Kornimate/medical-research-clean huggingface dataset:
a pragmatic approach to lowering the risk of diabetes mellitus after a diagnosis of gestational diabetes mellitus

Conditions: Gestational Diabetes

Summary: a pilot of metformin postpartum

the overall goal of this proposal is to assess metformin initiation at the time of hospital discharge for women with a history of gestational diabetes mellitus (gdm) improves maternal health at 1 year post-partum. our central hypothesis is that diabetes mellitus (dm) prevention with metformin can be initiated days after delivery, rather than months to years after delivery, and result in a pragmatic and efficacious means of preventing dm and improving weight loss over the first year post-partum. to test this hypothesis, we will perform a open-label randomized controlled trial of metformin compared to placebo routine care initiated at the time of hospital discharge in women with a history of gdm.

Eligibility criteria:
inclusion criteria: * gestational diabetes exclusion criteria: * cannot tolerate metformin
wi-intuit: bridging community based continence promotion and primary care

Conditions: Urinary Incontinence

Summary: this project seeks to determine whether primary care practices that receive supplemental partnership building implement ui-assist with higher fidelity than practices that receive streamlined practice facilitation alone.

this quality improvement research project is one of five across the country funded by the agency for healthcare research and quality (ahrq) through the evidencenow managing urinary incontinence initiative titled: "improving nonsurgical treatment of urinary incontinence among women in primary care." the purpose of this national initiative is to identify implementation strategies that best support primary care practices in delivering high quality care for urinary incontinence. components of high-quality care including screening, diagnosing, and offering non-surgical first-line treatments for urinary incontinence in women, all of which already occur in primary care. the wi-intuit quality improvement project compares two implementation strategies to implement ui-assist, an intervention to support primary care practices in increasing their rates of screening, diagnosing, and treating urinary incontinence in their adult female patients: (1) streamlined practice facilitation (spf) and (2) streamlined practice facilitation in combination with partnership building (spf+pb).

Eligibility criteria:
this is an organizational intervention. outcomes will be evaluated at the population-level by facility. primary care practices in wisconsin serving female adults: inclusion criteria: * patients must be 18 years or older and be assigned female at birth * practices must have and be willing to provide key data from electronic health records * practices willing to participate in partnership building activities (randomly allocated) * practices willing to work with a practice facilitator to implement ui-assist in their practice exclusion criteria: - no additional exclusion criteria
finding the invasive haemodynamic threshold for symptom relief in stable angina

Conditions: Stable Angina

Summary: orbita-fire is a randomised, double-blinded, placebo controlled experimental study that will identify the fractional flow reserve (ffr) and non-hyperemic pressure ratio (nhpr) thresholds that correlate with symptoms of angina for 58 patients measured invasively under experimental conditions.


Eligibility criteria:
inclusion criteria: * eligibility for percutaneous coronary intervention (pci) due to angina or angina-equivalent symptoms on exertion * anatomical evidence of significant single-vessel coronary stenosis defined by either: * ≥70% stenosis on invasive coronary angiography (ica) * severe stenosis on ct coronary angiography (ctca) * physiological evidence of ischaemia with a positive test on at least one of the following: * stress echocardiography * cardiac magnetic resonance perfusion * myocardial perfusion scintigraphy * invasive metrics of coronary physiology exclusion criteria: * age \<18 years * recent acute coronary syndrome * previous coronary artery by-pass graft * significant left main stem disease * multivessel disease (defined as \>50% angiographic stenosis in other vessels) * chronic total occlusion in the target artery * moderate to severe valvular disease * moderate to severe left ventricular impairment * chronotropic incompetence with a pacemaker * contraindication to pci or a drug-eluting stents * contraindication to antiplatelet therapy * contraindication to adenosine * moderate to severe respiratory disease * physical inability to exercise * pregnant * inability to consent

Keywords: symptoms angina physiology placebo
modelling of the upper airway in children with controlled asthma

Conditions: Controlled Asthma

Summary: asthma in children is recognized as a disease area with a high medical need. as the investigators move into this field it is necessary to improve the investigators knowledge of upper airway anatomical structure in paediatric patients. this study will provide airway/facial morphologies from controlled asthmatic patients. limited facial morphology can be used in order to build models to study the delivery of medication through a device that requires for example a facemask. in this study the anatomical structure of the upper airway and the facial geometry will be evaluated using a cone beam computed tomography (cbct) scan. the scan will be taken in a population of 20 asthmatic children between 6 and 12 years old.


Eligibility criteria:
inclusion criteria: * male and pre-menarchial female children aged 6-12yrs on visit 1. pre-menarchial females are defined in this study as girls with breast stage 1 or 2 and no menarche. * parents or guardian must be able to understand and complete to protocol requirements, instructions and protocol-stated restrictions. parents/guardians must give written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. * diagnosis of asthma at least 6 months previous prior to screening. * children must be controlled on their existing asthma treatment at screening as defined by act or childhood act score of ≥ 20 and pef\>80%. * children must be taking a stable regime of saba/ laba on an as need basis, with or without leukotriene antagonists and inhalation corticosteroids. * all children must be competent to perform the required tests. * children must be available to complete the study and comply with study primary objective investigations. * children must be able to withhold from short acting bronchodilators for 6 hours. exclusion criteria: * as a result of the medical interview, physical examination or screening investigations, the responsible physician considers the patient unsuitable for inclusion to the study. * children who have a past or present disease, or have had previous surgery which as judged by the investigator, may affect patient safety or influence the outcome of the study. * the child has received an investigational drug or participated in any other research trial within 30 days, or twice the duration of the biological effect of any drug (whichever is longer). * the child has had a respiratory tract infection within two weeks of the start of the study. * children who have had an exacerbation of disease requiring hospitalization for \> 24 hrs within four weeks prior to inclusion. * children who are unwilling or unable to follow any of the procedures outlined in the protocol. * child is mentally incapacitated.

Keywords: asthma controlled cone beam computed tomography upper airway paediatric
acupuncture for stiffness of joint related to aromatase inhibitors in patients with early-stage breast cancer

Conditions: Breast Cancer; Stiffness of Hand, Not Elsewhere Classified

Summary: rationale: acupuncture may help relieve joint stiffness related to aromatase inhibitors in patients with early-stage breast cancer. purpose: this single arm clinical study aims to evaluate how well acupuncture as a non-pharmacological treatment, works in treating patients with joint stiffness related to aromatase inhibitors (ais) in patients with early-stage breast cancer.

objectives of this study: primary objective: to evaluate whether acupuncture as a non-pharmacological treatment, administered twice weekly for 6 weeks can significantly reduce joint stiffness related to ais in women with early-stage breast cancer as measured by the western ontario and mcmasters universities osteoarthritis (womac) stiffness score at weeks 6. secondary objectives: to evaluate the effect of acupuncture on joint stiffness measured by the womac stiffness score at weeks 12. to evaluate the effect of acupuncture on joint stiffness measured by the modified score for the assessment of chronic rheumatoid affections of the hands (m-sacrah) stiffness score at weeks 6 and weeks 12. to evaluate the effects of acupuncture on quality of life (qol) assessed by the functional assessment of cancer therapy-endocrine subscales (fact-es) at weeks 6 and weeks 12. to evaluate the safety and tolerability of acupuncture in the enrolled patients. to identify potential genetic determinants to response to acupuncture.

Eligibility criteria:
inclusion criteria: 1. history of stage i-iii breast cancer and free of disease by clinical examination 2. postmenopausal or premenopausal with ovarian suppression 3. currently receiving aromatase inhibitors (anastrozole, letrozole, or exemestane) treatment 4. with joint stiffness attributed to the use of aromatase inhibitors 5. having had joint stiffness for at least 1 months 6. having had at least 15 days with stiffness in the preceding 30 days exclusion criteria: 1. women with recurrent or metastatic breast cancer 2. women having finished chemotherapy or radiation therapy less than 1 months prior to enrollment 3. women with history of bleeding disorder 4. women with joint stiffness attributed to inflammatory arthritis, such as rheumatoid arthritis, spondy loarthritis and osteoarthritis 5. women having joint stiffness prior to ai treatment 6. women that have received treatment of any kind for joint stiffness within the last 3 months 7. women that have previously received the acupuncture treatment before for any reason

Keywords: breast cancer stiffness aromatase inhibitor acupuncture high altitude
sequential therapy with wll/inhaling gm-csf for autoimmune pulmonary alveolar proteinosis

Conditions: Pulmonary Alveolar Proteinosis; Treatment

Summary: the purpose of the study is to evaluate the effectiveness of the sequential therapy with whole lung lavage (wll)/inhaling granulocyte-macrophage colony stimulating factor, compared to wll only, for adult patients with severe autoimmune pulmonary alveolar proteinosis in china over a two-year period.


Eligibility criteria:
inclusion criteria: * comfirmed diagnosis of autoimmune pulmonary alveolar proteinosis * disease severity score (dss) is 4-5 exclusion criteria: * the acute respiratory infection * heart failure (such as cardiogenic pulmonary edema) * the serious liver and kidney dysfunction (creatinine or alt were equal to or more than 2 times of the upper limit of normal range); * pregnancy; * the patients with hereditary and secondary factors (inhalation of dust, hematological diseases, autoimmune diseases, etc.); * dss is 1-3; * the patient is allergic to the drugs that be used in our research; * the patients with poor compliance, or suffering from mental illness; * the patients have not signed informed consent; * they were treated with whole lung lavage or regular gm-csf therapy (treatment for more than 2 weeks) within 3 months before the enrollment.

Keywords: pulmonary alveolar proteinosis granulocyte-macrophage colony-stimulating factor whole lung lavage
pharmacological activation of hmn for osa aim 2

Conditions: Obstructive Sleep Apnea

Summary: obstructive sleep apnea (osa) is common and has major health implications but treatment options are limited. osa patients show a marked reduction in upper airway (ua) dilator muscle activity at sleep onset and this phenomenon leads to increased collapsibility of ua compared to normal subjects. in this protocol the investigators will test the effect of ltm1201az, ltm1201at, ltm1201ad, ltm1201ag administered before sleep on osa phenotype traits and osa severity during sleep.


Eligibility criteria:
inclusion criteria: * ahi \> 10 events/h during nrem supine sleep exclusion criteria: * any medical condition other than well controlled hypertension and mild diabetes. * any medication known to influence breathing, sleep/arousal, or muscle physiology. * claustrophobia. * inability to sleep supine. * allergy to any of the medications tested in the protocol. * history of kidney stones, hypercalcemia, primary hyperparathyroidism, sarcoidosis, hypervitaminosis d. * individuals with underlying cardiac disease, such as arrhythmias. * individuals taking psychiatric medications, such as an mao-i, ssri or snri, or any of the studied medications for medical care. * for women: pregnancy. * pulmonary hypertension * severe osa with a mean sao2 lower than 88%
efficacy of new post kasai ilbs protocol in biliary atresia.

Conditions: Biliary Atresia

Summary: biliary atresia (ba) is a neonatal progressive fibrosing cholan- giopathy and the most frequent indication for pediatric liver trans- plantation \[1\]. surgical removal of biliary remnants and roux-en-y hepatoportoenterostomy (hpe) aims to restore biliary drainage and suppress progression to cirrhosis. successful hpe, defined as a serum total bilirubin level \<2 mg/dl at three months after surgery, occurs in ∼50% of patients in the united states \[2\]. young age seems to be the best predictor of response to hpe, with limited data on the efficacy of adjuvant therapies such as corticosteroids, antibiotics, and choleretic agents \[3,4\]. potential modes of action of these therapies are to increase bile flow as well as exert an anti- inflammatory effect \[5\]. in 2007, a double-blind randomized trial in the united kingdom identified a beneficial effect on corticosteroid therapy on reduction of bilirubin level at one month post hpe without sig- nificant change in the need for liver transplantation \[6\]. since then there have been multiple trial most prominent being, kings hospital trial \[7\] and start trial \[8\] which demonstrated reduction in bilirubin levels; however both failed to demonstrate any effect on native liver survival. however one study done by bezerra et al \[9\] where they employed steroid in customised manner showed significant improvement in bile drainage in their subjects versus their historical cohort. hence we propose to perform a prospective cohort study to assess the efficacy of new post kasai (steroid) ilbs protocol in biliary atresia.

study population : subject undergoing kasai sx at institute of liver and biliary sciences would be enrolled and will include retrospective historical cohort (jan 2015 to dec 2017) and retrospective + prospective cohort with new protocol (jan 2018 till june 2024). study design: cohort study with historical control ( jan 2015- dec 2017) sample size: time bound. all cases presenting during the study period will be included in the study. monitoring and assessment: liver function test, hemogram and international normalised ratio (inr) would be done weekly for one month, twice weekly for 2nd month and monthly thereafter till 1 year. statistical analysis: appropriate statistical test for correlation analysis will be applied. adverse effects: as per previous studies done , no serious adverse effect has been noted in treatment group vs control group.

Eligibility criteria:
inclusion criteria: 1. post kasai biliary atresia operated at ilbs with retrospective historical cohort (jan 2015 to dec 2017) and retrospective + prospective cohort with new protocol (jan 2018 till june 2024). exclusion criteria: 1. subjects having major surgical complications 2. defaulters or patient not following protocol/not giving consent 3. biliary atresia splenic malformation
gasdermin-d and pannexin-1 in pregnancy

Conditions: Pregnancy Complications; Maternal Obesity

Summary: one -third of fertile women around the world are overweight or obese. this means increasing risk for both the mother and the child. fat tissue is a factor in gestational dm development and the increase in material inflammation and oxidative stress. according to new knowledge, it is an important need to examine molecules that are not handled in new and human research in these mechanisms in fat and placenta tissues in obesity. for this purpose, the examination of the expression of gasdermin-d and pannex-1 proteins, which are shown to be produced in the cells of both tissues, is worth investigating in human fat tissue and placenta. gasdermins and pannexins are proteins intersecting by interacting in cellular functions. gasdermins cause piroptosis, a type of litic proinflammatory cell death. pannexin-1 plays in various cellular functions, including inflammation. these are examined in a small number of in vitro studies in material fat tissue and placenta, and the design of this study in people whose applications are applied is original in humans. the status of the expressions of the gasdermin-d and pannexin-1 proteins, which will be examined for the first time in obese pregnant women's fat and placental tissues, are the subject of this research with each other and their relationship with other maternal and neonatal data.


Eligibility criteria:
inclusion criteria: * being in the 20-35 age range * term pregnancy (37-41 weeks) * healthy pregnancy follow-up * planned cesarean section * having no complication in cesarean delivery * being a placenta with front or rear walls exclusion criteria: * intrauterine surgical procedure * presence of prenatal placental structural disorder * multiple pregnancies

Keywords: gasdermin-d pannexin-1 placenta omental tissue fat tissue maternal obesity inflammation oxidative stress biochemistry elisa
the use of clonidine in pain and anxiety associated with acute burn injury in children

Conditions: Pain; Anxiety

Summary: some of the children who suffer acute burn injury do not have adequate pain and anxiety management with the current regimen of scheduled opiates (morphine) and benzodiazepines (lorazepam). other children have significant side effects or contraindications, such as constipation or over sedation, when taking these medications. clonidine is known to reduce the need for morphine in the management of postoperative pain. the addition of clonidine to the pharmacological treatment of burn wound pain offers a possible adjunct to the standard opiate and benzodiazepines regimen. clonidine has been used in children in both on a short-term basis (such as postoperative pain management) and on a long-term basis (such as the treatment of attention deficit hyperactivity disorder (adhd)). this study tests the hypothesis that clonidine in a dose of 5 ug/kilo every 8 hours will be a useful adjunct to the management of pain and anxiety in the acutely burned child. all children will be treated by protocol with morphine (0.03mg/kilo) q4hr prn pain and lorazepam (0.03 mg/kilo) q 4 hours prn anxiety. in addition, after informed consent is obtained the children will be randomized to the addition clonidine or placebo. pain and anxiety will be assessed using standard instruments blind to the medication being used on a daily basis also the total dose of morphine and lorazepam during the 10 days of added clonidine or placebo will be recorded.. the pain rating, anxiety ratings, total morphine dose, and total lorazepam dose will be compared between the placebo and clonidine groups with a student's t test. once the blind is broken the child will be allowed to remain on the clonidine if it is beneficial. the second year of the grant will expand the age groups down to younger children and also begin to gain information about the effect of clonidine on the hypermetabolic state secondary to burn injury.


Eligibility criteria:
inclusion criteria: * pain not controled by morphine * anxiety not controled by lorazepam * burn injuries of 20% or greater * burn type: scald or flame exclusion criteria: * small burn injury * electrical burns

Keywords: pain not controled by morphine anxiety not controled by lorazepam
the relationship between internet-use behavior and mental health in youth

Conditions: Mental Health Issue

Summary: introduction: who defines youth as 15-24 years age group. at this stage, the brain is still under development, with high impulsiveness, being fond of stimulation and yearning for peer life. compared with traditional interpersonal interaction, modern youths use the internet as a main interpersonal interaction platform and conduct lots of leisure activities on the internet. poor cognitive emotion regulation strategies and personal traits may extend to new types of mental health issues; and are associated with depression, anxiety, suicidal/self-injurious behaviors, and cyberbullying. objectives: (1) to investigate whether emotion regulation strategies while facing stressful events are highly related to with cyberbullying, social media, and internet gaming disorder. (2) to investigate the relation between cyberbullying and depression, anxiety, suicide/self-injury among taiwanese youths. (3) to investigate the probability of cyberbullying, social media addiction, and internet gaming disorder occurring at the same time. method: this cross-sectional study recruits cases of youths from 15 to 24 years old and collects data through questionnaires survey. in addition to collection of basic data, internet using habits, and medical history, self-rated questionnaires include suicide/self-injury ideation questionnaire, the beck depression inventory 2nd edition, multidimensional anxiety scale for children-taiwan version, cognitive emotion regulation questionnaire, cyberbullying questionnaire, and internet gaming disorder scale-short form.


Eligibility criteria:
inclusion criteria: control group * able to understand the content of all questionnaires * healthy youths aged 15-20 years old and adults aged 20-24 years old experimental group * able to understand the content of all questionnaires * youths aged 15-20 years old and adults aged 20-24 years old * diagnosed with major depressive disorder, anxiety disorder, post traumatic stress disorder, or adjustment disorder according to dsm-v exclusion criteria: * illiterate or unable to understand the content of the questionnaires * diagnosed with organic brain injury, schizophrenia, or bipolar disorder according to dsm-v

Keywords: youth cyberbullying mental health social media addiction internet gaming disorder suicide/self-injury depression anxiety emotional regulation