Kornimate/medical-research-clean huggingface dataset:
non-magnified nbi in barrett's oesophagus neoplasia detection and delineation

Conditions: Barrett Esophagus

Summary: endoscopy plays a pivotal role in the management (diagnosis and treatment) of barrett's related neoplasia. the standard endoscopy is generally done under white light, which is known to be imperfect in detecting early neoplastic lesion. narrow band imaging (nbi) improves definition of the superficial morphology and vasculature of gi mucosa. some studies have shown the potential to improve diagnostic accuracy and reduce the number of biopsies required for barrett's related neoplasia. this can ultimately improve the cost-effectiveness of endoscopic surveillance. the ability to discriminate between healthy and diseased tissue also makes nbi a useful technique for the delineation of lesions to treat with endoscopic mucosal resection (emr). however not all studies provide evidence of diagnostic utility. also the majority of these studies have been conducted by expert endoscopists, which makes the results difficult to extend to general endoscopy practice. the limited number of barrett's specialists in certain areas of the country validates the need for a study to investigate whether there is an objective improvement in detection and delineation of barrett's neoplastic lesions by less experienced observers. the aim of this study was to determine the utility of non-magnified nbi in non-expert identification of lesions as compared to expert endoscopists as well as the inter-observer agreement among endoscopists on wle and nbi.

matched non-magnified white-light endoscopy (wle) and narrow band imaging (nbi) images of barrett's oesophagus with and without lesions from the same level will be obtained prospectively. lesions will be delineated by 3 expert endoscopists and the overlap between all delineations for each image, regarded as the "sweet spot", will be used as the gold standard. the images will then be assessed by a group of non-expert endoscopists (trainees and nurse endoscopists) as well as senior endoscopists with no interest in barrett's. first, white light images will be assessed, followed by a wash-out period and then nbi. assessments will be carried out using a computer application designed in matlab. observers will be also asked to complete the following 1) paris classification of lesion 2) delineation of the lesion on the screen 3) rate the ability to delineate the lesion for each of the two respective imaging modalities (using a visual analog scale (vas score 1-10), 4) choice a single point for virtual diagnostic biopsy. thus, the quantitative interobserver agreement of the delineations for wle and nbi will be calculated. vas scores for the ability to delineate the lesion will be compared between wle and nbi. rate of inclusion of the biopsy point in the sweet spot on wle and nbi will be compared.

Eligibility criteria:
inclusion criteria: * diagnosed with dysplastic or non-dysplastic bo at least c1 or m2 in length exclusion criteria: * reflux oesophagitis (los angeles grade ≥c);
effects of retro-walking in patients with knee oa

Conditions: Osteo Arthritis Knee

Summary: osteoarthritis is degenerative joint disease that cause deterioration of the articular cartilage and neighboring tissue and lead to osteophyte formation, weakening of surrounding muscles, ligamentous laxity and inflammation of synovium. diagnosis can be made based on history and clinical features and risk factors including age, sex, body mass index , absence of whole leg pain, fixed flexion deformity, absence of traumatic event, restricted flexion range of motion, pain in descending stairs, palpable effusion and crepitus. confirmation is usually based on radiological finding according to kellgren and lawrence diagnostic scale . radio graphic changes of osteoarthritis of the knee are bilateral in 85% of patients .

knee pain is a major symptom of knee osteoarthritis (oa) that lead to stiffness, and capsular contracture along with muscle spasm. decreased flexibility of muscles reduces the joint range of motion and thus contributes to increase in the stiffness of the joint lead to physical disability in persons with knee oa.eighty percent of persons with knee oa experience pain and 25% struggle to perform activities of daily living.) retro-walking is sometimes referred to as backward walking, has been thought to be used already for several decades in china, japan and europe to get a physical workout, improve sport performance, promote balance and also to stay mentally fit . in fact in europe, they have races which vary from sprints to the 26.2 miles marathon.

Eligibility criteria:
inclusion criteria: * unilateral knee oa . * kellgren-lawrence grading (grade 1 and 2) * participants fulfilling three out of the six clinical criteria listed by the american college of rheumatology the criteria are age \>40 years, morning stiffness lasting \<30 mins. crepitus with active motion, bony tenderness, bony enlargement and no warmth to touch and diagnosed to have knee oa * pain more than 6 weeks exclusion criteria: * trauma or surgery in the last 6 months. * hip, knee, and foot deformities. * stroke and other neurovascular issues. * severe pain (greater than 7 in nprs) * difficulty in walking for 10 min continuously. * obesity (body mass index greater than 25 kg/m2 ) * osteoporosis * patients having any systemic joint pathology, inflammatory joint disease (e.g. rheumatoid arthritis, gouty arthritis, psoriatic arthritis). * patients who had any neurological deficit, myelopathy any mental illness.

Keywords: osteoarthritis retrowalking balance gait
study of cs-3150 in hypertensive patients with type 2 diabetes and albuminuria

Conditions: Hypertension

Summary: to examine antihypertensive effect and safety of administration of cs-3150 in combination with arb or ace inhibitor in hypertensive patients with type 2 diabetes and albuminuria.


Eligibility criteria:
inclusion criteria: * male and female subjects aged 20 to 80 years at informed consent * subjects with type 2 diabetes and albuminuria (urine albumin-to-creatinine ratio ≥ 30, \< 1000 mg/g/cr) * subjects with hypertension (sitting sbp ≥ 140 mmhg, \<180 mmhg and sitting dbp ≥ 80 mmhg, \<110 mmhg * treatment with an arb or ace inhibitor * egfr ≥ 30 ml/min/1.73m\^2 exclusion criteria: * secondary hypertension or malignant hypertension * type 1 diabetes * secondary glucose intolerance * diagnosed with non-diabetic nephropathy * serum potassium level \< 3.5 or ≥ 4.8 meq/l

Keywords: hypertension with type 2 diabetes and albuminuria diabetic nephropathy diabetic renal disease albuminuria mineralocorticoid receptor antagonist
preliminary exploration of applying multi-person simulation training to improve nurse-led burn and scald nursing care

Conditions: Virtual Reality; High Fidelity Simulation Training

Summary: the purpose of this study was to compare the learning performance of trainees before and after learning burns and scald nursing care by applying the burns and scald virtual reality (vr) training module multi-person interactive training in different places and the traditional training model with a high-fidelity patient.

the clinical instructors, standard practice nurses, training content, and assessment process were the same for the experimental and control groups, except for the training methods of the interventions. a pre-recorded instructional video on burn care was provided to each participant one week prior to the experiment for self-study. the experiment procedure includes research description, pre-test and pre-test questionnaire (about 10 minutes), vr hands-on teaching or environment familiarization phase (about 10 minutes), multi-person simulation training (about 15 minutes) and post-test debrief (about 5 minutes), post-test and questionnaire (about 10 minutes). after completing all experiments, the collected data will be analyzed by the researcher using spss version 22.0 for descriptive, t-test, and other statistical analyses.

Eligibility criteria:
inclusion criteria: 1. people who are above 20 years old, with a nurse practitioner certificate and an acls or aha certificate within the validity period. 2. people who are interested in learning the role of a team leader in burn and scald care. 3. people who have never used an interactive virtual reality (vr) environment device. exclusion criteria: 1. people who are prone to vertigo or poor balance and are prone to motion sickness. 2. people with a history of epilepsy. 3. eye surgery or injury within the past 6 months. 4. people with facial wounds that prevent them from wearing vr glasses.

Keywords: virtual reality high fidelity simulation training burns
body image functioning among surgically treated patients with head and neck cancer

Conditions: Head and Neck Cancer; Skin Cancer

Summary: objectives: the purpose of this study is to obtain descriptive information about the nature and extent of body image concerns among surgical patients with head and neck cancer, satisfaction with care received regarding body image issues, and interest in psychosocial services targeting body image disturbance. findings from this study provide important preliminary data to guide future large scale research on the critical, yet understudied, psychosocial issue of body image functioning for head and neck cancer patients. information obtained from this study can specifically be used to facilitate the development of appropriate disease-specific body image instruments and to determine the need for body image focused psychosocial interventions to enhance quality of life and the survivorship experience for these patients. primary aims 1. to characterize the nature and extent of body image concerns in surgically treated patients with head and neck cancer and determine preferences for psychosocial intervention. 2. to compare body image and quality of life outcomes for patients at different time points relative to initiation of treatment. specific time points of interest are pre-treatment, within one year of initial surgical treatment, and greater than 1 year following initial surgical treatment. secondary aim 1. to compare body image and quality of life outcomes for patients with oral cavity, cutaneous, and midface cancers.

if you agree to take part in this study, you will be asked to fill out 1 questionnaire. this questionnaire can be filled out while you are waiting to be seen by your head and neck doctor and will take about 15-20 minutes to complete. in this questionnaire, you will be asked questions such as your age, gender, education level, and smoking history. you will also be asked about your treatment for cancer and how it has affected your appearance and body. there will also be questions about your mood, physical health, alcohol use, and social well-being. length of study: you will be off study after you complete the questionnaire. this is an investigational study. up to 350 people will take part in this study. all will be enrolled at m. d. anderson.

Eligibility criteria:
inclusion criteria: 1. 18 years of age or older 2. able to provide written informed consent to participate 3. diagnosis of oral cavity, cutaneous or other midface cancer involving the head and neck region 4. treatment plan includes surgical intervention 5. english speaking exclusion criteria: 1. significant preexisting facial disfigurement from a previous trauma or congenital defect 2. diagnosis of a serious mental illness involving formal thought disorder (e.g., schizophrenia) documented in medical record 3. cognitive impairment (e.g., dementia, delirium)

Keywords: questionnaire head and neck cancer skin cancer body image surgical treatment oral cavity cancer cutaneous cancer
adjuvant radiotherapy for resected hepatocellular carcinoma with mvi

Conditions: Hepatocellular Carcinoma

Summary: positive micro vascular invasion in early stage hepatocellular carcinoma(hcc) leads to early recurrence after surgery. adjuvant external radiotherapy will be applied in those patients to see if disease free survival and overall survival could be approved.

hepatocellular carcinoma(hcc) ranks the 6th most common cancer and is the 2nd leading cause of cancer-related death globally. surgical resection remains the most efficient therapy in early stage. though an anatomical resection of tumor lead to an up to 70% 5-year overall survival, the existence of micro vascular invasion(mvi) caused early recurrence. stereotactic body radiation therapy (sbrt) has been proved to be efficient in treating vascular tumor thrombosis. the investigators tried to implement this technique in adjuvant setting for hcc after surgery with mvi. participants with early stage hcc whose tumor locates closely to the main intrahepatic vascular will be regarded as potentially-not-enough-surgical-margin candidates. surgical resection will be carried out as scheduled and an additional silver clip will be put into the margin. postoperative pathological examination will detect micro vascular invasion or daughter nodule. mvi-positive candidates will be eligible for enrollment. eligible participants will be randomized to two groups, sbrt group and surgery-alone(sa) group with 1-to-1 ratio. participants in sbrt group will receive a 35gy limited resection margin parenchyma sbrt after surgery, while participants in sa group just get surgery. radiation related adverse events (ae) or reaction will be recorded and intervened necessarily. all participants will be followed up by investigators every three months. dfs, os, and aes are end points in this study.

Eligibility criteria:
inclusion criteria: 1. solitary nodule; 2. tumor adjacent to the main trunk of hepatic vein, cava vena, or to the major branch of portal vein (including the lobar branch at least); 3. macro-vascular negative; 4. no previous treatment before surgery; 5. no previous hepatic surgery; 6. child-pugh score a for hepatic function. exclusion criteria: 1. spontaneous rupture; 2. pathologically proved positive resection margin; 3. severe cirrhosis with hypersplenism or esophageal and gastric varices; 4. 4-weeks postoperative examination revealed α-fetal protein(afp) still positive or new lesion in remnant liver; 5. postoperative complications required a secondary operation or more than 3 weeks'recovery from surgery.

Keywords: stereotactic body radiotherapy micro vascular invasion narrow resection margin
emergency care at home

Conditions: Emergency Medical Services; Emergency Department Visits

Summary: this study will assess the efficacy of receiving emergency care at home versus in the brick-and-mortar emergency department.

care in an emergency department has many benefits. it delivers high-intensity critical care on demand to large populations and serves as an efficient gateway to hospitalization. however, some populations may not be well-served by the traditional emergency department, particularly older adults, adults with serious illness, and those who are homebound. many harms may come to older adults in the emergency department, including delirium, pressure injuries, infections, anxiety, and others. emergency department crowding secondary to hospital capacity constraints may also lead to suboptimal care, as patients wait many hours for their inpatient bed even after a disposition decision is made. as a result, the investigators will evaluate in a randomized controlled trial the efficacy of emergency care delivered at home instead of in the emergency department

Eligibility criteria:
inclusion criteria: * age \>= 18 years * resides within home hospital geographic area * lives in permanent housing (i.e., not in temporary housing such as a shelter) * patient of a mass general brigham primary care provider * primary care provider attests that their triage recommendation is the emergency department * emergency care at home nurse triages the participant to the emergency department or urgent care * patient attests that they intend to go to the emergency department exclusion criteria: * insurance: workers compensation and motor vehicle accident * lives in a healthcare facility (skilled nursing, rehab, long term acute care) * patient/caregiver cannot answer phone or door * active substance use * acute psychiatric concerns (e.g., suicidal ideation, even if passive) * home safety concerns (e.g., intimate partner violence) * high-risk features: ohigh risk signs, if available: heart rate \> 120 systolic blood pressure \ 1 oxygen \ 2 liters respiratory rate \> 28 diaphoresis ohigh risk symptoms: active chest pain severe work of breathing syncope hemoptysis seizure other concerning symptom per nurse triage * requires inpatient-level care * requires specialty consultation * requires physical, occupational, or speech therapy * requires blood transfusion * requires internal physical exam maneuver (e.g. rectal exam, genitourinary exam) * requires imaging that is not available at home * requires monitoring that is not available at home * troubleshooting wound vacs
comparative study between intrathecal (dexmedetomidine versus fentanyl)

Conditions: Cholecystitis

Summary: laparoscopy is one of the procedures of choice for most of the elective abdominal surgeries performed preferably under endotracheal general anesthesia. with the technical advances that have been made, laparoscopic cholecystectomy is considered a procedure with a good safety profile that offers advantages over open cholecystectomy.

laparoscopy is one of the procedures of choice for most of the elective abdominal surgeries performed preferably under endotracheal general anesthesia. with the technical advances that have been made, laparoscopic cholecystectomy is considered a procedure with a good safety profile that offers advantages over open cholecystectomy. in past general anesthesia is considered the only choice of anesthesia for laparoscopy, but nowadays regional anesthesia in the form of spinal anesthesia, epidural anesthesia and or combined spinal epidural provide beneficial advantages over general anesthesia. the most limiting factor for use of spinal anesthesia in laparoscopy is patient's discomfort with pneumo-peritoneum and the associated shoulder tip pain. spinal anesthesia is the most popular technique for lower abdominal surgeries as it is very economical and easy to administer. various adjuvants have been added to intra-thecal local anesthetic agents. as intrathecal α2 agonists when used as adjuncts potentiate the effect of local anesthetics and allows a decrease in required doses of local anesthetics. clonidine is a partial α2 agonist used intrathecally with well-established efficacy and safety. it prolongs the duration of motor and sensory spinal blockade when used along with local anesthetics. . dexmedetomidine is new highly selective α2 adrenoceptor agonist and has been approved by food and drug administration as intravenous (iv) sedative and co-analgesic drug. its α2/α1 selectivity is 8 times higher than clonidine. many studies have been conducted the effect of intrathecal dexmedetomidine when combined with levobupivacaine in spinal anesthesia. however, not much literature is available regarding the use of intrathecal dexmedetomitine with levobupivacaine to reduce shoulder tip pain in laparoscopic cholecystectomies.

Eligibility criteria:
inclusion criteria: - 60 patients aged from 30 to 60 years of either sex with american society of anesthesiologists (asa) grades i and ii undergoing elective laparoscopic cholecystectomies. exclusion criteria: * patients with asa grade \>ii, * patients' refusal , * patients using α2-adrenergic receptors antagonists, calcium channel blockers, * angiotensin converting enzyme inhibitors , * dysrhythmia , * body weight more than 120 kg, * spinal deformity , * history of allergy to the study drugs , * pregnancy , * coagulopathy , * neurological disorders * known contraindications to spinal anesthesia.
depression, anxiety, and stress in a sample of resident doctors in upper egypt

Conditions: Depression; Anxiety

Summary: to assess the prevalence and severity of symptoms related to depression, anxiety, and stress, among population of resident doctors in upper egypt in assiut university hospitals and other hospitals in upper egypt

many resident doctors during their training experience different levels of stress and this continuous pressure can cause feelings of discouragement and dissatisfaction, which might lead to the desire of leaving a training program. this pressure could be accompanied by anxiety and depression and have negative effects on clinical performance and even increase the risk of burnout. adjusting to these hectic job burdens affects individual emotional and intellectual contingency, and the capacity to create a healthy home-work balance. burnout in residents can have serious effects not only on personal well-being, interpersonal relationships as well as on career but also may have negative effects on patient care . the prevalence and impact of mental health issues among resident doctors have garnered increasing attention in recent years. studies suggest that residency training can exacerbate existing vulnerabilities and contribute to the development of mental health disorders. the implications of these conditions are profound, affecting not only the personal well-being of the doctors but also their professional performance, patient care quality, and overall healthcare system efficiency.

Eligibility criteria:
inclusion criteria: * resident doctors undergoing post-graduation training in hospital. * resident in hospitals in upper egypt exclusion criteria: * resident doctors who were already under treatment for any psychiatric disorder and chronic medical illnesses.