskeletal. * cardiopulmonary. * any congenital disorder or limb deformities.

Keywords: sleep deprivation
assessment of early pancreatic cancer prognosis by minimal residual disease using multi-omics approach

Conditions: Pancreatic Ductal Adenocarcinoma

Summary: this trial aims to develop a minimal residual disease (mrd) detection model for predicting recurrence of patients with stage i-ii pancreatic ductal adenocarcinoma after surgery and adjuvant therapy, based on cfdna fragmentation and methylation signal.

the entire study is divided into two stages. stage one is the enrollment period. 51 subjects with pancreatic ductal adenocarcinoma in stages i-ii who have not received neoadjuvant therapy and have undergone radical surgery were enrolled. blood samples at the time point before surgical treatment (t0) were collected and fresh tissue specimens (cancerous tissue and adjacent normal tissue) were collected. blood samples were subjected to methylation, fragment group, and cnv multi-omics testing, and tissue samples were subjected to target methylation area testing. stage two is the follow-up period. blood samples from the fifth week after surgery to before adjuvant therapy (t1) and blood samples from 4-8 weeks after adjuvant therapy (t2) were collected. blood samples were subjected to methylation, fragment group, and cnv multi-omics testing with different techniques. the subjects were followed up for 1.5 years. according to progression and recurrence, the subjects were divided into progression group and non-progression group. methylation and multi-omics prognosis models were trained and compared for their performance in residual detection and recurrence prediction.

Eligibility criteria:
inclusion criteria: 1. patients with clinically and/or pathologically diagnosis of stage i/ii pancreatic ductal adenocarcinoma; 2. aged ≥ 40 years and \< 75 years, both sexes; 3. patients receive radical resection with curative intent, followed by adjuvant therapy; 4. tumour size not less than 1 cm \* 1 cm \* 1 cm and be able to provide surgical tissue samples for molecular testing after pathological evaluation; 5. eastern cooperative oncology group (ecog) score of 0-2; 6. negative margins (r0 or r1) by naked eye or no recurrence/metastasis detected on imaging after surgery or before adjuvant therapy, and ca 19-9\<37 u/ml; 7. patients understand and voluntarily sign the informed consent form and follow the sampling, assessment and visit requirements of this study. exclusion criteria: 1. pregnant and lactating (by self-report); 2. any tumor history of malignancies; 3. positive cutting margins (r2); 4. received neoadjuvant therapy before surgery; 5. not be able to receive radical surgery; 6. organ transplantation history; 7. organ dysfunction (moderate or severe renal impairment with absolute centrocyte count \ 2.5 times upper limit of normal); 8. other conditions deemed unsuitable for enrollment by the investigator.
study of endostar with cisplatin and capecitabine as 1st line treatment in the advanced gastric cancer

Conditions: Advanced Gastric Cancer

Summary: the purpose of this study is to investigate whether endostar (recombinant human endostatin)with cisplatin and capecitabine (xeloda) as 1st line treatment in the advanced gastric cancer is effective and safe.

endostar, a recombinant human endostatin, has shown its antitumor ability in combination in nsclc and breast cancer. but to gastric cancer, few clinical data has been reported. however, bevacizumab, an angiogenesis inhibitor was shown effective in combination with chemotherapy in advanced gastric cancer in some phase ii study. so in this study, we want to explore whether endostar is also effective and safe in advanced gastric cancer. response predictive factor is expected to be identified.

Eligibility criteria:
inclusion criteria: * having signed informed consent * age 18 to 70 years old * histologically confirmed gastric adenocarcinoma * unresectable recurrent or metastatic disease * previous neo-adjuvant or adjuvant treatment for gastric cancer, if applicable, more than 6 months * previous chemotherapy with capecitabine or cisplatin, if applicable, more than 12 months. * measurable disease according to the recist criteria * karnofsky performance status ≥60 * life expectancy of ≥2 month * no prior radiotherapy except radiotherapy at non-target lesion of the study more than 4 weeks * alt and ast\<2.5 times uln (≤5 times uln in patients with liver metastases) * serum albumin level ≥3.0g/dl * serum akp \< 2.5 times uln * serum creatinine \<uln, and ccr \< 60ml/min * bilirubin level \< 1.5 uln * wbc\>3,000/mm3, absolute neutrophil count ≥2000/mm3, platelet\>100,000/mm3, hb\>9g/dl exclusion criteria: * brain metastasis (known or suspected) * previous systemic therapy for metastatic gastric cancer * inability to take oral medication * previous therapy targeting at angiogenesis or vasculogenesis pathway or other targeted therapy * surgery (excluding diagnostic biopsy) within 4 weeks prior to study entry * contraindications of nuclear magnetic resonance image such as fitment of cardiac pacemaker , nerve stimulator, or aneurysm clip, and metallic foreign body in eye ball and so on. * allergic constitution or allergic history to protium biologic product or any investigating agents. * severe heart disease or such history as recorded congestive heart failure, uncontrolled cardiac arrhythmia, angina pectoris needing medication, cardiac valve disease, severe abnormal ecg findings, cardiac infarction , or retractable hypertension. * pregnancy or lactation period * any investigational agent within the past 28 days * other previous malignancy within 5 year, except non-melanoma skin cancer * previous adjuvant therapy with capecitabine+platinum, * pre-existing neuropathy\>grade 1 * legal incapacity
behavioural text messages to improve retention in care in south africa

Conditions: HIV/AIDS

Summary: the proportion of south africans aware of their hiv status and on treatment remains lower than optimal. the goal of this study is to rapidly determine whether text messages framed according to behavioural economics principles increase clinic attendance among recipients of care on antiretroviral therapy in south africa. we hypothesize that messages incorporating behavioural economics principles will increase the likelihood of recipients of care attending clinic appointments and returning within 28 days of a missed appointment.

the objective of this study is to rapidly determine whether text messages framed according to behavioural economics principles increase the likelihood that recipients of care attend their clinic appointment and return to clinic within 28 days of a missed appointment. the study will be nested in a routine hiv program, in approximately 5 selected aurum institute clinics based in ekurhuleni district, gauteng province, south africa. intervention arms will include voice call attempts and one-way text messages sent by clinic staff to recipients of care in two scenarios: 1) approximately 3-7 days in advance of a clinic appointment for collecting antiretroviral medication supplies or collection of a specimen for viral load testing and 2) approximately 24 hours after a missed clinic appointment. this individually randomised trial will have four arms. each time there is an upcoming or missed clinic visit clinic staff will randomly assign recipients of care to one of the following study arms: 1) standard of care 2) loss aversion framed messaging 3) social norms framed messaging or 4) altruism framed messaging.

Eligibility criteria:
inclusion criteria: * registered to receive art (this includes patients receiving art through multi-month scripting) at selected study sites. * aged ≥18 years. * have a documented cell phone number in their clinic records * are eligible to receive appointment reminders as part of routine care or eligible to receive follow-up text messages as part of routine care for missed clinic appointments. exclusion criteria: * do not have contact details in their clinic records. * have contact details on record that are established to belong to someone else upon follow-up (i.e., wrong number). * have contact details that are deactivated/non-functional (i.e., voice notification that the number does not exist). * are documented to have self-transferred out of the clinic. * are known to have been deceased.

Keywords: behavioral sciences retention in care