Kornimate/medical-research-clean huggingface dataset:
reperfusion therapy for acute ischemic stroke due to large artery occlusion

Conditions: Stroke; Vascular Occlusion; Endovascular Treatment; Mechanical Thrombectomy; Perfusion Imaging

Summary: the aim of the study was to establish a clinical and advanced imaging database of acute ischemic stroke patients treated with mechanical thrombectomy due to large vessel occlusion of anterior circulation within 24 hours from stroke onset in china, and to investigate the predictors and potential mechanisms of futile recanalization after mechanical thrombectomy.

the time-window of mechanical thrombectomy for ischemic stroke has extended from 4.5 hours to 24 hours based on the results of the dawn and defuse 3 trials. however, evidence on the effectiveness and safety of mechanical thrombectomy within 24 hours in the real-world is insufficient. this is a multi-center, prospective, registry cohort study that acute ischemic stroke patients treated with mechanical thrombectomy due to large vessel occlusion of anterior circulation within 24 hours from stroke onset in china. a retrospective dataset was also build in these stroke centers for analysis. a total of 1600 patients with advanced imaging data were anticipated to be enrolled.

Eligibility criteria:
inclusion criteria: * older than 18 years; * perfusion imaging completed including cta+ctp or mra+pwi+dwi before thrombectomy * large vessel occlusion of cerebral anterior circulation (ica, mca-m1 or mca-m2) confirmed by cta or mra, planned to receive or received stenting or aspiration thrombectomy * time intervals ≤ 24 hours from stroke onset to groin puncture.(fulfilled the inclusion of dawn or defuse 3 trial if the time intervals from stroke onset to groin puncture was ≥6 hours) * mrs score ≤2 before admission * informed consent obtained for longitudinal enrolled patients, waived of consent for retrospectively included cases exclusion criteria: * had a history of infective disease, immunity disease, radiotherapy at head or neck, carotid dissection or other carotid disease. * unable to receive ct or mr scan due to heart failure, cardiac pacemaker, metal implants or claustrophobia, etc. * unable to be injected with contrast agent due to allergy, renal dysfunction, etc. * unlikely to adhere to the study protocol or follow-up ( life expectancy ≤ 3 months) * already participated in other drug trials

Keywords: ischemic stroke vascular occlusion endovascular treatment mechanical thrombectomy perfusion imaging
effects of 650nm low energy light on human retina and choroid microcirculation

Conditions: Myopia

Summary: this project is a single-center, prospective, self-controlled clinical study. it intends to select patients with simple medium and low degree myopia as subjects, and apply 650nm low-energy red light irradiation to the retina to observe its effect on macular microcirculation.

a total of 120 subjects are planned to be recruited and divided into 4 groups according to age and intervention, including 30 in the juvenile intervention group, 30 in the juvenile control group, 30 in the adult intervention group and 30 in the adult control group. two intervention groups received 650nm low-energy red light irradiation treatment with a 650nm low-energy light emitter, twice a day for 3 minutes each time, the subjects were treated and followed up for 3 months. the control group was not treated and followed up for 3 months too. all subjects were followed up before treatment, at the end of the 1st month and at the end of 3rd month. angio-oct was used as the main examination to observe and record the vascular density and blood perfusion in macular area. axial length, diopter and oct were used as secondary observation indexes. at the end of the experiment, the data of the intervention group and the control group were compared

Eligibility criteria:
inclusion criteria: 1. age from 7 to 17 years old or from 18 to 45 years old; 2. meet the diagnostic criteria for patients with simple low or moderate myopia, with diopter \< -6.0d and eye axis \< 26.0mm; 3. transparent refractive stroma, no other eye diseases except nearsightedness; 4. agree to participate in the clinical study and sign the informed consent. exclusion criteria: 1. other ocular lesions, such as uveitis, retinal/choroidal vascular lesions, congenital ocular lesions, glaucoma, high myopia (ocular axis \> 26cm), degenerative retinal disease, optic neuropathy, etc.; 2. another eye with low vision 3. corneal edema/epithelial detachment, corneal opacity; 4. redness, pain, dry eye, photophobia, difficulty in opening eyes; 5. had a history of eye surgery in recent 3 months; 6. severe impairment of liver and kidney function and/or serious systemic diseases (such as cardiovascular, respiratory, digestive, nervous, endocrine, genitourinary, etc.); 7. women who are already pregnant, preparing for pregnancy during the study period and lactating; 8. a history of substance abuse or alcohol abuse; 9. receiving prevention and control treatment for myopia other than glasses within the first 30 days; 10. any situation in which the study physician believes that the patient's condition will interfere with the clinical study (e.g., the patient is prone to nervous tension, uncontrollable emotions, depression, etc.)

Keywords: photobiomodulation,macular microcirculation,,myopia
asthma severity in children and environmental agents

Conditions: Asthma

Summary: this study measures residential exposures (indoor allergens, mold, nitrogen dioxide, nicotine) and relates exposure levels to daily symptoms (wheeze, persistent cough, chest tightness, shortness of breath) and medication use, in a population of children with physician diagnosed asthma, followed for 12 months.


Eligibility criteria:
* siblings of a birth cohort recruited 1997-1999 * age less than 11 years * physician diagnosed asthma * active symptoms (wheeze, persistent cough, chest tightness, shortness of breath) or medication use in the 12 months prior to enrollment.

Keywords: asthma indoor allergens
phase iii insulin add-on asia regional program - st

Conditions: Diabetes

Summary: the purpose is to determine if after 24 weeks of oral daily administration, there will be a greater mean reduction from baseline in glycosylated hemoglobin (hba1c) achieved with dapagliflozin 10 mg plus insulin compared to placebo plus insulin in subjects with type 2 diabetes.


Eligibility criteria:
inclusion criteria: * subjects must have type 2 diabetes with inadequate glycemic control, defined as hba1c ≥ 7.5% and ≤ 11.0% obtained at screening visit * subjects must be taking a stable mean dose of ≥ 20 iu injectable insulin daily for at least 8 weeks prior to enrollment inclusion criteria for randomization: hba1c ≥ 7.5 and ≤ 10.5% at day -14 exclusion criteria: * treatment with more than two oral antidiabetic (oad) agents within 6 weeks of enrollment * history of diabetic ketoacidosis of hyperosmolar nonketotic coma * clinically diagnosed type 1 diabetes mellitus * congestive heart failure defined as new york heart association (nyha) stage iii and iv * severe uncontrolled hypertension defined as systolic blood pressure (sbp) ≥ 180 mmhg and/or diastolic blood pressure (dbp) ≥ 110 mmhg * history of unstable or rapidly progressing renal disease * history of severe hepatobiliary disease * mallingancy within 5 years of the screening/enrollment visit
resource optimization in the intensive care unit setting

Conditions: Burnout, Professional

Summary: the purpose of the study is to facilitate cost-effective, high quality care within the the icus of two ottawa teaching hospitals through educational workshops and nurse scheduling optimization.

this intervention pilot study has been developed for intensive care unit (icu) physicians and nurses by the resource optimization network (ron) for implementation in the ottawa hospital (toh) civic campus and the montfort hospital. the intervention targets icu staff and is designed to reduce overall costs associated with icu health care service delivery and improve staff satisfaction through reducing stress and associated burnout without sacrificing quality of care and patient outcomes. the intervention involves two components that (a) build icu staffs' (i.e. physicians and nurses) knowledge to facilitate cost-effective and evidence-based decision making about patient care (including tests, treatments, and procedures); and (b) optimize nurse scheduling to ensure the presence of the appropriate number of nurses per shift, thereby reducing stress, burnout and limiting the need for overtime. to evaluate the impact of the intervention, a pre/post-intervention design will be employed, with a 3-month pre-intervention period, followed by a 6-month intervention period and a 3-month post-intervention period.

Eligibility criteria:
inclusion criteria: * employees aged 18 year and older who provide direct patient care in the icu at the civic campus of the ottawa hospital or the montfort hospital as physicians, nurses, or allied health professionals (e.g., respiratory therapists, occupational therapists). exclusion criteria: * n/a

Keywords: resource allocation personnel staffing and scheduling intensive care unit cost-effectiveness burnout
software as a medical device for the treatment of patients with ptsd

Conditions: Post-Traumatic Stress Disorder, PTSD

Summary: to evaluate the efficacy and safety of software as a medical device in patients with post-traumatic stress disorder (ptsd)


Eligibility criteria:
inclusion criteria: * diagnosis of ptsd according to the dsm-5 * subjects who are within 1 to 20 years since index trauma exclusion criteria: * subjects diagnosed with schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, bipolar i disorder, autism spectrum disorder, or intellectual disability based on dsm-5. * subjects diagnosed with any mood disorder and anxiety disorder according to dsm-5 that is the primary focus of treatment in the last 6 months prior to screening, as per the clinical judgement of the investigator * subjects who have completed two or more full courses of trauma-focused therapy in the past
acute effects of focused ultrasound modulation on eeg behavior in status epilepticus patients

Conditions: Seizures

Summary: in this study, the investigators propose pulsed low-intensity focused ultrasound (plifu) stimulation of brain regions that modulate (thalamus) or generate focal motor seizures (primary motor cortex), with the goal of ameliorating seizure activity in subjects in non-convulsive or focal motor status epilepticus. the course of treatment will consist of an initial 10 minute plifu treatment session with an option for a 2nd session if necessary. the primary objective of this study is to determine whether plifu reduces or suppresses epileptic activity in patients with non-convulsive status epilepticus (ncse)/focal motor status epilepticus (fmse) that have not responded to standard of care.

this study proposes to sonicate epileptic zones or circuits at the bedside with a custom built plifu device in two groups of participants experiencing non-convulsive seizures while treated in the intensive care unit (icu): 1) non-convulsive se or 2) focal motor status epilepticus (se), targeting the thalami or motor cortical areas responsible for generating ictal activity, respectively. plifu modulation is non-ablative, nonionizing, and noninvasive, while it also preserves the integrity and function of brain tissue. the aim is to quantify ictal and interictal eeg before, during, and after sonication. experiments will not alter the standard of care and only be implemented after antiseizure medications (asms) have been delivered to the patient. plifu sonication will be delivered to participants using burst tone and nonthermal parameters for 10 minute exposures. hypothesis: plifu is a safe and non-invasive treatment that can reduce or suppress epileptic activity. the pilot data acquired is intended to be used as preliminary data for justifying a larger study. recruitment was put on hold from dec. 2023 to oct. 2024 due to personnel changes and modifications to study needing approval.

Eligibility criteria:
inclusion criteria: * subjects diagnosed with ongoing ncse or fmse despite treatment with at least 2 asms * provision of signed and dated informed consent form obtained from the next-of-kin/legally authorized representative * treated in the icu while monitored with continuous scalp eeg electrodes exclusion criteria: * unable to obtain informed consent * presence of an implanted cranial neuromodulation device for treatment of epilepsy * pregnancy * treatment with another investigational drug or other intervention within 24 hr * presence of burr hole(s) or craniotomy * subjects with ferromagnetic materials in the head * subjects with a tens unit
intrathecal dexmedetomidine to decrease postoperative nausea and vomiting and shivering.

Conditions: Intrathecal Dexmedetomidine

Summary: background: highly selective α-2 agonist dexmedetomidine in increasingly used as an intrathecal adjuvant for caesarean section performed under subarachnoid block. aim of the study: the aim of the study is to determine whether low dose dexmedetomidine added to local anesthetic for spinal anesthesia will attenuate perioperative nausea and vomiting and shivering in lower segment caesarean section (lscs) with minimal hemodynamic instability or not. patients and methods: sixty parturients planned for elective css under spinal anesthesia were enrolled in this prospective controlled study and randomly divided into two equal groups. spinal block was achieved with 10mg hyperbaric bupivacaine 0.5% plus 5µg dexmedetomidine (group d) (dexmedetomidine group) or 0.2 ml normal saline (group c) (control group). hemodynamic parameters, incidence of nausea and vomiting and shivering were recorded. keywords: dexmedetomidine, cesarean section, bupivacaine, spinal anesthesia, shivering, ponv


Eligibility criteria:
inclusion criteria: * medically free pregnant female from 18 to 30 yrs old. * undergoing elective lscs. * body mass index less than 40. * consenting for sub arachnoid anesthesia. * coagulation profile is within normal ranges. exclusion criteria: * emergency lscs. * patient refusal enrollment in the study. * allergy to the medications. * coagulopathy or anticoagulation drugs. * fetal or maternal comorbidities.
myoma screw in manipulation of large uterus in total laparoscopic hysterectomy

Conditions: Total Laparoscopic Hysterectomy With Myoma Screw

Summary: to compare between myoma screw and uterine manipulator in manipulation of large uterus in total laparoscopic hysterectomy

hysterectomy is performed on 1,500,000 women worldwide each year to treat benign disorders such leiomyoma, prolapse, and irregular bleeding, as well as gynecologic malignancies. prior to the introduction of the first laparoscopic procedures in the late 1980s, hysterectomy was traditionally accomplished by laparotomy or the vaginal route. total laparoscopic hysterectomy (tlh) became the most commonly used hysterectomy technique in the last ten years, especially in developed nations, because laparoscopic hysterectomy has some advantages over other hysterectomy types, including high patient satisfaction, an earlier return to work, less blood loss, the ability to diagnose and treat other pelvic diseases, and the ability to maintain thorough intraperitoneal haemostasis. however, there are some drawbacks to tlh as well, such as its expensive cost, lengthier operating time, and requirement for advanced technological instruments including uterine manipulators (um) and sealing devices. in order to facilitate colpotomy by defining the cervicovaginal junction and enable safer dissection around the cervix, the main goal of utilising a um is to extend the distance between the cervix and ureter.there isn't enough clinical data in the literature to say whether using um meets these expectations, though.additionally, the use of ums has been linked to a number of specific problems, such as uterine rupture, intestinal perforation, and vaginal wall laceration.ums are also not appropriate in certain cases, such as vaginal stenosis, anatomical differences that make it difficult to identify the uterus or cervix, and patients who refuse vaginal penetration because they are virgins. there is still no "optimal um" that is consistently safe, effective, and economical, despite the fact that numerous ums have been developed in recent decades. some studies have suggested alternatives including the use of certain sutures, gripping forceps, or myoma screws (ms) as answers to the issues that arise with the use of um. when performing a myomectomy using the vaginal method, laparotomy, or laparoscopy, the ms is a conventional, reusable instrument. mss are renowned for their ability to deliver a powerful three-dimensional traction force. additionally, using ms does not require specialised knowledge like ums do.

Eligibility criteria:
inclusion criteria: 1. age 30-60 2. bmi 25-40 3. large uterus with fundal level 12-24w diagnosed by tas( transabdominal ultrasound)/tvus(transvaginal ultrasound) 4. adenomyosis exclusion criteria: 1. bmi more than 40 2. patients with contraindication for laparscopic surgery e.g cardiac and cirrhotic patients
mri screening versus symptom-directed surveillance for brain metastases among patients with triple negative or her2+ mbc

Conditions: Breast Neoplasm; Brain Metastases; Triple Negative Breast Cancer; HER2-positive Breast Cancer

Summary: in this study, 50 women with either her2+ or triple negative metastatic breast cancer but no known brain metastases will be recruited at the sunnybrook odette cancer centre. they will be randomized to undergo either routine mri screening of their brain every 4 months for 1 year or standard-of-care (mri only if symptoms of brain metastases develop). patients will complete questionnaires about quality of life and cancer-related anxiety throughout the study. to determine why some cancers spread to the brain and others do not, blood samples will be collected to analyze the genetic makeup of patients' breast cancers. finally, a novel mri imaging technique that detects abnormal metabolism in the brain will be used to help detect brain metastases even earlier than the standard mri. if results are promising, we will conduct a large multi-centre randomized trial to determine whether screening for brain metastases can help them live longer with improved quality of life.

please see trial details below.

Eligibility criteria:
inclusion criteria: 1. age ≥18 2. triple negative or her2+ breast cancer (asco/cap guidelines 2018)\* 3. mbc, as defined as distant disease outside of the breast and local/regional lymph nodes. physicians' clinical judgment will be used to determine the possible need for biopsy in confirming a mbc diagnosis. however, biopsy of a metastatic site is not required for pathologic confirmation of stage iv disease. 4. diagnosis of metastatic disease within 12 weeks prior to study enrollment. 5. no symptoms of brm or known asymptomatic brm at study entry. 6. patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen may participate. * this will generally be based on the primary cancer but in the event that a metastatic site is biopsied eligibility will be based on the er, pr and her2 profile of the metastasis. exclusion criteria: 1. inability to participate in an mri screening program as determined by the patient and/or physician. this may be on the basis of severe claustrophobia, performance status that limits additional testing, or a metal foreign body that would prevent mri imaging. 2. inability to provide informed consent. notably participants who require translators are allowed to enroll. 3. creatinine clearance \<30 ml/min using the cockcroft-gault equation. 4. established need for brain imaging apart from the breast cancer diagnosis (e.g surveillance for an aneurysm). 5. ecog performance status \>2. 6. pregnancy. 7. grade 3+ allergy to gadavist iv contrast (ctep adverse event reporting system).

Keywords: mri screening quality of life surveillance
adl- training for patients with chronic obstructive pulmonary disease (copd)

Conditions: Chronic Obstructive Pulmonary Disease

Summary: adl training of copd patients results in better execution of activities of daily living.


Eligibility criteria:
inclusion criteria: * copd * referred for rehabilitation * age \> 18 years * symptoms affecting adl function * 6 minute walk distance (6mwd) \< 400 meters exclusion criteria: * patients who smokes or has smoked during the last three months. * ltot * patients who has another disability * patients who can't read or speak norwegian

Keywords: copd pulmonary rehabilitation adl-training copd rehabilitation
investigation of systemic metal ion concentration following a ceramic-on-metal total hip arthroplasty

Conditions: Hip Replacement; Hip Implant; Total Hip Arthroplasty; Orthopaedic Surgery

Summary: this is a pilot study to compare systemic concentrations of cobalt and chromium in patients that have previously undergone total hip arthroplasties with ceramic on metal and metal on metal bearing surfaces.

this is a pilot study to compare systemic concentrations of cobalt and chromium in patients that have previously undergone total hip arthroplasties with ceramic on metal and metal on metal bearing surfaces. secondary goals include an assessment of osteolysis on radiographs, potential long term analysis of implant survivability, and cancer rates in the two patient populations. increased metal ion production has been documented in metal-on-metal arthroplasty articulations. there are several concerns over metal ion production. first, even though there is a decreased histiocytic response to metallic debris, a dose dependent cytotoxic response with interleukin 6, prostaglandin e2, and tumor necrosis factor alpha persists and may cause osteolysis in the long term. second, increased levels of cobalt, chromium and nickel has been shown to correlate with increased cancer rates in several animal models, and the carcinogenic risk in humans has not been fully elucidated as yet. third, hypersensitivity reactions to metal ion develop in up to 25% of these patients, and 60% of patients with poorly functioning hip. ceramic on metal avoids many of these problems due to the improved wear characteristics. if the level of metal ion production is significantly reduced and the implant survivability is proven in long term studies, this articulation may become the preferred method.

Eligibility criteria:
inclusion criteria: * subject is 40 - 80, who has undergone a top hip arthroplasty with either metal on metal or ceramic on metal articulation for a diagnosis of non-inflammatory degenerative joint disease. we will also include subjects who have had bilateral hip arthroplasties or a second arthroplasty performed since the initial surgery. * patient must be able to provide consent to participate exclusion criteria: * diagnosis other than non-inflammatory degenerative joint disease, chronic renal insufficiency, or any systemic inflammatory condition * evidence of active infections * patients whose occupations include welding or metal working * a second arthroplasty performed since the initial will not be exclude, but their data will be analyzed as a subpopulation * unwillingness to comply with rehabilitation program or inability to return for follow-up visits * any systemic steroid therapy within 3 months of surgery * subjects who are pregnant

Keywords: metal ion concentration osteolysis