Kornimate/medical-research-clean huggingface dataset:
artificial intelligence for diminutive polyp characterization

Conditions: Colorectal Neoplasms

Summary: artificial intelligence is a promising tool that may have a role in characterizing colon epithelial lesions (cadx), helping to get a reliable optical diagnosis regardless of the endoscopist experience. performances of the different cadx systems are variable but it seems that, in most cases, high accuracy and sensitivities are achieved. however, these cadx systems have been developed and validated using still pictures or videos, and a real-world accurate test is lacking. no clinical trials have tested this technology in clinical practice and, therefore, performance in real colonoscopies, practical problems, applicability, and cost are unknown.

the resect-and-discard (r\&d) and diagnose-and-leave (d\&l) strategies have been proposed as a means to reduce costs in the evaluation of colorectal polyps avoiding a substantial number of pathology evaluations. a pre-requisite for this paradigm shift is an accurate optical diagnosis (hod). however, performance results for hod have been highly variable among endoscopists representing a barrier for the adoption of the r\&d and the d\&l strategies. artificial intelligence is a promising tool that may have a role in characterizing colon epithelial lesions (cadx), helping to get a reliable optical diagnosis regardless of the endoscopist experience. performances of the different cadx systems are variable but it seems that, in most cases, high accuracy and sensitivities are achieved. however, these cadx systems have been developed and validated using still pictures or videos, and a real-world accurate test is lacking. no clinical trials have tested this technology in clinical practice and, therefore, performance in real colonoscopies, practical problems, applicability, and cost are unknown. methods and analysis: the oddity trial is a european multicenter randomized, parallel-group superiority trial comparing gi-genius artificial intelligence optical diagnosis (aiod) to human optical diagnosis (hod) of colon lesions ≤ 5 mm performed by endoscopists, using histopathology as the gold standard. a total of 643 patients attending a colonoscopy within a crc screening program (either fit- or colonoscopy-based) or because of post-polypectomy surveillance will be randomized to the adi group or the hod (control) group. a computer-generated 1:1 blocking randomization scheme stratified for center and endoscopist will be used.

Eligibility criteria:
inclusion criteria: * patients attending a colonoscopy within a population-based crc screening program (fit- or colonoscopy-based) or because of post-polypectomy surveillance, * written informed consent before the colonoscopy, exclusion criteria: * none, patient included * previous history of inflammatory bowel disease. * previous history of crc * previous cr resection * polyposis or hereditary crc syndrome * coagulopathy/anticoagulants * unwillingness to participate

Keywords: artificial intelligence colorectal cancer polyp characterization
augmented cerebral pain processing in chronic, unexplained pain: a fmri study

Conditions: Pain

Summary: chronic, unexplained pain symptoms are very common in all layers of the population, but it is largely unknown what causes them. this study examines the hypothesis that patients with these pain symptoms process pain abnormally in their brain. to this aim, we compare patients and healthy people: they receive mild pain at their painful body region and at another location. concurrently, we measure brain activity with brain scans (functional mri scans). with our study results, we want to increase understanding of what causes chronic, unexplained pain symptoms, in order to find better methods of diagnosing and treating them.

background chronic, unexplained pain is a heterogeneously defined, but common and recurring clinical problem, in general medical practice as well as in specialist care. chronic, unexplained pain causes considerable loss of quality of life, frequent absence from work and it is a common reason for health care visits. from a pathophysiological point of view, an augmented and self-amplifying sensitivity for physical signals such as pain (as well as for other signals) seems to be important. this is referred to as 'generalised hypervigilance', a specific type of sensitisation. central sensitisation mechanisms have been implied in several pain syndromes. in our own psychophysical pilot study, we confirmed the existence of amplified pain perception in chronic, unexplained pain, as well as the disturbed influence of attentional processes. our study results probably reflect a general disturbance of perception, not associated with a specific body location. this general perceptual disturbance is expressed in a stronger fashion in the clinically affected body region. abnormal pattern of cerebral pain processing have been found in functional mri studies in other syndromes of unknown origin, such as fibromyalgia, somatoform pain disorder and irritable bowel syndrome. however, the role of several neurobiological factors in chronic, unexplained pain remain to be elucidated and to be placed in the context of the biopsychosocial model. work plan: a 3t rapid event-related, functional mri-experiment into the cerebral processing of experimental pain stimuli in chronic, unexplained pain-patients versus healthy controls. twelve chronic, unexplained pain-patients with unilateral limb pain and twelve healthy control subjects experience painful and non-painful electrical stimuli on the painful limb, whilst the attentional state of the subject is controlled. with functional mri, we record the pain-related cerebral activations and compare them between groups, in order to characterise the cerebral correlates of altered pain processing in chronic, unexplained pain.

Eligibility criteria:
inclusion criteria: * chronic limb pain \> 6 months * no known somatic cause exclusion criteria: * chronic benzodiazepine use * axis-i psychiatric co-morbidity * contra-indications for mri scanning (e.g. implanted pacemaker)

Keywords: pain chronic pain pain disorder functional mri sensitization
telemedicine and nursing home

Conditions: Elderly; Multimorbidity

Summary: telemedicine-based care provides remote health and social care to maintain people's autonomy and increase their quality of life. the rapidly aging population has come with a significant increase in the prevalence of chronic diseases and their effects, and thus the need for increased care and welfare. this solutions give a new opportunity for diagnosis, treatment, education, and rehabilitation, and make it possible to monitor patients with a number of chronic diseases. it also reduces socioeconomic disparity with regard to access to care and gives equal chances to patients from urban and rural areas. this a randomized trial of telemedicine versus usual care alone to reduce hospitalization and emergency hospital admissions for nursing home residents . after an initial assessment , each participant is monitored by teleconsultation on six occasions over 12 months. patients with usual care have an initial and a 12 months assessments.


Eligibility criteria:
inclusion criteria: * elderly over 60 years * resident in nursing homes * resident with multiples chronic diseases with at least two comorbidities * having given free and informed consent in writing and signed by himself and / or his legal representative exclusion criteria: * resident unaffiliated or not beneficiary of social security * resident with a life-threatening disease
efficacy of topiramate for hospitalized patients with alcoholism

Conditions: Alcohol Dependence

Summary: this is a 12-week, randomized controlled study of topiramate in hospitalized patients with alcoholism


Eligibility criteria:
inclusion criteria: * patients hospitalized due to alcohol-related problem * dsm-iv-tr alcohol dependence * for male: history of alcohol drink \>=35/week, female: history of alcohol drink \>=28/week for at least 1 week during four weeks prior to the admission * audit score at least 8 * mild or no alcohol withdrawal symptom * bmi \> 18 kg/m2 * not pregnant and no plan for pregnancy * intention to decrease or stop drinking exclusion criteria: * severe psychiatric and cognitive disorders * other substance dependence, except nicotine and caffeine dependence, during 6 months prior to enrollment * taking antipsychotics, mood stabilizers, anticonvulsants, opioid analgesics, systemic steroids, carbonic anhydrase inhibitors, hydrochlorthiazide, metformin, pioglitazone, or disulfiram * unstable medical condition * medical history of narrow angle glaucoma, renal impairment, kidney stones, and seizures * moderate to high risk of suicide * under legal process * plan to receive a formal treatment for alcoholism from other treatment settings * pregnancy and nursing woman * abnormal laboratory tests, including blood urea nitrogen, creatinine, electrolytes, and fasting blood sugar

Keywords: alcohol dependence alcoholism topiramate
sensor-equipped ultrathin pressure microcatheter versus pressure wire for ffr measurement

Conditions: Coronary Artery Disease; Coronary Disease; Myocardial Ischemia

Summary: truephysiotm sensor-equipped ultrathin pressure microcatheter (referred to as truephysiotm microcatheter below) is a novel device for evaluating the functional significance of coronary stenosis. this study will compare the differences, if any, between the coronary fractional flow reserve (ffr) measured by the truephysiotm microcatheter and the pressure wire.

many studies have reported that ffr-guided coronary revascularization leads to improved long-term clinical outcomes and reduced costs compared with angiography-guided coronary revascularization alone. current guidelines emphasize the measurement of ffr as the standard of reference when determining the functional significance of coronary artery stenosis in stable patients when evidence of ischemia is not available (class ia indication). but ffr is still underutilized in clinical practice. one of the reasons may be the difficulty in manipulating the pressure wire. truephysiotm microcatheter is a novel device for evaluating the functional significance of coronary stenosis, which may simplify ffr measurements by allowing the use of standard guidewires best suited to negotiating the patients' anatomy. this study is a prospective, open label, multi-center study with the purpose of comparing the differences, if any, between ffr measured by the truephysiotm microcatheter and pressure wire. the secondary purpose is to analyze the correlation between ffr measured by the truephysiotm microcatheter and pressure wire. a total of 239 patients will be recruited at 4 centers in china.

Eligibility criteria:
general inclusion criteria: * age: 18-75 years old * subjects with coronary artery disease * able to understand and provide signed consent angiographic inclusion criteria: * subject has an intermediate stenosis in a native coronary vessel * the target stenosis has a reference diameter ≥2.50 mm by visual assessment. exclusion criteria: general exclusion criteria: * acute st-elevation or non-st-elevation myocardial infarction * severe heart failure (nyha≥iv) * left ventricular ejection fraction \<30% * allergy to adenosine triphosphate (atp) * contraindications for percutaneous coronary intervention (pci) angiographic exclusion criteria: * target vessel has angiographically visible or suspected thrombus * angiographic evidence of a dissection * excessive tortuosity or calcification stenosis, left main stenosis, serial stenosis
establishment and characterization of meningioma patient-derived organoids

Conditions: Meningioma

Summary: in this study, meningioma organoids will be established from patients' tissues and the characterization of the organoid will be performed.

aims and hypothesis to be tested: the investigators hypothesized that the derived organoid should have a similar morphological and genetic mutation signatures to the patient primary tissue. study period: 1 year for patient recruitment and organoid generation from patient tumor study population: 30 study samples: patient's meningioma tumor sample are collected from patients with surgical needs. sample collected are used for organoid culture. morphological and genetic characteristics will be compared between the patient tumor sample and the corresponding derived organoids primary outcome measures: whole exome sequencing data of patient tumor tissue and patients-derived organoids

Eligibility criteria:
inclusion criteria: 1. adult patients (aged \>18 years) with meningioma 2. admission into prince wales hospitals neurosurgical services 3. patients with surgical needs of meningioma removal exclusion criteria: 1. patients (or next-of-kin as appropriate) refuse to participate into the study
evaluation of ceftaroline fosamil versus vancomycin plus aztreonam in the treatment of patients with skin infections

Conditions: Complicated Skin and Soft Tissue Infection

Summary: the purpose of this study is to evaluate the effects of ceftaroline fosamil versus vancomycin plus aztreonam in treatment of patients with complicated bacterial skin and soft tissue infections.

a phase iii, multicentre, randomised, double-blind comparative study to evaluate the efficacy and safety of ceftaroline fosamil (600 mg every 8 hours) versus vancomycin plus aztreonam in the treatment of patients with complicated bacterial skin and soft tissue infections with evidence of systemic inflammatory response or underlying comorbidities

Eligibility criteria:
inclusion criteria: * male or female, aged 18 years or older * complicated skin and skin structure infection (cssti) * infection of sufficient severity to warrant hospitalization * infection of sufficient severity such that it is expected to require at least 5 days of intravenous antibiotic therapy exclusion criteria: * received systemic antibacterial drugs for greater than 24 hours within 96 hours prior to first dose of study drug * uncomplicated skin and skin structure infections, skin infections suspected to be caused by viral or fungal pathogens * diabetic foot infections, decubitus ulcers, ulcers due to peripheral vascular disease * infection caused by human or animal bites, sternal wound infections, bone infection or arthritis due to an infection, critical limb ischemia of the affected limb * chronic liver disease or severe impaired renal function, severe low white blood cell count, burns on greater than 15% of total body surface area, necrotizing skin infection, amputation required of primary site of infection, sustained shock

Keywords: complicated skin and soft tissue infections (cssti) skin infection ceftaroline wound infection cellulitis burn infection bacterial infection vancomycin
the evaluation and management of patients with acute chest pain in china

Conditions: Acute Chest Pain; Acute Coronary Syndrome

Summary: empact is the first attempt to comprehensively evaluate the current emergency care of acute chest pain from a regional representative sample in china.findings will allow new opportunities to facilitate the clinical quality improvements and ultimately reduce the mortality and health care burden in patients with acute chest pain. it also will help to establish a regional network and database for further research and performance improvement.


Eligibility criteria:
inclusion criteria 1. eighteen years and older 2. presenting to the ed 3. with acute chest pain or suspected acs 4. symptoms occurring within 24 hours 5. informed consent from patient or next of kin exclusion criteria 1. chest pain caused by trauma 2. persisting or recurrent chest pain caused by rheumatic diseases or cancer 3. transferred from another grade ii or grade iii hospital 4. presenting to the ed again within 30 days after initial enrollment

Keywords: acute chest pain acute coronary syndrome evaluation and management decision aid healthcare utilization
safety and immunologic effect of low dose versus high dose vitamin d3 in multiple sclerosis

Conditions: Multiple Sclerosis; Vitamin D Deficiency

Summary: the purpose of this study is to determine the safety and the immunologic effects of supplementation with low-dose and high-dose cholecalciferol (vitamin d3) in patients with multiple sclerosis.


Eligibility criteria:
inclusion criteria: * between ages of 18-55 years (inclusive) * serum 25(oh) vitamin d levels between 20-50 ng/ml and a candidate for vitamin d supplementation * patients with or without immunomodulatory therapy for rrms * diagnosis of multiple sclerosis exclusion criteria: * serum 25(oh) vitamin d deficient level \< 20 ng/ml * high dose vitamin d supplementation in the past 3 months * pregnancy * history of tuberculosis, hyperparathyroidism, sarcoidosis or kidney stones * baseline serum creatinine above 1.5 * hypersensitivity to vitamin d preparations * milk allergy * unable to consent

Keywords: cholecalciferol multiple sclerosis vitamin d d3
efficacy of enteral iron supplementation in critical illness

Conditions: Anemic, Critically Ill Patients

Summary: the purpose of this study is to investigate the efficacy of enteral iron supplementation for improving anemia, decreasing the risk of blood transfusion, and decreasing mortality in patients who are hospitalized in the intensive care unit. this study will also address any relationship between enteral iron supplementation and risk of infection.

critical illness is characterized by the anemia of inflammation, which is partially caused by sequestration of iron from bone marrow sites of erythropoiesis into storage within the reticuloendothelial system as ferritin. also the majority of critically ill patients are hypoferremia, the efficacy of iron supplementation remains unknown. furthermore, several retrospective studies have found an association between iron overload and infection. however, the relative risk/benefit profile of enteral iron supplementation with respect to infection has not been studied. the purpose of this study is to evaluate the efficacy of enteral iron supplementation in critically ill patients. the hypothesis is that enteral iron supplementation will result in both an improved hematocrit and a decreased need for blood transfusion, without increasing the risk of infection.

Eligibility criteria:
inclusion criteria: * age \> 18 years * anemia (hemoglobin \< 13.0 g/dl) * ≤ 72 hours from hospital admission * current tolerance of enteral medications * expected icu los \> 5 days exclusion criteria: * active bleeding * chronic inflammatory disease * end-stage renal disease * hematologic disorders * macrocytic anemia * current use of erythropoietin * pregnancy * prohibition of rbc transfusions * moribund state in which death is imminent * enrollment in another clinical trial

Keywords: iron critical illness anemia infection
iris: incontinence research intervention study

Conditions: Urinary Incontinence; Urinary Incontinence, Stress

Summary: the iris project stands for incontinence research intervention study. the purpose of this research project is to develop an effective behavioral therapy for urinary incontinence and specifically to test knack therapy, a self-help treatment. the knack therapy involves learning the skill of performing a pelvic muscle contraction simultaneously with an event known to trigger leakage, in order to stop that leakage.

this proposal aims to develop and test, in a general population of women with stress urinary incontinence (sui), a model for predicting who will succeed in overcoming incontinence long-term (1-year) by simply using knack therapy (thus avoiding invasive and costly surgery and time consuming kegel's exercises). specific aims are to: * develop a logistic regression model to predict success with the knack; * validate the model by determining the proportion of people who succeed according to who is predicted to succeed; and * develop long-term effectiveness of the knack (1-year). the project will be implemented in three phases: model development (n=160 women), model validation (n\~160), and long-term follow-up of women who demonstrate response. this will be evaluated immediately and at 1 month and at 3-months and 1-year.

Eligibility criteria:
inclusion criteria: * women who are incontinent * women who experience leakage with coughing, sneezing or exercising * women who are generally healthy * women who are over the age of eighteen * women who are not pregnant nor expecting to become pregnant within a year exclusion criteria: * no urine leakage when coughing, sneezing, or exercising * under the age of eighteen * pregnant or expecting to become pregnant * untreated urinary tract infection * pronounced pain or discomfort with pelvic exams * history of neurologic conditions

Keywords: pelvic muscle therapy urinary incontinence therapy stress incontinence intervention incontinence intervention incontinence sui stress incontinence
a hospital based survey on lung cancer related-pain in northern china

Conditions: Cancer Pain; Lung Cancer

Summary: this cross-sectional study, utilizing two sets of questionaire designed for patients and physicians respectively, aims at the epidemiology, the clinical features, and the current status of evaluation and management of lung cancer related pain in 20 participating hospitals in northern china.

lung malignancies have become the most common cause of mortality among patients with cancer in china. a significant proportion of lung cancer patients suffer from cancer related pain, however few studies have reported the prevalence and clinical features of such pain, especially in china. this study is a cross-sectional survey in 20 hospitals in northern china. we designed two separate series of questions to be answered by patients and cancer management professionals. in the patient questionaire, we collect information on the prevalence, location, intensity, impact on life of lung cancer related pain. questions on how doctors evaluate and manage the pain are included in both the patients' and physicians' surveys. in the doctors' questionaire, we also assess current situation of cancer pain educational programs attended in medical schools and post graduation through related questions.

Eligibility criteria:
inclusion criteria: 1. the patient questionaire * all patients (outpatient and inpatient) diagnosed with lung cancer visiting the participating hospitals on the designated day of investigation * informed consent must be obtained from the participating patients 2. the physician questionaire * all physicians who receive lung cancer patients (outpatient and inpatient) in the participating hospitals on the designated day of investigation