Kornimate/medical-research-clean huggingface dataset:
accuracy of the thoracic epidural catheter insertion confirmed by fluoroscopic imaging

Conditions: Patients Undergoing Thoracic Surgery; Patients Undergoing Upper Abdominal Surgery

Summary: in patients scheduled for thoracic surgery or upper abdominal surgery, investigators will determine the accuracy of the epidural catheter placement by using fluoroscopic imaging. previous studies have drawn contradictory conclusions based the potential flaw assumption of 100% success rate for correct epidural catheter placement in the thoracic region.

thoracic epidural analgesia (tea) is a key tool in management of pain after thoracic or upper abdominal surgery. tea optimizes pain relief while minimizing the use of systemic opioids, thus reducing the duration of postoperative ileus. tea also attenuates surgical stress response and allows for early mobilization. despite all the touted benefits of tea, much controversy limits its use for post surgical pain due to fear of exceedingly rare, if not entirely theoretical complication of epidural hematoma. beneficial effects of tea require that catheter placement and infusate be targeted at the thoracic segments innervating injured skin, muscle, and bone from which pain input originates. the purpose of this study is to determine the accuracy of thoracic epidural continuous catheter insertion by using fluoroscopic imaging.

Eligibility criteria:
inclusion criteria: * 18- 80 years old patients * patients undergoing thoracic surgery * patients undergoing upper abdominal surgery exclusion criteria: * severe aortic valve stenosis * active neurologic disease * allergy to lidocaine or bupivacaine * allergy to iodine-based contrast * cutaneous disorders at epidural insertion site * preoperative impaired coagulation status * pregnancy
ai in predicting polyp pathology and endoscopic classification

Conditions: Colorectal Polyps

Summary: background: colonoscopy with optical diagnosis based on the appearance of polyps can guide the selection of endoscopic treatment methods, reduce unnecessary polypectomy procedures and the need for tissue pathological diagnosis, and formulate follow-up strategies in a timely manner \[1\]. this approach significantly alleviates the economic burden on patients and the healthcare system and can effectively ease the tension on clinical resources \[2\]. various endoscopic polyp classification methods, including pit pattern \[3\], nice \[4\], wasp \[5\], and ms \[6\], are used to determine pathological types. however, mastering these classification methods requires endoscopists to undergo extensive training, and due to the inherent flaws in each method, no single endoscopic classification method can accurately diagnose all types of polyps to meet the requirements of optical diagnosis. this limitation has hindered the widespread application of optical diagnosis in clinical practice \[7\]. the application of artificial intelligence technology in this field, known as computer-aided diagnosis (cadx), has seen rapid development in recent years. numerous large-scale, prospective studies have demonstrated that the accuracy of cadx technology for optical diagnosis of minute lesions (\<5mm) has essentially met the threshold set by european and american endoscopy societies for optical diagnosis \[8,9\]. however, the diagnostic efficacy of cadx for polyps ≥5mm remains unclear. moreover, current research is mostly limited to distinguishing between common adenomas and hyperplastic polyps, with little attention given to serrated lesions, which are also precancerous lesions and progress even more rapidly, and are more challenging for endoscopists to assess. these reasons prevent cadx from being widely applied in clinical practice for real-time accurate judgment of polyp pathological types.


Eligibility criteria:
inclusion criteria: 1. outpatients or inpatients undergoing routine colonoscopy screening at the endoscopy centers of multicenter hospitals; 2. aged 18 years or older; 3. have understanding of the study content and have signed the informed consent form. exclusion criteria: 1. gastroparesis or gastric outlet obstruction; 2. known or suspected intestinal obstruction or perforation; 3. severe chronic renal failure (creatinine clearance less than 30 ml/minute); 4. severe congestive heart failure (new york heart association class iii or iv); 5. currently pregnant or breastfeeding; 6. toxic colitis or megacolon; 7. poorly controlled hypertension (systolic blood pressure greater than 180 mmhg and/or diastolic blood pressure greater than 100 mmhg); 8. moderate or massive active gastrointestinal bleeding (\>100 ml/day); 9. significant psychiatric or psychological illness; 10. allergy to medications used for bowel preparation; 11. patients who have undergone colorectal surgery.

Keywords: colonoscopy artificial intelligence optical diagnosis sessile serrated adenoma adenoma
epividian / ahf: positive pathways - hiv retention in care

Conditions: HIV/AIDS

Summary: the primary objective of this study is to evaluate the effectiveness of a clinical decision support system (cdss) combined with enhanced patient contact to retain hiv+ patients in care with aids healthcare foundation. specifically, the study aims to evaluate the effectiveness of having the patient's primary caregiver (or dedicated case manager) telephone the patient when the patient is identified as a significant risk to loss of follow-up (at-risk patients) based upon pre-defined criteria. the secondary objective gain a better understanding about the implementation of the study's procedures in clinical practice by evaluating survey responses delivered to participating healthcare providers and ahf staff members engaging with the study's intervention.

retention in care and re-engagement in care is a primary concern in hiv treatment today and a major obstacle in the us to reach the unaids 90-90-90 goal \[1\]. the u.s. cdc supports the use of hiv surveillance data to identify not-in-care (nic) patients and re-link them to care (data-to-care). the optimal strategy for identifying patients for data-to-care is unknown. it has been postulated that by increasing follow up of high-risk patients not meeting the retention in care measures, the number of people living with hiv being retained in care may be increased by 10%. multiple hiv clinics within the ahf organization in the us are eligible for study participation. "primary" hiv provider will be defined as the primary physician or advanced care practitioner following a patient, as recorded in their respective ehrs and identified through chorus, a cdss developed by epividian. the cdss will track patient case status as active or inactive (loss to follow-up, transferred medical care, or deceased). providers will be informed of the study and sites will be contracted to participate in this collaborative research study. the cdss will generate alerts to the providers warning of suboptimal patient attendance among the population. the alerts will be generated using the following four criteria of at-risk of loss to follow-up: * at risk #1: no visit in the previous 4 months and no scheduled appointment in the subsequent 2 months. * high risk #2: single appointment in the previous year, a missed appointment in the previous month and no scheduled appointment in the next 2 months. * high risk #3: those with 2 missed sequential appointments, and no scheduled appointment in the subsequent 7 days. * high risk #4: those with an attended appointment \>3 months ago and their most recent viral load \>1000 copies/ml.

Eligibility criteria:
inclusion criteria: * hiv-1+ * 18 years old or older * any sex * seen at least once in a us-based ahf clinic in the last 2 years with care documented in the ehr exclusion criteria: * patients known to have left the practice * patients who choose not to be contacted about their care via telephone
seroepidemiological investigation of coronavirus 2019 (covid-19) infection in gabon

Conditions: Laboratory Confirmed SARS-CoV-2 Infection Without Symptoms

Summary: gabon is the 3rd country most affected by covid-19 behind cameroon and democratic republic of congo in central africa, with 8860 cases and 54 deaths in critically ill patients, since the first confirmed case of covid-19 on the 10th of march 2020 (https://africacdc.org/covid-19/). most of the individuals infected by sars-cov-2 are asymptomatic and they represent a major source of viral spread. to date, african countries have been less affected by deaths caused by the covid-19 pandemic compared to other countries. it is currently unknown why africa has avoided more deaths and appears to not simply be due to a lack of testing, since the overall death rate has not increased. better quality data on seroprevalence in different african regions and proven explanations of the differences between africa and other continents, are urgently needed. the aim of this study is to learn about the proportion of people after a first pic of transmission, who have been exposed to covid-19 in gabon by testing for plasma antibodies to the sars-cov-2 virus. the overall goal of this study is to examine the trend of specific anti-sars-cov-2 antibodies in gabonese population.

based on its technical capacities (elisa bench and multiparametric flow cytometer), we will provide evident data on the immune responses in covid-19 infected patients. the quantification of antibodies against sars-cov-2 recombinant protein will be done by elisa using wantai elisa total ab. meanwhile, data on clinical status will be recorded and classified using who patient form. data obtained will be analyzed by a statistician based at cermel using robust models in compliance with the type of data generated.

Eligibility criteria:
inclusion criteria: * persons of both sexes aged one year and older and residing for more than three months in the study area are eligible to participate in the study exclusion criteria: * any person not residing in the locality surveyed or any person residing for less than three months. refusal to give informed consent and contraindication to venipuncture venipuncture.
comparative study of thymosin beta 4 eye drops vs. vehicle in the treatment of severe dry eye

Conditions: Dry Eye; Sjogren's Syndrome; Graft vs. Host Disease

Summary: severe dry eye is a debilitating ocular disease resulting in loss of vision, reduced day-to-day function and significant discomfort. tear substitutes are an important part of the treatment of all patients, however, even with aggressive us, the corneal(ocular)surface often remains very irregular due to poor surface healing. the agent being evaluated in this study, thymosin beta 4, promotes healing of the corneal surface and has been studied in patients with recalcitrant corneal ulcers and erosions with significant success (arch ophthalmol. 2010;128(5):636-638., ann of the ny acad of sci, may, 2010). the study hypothesis is that thymosin beta 4, in its role as a modulator of corneal surface healing, may be able to promote healing of the corneal surface allowing for more conventional modalities to take over and maintain a smooth and regular ocular surface. the investigators hope to be able to demonstrate an improvement in visual acuity, surface healing and a reduction in dry-eye related symptoms.

see above

Eligibility criteria:
inclusion criteria: * schirmers of \< 5 mm at 5 minutes * tfbut: less than 10 seconds * corneal staining of \>3 of 15: conjunctival staining of \>3 of 18 * ocular surface disease index of \> 50 * presumed best corrected vision of 20/60 or better exclusion criteria: * acute or inflammatory corneal disease * pregnancy or lactation * monocular status * punctal occlusion within 30 days * ocular surgery within 3 months * corneal thinning of \>50% * active corneal infection * history of ocular malignancy * retinal neovascularization * current use of topical cyclosporin a

Keywords: dry eye sjogren's syndrome graft vs. host disease rheumatoid arthritis systemic lupus erythematosus scleroderma
phase i study to investigate the alcohol interaction of da8159

Conditions: Healthy Volunteers; Erectile Dysfunction

Summary: this study is designed to to investigate the effects of alcohol on the pharmacokinetics of udenafil tablet in healthy male volunteers


Eligibility criteria:
inclusion criteria: * adult males aged 19 to 55 years at screening. * subjects with body weight ≥ 55 kg and within ±20% of the ideal body weight : ideal body weight = (height \[cm\] - 100)x0.9. * subjects who have received and understood completely the information regarding the current study and given written informed consents to voluntarily participate in the study and followed all instructions specified in the protocol. exclusion criteria: * subjects with the test results of qtc \> 430 ms or non-sinus cardiac rhythm by ecg analysis. * subjects with hypotension or hypertension. * subjects who have drunken habitually (exceeding 21 units/week, 1 unit = 10 g of pure alcohol) or who are unable to abstain from drinking during the study period from 2 days prior to the first administration of investigational product and during this study. * subjects deemed ineligible by investigator based on other reasons, including abnormal laboratory values or diseases.

Keywords: da-8159 udenafil alcohol
the cardiovascular benefits of reducing personal exposure to air pollution

Conditions: Blood Pressure; Heart Rate Variability

Summary: exposure to air pollution is an important risk factor for cardiovascular morbidity and mortality, and is associated with increased blood pressure, reduced heart rate variability, endothelial dysfunction and myocardial ischaemia. the study objectives were to assess the potential cardiovascular benefits of reducing personal particulate air pollution exposure by wearing a facemask in healthy volunteers.


Eligibility criteria:
inclusion criteria: * healthy volunteers exclusion criteria: * current smokers * significant occupational exposure to air pollution * regular medication use (except oral contraceptive pill) * intercurrent illness

Keywords: air pollution heart rate heart rate variability blood pressure face mask
prognostic relevance of coagulation activation in risk assessment and stratification

Conditions: Local Cancer

Summary: carcinogenesis and coagulation activation are closely related processes. in a previous study of coagulation activation in stage i-iia breast cancer patients, we developed a prognostic model that includes coagulation activation biomarkers and demonstrated efficacy to in distinguish between risk categories and survival. here, we propose a study useful for the validation of this prognostic model in an independent cohort of 108 patients with locally advanced breast cancer and indicated for neoadjuvant chemotherapy, followed by breast surgery. within this study population, we will validate our prognostic model for risk assessment and risk stratification with respect to the following endpoints: 1. complete pathological response rate to definitive breast surgery; 2. rate of thromboembolic events.


Eligibility criteria:
inclusion criteria: * patients with normal organ functions * cytologically/histologically proven breast cancer, stage iib-iiic * participants must not have prophylactic or therapeutic indications for anticoagulants. exclusion criteria: * pregnacy * metastatic breast cancer * previous chemotherapy, hormone therapy, radiotherapy * previous malignancies or contralateral breast cancer
oral berotralstat expanded access program

Conditions: Hereditary Angioedema; HAE; Prophylaxis

Summary: this expanded access program will provide access to berotralstat for eligible participants with hereditary angioedema in the u.s.

physicians may request access to berotralstat for eligible participants with unmet medical need physicians can send email inquiries to access.us@inceptua.com or call 1-888-225-8677 patients who may be interested should contact their physician about participation berotralstat (bcx7353) will be available through this expanded access program until it is commercially available

Eligibility criteria:
inclusion criteria patients must meet all of the following inclusion criteria to be eligible for participation in this program: 1. at least 12 years of age 2. able to provide written, informed consent or assent 3. patients with a clinical diagnosis of hae type i or ii who, in the opinion of their treating physician, are expected to benefit from an oral treatment for the prevention of angioedema attacks, and who are not eligible or able to access a berotralstat clinical trial 4. females must use acceptable effective contraception exclusion criteria patients must meet none of the below exclusion criteria to be eligible for participation in this program: 1. pregnancy or breast-feeding 2. any clinically significant medical condition or medical history that, in the opinion of the treating physician, would interfere with the patient's safety 3. current infection with hepatitis b virus (hbv), hepatitis c virus (hcv), or human immunodeficiency virus (hiv)

Keywords: berotralstat bcx7353 hereditary angioedema hae
internal iliac artery ligation and abnormally invasive placenta

Conditions: Placenta Percreta

Summary: this trial is set to detect the impact of bilateral internal iliac artery ligation on the amount of intra-operative blood loss during the hysterectomy procedure done for the management of abnormally invasive placenta


Eligibility criteria:
inclusion criteria: * females with pre-operative diagnosis of abnormally invasive placenta exclusion criteria: * refusal to get enrolled in the study
use of fish oils to prevent atrial mechanical stunning and atrial remodeling due to atrial arrhythmia

Conditions: Atrial Fibrillation; Atrial Flutter

Summary: the purpose of this study is to investigate whether fish oils may be of benefit to patients with certain heart rhythm disturbances called atrial fibrillation and atrial flutter. atrial fibrillation and atrial flutter are two heart conditions that can be successfully treated in the hospital by an ablation (in the case of atrial flutter) or a cardioversion (in the case of atrial fibrillation). ablation involves the application of high frequency energy waves to a particular spot in the heart. cardioversion involves resetting the heart back to a normal rhythm with the use of an electric current. fish oil supplements may be of benefit to patients with heart problems. recent evidence suggests that fish oils may benefit those with rhythm disturbances.


Eligibility criteria:
inclusion criteria: * chronic atrial flutter requiring radiofrequency ablation. * chronic atrial fibrillation requiring internal cardioversion. exclusion criteria: * sinus rhythm. * pregnancy. * patients \> 80 years and \< 18 years of age

Keywords: atrial mechanical stunning and atrial electrical remodeling
efficacy of aac for functional communication

Conditions: Learning Disabilities; Cerebral Palsy; Down Syndrome

Summary: there is a considerable number children who are unable to speak, and our currently not being provided with any aac options in their therapeutic facilities. the study aims to identify the current practice being employed with these children and then provide an aac intervention for choice making with in group activities in the existing system, where the child is enrolled. currently there is no indigenous evidence of aac being employed effectively with these children. a pre- assessment will be carried out to establish the level of communication of the children. intervention will be provided in a group for 6 weeks, three days a week, as these children already attend these groups.

the study is a novel approach to intervention in pakistan. there are currently no such studies conducted on intervention using aac use in pakistan. the objective of the the study are as follows 1. to compare establish current practices with aac for choice making in group activities. 2. to determine the frequency of choice making in structured group activities. hypothesis: null hypothesis: the use of augmentative alternative communication does not increase functional communication in group activities. alternative hypothesis: the use of augmentative alternative communication increases functional communication in group activities. study setting: step to learn school assessment: an assessment will be carried out using the online communication matrix to establish baseline communication skills of all the children. the children will also be assessed informally for their current means of communication in existing group activity at baseline, mid level (3 weeks) and at the end of the study (6 weeks). intervention: intervention will (3 days a week for 6 weeks) be provided through objects, picture cards placed on a choice board. the choice will be given for rhymes, individual rhymes \& sensory objects. auditory, visual and tactile prompts will be provided.

Eligibility criteria:
inclusion criteria: * children with special needs * children not currently using any aac exclusion criteria: * children with any co-morbid conditions.

Keywords: aac functional communication group intervention
the potential protective effect of using muscle relaxants during electroporation ablation (pfa)

Conditions: Kidney Failure, Acute; Myopathy; Drugs; Heart Arrhythmia; Succinylcholine Sensitivity; Muscle Relaxation; General Anesthetic Drug Adverse Reaction; Projection

Summary: the study aims to improve the safety of the electroporation ablation (pfa) procedure by using muscle relaxants to reduce skeletal muscle damage during the procedure. it will also assess myocardial damage to improve the procedure's quality and speed up recovery after the procedure.

the procedure of electroporation (pfa) is a method of atrial fibrillation ablation introduced in poland in 2022. a biphasic high voltage current (2000 volts) is applied to the electrode placement site. local coagulation of the site is followed by myocardial scarring and interruption of the pathological conduction pathway of premature electrical impulses in the heart. the patient, once qualified by the cardiologist for the procedure of electroporation ablation (pfa), will undergo a standard anaesthetic qualification process with assessment of basic demographics, comorbid conditions, medications taken, determination on the surgical risk scale. participants will be randomized into 2 groups. group i will consist of patients undergoing general anaesthesia without the muscle relaxant rocuronium. group ii will consist of patients undergoing general anaesthesia with the muscle relaxant rocuronium. a total of 32 patients were initially planned for the study (16 patients in each of the two groups). before the procedure, the anaesthetist will be given a sealed envelope by a person unrelated to the project (hospital administration staff) with a randomised method of anaesthesia based on simple randomisation. before the procedure, each patient will have a transthoracic ultrasound of the heart (tte). the patient will not know which study group he/she has been assigned to. the operator performing the procedure will not be informed about the type of anaesthesia used \[double blind randomisation\].

Eligibility criteria:
inclusion criteria: * patients with requirement for pfa ablation for cardiac indications and ability to provide informed consent for study participation exclusion criteria: * patients with allergies to the general anaesthetics used, genetic diseases of the neuromuscular plateau - e.g. duchenne dystrophy, myasthenia gravis - and patients who do not gived informed consent to participate in the study will be excluded from the study.

Keywords: electroporation ablation (pfa) muscle relaxants rocuronium chronic pain acute kidney failure chronic heart failure drug protection