Kornimate/medical-research-clean huggingface dataset:
validate the difficulty scoring system and develop a novel scoring system for laparoscopic and robotic liver resections

Conditions: Liver Diseases

Summary: to validate the iwate difficulty scoring system and institut mutualiste montsouris (imm) scoring system (appendix 2) in both laparoscopic and robotic liver resections

minimally-invasive liver resections (milr) are increasingly conducted world-wide today. several international consensus meetings were convened to enable the safe dissemination of laparoscopic and robotic liver resections. the iwate difficulty scoring system (appendix 1) was formulated in japan to grade the difficulty of liver resections. this was to allow beginners to adopt a stepwise approach to safely perform milr according to their experience and competency level. although this system has been recently validated in a recent japanese multicenter study, it has not been externally validated in a large cohort of patients. thus far, it has only been validated in several small single center studies. furthermore, its utility for robotic liver resections has not been well-studied.

Eligibility criteria:
inclusion criteria: * all consecutive patients operated at a single institution during a fixed period * most recent operation date allowed (up till december 31, 2020, to allow three months follow-up). * all minimally invasive hepatectomy approaches can be included, including lap- assisted (hybrid), hand-assisted, robotic-assisted and pure laparoscopy. * the data of all patients including those that had repeat liver resections, concomitant surgeries (e.g. colectomies, hilar lymph node dissection, enbloc resections) may be included * patients with no "liver tumors" such as recurrent pyogenic cholangitis/ gallbladder may be included * the site of the "lesion/ pathology" will be considered as the tumor site, size will be considered less than 3 cm unless tumor invades the liver. exclusion criteria: * • patients \< 18 years of age * patients with liver transplant living donor hepatectomies
a study of curcumin (soloways ™) in patients with inflammatory bowel disease homozygous for the il-10 variant

Conditions: Inflamatory Bowel Disease

Summary: this pilot, genotype-stratified clinical trial aims to evaluate the safety and preliminary efficacy of liposomal curcumin in patients with inflammatory bowel disease (ibd) who are homozygous for a specific "unfavorable" il-10 gene variant (e.g., rs1800896). the study will compare clinical and inflammatory markers in two cohorts: (1) homozygous carriers of the il-10 variant and (2) non- carriers. the hypothesis is that curcumin supplementation will lead to more pronounced improvement in clinical activity scores and inflammatory biomarkers among homozygous carriers due to their inherently reduced anti-inflammatory capacity.

inflammatory bowel diseases (including crohn's disease and ulcerative colitis) are characterized by chronic intestinal inflammation driven by a complex interplay of genetic, immune, and environmental factors. il-10 plays a crucial role in anti-inflammatory pathways; certain genetic variants can reduce il-10 production and predispose patients to more severe disease phenotypes. curcumin, a polyphenol derived from turmeric, has shown anti-inflammatory effects via multiple molecular targets, including nf-κb. however, curcumin's bioavailability is limited; liposomal formulations may enhance its absorption and therapeutic impact. this pilot trial examines whether liposomal curcumin provides a more significant clinical benefit specifically in patients with the homozygous il-10 variant, as this subgroup may be particularly responsive to additional anti- inflammatory support.

Eligibility criteria:
inclusion criteria: - adults aged 18-70 years with a confirmed diagnosis of ulcerative colitis or crohn's disease. stable background ibd treatment regimen (5-asa, immunomodulators, or low-dose corticosteroids) for at least 4 weeks prior to enrollment. * willingness to undergo genotyping for the il-10 variant and to comply with the study protocol. * for the il-10 homozygous variant cohort: confirmed homozygous "unfavorable" variant (e.g., rs1800896) prior to enrollment. 5. for the non-variant cohort: confirmed absence of the "unfavorable" allele (wild-type). exclusion criteria: * use of high-dose corticosteroids or biologics (e.g., tnf inhibitors) initiated within 4 weeks prior to enrollment. * known allergy or hypersensitivity to curcumin or related compounds. severe concomitant illness (significant liver or renal dysfunction, uncontrolled diabetes, etc.) that could interfere with interpretation of results or patient safety. * pregnancy or breastfeeding. * inability to provide informed consent or comply with study procedures.

Keywords: inflamatory bowel inflammation interleukins il-10 supplements curcumin
toward safer opioid prescribing for chronic pain in high risk populations

Conditions: HIV Disease; Chronic Pain

Summary: the overarching plan for tower is to develop and test an algorithmic version of the center for disease control guidelines (cdcg) tailored for a specific primary care setting, the hiv primary care clinic. this cdcg intervention incorporates communication and implementation strategies tailored for the hiv primary care setting, and enabled with technology (an app for use by patients and emr tools for providers).

however, according to a 2014 ahrq report, there have been no studies evaluating the effectiveness of any prescription opioid risk mitigation strategies. furthermore, due to ambiguity in some of the cdcg recommendations and the challenging nature of the patient-provider opioid conversation, the success of the cdcg may hinge on the manner in which it is implemented in individual care settings. thus it is unclear what the true effect of the cdcg will be. the investigators believe that for the cdcg to have the greatest likelihood of achieving its goals of improving prescription opioid safety without causing unintended effects (e.g. exacerbation of pain, disruption of other aspects of care), its recommendations will need to be skillfully communicated. furthermore, because of this "human element"and other sources of variability, documenting the effectiveness of the cdcg will require standardization of implementation. the overarching plan for tower is to develop and test an algorithmic version of the cdcg tailored for a specific primary care setting, the hiv primary care clinic. this cdcg intervention incorporates communication and implementation strategies tailored for the hiv primary care setting, and enabled with technology (an app for use by patients and emr tools for providers). achieving this goal has involved soliciting input from the hiv community using the method of public deliberation (pd) in the setting of two citizen' s panels, each with \~22 hiv-infected participants and lasting one day; and using the information obtained from the deliberative process to inform the development of the cdcg intervention. the investigators now plan to test the cdcg intervention for feasibility.

Eligibility criteria:
inclusion criteria: * attending physician or advance practice provider in one of the institute of advanced medicine (iam) clinics * designated pcp for at least 5 patients to whom he/she prescribes opioids * willing and able to adhere to study procedures including randomization, and refraining from discussion of study procedures with other clinical staff or patients exclusion criteria: * unwillingness to undergo randomization * plans to leave iam within the study period.

Keywords: center for disease control guidelines opioids for chronic pain communication strategies
skin blood flow in patients with type 1 diabetes mellitus compared to normal controls

Conditions: Type 1 Diabetes,; Bone

Summary: the effects of high serum glucose on bone could be direct or could be indirect through its effects on the microvasculature. previous studies by rendell et al and brugler et al have found significant differences in skin blood flow between diabetics and control. the investigators are proposing that blood flow measurements of the skin may be correlated with bone remodeling rates in iliac bone biopsies.


Eligibility criteria:
inclusion criteria: * must have completed a previous study.

Keywords: type 1 diabetes bone
efficacy and safety of t-817ma in patients with mild cognitive impairment due to alzheimer's disease (ad) or mild ad

Conditions: Mild Cognitive Impairment

Summary: primary objective is to evaluate the neuroprotective effect of t-817ma on tau protein phosphorylated at threonine 181 (p-tau 181) in cerebrospinal fluid (csf) compared with placebo in patients with a diagnosis of mci due to ad or mild ad. secondary objectives are: 1. to evaluate in patients on t-817ma and placebo: * cognitive function measured by the clinical dementia rating scale sum of boxes (cdr-sb) and working memory and attention domain as measured by the cognitive functional composite (cfc). * ad-related biomarkers in csf and plasma * imaging analysis using volumetric magnetic resonance imaging (vmri) * alpha/theta ratio of the electroencephalogram (eeg) 2. to evaluate the safety of t-817ma by clinical laboratory tests and adverse events (aes). 3. to evaluate the pharmacokinetics of t-817ma


Eligibility criteria:
key inclusion criteria: * female of non-childbearing potential or male, ages 50 to 80 years (inclusive) * mci due to ad or mild ad per nia-aa diagnostic criteria (jack et al., 2018), with mmse 24 to 30 (inclusive) * csf results at screening consistent with the presence of aß and p-tau181 abnormality (≤1000 pg/ml for aß, ≥19 pg/ml for p-tau181). * taking stable dose of ache inhibitor (donepezil, galantamine or rivastigmine) at least for 3 months prior to randomization, or not taking any ache inhibitors. key exclusion criteria: * mri of the brain within the previous 2 years that showed pathology that would be inconsistent with a diagnosis of ad * taking memantine * any contraindications to lumbar puncture * any contraindications to mri
natural killer cells function in patients with chronic lymphocytic leukemia

Conditions: Chronic Lymphocytic Leukemia

Summary: purpose: the involvement of natural killer cells (nk) in the efficiency of the treatment in lymphoma and the beginning of new therapies based on function and activation of nk, justify an improvement of knowledge about the status of the population of nk (number, function, genic expression) in chronic lymphocytic leukemia (cll).

method: prospective, monocentric, descriptive study primary objective: evaluation of the expression and function of receptors activator of nk cell (kirs) in patients with cll at stage a with therapeutic abstention, or stage b or c which require a treatment. secondary objectives: measure of the evolution of cytotoxic function of nk cells and theirs biomarkers of activation when the patient receives an immunochemotherapy with rituximab/ fludarabine/ cyclophosphamide (rcf). verification, by analysis, of functions and biomarkers of the adaptive and innate immunity

Eligibility criteria:
inclusion criteria: * diagnosis of cll (score of matutes \>=4) with no history of treatment: stade a of binet, or stade b or c before the beginning of the treatment with rfc * patients who can undergo blood collection * patient aged 18 years and older * signed consent non inclusion criteria: * patient with anemia: haemoglobin \< 9 g/dl * pregnancy, breast feeding * patient in an urgent situation, or unable to give a consent

Keywords: chronic lymphocytic leukemia nk cells
piir study: comparison of genetic tests for age-related macular degeneration

Conditions: Age-Related Macular Degeneration (ARMD)

Summary: this study is being conducted to compare two different genetic tests developed to determine an individuals risk of developing serious vision threatening complications from age-related macular degeneration (armd).

there are currently two different genetic tests that have been developed for this purpose. they both look at specific dna components to determine the risk. participants in the study will be over the age of 60 years and caucasian as this is the population of people in which these tests have been validated. each participant will have the study explained to them and then will be asked to sign the informed consent document if they agree to participate. they will have a dilated exam of their eyes along with photographs taken of the retina. if their doctor sees that it is necessary they will also have a special scan or a special angiogram of their eyes to look at their retina in more detail. for the genetic testing a member of the research team will use two swabs from each of the genetic companies to gently scrap some cells from the inside of the cheek. these cells will be sent to each respective lab for analysis.

Eligibility criteria:
inclusion criteria: * caucasian race * age \>/= 60 years * patient's written informed consent * ability to comply with the protocol procedures exclusion criteria: * race other than caucasian * age \< 60 years * macular or retinal pathology other than armd * known hypersensitivity to any drug included in the treatment protocol * any other severe clinical condition that in the judgment of the local investigator would place the patient at undue risk or interfere with the study completion * prisoners

Keywords: macular degeneration genetic testing age-related macular degeneration age-related maculopathies
prospective cohort of diagnostic bronchoscopy for peripheral lung lesions

Conditions: Lung Cancer

Summary: the primary objective is to evaluate the usefulness and safety of advanced guided bronchoscopy for histological diagnosis of peripheral pulmonary lesions. the secondary objective is to establish a strategy that can most effectively use endoscopes for early diagnosis of lung cancer in a real-world care environment by identifying patient/clinical/image/procedure-related characteristics that can optimize the practicality of emerging technologies.

* patients with peripheral pulmonary lesions who need histological diagnosis due to suspected lung cancer and whose lesions are judged capable of histological examination through guided bronchoscopy will be prospectively recruited. * this study is a pure non-interventional pragmatic design. in addition to biopsy for lung lesions using bronchoscopy, lung cancer staging and tests necessary for metastases and treatment for diagnosed lung cancer are performed according to existing guidelines and the judgment of medical staff. * we will analyze the clinical characteristics of guided bronchoscopy procedures used in clinical practice and the main results during the follow-up period of up to one year (diagnostic yield, sensitivity, safety, practicality, and various factors affecting usefulness).

Eligibility criteria:
inclusion criteria: 1. patients who agreed in writing to participate in this study 2. adult men and women over 19 years of age 3. patients who visited the hospital with lung lesions suspected of lung cancer and require a diagnostic biopsy 4. patients capable of biopsy through guided bronchoscopy exclusion criteria: 1) patients who are unable to express their opinions and cannot cooperate due to a lack of cognitive function

Keywords: electromagnetic navigation bronchoscopy guided bronchoscopy diagnosis radial endobronchial ultrasound
peng block vs fascia iliaca block for emergency department analgesia in hip fractures

Conditions: Hip Fractures

Summary: pain management is a crucial aspect of the care of hip fracture patients. patients with poorly controlled pain have an increased risk of delirium, long-term functional impairment, and remain hospitalized longer. today, to relieve hip fracture pain, fascia iliaca block is routinely performed in the emergency department in addition to other pain medications administered by vein or by mouth. several studies have questioned the analgesic efficacy of this block, suggesting the superiority of the newer peng block. the purpose of this multicenter, randomized study is to compare the analgesic efficacy of peng block versus fascia iliaca block, hypothesizing the superiority of the new approach over the gold standard. participants will be blindly assigned in a 1:1 ratio to the study or control group, recruited from the emergency departments of irccs policlinico san matteo and colchester hospital (uk). the main outcome is represented by the reduction of pain after the two blocks, measured as %spid (percentage of "pain intensity difference"), a value derived from vas scale measurements in the first hour post-procedure. secondly, we will evaluate the proportion of patients with satisfactory pain control, the amount of opioids used and the safety profile of the two approaches.


Eligibility criteria:
inclusion criteria: * age \>18 * capacity to understand the aim of the study, the potential benefits and side-effects of the procedures * capacity to provide consent * capacity to provide a self-assessment of pain using the written vas scale * confirmed radiological diagnosis of hip fractures (including subcapitate, transcervical, intertrochanteric and perthrocanteric fractures) * moderate or severe worst pain (visual analogue scale, vas \>40 mm) (at rest or dynamic) exclusion criteria: * known hypersensitivity to local anaesthetics * confirmed radiological diagnosis of subtrochanteric or diaphyseal femur fractures * hemodynamic instability * known diagnosis of severe cognitive impairment * dementia and/or delirium (defined by a 4at score ≥ 2) * lack of capacity to provide consent and to understand the aim of the study * bmi\>35 * body weight \< 40 kg * prior hip surgery on the same fracture side * mild worst pain (visual analogue scale, vas \< 40 mm) (at rest or dynamic)

Keywords: fascia iliaca block peng block regional anaesthesia at emergency departments hip fracture analgesia
a study of the safety and efficacy of ebv specific t-cell lines

Conditions: Epstein-Barr Virus Infections; Post-Transplant Lymphoproliferative Disorder; Lymphoma

Summary: this study evaluates the safety and efficacy of ebv-specific t-cell lines to treat patients suffering from high ebv viral titers not responding to standard of care therapies and to treat ebv-related lymphoma. the study will recruit 6 patients to receive autologous t cells or a t cell line derived from the patient's allogeneic donor (in the case of stem cell transplant recipients), and 6 patients to receive a t-cell line prepared from a matched or partially matched related donor.

epstein-barr virus (ebv) is a member of the herpes virus family and infects up to 95% of individuals over their lifetime. most initial infections occur in childhood and after a brief flu-like illness, the virus enters a phase of latency. patients who receive a bone marrow transplant or an organ transplant take medications drugs that weaken their immune systems. in these contexts, the virus can "reactivate" and cause very serious problems, such as lymphoma. for unknown reasons, people with a normal immune system can also develop lymphoma due to ebv. the purpose of this study is to test the safety and efficacy of immune cells (t lymphocytes) that are specifically "taught" to recognize the virus-infected cells and to eliminate them. this "education" occurs is done over during a 2 weeks period (approximately), in the research laboratory. the cells are then transfused into the patient.

Eligibility criteria:
inclusion criteria: * capacity to provide informed consent * age ≥ 18 years old * confirmed treatment-refractory ebv reactivation or ebv-related lymphoma * ecog of 2 or less exclusion criteria: * medical condition requiring a corticosteroid dose greater than prednisone 0.5mg/kg/day (or equivalent) at the time of the infusion. * patient has received t-cell depleting antibodies or stem cell transplantation in the 28 days prior to proposed date of anti-ebv t-cell line infusion * patient has received a solid organ transplant in the 3 months prior to proposed date of anti-ebv t-cell line infusion. * pregnant or nursing females * life expectancy of less than 3 months due to a condition unrelated to the ebv- related disease. * active uncontrolled gvhd * active uncontrolled sot rejection episode donor eligibility: an allogeneic donor must be a first-degree relative with at least 3/6 hla compatibility, have consented to donate peripheral blood mononuclear cells, and fulfill the same criteria for stem cell donation according to the hospital's standard operating procedure.

Keywords: allogeneic transplantation t cell epstein-barr virus
the effect of molar incisor hypomineralisation on the stomatognathic system

Conditions: Molar Incisor Hypomineralization

Summary: this study aims to examine whether children with molar incisor hypomineralization (mih) are more likely to have problems with the jaw joint and chewing muscles. mih is a dental condition where the enamel of the first molars and incisors is weaker than normal. the researchers performed clinical examinations and ultrasound imaging to evaluate the thickness and elasticity of the chewing muscles. they also used a questionnaire to check for symptoms of temporomandibular disorders (tmd), such as jaw pain, headaches, and joint sounds.

this prospective clinical study investigates the potential impact of molar incisor hypomineralization (mih) on the stomatognathic system in children. mih is a developmental enamel defect that affects the first permanent molars and incisors, resulting in weakened enamel and increased sensitivity. while mih has been well documented in the context of dental health, its broader functional consequences remain underexplored. a total of 84 children aged 9-14 years participated in this study, including 43 with mih and 41 healthy controls. the evaluation involved both clinical and ultrasonographic examinations. temporomandibular disorders (tmd) were assessed using the fonseca anamnestic index and through clinical parameters such as joint sounds, headaches, mandibular deviation/deflection, and mouth opening limitation. ultrasound imaging, including shear wave elastography, was used to evaluate the thickness and elasticity of the masseter, temporalis, and sternocleidomastoid muscles, as well as the articular disc of the temporomandibular joint.

Eligibility criteria:
inclusion criteria: * children aged between 9 and 14 years * good general health with no systemic disease * score of 3 or 4 on the frankl behavior rating scale * no parafunctional oral habits (e.g., bruxism) * no skeletal orthodontic abnormalities * for the mih group: presence of at least one first permanent molar diagnosed with mih * for the control group: absence of mih diagnosis exclusion criteria: * presence of advanced periodontal disease or tooth mobility * history of facial trauma or jaw fracture * current medication use * inability to cooperate during clinical or ultrasonographic examinations * any condition that may affect temporomandibular joint structure or function

Keywords: elasticity temporomandibular disorders ultrasound masticatory muscle