Kornimate/medical-research-clean huggingface dataset:
cad eye detection of remaining lesions after emr

Conditions: Colorectal Dysplasia; Colorectal Neoplasms

Summary: in the last decade, many innovative systems have been developed to support and improve the diagnosis accuracy during endoscopic studies. cad-eye™ (fujifilm, tokyo, japan) is a computer-assisted diagnostic (cadx) system that uses artificial intelligence for the detection and characterization of polyps during colonoscopy. however, the accuracy of cad-eye™ in the recognition of remaining lesions after endoscopic mucosal resection (emr) has not been broadly evaluated. finally, based on the importance of complete resection of the colonic mucosal lesions, namely suspicious high-grade dysplasia or early invasive cancer, the investigators aimed to assess the accuracy of cad-eye™ in the detection of remaining lesions after the procedure.

nowadays, the increased polyp and adenoma detection rate, and its early treatment have reduced considerably colorectal cancer-related mortality. for lesions suspicious of high-grade dysplasia or early invasive cancer, the endoscopic mucosal resection (emr), along with snare polypectomy, is now considered one of the established standard treatments. however, there are many ´difficult-to-treat lesions´ such as the large and fibrotic ones, which can lead to incomplete resections. based on the above, many newly diagnostic techniques guided by artificial intelligence (ai), currently proposed to improve the polyp detection rate during colonoscopy, can be applied for the detection of remaining lesions after endoscopic treatment. cad-eye™ is cadx for polyp detection and characterization. it improves polyp visualization by using techniques such as blue-laser imaging (bli-laser), blue-light imaging (bli-led), and linked-color imaging (lci). this device aimed to improve real-time polyp detection, helping experts identify multiple polyps simultaneously and common inadvertently missed lesions (flat lesions, polyps in difficult areas). cad-eye™ had demonstrated in previous studies an accuracy of 89% to 91.7% in polyp detection. however, few studies had demonstrated its performance in the detection of remaining lesions after emr. the investigators aimed to take advantage of this system in the detection of remaining lesions immediately after emr and in its endoscopic control after three months.

Eligibility criteria:
inclusion criteria: * patients referred to our center with an indication of colonoscopy and emr for the treatment of lesions suspicious of high-grade dysplasia and early invasive cancer. * patients who authorize emr and colonoscopy. * signed informed consent exclusion criteria: * any clinical condition which makes emr inviable. * poor bowel preparation score defined as the total boston bowel preparation score (bbps) \<6 and the right-segment score \<2 * patients with more than one previous emr * lost on a three-month follow-up after emr * pregnancy or nursing

Keywords: artificial intelligence colonoscopy endoscopic mucosal resection computer-assisted diagnosis
pharmacogenetics of cannabinoid response

Conditions: COMT Gene Polymorphism

Summary: this study attempts to examine genetic influences on the effects of tetrahydrocannabinol (δ9-thc), the active ingredient of marijuana, cannabis, "ganja", or "pot".


Eligibility criteria:
inclusion criteria: * 18 and 55 years (extremes included) on the day of the first dosing. exclusion criteria: * cannabis naïve individuals.

Keywords: thc comt gene polymorphism schizophrenia cannabis use
effectiveness study of an exercise program for older adults with chronic musculoskeletal pain

Conditions: Chronic Musculoskeletal Pain

Summary: the goal of this clinical trial is to evaluate the effectiveness of a multimodal physical exercise program for older adults (\> 60 years) with chronic musculoskeletal pain. the main question it aims to answer is: what is the impact of the intervention program on participants´ pain intensity (primary outcome), function, physical performance, and somatosensory function (secondary outcomes)? participants will be assessed at 3 different moments: initial assessment (t0), at the end of the intervention protocol (10 weeks) (t1) and 3 months after the end of the intervention protocol (t2). the intervention protocol will consist of a multimodal exercise program to be carried out over a period of 10 weeks at a frequency of twice a week.


Eligibility criteria:
inclusion criteria: * community-dwelling older adults aged 60 years or older * people with primary or secondary chronic musculoskeletal pain in any body site * people able to walk independently exclusion criteria: * individuals undergoing surgery in the last 3 months * patients with a self-reported diagnoses of infection diseases, dementia, tumor/cancer, stroke, uncontrolled diabetes, or at high risk of developing cardiovascular events * those with physical limitations that make it impossible for them to carry out the intervention protocols independently (e.g., wheelchair user) * patients who are receiving another physical therapy intervention to treat their pain.

Keywords: chronic musculoskeletal pain older adults exercise program physiotherapy
doravirine and weight gain in antiretroviral naive

Conditions: Body Weight Changes; Human Immunodeficiency Virus; ART; Obesity; Minority Health; BMD; Metabolic Syndrome; Fasting

Summary: the purpose of this study is determine whether different antiretroviral therapy (art) changes the effects on body fat and predict the weight change in black and hispanic females.

study is three-arm, open-label, randomized, interventional trial, in which all patients who are successfully enrolled will be randomized 1:1:1 to initiate art therapy with doravirine/lamivudine/tenofovir disoproxil fumarate vs. doravirine + emtricitabine/tenofovir alefenamide, bictegravir/emtricitabine/tenofovir alafenamide. all patients will be followed or a total o 48 weeks. .

Eligibility criteria:
inclusion criteria: * 18 years or older; * no prior exposure to antiretroviral therapy for \>7 days prior to study entry; * plasma hiv1 rna concentration \>/=5000 copies/ml; * cd4 t cell count \>/=200 cells/µl. * for persons capable of becoming pregnant, negative serum or urine pregnancy test within 45 days prior to entry * ability and willingness of participant or legal guardian/representative to provide informed consent exclusion criteria: * evidence of resistance to dor, tdf, 3tc/ftc or bic. * creatinine clearance \<60 ml/min * use of weight loss agents or plans to initiate weight loss program (diet or exercise-based) * known allergy/sensitivity or any hypersensitivity to components of study drug(s) or their formulation

Keywords: treatment naive african american women hispanic women fasting glucose fasting insuline negative pregnancy test 18 years or older
therapeutic processes and treatment outcome in adolescents with anxiety disorders

Conditions: Anxiety Disorders

Summary: the purpose of this study is to examine the relationship between different aspects of cognitive behavior therapy (cbt) and treatment outcome.

anxiety disorders are common among children; if untreated, they can negatively affect children's lives. evidence suggests that cbt can benefit children with anxiety disorders, but the causal mechanisms between therapy and beneficial outcomes have not been thoroughly investigated. audio and videotaped sessions of children currently receiving cbt and those who received cbt in previous trials will be examined. various rating scales will be used to rate therapeutic alliance, child involvement, and therapist flexibility for each session of cbt. to evaluate potential process variables that contribute to participant drop-out, this study will compare the early process variables for children who complete treatment and for those who discontinue treatment.

Eligibility criteria:
inclusion criteria: * diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia * at least one english-speaking parent exclusion criteria: * iq \< 80 * psychotic symptoms

Keywords: adolescent
ablation of pulmonary oligometastasis combined with system for advanced hepatocellular carcinoma

Conditions: Advanced Hepatocellular Carcinoma; Lung Cancer; Oligometastasis; Ablation; Systemic Therapy

Summary: ablation has been an effective therapy in treating intrathoracic metastases. however, for hepatocellular carcinoma with pulmonary oligometastasis, ablation of metastases remains relatively unexplored and still needs clinical evidence.

systemic therapy is the standard treatment for advanced hepatocellular carcinoma (hcc) with metastasis. however, metastases with limited number (oligometastasis) can represent a subtype and transition point between localized disease and widespread metastases. thus, eliminating metastases could be advantageous and beneficial to the prognosis if feasible and permitted. image-guided ablation therapy, such as microwave ablation (mwa), radiofrequency ablation (rfa), and cryoablation, has attracted great interest as a minimally invasive approach against intrathoracic metastases. recently, ablation has been used on patients with pulmonary metastases from various cancers. this technique yields high proportions of sustained complete responses and is associated with relatively low morbidity. this multicenter study focuses on the management of ablation of oligometastasis therapy combined with systemic therapy.

Eligibility criteria:
inclusion criteria: 1. diagnosis of primary hcc, confirmed histologically or clinically according to the criteria of the american association for the study of liver diseases; 2. presence of pulmonary oligometastasis, the metastases found within three month of hcc diagnosis; 3. metastases with limited five sites and no more two organs involved, with a maximum diameter of ≤5cm; 4. receipt of first-line systemic therapy for minimum of 3 months before ablation, with controlled intrahepatic tumors and no progression of metastases. controlled intrahepatic tumors were defined as those showing a partial or stable response according to the modified response evaluation criteria in solid tumors (mrecist); 5. undergone locoregional treatments, including transarterial artery chemoembolization (tace) or hepatic arterial infusion chemotherapy (haic) were included; 6. classified as child-pugh class a or b and having an eastern cooperative oncology group (ecog) performance status of 0 or 1; 7. no history of other malignancies. 8. life expectancy more than 3 months; 9. agreed to participated in this clinical trial; 10. hemameba ≥3.0 x109/l, neutrophil ≥1.5x109/l, hemoglobin≥10.0 g/l, platelet≥100x 109/l, alt; ast; bilirubin ≤1.5-fold normal, gfr≥60ml/min. exclusion criteria: 1. intermediate hcc; 2. age \ 75 years; 3. advanced hcc with more than five metastases; 4. no response to lenvatinib; 5. metastases size \> 5 cm; 6. life expectancy less than 3 months.

Keywords: advanced hepatocellular carcinoma lenvatinib sorafeinib camrelizumab tislelizumab sintilimab toripalimab apatinib
pfas exposure and immune response to vaccination in adults

Conditions: Innate Inflammatory Response; Vaccination; Diphtheria; Tetanus; Environmental Exposure; Vaccine; Antibodies; Adult; Immunity; Pollution; Exposure

Summary: this clinical trial aims to investigate how exposure to perfluorononanoic acid (pfna), a type of per- and polyfluoroalkyl substance (pfas), affects the immune response to the standard tetanus and diphtheria (td) vaccine. the study focuses on participants from a community with known prior pfna exposure through contaminated drinking water. the main question it aims to answer is: * does exposure to pfna weaken the body's initial immune response, leading to lower levels of protective antibodies after vaccination? participants will: * receive tetanus and diphtheria (td) booster vaccination * visit the study office 7 times over a 30-day period * have blood and saliva collected at each study visit


Eligibility criteria:
inclusion criteria: * participated in the paulsboro pfas health study * provided a blood sample for the paulsboro pfas health study * weigh at least 110 pounds exclusion criteria: * currently pregnant * history of difficult blood draws * history of adverse reaction to prior vaccinations * currently taking immune suppressants * recent dental surgery or dental procedure within 4 weeks of starting study * had a td booster in the past 10 years

Keywords: pfas perfluoroalkyl substances polyfluoroalkyl substances vaccine fluorocarbons tetanus-diphtheria vaccine prospective study adaptive immunity innate immunity pfna, perfluorononanoic acid
prevention of pain caused by the oro-gastric tube laying in neonatology

Conditions: Pain Score

Summary: subject of research : evaluation of a technique of care to reduce the pain caused by the laying of the gastric tube in the newborn

after inclusion, the nurse performs randomization by opening the envelope. the newborn then receives the care with the introduction of the gastric tube after randomization (experimental arm with holed baby bottle nipple and control arm: with pacifier). the treatment is filmed and recorded by a previously installed camera. the films are viewed by two independent experts from the pain of the study, to assess pain by scale score (dan acute pain of the newborn

Eligibility criteria:
inclusion criteria: * newborn term, or premature (from 32 weeks) from 48 hours to 14 days of life. * presence of sucking reflex * patient whose authors of parental authority have given their written consent for their participation * patient affiliated to or benefiting from a social security scheme exclusion criteria: * newborn intubated or niv and / or sedated * newborn with malformation (especially cleft palate) * contra-indication to sugar administration * newborn previously included in the study * administration of analgesics in the previous 8 hours * atresia of the unoperated esophagus * non-operated oeso-tracheal fistula * major swallowing disorders * necrotizing ulcerative colitis

Keywords: feeding tube gastric newborn infant nursing pain
case series for traumatized refugees with khat dependence

Conditions: Posttraumatic Stress Disorder; Khat Use Disorder

Summary: the research project will offer psychotherapeutic treatment to somali refugees with ptsd and comorbid khat dependence. in this case series, evidence-based techniques will be applied and adapted to the cultural background of somali refugees in kenya.

more than 500.000 somali refugees live in kenya. this group is especially burdened by high rates of exposure to traumatic events, high prevalence of ptsd and a high comorbidity with substance use disorders, mainly related to khat (catha edulis). there's a shortage of literature on psychotherapeutic methods that are applicable in this group. the aim of this case series is to develop modifications of standard therapeutic techniques to the somali culture and to the needs of this group. twenty successive cases will be recruited from a community clinic where refugees often seek for treatment because of psychiatric problems. senior level psychotherapists will apply and adapt techniques and approaches like community reinforcement approach (cra), relapse prevention (rp), and narrative exposure therapy (net); all sessions will be video recorded. regular supervision with external experts and group discussions will be held to evaluate and adapt the single procedures and techniques. the aim of this study is the development of a standardized approach that can be used in a randomized controlled trial which will be conduced in the future.

Eligibility criteria:
inclusion criteria: ptsd (dsm-iv) khat dependence (dsm-iv) exclusion criteria: severe psychotic disorder suicidality mental disability
impact of art therapy on alexithymia in people with alcohol use disorder

Conditions: Alexithymia; Alcohol Use Disorder

Summary: art therapy support combined with standard care for people with an alcohol use disorder coming to a day hospital for withdrawal could be beneficial compared to standard care alone because it would improve the alexithymia of these patients, helping them to better identify their feelings and / or emotions, and improve their self-confidence, their self-esteem self and their oral communication.

alexithymia is an inability to identify and describe one's emotions associated with outward thinking. frequently found in people with an alcohol use disorder, a true mental handicap, alexithymia has been clearly identified as a relapse factor in addictive problems related to alcohol. the alexart study intends to study the evolution of alexithymia in people with an alcohol use disorder hosted in an addictology day hospital unit through the use of an approach non-drug that is art therapy. our hypothesis is that art therapy can help patients with alcohol use disorders to develop a better understanding of their own behaviors, to name their emotions and feelings, and to improve their communication with others and thereby be able to choose to change their behavior.

Eligibility criteria:
inclusion criteria: * adult 18 or over * patient with an alcohol use disorder starting day hospital care in the psychiatry and addiction department of the angers university hospital * subjects who gave and signed informed consent to participate in the study with alexithymia (toronto test greater than or equal to 56) exclusion criteria: * non-understanding of the french language * non-affiliation to a social security scheme * major cognitive impairment * motor problems preventing walking * protective patients * pregnant or lactating women * patients under protection of justice or deprived of liberty * patients under protective supervision or guardianship
rehabilitation at home using mobile health in older adults after hospitalization for ischemic heart disease

Conditions: Ischemic Heart Disease

Summary: resilient is a phase ii, multi-center, prospective, pragmatic randomized clinical trial with blinded assessment of the primary endpoint. this study aims to evaluate whether mhealth-cr improves functional capacity in older adults (age ≥65) with ihd compared with standard traditional cardiac rehabilitation care. a total of 400 eligible patients will be randomized in 3:1 manner to mhealth-cr versus usual care for assessment of primary endpoint. enrollment will occur over approximately 42 months with an expected minimum of 3 months follow-up per participant.

the primary objective of resilient is to evaluate whether mobile health cardiac rehab (mhealth-cr) improves functional capacity in older adults (age ≥65) with ischemic heart disease (ihd), identified at the time of acute myocardial infarction (ami), percutaneous coronary intervention (pci), or coronary artery bypass graft (cabg), compared with usual care. our central hypotheses related to efficacy are that mhealth-cr will (1) improve functional capacity (primary outcome), (2) improve goal attainment, health status, and activities of daily living, and (3) lower rates of hospital readmission and death (secondary outcomes). our central hypothesis related to engagement is that we will identify distinct trajectories of engagement and characteristics that predict membership in each category.

Eligibility criteria:
inclusion criteria: 1. age ≥65 2. currently hospitalized for ami, pci, or cabg or hospitalized for ami, pci or cabg within prior 2 weeks. 3. capable of self-consent. 4. understand and are able to perform study procedures (i.e. 6-minute walk test, use mhealth in english or spanish). exclusion criteria: 1. non-ambulatory. 2. moderate or severe cognitive impairment. 3. unable/unwilling to consent. 4. pci-related groin hematoma that precludes brisk walking. 5. incarcerated. 6. unable to use mhealth software in english or spanish. 7. severe osteoarthritis, or joint replacement within last 3 months. 8. parkinson's disease or other progressive movement disorder. 9. regular use of walker for ambulation. 10. projected life expectancy \<3 months. 11. clinical judgment concerning other safety or nonadherence issues. 12. participants admitted from long-term care facility. 13. currently listed for heart transplant. 14. left ventricular assist device recipient. 15. completion of ambulatory cardiac rehabilitation program within prior 3 months.
clinical usability of intranasal glucagon in treatment of hypoglycemia

Conditions: Hypoglycemia; Diabetes Mellitus; Drug-Specific Antibodies

Summary: up to two hundred (200) adult participants with type 1 diabetes (t1d) aged 18 to 75 years will be selected for inclusion in the study. the target is to obtain treatment response and user-experience data following use of nasal glucagon (amg504-1) in treating episodes of hypoglycemia. the population will be enriched to include participants who suffer from impaired hypoglycemia awareness.

this study is designed to evaluate the effectiveness of nasal glucagon (ng) administered under clinical use conditions in treating episodes of hypoglycemia in persons with t1d. this study also aims to assess the ease with which caregivers can administer the experimental medication in treatment of hypoglycemic events. the study will also generate data on the participants' assessment of local tolerability and provide information on immunogenicity of nasal glucagon with regards to the potential development of anti-glucagon antibodies.

Eligibility criteria:
inclusion criteria: * male or female person with diabetes (pwd) lives with or is in frequent contact with one or more caregivers who are available to administer the glucagon in case of an episode of severe or moderate hypoglycemia * with a history of type 1 diabetes \>1 year * at least 18 years of age but not older than 75 years * body mass index (bmi) greater than or equal to 18.50 and below 35.00 kg/m2. * pwd will be otherwise healthy according to medical history, general physical examination (including vital signs), nasal examination, and laboratory tests (biochemistry, hematology, and urinalysis). * for female subjects, a urine pregnancy test must be negative. exclusion criteria: * presence or history of pheochromocytoma (i.e. adrenal gland tumor) or insulinoma. * use of a daily systemic beta-blockers, indomethacin, warfarin or anticholinergic drugs.

Keywords: diabetes mellitus hypoglycemia glucagon anti-glucagon antibody immunogenicity