Kornimate/medical-research-clean huggingface dataset:
a randomized study on comparing the efficacy of foley catheter and extraamniotic saline infusion for labor induction

Conditions: Cervical Ripening; Labor, Induced

Summary: our purpose was to compare the efficacy and safety of foley catheter with oxytocin and extraamniotic saline infusion with oxytocin for induction of labor requiring cervical ripening.

induction of labor is indicated when the benefit to either the mother or fetus outweighs that of continuing the pregnancy. labor induction in the presence of an unripened cervix is associated with prolonged labor, chorioamnionitis, and cesarean delivery. numerous mechanical and pharmacological methods have been used for cervical ripening. there are limited numbers of rigorous studies comparing the efficacy of the various methods. one of the most common mechanical methods for cervical ripening is placement of a foley catheter with a 30 cc balloon inside the cervix, with or without the use of oxytocin. the foley balloon will disrupt the amniotic membrane surface and cause the release of prostaglandin, a natural chemical from the cervix, to facilitate the ripening process. oxytocin will be used concurrently as the induction agent. recently, a modification of this method, extraamniotic saline infusion (easi) has become more popular. the easi method involves similar procedure including the placement of foley catheter inside the cervix; in addition, saline solution will be infused through the catheter. this additional step is thought to further facilitate the disruption of amniotic membrane surface. both methods are safe and become the standard treatment for cervical ripening. however, there are no published trials so far comparing the two methods. the objective of this study is to compare the efficacy and safety of foley catheter with oxytocin and easi with oxytocin for induction of labor requiring cervical ripening. the study is designed to be a single masked randomized trial.

Eligibility criteria:
inclusion criteria: * singleton gestation * cephalic vertex presentation * intact membrane * gestational age between 30 and 42 weeks * bishop score less than or equal to 5 exclusion criteria: * suspected chorioamnionitis * placenta previa * low lying placenta * unexplained vaginal bleeding * intrauterine fetal demise * hiv * any contraindication to vaginal delivery

Keywords: cervical ripening labor, induced balloon dilation oxytocin
efficacy analysis of comparison of cams（chinese academy of medical sciences）-2005 trial and cams-2009 trial for pediatric acute myeloid leukemia

Conditions: Acute Myeloid Leukemia, Pediatric

Summary: the investigators adopted the cams（chinese academy of medical sciences）-2009 trial for pediatric acute myeloid leukemia (aml) patients between 2009 to 2015, in which a risk-stratified strategy and dose-dense intensive chemotherapy were introduced. the outcomes of cams-2009 trial were retrospectively analyzed, and compared to the cams-2005 trial.


Eligibility criteria:
inclusion criteria: * newly diagnosed aml exclusion criteria: * children with down's syndrome and acute promyelocytic leukemia (apl)
alternate run study

Conditions: Overuse Injury

Summary: the proposed study will investigate the effect of alternating footwear model and workout-type on the occurrence of running-related pain. to achieve this goal participants will be randomly assigned into one of four different groups who will perform: 1) the same workout throughout a week in the same running shoe model, 2) alternating workout-types throughout the week in the same shoe model, 3) the same workout throughout a week in alternating shoe models, and 4) alternating workouts in alternating shoes. participants will be characterized based on body alignment, strength, injury and training history. pain and injury status will be monitored.


Eligibility criteria:
inclusion criteria: * subjects in this study will include adults (men and women) between the ages of 19 and 60, have been running on a regular basis (minimum once per week) over the past 6 months, are able to run for 60 minutes continuously, could tolerate 20-40km per week in training, and have not experienced a running related injury requiring a stoppage of 2-weeks or more in the past 6 months. only neutral and pronated foot postures (foot posture index between -2 and 8) will be recruited exclusion criteria: * have a history of surgery to their plantar fascia or achilles tendon, * have a diagnosis of osteoarthritis - or other degenerative musculoskeletal disorder - affecting the lower extremity, * take analgesic or anti-inflammatory medication 2 or more times per week over the past 4 weeks, * take part in high impact activities 2 or more times per week during the study period

Keywords: running injuries, footwear, alternating load
deprescribing proton pump inhibitors to reduce post-tips hepatic encephalopathy

Conditions: Hepatic Encephalopathy

Summary: a total of 40 patients taking proton pump inhibitors (ppis) who undergo transjugular intrahepatic portosystemic shunt (tips) creation as part of routine clinical care will be randomized in 1:1 fashion to either continue or discontinue their ppis to determine whether these commonly used gastric acid suppressing agents increase risk of post-tips hepatic encephalopathy (he). patients will be assessed for symptoms of minimal he (mhe), using the established psychometric hepatic encephalopathy score (phes) battery of tests. mhe assessment will be conducted at two timepoints: at baseline prior to randomization and tips creation and approximately 4 weeks after randomization and tips creation. stool samples will also be collected at both timepoints to allow characterization of the gastrointestinal (gi) tract microbiome using 16s rrna sequencing. the pre to post-tips change in phes scores will be compared between patients randomized to continue versus discontinue their ppis. quality of life (qol) will also be assessed. changes in the gi tract microbiome will be analyzed to determine whether this represents a potential biological mechanism linking ppi use with post-tips he.


Eligibility criteria:
inclusion criteria: * undergoing tips creation as part of routine clinical care * on ppis therapy (at least 20 mg omeprazole equivalent daily) * provision of signed and dated informed consent form by participant or legal representative * stated willingness to comply with all study procedures and availability for the duration of the study * male or female, age greater or equal to 18 exclusion criteria: * grade iv esophagitis or gastric or duodenal ulcer * recent endoscopic esophageal variceal band ligation necessitating ppi therapy for prevention of banding ulcer * zollinger-ellison syndrome * active helicobacter pylori infection * pregnancy
determining the optimal cut-off point of pea by corsens device for discriminating between mi and non-mi subjects

Conditions: Myocardial Infarction

Summary: acute myocardial infarction (mi) is still the leading cause of death in the western world. early warning (chest pain) signs of an acute mi are often misinterpreted and disregarded. in average it takes between 2-3 hours from the beginning of the chest pain. the damage to the heart in these 2 hours is critical and often irreversible. thus an early warning test or device is highly warranted. corsens has developed a noninvasive device using several sensors applied to the chest and a detection system able to recognize the ischemic origin of chest pain. this clinical study is intended for evaluating the safety and efficacy of the corsens technology while use for myocardial infarction detection


Eligibility criteria:
inclusion criteria: * patients admitted to the cardiac care unit (ccu) with st elevation acute mi (stemi) within 4 hours from beginning of chest pain. * male or female subjects aged 18 years or more (with no upper limit), of any race. * subjects willing to participate as evidenced by signing the written informed consent. exclusion criteria: * obese patients with bmi\>35. * subjects with cardiac arrhythmias including atrial fibrillation. previous mi. * patients after coronary artery bypass grafting * unstable hemodynamic condition. * patient that can't or do not wish to sign the inform consent form
s9304a study of protein expression in tumor tissue samples from patients with stage ii or stage iii rectal cancer enrolled in clinical trial swog-9304

Conditions: Colorectal Cancer

Summary: rationale: studying samples of tumor tissue from patients with cancer in the laboratory may help doctors learn more about changes that occur in dna and identify biomarkers related to cancer. it may also help doctors predict how patients will respond to treatment. purpose: this research study is looking at protein expression in tumor tissue samples from patients with stage ii or stage iii rectal cancer enrolled in clinical trial swog-9304.

objectives: * determine expression levels of thioredoxin-1 (trx-1), thioredoxin-interacting protein (txnip), and hypoxia inducible factor-1 alpha (hif-1α) in paraffin-embedded resected tumor tissue samples from patients with stage ii or iii rectal cancer enrolled in clinical trial swog-9304. * determine if there is a correlation between trx-1 and txnip expression and hif-1α expression. * correlate expression of these proteins with tumor stage, disease-free survival, overall survival, and risk of recurrence. * determine interactions for patient age, performance status, and type of therapy received on clinical trial swog-9304. outline: this is a multicenter study. paraffin-embedded resected tumor tissue samples are analyzed for protein expression levels (thioredoxin-1, thioredoxin-interacting protein, and hypoxia inducible factor-1 alpha) by tissue microarray and immunostaining.

Eligibility criteria:
disease characteristics: * histologically confirmed adenocarcinoma of the rectum * stage ii or iii disease * no metastases * enrolled on clinical trial swog-9304 patient characteristics: * not specified prior concurrent therapy: * see disease characteristics

Keywords: stage ii rectal cancer stage iii rectal cancer adenocarcinoma of the rectum
laser assisted treatment of fistula in ano

Conditions: Fistula in Ano; Rectal Fistula

Summary: randomised controlled trial comparing laser assisted closure of transsphincteric fistula to the rectal advancement flap.

a prevalent and complex fistula type is the high transsphincteric (ts) fistula. it typically runs through the upper two-thirds of the external anal sphincter (eas) and is, due to the high risk of fecal incontinence, not suitable for fistulotomy and sphincter sparing treatment is required. to be included in this trial the participants should have a single, continuous ts fistula of cryptoglandular origin, that is treated by loose seton drainage for at least 2 months and is mapped by mri. participants with ibd, hidradenitis suppurativa or a malignant fistula will be excluded. intervention fistula laser closing (filactm) (biolitec, germany) is an endofistular technique, using a radial-emitting laser fiber that emits laser light with a maximum penetration depth of 2 - 3 mm. it destroys both the crypt gland and the additional epithelial layer of the fistula without damaging the sphincter. the fiber is inserted until the internal opening, activated and pulled backwards slowly, allowing the laser to have its effect. the external opening is excised and the internal opening is closed with a single absorbable suture. rectal advancement flap is currently the gold standard for sphincter sparing treatment of high transsphincteric fistulae. the fistula is cored out and an advancement flap is made of mucosa and submucosa. the opening of the fistula in the flap is excised, the residual internal opening is closed with absorbable suture and the flap is sutured below the fistula to the anoderm. the advancement flap is a difficult technique that requires a relatively large transanal dissection that results in postoperative pain and may lead to disturbances in continence. preliminary results with the filac technique show fistula healing rates comparable to the advancement flap. due to its simplicity, speed and minimal invasiveness the investigators expect a benefit for the participants in terms of postoperative pain, operating time and quality of life.

Eligibility criteria:
inclusion criteria: * patients with fistula involving more than one-third of the external anal sphincter * single, continuous fistula tract at time of inclusion * loose seton present in fistula tract for 2 months or more at time of inclusion * age ≥ 18 * able to complete an informed written consent, understand its implications and contents, and participate in follow-up exclusion criteria: * fistula tract \< 1 cm * complex fistula tract system (branching of fistula tract inside the sphincter complex) * pregnancy * hiv-positive * crohn´s disease, ulcerative colitis * fistula due to malignancy * tuberculosis * hidradenitis suppurativa * no internal opening * unable to undergo or contraindications to mri

Keywords: rectal, advancement flap laser assisted fistula closure randomised control trial
stromal lenticule implantation for management of herpetic stromal keratitis

Conditions: Stromal Keratitis

Summary: the aim of this study is the evaluation of corneal transparency and improvement of visual acuity in patients with herpetic stromal keratitis.

stromal keratitis is an infectious ocular disease of either necrotizing or non-necrotizing form, due to an hsv infection, and characterized by corneal stromal necrosis, inflammation, ulceration and infiltration by leukocytes. in our study these early findings suggest that the use of corneal stromal lenticules with stromal stem cells and live keratocytes could be a safe and efficient treatment for stromal scar after herpetic keratitis, and excluding the recurrence of the disease by removing the corneal scar after herpetic infection using smile and implanting the lenticule equal to the volume of the removed scar tissue. stromal lenticule implantation is relatively simple, low-cost and offers advantages over corneal transplantation as a definitive procedure in the treatment of this disease.

Eligibility criteria:
inclusion criteria: * low transparenc of cornea * low visual acuity * recurrence of herpetic stromal keratitis exclusion criteria: * previous corneal or anterior segment surgery * any infection
examining relationships between family mealtime and feeding outcomes in young children with sensory food aversions

Conditions: Feeding Disorder of Infancy or Early Childhood

Summary: this study will examine the feasibility and preliminary effects of the mealtime prep (promoting routines of exploration and play) intervention package for young children with sensory food aversions and their parents.

this pilot study will collect rich data from twenty participants on the feasibility and effects of a novel intervention, the mealtime prep, which has a dyadic focus on both the young child and the parent participants. the investigators will collect video recorded child meals in the home during a baseline period (under normal circumstances), during parent-training (while parents are practicing skills learned), and following parent training (when therapist support is withdrawn). this in depth examination of child meals will provide valuable information to guide the optimization of this intervention approach for future trials.

Eligibility criteria:
inclusion criteria: * child must meet all criteria of the diagnosis of sensory food aversions 1. the child consistently refuses to eat specific foods with specific tastes/textures and/or smells. 2. onset of food refusal occurs during the introduction of a novel type of food (e.g., the child may drink one type of milk but refuse another, may eat carrots but refuse green beans, may drink milk but refuse baby food). 3. the child eats without difficulty when offered preferred foods. 4. the food refusal causes specific nutritional deficiencies or delay of oral motor development. * parent is able to read, write, speak and understand english. exclusion criteria: none

Keywords: sensory food aversions
impact of medical education of physician action 2

Conditions: Spondyloarthritis

Summary: this is a retrospective and prospective designed study, included hospitals are 1:1 assigned into two groups: ①interventional hospital, which will receive 3-month medical education; ②non-interventional hospital, which will not receive 3-month medical education. during 1 month before education, all the electronic records of outpatients and inpatients who visit the included rheumatologists will be collected and the data of test and evaluation results of spondyloarthritis (spa) patients diagnosed according to new assessment of spondylo-arthritis international society (asas) criteria will be collected from outpatient electronic records and inpatients medical charts; in the 3 months after education, the same data will be collected and compared with the data before education, and the impact of medical education on physician behaviour will be analyzed. meanwhile, the understanding and acceptance level will be evaluated by the questionnaire, the differences before and after education and the impact of education on physician cognition will be evaluated.


Eligibility criteria:
interventional hospital will be selected based on following criteria: 1. having complete outpatients and inpatients electronic records; 2. more than 50% of registrars and/or consultants in the department participated the professional education event; 3. the department head is willing to participate the clinical audit and provide the information from outpatients and inpatients records for data collection; 4. except for rheumatic diseases have been clearly diagnosed. non-interventional hospital will be selected based on following criteria: 1. having complete outpatients and inpatients electronic records; 2. no professional education event covered; 3. the department head is willing to participate the clinical audit and provide the information from outpatients and inpatients records for data collection; 4. except for rheumatic diseases have been clearly diagnosed.

Keywords: medical education spondyloarthritis physician action
continuous spinal anesthesia versus general anesthesia in sepsis

Conditions: Sepsis; Continuous Spinal Anesthesia; General Anesthesia

Summary: the anesthetic efficacy and safety of continuous spinal anesthesia and comparing it with general anesthesia technique in sepsis diagnosed patient.

hemodynamic instability due to high block largely limits the use of conventional dose spinal anesthesia in high-risk septic patients. hypotension is more common, and also more hazardous, in septic patients, as they may have decreased physiological reserve and compromised blood supply to various vital organs. a smaller dose of local anesthetic reduces the severity and incidence of hypotension during spinal anesthesia.

Eligibility criteria:
inclusion criteria: * patients over 21 years old * american society of anesthesiologists (iii, iv) diagnosed with sepsis (sequential organ failure assessment (sofa) score ≥ 7) * hemodynamically stable and not on vasopressor due to lower limb pathology candidate for spinal anesthesia to drain source of infection. exclusion criteria: * patients with known hypersensitivity to local anesthesia. * infection at the site of injection. * coagulopathy. * septic shock. * increase of intracranial pressure. * severe deformity of the spinal column.
effects of induced inspiratory muscle fatigue on functional mobility of older adults

Conditions: Healthy Older Adults

Summary: the aim of study was to evaluate the effects of inspiratory induced muscle fatigue on functional mobility of older adults. though, limited literature exists regarding inspiratory muscle fatigue and its consequences on functional activities of daily living and balance. yet, it is not clear how improvement in inspiratory muscle strength is related with improvement in functional mobility.

respiratory muscle fatigue was first described in 1977. inspiratory muscle relaxation rates are known to slow following induction of fatigue. inspiratory muscle fatigue was induced by threshold loading at 80 percent of (maximum inspiratory pressure) pimax until the subjects were unable to generate the target pressure. inspiratory muscle fatigue (imf) is proposed to negotiation exercise performance, probably via a respiratory muscle metaboreflex that impairs blood flow to working muscles, thereby accelerating the progress of fatigue in these muscles. respiratory muscle fatigue revealed that a maximal inspiratory load of 50% could quickly fatigue both the inspiration and expiration muscles. increased inspiratory muscle work may induce fatigue of the respiratory muscles, as well as of the non-respiratory muscles by central alterations at spinal and supraspinal level. also there is an association between respiratory muscle dysfunction and physical performance in older adults. the abnormalities of respiratory movements may be dependable clinical signs of inspiratory muscle fatigue, mostly when accompanied by tachypnea and hypercapnia. fatigue is distinguished from weakness, a decrease in force generation that is static and not reversible by rest, though muscle weakness may be a susceptibility to muscle fatigue. this study will contribute to determine the effects of respiratory muscle fatigue on balance and functional mobility with healthy older adults. to further understand this relationship, a battery of tests (considered as gold standard) will be performed after induced inspiratory muscles fatigue.

Eligibility criteria:
inclusion criteria: * adults with age 60+ years * both male and female participants * patients with forced expiratory volume 1/forced volume capacity ratio greater than 80% exclusion criteria: * smokers * subjects with a history of cardiovascular, respiratory, or neuromuscular * diseases that can impede test or alter the maximum inspiratory pressure. * subjects with cognitive impairment. * subjects with low back and musculoskeletal disorders. * previous experience in respiratory muscle training.

Keywords: inspiratory muscle fatigue functional mobility maximum inspiratory pressure
anlotinib plus anti-pd-1 antibody ak105 for advanced pancreatic cancer

Conditions: Anlotinib; Anti-PD-1 Antibody; Advanced Pancreatic Cancer

Summary: this study was designed to explore the clinical efficacy of anlotinib combined with anti-pd-1 antibody ak105 in the treatment of third- and above -line advanced pancreatic cancer patients, in order to find a better therapy strategy for pancreatic cancer patients.


Eligibility criteria:
inclusion criteria: * locally advanced or metastatic pancreatic cancer (pc), * histologically or cytologically proven diagnosis of adenocarcinoma or adenosquamous carcinoma, * failed to second-line chemotherapy for pc, * 18-75 years of age, * an eastern cooperative oncology group performance status score of 0 to 1, * adequate organ functions exclusion criteria: * had received pd 1 /ctla 4 antibody treatment * had received anti-vegfr inhibitors or antibodies