Kornimate/medical-research-clean huggingface dataset:
enhanced recovery after cesarean section with low dose intrathecal morphine.

Conditions: Pain, Postoperative; Pruritus; Nausea, Postoperative; Vomiting, Postoperative

Summary: this study is designed to see the effect of low dose intrathecal morphine on promting enhanced recovery after cesarean delivery with early ambulation and reduction of hospital stay.

parturients showing for elective cesarean section will be randomized into 3 groups by a computer generated randomization list. each randomization slip will be put in a sealed envelope until patient enrollment. patients will be divided into group c: control group, given intrathecal bupivacaine 12.5 mg. group m25: intrathecal bupivacaine 12.5mg + morphine 25 microgram. group m50: intrathecal bupivacaine 12.5mg + morphine 50 microgram.

Eligibility criteria:
inclusion criteria: * females scheduled for cesarean section * age: 16-45 yrs. * gestation age \>38 weeks. * asa i,ii exclusion criteria: * refusal to participate. * significant cardiac, hepatic or renal dysfunction. * history of chronic itching problem, or hyperemesis during pregnancy

Keywords: pain morphine cesarean section enhanced recovery
observational feasibility study of home-based training with therabands in pad-patients

Conditions: Peripheral Artery Disease; Intermittent Claudication

Summary: the study is an observational feasibility study to evaluate the feasibility of a combined aerobic+resistance training program in patients with ic.


Eligibility criteria:
inclusion criteria: * age ≥ 50 yrs; * ankle-brachial index (abi) ≤ 0.9 in one or two legs; * fontaine stage ii (rutherford i 1-3) of pad (new onset or conservatively treated); * body mass index \<35 kg/m 2 ; * resting systolic blood pressure (bp) \<160 mmhg and diastolic bp \<105 mmhg; * ability to walk at least 2 min at 2.0 mph; * ability to undertake an incremental treadmill test; * decrease of at least 15% in abi after a maximal treadmill test; * not currently engaging in any regular exercise program. exclusion criteria: * exercise induced signs of myocardial ischemia or complex ventricular arrhythmias; * no access to laptop or internet; * no medical clearance for exercise
study to evaluate the safety and efficacy of selonsertib, firsocostat, cilofexor, and combinations in participants with bridging fibrosis or compensated cirrhosis due to nonalcoholic steatohepatitis (nash)

Conditions: Nonalcoholic Steatohepatitis

Summary: the primary objectives of this study are: * to assess the safety and tolerability of selonsertib (sel), firsocostat (fir) and cilofexor (cilo), administered alone or in combination, in participants with bridging fibrosis or compensated cirrhosis due to nash * to evaluate changes in liver fibrosis, without worsening of nash


Eligibility criteria:
key inclusion criteria: * liver biopsy consistent with nash and f3 or f4 in the opinion of the central reader * in participants who have never had a liver biopsy, liver stiffness by fibroscan® ≥ 14.0 kpa and enhanced liver fibrosis (elf™) test score ≥ 9.8 at screening * screening laboratory parameters, as determined by the central laboratory: * estimated glomerular filtration rate (egfr) ≥ 60 ml/min, as calculated by the cockcroft-gault equation * hemoglobin a1c (hba1c) ≤ 9.5% * alanine aminotransferase (alt) \< 5 x upper limits of normal (uln) * platelet count ≥ 125,000/μl key exclusion criteria: * prior history of decompensated liver disease including ascites, hepatic encephalopathy, or variceal bleeding * child-pugh (cp) score \> 6 at screening, unless due to an alternative etiology such as gilbert's syndrome or therapeutic anticoagulation * model for end-stage liver disease (meld) score \> 12 at screening, unless due to an alternate etiology such as therapeutic anticoagulation * other causes of liver disease based on medical history and/or centralized review of liver histology, including but not limited to: alcoholic liver disease, hepatitis b, hepatitis c, autoimmune disorders (eg, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis), drug-induced hepatotoxicity, wilson disease, clinically significant iron overload, or alpha-1-antitrypsin deficiency requiring treatment * history of liver transplantation * current or prior history of hepatocellular carcinoma note: other protocol defined inclusion/ exclusion criteria may apply
magnetic resonance imaging study on patients with trigeminal neuralgia

Conditions: Trigeminal Neuralgia

Summary: up to now, multiplanar reconstruction (mpr) has been widely used to detect the neurovascular compressions (nvc) on the patients with idiopathic trigeminal neuralgia (itn). however, due to lack of stereoscopic vision, this traditional method sometimes cannot meet the requirement on identifying the existence and details of nvc, especially when the aberrant vessels turn out to be delicate veins. the three-dimensional analytic techniques, such as curved planar reconstruction (cpr) and magnetic resonance virtual endoscopy (mrve), may be helpful to improve the sensitivity and specificity on the demonstration of nvc with stereo and dynamic views, so as to assist to design the surgical plan. furthermore, the frequent finding of nvc on mri studies of asymptomatic patients incited the creation of several strict criteria for the imaging diagnosis of nvc: the vessel must cross perpendicular to the long axis of the nerve, the nerve must be deviated or indented at the root entry zoon (rez) by the vessel. alternatively, morphological measurement of the nerve may correlate with the severity of facial pain due to atrophy of the nerve in most cases of itn, and is likely secondary to the micro-structural abnormalities, such as axonal loss, demyelination, collagen deposition, etc. in this study, cross-sectional area (csa) and volume (v) of the cisternal trigeminal nerve will be assessed to determine whether it can be a useful biomarker for predicting the degree of itn.


Eligibility criteria:
inclusion criteria: * diagnosis according to the international classification of headache disorders criteria (3rd edition); 1 year disease duration at least. exclusion criteria: * secondary causes of itn; precarious general health status; percutaneous lesions or surgical treatments; cardiac pacemaker or metal implants.

Keywords: mri virtual endoscopy pain measurement
a research study in children born small and who stayed small. treatment is somapacitan once a week compared to norditropin® once a day

Conditions: Short Stature Children Born Small for Gestational Age (SGA)

Summary: the study compares 2 medicines used for the treatment of children who are born small and who stayed small: somapacitan given once a week (a new medicine) and norditropin® given once a day (the medicine doctors can already prescribe). participants will either get somapacitan or norditropin® - which treatment is decided by chance. both participants and the study doctor will know which treatment the participants get. the study will last for 5 years. participants will take either an injection once every week or once every day.


Eligibility criteria:
inclusion criteria: * pre-pubertal children, boys: 1. age between 2.5 and 11.0 years at screening. 2. testes volume below 4 ml. * pre-pubertal children, girls: 1. age between 2.5 and 10.0 years at screening. 2. tanner stage 1 for breast development (no palpable glandular breast tissue). * born small for gestational age (birth length and/or weight below -2 standard deviation scores) (according to national standards). * impaired height defined as at least 2.5 standard deviations below the mean height for chronological age and gender at screening according to the standards of centers for disease control and prevention at screening. * impaired height velocity defined as annualized height velocity below the 50th percentile for chronological age and gender according to the standards of prader calculated over a time span of minimum 6 months and maximum 18 months prior to screening. * no prior exposure to growth hormone therapy or insulin-like growth factor-i (igf-i) treatment. exclusion criteria: * any known or suspected clinically significant abnormality likely to affect growth or the ability to evaluate growth with standing height measurements. * children with hormonal deficiencies including suspected or confirmed growth hormone deficiency according to local practise. * current inflammatory diseases requiring systemic corticosteroid treatment for longer than 2 consecutive weeks within the last 3 months prior to screening. * children requiring inhaled glucocorticoid therapy at a dose of greater than 400 μg/day of inhaled budesonide or equivalents for longer than 4 consecutive weeks within the last 12 months prior to screening. * concomitant administration of other treatments that may have an effect on growth, e.g but not limited to methylphenidate for treatment of attention deficit hyperactivity disorder. * diagnosis of attention deficit hyperactivity disorder. * prior history or presence of malignancy including intracranial tumours.
add-on to micamlo bp trial

Conditions: Hypertension

Summary: this is a multi-centre, randomised, double-blind, active-controlled, parallel-group comparative trial to compare the fixed dose combination (fdc) of telmisartan 80 mg +hydrochlorothiazide 12.5 mg and amlodipine 5 mg (t80/a5/h12.5 mg) to telmisartan 80 mg+ amlodipine 5 mg (t80/a5 mg) in blood pressure lowering effect at week 8, the end of the double-blind period in essential hypertensive patients who fail to respond adequately to telmisartan 80 mg+ amlodipine 5 mg. patients are assigned to one of the two groups after a 6-week open-label run-in period taking t80/a5 mg.


Eligibility criteria:
inclusion criteria: * essential hypertensive patients who have already taking 2 or 3 antihypertensive drugs and mean seated diastolic blood pressure (dbp) must be \>=90 and \<=114 mmhg and mean seated systolic blood pressure (sbp) must be =\<200 mmhg * able to stop all current antihypertensive drugs (other than study medication) from visit 1b through the end of the trial without risk to the patient based on the investigator's opinion * age 20 years or older exclusion criteria: * patients with known or suspected secondary hypertension * patients with clinically relevant cardiac arrhythmia * congestive heart failure with new york heart association (nyha) functional class iii-iv * patients with recent cardiovascular events * patients with recent stroke events * patients with a history of sudden deterioration of renal function with angiotensin ii receptor blockers or angiotensin converting enzyme inhibitors; or patients with post-renal transplant or post-nephrectomy * patients with hepatic and/or renal dysfunction * pre-menopausal women who are nursing or pregnant
study of blood clotting after transcatheter atrial septal defect closure

Conditions: Thrombosis

Summary: the purpose of this study is to evaluate blood clots after percutaneous asd closure in different age, sexuality and defective diameter; evaluating the relationship of blood clotting with occluder, injury of intima and inflammation;comparation of the effect and safety between different anticoagulation after percutaneous asd repair; explore propose an optimal anticoagulation plan.

atrial septal defect (asd) is a common clinical congenital heart disease. it is estimated that the congenital heart disease increase in children by about 15 million annual in china , of which asd accounted for 10% to 15%. secundum asd is the most common clinical type of asd, of which about 70% is suited to tanscatheter close.with the cardiac catheterization advancing and the devices developing in recent years ,the method has gradually replaced open-chest surgical repair to the person with secundum asd. at present, the most widely used device is amplatzer occluder. with the wide ues of the occlur,there has gradually emerged occluder thrombosis after closure.there are much different methods to antiplatelet and anticoagulation，not only in china but also in the world.so we perfom the study to evaluating the blood clotting after percutaneous asd closure in different age, sexuality and defective diameter; evaluating the relationship of blood clotting with occluder, injury of intima and inflammation;comparation of the effect and safety between different anticoagulation after percutaneous asd repair; explore propose an optimal anticoagulation plan.

Eligibility criteria:
inclusion criteria: * age≥3 years * diameter of defect≥5mm and increasing volume load of right heart * ≤36 mm secondary left to right shunt * the distance between defective edge and coronaria venosus sinus, inferior caval vein, superior vena and pulmonary vein≥ 5 mm, between artrial-ventricular valve≥7 mm * the diameter of defect\>occluder * no other cardiac anomalies need surgery intervention exclusion criteria: * hypertension * coronary artery disease * diabetes * atrial fibrillation and oral contraceptive medication * aspro, clopidogrel and warfarin in 2 weeks.

Keywords: platelet thrombozyme asd heparin enoxaparin
online ultrasound curriculum on learning outcomes of post-graduate physicians

Conditions: Medical Education

Summary: this single-center retrospective study evaluates the effectiveness of the training management system (tms) ultrasound curriculum on the learning outcomes of pgy emergency physicians. by analyzing test scores and course participation data from 2018 to 2025, the study investigates whether blended learning improves pocus proficiency and explores its potential role in enhancing ultrasound education for junior physicians.

current point-of-care ultrasound education faces multiple challenges. traditional teaching methods, such as didactic lectures and bedside one-on-one training, are constrained by time, clinical workload, and faculty availability, leading to inconsistent learning outcomes. additionally, pgy physicians, due to their limited clinical experience, struggle to develop proficiency in ultrasound in a randomized learning environment. the quality of ultrasound image acquisition and diagnostic accuracy is also highly dependent on the operator's experience. in recent years, online learning platforms, such as the training management system, have been introduced to enhance learning flexibility. however, the long-term impact of such platforms on trainees' clinical application remains unclear. this study aims to evaluate the impact of the tms ultrasound curriculum on the learning outcomes of pgy emergency physicians and explore the feasibility of a blended learning approach in improving ultrasound skill application. this single-center retrospective study analyzes test data from pgy trainees who participated in emergency pocus training between 2018 and 2025, including post-course test scores, objective structured clinical examination scores, and self-reported tms course participation. the findings of this study may provide insights into the effectiveness of online and blended learning models in developing ultrasound proficiency among junior physicians and inform future medical education curriculum design.

Eligibility criteria:
inclusion criteria: 1. pgy trainees who participated in the department of emergency medicine ultrasound training program during the study period. 2. trainees with complete course participation records and assessment results. exclusion criteria: 1. non-pgy participants (e.g., senior residents, attending physicians, medical students). 2. incomplete assessment data that prevents a full evaluation of learning outcomes. 3. any abnormal data not meeting study criteria (e.g., recording errors or duplicate entries).

Keywords: medical education ultrasound online training management system
fruquintinib combined with sintilimab and chemotherapy in the treatment of non-small cell lung cancer

Conditions: Carcinoma, Non-Small-Cell Lung

Summary: a phase ii study to assess the efficacy and safety of fruquintinib combined with sintilimab and chemotherapy as a first-line treatment in patients with unresectable or metastatic advanced wild-type genotype non-squamous non-small cell lung cancer.


Eligibility criteria:
inclusion criteria: 1. voluntary provision of informed consent. 2. males or females aged 18-75. 3. histological or cytologically confirmed nsclc, metastatic or non-resectable (stage iiib-ⅳ). 4. not suitable for targeted therapy (patients with non-squamous nsclc have no egfr, alk, gene mutation) 5. at least one lesion can be measured by imaging. 6. have not received systemic treatment in the past. 7. eastern cooperative oncology group (ecog) performance status (ps) of 0-1. 8. life expectancy ≥ 12 weeks. 9. female of childbearing age must have a negative pregnancy test (serum or urine) within 7 days before enrolment. exclusion criteria: 1. histological or cytologically confirmed small cell lung cancer (sclc), including lung cancer mixed with sclc and nsclc. 2. diagnosed with other malignant diseases other than nsclc within 5 years. 3. have participated in other interventional clinical research treatments now or within 4 weeks. 4. have previously received multi-targeted kinase inhibitors therapy. 5. have active autoimmune diseases requiring systemic treatment within 2 years. 6. received systemic glucocorticoid therapy or immunosuppressive therapy within 2 weeks. 7. clinically uncontrollable pleural effusion/abdominal effusion. 8. vaccinated vaccines or attenuated vaccines within 4 weeks before the group; 9. pregnant or breastfeeding females. 10. other serious hazards to the safety of patients.
individual optimal positive end-expiratory pressure during robot-assisted laparoscopic radical prostatectomy

Conditions: Pulmonary Atelectasis, Postoperative

Summary: during robot-assisted radical prostatectomy, pneumoperitoneum with trendelenburg position is used. however, perioperative atelectasis and respiratory complications may occur with high incidence due to general anesthesia and carbon dioxide pneumoperitoneum. intraoperative ventilatory strategy to address these issues include intraoperative recruitment maneuver and positive end-expiratory pressure (peep). recently, individualized optimal peep with minimal driving pressure or maximal respiratory compliance was reported to reduce respiratory complications after general anesthesia. a recent version of general anesthesia ventilator provides a stepwise procedure of determining optimal peep by calculating respiratory compliance. we investigated whether the application of individualized optimal peep could reduce the incidence of atelectasis and respiratory complications after robot-assisted laparoscopic radical prostatectomy compared to uniform peep.

during robot-assisted radical prostatectomy, pneumoperitoneum with trendelenburg position is used. however, perioperative atelectasis and respiratory complications may occur with high incidence due to general anesthesia and carbon dioxide pneumoperitoneum. intraoperative ventilatory strategy to address these issues include intraoperative recruitment maneuver and positive end-expiratory pressure (peep). recently, individualized optimal peep with minimal driving pressure or maximal respiratory compliance was reported to reduce respiratory complications after general anesthesia. a recent version of general anesthesia ventilator provides a stepwise procedure of determining optimal peep by calculating respiratory compliance. we investigated whether the application of individualized optimal peep could reduce the incidence of atelectasis and respiratory complications after robot-assisted laparoscopic radical prostatectomy compared to uniform peep. we plan to determine the degree of immediate postoperative atelectasis by measuring the lung ultrasound score and compare the lung ultrasound score between groups.

Eligibility criteria:
inclusion criteria: * patients undergoing robot-assisted laparoscopic radical prostatectomy * patients receiving mechanical ventilation by aisys care station anesthesia ventilator * patients who provided written informed consent to participate in this clinical trial exclusion criteria: * american society of anesthesiologists physical status classification class 3 or more * moderate or more obstructive or restrictive pulmonary disease * preoperative adult respiratory distress syndrome or previous history of adult respiratory distress syndrome * history of heart failure, unstable angina, increased intracranial pressure * history of pneumothorax or presence of bullae

Keywords: robot-assisted surgery prostatectomy laparoscopy positive end-expiratory pressure individualized atelectasis general anesthesia
collaborative care for opioid dependence and pain pilot study

Conditions: Opioid Dependence; Chronic Pain

Summary: this pilot study evaluates a collaborative care program to assist with opioid tapering in patients with chronic pain. patients will be randomized to receive the intervention or usual care.


Eligibility criteria:
inclusion criteria: * chronic pain for at least 6 months * receiving daily opioid treatment exclusion criteria: * not speaking english * significant psychiatric impairment including severe cognitive impairment, suicidality, schizophrenia, or bipolar disorder * known life expectancy of less than 6 months
strategy therapy on cancer therapy-related cardiac dysfunction

Conditions: Chemotherapeutic Toxicity; Cardiotoxicity; Heart Failure; Breast Cancer; Lymphoma

Summary: the investigators use the cancer registration system of national cheng kung university hospital to timely screen and evaluate those patients having breast cancer or lymphoma to enroll patients to participate in this clinical trial. the investigators planned an earlier initiation of sacubitril/valsartan treatment on breast cancer and lymphoma patients before the chemotherapy, and starting therapeutic intervention by sacubitril/valsartan once the heart damage sign appeared via novel echocardiography. the investigators aim to assess the protective and therapeutic benefit of cardioprotective drugs on the cardiotoxicity of anti-cancer therapy.

the investigators use the cancer registration system of national cheng kung university hospital to timely screen and evaluate those patients having breast cancer or lymphoma to enroll patients to participate in this clinical trial. also, the patient recruitment system support to complete the patients' database. the investigators cooperate with other hospitals in south taiwan to carry on an early phase clinical trial, named "strategy by novel anti-heart failure therapy on early phase cancer therapeutics-related cardiac dysfunction (ctrcd) patients" focusing on the either preventive strategy to earlier initiation of sacubitril/valsartan treatment on breast cancer and lymphoma patients before the chemotherapy, and starting therapeutic intervention by sacubitril/valsartan once the heart damage sign appeared via novel echocardiography, and collect clinical and genetic information from the enrolled patients. these patients randomized into 2 groups: cardioprotective drug vs. placebo. the regular assessment of cardiac function is as following: baseline (prior to anti-cancer treatment) and every 3 months. thereafter. the investigators aim to assess the protective and/or therapeutic benefit of cardioprotective drugs on the cardiotoxicity of anti-cancer therapy.

Eligibility criteria:
inclusion criteria: * patients who are newly diagnosed with breast cancer or lymphoma and never accepted anti-cancer therapy * age 20-65 years old * systolic blood pressure ≥ 110 mmhg exclusion criteria: * end-stage renal disease (estimated glomerulus filtration rate \<15 ml/min/1.73 m2) * echocardiography baseline left ventricle ejection fraction \< 50% * allergy history to angiotensin receptor blockers * life expectancy \< 1 year * pregnancy * unwilling to participate in this clinical study