Kornimate/medical-research-clean huggingface dataset:
3d printed guide in ankle arthrodesis

Conditions: Ankle Injuries

Summary: this study applies 3d-printed customized guide plate in assisting the accurate drilling of kirschner wire in ankle arthrodesis. this technique can shorten the operation time, reduce the intra-operative radiation, and do not affect the surgical outcome.

ankle arthrodesis is the standard procedure for treating end-stage joint diseases. in order to improve the surgical outcome and reduce the operation time, 3d-printed customized guide plates are fabricated using patients' ankle dicm data of ankle via ct examinations. two 2mm kirschner wires are drilled with the help of the guides; the c-arm fluoroscopy is used to confirm the position of the wires before applying the cannulated screws for effective fixation. in the past when there were no customized guides, the surgeons would drill the kirschner wire according to his/her previous experience and then use c-arm fluoroscopy to confirm whether the position of the wire is satisfactory; if not, repeated procedure will be performed. this would lead to an increase in the duration of surgery and intra-operative radiation, which is detrimental to both the surgeon and the patient. this problem is well solved by applying the 3d-printed customized guides. the application procedure for the customized guide plates: the model of the ankle joint is established according to the patient's ct scan data to prepare the customized guide plate, then sterilize them for future use. apply routine surgical treatment to the ankle joint surface, reset the fusion joint to the functional position, and drill two 2mm kirschner wires with the guidance of the guide plate. if the locations of the fusion joint and the kirschner wires are satisfactory under the c-arm fluoroscopy, drill the cannulated screws for final fixation.

Eligibility criteria:
inclusion criteria: * patients who receive ankle arthrodesis and consider internal fixation with screws exclusion criteria: * patients who receive ankle arthrodesis but do not consider internal fixation with screws

Keywords: ankle joint arthrodesis 3d printing customized guide
management of persistent epistaxis using floseal hemostatic matrix

Conditions: Epistaxis

Summary: nosebleeds that persist even after adequate traditional nasal packing may require aggressive treatment strategies to stop bleeding. currently these strategies include a surgical approach to cut off blood supply to the vessel that is bleeding. floseal hemostatic matrix is a gel like medical therapy that is inserted into the nose and is engineered to stop bleeding in severe cases, possibly avoiding the need for surgery. in this study the investigators will randomize patients to either receive floseal hemostatix matrix or traditional nasal packing as a treatment for severe nosebleeds. the main outcome will be whether the investigators are able to stop bleeding with floseal or traditional packing alone and whether additional measures are necessary to stop the bleeding. the investigators will also perform a patient comfort survey and cost analysis. even if floseal has equal effectiveness in treating nosebleeds as traditional packing, if it is much more comfortable for patients then it may be the favourable treatment.

background: epistaxis is the most common emergent consultation to otolaryngology-head \& neck surgery (ohns) and with 60% of the population having experienced an episode and 1.6 in 10,000 requiring hospitalization in their lifetime. in preliminary studies floseal® (baxter, usa) hemostatic matrix has shown efficacy in up to 80% of persistent anterior epistaxis. we sought to evaluate the clinical efficacy¬ and cost-effectiveness of floseal® (baxter, usa) compared to traditional nasal packing for persistent epistaxis. methods: a prospective, randomized controlled trial was conducted on all adult patients consulted to the ohns service at the tertiary referral centers of the university of alberta hospital and royal alexandra hospital for persistent epistaxis. patients were randomized to the floseal® (baxter, usa) or traditional packing study arms. our main clinical outcome measures were: 1) hemostasis directly following treatment and at 48 hours post-treatment, and 2) self-reported patient comfort at 48 hours post-treatment. further, trial data was used for a formal cost-effectiveness analysis to determine incremental cost-effectiveness ratio (icer). univariate sensitivity analysis and uncertainty analysis were performed.

Eligibility criteria:
inclusion criteria: * all patients age 18+ presenting with epistaxis that requires an ent consult that had a first attempt at treatment by an emergency physician. exclusion criteria: * patients will be excluded based on the presence of a hypo-coagulable state. including patients actively taking anti-coagulant medications or other patients with either acquired or hereditary bleeding disorders.

Keywords: floseal® (baxter, usa) epistaxis nasal packing persistent
community health assessment program in the philippines (chap-p)

Conditions: Diabetes Mellitus, Type 2; Hypertension

Summary: this study aims to evaluate the effectiveness of the community health assessment program in the philippines (chap-p), looking at the differences between communities implementing chap-p versus communities not implementing chap-p.

in this study, the investigators are evaluating the effectiveness of the chap-p intervention in communities of the zamboanga peninsula, philippines. specifically, the investigators are looking at the difference between hemoglobin a1c (hba1c) levels in randomly selected residents of control communities versus those in communities implementing the chap-p intervention. the investigators are also looking at the differences between control and intervention communities in modifiable lifestyle risk factors for diabetes, screening rates for diabetes, rates of newly diagnosed cases of diabetes, general diabetes management, and hospital admission rates, as well as the cost effectiveness of chap-p. the chap-p intervention consists of initial and follow-up sessions where trained local volunteers (barangay health workers, or bhws) take physical measurements (blood pressure, height, weight, waist circumference) and facilitate a diabetes risk survey; based on these findings, they provide education, materials, and referrals to local health resources as needed. the participant groups in this evaluation include those that attend chap-p sessions, randomly selected community members that provide consent for a survey and hba1c testing, and community members and bhws/other lead local organization staff who provide consent for focus groups and interviews.

Eligibility criteria:
inclusion criteria (community survey participants \& chap-p session participants): * aged 40 years of age or older * resident of community exclusion criteria (community survey participants \& chap-p session participants): * under 40 years of age * resident of a different community inclusion criteria (barangay health workers \[bhw\]/lead local organization \[llo\] staff) - must be a bhw or other llo staff who is participating in the chap-p intervention
study on clinical value of vitamin d in recurrent spontaneous abortion

Conditions: Vitamin D Deficiency; Recurrent Spontaneous Abortion

Summary: the observational study is to compare vitamin d deficiency and related indicators among different spontaneous abortions in describe female reproductive health.the main question aim to answer is: the possible pathogenesis of recurrent spontaneous abortion caused by vitamin d. participants, who visit the rsa specialty clinic, will provide medical history information, regularly exam based on the condition, following up on pregnancy status.participants will be asked to supply vitamin d preparation and do moderate exercise outdoors, comparing the effect after treatment.

examinations include uterine artery resistance parameter s/d, some embryonic chromosomes tested voluntarily, plasma vd content and the level of anticardiolipin antibody.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of patients without spontaneous abortion; * clinical diagnosis of patients with a spontaneous abortion; * clinical diagnosis of patients with recurrent pontaneous abortions; exclusion criteria: * patients with chromosomal abnormalities in rsa couples, such as balanced translocation; * patients who take vd preparations or related vd supplements within 3 months before treatment; * patients with a combination of certain malignant tumors and severe mental illness.
efficacy of n-acetylcysteine versus placebo as prophylaxis of sinusoidal obstruction syndrome in patients undergoing hematopoietic stem cell transplantation

Conditions: Sinusoidal Obstruction Syndrome (SOS); Hematopoietic Stem Cell Transplant (HSCT)

Summary: sinusoidal obstruction syndrome (sos) or hepatic veno-occlusive disease (vod) is a serious complication that occurs, most often occurring in patients undergoing hematopoietic stem cell transplantation (hsct), especially in its first thirty days. the morbidity and mortality in this syndrome are considerable, since severe sos is associated with a mortality of more than 90% in the first hundred days of hsct. some risk factors are modifiable, especially those related to transplantation, but when non-alterable factors are present, preventive measures are needed that can reduce the incidence and / or severity of sos.

this is a single-center, randomized, placebo-controlled study to evaluate the efficacy and safety of n-acetylcysteine as prophylaxis of sinusoidal obstruction syndrome in patients undergoing hematopoietic stem cell transplantation up to date, no approved medications are available for prophylactic treatment of sinusoidal obstruction syndrome in patients undergoing hematopoietic stem cell transplantation. n-acetylcysteine is a drug that has been long used as a mucolytic. and placebo responses contribute to help assess the appropriateness of randomized clinical trials in determining the size of drug effect. the study will enroll patients undergoing hematopoietic stem cell transplantation to receive sequentially one of two treatment: n-acetylcysteine or placebo.

Eligibility criteria:
inclusion criteria: * men or women * age ≥ 18 years * a proven diagnosis of one of the hematological malignancies: acute myeloid leukemia, acute lymphoid leukemia, chronic myeloid leukemia, chronic lymphoid leukemia, multiple myeloma, non-hodgkin's lymphoma, hodgkin's lymphoma * patients must be scheduled to undergo of allogeneic hematopoietic transplantation or hla (human leukocyte antigen) haploidentical related or unrelated or hla-matched related or autologous stem cell transplant * patients must be able to understand and sign a written informed consent exclusion criteria: * patient has a serious active disease or co-morbid medical condition, as judged by the investigator, which would interfere with the conduct of this study * patient, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study * known hypersensitivity to n-acetylcysteine * contraindications to perform any procedure provided for in this study * patients who have already undergone a previous transplant

Keywords: stem cell transplant hematopoietic stem cell transplant (hsct) sinusoidal obstruction syndrome (sos) veno-occlusive disease (vod) n-acetylcysteine
sarcopenia studies for the elderly population in taiwan

Conditions: Sarcopenia

Summary: health promotion in the elderly has been a major recent public health concern. sarcopenia is a term utilized to define the loss of muscle mass and strength that occurs with aging. it has been demonstrated to be associated with decreased functional capacity among the elderly. the magnitude of the public health problem posed by sarcopenia is not yet established. the purposes of this study are to investigate sarcopenia and its relationship with functional status in elderly taiwanese community-dwellers, and to develop the preventive strategy for sarcopenia in the elderly. firstly, the investigators will recruit 100 volunteers (aged 18-90 years old) to participate in this study. all of the participants will receive bioelectric impedance analysis (bia), muscle strength and endurance assessment, physical activity level assessment by a seven-day recall questionnaire, protein intake assessment, cognition evaluation (mini-mental state examination) and functional status assessment by the functional independence measurement (fim) questionnaire. a multiple regression model will be used for statistical analyses. then, this project will be used to evaluate the efficacy of a 12-week supervised resistance strengthening exercise program for sarcopenia in the elderly. participants who are defined as having sarcopenia from the previous examination will be randomized into either the exercise or control groups. subjects in the exercise group will receive resistance strengthening exercises 3 times per week for 12 weeks. all measurements will be performed as described above. the investigators expect that resistance exercises are effective in offsetting age-related decline of muscle mass and strength in the elderly.


Eligibility criteria:
inclusion criteria: * 18-90 year old healthy adults exclusion criteria: * no systemic diseases

Keywords: sarcopenia exercise
manual-based art therapy for adolescents with depression

Conditions: Depression; Depressive Disorder

Summary: there is a need to evaluate different interventions in order to meet young people's needs of treatment. the study's goal is to find out if manual-based art therapy is a useful method for young people with depression and thus increase the availability of methods of treatment for adolescents with depression in child and youth psychiatry in sweden. the aim is to investigate whether manual-based art therapy is useful as treatment for adolescents with depression by examining feasibility, acceptability and compliant to treatment. secondary, preliminary study of adolescent depressive symptoms, quality of life and functional level is affected by the treatment. method: data from youths aged 13-17 years old and their parents will be collected with questionnaires and structured interviews. measurements are taken before and after treatment. acceptability and feasibility will be examined by participants' presence, drop out and cancellations and also by checking the art therapists' compliance to the manual and investigate their reasons to diverge from the manual


Eligibility criteria:
inclusion criteria: * age 13-17 year * depression as main diagnosis exclusion criteria: * high suicide risk * ongoing psychosis * eating disorder * untreated ptsd * patients are excluded if there is suspicion of violence, abuse, abuse in the home or other vulnerability which requires other interventions to ensure the safety.

Keywords: art therapy program development adolescent health
itga6 targeting nir-ii fluorescence image guided surgery

Conditions: Hepatocellular Carcinoma

Summary: in this study, the investigators will detect hepatocellular carcinoma lesions using fluoescence imaging with itga6 targeting probes during tumor resection surgery. the aim is to evaluate wether intraoperative fluorescence imaging targeting itga6 can help to improve the detction effect of hepatocellular carcinoma, and finally help the accurate surgical resection. the main purposes of this study include: 1. to raise the detection rate of hepatocellular carcinoma intraoperatively using the novel nir-ii fluorescence molecular imaging and the itga6 targeting probe. 2. to validate the safety and effectiveness of the proposed itga6 targeting probes for clinical application.


Eligibility criteria:
inclusion criteria: 1. patients who have been diagnosed with hepatocellular carcinoma. 2. planned to receive hepatectomy. 3. liver function child-pugh a. 4. itga6 was validated highly expressed preoperatively. 5. aged 18 to 80, and the expected lifetime is longer than 6 months. 6. approved to sign the informed consent. exclusion criteria: 1. allergic to cy7. 2. enrolled in other trials in the past 3 months. 3. another malignant tumor was found. 4. undesirable function of heart, lung, kidney, or any other organs. 5. unable to tolerate a hepatectomy. 6. the researchers considered inappropriate to be included.
identification and clinical relevance of an oxytocin deficient state (crh study)

Conditions: Hypopituitarism; Central Diabetes Insipidus; Panhypopituitarism; Psychological Disorder; Social Isolation; Hypothalamic Diseases; Pituitary Diseases; Oxytocin Deficiency

Summary: oxytocin (ot) is a hypothalamic peptide that enters the peripheral circulation via the posterior pituitary gland. ot plays a key role in regulating appetite, psychopathology, prosocial behavior and sexual function. hypopituitarism is associated with increased obesity, increased psychopathology, sexual and prosocial dysfunction despite appropriate hormone replacement. a few studies suggest the existence of a possible ot deficient state in hypopituitarism. in animal models, corticorelin hormone (crh) has shown to increase ot release. this study is designed to evaluate oxytocin values after administration of crh in adults (healthy volunteers and patients with hypopituitarism). the investigators hypothesize that ot response will be blunted following crh in patients with hypopituitarism compared to healthy controls.

this research is focused on two groups of participants: healthy controls (hc) and hypopituitary patients (hypo) with at least one symptom of hypothalamic damage, presumably at highest risk for ot deficiency. the aim is to improve knowledge on the physiology and patho-physiology of endogenous ot secretion in hypopituitary patients compared to healthy controls using a randomized, single-blind, crossover assignment (crh vs placebo), placebo-control design. clinical implications of secretory ot dynamics and release under different stimuli using validated questionnaires to evaluate psychopathology, socio-emotional functioning, disordered eating behavior, impaired quality of life and sexual dysfunction, will be also evaluated.

Eligibility criteria:
inclusion criteria: * patients with hypopituitarism (hypo) (\>1 pituitary hormone deficiency) and stable hormone replacement for the prior three months * at least one clinical sign of hypothalamic damage * female participants will be done in the early to midfollicular phase exclusion criteria: * uncorrected hormone deficiency * creatinine \>1.5mg/dl * alanine aminotransferase (alt) or aspartate aminotransferase (ast) \>2.5x upper limit of normal * hematocrit less than 30% * suicidality or active psychosis * participation in a trial with investigational drugs within 30 days * using a high glucocorticoid dose * vigorous physical exercise * alcohol intake within 24 hours before the study participation * evidence of any acute illness or any illness that the investigator determines could interfere with study participation or safety * pregnancy or breastfeeding for last 8 weeks * known allergies towards crh * patients refusing or unable to give written informed consent * additionally for healthy controls: the presence of brain or pituitary tumor, radiation involving the hypothalamus or pituitary, history of hypopituitarism or receiving testosterone or glucocorticoids esters.

Keywords: oxytocin panhypopituitarism central diabetes insipidus hypothalamus-pituitary diseases cortisol acth corticorelin hormone
pain empathy assessment in sleep deprived emergency & acute care clinicians

Conditions: Empathy; Sleep; Pain

Summary: cognitive empathy is relevant in clinical practice and will be assessed based on the accuracy of pain recognition and the pain intensity evaluation in a computerised task using facial expressions. repeated measures across day and night shifts will provide the basis to understand the impact of shift work on those abilities in health care professionals.

assessment and management of the pain patients experience is one of the key skills needed in the field of anesthesiology. the consideration of non-verbal cues is essential, especially the recognition of facial expressions. the human ability to recognize emotions in others depends on the capacity for empathy of an individual, specifically cognitive empathy. in the clinical context empathy is understood as a set of skills and competences rather than a character trait. it may therefore vary due to various parameters. currently there is no research available on the influence of shift work on the human ability to recognize pain in facial expressions. however, work schedules that do not fit the natural circadian rhythm are known to alter the processing of emotions. in particular the ability to judge the intensity of an emotion is influenced. therefore, the hypothesis of the present study will be, that shift work impairs the pain assessment performance of an individual. to test this hypothesis, the effect of shift work on the performance in recognizing and assessing pain intensity of faces by health care professionals in the anesthesia department will be assessed. a repeated measures assessment will be used.

Eligibility criteria:
exclusion criteria: * refuse to participate * not working night shifts * no patient contact inclusion criteria: * working day and night shifts * health care professional with patient contact

Keywords: cognitive empathy health care professionals pain recognition pain assessment sleep misalignment quality of care
integrated ptsd and smoking treatment

Conditions: Post-Traumatic Stress Disorder

Summary: research shows that people with ptsd are more likely to smoke than people without ptsd. it also shows that people with ptsd have more difficulty at attempts to quit smoking. this study is part of a program aimed at finding out how best to help smokers quit who also have ptsd. one option is to give patients standard smoking cessation treatment including nicotine replacement and cognitive behavioral therapy. another option is to give patients the standard smoking cessation treatment in addition to treatment for their ptsd symptoms (called prolonged exposure). however, it is not known which method works better. in order to answer this question, patients will be assigned by chance to one of two groups. one group will be given standard smoking cessation treatment to help quit smoking. a second group will be given the standard smoking cessation intervention to help quit smoking in addition to a form of psychotherapy called prolonged exposure to reduce symptoms of ptsd. the patients will be randomly assigned (by chance) to one of these groups. if the patient is assigned to the smoking cessation only condition and the patient still has ptsd symptoms after the last study visit (week 30) the patient will be offered treatment for your ptsd symptoms (prolonged exposure) at no cost. the patient's participation will help the investigators determine if treating ptsd symptoms enhances the ability of standard smoking cessation to help people quit smoking.


Eligibility criteria:
inclusion criteria: * you have ptsd * you currently smoke more than 8 cigarettes per day * you have a motivation to quit smoking * you are between the age of 18 and 65. exclusion criteria: * you are currently using other tobacco products (other than cigarettes) * you have any history of a suicide attempt, or are at significant risk of self-harm or harm to others * you have severe depression * you have any history of bipolar disorder, psychotic disorder * you have a diagnosis of eating disorder, or substance abuse or dependence (excluding nicotine) within the past six months * you are currently receiving other treatment specifically for ptsd or smoking cessation * you are unable to read and speak english (as the materials are provided in english)