Kornimate/medical-research-clean huggingface dataset:
application of whole-course standardized nutrition management during peri-radiotherapy in patients with nasopharyngeal carcinoma after radiotherapy: a multicenter randomized controlled clinical study

Conditions: Nasopharyngeal Carcinoma; Radiation Therapy Induced Change; Nutrition Disorders

Summary: this study will present an advanced equipment of tumor nutrition diagnosis and assesment for nasopharyngeal cancer(npc) radiotherapy patients in nutritional risk screening, evaluation, diagnosis and directing nutritional intervention, aiming to explore the advantages of the whole nutritional management in acute radiation reaction rate, completion rate of radiotherapy, nutritional status, and quality of life for npc patients.

in this study, nutrition intervention was performed in one group of nasopharyngeal carcinoma patients with no nutritional risk during the periperiod of radiotherapy , and the other group with no additional intervention when without nutritional risks, for evaluating the value of overall nutritional management in the periperiod radiotherapy.

Eligibility criteria:
inclusion criteria: * patients with nasopharyngeal carcinoma confirmed by histopathology * newly diagnosed patients without distant metastasis * age \>18 * kps ≥ 70 * nasopharyngeal radiotherapy alone or concurrent chemoradiotherapy was planned to be received, andimrt was used for radiotherapy * the patient's blood counts，the lung, liver and renal functions were tolerant to radiotherapy/chemoradiotherapy（ wbc ≥ 4.0\*109/l, ne ≥ 2.0\*109/l, plt 100\*109/l and hb≥ 10g/l. ast and alt ≤ 2.5 \*the upper limit（ul） ,tbil≤1.2\*the ul, cre≤1.2\* the ul, and alp≤5\* the ul）. and the ecg should be normal * good nutritional status,bmi:18\~23kg/ m2, pg-sga ≤1,nrs 2002\<3score * no other previous neoplastic diseases, except for cured cervical carcinoma in situ skin basal carcinoma * no serious gastrointestinal diseases (moderate and severe duodenal and gastric ulcer, ulcerative colitis, crohn's disease, etc.) * no aids and no diabetes * clear mind, no communication barriers, able to answer questions * voluntarily participate and sign the informed consent in person. exclusion criteria: * patients with gastrointestinal dysfunction, intestinal obstruction, pyloric obstruction, acute gastrointestinal bleeding * patients who are allergic to nutritional therapy or have severe allergic constitution * uncontrolled systemic diseases, such as severe liver disease (such as cirrhosis), kidney disease, respiratory diseases and so on. * women who are pregnant or breastfeeding or no contraception and women with positive pregnancy test before receiving treatment * special dietary requirements: such as no having a certain food or a vegetarian.
application of linked color imaging（lci） in diagnosis of early gastric cancer(egc)

Conditions: Early Gastric Cancer

Summary: the purpose of this study is to evaluate application value of lci in the diagnosis of early gastric cancer.

the detection rate of early gastric cancer is still very low in china. the investigators need a new and effective screening method to improve the detection rate. lci (linked-color imaging)is a new model of laser endoscopy which can provide brighter image. lci can provide clear image which can make red part redder and white part whiter, so suspicious lesion could be found easier. the study of this randomized controlled trial is to discuss effectiveness of lci in the diagnosis of early gastric cancer and to find a new method to improve the detection rate of early gastric cancer in china.

Eligibility criteria:
inclusion criteria: 1. high-risk group of gastric cancer: h. pylori infection; previously suffering from chronic atrophic gastritis, intestinal metaplasia, gastric ulcer, gastric polyps, residual stomach after surgery, hypertrophic gastritis, malignant anemia and other precancerous diseases of gastric cancer; 2. first degree relatives of patients with gastric cancer; 3. there are other high risk factors for gastric cancer (high salt, salted diet, smoking, heavy drinking, etc.). 4. patients with early gastric cancer treated with endoscopic therapy (esd, emr). 5. the informed consent has been signed. exclusion criteria: 1. the tnm classification of cancer is consistent with those diagnosed by t2 above. 2. patients with abnormal blood coagulation function or taking anticoagulants can not biopsy. 3. there were contraindications for gastroscopy. 4. a patient without self judgement; 5. those who did not sign informed consent. 6. previous gastroscopy has found suspicious lesions requiring careful examination.

Keywords: linked-color imaging detection
mindfulness meditation for insomnia

Conditions: Insomnia

Summary: this is a pilot study evaluating the feasibility and acceptability of a non-pharmacological, mind-body intervention to improve sleep quality, including a preliminary evaluation of neurophysiological signals. the study involves 4 weeks of guided mind-body practice at home using a smartphone app during bedtime and pre/post in-lab sleep study visits.


Eligibility criteria:
inclusion criteria: * 1. age 20 - 50 years\* * 2. chronic insomnia (defined by diagnostic and statistical manual diploma in social medicine, dsm-v or international classification of sleep disorders - third edition, icsd-3) with sleep latency \>20 minutes * 3. speak and understand english * 4. have a smart phone for mobile app installation exclusion criteria: * 1. sleep disorders other than insomnia (e.g., narcolepsy, restless leg syndrome, sleep deprivation, jet lag, etc) * 2. shift worker or routine night shifts * 3. women with pregnancy or breast feeding * 4. history of head trauma or surgery * 5. regular (defined as twice a week or more) practice of mind-body interventions * 6. neurological disorders (e.g. epilepsy, dementia, stroke, parkinson's disease, neuroinfections, brain tumors, etc.) * 7. current use of neurologic, psychiatric, or cardiovascular medications that have expected neuropsychiatric or cardiovascular effects (i.e., beta-blockers, hypnotics, antidepressants).
clinical outcomes and healthcare cost and resource utilization (hcru) in patients with type 2 diabetes and cardiovascular disease on 2nd line empagliflozin versus 2nd line sulfonylureas

Conditions: Diabetes Mellitus, Type 2; Cardiovascular Diseases

Summary: evaluation of clinical outcomes (specifically cardiovascular outcomes like hospitalization for heart failure), and healthcare cost, and resource utilization, among patients on empagliflozin as an add-on therapy to metformin versus patients on sulfonylureas as an add-on therapy to metformin in patients with type 2 diabetes (t2d) and cardiovascular disease (cvd).


Eligibility criteria:
inclusion criteria: * prevalent metformin use + initiation of empagliflozin or prevalent metformin use + initiation of sulfonylurea * ≥18 years of age at index date during study observation * ≥1 inpatient and/or ≥ 2 outpatient claims denoting t2d diagnosis (in any position) in the 12 months prior to index date * ≥1 inpatient and/or ≥2 outpatient claims denoting cvd (in any position) diagnosis in the 12 months prior to index date * ≥2 months post-index date * ≥12 months of no exposure to t2d medications in the pre-index period (excluding metformin in both arms) * ≥12 months of continuous enrolment prior to index date exclusion criteria: * diagnosis of type 1 diabetes, secondary, or gestational diabetes in the 12 months prior to index date * diagnosis of severe comorbidities including malignancy, end-stage renal disease, human immunodeficiency virus, hepatitis c infection, or organ transplant in the 12 months prior to index date * admission to nursing home in the 12 months prior to index date
evaluation of surgical outcomes of patients treated with the surgery first approach and aligners

Conditions: Malocclusion, Angle Class III

Summary: the purpose of this prospective study is to compare treatment outcomes and the quality of life of skeletal class iii patients treated with conventional fixed appliances and aligners undergoing surgery-first approach. data will be collected through validated questionnaires: oqlq (orthognathic quality of life questionnaire), ohip-14 (oral health impact proﬁle), sf-36 (medical outcomes study 36 - item short-form health survey) and iotn (index of orthodontic treatment need).


Eligibility criteria:
inclusion criteria: * adults; * skeletal malocclusion; * anb angle zero or negative; * witts negative; * etiology: mandibular excess, a maxillary deficiency, or a combination of both; * indication for bimaxillary surgery; exclusion criteria: * previous orthodontic treatment; * craniofacial anomaly or previous fracture of the facial bones; * total edentulism; * deep curve of spee; * vertical asymmetry; * any medication use that contraindicates surgical treatment.

Keywords: surgery-first orthognathic aligner aesthetic treatment
solving wellness: an initiative to enhance canadian healthcare provider wellness

Conditions: Stress; Burnout, Professional; Burnout

Summary: given the high incidence of burnout, depression, and suicidal ideation among canadian healthcare providers (hcps), there is an urgent need to support wellness through strengthening peer networks and engaging key stakeholders. this project will explore the capacity of digital tools to educate hcps and enable them to support their mental health. the investigators will evaluate specific research questions: are hcps more aware of their wellness needs? did burnout and stress decrease? do hcps feel more supported by their peers? the overarching objective is to contribute towards a culture prioritizing hcp wellbeing. the investigators hope to achieve this through two outcome-oriented objectives: 1) to create resources to promote hcp wellbeing and 2) to foster a web-based hcp community. this initiative integrates big data tools, interactive online content, and the solving healthcare podcast to improve hcp wellness. it is anticipated that hcps will become more aware of their wellness needs, and once they are able to identify strategies to live healthier work lives, cultural changes will take place, leading to a new attitude surrounding hcp mental health. to complete these objectives, resources will be drawn from the help-md physician database and an advisory circle, and will be disseminated via a web platform and the widely known solving healthcare podcast. the project's significance stems from the changes it will incite in both individuals and health care institutions, inspiring long term changes in workplace culture and teaching the next generation that a balanced work life is attainable.


Eligibility criteria:
participant inclusion criteria healthcare providers who are * aged 18 years or older * physicians, residents, medical students, nurses, and allied health professionals of various specialties at the montfort hospital and will also be open to canadian medical professionals (physicians, residents, medical students, nurses, and allied health professionals). participant exclusion criteria: healthcare providers who have previously enrolled as a member of solving wellness prior to project start. stakeholder staff inclusion criteria: employees who are * aged 18 years or older; and * whose roles provide them with direct knowledge of topics relating to physician wellness at the montfort hospital and of the interventions implemented during the study period (e.g., senior physicians, experts on physician wellness, health system decision makers, mental health experts, health care service managers, nurse managers, icu managers, medical site lead, directors or department heads). stakeholder staff exclusion criteria: any employees who are involved in the project design and execution (ie. advisory circle members or research team members)

Keywords: mental health healthcare providers digital tools wellness resources
a clinical trial investigating the effect of salmon bone meal on osteoarthritis among men and women

Conditions: Osteoarthritis; Osteoarthritis, Knee; Osteoarthritis, Hip

Summary: the purpose of this study is to evaluate the efficacy of hydrolyzed collagen in osteoarthritis.

the current study is part of a larger project called the calgo-project. the overall purpose of the study is to use bone meal from salmon to promote skeletal health. specifically, the potential for hydrolyzed collagen type ii derived from salmon bone meal in ameliorating pain, stiffness and function in participants diagnosed with osteoarthritis will be evaluated over a time period of 6 months. past literature indicates that collagen derivatives may be a potential supportive strategy in people suffering from osteoarthritis. osteoarthritis is a common but complex joint disease with significant unmet medical needs, as there are currently no disease-modifying drugs available. osteoarthritis represents a global health burden and the only curative treatment when pain becomes unmanageable, is joint replacement. the dimensions of pain, stiffness, and function will be evaluated using the western ontario and mcmaster universities osteoarthritis index (womac 3.1). plain x-rays with kellgren-lawrence grading will be employed to classify the severity of osteoarthritis. 100 potential participants will be screened for eligibility. participants who meet the eligibility criteria will be randomized in a double-blind manner to receive 10 capsules daily of hydrolyzed collagen type ii (a total of 5000 mg), 10 capsules daily of salmon bone meal, or 10 capsules daily of placebo.

Eligibility criteria:
inclusion criteria: * characteristic joint pain indicating osteoarthritis (oa) in the hip(s) or knee(s). * a radiologically and clinically verified diagnosis of mild to moderate oa graded 1-3 on a kellgren-lawrence (kl) grading scale in affected hips or knees. * age 18-70 years. * familiar with the norwegian language, both in writing and orally. * willingness to participate in the study. exclusion criteria: * a radiologically and clinically verified diagnosis of severe oa graded 4 on a kl grading scale in affected hips or knees. * use of drugs (and supplements) known to influence bone and joint metabolism, including glucocorticoids, \> 500 mg daily intake of elemental calcium in medication or supplement form, \> 800 iu daily intake of vitamin d3, cancer therapy * pregnancy or breastfeeding * known fish allergy and history of hypersensitivity to any of the components in the interventional product. * other reasons which the principal investigator deems it necessary to exclude a potential participant.

Keywords: stiffness pain knee pain hip pain osteoarthritis
study of weekly dcf to treat advanced gastric cancer

Conditions: Gastric Cancer

Summary: the purpose of this study is to evaluate the efficacy of weekly docetaxol combined with cisplatin and 5-fu in patients with agc.

recently,in a multi-center, open-label randomized phase iii study (v325), compared to the control arm of cf regimen, dcf showed higher efficacy in terms of response rate, time to progression and overall survival. but the regimen had increased grade 3-4 neutropenia (82% vs 57%) and febrile neutropenia infection (29% vs 12%). we began to study on weekly dcf in the patients with advanced gastric cancer to evaluate the efficacy no less than that of 3-week' regimen.

Eligibility criteria:
inclusion criteria: * age between 18 and 70 years * patients with histologically confirmed, unresectable, recurrent and/or metastatic gastric adenocarcinoma * ecog performance status ≤1,life expectancy more than 3 months, * normal laboratory findings:absolute neutrophil count and platelet count ≥ 2.0×109/l and 80×109/l, respectively, hepatic function (total serum bilirubin ≤ unl, transaminases ≤ 1.5 times upper normal limit) and renal function (calculated creatinine clearance ≥ 60 ml/min). * measurable disease according to the recist. exclusion criteria: * pregnant or lactating women * serious uncontrolled diseases and intercurrent infection * the evidence of cns metastasis * history of other malignancies except cured basal cell carcinoma of skin and carcinoma in-situ of uterine cervix * received other chemotherapy regimen after metastasis * used taxane in adjuvant settings * participated in other clinical trials.

Keywords: dcf advanced gastric cancer phase ii study efficacy toxicity
enthesitis assessment before and after anti-tumor necrosis factor treatment in spondyloarthritis

Conditions: Spondyloarthritis; Enthesitis; Anti-Tumor Necrosis Factor Drugs

Summary: biological therapies should be considered in patients with high disease activity despite nonsteroid antiinflammatory drug treatment. the first option among biological therapies is anti-tumor necrosis factor (anti-tnf) drugs. in recent years, anti-tnf treatments have shown that clinical and ultrasonographic enthesitis may improve as well as disease activity, quality of life and acute phase reactants. in this prospective study, we aimed to evaluate the clinical and ultrasonographic evaluation of enthesitis and to determine its response to anti-tnf treatment in patients with spa.in this prospective study, we aimed to evaluate the clinical and ultrasonographic evaluation of enthesitis and to determine its response to anti-tnf treatment in patients with spa.


Eligibility criteria:
inclusion criteria: * spondyloarthritis patients were diagnosed according to 2009 assessment of spondyloarthritis international society (asas) criteria exclusion criteria: * severe cardiovascular and respiratory diseases, * severe liver and kidney failure, * pregnancy and lactation, * active infection, * malignancy, * demyelinating diseases, * systemic lupus erythematosus, * history of knee, elbow, foot and ankle surgery, * fluoroquinolone, retinoid and fluoride use, * local corticosteroid injection at the examination sites within the six weeks before evaluation * peripheral neuropathy
comparisons of two airway clearance techniques

Conditions: Airway Clearance Impairment

Summary: the goal of this clinical trial is to compare the effectiveness of two airway clearance techniques for patients with ventilator associated pneumonia. the main questions it aim to answer are: * effect of the therapies on volume changes * outcome on sputum clearance participants will receive airway clearance techniques of * chest physiotherapy * high frequency chest wall oscillation.

sputum can be accumulated in the airways of intubated patients, resulting in recurrent pneumonia. the airway clearance therapy is often utilized with chest physiotherapy or high frequency chest wall oscillation which has become popular for its easy of use and less time consuming to the healthcare workers. the main questions it aim to answer are on effectiveness of the therapies on lung volume changes and sputum clearance by two airway clearance techniques. with the oscillation of entire chest wall, the investigators hypothesize that the high frequency chest wall oscillation is more effectively clear sputum in the distal airways.

Eligibility criteria:
inclusion criteria: * diagnosed with chronic pulmonary disease * diagnosed with ventilator associated pneumonia * receive airway clearance therapy exclusion criteria: * head injury, spinal injury * instable hemodynamics * intercranial pressure \> 20 cmh2o * active hemoptysis * empyema * eye surgery * abdominal distension * chest tube insertion * active tuberculosis

Keywords: airway clearance technique ventilator associated pneumonia electrical impedance tomography high frequency chest wall oscillation chest physiotherapy
the impact of patient safety incidents on patients' quality of life

Conditions: Hip Fractures; Knee Fracture

Summary: this study estimates the impact of patient safety events on qol in elective surgery patients using a secondary data set

background: the burden of patient safety incidents (psis) is often characterised by their impact on mortality, morbidity and treatment costs. few studies have attempted to estimate the impact of psis on patients' health-related quality of life (hrqol) and the studies that have made such estimates primarily focus on a narrow set of incidents. the aim of this paper is to estimate the impact of psis on hrqol of patients undergoing elective surgery in england. materials and methods: a unique linked longitudinal data set consisting of patient reported outcome measures (proms) for patients with hip and knee replacements linked to hospital episode statistics (hes) collected between 2013/14 and 2016/17 is examined. patients with any of nine us agency for healthcare research and quality (ahrq) psi indicators are identified. hrqol is measured using the general euroqol five dimensions questionnaire (eq-5d) before and after surgery. exploiting the longitudinal structure of the data, exact matching combined with difference in differences to estimate the impact of experiencing a psi on hrqol and its individual dimensions, comparing hrqol improvements after surgery in similar patients with and without a psi.

Eligibility criteria:
inclusion criteria: * no exclusion criteria: * patients for which health related quality of life is not observed both before and after surgery.
conventional or unconventional lymph node dissection during resection of intrahepatic cholangiocarcinoma

Conditions: Intrahepatic Cholangiocarcinoma

Summary: the aim of this study is to compare the surgical outcomes of conventional lymph node dissection with unconventional lymph node dissection during resection of intrahepatic cholangiocarcinoma.

intrahepatic cholangiocarcinoma (icc) is one of the primary liver cancer, which has higher malignant, more difficult treatment and worse prognosis compared to hepatocellular carcinoma and its incidence continues to rise. the main radical treatment is surgical resection, however, postoperative recurrence rate is extremely high. the 3-year recurrence rate is more than 50%. it is reported that lymph node metastasis rate of icc is as high as 20% to 65%, which is the most significant factor of the poor prognosis. the probability of lymph node metastasis is 13% when lymph nodes metastasis were not found preoperative or intraoperative. it is highly controversial whether or not to undergo conventional lymph node dissection when lymph nodes metastasis were not found preoperative or intraoperative . a number of researchers approved of lymph node dissection at that situation. however, some authors such as kim suggest that lymph node resection is not necessary. others such as yang think should consider in different condition. clark cj thinks that the evidence for dissection or not of lymph node is insufficient in view of the above reasons, the investigators have planned to implement a randomized controlled study to confirm the prognostic value of conventional or unconventional lymph node dissection during resection of intrahepatic cholangiocarcinoma.

Eligibility criteria:
inclusion criteria: * male or female patients \> 18 years and \<=70 years of age. * diagnosis of intrahepatic cholangiocarcinoma ( through imaging, serology, intraoperative frozen, etc.) * no lymph node metastasis preoperatively or intraoperatively. * tumors can be completely resected. * criteria of liver function: child a-b level, serum bilirubin ≤ 1.5 times the upper limit of normal value, alanine aminotransferase and aspartate aminotransferase ≤ 2 times the upper limit of normal value. * patients who can understand this trial and have signed information consent. exclusion criteria:lymph node metastasis preoperatively. * tumors can not be resected . * patients with apparent cardiac, pulmonary, cerebral and renal dysfunction, which may affect the treatment of intrahepatic cholangiocarcinoma. * patients with a medical history of other malignant tumors. * subjects participating in other clinical trials. * liver function:child c.

Keywords: lymph node dissection