Kornimate/medical-research-clean huggingface dataset:
aortic remodeling after endovascular management of type b aortic dissection.

Conditions: Type B Aortic Dissection

Summary: assess the clinical outcome, morphological changes and behaviour of type b aortic dissection after endovascular repair.

aortic dissection (ad) is considered the most common catastrophic event of the aorta, and its incidence has been reported to be ≈3/100000 per year, exceeding that of ruptured abdominal aortic aneurysm. ad is a dynamic process and can occur anywhere along the course of the aorta, with the pathognomonic lesion being an intimal tear followed by blood surging either antegrade (typically) or retrograde, cleaving the the intima and medial layers of the aortic wall longitudinally for a variable distance, thus creating a true and false lumens. aortic dissections are classified by chronicity, anatomic location of false lumen, generally the entry tear and longitudinal extent, and the presence or absence of complicating features. temporally, ad is categorized as acute phase {\ 90 days}. thoracic endovascular aortic repair (tevar) has emerged as the first-line therapy for the treatment of ad, with better short-term results than open repair due to a significant decrease in perioperative morbidity and mortality. by covering the primary entry tear with stent-grafts, the blood flow is redirected into the true lumen, resolving malperfusion and/or preventing rupture of the false lumen, followed by its regression and re-expansion of the true lumen, which is known as "aortic remodeling"

Eligibility criteria:
inclusion criteria: 1. complicated stanford type b dissections: * rupture. * malperfusion (visceral, extremities or spinal cord ischemia). 2. high-risk aortic dissections: * refractory pain, refractory hypertension or bloody pleural effusion. * high-risk radiographic features (max. aortic diameter \>40mm, false lumen diameter \>22mm, 1ry entry tear \>1cm, entry tear location on the lesser curve and radiographic only malperfusin). 3. aortic anatomy suitable for stent graft therapy: * proximal landing zone (diameters between 15 and 42mm, measured form outer wall to outer wall) isn't aneurysmal, dissected or significantly thrombosed. * proximal landing zone length ≥20mm. * radius of curvature ≥20mm for aortic arch landing zones. * arch or distal aortic angulation 45≤ degrees. 4. compatible iliac and/or femoral access vessel morphology (diameter and tortousity) that allows endovascular access to the dissection site with the delivery system of the appropriately sized device, with or without the use of either surigcal or endovascular conduit. 5. age ≥18yrs. 6. life expectancy \>2yrs exclusion criteria: 1. known hypersensitivity to device component or contraindication to anticoagulation or contrast media. 2. systemic or local infection that may increase the risk of endovascular graft infection. 3. subjects with past descending or abdominal aortic interventions. 4. un-correctable coagulopathy 5. active vasculitis 6. inability or refusal to give informed consent by subject or legal representative 7. subject is unwilling to comply with the follow-up schedule.
a study of the cost effectiveness of generalist care managers for depression treatment in medicaid recipients

Conditions: Major Depressive Disorder

Summary: this project will enable the investigators to conduct a randomized clinical trial to demonstrate the value of generalist care managers in the treatment of depression in medicaid patients seen in primary health care practices. depressed patients will be recruited at two primary care practices in western north carolina and randomly assigned to either generalist care management or usual care. patients in each condition will be assessed at baseline and six months follow-up. outcomes will include depressive symptoms, level of functioning, and cost-effectiveness measures.

randomized trial among depressed medicaid patients aged 18 years and older in 2 primary care practices in western nc comparing an intervention with a gcm to usual care (uc) between july 2003 and february 2005. gcms, already providing diabetes and asthma services, were further trained and given ongoing supervision to provide algorithm-based depression care to enhance guideline concordant treatment. gcms provided elements of self-management, decision support, use of information systems, and core care management components.

Eligibility criteria:
inclusion criteria: * scoring 10 or greater on phq-9 and primary care physician verification of major depression by clinical exam; and * willing to begin or continue antidepressant medication exclusion criteria: * bipolar disorder, psychotic symptoms, or active suicidal ideation requiring psychiatric admission (

Keywords: depression primary care care manager
microalbuminuria and allopurinol in type 1 diabetes

Conditions: Type 1 Diabetes; Diabetic Nephropathy

Summary: the objective is to determine if lowering serum uric acid by means of allopurinol in the course of kidney disease may be effective in preventing or improving albuminuria and renal function in type 1 diabetic patients. the study is a double blinded, randomised, placebo-controlled cross-over clinical trial.


Eligibility criteria:
inclusion criteria: * albuminuria (≥30 mg/g) * uric acid ≥ 0,265 mmol/l * gfr (glomerular filtration rate) \> 40 ml/min/1.73m2 exclusion criteria: * history of gout or xanthinuria or other indications for uric acid lowering therapy such as cancer chemotherapy. * recurrent renal calculi. * current use of azathioprine, 6-mercaptopurine, didanosine, tamoxifen, amoxicillin/ampicillin, or other drugs interacting with allopurinol. * known allergy to xanthine-oxidase inhibitors. * renal transplant. * non-diabetic kidney disease. * home, 24h og clinical bp\>180 or diastolic bp \>130 mmhg at screening. * cancer treatment within two years before screening. * history of hepatitis b or c. * history of acquired immune deficiency syndrome or human immunodeficiency virus (hiv) infection. * history of alcohol or drug abuse. * breastfeeding or pregnancy or unwillingness to be on contraception throughout the trial. * poor mental function or any other reason to expect patient difficulty in complying with the requirements of the study. * serious pre-existing medical problems other than diabetes, e.g. congestive heart failure, pulmonary insufficiency.

Keywords: type 1 diabetes diabetic nephropathy albuminuria allopurinol
assessment of the age, reasons, oral health status and dental treatment needs of children in their first dental visit

Conditions: Dental Caries; Parents; Parenting; Pain

Summary: to asses the age, reasons, oral health status and dental treatment needs of children in their first dental visit.

we are going to provide each parent or guardian whose children fulfilling the inclusion criteria attending to department of paediatrics dentistry at cairo university to fulfil questionnaire which include multiple mcq questions. the state of oral health and dental treatment needs will be assessed based on clinical examination, according to recommendations of the world health organization. the total number of teeth and number of teeth affected by decay (d, d) in every child will be recorded. the intensity of caries will be estimated based on the average dmf/dmf number, i.e. caries intensity index. the dental treatment needs of each child will be assessed based on the following categories: 1. none: no restorative treatment required. 2. simple: preventive treatment required, such as scaling and brushing, oral hygiene instruction (ohi), application of topical fluoride and fissure sealant. 3. moderate: one or more of teeth require one or two surface restoration. 4. complex: one or more teeth require three or four surface restoration / stainless steel crown, endodontic therapy and crown, and /or extraction(7) . reasons for first dental visit will be categories as : a. adaptive visit dental check-up preventive purpose. b. tooth pain. c. emergency case (tooth injury, abscess, infection). d. decay noted by parent. e. any other. we will explain to the parents and legal guardians the aim of the study without any guiding to prevent any information bias which may occur. the questionnaire will be given before the treatment and will be collected after it. any children whose records will include missing information will be excluded from the study.

Eligibility criteria:
inclusion criteria: * children with primary and mixed dentition. * children visiting the dentist for the first time (first dental visit exclusion criteria: * children with systemic diseases or physical and mental problem. * children whose parents refuse participation

Keywords: first dental visit oral health reasons of first dental visit dental treatment needs
digital dialectical behavioral therapy (d-dbt) skills for acute suicidality in psychiatric inpatients

Conditions: Suicidal Ideation

Summary: suicidality (ideation about taking one's life, suicide plans, and attempts) is a major public health concern in ontario and worldwide. psychiatric inpatients with suicidality represent a group that is high-risk for subsequent suicide. current standard-care for suicidal psychiatric inpatients focuses on containment of risk and indirect treatment of suicidality by treating any underlying mental disorder. though there is evidence that addressing suicidality directly is more effective than an indirect approach, there are limited evidence based treatments that target suicidality. furthermore, there are few high-quality studies that have included inpatients. psychotherapeutic interventions are under-utilized for inpatients and covid-19 has further widened this gap given attempts by hospitals to reduce face-to-face contact with patients. digital psychotherapy interventions have the ability to bridge this gap given their lower cost, ease of dissemination, acceptability by patients, and effectiveness. to our knowledge, there are no studies that have assessed the feasibility, acceptability and effectiveness of digital interventions for suicidal inpatients. our study is a feasibility trial of a previously studied digital dialectical behavioural therapy (d-dbt) skills intervention in suicidal psychiatric inpatients. the study is a two arm randomized parallel group-controlled trial, 6-10 day, flexible timeline, randomized feasibility trial of a d-dbt skills intervention added to standard care for patients admitted to psychiatric inpatient units with suicidality. there will be 20 patients who will receive the intervention in addition to standard care and 20 patients who will receive standard care alone. there will also be a 4 week follow-up after discharge from hospital. participants will be admitted for psychiatric care at the complex and critical care units, centre for addiction and mental health (camh), toronto.


Eligibility criteria:
inclusion criteria: 1. patients with any dsm-5 diagnosis aged 18 years and above; 2. admitted to camh with suicidality and a baseline bsi score of \> 6; 3. capable and willing to give informed consent; 4. anticipated length of admission is greater than 5 days; 5. deemed suitable by the primary team to take part in a psychotherapeutic intervention as part of standard care capacity to consent will be evaluated by the research staff performing the informed consent process. it will be assessed as the participant's ability to understand and appreciate the risks and benefits of taking part in the proposed study. exclusion criteria: 1. presence of psychiatric symptoms that interfere with the ability to complete the d-dbt 2. concurrent treatment with ect or mst
computerized assessment and referral system screener for mental health evaluations in the emergency setting

Conditions: Mental Health

Summary: this is a hybrid effectiveness-implementation randomized controlled trial which will be conducted at the emergency department (ed) at the university of arkansas for medical sciences (uams) in little rock, arkansas. the hypothesis of this study is that use of the cars (a computerized mental health screener) will modify emergency department treatment of patients with previously undiagnosed mental illness.

this pragmatic mixed methods clinical trial will compare the intervention of providing a cars screener report to emergency providers to not providing the report. it will also collect qualitative data regarding implementation of the cars screener and report. consecutive patients presenting when a research associate is available will be approached to participate. patients will be approached after evaluation by an emergency physician. the computerized assessment and referral system (cars) is based on the composite international diagnostic interview (cidi), a validated instrument for assessing mental health diagnoses.cars was piloted at 6 different sites in 2016, all in dui populations. as cars has not been specifically validated on non-dui populations, investigators will collect alcohol history (see below). the cars self-assessment version (cars-sa) will be utilized in this study.

Eligibility criteria:
inclusion criteria: * \>18 years of age * not incarcerated * english-speaking and english-writing (as translators will not be available for this study) exclusion criteria: * unable or unwilling to complete cars screener * unable or unwilling to provide any history of alcohol abuse * currently presenting with a chief complaint of a psychiatric symptom * currently presenting with a substance use complaint * history of a known psychiatric condition * patients taking psychiatric medication
virtual reality therapy for chronic low back pain

Conditions: Chronic Low Back Pain

Summary: this study will test the efficacy of an evidence-based virtual reality (vr) therapy program as a non-pharmacological supplement for the management of chronic lower back pain. study participants will be randomized to receive one of three vr programs: skills-based vr, distraction vr, or sham vr. in addition to a vr headset, all participants will receive a fitbit charge 4 watch. study devices will be delivered to the participant's home with instructions for use via fedex; participants will receive remote technical support. they will be followed for 90 days and complete patient reported outcome (pro) questionnaires to assess functional status, pain levels, and use of pain medications (including opioids). participants will also be asked to provide consent/authorization to access medical records from their treating facility.

this is a randomized double-blind, placebo-controlled trial for individuals with chronic lower back pain. this study investigates the effect of at-home virtual reality (vr) pain reduction therapies on a set of outcome measures. the primary outcome is patient-reported outcomes measurement information system (promis) pain interference version 8. this study will enroll 360 analyzable participants into one of three vr therapy groups. data collection will occur at home via personal computer or smartphone (iphone/android), with baseline data collected one week before the intervention is mailed to the patient. participants will have the vr headset for 90 days. patients are also sent fitbit smartwatches to track physical activity.

Eligibility criteria:
inclusion criteria: 1. able to provide consent to participate in research 2. stated willingness to comply with all study procedures and availability for the duration of the study 3. male or female, age 13 or older 4. an ongoing low back-pain problem that has persisted at least 3 months and has resulted in pain on at least half the days in the past 6 months. 5. ability to comprehend spoken and written english 6. owns a compatible android or ios smartphone, or personal laptop or desktop computer (excluding tablets) to complete surveys and has access to email. exclusion criteria: 1. presents with a condition that interferes with virtual reality usage, including history of seizure, facial injury precluding safe placement of headset, significant visual or hearing impairment that impacts ability to see the virtual reality images or follow audio instructions 2. are being recommended for long-term hospitalization that would require more than three-week stay in the hospital 3. received surgical procedure within the previous 8 weeks 4. surgery is planned within the next 3 months 5. is currently using a spinal cord stimulator 6. has low back pain attributable to a recognizable, specific pathology, including spinal infection, cancer, fracture, or inflammatory spondylopathies, consistent with the nih task force on research standards for chronic low back pain 7. previously participated in a virtual reality clinical trial

Keywords: virtual reality chronic low back pain analgesia
infant formula feeding and necrotizing enterocolitis in newborns

Conditions: Necrotizing Enterocolitis; Necrotizing Enterocolitis of Newborn; Sepsis Newborn; Cows Milk Allergy

Summary: necrotizing enterocolitis (nec) is the most common life-threatening gastrointestinal emergency of prematurity, associated with a significant morbidity and mortality. early diagnosis and early treatment interventions may reduce the risk of mortality and morbidity. the primary goal of this observational study is to gather survey data to establish a national database of nec in newborns in order to better understand the risk factors underlying nec. survey data will be used along with a medical history to identify the mechanism(s) underlying the increased prevalence of nec in non-breast fed, formula fed premature infants.

nec affects between 2 to 7% of premature infants. it is is an acquired disease, caused, in part by inflammation of the intestinal lining. nec is the most common life-threatening gastrointestinal emergency of prematurity and it is associated with significant morbidity and mortality. studies have linked the consumption of non-breast milk, commercial infant formula (made from cow's milk) or formula-derived nutrition with increased risk of nec compared to consumption of human breast milk. the mechanism of the nec lesions appears to involve factors including allergic reaction to the infant formulas containing cow's milk, immaturity of the intestinal barrier and the immune system, microvascular imbalance, disturbed gut flora and systemic inflammation that is hypothesized to be exacerbated by infant formula consumption. the primary goal of this national observational study is to gather survey data in order to establish a database of nec in newborns to gain a better understanding of the risk factors underlying nec. survey data will be used along with a medical history to identify the mechanism(s) underlying the increased prevalence of nec in non-breast fed, formula fed premature infants.

Eligibility criteria:
inclusion criteria: * infants born after 2018 * newborns that have been diagnosed with nec and have consumed infant formula. * infants whose death resulted from nec or complications thereof exclusion criteria: * infants who were born prior to 2019 * newborns who have been fed exclusively on breast milk. * subjects lacking medical records or who cannot provide a medical history.
a comparison of laparoscopic with open distal gastrectomy in advanced gastric cancer after neoadjuvant chemotherapy

Conditions: Gastric Cancer

Summary: the purpose of the study is to evaluate the safety and efficacy of laparoscopic distal d2 gastrectomy (ldg) compared with open surgery (odg) for resectable gastric cancer, to determine whether ldg can be a test arm for a future phase iii trial to evaluate the non-inferiority of overall survival compared with odg in patients who receive neoadjuvant chemotherapy.

the study is an open-label, controlled, randomized phase ii clinical trial. the protocol has been approved by the ethics committee of beijing cancer hospital. the primary endpoint is the 3-year progression-free survival (pfs) rate. the secondary endpoints are the overall survival, surgical morbidity and mortality.

Eligibility criteria:
inclusion criteria: * histologically proven adenocarcinoma of the stomach. * clinical ct2n+m0,or ct3-4a/n+m0 disease, confirmed by upper gastrointestinal endoscopy and abdominal computed tomography (ct) and laparoscopy. the t and n stages are determined by the method of habermann et al. * the gastric tumors are located in the middle to lower third of the stomach, are macroscopically resectable by distal gastrectomy with d2 lymph node dissection, and r0 or r1 resection can be achieved. * no bulky lymph node metastasis is detected by abdominal ct. * no pleural effusion, no ascites exceeding the pelvis and no metastasis to the peritoneum, liver or other distant organs are confirmed by abdominal pelvic ct. * no clinically apparent distant metastasis. * karnofsky performance status ≥70%. * sufficient oral intake. * no previous treatment with chemotherapy or radiation therapy for any tumors. * no previous surgery for the present disease. * sufficient organ function, as evaluated by laboratory tests 7 days or more after the date when the anticancer drugs were given. when patients are recovering from myelosuppression,the revised criteria are shown in parentheses. white blood cell count≥3000/mm3 (2000/mm3) platelet count≥10.0\*104/mm3 (5.0\*104/mm3) aspartate aminotransferase≤100 iu/l alanine aminotransferase≤100 iu/l total bilirubin≤2.0 mg/dl serum creatinine≤1.5 mg/dl * no need for emergency surgery due to bleeding or perforation of the primary tumor. * no mechanical obstruction. * written informed consent. exclusion criteria: * past history of upper abdominal surgery. * past history of surgery for the gastrointestinal tract. * body mass index exceeding 30 kg/m2.

Keywords: locally advanced gastric cancer laparoscopic distal d2 gastrectomy neoadjuvant chemotherapy
comparison of the live birth rate between the ppos and the gnrh antagonist protocol in patients undergoing ivf

Conditions: Infertility; ART

Summary: a randomized comparison of the live birth rate between the progestin-primed ovarian stimulation protocol and the gonadotrophin releasing hormone antagonist protocol in patients undergoing in vitro fertilization research question does the live birth rate of the progestin-primed ovarian stimulation protocol comparable with the gnrh antagonist protocol for patients undergoing ivf? design this is a randomized controlled trial. research plan population: infertile women who have medical indication for ivf will be recruited for study if they fulfil the selection criteria. intervention: women will receive oral dydrogesterone 20mg daily from day 3 till the day of ovulation trigger. comparator: women will receive antagonist (cetrorelix 0.25mg) once subcutaneously daily from day 6 of ovarian stimulation till the day of the ovulation trigger. outcomes: the primary outcome is the live birth rate the first fet. ovarian stimulation, egg retrieval, embryos frozen and frozen embryo transfer will be performed according to the standard operating procedures of the centres.


Eligibility criteria:
inclusion criteria: * age of women \<43 years at the time of ovarian stimulation for ivf * antral follicle count (afc) on day 2-5 of the period≥5 exclusion criteria: * presence of a functional ovarian cyst with e2\>100 pg/ml * recipient of oocyte donation * undergoing preimplantation genetic testing * presence of hydrosalpinx which is not surgically treated or endometrial polyp on scanning during ovarian stimulation