Kornimate/medical-research-clean huggingface dataset:
machine learning model to predict postoperative respiratory failure

Conditions: Noncardiac Surgery

Summary: the main objective of this study is to develop a machine learning model that predicts postoperative respiratory failure within 7 postoperative day using a real-world, local preoperative and intraoperative electronic health records, not administrative codes.

postoperative pulmonary complications are known to increase the length of hospital stay and healthcare cost. one of the most serious form of these complications is postoperative respiratory failure, which is also associated with morbidity and mortality. a lot of risk stratification models have been developed for identifying patients at increased risk of postoperative respiratory failure. however, these models were built by using a traditional logistic regression analysis. a logistic regression analysis had disadvantages of assuming the relationship between dependent and independent variables as linear. recent advances in artificial intelligence make it possible to manage and analyze big data. prediction model using a machine learning technique and large-scale data can improve the accuracy of prediction performance than those of previous models using traditional statistics. furthermore, a machine learning technique may be a useful adjuvant tool in making clinical decisions or real-time prediction if it is integrated into the healthcare system. however, to our knowledge, there was no study investigating the predictive factors of postoperative respiratory failure using a machine-learning approach. therefore, the main objective of this study is to develop a machine learning model that predicts postoperative respiratory failure within 7 postoperative day using a real-world, local preoperative and intraoperative electronic health records, not administrative codes and evaluate its performance prospectively.

Eligibility criteria:
inclusion criteria: * adults patients undergoing general anesthesia for noncardiac surgery exclusion criteria: * age under 18 years * surgery duration \< 1 hr * cardiac surgery * surgery performed only regional or local anesthesia, peripheral nerve block, or monitored anesthesia care * organ transplantation * patient with preoperative tracheal intubation * patients who had tracheostoma prior to surgery * patients scheduled for tracheostomy * surgery performed outside the operating room * length of hospital stay \< 24 h if the patients had multiple surgeries during the same hospital stays, we included the first surgical cases in the dataset.

Keywords: artificial intelligence risk factors postoperative respiratory failure validation
ggt and uric acid to predict gestational diabetes mellitus

Conditions: Gestational Diabetes

Summary: gestational diabetes mellitus (gdm) is a common metabolic complication of pregnancy defined as new onset hyperglycemia during gestation. gdm conveys significant risk of morbidity and mortality for both mother and infant. an estimated 268,900 infants were born to mothers with gdm in the usa, accounting for approximately 6.9% of births. although individual correlations have been found between elevated ggt and uric acid levels and later development of gdm, no research has established and validated combined criteria for ggt and uric acid levels that would lead to their use in identifying women at high risk of gdm in the first trimester. central hypothesis: serum ggt and serum uric acid collected between \>9-14.0 weeks gestation will be significantly elevated in women who later develop gdm compared to those who do not. combined analysis of serum uric acid and ggt levels within the first trimester allows for accurate prediction of the development of gdm. study population includes women between 9-14 weeks gestation undergoing a standard first trimester blood draw. additional blood will be drawn during the standard blood draw to assess ggt and uric acid levels. research participants will be tracked afterwards to determine whether they tested positive for gestational diabetes during the standard testing process which typically occurs at 24-28 weeks gestation. the data will then be analyzed to estimate the sensitivity, specificity, positive and negative predictive values of the first trimester ggt and uric acid tests. the ggt and uric acid levels which maximize the area under the receiver-operator characteristic curve will be identified.


Eligibility criteria:
inclusion criteria: * pregnant women between \> 9 weeks and \< 14.0 weeks gestation exclusion criteria: * known history of or current diagnosis of type i or type ii diabetes mellitus * known liver disease * known kidney disease * known history of or current diagnosis of gout * known history of alcoholism or current alcohol use * multiple gestation * \< 18 years of age

Keywords: pregnancy screening gamma glutamyl transferase serum uric acid sensitivity specificity predictive value
custom-made ceramic barrier vs titanium mesh

Conditions: Bone Loss

Summary: it is a comparative study between custom-made ceramic barrier and titanium mesh for augmentation of atrophic posterior mandible.


Eligibility criteria:
inclusion criteria: * patients with atrophic posterior mandible * both sexes * no intraoral soft and hard tissue pathology * no systemic condition that contraindicate implant placement exclusion criteria: * untreated gingivitis * periodontitis * insufficient oral hygiene * previous radiation therapy * head and neck neoplasia * systemic disorders * heavy smokers * bone pathology * psychiatric problems * emotional instability * unrealistic aesthetic demands
efficacy and safety of the yukon drug eluting stent in diffuse coronary artery disease

Conditions: Acute Coronary Syndromes

Summary: polymer carried by drug-eluting stents may increase inflammatory response and thrombosis. our previous study showed that polymer-free rapamycin-coated stents brings dose-dependent reduction in restenosis. this prospective, multicenter, randomized controlled clinical trials aimed to explore efficacy and safety of the yukon drug eluting stent in diffuse coronary artery disease.


Eligibility criteria:
inclusion criteria: * age from 18-85 years old, male or nonpregnant women * asymptomatic ischemia, stable or unstable angina, old myocardial infarction patients * at least one target lesion length ≥ 20 mm (visual method) * target lesion diameter 2.5mm-4.0 mm (visual method) * target lesion diameter stenosis ≥ 70% * patients who has indications for coronary artery bypass graft (cabg) surgery * patients who is voluntary, understand the purpose of the study, willing to accept angiography and clinical follow-up exclusion criteria: * acute myocardial infarction for less than 1 week * bridge vascular disease * in-stent restenosis lesions * patient with bleeding tendency, history of active peptic ulcer, history of cerebral hemorrhage or subarachnoid hemorrhage, history of stroke within half year, contraindications to anticoagulant therapy and antiplatelet * allergic to aspirin, clopidogrel or ticlopidine, heparin, contrast agent, rapamycin and metal * life expectancy is less than 12 months * patient who has participated in other clinical trials but does not meet the deadline of the primary endpoint * poor patient compliance * heart transplant recipient * patient who had other stent implanted within 1 year * patient who has multi-vessel disease(long lesions) and has already received other stent implantation

Keywords: acute coronary syndromes drug eluting stent diffused lesion
a study on anticholinergic use: attribution of overactive bladder (oab) medications to the anticholinergic burden

Conditions: Overactive Bladder (OAB)

Summary: outpatients with at least one dispensing record of any medication will be included in the study. an index date will be assigned to each participant and prescription records for anticholinergics will be used in the study.


Eligibility criteria:
inclusion criteria: * have at least one dispensing of any medication between january 22, 2016 and december 31, 2016. inclusion criteria for korea: * have at least one dispensing of any medication between january 1st, 2016 and december 31, 2016. * participant was diagnosed with oab (icd-10 n32.8, n31.0, n31.1, n31.2, n31.8, n31.9, n32.9, n39.8 and n39.40) at index date. * participant did not have dispensing record of an oab medication during the washout period (6 months prior to the index date). exclusion criteria: * participants who do not have a complete year of data availability in the database prior to index date. * have record of hospitalization on the index date. exclusion criteria for korea: * participant was hospitalized on the index date. * participant did not have an active insurance status during the washout period or on the index date. * participant received onabotulinumtoxin a and/or surgical intervention as part of the oab treatment during the washout period. * participant was diagnosed with stress incontinence (icd-10 n39.3 or equivalent) or had dispensing record of medication for stress incontinence (duloxetine) during the washout period. * participant was diagnosed with urinary tract infection (icd-10 n30.0 and n39.0 or equivalent) during the washout period or on the index date.

Keywords: anticholinergic burden anticholinergic overactive bladder
use of flexhd as post trapeziectomy spacer

Conditions: Osteoarthrosis of the Carpometacarpal Joint of the Thumb

Summary: the objective of this study is to show that using flexhd® (or hadm) to fill the empty space created by removal of the trapezium improves the subject's outcome and subsequent functionality of the basilar joint arthroplasty procedure.

subjects will be followed for 12 months post basilar joint arthroplasty procedure with an interposition arthroplasty technique using a spacer constructed from human acellular matrix (hadm). their postoperative dash scores, grip strength, pinch strength, pain scale scores, quality of life and trapezial space on radiographs are compared to their preoperative scores. study visits will coincide with standard clinical course visits including: pre-operative visits and follow-up visits at week 6, month 6, and year 1 post-operatively.

Eligibility criteria:
inclusion criteria: * male or female \>18 years of age * be willing to undergo thumb basilar joint arthroplasty with the use of acellular dermal matrix * basilar joint arthritis eaton stage iii or iv * be in good health other than the arthritis * have realistic expectations of surgical results * understand and be willing to follow all aspects of the study protocol and have signed and dated the irb-approved informed consent form and the authorization for use and release of health and research study information (hipaa) form prior to any study-related procedures being performed exclusion criteria: * have collagen-vascular, connective tissue, or bleeding disorders * be a smoker or have smoked in last 2 months * have any disease, including uncontrolled diabetes, which is clinically known to impact wound healing ability * have regional sympathetic dystrophy * be pregnant, lactating or expecting to be within the next 24 months

Keywords: thumb arthritis cmc arthritis arthroplasty
can epidermal growth factor receptor improve the postoperative survivorship for inoperable non-small cell lung cancer with spinal metastasis ?

Conditions: Is Targeted Therapy Increasing Survival Inoperable Nonsmall Cell Lung Cancer With Spinal Metastasis ?

Summary: not significantly increased survival in t/t


Eligibility criteria:
inclusion criteria: * nsclc with spinal metastasis exclusion criteria: * brain metastasis and expected survival \< 3 months
immunotherapy of hla-a2 positive stage ii-iv melanoma patients

Conditions: Melanoma

Summary: the purpose of this study is to determine whether vaccination with tumor antigenic peptides and both imp321/lag-3 and montanide adjuvants can induce an immune response in melanoma patients and to assess the safety and tolerability of this vaccination. tumor responses following this vaccination will also be documented.

the primary objective of this study is: * to evaluate melanoma antigen specific immune response induced by this vaccination with tumor antigenic peptides derived from mage-a3 (melanoma antigen family a3) (mhci: mage-a3.a2 and mhcii: mage-a3.dp4), ny-eso-1 (new york esophageal squamous cell carcinoma antigen-1), melan a (analog ela and native eaa) and na-17a with imp321 (immufact)/ lag-3ig (lymphocyte activation gene-3 immunoglobulin-like domains) as adjuvant/immunostimulant, formulated with montanide isa-51. * to assess the safety and tolerability of this vaccination the secondary objective is to document tumor responses in patients following this vaccination.

Eligibility criteria:
inclusion criteria: * histologically confirmed stage ii, iii or iv melanoma patients. * tumor expression of melan-a. * human leukocyte antigen-a2 (hla-a2) positive. * expected survival of at list 3 months. * karnofsky scale performance status of 70 % or more. * age ≥ 18 years. * able to give a written informed consent. * the following laboratory results: hemoglobin ≥ 100g/l, neutrophil count ≥ 1.5 x 109/l, lymphocyte count ≥ 0.5 x 109/l, platelet count ≥ 100 x 109/l, serum creatinine ≤ 2 mg/dl (0.18mmol/l), serum bilirubin ≤ 2mg/dl (0.034mmol/l), granulocyte count \> 2.5x109/l, aspartate amino transférase (asat), alanine amino transferase (alat) \< 2.5 x upper limit of normal, activated partial thromboplastin time (aptt) within the normal ranges ±25%, thromplastin (tp) ≥ 80% exclusion criteria: * clinically significant heart disease. * serious illness, eg. serious infections requiring antibiotics, uncontrolled peptic ulcer, or central nervous system disorders. * history of immunodeficiency disease or autoimmune disease. * metastatic disease to the central nervous system, unless treated and stable. * known hiv positivity. * known seropositivity for hepatitis b surface antigen. * concomitant treatment with steroids, antihistamine drugs. topical or inhalation steroids are permitted. * participation in any other clinical trial involving another investigational agent within 4 weeks prior to enrollment. * pregnancy or lactation. * women of childbearing potential not using a medically acceptable means of contraception. * psychiatric or addictive disorders that may compromise the ability to give informed consent. * lack of availability of the patient for immunological and clinical follow-up assessment. * coagulation or bleeding disorders. * kidney dysfunction with creatinine \> 2 x the upper limit of the normal value. * reported strong (allergic) reactions to previous vaccination.

Keywords: melanoma stage ii-iv immunotherapy vaccination hla class i and ii tumor-specific peptides imp321 montanide isa-51
asses the impact of early starting erythropoetin in the reduction of transfusions blood in childrens

Conditions: Anemia; Neoplasms; Chemotherapeutic-Induced Anemia

Summary: anemia is a frequent complication among cancer patients, both as a result of the malignancy of the disease and the aggressiveness of the treatment. regardless of the degree of anemia, cancer patients produce less erythropoietin (epo) and, consequently, cannot compensate for the deficit in the production of red blood cells, a situation that can worsen in presence of inflammation or infection. in the pediatric oncology population, studies vary in relation to anemia treatment protocols, indications for starting treatment and even there is no robust evidence that treatment with erythropoiesis stimulators results in increased hemoglobin levels, even in mild and moderate anemia, with improvement in quality of life scores and fatigue. therefore, the proposed study aims to test the efficacy and safety of erythropoietin therapy in the treatment of cancer-related anemia in children and adolescents aged 2 to 17 years. as a secondary objective, to evaluate the benefit of early initiation of epo (hb\<12g/dl) in children undergoing chemotherapy in improving quality of life and reducing fatigue. for the evaluation of secondary outcomes, the student's t test can be applied and analyzes of variance or covariance (anova or ancova) (with treatment group as a factor, and baseline hemoglobin level as a covariate) will be used to compare the outcomes of efficacy defined by variation (change) time point post versus baseline between 2 groups. adjusted means ("least square means") with 95% ci will be reported. when applicable, secondary outcomes defined by continuous variables evaluated over time (3 or more instants) will be analyzed using mixed model analysis of variance for repeated measures


Eligibility criteria:
inclusion criteria: * children between 2-17 years old * hemoglobin \<12g/dl * solid tumors without bone metastasis * being on current chemotherapy treatment * adequate serum levels of iron, folic acid and vitamin b12 * signature of the free and informed consent form by the person responsible and term of assent by the patient exclusion criteria: * refusal to sign the free and informed consent form and/or term of assent * estimated survival less than 12 weeks * previous adverse reactions associated with epo * estar em uso de epo e inibidores do fator de indução de hipóxia.

Keywords: children anemia chemotherapy treatment quality of life erythropoietin
ranibizumab as a rescue therapy for diabetic macular edema

Conditions: Diabetic Macular Edema

Summary: treatment with ranibizumab of the residual diabetic edema in patients with failed response to bevacizumab.


Eligibility criteria:
inclusion criteria: subjects will be eligible if the following criteria are met: 1. age \> 18 years 2. diagnosis of diabetes mellitus (type 1 or 2) 3. residual edema as determined by mean foveal thickness on spectralis oct (optical coherence tomography) \> 300 microns and leakage seen on fa at baseline 4. clinical evidence of retinal thickening due to macular edema involving the center of the macula, associated with diabetic retinopathy. 5. previous history of at least 3-5 or more consecutive 1.25 mg of intravitreal bevacizumab injections for the treatment of diabetic macular edema (consecutive injections administered no more than 6 weeks apart). 6. bcva of 20/32-20/400 using early treatment diabetic retinopathy study (etdrs) 7. media clarity, pupillary dilation and patient cooperation sufficient to allow oct testing and retinal photography exclusion criteria: 1. pregnancy (positive pregnancy test) or known to be pregnant; also pre-menopausal women not using adequate contraception. 2. participation in another ocular investigation or trial simultaneously. 3. systemic use of anti-vegf within 3 months prior to day 0. 4. blood pressure \> 180/110 (systolic above 180 or diastolic above 110) 5. any condition that, in the opinion of the investigator, would preclude participation in the study (e.g. chronic alcoholism, drug abuse). 6. evidence of vitreoretinal interface abnormality after ocular exam or oct that may be contributing to the macular edema. 7. an eye that, in the investigator's opinion, has no chance of improving in visual acuity following resolution of macular edema (e.g. presence of subretinal fibrosis, ischemic maculopathy or geographic atrophy). 8. presence of another ocular condition that may affect the visual acuity or macular edema during the course of the study (e.g. age-related macular degeneration, uveitis, irvine-gass). 9. evidence of active neovascularization of the iris or retina. 10. evidence of central atrophy or fibrosis in the study eye. 11. presence of substantial cataract, one that might decrease the vision by 3 or more lines of vision at sometime during the study. 12. history of vitreous surgery in the study eye. 13. history of cataract surgery within 6 months of enrollment. 14. history of yag capsulotomy within 2 months of enrollment.

Keywords: diabetes edema ranibizumab bevacizumab refractory
ultrasound guided microwave ablation of splenomegaly in children

Conditions: Splenomegaly; Congestive, Chronic; Panhematopenia; Splenic; Portal Hypertension

Summary: children with liver cirrhosis frequently develops portal hypertension. one of the serious complications to portal hypertension is splenomegaly, which may result in pancytopenia, especially thrombocytopenia that may cause bleeding tendencies. symptomatic splenomegaly is often treated with partial splenic embolization (pse). pse is effective but may give rise to postembolization syndrome not well tolerated in the pediatric population. in adults, microwave ablation (mwa) has been used to treat splenomegaly with promising results but with less post-operative pain. our study is a pilot trial to evaluate the feasibility and acceptability of this treatment in children.

the ablation will be performed under general anesthesia by an experienced interventional radiologist. ultrasound will be used for peri-operative assessment and the microwave antenna will be inserted under ultrasound guidance focusing on the middle to inferior part of the spleen to avoid harm to the diaphragm. after the emission of microwaves for up to 5 minutes, the antenna will be pulled back and the emission will be repeated until the ablation zone is approximately 1 cm from the splenic surface. in this way, two or three overlapping areas will be ablated with every insertion of the antenna. the ablation zones will be visible as hyperechoic areas on b-mode ultrasound during operation, and the goal is to ablate up to 40-50% of the total volume of the spleen (as estimated by the radiologist). if the ablated volume is less than 40-50% at follow up, the procedure can be repeated in a second session for additional effect.

Eligibility criteria:
inclusion criteria: * spleen length \> +2 standard deviations of normal limit * platelet count below 30-35 x 109 cells/l and a history of bleeding tendencies * symptoms of portal hypertension such as splenomegaly, thrombocytopenia, leucopenia, ascites, esophageal or gastric varices, hypertensive gastropathy, anal hemorrhoids and increased portal scintigraphy index, where alternative methods have not been enough or suitable * a necessity for reduction of splenic volume due to splenic inhibition of motion and activity in the child exclusion criteria: * age younger than 10 or older than 17 years of age * legal guardians or child do not give consent * ongoing infection

Keywords: microwave ablation
internal carotid artery blood flow in robot-assisted laparoscopic prostatectomy

Conditions: Prostate Cancer

Summary: the purpose of this study is to evaluate the change of the internal carotid artery blood flow according to the steep trendelenburg position and pneumoperitoneum in patients undergoing robot-assisted laparoscopic prostatectomy.


Eligibility criteria:
inclusion criteria: * patients who have undergone robot-assisted laparoscopic prostatectomy with prostate cancer and who are 20 years or older and under 80 years * patients who agree to voluntarily participate in this study * patients with asa class 1-2 exclusion criteria: * history of diagnosis of cerebrovascular disease * patients who refused to participate in clinical studies