Kornimate/medical-research-clean huggingface dataset:
differentiating tumor-stroma ratio in pancreatic ductal adenocarcinoma

Conditions: Pancreatic Ductal Adenocarcinoma

Summary: this study introduces a novel transfer learning-based contrastive language-image pretraining adapter (clip-adapter) model for predicting the tumor-stroma ratio (tsr) in pancreatic ductal adenocarcinoma (pdac) using preoperative dual-phase ct images. the primary aim is to develop an efficient and accessible tool for risk stratification and personalized treatment planning.

the proposed novel contrastive language-image pretraining-adapter (clip-adapter) model, leveraging transfer learning, framing clip and a self-attention mechanism for predicting tsr in pdac, in order to exhibit high performance in distinguishing low and high tsr pdac in the test cohort. we speculated the clip-adapter model outperformed single-phase models, specifically clip models based on arterial or venous phase images alone. the addition of a feature fusion module could enhance the model's differentiation capacity, emphasizing its superiority over single-phase models. besides, the model we designed utilized both image and text information during network training, instead of focusing on images only. this underscores the importance of comprehensive assessment in pdac imaging evaluation, with the potential to contribute to risk stratification and personalized treatment planning.

Eligibility criteria:
inclusion criteria: 1. patients with pathologically proven pdac by surgical resection 2. patients who underwent ct scan within a month before surgery 3. observable pancreatic lesions on available images. exclusion criteria: 1. any anti-cancer therapy before ct scanning 2. conspicuous interference or significant motion distortions found on images 3. partial clinical data 4. patients with liver metastases or peritoneal carcinomatosis prior to surgical intervention.

Keywords: pancreatic ductal adenocarcinoma tumor stroma ratio contrastive language-image pretraining self-attention mechanism multi-modality feature fusion
abdominal plain x-ray in the emergency departement

Conditions: Emergencies; Diagnostic Imaging; Abdomen, Acute

Summary: there are only few recognized indications for the realization of plain abdominal x-rays in the emergency departement. the objective of this study is to explore the reasons for abdominal plain x-rays prescription in the emergency departments (eds) of two hospitals.

all abdominal plain x-rays prescription will be reviewed in order to identify reasons for prescribing this exam. the indications will be compared to international guidelines in order to identify whether abdominal plain x-rays are overprescribed. reasons for overprescription will be identify by chart review.

Eligibility criteria:
inclusion criteria: * \>= 16 years * prescription of an abdominal plain x-ray during their stay in the ed exclusion criteria: * \< 16 y * no abdominal plain x-ray prescribed
apremilast after fumaric acid ester treatment

Conditions: Psoriasis

Summary: patient treatment preference and treatment satisfaction of physicians and patients comparing fumaric acid ester therapy with subsequent apremilast treatment


Eligibility criteria:
inclusion criteria: * adult patients ≥18 years * moderate to severe plaque-type psoriasis according to smpc * phase i: patients will be included once they are started on systemic fumaric acid esters (e.g. fumaderm initial®) for the treatment of moderate-to-severe psoriasis vulgaris. patients initiated on fumaric acid esters will be followed for a maximum of 24 weeks during phase i. patients continued on fumaric acid esters beyond 24 weeks or switched to a therapy other than apremilast during or at the end of the 24-week phase i period will no longer be followed. * phase ii: patients switched to apremilast during or at the end of the 24-week phase i period will be included in phase ii and followed for additional 32 weeks. * written informed consent exclusion criteria: * prior treatment with biologics * according to smpc * participation in another clinical trial (parallel inclusion in the national psoriasis registry psobest is allowed)
olfactory training for olfactory dysfunction after coronavirus disease - 19 (covid-19)

Conditions: Covid19; SARS-CoV Infection; Olfactory Disorder; Anosmia

Summary: it is a randomized controlled clinical trial study that aims to follow a sample of individuals with persistent olfactory dysfunction post-covid-19. the aim of this study is assess the clinical outcomes of olfactory training therapy in the treatment of persistent olfactory dysfunctions after covid-19. the sample will consist of 350 participants, being 300 individuals with persistent olfactory dysfunction post-covid-19 and 50 healthy individuals. volunteers' will be separated in two experimental groups (1 and 2 ) and a control group. all participants will be submitted to clinical evaluation that include the connecticut chemosensory clinical research test (cccrt), an olfactory test to diagnose anosmia and hyposmia, and two skull magnetic resonance imaging (mri). only participants of experimental group 1 will be submitted to an olfactory training with essences oils. experimental group 2 will only receive a clinical follow-up after three months and control group will be only submitted to neurological exam, olfactory test, mri imaging and test their ability to discriminate the essence oils used in olfactory training. as a result, is expected a better understanding of the characteristics of olfactory dysfunction caused by severe acute respiratory syndrome coronavirus-2 (sars-cov-2) virus infection, as well as the effectiveness and viability of using olfactory training as a therapeutic alternative.


Eligibility criteria:
inclusion criteria: * confirmed diagnosis of covid-19 by real time polymerase chain-reaction for sars-cov-2 or serological tests for sars-cov-2 antigens.\\ * olfactory dysfunction confirmed by connecticut chemosensory clinical research test (cccrc-t). exclusion criteria: * smokers * individuals with diagnosed rhinitis * individuals with diagnosed neurological diseases * individuals submitted to brain surgery * previous historic of hyposmia and/ or anosmia * pregnancy * allergy to any of the substances present in the olfactory test kit * individuals who are undergoing another treatment for olfactory dysfunction
local registration trial in china humalog mix 50

Conditions: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2

Summary: the primary objective of this study is to compare the 2-hour ppbg excursion following a standard test meal in insulin-requiring diabetic patients treated twice daily with human insulin mix 50/50, versus the 2-hour ppbg excursion in patients treated twice daily with insulin lispro mix 50/50.


Eligibility criteria:
inclusion criteria: 1. men and women who have had either type 1 or type 2 diabetes (world health organization\[who\]classification)for at least 2 months and are between the ages of 18 and 70 (inclusive) at the signing of the informed consent. 2. have been treated with commercially available human insulin mix 50/50 or human insulin mix 30/70 twice daily as the only pharmacological treatment for their diabetes for at least 2 months prior to entering the study. 3. have an hba1c between 1.1 and 1.7 times the upper limit of the normal reference rang(inclusive) as determined by a local laboratory within 2 weeks prior to or at visit 1. 4. have achieved compliance with their diets and insulin therapies as determined by the investigators and perform regular blood glucose monitoring. 5. have given informed consent to participate in this study in accordance with local regulations. exclusion criteria: {1\] have used oral antidiabetic agents, including biguanides, sulfonylureas, glucosidase inhibitors, and insulin-sensitivity enhancers within 30 days prior to entry into the study. \[2\] receive a total daily dose of insulin \>2 units/kg. \[3\] have had more than two episodes of severe hypoglycemia (defined as requiring assistance of another person due to disabling hypoglycemia) within 6 months prior to entry into the study. \[4\] have a body mass index \>35 kg/m2. \[5\] have serum creatinine \> the upper limit of normal (uln), as determined by a local laboratory.
oklahoma study of native american pain risk iii: stress and resilience

Conditions: Discrimination, Racial; Stress Physiology; Pain

Summary: the goal of this observational study is to learn about the relationship between environmental structural racism and discrimination and chronic pain risk in native american adults. the main questions it aims to answer are: 1. how does environmental structural racism and discrimination affect chronic pain-promoting mechanisms in native americans? 2. what psychosocial factors buffer the negative effects of environmental structural racism and discrimination on chronic pain-promoting mechanisms?

native americans experience higher rates of chronic pain than the general u.s. population, and previous research has shown that pain-free native americans transition to chronic pain at almost three times the rate of non-hispanic whites. yet, little is known about the mechanisms that contribute to this pain disparity. this study aims to better understand the role of environmental and society-wide stressors, like structural racism and discrimination, in contributing to this pain disparity. it is believed that these environmental and social stressors may contribute to chronic pain risk by increasing an individual's mental and physical stress levels. in turn, increased stress may alter how an individual responds to pain, both physically and emotionally, which may place them at greater risk for developing chronic pain in the future.

Eligibility criteria:
inclusion criteria: * self-identify as native american/american indian exclusion criteria: * \<18 years of age * self-reported history of cardiovascular, neuroendocrine, musculoskeletal, or neurological disorders * surrent chronic pain, defined as persistent, bothersome pain on more days than not for at least 3 months) * self-reported current substance dependence * sse of medication that could interfere with testing (e.g., recent use of analgesics, antidepressants, or anti-anxiety medications) * inability to speak english * current psychosis (assessed by psychosis screening questionnaire) * serious cognitive impairment (assessed by \<20 score on the montreal cognitive assessment \[moca\]) * possible peripheral neuropathy (assessed by nerve conduction study)

Keywords: structural racism and discrimination stress reactivity quantitative sensory testing
analysis of the duration of combination therapy that is necessary for hcv genotype 1 eradication

Conditions: Chronic Hepatitis C, HCV Genotype 1

Summary: open-label, single centre study evaluating efficacy and viral kinetics of combination peg-ifna2a and ribavirin treatment on chc genotype 1 patients, administered until viral clearance demonstrated between 4 - 12 weeks, then randomised to further continued combination treatment for one of three defined durations. followed-up for 24 weeks after treatment cessation. objectives: 1. to determine the necessary duration of combination treatment with pegylated-interferon alfa2a (pegasys) \& ribavirin in patients infected with genotype 1, in order to achieve viral clearance 2. to identify host factors, which are associated with different patterns of virological response to combination treatment (fast responder, slow responder, non-responder). on this basis, to identify possible predictors for the duration of antiviral treatment.

forty treatment-naïve patients with chronic hepatitis c, all infected with genotype 1, will be entered into this study. all 40 patients will be started on the same regimen of 180mg pegylated-interferon alfa2a (pegasys) weekly plus ribavirin 1000-1200mg daily. hcv rna in the serum will be monitored by qualitative pcr at treatment weeks 4, 8 and 12. patients who become hcv rna negative at any of the above time-points (4,8 or 12), will be randomised into one of three groups to continue the same antiviral regimen for an additional 3 month, 6 month or 9 month period. all these patients will subsequently be followed-up and monitored for a further 6 months after stopping all antiviral treatment. treatment will be discontinued for patients who remain persistently hcv rna positive at treatment week 12 and they will be withdrawn from the study protocol.

Eligibility criteria:
inclusion criteria: * age 18 - 65 * hcv rna positive * hcv genotype 1 * histologically proven chronic hepatitis * no previous antiviral treatment exclusion criteria: * liver histology showing cirrhosis * decompensated liver function * wcc \< 1500/mm3 or platelet count \<90,000/mm3 * co-infection with hiv or hbv/hav * alcohol intake greater than 40 units/week * current intravenous drug dependence * pregnancy or breast feeding of infants * inadequate contraception * neuropsychiatric disorder * neoplastic disease * other significant medical problems

Keywords: hcv, genotype 1, treatment, hcv kinetics, t-cells
effects of anesthetics and surgery on sleep quality in patients undergoing posterior spinal instrumentation surgery

Conditions: Sleep Disturbance; Anesthesia; Adverse Effect

Summary: investigators aimed to evaluate the impact of the anesthesia method and surgical procedure on the sleep patterns and sleep quality of patients undergoing posterior spinal instrumentation using the pittsburgh insomnia rating scale-20 (pirs-20).

a total of 40 participants asa (american society of anesthesiology) i-iii aged 18 and over who underwent elective spinal posterior instrumentation was included. the participants were divided into two groups randomly - those with sevoflurane and remifentanil anesthesia and those with total intravenous anesthesia (tiva) - using the closed envelope method. participants were evaluated before and after the surgery with the pirs-20 (surgery one month previously and postoperative 7th day) for sleep quality, vas (visual analogue scale; recorded preoperative night and postoperative first hour), pain, and state-trait anxiety inventory (stai) for anxiety (recorded preoperative night and postoperative 7th day) scores.

Eligibility criteria:
inclusion criteria: * asa (american society of anesthesiology) i-iii * aged 18 and over * who underwent elective spinal posterior instrumentation exclusion criteria: * aged 17 and under * asa (american society of anesthesiology) iv * presence of psychological illness * presence of psychological illness * presence of sleep disorder

Keywords: posterior instrumentation sleep quality anesthetics spine surgery
jupiter - crestor 20mg versus placebo in prevention of cardiovascular (cv) events

Conditions: Elevated High-sensitivity C-Reactive Protein (hsCRP)

Summary: the purpose of this study is to determine the safety and effectiveness of long-term therapy with rosuvastatin compared with a placebo, and to evaluate whether treatment with rosuvastatin might be effective in reducing the risk of major cardiovascular events.

astrazeneca announced it has decided to stop the crestor jupiter clinical study early based on a recommendation from an independent data monitoring board and the jupiter steering committee, which met on march 29, 2008. the study will be stopped early because there is unequivocal evidence of a reduction in cardiovascular morbidity and mortality amongst patients who received crestor when compared to placebo.

Eligibility criteria:
inclusion criteria: * men 50 years or older, women 60 years or older * low to normal levels of low density lipoprotein (ldl) cholesterol (\< 130mg/dl) * elevated levels of c-reactive protein (crp) \> 2.0 mg/l exclusion criteria: * history of cardiovascular or cerebrovascular events * active liver disease * diabetes mellitus * uncontrolled hypertension or hypothyroidism * history of certain malignancies * chronic inflammatory conditions * history of alcohol or drug abuse

Keywords: primary prevention cardiovascular disease statin therapy c-reactive protein
pet/mr imaging in lung cancer

Conditions: Lung Cancer

Summary: the purpose of this project is to investigate if pet/mr imaging improves the accuracy in visualization and characterization of lung cancer disease, compared to pet/ct.

lung cancer is the most frequent cancer type and the leading cause of cancer-related death worldwide. positron emission tomography (pet) coupled with computed tomography (ct) is the standard of care for visualization and staging of lung cancer. recent clinical introduction of hybrid pet and magnetic resonance (mr) imaging systems has shown potential to improve tumor imaging beyond the limits of pet/ct. however, knowledge about the clinical impact of this new hybrid modality is still limited. this project aims to investigate how pet/mr may improve the diagnosis and treatment of lung cancer disease, compared to pet/ct: pet/mr may allow early detection of brain and liver metastases, which strongly affects treatment outcome and survival; predictive models based on machine learning may combine image derived biomarkers from pet/mr, histology and health record data, to automatically visualize and characterize the tumor, facilitating computer aided diagnosis and personalized radiotherapy treatment.

Eligibility criteria:
inclusion criteria: * referred to clinical pet/ct examination for investigation of lung disease. exclusion criteria: * blood glucose level \>8.3 mmol/l * mr incompatible objects, e.g. metal implants, inside the body * intolerance to gadolinium-based contrast agents, e.g. severe renal disease (gfr\<30). * unable to give written consent.
comparison between contact force guided and blinded strategy on pv isolation in af patients

Conditions: Atrial Fibrillation

Summary: pulmonary vein (pv) isolation is very important in atrial fibrillation (af) catheter ablation. pv reconnection is one of the main reasons in af recurrence. contact force-sensing catheter is a new catheter which has valuable tools to monitor and increase the efficacy of pv isolation. previous paper reported the efficacy of contact force-sensing catheter on immediate pv isolation and outcome. however, there might be confounding factor as inter-individual variation. therefore, we would like to compare the efficacy of contact force-sensing catheter within same patient but different veins. in this study, we would like to confirm the efficacy of contact force-sensing catheter on immediate pv isolation outcome within same patient. this study randomized the right or left pvs whether to use the contact force-sensing function or not. the study design will minimize the inter-individual variation on evaluating the efficacy of contact force-sensing catheter on immediate pv isolation. also, in patients who had recurred af or at, we would like to evaluate the long-term efficacy of contact force-sensing catheter on pv isolation.

sixty patients will be randomized to select right or left pulmonary veins whether to apply contact force-guided ablation or contact force-blinded ablation strategy. each pv will be ablated with same contact force-sensing catheter (thermocool smart touch catheter, biosense webster inc. ca). the pv (right or left) which will be randomized to contact force-sensing pv or blind pv. contact force-sensing pv will be ablated guided by contact force, whereas the blind pvs will be ablated without contact force-sensing information. the change of impedance, total ablation and time to ablate pv will be collected and analysed according to contact force-sensing strategy. after exit and entrance block by conventional method, dormant conduction will be evaluated by using adenosine. the proportion of dormant conduction will be compared between contact force-sensing guided or blinded strategy. during 1-year follow up, patients who recurred af or at will be undergo second ablation procedure. in these patients, pv reconnection rate will be evaluated by a duodecapolar lasso circular mapping catheter. we would like to know whether pvs which have ablated with contact force-sensing information at index procedure have less reconnection than those which was ablated without contact force-sensing information.

Eligibility criteria:
inclusion criteria: * patients with symptomatic paroxysmal atrial fibrillation (af) who had failed with anti-arrhythmic agents. exclusion criteria: * patients who had previous ablation for af * patients with symptomatic persistent af

Keywords: pulmonary vein isolation contact force sensing catheter
ocular hemodynamic effects of nitrovasodilators in healthy subjects

Conditions: Glaucoma

Summary: glaucoma, one of the most common causes of blindness, is associated with increased intraocular pressure (iop) and optic nerve head ischemia. nitrovasodilators are discussed in the treatment of glaucoma. nitrates relax smooth muscle cells in the vasculature by liberating the vasodilator nitric oxide. the iop lowering potential and the vasodilator action in retinal and choroidal vessels of nitrates is still a matter of controversy. previous studies on the ocular hemodynamic effects of nitrates showed partially contradicting results. in addition the iop lowering effect of nitrates is still unclear. however, recent studies show that long acting nitrates may preserve optic nerve deterioration and visual field loss. therefore, the role of nitrovasodilators in control of ocular blood flow and intraocular pressure has to be elucidated. for this purpose the investigators plan to test the hypothesis that nitrovasodilators improve ocular blood supply to the optic nerve head at doses which do not affect systemic hemodynamics.


Eligibility criteria:
inclusion criteria: * men aged between 19 and 35 years, nonsmokers * body mass index between 15th and 85th percentile (must et al. 1991) * normal findings in the medical history and physical examination unless the investigator considers an abnormality to be clinically irrelevant * normal laboratory values unless the investigator considers an abnormality to be clinically irrelevant * normal ophthalmic findings, ametropia \< 3 dpt. exclusion criteria: * regular use of medication, abuse of alcoholic beverages, participation in a clinical trial in the 3 weeks preceding the study * treatment in the previous 3 weeks with any drug * symptoms of a clinically relevant illness in the 3 weeks before the first study day * history of hypersensitivity to the trial drug or to drugs with a similar chemical structure * history or presence of gastrointestinal, liver or kidney disease, or other conditions known to interfere with, distribution, metabolism or excretion of study drugs * history of migraine * blood donation during the previous 3 weeks

Keywords: nitrovasodilators onh blood flow choroidal blood flow nitroglycerin isosorbide dinitrate sodium nitroprusside laser-doppler flowmetry regional blood flow