Kornimate/medical-research-clean huggingface dataset:
association between vitamin d and inflammation and diabetes risk in morbidly obese pre-menopausal women

Conditions: Insulin Sensitivity

Summary: obesity is associated with low-grade inflammation, insulin resistance and low vitamin d status. vitamin d has traditionally been known to involve in calcium homeostasis and prevent rickets; however, recently it has been recognized to inversely associate with many non-skeletal diseases and conditions including obesity and type 2 diabetes (t2dm). in vitro studies have demonstrated that vitamin d possesses anti-inflammatory properties. it remains unknown if the effect of vitamin d on insulin sensitivity is mediated by suppressing inflammation in human adipose tissues. the main objective of this study was to assess the association between vitamin d and insulin sensitivity and inflammation in morbidly obese pre-menopausal women. obese women (n=76) were recruited from the university of illinois at chicago (uic) nutrition and wellness center and the uic medical center bariatric surgery clinics. insulin sensitivity/resistance was assessed by (1) oral glucose insulin sensitivity (ogis) index, derived from dynamic oral glucose tolerance test (ogtt), and (2) homeostasis model of insulin resistance (homa-ir), calculated from fasting steady-state glucose and insulin. also, to better understand the potential mechanism and the role circulating vitamin d (25ohd) plays in adipose tissue inflammation, we assessed messenger ribonucleic acid (mrna) expression of vitamin d receptor (vdr) and various inflammatory genes in visceral (vat) and subcutaneous adipose tissues (sat) of obese women that underwent a restrictive bariatric procedure. we hypothesized that subjects with higher serum vitamin d levels would be less inflamed and more insulin sensitive and have increased expression of vdr and pro-inflammatory markers compared to those with lower serum vitamin d levels.


Eligibility criteria:
inclusion criteria: * premenopausal women between the age of 21 and 49 years old * bmi \>=35(kg/m2) * not pregnant * english speaking * approved for a bariatric surgery exclusion criteria: subjects with: * diabetes * cancer * kidney disease * liver disease * gallbladder disease * rheumatoid arthritis * hiv/aids * crohn's disease or inflammatory bowel disease * subjects taking anti-inflammatory medications

Keywords: vitamin d deficiency inflammation obesity
a comparative study of indobufen and aspirin in patients with coronary atherosclerosis

Conditions: Coronary Atherosclerosis

Summary: in addition, studies have found that indobufen can inhibit coagulation function in rats. compared with aspirin, the duration of antiplatelet efficacy of indobufen was shorter, and the platelet function recovered completely 24 hours after drug withdrawal. however, there are few studies on the antiplatelet efficacy of indobufen. the investigators' previous study found that the inhibitory effect of indobufen 100 mg bid on cox system in atherosclerosis or healthy volunteers was equivalent to that of aspirin 100 mg qd, but the inhibitory effect on platelet cox-1 channel was significantly weaker than that of aspirin 100 mg qd. in view of this, this study intends to investigate the antiplatelet effect of indobufen 200 mg bid in patients with coronary atherosclerosis by comparing it with conventional-dose aspirin 100 mg qd.


Eligibility criteria:
inclusion criteria: 1. clinical diagnosis of coronary atherosclerosis without indications for stent implantation. 2. age ≥ 18 years, ≤ 65 years 3. sign informed consent exclusion criteria: 1. a history of asthma or allergic constitution or known allergy to indobufen or aspirin. 2. high risk of bleeding (low hemoglobin 10g / l, history of peptic ulcer disease, fecal occult blood positive or known active bleeding, history of cerebral hemorrhage within 6 months, history of fundus hemorrhage, etc). 3. creatinine was 1.2 times higher than the upper limit of normal value and alt was 1.2 times higher than the normal value. 4. history of smoking and alcoholism. 5. history of diabetes. 6. pregnancy and lactation women. 7. nonsteroidal anti-inflammatory or other antithrombotic drugs other than indobufen are required. 8. any other reason may affect the results of this study.

Keywords: light transmittance aggregometry indobufen aspirin plasma thromboxane urine 11-dehydro thromboxane
testing strategies to encourage weight loss in an employer setting

Conditions: Weight Loss

Summary: this is a 3-arm pilot randomized controlled trial to evaluate the effectiveness of two novel ways of structuring financial incentives to motivate and sustain long-term weight loss. the study will recruit eligible employees at children's hospital of philadelphia (chop) to participate in a 6-month weight loss program and an additional 3-month follow-up period. the primary outcome measure in this randomized control trial will be pounds of weight lost between baseline and 6 months. the goal of this study is to evaluate whether a novel financial incentive program delivered through a workplace can effectively encourage sustained weight loss among obese employees. the study hypotheses are 1) mean weight loss will be greater in all the intervention groups compared to the control group by the end of the 24-week intervention period; and 2) individuals in the intervention groups will have a lower mean weight at the end of the 12-week follow-up period than individuals in the control group.


Eligibility criteria:
inclusion criteria: * aged 18 to 70 (inclusive) * bmi between 30 and 40 (inclusive) exclusion criteria: * inability to consent * illiteracy and/or inability to speak, read, and write english * participation in another research study * current treatment for drug or alcohol use * consumption of ≥ 5 alcoholic drinks per day * myocardial infarction or stroke within the past 6 months * current addiction to prescription medicines or street drugs * serious psychiatric diagnoses (e.g., severe major depressive disorder, bipolar disorder, schizophrenia) * pregnant or currently breastfeeding * diabetic and using any medicine besides metformin to control blood glucose * metastatic cancer * unstable medical conditions that would likely prevent the subject from completing the study * previous diagnosis of an eating disorder * history of unsafe weight loss behaviors such as binging or the use of laxatives

Keywords: weight loss motivation workplace web platform
evaluation and management of parturients' pain intensity

Conditions: Labor Pain

Summary: the primary objective of this study is to examine the effects of attentional bias modification (abm) on the labor pain in parturients. one-third of the participants will undergo abm training away from affective pain stimuli. one-third of the participants will undergo abm training away from sensory pain stimuli. the rest of participants will be the control group.

in recent years, significant attention has been paid to the attentional bias in patients with chronic pain. studies found that attentional bias modification (abm) could reduce the pain intensity in participants with chronic pain. the investigator's goal is to evaluate the effects of abm on labor pain and patient satisfaction with the labor and delivery experience.

Eligibility criteria:
inclusion criteria: * parturients who are at 36 weeks gestation (at time of starting the study) exclusion criteria: 1. any patient who refuses 2. patients with impaired decision-making capacity 3. patients who are blind or extremely visually impaired 4. patients who cannot understand or read english
non-invasive stimulation of brain networks and cognition in alzheimer's disease and frontotemporal dementia

Conditions: Alzheimer's Disease; Frontotemporal Dementia, Behavioral Variant

Summary: this pilot study aims to test clinical and connectivity changes following non-invasive stimulation of disease-specific networks in alzheimer's disease (ad) and behavioral variant frontotemporal dementia (bvftd). brain network stimulation will be carried out with transcranial direct current stimulation (tdcs). target networks will be the default mode network (dmn) and salience network (sn). twenty ad and 20 bvftd patients will be recruited and assessed with a comprehensive clinical, behavioral and cognitive battery, and 3 tesla mri scan (including resting-state functional mri, arterial spin labeling, diffusion tensor imaging, structural mri) at three time-points: baseline, after tdcs, and after 6 months. patients will be randomized to 2 arms: anodal stimulation of the disease-specific network (dmn in ad, sn in bvftd) or cathodal stimulation of the anti-correlated network (sn in ad, dmn in bvftd). the intervention will consist of 10 tdcs sessions over two weeks. cerebrospinal fluid (csf) samples will be collected at baseline for biomarker's assessment; blood samples will be collected at each time-point to assess changes in peripheral inflammatory markers. blood and csf collection will be optional. a sample of 20 elderly controls will be included for baseline comparisons.


Eligibility criteria:
inclusion criteria: * diagnosis of ad or bvftd according to current clinical criteria (albert et al., 2011; rascovsky et al., 2011) * ability to provide written informed consent * availability of a collateral source exclusion criteria: * moderate/severe dementia * presence of any medical or psychiatric illness that could interfere in completing assessments exclusion criteria for mri and tdcs: * metal implants, pace-makers, prosthetic heart valves * claustrophobia * history of epilepsy * pregnancy exclusion criteria for controls: * current or past history of clinical, neurological, or psychiatric conditions that could interfere with the assessment (e.g., transient ischemic attack, ictus, head trauma, epilepsy, multiple sclerosis, neuropathy, mood disorders, substance abuse)
the effects of aldara as an adjunct to laser treatment

Conditions: Port Wine Stains

Summary: the primary objective is to determine the effects of aldara on the cosmetic outcome of laser treatment of vascular malformations.

this is a randomized, controlled, double-blinded study. volunteers who are scheduled for laser treatment of port wine stains will be screened and eligible subjects will be asked to participate. the patients will be randomized and placed in the experimental or the control group. they will be given unlabeled sachets and instructed to apply the product each night to the right half of their treated lesion beginning the night after surgery for 4 weeks. digital photographs of the port wine stain will be taken prior to surgery and repeated at follow up appointments at 1 week, 1 month, 2 months, and 3 months after surgery. the photographs will be analyzed by blinded board certified plastic surgeons as well as a computer program.

Eligibility criteria:
inclusion criteria: * male or female patient between the ages of 2 and 60 years with a vascular malformation that is seeking cosmetic treatment. * all races will be included as well as male and female. * clinical data on the usage of aldara below the age of 2 years is limited and therefore all patients in the study will have to be at least 2 years of age. * the majority of port wine stains are initially treated during childhood * in order to determine the effectiveness of aldara as an adjunct to laser therapy of port wine stains, some of the patients in the study need to have lesions that have not undergone previous treatment. exclusion criteria: * patients under the age of 2 or over the age of 60. * patients that have serious medical problems that would put them at risk of the anesthesia. * patients that have sensitivity reactions to the ingredients in the product including imiquimod, isostearic acid, cetyl alcohol, stearyl alcohol, white petrolatum, polysorbate 60, sorbitan monostearate, glycerin, xanthan gum, purified water, benzyl alcohol, methylparaben, and propylparaben. * patients who are pregnant or have significant immunodeficiency or autoimmune diseases.

Keywords: laser pediatric skin pigmentation
evaluation of socket shield technique with immediate implant placement in the esthetic zone

Conditions: Alveolar Bone Resorption

Summary: the study was conducted on 20 immediate implant placement sites in the anterior maxillary region. in the study group, 10 implants were inserted using socket shield technique, while in control group, 10 implants were inserted using conventional immediate placement technique. all patients received immediate and 6 months post-operative cbct to assess horizontal bone loss, vertical bone loss, and measurement of bone density. implant stability quotients (isqs) was measured immediately, 1st, 3rd and 6 months post-operatively.

unrestorable tooth extraction with immediate implant placement is considered one of the best treatment options in restoring the esthetics and function. extraction socket resorption is considered a challenging procedure when it involves the esthetics zone. the preservation of the entire attachment apparatus for complete preservation of the alveolar ridge makes socket shield technique a promising procedure that helps to maintain anatomy, esthetics and function. socket shield technique, eliminate the negative consequences of bone resorption of the buccal plate of bone; leading to maintaining hard and soft tissue contours and provides a perfect pleasing esthetic result with good function. it is a highly promising technique in terms of maintaining pink and white esthetics through preservation of the interdental papilla during preparation of the interdental socket shield. it is considered a minimally invasive surgical procedure and offers the advantages of immediate implant placement.

Eligibility criteria:
inclusion criteria: 1. endodontic or non-endodontic treated un-restorable remaining root/ tooth related to maxillary anterior teeth. 2. healthy adult patients \> 20 years old (asai, ii) . 3. adequate oral hygiene. 4. intact periodontal tissues. exclusion criteria: 1. periapical or periodontal active infection involving the teeth/root to be extracted (as excluded by radiographic examination). 2. medically compromised patients (asa iii, iv, v). 3. patients receiving chemotherapy or radiotherapy. 4. heavy smokers,alcohol or drug abuse. 5. patients with parafunctional habits such as bruxism, clenching, excessive gum chewing, lip or fingernail biting.

Keywords: immediate implants, sockets shield technique, esthetic zone
development of variable volume automated mandatory boluses for patient-controlled epidural analgesia during labour

Conditions: Labor Pain; Breakthrough Pain

Summary: a novel epidural delivery regimen was developed: variable volume automated mandatory bolus (amb) (vvamb) will advance individualisation of labour epidural analgesia, by which a larger volume of bolus may contribute to better spread of the local anaesthetics within brief period and thereby reduces the chances of motor blockade that could reduce instrumental deliveries.

epidural analgesia is the gold standard of pain relief for labour pain. despite this, up to 50% of parturients continue to experience pain leading to suffering and increased caregiver workload. there is also higher risk of motor blockade found in those receiving epidural analgesia, and these factors is associated with dysfunctional labour requiring obstetric intervention (instrumental delivery). automated mandatory bolus (amb) of variable-frequency (vamb) has been shown to provide better pain relief as compared with conventional patient-controlled epidural analgesia (pcea) with basal infusion, however its long lockout time per hour is associated with unsuccessful patient bolus requests, with similar motor block to conventional regimens. the investigators therefore proposes to develop a novel epidural delivery regimen: variable volume amb (vvamb) will advance individualisation of labour epidural analgesia, by which a larger volume of bolus may contribute to better spread of the local anaesthetics within brief period and thereby reduces the chances of motor blockade that could reduce instrumental deliveries. this algorithm development including pilot and clinical trial will compare vvamb with vamb regimens, in reducing the incidence of motor block in 216 term women requesting for labour epidural analgesia.

Eligibility criteria:
inclusion criteria: * healthy (american society of anesthesiologists (asa) physical status 1 and 2) primiparous parturient at term (≥36 weeks gestation); * singleton fetus; * in early labor stage (cervical dilation ≤5cm); * request labor epidural analgesia and able to administer combined spinal epidural analgesia (csea) according to protocol. exclusion criteria: * non-cephalic fetal presentation; * obstetric (e.g. pre-eclampsia, premature rupture of amniotic membranes for more than 48 hours, gestational diabetes on insulin, pregnancy-induced hypertension on medication) and uncontrolled medical (e.g. cardiac disease) complications; * have contraindications to neuraxial blockade or have received parenteral opioids within last 2 hours; * dural puncture/ suspected dural puncture at initiation of csea.

Keywords: labor pain breakthrough pain infusion pump
rehabilitation of chronic diseases and smart health management system service

Conditions: Pulmonary Rehabilitation; Cardiac Rehabilitation

Summary: in republic of korea, it is not easy to practice standard pulmonary rehabilitation (pr) or cardiac rehabilitation (cr). in this study, the investigators will provide newly developed smartphone application to patients with chronic respiratory, cardiac, or geriatric diseases. the investigators want to confirm whether participants, who perform smartphone application based 12-week pr or cr program, present improved exercise capacity, dyspnea symptom, muscle strength, or quality of life.


Eligibility criteria:
inclusion criteria: * dyspnea symptom \>= mmrc 1 or nyha i * adults between 20 years and 80 or years chronic respiratory disease * fev1/fvc \< 0.7 in pulmonary function test * bronchiectasis in more than one lobe on chest computed tomography * fvc of dlco \< 0.8 of predicted value in pulmonary function test chronic cardiac disease * reperfusion therapy for angina pectoris or myocardial infarction * heart failure with reduced ejection fraction (lvef \< 50%) chronic geriatric disease * ages between 60 and 80 years * clinical frailty scale between 1 and 4 exclusion criteria: * history of acute exacerbation within 4 weeks * unable to comply rehabilitation program * not suitable for study on decision by duty physician * no consent
conservative versus operative - first time shoulder dislocations

Conditions: Shoulder Dislocation

Summary: there is no consensus regarding whether rehabilitation or surgical stabilization leads to optimized outcomes for treatment of primary anterior shoulder dislocations. this prospective, randomized controlled trial therefore aims to compare arthroscopic bankart repair versus physical therapy for the treatment of primary anterior shoulder dislocations.

while primary anterior shoulder dislocations had been previously treated conservatively, growing concerns amidst recurrent shoulder instability have fueled interest in managing these injuries with surgery to mitigate the risk of future instability events. while the significant literature investigating the rates of shoulder instability with initial operative management suggests improvement outcomes, there is limited level 1 evidence to support these implications. a randomized-controlled trial (rct) of 21 primary anterior shoulder dislocations undergoing arthroscopic bankart repair or rehabilitation ( 9 operative vs 12 nonoperative; mean age: 22), found lower rates of recurrent shoulder instability (11% in operative vs 72% in non-operative; p=0.004) and higher single assessment numeric evaluation (sane) scores (88 in operative vs 57 in non-operative; p\ 0.05) at 2 years follow-up. a rct of 40 patients (20 operative vs 20 non-operative; mean age: 21), found lower rates of recurrent shoulder instability (10% in operative vs 70% in non-operative; p=0.0001) and a higher wosi (17.1 in operative vs 11.5 in non-operative; p=0.035) at 2 years follow-up. the previous 5 rct's represent the only level 1 evidence amidst a much larger proportion of lower-level evidence upon which much of the discussion of surgical vs non-operative management has been formulated. additionally, only 2 rct's conducted power analyses to determine if their sample size was adequate, and they did not demonstrate unanimous results with patient reported outcomes as described above. it is therefore critical to increase the amount of level 1 evidence on the topic of operative vs non-operative management of primary shoulder dislocations to better inform this debate. this study aims to compare the incidence of recurrent shoulder instability and patient reported outcomes of patients with primary anterior shoulder dislocations managed with surgery (arthroscopic bankart repair) compared to non-operative management (standardized rehabilitation protocol, control group).

Eligibility criteria:
inclusion criteria: * patients 12 and older * seen by the columbia university shoulder elbow and sports medicine service * first time anterior shoulder dislocation diagnosis exclusion criteria: * humeral avulsion during arthroscopy * bony defect \> 25% of glenoid surface * general anesthesia contraindication * previous shoulder surgery * inability or unwillingness to adhere to study participate * lost to follow up
immediate breast reconstruction with free greater omentum

Conditions: Breast Reconstruction

Summary: luminal subtype breast cancer, accounting for 70 to 80% of all breast cancers, has been reported to be associated with good prognosis. however, for the patients with large mass or worse mass position, free greater omentum transplantation may provide a new option for breast reconstruction.

breast-conserving surgery, laparoscopic greater omentum harvest and vascular anastomosis was carried out orderly. the omentum was harvested laparoscopically, following breast-conserving surgery . following the remove of resected omentum, the harvested greater omentum was poured by ice protection fluid from right gastric omentum artery. besides, right arteriovenous vein of stomach omentum was dissected carefully under microscope. when operation started, front latissimus dorsi was separated from subaxillary incision, as well as the right thoracic dorsal artery and accompanying vein. separated greater omentum was put on the subcutaneous deficient site of right breast incision and vascular pedicle was pulled through tunnel, reaching to the axillary incision. under the help of microscope, vascular anastomosis between right stomach omentum arteriovenous and right thoracic dorsal arteriovenous was proceeded. consequently, greater omentum was filled to shape the reconstructed breast. finally, drainage tube and drainage strip were left at subcutaneous and subaxillary incision, respectively.

Eligibility criteria:
inclusion criteria: - patient aged 18 -60 years patient diagnosed with luminal breast cancer no neoadjuvant chemotherapy previously no distant metastasis suitable for breast conserving surgery willing and able to give written informed consent to participate in the study including all follow-up examinations exclusion criteria: - participate in another clinicaltrial bilateral lesions pregnancy or lactation greater omentum unable to extract or insufficient omentum other surgical contraindication

Keywords: immediate breast reconstruction free greater omentum breast-conserving surgery luminal breast cancer