Kornimate/medical-research-clean huggingface dataset:
an assessment of voluntary adolescent mental health screening and referral in a children's hospital emergency department

Conditions: Mental Health

Summary: the purpose of this study is to compare the teenscreen intervention to usual care for adolescents who screen positive for mental health problems in a pediatric emergency department. it is anticipated that adolescents receiving the teenscreen intervention will be more likely to attend a first session of outpatient mental health services within 60 days of the initial screening than those receiving the usual care.


Eligibility criteria:
inclusion criteria: * patients between 11 and 17 years old * medically stable and presenting with a non-psychiatric complaint * english speaking * parent/guardian present for consent * insurance coverage by medicaid * hamilton county residents * not currently receiving mental health treatment exclusion criteria: * less than 11 years or greater than 17 years old * parent/guardian not present at time of visit * medically unstable * non-english speaking * insurance other than medicaid * presenting complaint is a mental health problem * currently receiving mental health treatment

Keywords: teenscreen mental health adolescent mental health social work
optimal positioning of local anaesthetic in femoral nerve block prior to hip surgery

Conditions: Fractured Neck of Femur

Summary: the aim of the study is to compare patient comfort and analgesic efficacy of ultrasound guided femoral nerve block using the following endpoints: circumferential spread, anterior or posterior local anaesthetic deposition prior to positioning for spinal anaesthesia for operative fixation of fractured neck of femur.

fractured neck of femur is a common cause of admission to hospital in elderly patients and requires operative fixation. the recommended anaesthetic technique for these cases is spinal anaesthesia, which is performed with the patient in lateral decubitus. positioning the patient prior to administering spinal anaesthesia is the most painful manouvre due to the movement of the fractured bone. regional anaesthesia is effective in alleviating pain due to trauma, and it has the advantage of producing localized but complete pain relief (1). femoral nerve blockade prior to positioning for spinal anaesthesia provides excellent pain relief and is a well tolerated procedure (2-5). using ultrasound guided femoral nerve block is a relative new method to improving the block success rate. it is widely used in our hospital. in a recent study casati and al. showed a 42 % decrease of ed50% using ultrasound for localization of the femoral nerve (6). in a recent editorial by brian d. sites was mentioned that the positioning of the local anaesthetic in ultrasound guided blocks is unclear (7). we currently follow different patterns in relation to injection of the local anaesthetic solution around the femoral nerve. one of them is a circumferencial spread around the nerve. this, however, needs several needle passes which are likely to be painful for the patient. another option is injecting the local anaesthetic on one side, above or below the nerve without changing the position of the tip of the needle, avoiding patient discomfort. whether this results in a comparable quality of sensory block is unknown. the femoral nerve is separated in branches at this level and we assume that the spread of local anaesthetic may influence the quality and the distribution of the block. we propose to study the characteristics of femoral nerve block in relation to different patterns of local anaesthetic injection (circumferencial, inferior or superior).

Eligibility criteria:
inclusion criteria: * fractured neck of femur surgical fixation performed under spinal anaesthesia * asa i to iii exclusion criteria: * patient refusal * coagulation disorders * head injury or other associated injuries * previous vascular surgery in the femoral area. * loss of consciousness and signs of acute coronary syndrome * mini-mental score \< 25 (see appendix 3) * allergy to lignocaine, * skin lesions/infection at site of injection * sepsis
probability of oncotypedx to reallocate as low or high risk of recurrence breast cancer patients with uncertain biology

Conditions: Breast Cancer

Summary: in some cases of hormone receptor positive, human epidermal growth factor receptor 2 (her2) negative early breast cancer the benefit of adding adjuvant chemotherapy to hormonal treatment, estimated on the basis of the classical clinico-pathological parameters, is unclear. in these cases the application of a genomic test could be useful in guiding the therapeutic choice.

oncotype dx (odx) is a 21-gene assay that classifies primary er+ breast tumors into three categories of recurrence risk: high (hr), intermediate (ir) and low (lr). available data show that 1. patients with odx low score breast cancer perform well without chemotherapy, 2. chemotherapy has an additive value to endocrine therapy in patients with odx high score tumors, and 3. the role of chemotherapy is unknown in patients with odx intermediate score cancer. in this study, the investigators aim to evaluate the capability of odx to help in guiding the choice of systemic adjuvant treatment in a group of patients with er+ and her2- , node negative (pn0) or micrometastatic (pnmi) breast cancer with uncertain biological behavior for whom there is uncertainty about the indication of adjuvant chemotherapy.

Eligibility criteria:
inclusion criteria: * histological diagnosis of infiltrating ductal or lobular er+ her2- early breast cancer adequately treated with surgery * nodal status: no regional lymph node metastasis (pn0) or micrometastatic regional lymph node (pn1mic) * uncertain biological behavior defined by all of the following parameters: er \>20% and progesterone receptor (pgr) \>20% and ki67 between 14% and 30% and g2 * written informed consent exclusion criteria: * pathologic tumor stage (pt) \> 5 cm (not applicable to the internal control group) * prior neoadjuvant therapy * evidence of metastatic disease * no axillary exploration (sentinel lymph node biopsy or axillary dissection) * multifocal or multicentral or bilateral tumors

Keywords: estrogen receptor positive her2 negative
comparison of metformin and repaglinide monotherapy in the treatment of new onset type 2 diabetes mellitus in china

Conditions: Diabetes Mellitus, Type 2

Summary: the prevalence of diabetes is up to 11.6% according to the data released in 2013 by the china noncommunicable disease surveillance group.less than 40% of all diagnosed-diabetes were well controlled.among all kinds of antidiabetic medications, metformin is recommended as the first-line antihyperglycemic management for type 2 diabetes. insulin secretagogue,repaglinide is still one of the most widely used antidiabetic medications in china. however, there were few studies comparing the effects of these two medications on glycaemic control in chinese patients with type 2 diabetes.


Eligibility criteria:
inclusion criteria: * all participants with type 2 diabetes, diagnosed by world health organization criteria, were recruited from outpatient of the endocrinology department in shanghai renji hospital exclusion criteria: * patients who had a history of coronary heart disease, abnormal renal function, active liver disease, chronic metabolic acidosis (including diabetic ketoacidosis), or severe chronic gastrointestinal disease.
pan-immune-inflammation value (pin) in behçet's disease and its correlation with disease activity

Conditions: Behcet Syndrome

Summary: behçet's disease (bd) is a systemic vasculitis affecting both small and large blood vessels in the venous and arterial systems. it is a multiorgan disease with various manifestations, including mucocutaneous, articular, ocular, gastrointestinal, vascular, and neurological involvements. the aim of present study is to assess pan immune inflammation value (pin) value in bd in comparison to healthy control ,assess the pin value in association with demographics and clinical characteristics of behcet patients and to assess the pin value in association with disease activity.

behçet's disease (bd) is a systemic vasculitis affecting both small and large blood vessels in the venous and arterial systems. it is a multiorgan disease with various manifestations, including mucocutaneous, articular, ocular, gastrointestinal, vascular, and neurological involvements. inflammation of the vascular wall is the primary pathophysiology contributing to thrombosis in bd. hematological and biochemical values are altered due to systemic inflammation and aberrant immune response. neutrophils, lymphocytes, and platelets play a significant role in systemic inflammation and thrombosis. in addition to the number and volume of peripheral cells, changes in multiple cell count ratios, such as the platelet-to-lymphocyte ratio (plr), neutrophil-to-lymphocyte ratio (nlr), and monocyte-to-lymphocyte ratio (mlr), have become important predictors of the diagnosis, disease activity, s and severe organ damage in rheumatologic disorders. pan immune inflammation value (piv) was first described by fuca et al and used to evaluate the inflammation. literature showed that piv performed better than previous immune-inflammatory biomarkers, such as nlr in colorectal cancer patients. piv is calculated from four blood cell counts, including neutrophils, platelets, monocytes, and lymphocytes. in some rheumatological diseases such as ra, familial mediterranean fever, and vasculitis, piv has been studied. in clinical practice, hematological and inflammatory laboratory tests are easily accessible and cost-effective. it is important to determine which blood parameter will be more effective in detecting disease activity and monitoring the treatment response in bd. in our study, our aim is to investigate the association of pin with demographics and clinical characteristics of bd patients and its correlation with disease activity.

Eligibility criteria:
inclusion criteria: * adult bd patients who fulfilling the criteria for the diagnosis by international team for the revision of the international criteria for bechet's disease . * accept to participate in the current study. exclusion criteria: * individuals with other autoimmune diseases. * patients unwilling to participate in the study. * patients less than 18 years old. * patients with malignancy or infections. * pregnancy and lactation
changes in abdominal tissues induced by magnetic device - ct evaluation

Conditions: Fat Burn

Summary: the study is a prospective multi-center open-label single-arm study. the subjects will be enrolled and assigned into a single study group. subjects will be required to complete four (4) treatment visits and four follow-up visits, 1 month, 3, 6 and 12 months after the final treatment. at the baseline visit, photographs of the abdomen will be taken. in addition, adipose/muscle layer thickness will be measured with the computed tomography and the subject's weight will be recorded. in addition, at the last therapy visit, subjects will receive subject satisfaction and therapy comfort questionnaires to fill in. safety measures will include documentation of adverse events (ae) including subject's experience of pain or discomfort after the procedure. following each treatment administration and at the follow-up visits, subjects will be checked for immediate post-procedure adverse event assessment. post-procedure evaluation (follow-up visits) will be conducted 1 month, 3, 6 and 12 months after the final treatment. computed tomography and weight measure will be conducted at every follow-up visit. also, subject's satisfaction will be noted. during the first (1 month), third (6 months) and last (12 months) follow-up visits, photographs of abdomen will be taken.


Eligibility criteria:
inclusion criteria: * adult subjects of both genders with unwanted abdominal fat and expressing interest in treatment * age ≥ 22 years * voluntarily signed informed consent form * bmi ≤ 30 kg/m2 exclusion criteria: * cardiac pacemakers * electronic implants * pulmonary insufficiency * metal implants * drug pumps * haemorrhagic conditions * anticoagulation therapy * heart disorders * malignant tumor * fever * pregnancy * breastfeeding * following recent surgical procedures when muscle contraction may disrupt the healing process * application over menstruating uterus * application over areas of the skin which lack normal sensation * scars, open lesions and wounds at the treatment area * unrepaired abdominal hernia

Keywords: abdominal tissues
pulsed dye laser treatment of acne vulgaris

Conditions: Acne Vulgaris

Summary: the results of pulsed dye laser (pdl) treatment of acne vulgaris published so far are controversial: whereas seaton et al. described a marked improvement of mild-to-moderate acne after low-fluence pulsed-dye laser therapy, orringer et al. were unable to replicate said results in a similar, albeit not identical, study design. more recently published studies failed to resolve the controversy, varying in terms of treatment procedure(s) as well as results. while published results are certainly promising enough to be followed up by independent research, they are insufficient to justify the abdication of methods with proven efficacy. considering patient treatment ethics and the short 'window of opportunity' for scar prevention when active inflammatory lesions are present, the investigators planned the adjuvant application of the pdl in the present study, providing all patients with the well established and evidentially effective modality of a fixed-combination clindamycin 1%-benzoyl peroxide 5% hydrating gel (c/bpo). the goal of the study was the assessment of the efficacy and safety of a low-fluence pdl treatment in addition to c/bpo in patients with facial inflammatory acne.


Eligibility criteria:
inclusion criteria: * adolescents and adults with moderate inflammatory acne vulgaris (isga degrees 2-4) * fitzpatrick skin type i-iii exclusion criteria: * atopic dermatitis * oral antibiotics during the last 4 weeks prior to enrolment * oral isotretinoin during the last 52 weeks prior to enrolment * oral contraceptives during the last 26 weeks prior to enrolment * topical acne therapeutics during the last 4 weeks prior to enrolment * diagnosis or anamnestic indication of a regional enteritis, morbus crohn or antibiotics-associated colitis * laser surgery interventions within the treatment region during the last 12 weeks prior to enrolment * coagulation anomalies or anticoagulant treatment * photo-sensitizing medication (e. g., tetracycline, gold) * pregnancy

Keywords: acne vulgaris laser surgery pulsed dye lasers benzoyl peroxidase clindamycin randomized controlled trial
a phase 1/2 study of donafenib in combination with kn046 in advanced gastrointestinal tumors

Conditions: Advanced Gastrointestinal Tumors

Summary: this study is an open, multi-center clinical trial, the purpose is to study the safety and preliminary efficacy of donafenib combined with kn046 in subjects with advanced gastrointestinal tumors.

the study consists of dose escalation and dose expansion. the preset dose of donafenib is 50 mg bid, 100 mg bid and 200 mg bid, and the preset dose of kn046 is 5 mg/kg q3w. dose expansion will enroll subjects who with advanced hepatocellular carcinoma.

Eligibility criteria:
inclusion criteria: * male or female aged 18-70 years; * phase i dose escalation: advanced gastric cancer, esophageal cancer, colorectal cancer, hepatocellular carcinoma, pancreatic cancer (other than pancreatic neuroendocrine tumors) and intrahepatic cholangiocarcinoma that failed standard treatments confirmed by histopathology and/or cytology; among them, the child-pugh score of liver function in patients with hepatocellular carcinoma is less than 5, * phase ii advanced hepatocellular carcinoma dose expansion: patients with advanced hepatocellular carcinoma who are clinically diagnosed or confirmed by histopathology and/or cytology and are not suitable for surgical resection; the patient has not undergone first-line systemic treatment \[small molecule targeted drugs (such as sorafenib, lenvatinib, etc.), systemic chemotherapy\] and tumor immunotherapy (anti-pd-1/l1, ctla-4, etc.); child-pugh score of liver function ≤ 6; * has at least one measurable lesion based on recist 1.1; * eastern cooperative oncology group (ecog) performance status score of 0 or 1; * life expectancy ≥12 weeks; * patients must be able to understand and willing to sign a written informed consent document. exclusion criteria: * subjects who have previously received immune checkpoint inhibitors (such as anti-pd-1/l1, ctla-4, etc.); * history of interstitial lung disease or non-infectious pneumonia; * clinically obvious gastrointestinal abnormalities, which may affect the intake, transport or absorption of drugs (such as inability to swallow, chronic diarrhea, intestinal obstruction, etc.), or patients undergoing total gastrectomy; * has received vaccination within 4 weeks prior to the first dose. * has participated in other anticancer drug clinical trials within 4 weeks. * according to the judgement of the investigators, there are other factors that subjects are not suitable for the study.
the impact of large language models on diagnostic reasoning among llm-trained medical doctors

Conditions: Diagnosis

Summary: this study aims to evaluate whether large language model-trained medical doctors demonstrate enhanced diagnostic reasoning performance when utilizing chatgpt-4o alongside conventional resources compared to using conventional resources alone.

diagnostic errors are a major source of preventable patient harm. recent advances in large language models (llm), particularly chatgpt-4o, have shown promise in enhancing medical decision-making. however, little is known about their impact on medical doctors' (e.g., physicians' and surgeons') diagnostic reasoning. diagnostic accuracy relies on complex clinical reasoning and careful evaluation of patient data. while ai assistance could potentially reduce errors and improve efficiency, chatgpt-4o lacks medical validation and could introduce new risks through incorrect information generation (also known as hallucinations). to mitigate these risks, doctors need adequate training in understanding chatgpt-4o's capabilities, limitations, and proper usage. given these uncertainties and the importance of proper ai training, systematic evaluation is essential before clinical implementation. this randomized study will assess whether chatgpt-4o access improves llm-trained medical doctors' diagnostic performance compared to conventional resources (e.g., textbooks, online medical databases) alone. all participating doctors will have completed at least a 10-hour training program covering chatgpt-4o usage, prompt engineering techniques, and output evaluation strategies. participants will provide differential diagnoses with supporting evidence and recommended next steps for clinical cases, with responses evaluated by blinded reviewers.

Eligibility criteria:
inclusion criteria: * full or provisionally registered medical practitioners with the pakistan medical and dental council (pmdc). * completed bachelor of medicine, bachelor of surgery (mbbs) exam. the equivalent degree of mbbs in us and canada is called doctor of medicine (md). * participants must have completed a structured training program on the use of chatgpt (or a comparable large language model), totaling at least 10 hours of instruction. the program must include hands-on practice related to llm's aspects, specifically prompt engineering and content evaluation. exclusion criteria: * any other registered medical practitioners (full or provisional) with pmdc (e.g., professionals with bachelor of dental surgery or bds).

Keywords: clinical reasoning large language models computer-assisted diagnosis
modulation of anti-tumor t cell responses in cancer patients treated by concomitant radiochemotherapy

Conditions: Lung Cancer; Head and Neck Cancer

Summary: the aim of this study is to evaluate modulation of anti-tumor t cell responses in cancer patients treated by concomitant radiochemotherapy (i-rtct)


Eligibility criteria:
inclusion criteria: * histologically confirmed nsclc (non small cell lung cancer) or sclc (small cell lung cancer) or histologically confirmed head and neck cancer * patient candidate to a first-line concomitant radiochemotherapy * written informed consent exclusion criteria: * sequential radiochemotherapy, exclusive radiotherapy, or stereotactic radiotherapy * history of adjuvant radiochemotherapy for cancer treatment * patients under immunotherapy, chemotherapy or other immunosuppressive drugs (prednisone or prednisolone ≤ 10 mg/day is allowed) * hiv, hepatitis c or b virus * patients with any medical or psychiatric condition or disease, * patients under guardianship, curatorship or under the protection of justice.

Keywords: immunomonitoring immune checkpoint chemoradiation t cells
a study to evaluate the efficacy and safety of hrs4800 tablets for postoperative analgesia after impacted teeth removal surgery.

Conditions: Pain

Summary: the study is being conducted to evaluate the efficacy and safety of hrs4800 tablets for postoperative analgesia after impacted teeth removal surgery.


Eligibility criteria:
inclusion criteria: 1. 18 to 65 years old. 2. scheduled to remove the impacted tooth. 3. any nrs score ≥5 within 4 hours after the surgery. 4. willing to comply with the study procedures and requirements. 5. willing and able to provide written informed consent for this study. exclusion criteria: 1. subjects who had used other drugs that affect the analgesic effect. 2. subjects who have infection or other complications on the planned oral surgical site. 3. subjects with uncontrolled hypertension or hypotension. 4. subjects with severe cardiovascular and cerebrovascular diseases. 5. subjects with severe gastrointestinal disease. 6. subjects with a history of drug or alcohol abuse. 7. subjects with significant abnormal electrocardiogram. 8. subjects with significant abnormal laboratory value. 9. subject who were allergic to the study drug and ingredients. 10. pregnancy, lactation or having recent pregnant plan. 11. subjects who participated in other clinical research study 30 days before entering this study. 12. other conditions unsuitable for participation in the study.