Kornimate/medical-research-clean huggingface dataset:
optimization of cervical nodal ctv for early and medium stage npc

Conditions: Nasopharyngeal Carcinoma

Summary: current radiotherapy guidelines and consensus statements uniformly recommend elective region irradiation (eri) as the standard strategy for nasopharyngeal carcinoma (npc). however, given the scarcity of skip-metastasis, the improved assessment accuracy of nodal involvement, and the striking advancements in chemotherapy for npc, a one-fits-all delineation scheme for clinical target volumes for the nodal region (ctvn) may not be appropriate anymore, and modifications of the ctvn delineation strategy may be warranted. involved site irradiation (isi) covering merely the initially involved nodal site and potential extranodal extension has been confirmed to be as effective as eri with decreased radiation-related toxicities in some malignancies, but has not yet been investigated in npc. this study aims to compare the regional control, survival outcomes, radiation-related toxicities, and quality of life (qol) of isi with conventional eri in npc patients with a limited nodal burden.

isrt-npc is a prospective, multicenter, open-label, noninferiority, phase iii randomized controlled trial. a total of 488 patients will be randomly assigned in a 1:1 ratio to receive isi or eri. randomization will be stratified by institution and n stage. generally, in the isi group, the high-risk ctv1 (dose: 60 gy) includes a 1-cm expansion of the positive ln as well as the viia and the retrostyloid space above the bilateral transverse process of the atlantoaxial spine (c1), regardless of n status. the low-risk ctv2 (dose: 50 gy) covers the cervical nodal region with a 3-cm caudal expansion below the transverse process of c1 for n0 disease and a 3-cm expansion below the positive ln for positive lns (at least covering the level ii).

Eligibility criteria:
1. age between 18 and 75 years; 2. karnofsky performance status (kps) score ≥ 70; 3. pathologically confirmed world health organization (who) type ii-iii npc; 4. tnm stage i-iii (t1-3n0-2m0) according to the 8th american joint committee on cancer / union for international cancer control (ajcc/uicc) staging system with a maximum diameter (mad) of cervical involved lns ≤ 3 cm, namely lb-ln; 5. available baseline nasopharynx and neck computed tomography (ct) or magnetic resonance imaging (mri) (strongly advocated) data (including functional mri sequences) and measurable tumor lesions; 6. all procedures for defining the tumor burden completed within 4 weeks of registration; 7. survival expectancy of at least 6 months; 8. normal marrow and organ function: hemoglobin ≥ 120 g/l, wbcs ≥ 4 × 109 /l, platelets ≥ 100 × 109 /l; liver and kidney function-related indicators within 1.25\*the normal upper limit; 9. patient willingness to comply with the protocol; 10. patient willingness and ability to provide an informed consent form.
circulating non-coding rna in acute ischemic stroke (aisrna)

Conditions: Acute Stroke; Ischemic Stroke

Summary: aisrna is to analyze the expression pattern of circular rna (circrna), micro-rna (mirna) and long non-coding rna (lncrna) by next-generation sequencing in patients with acute ischemic stroke and healthy control. the candidate circrna/mirna/lncrna will be verified as biomarkers for the detection and prognosis of acute ischemic stroke.

noncoding rnas have been highlighted to be involved in the pathological process of ischemic stroke (is). the purpose of this protocol will investigate the expression pattern of circular rna (circrna), micro-rna (mirna) and long non-coding rna (lncrna) by next-generation sequencing in patients with acute ischemic stroke and healthy control. the candidate circrna/mirna/lncrna will be verified as biomarkers for the detection and prognosis of acute ischemic stroke. distinctive expression patterns of circrna/mirna/lncrna will be identified by the next-generation sequencing and individual quantitative real time polymerase chain reaction (qrt-pcr). a diagnostic or predictive model will be established using logistic regression. the panel of these altered ncrnas may be associated with acute is and could serve as a novel diagnostic or predictive method.

Eligibility criteria:
inclusion criteria: * aged 18 years or older * confirmed acute ischemic stroke by a diffusion-weighted imaging-position lesion on magnetic resonance imaging (mri) and a new lesion on a brain computed tomography (ct) scan * within 72 hours of symptom onset * good performance status * signed an approved informed consents exclusion criteria: -a history of hemorrhagic infarction, chronic kidney/liver diseases, peripheral arterial occlusive disease, active malignant disease, and inflammatory or infectious diseases

Keywords: acute ischemic stroke noncoding rna clinical significance outcome
personalized feedback programs for college students

Conditions: Alcohol Use, Unspecified

Summary: the purpose of this research study is to evaluate the effectiveness of different forms of personalized feedback intended to help students make their best personal choices to support their health and well-being in college.

risky substance use among college students is a widespread challenge that requires innovative prevention methods to address. a primary aim of this study is to assess the efficacy of receiving different types of personalized feedback on the substance use and wellbeing of college students. this preliminary efficacy will be evaluated through a multi-part randomized controlled trial comparing four conditions: (1) resources program, (2) on-line personalized feedback program (pfp), (3) on-line substance use feedback program (based on brief motivational intervention (bmi) principles), and (4) pfp+bmi. at the first time point, participants will be randomly selected into one of four conditions. participants have an equal chance of being assigned to any one of the conditions. all participants will complete follow-up surveys at two additional timepoints (30 day follow-up; 3-month follow-up) to determine any changes that have occurred since they took part in their program at time point 1. after the final survey, all participants, regardless of their initial group, will be invited to receive all of the personalized feedback components available across all conditions. findings from this study have great potential to enhance the effectiveness of college student substance use prevention programming and improve college student wellbeing.

Eligibility criteria:
inclusion criteria: * consent: voluntary consent must be provided. * age: students over the age of 18 may participate. * year in college: newly enrolled freshmen. * enrollment status: only full-time vcu students will participate. exclusion criteria: * age: under the age of 18 * year in college: a sophomore, junior or senior * enrollment status: enrolled part-time
observational study with investigation of two second generation laryngeal masks

Conditions: Airway Remodeling

Summary: in a observational study the second-generation laryngeal masks lma supreme and ambu auragain are investigated.

after approval from the local ethics committee, data were collected in a prospective, non- randomised study over a three-month period. when contra-indications for laryngeal mask use were absent anaesthesiologists used either supreme (teleflex medical gmbh, germany) or gain (ambu gmbh, germany). endpoints were the success rate and time to insertion.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * no concurrent participation in another study * capacity to consent * present written informed consent of the research participant * elective surgery under general anesthesia exclusion criteria: * age \<18 years * existing pregnancy * lack of consent * inability to consent * emergency patients * emergency situations in the context of a difficult airway management * asa classification\> 3 * situations where the possibility of accumulated gastric contents * participation in another study

Keywords: laryngeal mask airway leakage airway morbidity
nursing intervention program in the management of parental anxiety and infant pain in the surgical process of children to be circumcised

Conditions: Anxiety; Pain, Postoperative; Child Development

Summary: entering the hospital and waiting for surgery is a very stressful time for people. according to some studies, surgical interventions in children generate in family members concerns related to: anesthesia, fear of being harmed, penile injury, excessive pain, the death of their child, not being able to contain their own anxiety and, therefore, participants may have difficulties in assuming an active role in caring for their child . for these reasons, the investigators propose the development and implementation of an action program for the reduction of child pain and anxiety in parents in the foreign muslim population residing in spain.

1. introduction entering the hospital and waiting for surgery is a very stressful time for people. according to some studies, surgical interventions in children generate in family members concerns related to: anesthesia, fear of being harmed, penile injury, excessive pain, the death of their child, not being able to contain their own anxiety and, therefore, participants may have difficulties in assuming an active role in caring for their child. for these reasons, the investigators propose the development and implementation of an action program for the reduction of child pain and anxiety in parents in the foreign muslim population residing in spain. 2. hypothesis / problem a nursing intervention program in the surgical process of circumcision decreases the degree of anxiety of family members and reduces infant pain. 3. methodology a randomized clinical trial will be carried out at the policlínica maresme, located in pineda de mar, on the relatives/guardians and children aged 0-3 years who are going to undergo circumcision. the intervention group will undergo an education program related to the circumcision process for the child's relatives/guardians. the control group will receive the usual intervention of the center. it has been estimated that 157 subjects are needed in each group, estimating a loss to follow-up of 10%. among other variables, the preoperative anxiety level of the parents will be measured using the hamilton scale; intraoperatively, child pain will be measured using the flacc scale and, subsequently, a postoperative telephone follow-up will be carried out during the 2 and 10 days following the intervention, to assess aspects related to the clinical evolution of the surrounded child and the resolution of any doubts that the caregivers may have. the confidentiality of the study participants will be guaranteed. the research project has been approved by the comité d'ètica d'investigació clínica amb medicaments de l'hospital de mataró with code ceim 03/22.

Eligibility criteria:
inclusion criteria: * children aged 0-3 years who are going to undergo circumcision and the relatives/guardians. exclusion criteria: * children with micropenis

Keywords: anxiety child preschool circumcision male pain
obstetric anaesthesia and analgesia month attributes - in covid-19

Conditions: Obstetric Anesthesia Care

Summary: a national survey of current practices, preferred drug and technique choices for obstetric anesthesia and analgesia and to evaluate the impact of covid-19 pandemic on obstetric anesthesia and analgesia in czech republic and slovak republic

a one month-long project monitoring an obstetric anesthesia practices in obstetric/anesthesia departments throughout the czech republic and slovak republic. electronic case report form (ecrf) is used to collect data on all obstetric anesthesia procedures in peripartal period and obstetric and anesthesia complications. all consecutive cases in each participating center during the study period are recorded. each record is related to parturient and contains the following sections: history, form of labour analgesia, type of anesthesia for cesarean section and anesthesia in third stage of labor.

Eligibility criteria:
inclusion criteria: * women in labor undergoing anesthesia care exclusion criteria: * not meeting inclusion criteria

Keywords: obstetric anesthesia survey covid-19
development of a positive psychology intervention to reduce suicide risk

Conditions: Suicidal Ideation; Suicide Attempt

Summary: this pilot study will recruit patients admitted to the inpatient psychiatric unit at mgh for suicidal ideation or a suicide attempt. inclusion criteria will be broad to increase enrollment rates and obtain information for patients with a wide range of diagnoses and illness severity. enrolled subjects will complete randomly-selected positive psychology exercises daily (on weekdays) until discharge and will rate the exercises in multiple domains. subjects' participation will be complete at the end of their admission or when all exercises have been completed, whichever comes first. overall, our goal is to assess the acceptability and utility of eight possible positive psychology interventions related to gratitude, optimism, kindness, mindfulness, recollection, and forgiveness in suicidal inpatients. this is a single-arm study, completed with patients who have been admitted to the hospital for suicidal ideation or a suicide attempt. it is aimed at developing a positive psychology treatment aimed at suicidal patients. the study consists of serial completion of different positive psychology exercises, once daily, during admission, to get subjects' input on their feasibility and impact. this will allow us to work collaboratively to identify the specific exercises that best fit this population. subjects' participation ends when they are discharged from the hospital. the investigators plan to enroll 30 subjects at mgh (and total) in this study.


Eligibility criteria:
inclusion criteria: * adult (age 18 and older) admitted to inpatient psychiatric unit at massachusetts general hospital * suicidal ideation at time of admission or * admission occurring in context of suicide attempt * ability to read and write in english exclusion criteria: * psychotic symptoms * cognitive disorder
closure of muscular ventricular septal defects with the amplatzer™ muscular vsd occluder

Conditions: Heart Septal Defects, Ventricular

Summary: the objective is to investigate the safety of the amplatzer muscular vsd occluder for the treatment of muscular ventricular septal defects, which are hemodynamically significant and are either isolated or in conjunction with other congenital heart defects in infants and children.

the objective of this feasibility study is to investigate the safety of the amplatzer muscular vsd occluder for the treatment of muscular ventricular septal defects, which are hemodynamically significant and are either isolated or in conjunction with other congenital heart defects in infants and children.

Eligibility criteria:
inclusion criteria: * patients with hemodynamically significant muscular vsd's (demonstrated by echocardiography or angiography), either isolated or in conjunction with other congenital heart defects * age \< 18 years old exclusion criteria: * less than 4 mm distance from the semilunar (aortic and pulmonary) and atrioventricular valves (mitral and tricuspid) * patients with severely increased pulmonary vascular resistance above 7 woods units and a right-to-left shunt and documented irreversible pulmonary vascular disease * patients with perimembranous (close to the aortic valve) vsd * patients \< 3 kg * patients with sepsis (local/generalized) * patients with gastritis, gastric ulcer, duodenal ulcer, bleeding disorders etc. and other contraindications to aspirin therapy unless other anti-platelet agents can be administered for 6 months * inability to obtain informed consent

Keywords: muscular ventricular septal defects vsd
handheld ultrasound-guided cannulation of difficult haemodialysis arteriovenous access by renal nurses

Conditions: Hemodialysis Complication; Dialysis; Complications; Vascular Access Site Haematoma; Vascular Access Complication; Dialysis Access Malfunction; Fistula; Graft Av

Summary: cannulation of complex arteriovenous fistula (avf) or graft (avg) is a challenge to renal nurses. ultrasound (us) guidance on central and peripheral venous access visualisation has been widely adopted in nephrology and shown to reduce complications of vascular interventions. with broader adoption of handheld us devices in clinical services, renal nurses could acquire this point-of-care technique to increase the successful cannulation rate while facilitating confidence build-up during training and practice. we aim to evaluate the use of handheld us on difficult avf/avg cannulation in a hospital-based dialysis unit.

we conducted a prospective randomised controlled study from january 2021 to january 2022. ten renal nurses were trained by an interventional nephrologist before patient recruitment and had completed a pre- and post-training questionnaire on their confidence level. fifty haemodialysis patients with complex avf were randomised to us-guided or conventional cannulation. the total time spent on cannulation and patients' pain scores were also collected.

Eligibility criteria:
inclusion criteria: 1. first-time cannulation, 2. post-angioplasty or thrombectomy, 3. partial stenosis confirmed with imaging or by vascular surgeons/interventional radiologists, 4. failed cannulation by dialysis nurses at community centres, 5. bruises or haematoma around avf/avg, 6. presence of clots in avf/avg and 7. deep-seated access by physical examination. exclusion criteria: complex access with a high risk of complications (calibre ≤0.4cm or vessels ≥0.8cm in depth from skin)

Keywords: haemodialysis dialysis arteriovenous fistula arteriovenous graft ultrasound vascular access
intelligent robotic interactions for children with autism spectrum disorders

Conditions: Autism Spectrum Disorder

Summary: for several years, studies have been developed on the contribution of social robots as a tool for interventions for children with autism spectrum disorders (asd). one of the recommended intervention models is the esdm (early start denver model). it consists of setting up an individualized, intensive program (at least 20 hours per week) through the pleasure of play. the teacher follows the motivation and interests of the child, and it is the child who chooses the activities. studies published in recent years tend to show that robots bring benefits to asd children, particularly in the treatment of social interactions and in clinical settings. however, there is no scientific consensus on the generalized contribution and effect over time of these interventions. moreover, a robotic solution controlled by a practitioner through a telepresence system allows for a better adaptability to the responses and desires of the children during the interventions. the investigators believe that such a solution would allow for better assessment of progress in the core skills of expressive communication and imitation and greater engagement during interventions.


Eligibility criteria:
inclusion criteria: * patient living in the hérault department (france), * patient with a diagnosis of asd confirmed by a psychiatrist or a psychologist and receiving current care according to the esdm model in the mpea peyre plantade child psychiatry service. exclusion criteria: * patients * failure to obtain written informed consent after a cooling-off period * participating in another type of program other than esdm * not being affiliated to a french social security system or being a beneficiary of such a system * therapist * history of epilepsy for health professionals (therapists)

Keywords: autism spectrum disorder children interventional care robotics telepresence
study to evaluate the optimal dose of remifentanil during mri of the heart under general anaesthesia

Conditions: Children; Heart Diseases; Anaesthesia; Magnetic Resonance Imaging

Summary: what is the optimal maintenance dose of remifentanil to ensure apnoea, during breath hold episodes in children having cardiac mr imaging with general anaesthesia?

the management of congenital heart disease depends upon accurate imaging of the heart to define anatomical abnormalities. the use of magnetic resonance imaging has grown in response to this need. young children, however, are unable to cooperate sufficiently to allow the scan to occur; this necessitates the use of general anaesthesia. the optimal anaesthetic management of children in this situation is complex. imaging of an acceptable quality depends on a low (normal) heart rate which is relatively constant during the scan and frequent breath holds to avoid respiratory artefacts. children undergoing such scans commonly have significant cardiac and non-cardiac disease. a technique, currently used at alder hey hospital, is to use intravenous agents to provide anaesthesia: commonly a mixture of the intravenous anaesthetic propofol and the potent opiate remifentanil. the patient's own ventilation is suppressed by the use of remifentanil which also reduces heart rate and heart rate variability. controlled ventilation is provided via a ventilator and endotracheal tube. adequate doses of remifentanil are required to ensure suppression of the patient's ventilation whilst excess doses are avoided to reduce the risk of adverse effects (primarily arterial hypotension) and ensure rapid recovery. remifentanil dose has been studied during surgery(3-6), however this is a unique indication and optimal dosage has not been formally studied. in particular the absence of any stimulation from surgery is likely to mean that substantially lower doses of remifentanil will be required.

Eligibility criteria:
inclusion criteria: * children of one year (of age) or older and younger than 7 years of age. * scheduled for cardiac mr imaging under general anaesthesia at alder hey children's hospital. * parental consent exclusion criteria: * hypersensitivity to any study drug * known abnormal response to opiate analgesics or co-morbidity associated with abnormal central control of breathing * families unable to understand or complete consent * any other contraindication to proposed anaesthetic technique: at the discretion of the responsible anaesthetist. * documented significant renal or hepatic dysfunction