Kornimate/medical-research-clean huggingface dataset:
assessing the implementation and feasibility of the smart-mr

Conditions: Moral Injury

Summary: the objective of the proposed pilot study is to assess the feasibility and implementation of the smart-mr program, an integration of stress management, general resilience, and moral resilience skills, with frontline staff who provide direct patient care at the ottawa hospital (toh).

many of the sources of stress facing healthcare workers during the covid-19 pandemic involve difficult ethical trade-offs that give rise to moral distress. moral distress has personal consequences for healthcare workers, notably for their mental health, and wider consequences for the organization and health system as a whole as it negatively affects quality of care, patient satisfaction, and the recruitment, retention and satisfaction of staff. moral resilience refers to the capacity of an individual to sustain or restore their integrity in response to moral adversity and has been raised as a potential way to mitigate moral distress. the stress management and resilience training (smart) program is one of the few evidence-based interventions designed to build resilience in healthcare workers. the smart program is a brief, neuroscience-based intervention, typically delivered in a single 90-minute session. the structured program teaches self-care skills by developing intentional attention and the ability to reframe potentially stressful situations more quickly. recently, a modified version of the existing smart program, smart-moral resilience (smart-mr), has been developed with an additional focus on reducing moral distress and building moral resilience for healthcare workers. the synergy of general resilience strategies with focus on the moral/ethical dimensions of clinical practice offer clinicians specific skills to address ethical challenges. we believe implementing the smart-mr program with frontline staff during the covid-19 pandemic is warranted. therefore, we plan to pilot this innovative intervention at toh to assess its feasibility and implementation.

Eligibility criteria:
inclusion criteria: • full-time or part-time toh staff who provide direct patient care, including: attending physicians, nurses, allied health, social workers and spiritual care providers exclusion criteria: • toh staff members who do not provide direct patient care

Keywords: moral distress moral resilience healthcare workers covid-19
continuous central venous oxygen saturation assisted intraoperative hemodynamic management

Conditions: Major Abdominal Surgery; Perioperative Haemodynamic Monitoring; Perioperative Fluid Management; Perioperative Vasopressor Requirement; Postoperative Organ Function; Postoperative Complications

Summary: patients who are scheduled for: elective oesophageal tumour resection, total gastrectomy, pancreas resection, major vascular, total cystectomy will be recruited.to investigate effects of central venous pressure (cvp) and central venous saturation (scvo2) guided fluid management on intraoperative haemodynamic parameters, volume and vasopressor requirement, and postoperative organ function and postoperative inflammatory response.


Eligibility criteria:
inclusion criteria: * patients undergoing the following elective major abdominal surgery: oesophagectomy, total gastrectomy, radical cystectomy, aorta-bifemoral bypass or elective operation of abdominal aortic aneurysm. * after surgery patients were admitted to our intensive care unit. exclusion criteria: * patients younger than 18 years * chronic organ insufficiency: "acute physiology and chronic health evaluation (apache) ii" scoring system: new york heart association class iv, chronic hypoxia or hypercapnia, chronic renal failure requiring renal replacement therapy, biopsy proven cirrhosis or portal hypertension and immunodeficiency. * preoperative anaemia (haemoglobin\<100g/l) * coagulation abnormality * and patients with chronic use of corticosteroids and non-steroid anti-inflammatory drugs * patients requiring an operation due to malignant disease where the tumour then proved to be inoperable.
stereotactic body radiotherapy for unresectable pancreatic cancer

Conditions: Pancreatic Cancer

Summary: this study will evaluate the local control rate as well as acute and late toxicity rates of stereotactic body radiotherapy (sbrt) for the treatment of unresectable pancreatic cancer.

this is a single institution, non-randomized, prospective, phase iv trial of sbrt for unresectable pancreatic cancer. data collected will include patient demographics, pathology data, tumor stage, sbrt dose fractionation scheme, dose received by adjacent critical normal tissues, tumor recurrence data, and acute and late toxicities. follow up data will be collected during the patient's standard office visits. the anticipated duration of this study is 5 years.

Eligibility criteria:
inclusion criteria: * patient age \>= 18 years * performance status of 0-3 * unresectable pancreatic cancer * maximum tumor diameter \< 7.5 cm * signed study-specific consent form exclusion criteria: * maximum tumor diameter \> 7.5 cm * prior radiotherapy to the upper abdomen * pregnant or lactating women, due to potential exposure of the fetus to rt and unknown effects of rt on lactating females * patients with psychiatric or addictive disorder that would preclude obtaining informed consent

Keywords: pancreatic cancer
project impact: an innovative approach to weight loss maintenance

Conditions: Obesity; Weight Loss; Overweight

Summary: the major goal of this project is to evaluate an innovative approach to obesity. this study will determine if behavioral treatment can be improved by 1) implementing a primary focus on pa following initial weight loss treatment, and 2) using a novel, acceptance-based approach to the promotion of pa.

most adults who engage in lifestyle modification find it difficult to maintain a high level of pa over the long-term, and most also find that weight regain is inevitable. the current portfolio of available interventions does not adequately address these challenges. this project is designed to test the effectiveness of an intervention that is specifically designed to enhance the ability to maintain, in the long-term, a level of pa high enough to achieve long-term weight loss maintenance. in the study, 300 obese adults will be recruited from the community and provided with 6 months of group-based, standard behavioral treatment for induction of weight loss (phase i). a 6-month phase i was chosen so that all participants will have sufficient time to accomplish initial weight loss before phase ii begins, allowing phase ii to truly be a test of weight loss maintenance. in phase ii, participants will receive one of three interventions, to be delivered for an additional 12 months: 1) behavioral treatment, with the standard emphasis on maintaining changes in diet and pa (bt), 2) behavioral treatment, with a primary emphasis on using these skills to maintain pa (bt-pa), or 3) acceptance-based behavioral treatment, with a primary emphasis on using these skills to maintain pa (abt-pa). assessments will be conducted at baseline, 6 months, 18 months (end of treatment), 24 months (6-month follow-up), and 36 months (18-month follow-up).

Eligibility criteria:
inclusion criteria: * have a bmi between 27 and 45 kg/m2 * have the ability to engage in at least 15 minutes of moderate physical activity (e.g. brisk walking) * successfully complete all steps in the enrollment process, including attendance at all pre-randomization clinic visits and providing physician clearance exclusion criteria: * have a medical condition that prevents safe engagement in moderate-to-vigorous physical activity * are lactating, pregnant, or planning to become pregnant in the next three years * report recently beginning a course of or changing the dosage of prescription medications that can cause significant weight loss or weight gain * are participating in or plan to participate in another weight loss program in the next three years * have a primary family member or member of their household participating in the study

Keywords: obesity weight loss overweight
prostate cancer survey

Conditions: Prostate Cancer

Summary: there have been calls from patients, payers, healthcare providers, and policy makers for an evaluation of newer, high-cost radiation technologies compared to conventional forms of radiation therapy. national attention has focused on the use of intensity modulated radiation therapy (imrt) into routine daily clinical practice for prostate cancer. the goal of the present study is to determine whether the type of radiation treatment received by the patients can result in a reduction in patient-relevant side effects following prostate irradiation. the analysis will be performed by obtaining patient answered surveys looking at side effects.


Eligibility criteria:
inclusion criteria: * participant is 18 years or older * has been diagnosed with prostate cancer * able to speak and read english exclusion criteria: * participant is not being seen for prostate cancer * under the age of 18

Keywords: survey focus group treatment preferences
safety and effectiveness of the akura thrombectomy system for use in the removal of emboli from the pulmonary arteries in treating acute pulmonary embolism (pe)

Conditions: Pulmonary Embolism Acute

Summary: this study is a prospective, single-arm, interventional, multicenter study to evaluate the safety and effectiveness of percutaneous mechanical thrombectomy using the akura thrombectomy system in subjects with acute pulmonary embolism (pe).


Eligibility criteria:
inclusion criteria: * the patient is 18 years of age or older and deemed medically eligible for interventional procedure, per institutional guidelines and clinical judgement * clinical signs, symptoms and presentation consistent with acute pe * pe symptom duration ≤ 14 days * cta evidence of proximal pe (filling defect in at least one main or lobar pulmonary artery) * cta evidence of rv/lv ratio of ≥ 0.9 (note: enrollment qualification assessment is based on the investigator's interpretation of rv/lv ratio at baseline) * systolic bp ≥ 90 mmhg (initial sbp may be \< 90 mmhg but ≥ 80 mmhg if the pressure recovers with volume resuscitation) * stable hr \< 130 bpm prior to the procedure exclusion criteria: * prior pe \<180 days from index procedure * thrombolytic use within 30 days prior to baseline cta * pulmonary hypertension with peak pulmonary arterial pressure (pap) \> 70 mmhg by right heart catheterization * vasopressor requirement after fluids to keep pressure at ≥ 90 mmhg * fio2 requirement \> 40% or \> 6 lpm (to keep oxygen saturation \> 90%) * hematocrit \< 28% (note: hematocrit required within 6 hrs. of index procedure) * platelets \< 100,000/μl * egfr \<30 ml/min per 1.73 m2 * international normalized ratio (inr) \> 3 * major trauma injury severity score (iss) \> 15 * presence of intracardiac lead in right ventricle or atrium placed ≤ 6 months of enrollment * cardiovascular or pulmonary surgery within the last 7 days * actively progressing cancer treated by chemotherapeutics * known bleeding diathesis or coagulation disorder * left bundle branch block * history of severe or chronic pulmonary arterial hypertension * history of chronic left heart disease with left ventricular ejection fraction ≤ 30% * history of uncompensated heart failure. * history of underlying lung disease that is oxygen dependent * history of chest irradiation * history of heparin-induced thrombocytopenia (hit) * contraindication to systemic or therapeutic doses of anticoagulants * known anaphylactic reaction to radiographic contrast agents that cannot be pretreated * known residual iliac deep vein thrombosis (dvt), inferior vena cava (ivc) clot or clot in transit (right atrium and/or right ventricle) * cta imaging or other evidence that suggest, in the opinion of the investigator, the subject is not appropriate for mechanical thrombectomy intervention (e.g. inability to navigate to target location, predominantly chronic clot or non-clot embolus) * life expectancy \< 90 days, as determined by investigator (e.g., stage 4 cancer, frailty or severe covid infections) * female who is pregnant or nursing * current participation in another investigational drug or device treatment study
effect of high-quality pre-operative videos on patient anxiety levels prior to ambulatory hand surgery

Conditions: Anxiety; Carpal Tunnel Syndrome; Trigger Finger; Engagement, Patient; Pain

Summary: previous research has shown that youtube is a poor source of high-quality medical information. this is likely because there is no regulation of the content on youtube and relatively little of the content is posted by qualified medical professionals. it is known that up to 30% of patients use the internet to research the procedure they will be having and given the increasing popularity of youtube we suspect many patients are using youtube or similar sites as a source of information prior to elective surgery. there are likely a number of patient factors that contribute to patients seeking out videos as a source of pre-operative medical information. patient age, which is generally inversely correlated to computer literacy, may have a role. patient anxiety and pre-operative worrying may cause a patient to turn to the internet to search for information, and the poor overall quality of the content available may worsen pre-operative anxiety. the primary objective of this study is to determine if providing patients with a reliable, high-quality video about their condition and operation prior to surgery reduces pre-operative anxiety. secondary aims are to determine the percentage of patients that independently seek out videos online as a source of medical information prior to elective hand surgery, identify patient attributes that are associated with this behavior, and understand if introducing high quality pre-surgical videos has an impact on post-operative patient outcomes and/or patient engagement. the investigators hypothesize that providing patients with high-quality pre-operative videos will reduce pre-operative anxiety. its is also expected that patients who seek out videos on their own for pre-operative medical information will be younger and have higher anxiety levels and pain catastrophizing scores. additionally, the investigators hypothesize that patients who watch high-quality pre-operative videos may have better short term post-operative outcomes and greater engagement in their care than their counterparts that did not watch videos or who sought out videos on their own.


Eligibility criteria:
inclusion criteria: * undergoing a primary routine elective hand procedure (carpal tunnel release, trigger finger release) * age \> 18 years exclusion criteria: * revision procedure * prior debilitating upper extremity injury * surgery not being performed on ambulatory basis * special populations (pregnant patients, prisoners or other institutionalized patients, cognitive impairment) * non-english speaking patients (videos only available in english language) * age \< 18 years
the safety and efficacy of combined microwave ablation during limb-sparing surgery in high-risk soft tissue sarcoma patients

Conditions: Sarcoma; Microwave; Ablation Techniques

Summary: soft tissue sarcoma (sts) is a rare, aggressive malignancy with a high risk of recurrence when invading surrounding structures, and the optimal treatment strategy for safe surgical margin is still unclear. this study aimed to evaluate the safety and efficacy of combined local inactivation by ablation in sts during limb-sparing surgery in high-risk sts patients.

soft tissue sarcoma (sts) is a rare, aggressive malignancy with a high risk of recurrence when invading surrounding structures, and the optimal treatment strategy for safe surgical margin is still unclear. this study aimed to evaluate the safety and efficacy of combined local inactivation by ablation in sts during limb-sparing surgery in high-risk sts patients. investigators collected data retrospectively from participants diagnosed with soft tissue sarcoma who were treated at a tertiary medical institution from january 1, 2018, to december 31, 2022. this study was approved by the hospital's ethics committee (xjs2022-101-01), and all participants provided written informed consent. the participants were divided into two groups (mwa and control group). the mwa group received surgical resection combined with local lesion inactivation by mwa, while the control group underwent standard surgical resection alone. non-specified sarcomas are treated with the ai(doxorubicin+ifosfamide) chemotherapy regimen, while ewing's sarcoma is treated with the standard recommended vdc ((vincristine + doxorubicin + cyclophosphamide)/ie(ifosfamide + etoposide) chemotherapy regimen.

Eligibility criteria:
inclusion criteria: 1. pathologically confirmed soft tissue sarcoma (fnclcc grade g2-g3); 2. mri/ct confirmed tumor invasion beyond anatomical compartments, joint involvement, or encroachment on surrounding tissues (bones, muscle, etc.); 3. after being fully informed of the risks, the patient strongly refuses amputation or wide resection, which leads to irreversible impaired function. 4. good physical condition, able to tolerate surgery; exclusion criteria: 1. patients with distant metastasis at the time of initial diagnosis; 2. patients with missing clinical or follow-up data.

Keywords: sarcoma microwave ablation limb-sparing surgery
dietary nitrate on salivary flow for nasopharyngeal carcinoma patients

Conditions: Nasopharyngeal Carcinoma

Summary: the purpose of this study is to evaluate whether dietary nitrate supplementation could improve the salivary flow for nasopharyngeal carcinoma patients receiving concurrent chemo-radiation therapy.

thirty patients diagnosed as nasopharyngeal carcinoma will be recruited. nitrate supplement(sodium nitrate: 0.5 mmol/kgbodyweight,bid) or placebo(sodium chloride: 0.5 mmol/kgbodyweight,bid) will be provided to the patients from 7 days before radiotherapy to one month after the finish of radiotherapy . the salivary flow and plasma nitrate levels will be determined before the course of nitrate supplementation and radiotherapy,before the course of radiotherapy,post the course of radiotherapy immediately and one month after the finish of radiotherapy.

Eligibility criteria:
inclusion criteria: * patients with newly diagnosed stages iii-ivb (uicc 2002) nasopharyngeal carcinomas, will be recruited. exclusion criteria: * patients with local invasion or metastatic foci in salivary glands, detected by mri and positron emission computed tomography(pet-ct) prior to treatment, were excluded, as were patients suffering from diseases, such as sjogren's syndrome, or with a history of surgery to major salivary glands, or prior head and neck radiotherapy.

Keywords: dietary sodium nitrate radiotherapy nasopharyngeal carcinoma
assessing the safety/efficacy of asacol® given every 12 hours to children and adolescents with active ulcerative colitis

Conditions: Ulcerative Colitis

Summary: the overall objective of this study is to assess the safety and efficacy of high dose and low dose asacol administered as 400 mg delayed-release tablets given every 12 hours for 6 weeks to children and adolescents with mildly-to-moderately active ulcerative colitis.


Eligibility criteria:
inclusion criteria: * are male or female between the ages of 5 and 17 years, inclusive, at the time of the first dose of study medication, with a history of biopsy and endoscopy confirmed uc; * have mildly-to-moderately active uc (either newly diagnosed or that has relapsed) as defined clinically by a pediatric uc activity index (pucai) score 10 and 55, and, in the opinion of the investigator, the patient does not require steroids; * have baseline scores of at least 1 for both rectal bleeding (streaks of blood with stool less than half of the time) and stool frequency (1-2 stools greater than normal per day) as defined by the tm-mayo score exclusion criteria: * have uc known to be confined to the rectum (isolated rectal proctitis); * have a history of allergy or hypersensitivity to salicylates, aminosalicylates, or any component of the asacol tablet; * have a significant co-existing illness or other condition(s), including but not limited to cancer or significant organic or psychiatric disease on medical history or physical examination, that, in the judgment of the investigator, contraindicate(s) administration of the study drug and/or any study procedures
risk evaluation by coronary cta and artificial intelligence based functional analyzing techniques - ii

Conditions: Coronary Artery Disease

Summary: this study is a multicenter, prospective clinical cohort study. the study intends to continuously enroll patients with coronary heart disease. all subjects will undergo coronary cta (followed by anatomic, functional and radiomics analysis), proteomics research as well as clinical follow-up of cardiovascular events. the purpose of this study is to establish a new, non-invasive cardiovascular disease risk stratification system.

coronary angiography has been the gold standard for the diagnosis of coronary heart disease and pci decision-making. however, the value of cag in risk stratification is limited due to its invasive nature and lack of ability to evaluate coronary physiology and plaque characteristics, which often leads to over-treatment or under-treatment. in recent years, with the development and improvement of imaging technology, the resolution and diagnostic accuracy of coronary artery cta have been greatly improved, and the subsequent anatomy and function (non-invasive ct-ffr, etc.) have made the assessment of coronary artery lesion risk multi-dimensional. comprehensive and accurate coronary artery cta scan plays a positive role in establishing the appropriate standard for pci and improving the prognosis of patients. however, the existing problems of coronary artery cta are insufficient imaging studies, complex image analysis, inconsistent diagnostic criteria, and insufficient clinical evidence. this study is one of the series of clinical studies on the topic of "risk evaluation by coronary computed tomography and artificial intelligence based functional analyzing techniques (recognize)". the purpose of the study is to evaluate the accuracy of early identification of cardiovascular high-risk groups based on the functional evaluation model based on coronary cta images through a multi-center, prospective clinical cohort study, so as to establish an early, non-invasive and accurate risk classification of cardiovascular events in coronary heart disease.

Eligibility criteria:
inclusion criteria: * age 18-80 years * clinically significant angina pectoris, suspecting coronary artery disease exclusion criteria: * unsuitable for coronary cta (such as severe renal impairment, uncontrolled thyroid condition, allergic to iodine, etc.) * without a visible plaque (defined as ≥ 30% stenosis) in major coronary arteries in coronary cta * prior history of myocardial infarction or heart failure * prior history of percutaneous coronary intervention (pci) or coronary artery bypass graft (cabg) * severe renal or liver failure * familial hypercholesterolemia * estimated survival ≤1 year * malignant tumor * poor coordinance, unable to follow-up

Keywords: coronary cta ct-ffr risk stratification artificial intelligence