Kornimate/medical-research-clean huggingface dataset:
the role of immune checkpoints in lung transplant (iltra)

Conditions: Lung Transplant Rejection

Summary: the goal of this observational study is to learn about rejection in lung transplantation. the main question it aims to answer is: • what is the role of immune checkpoints in lung transplantation? participants will describe pathways of rejection in lung transplantation analyzing the immune checkpoints on explanted lungs as well as trans-bronchial biopsies.

lung transplantation is the less common solid organ transplant performed; it is the treatment of choice for end stage lung disease. lung transplantation is "problematic" for a number of reasons: low graft availability, high waitlist mortality and unsatisfactory survival. acute rejection, occurring days to months after surgery, has been identified as one of the main risk factors for the development of chronic rejection: in the first five years after lung transplantation, chronic rejection is the major cause of graft failure, morbidity and mortality. a deep knowledge of the immunological scenarios associated with lung graft tolerance could allow selectively switch-off t-cells involved in the rejection process. the researches, preliminary demonstrated the central role of immunological checkpoints in the development of acute rejection and its evolution towards chronic rejection. the aim of this study is the identification of markers that could be associated with the establishment of lung graft tolerance. the project is articulated into two parts: a retrospective and a prospective section. the retrospective section is constituted by a cross-sectional study of immune checkpoints on lungs explanted during lung re-transplantation for chronic rejection (cohort 1). in addition, the retrospective section includes a retrospective cohort study of immune checkpoints on specimens from transbronchial lung biopsies of participants who received lung transplantation and have 3 years of follow-up (cohort 2). the prospective section is a cohort study of immune checkpoints on specimens from transbronchial lung biopsies and gene expression analysis on immune cells purified from bronchoalveolar lavage; participants will be subjects receiving the lung transplantation during the first year of recruitment and followed for one year (cohort 3).

Eligibility criteria:
inclusion criteria: * lung transplant patients exclusion criteria: * hyperimmunized patients * history of auto-immune disorders

Keywords: lung transplantation immune checkpoint acute rejection chronic rejection chronic lung allograft dysfunction
nerve transfers in post-stroke spasticity

Conditions: Spasticity as Sequela of Stroke; Nerve Transfers

Summary: stroke is nowadays a leading cause of disability with devastating sequelae. upper limb spasticity is one of them. nevertheless, not all the muscles are equally affected, as some may turn spastic or paretic and other remain intact. this unique pathophysiological mosaic dictates a precise therapeutic plan. existing spasticity treatment has significant drawbacks due to its unspecific targeting and short duration. a causal, life-lasting treatment, precisely adapted to every single patient's needs and to disease pattern, is currently missing. hyperselective muscle denervation and subsequent cognitive reinnervation with appropriate unaffected donor nerves may break the pathological spastic circuit and provide volitional muscle control. with this pioneering study we will perform cognitive nerve transfers to spastic muscles and will prospectively investigate their effects on clinical, electrophysiological, molecular-biological and histological level. accurate donor nerve selection will be for the first time quantified through motor unit number estimation with high-density needle electromyography. this revolutionary concept can open the window to a new era of therapeutic possibilities for stroke victims.


Eligibility criteria:
inclusion criteria: * are undergoing nerve transfers * age from 18 to 75 years old * minimum of 1 year interval after stroke * are able to understand german or english * medical research council (mrc) muscle scale for donor nerves: m4 or m5 * walking patients, with or without crutches * good general health condition and social support for the control group: * age 18-75 years old * indication for ulnar nerve release and submuscular transposition for compression neuropathy in the elbow * no other neurological disorders exclusion criteria: * stroke earlier than 3 years at the time of first consultation * lower limb spasticity and patients mobile with wheel chair
comparison of different umbilical port entry techniques in terms of cosmetic results

Conditions: Cicatrix

Summary: investigators selected participants who operated by laparoscopic technique due to any gynecologic indication according to random number table. the ten mm trocar was inserted supraumbilical, infraumbilical and intraumbilical. the verres needle was not used in all of patients. one month after we evaluated umbilical scar by used vancouver scar scale and compared results of vancouver scar scale.


Eligibility criteria:
inclusion criteria: * participant with eligible for laparoscopic surgery exclusion criteria: * participant with umbilical scar due to previous surgery, burn eg.
effect of transcutaneous vagal stimulation (tvs) on endothelial function and arterial stiffness in hfref

Conditions: Heart Failure With Reduced Ejection Fraction; Endothelial Dysfunction

Summary: heart failure (hf) is the leading cause of hospitalization in the us. endothelial dysfunction, characterized by the decreased vasodilatory capacity of the vascular endothelium, is rampant in atherosclerotic diseases such as coronary artery disease and also in hf. endothelial dysfunction also correlates with hf severity, progression, and mortality. it is postulated that endothelial dysfunction may in part be due to enhanced sympathetic drive, diminished parasympathetic drive, chronic inflammatory state thereby leading to reduced nitric oxide synthase activity in the vascular endothelium. low-level vagus nerve stimulation (llvns) is an invasive way to modulate autonomic tone. recent experimental and clinical data suggest that low-level transcutaneous vagal stimulation (tvs) (by stimulating the auricular branch of the vagus nerve located at the tragus of the external ear) may produce the same desired neuromodulator effect compared to llvns. the objective of this study is to determine the impact of tvs on endothelial dysfunction and arterial stiffness. the study population will include patients with chronic hfref. after performing baseline flow-mediated dilation (fmd), laser speckle contrast imaging(lsci) and pulse wave analysis (pwa) testing, patients will be randomized to tvs or sham stimulation with a crossover design at different time points. the patient randomized to tvs arm will undergo stimulation for 1 hour followed by immediate measurement of fmd,lsci and pwa. there will be a washout period of at least 24 hours with patient crossing over to the other arms thus serving as their self-control.


Eligibility criteria:
inclusion criteria: 1. patients (18 years or older) with heart failure with reduced ejection fraction (hfref), which is a history of symptomatic heart failure with left ventricular ejection fraction (lvef) of \< 40%. exclusion criteria: 1. patients in overt congestive heart failure / recent acute myocardial infarction (\< 3 months) or unstable angina 2. active malignancy 3. perimenopausal women and post-menopausal women on hormone supplements. 4. unilateral or bilateral vagotomy 5. patients with bilateral upper extremity amputation 6. pregnant patients 7. end-stage renal disease 8. end-stage liver disease 9. history of recurrent vasovagal syncope, sick sinus syndrome, 2nd- or 3rd-degree atrioventricular (av) block. 10. patients with clinically documented upper extremity arterial disease 11. patients with bmi\>34
mobile device to help frax® screening

Conditions: Osteoporosis; Fracture

Summary: background: the taiwanese frax® (fracture risk assessment tool) calculator is available online for clinical use. our taiwanese osteoporosis clinical treatment guidelines suggests using the american high risk cut-points for considering treatment but also suggests deriving domestic cut-points from cost-effective approach. establishing cost-effective domestic cut-points for policy suggestions coupled with mobile devices with wireless access would potentially increase the usage of frax® tool. objectives: 1) using literature review to establish cost-effectiveness frax® cut-points. 2) to assess the effectiveness of mobile devices assisted frax® tool based osteoporosis diagnostic and management model. 3) to provide frax® based reimbursement policy suggestions. methods: 1) investigators will use frax®, cost-effectiveness and other key words to search pubmed and international osteoporosis guidelines to better understand the clinical applications of frax® in other countries. investigators will also search epidemiological data for osteoporosis, facture, quality of life and cost to establish domestic cost-effeteness, and translational approach frax® cut-points. 2) three targeting populations from national taiwan university hospital (ntuh) are selected for prospective study (group a: geriatric health exam clinics with american cut-points, group b: orthopedic clinics with translational approach cut-points and group c: endocrine clinics with cost-effectiveness cut-points,). a mobile device with app application coupled with the frax® tool is used by a trained research assistant during clinic waiting periods to screen and enroll high risk (75 from each clinic) adults with informed consents. participants are referred to geriatric clinics for systemic osteoporosis diagnoses and managements. percentage of participants that meet the current nhi medication reimbursement regulation and percentage of self-pay medications are calculated. analysis is stratified by age and gender. 3) the impacts of 3 different cut-points on increment nhi reimbursement are estimated. an osteoporosis expert group meeting is to be held for frax® based osteoporosis medication reimbursement modifications to the nhi and the department of health. expected outcomes: 1) to establish the mobile device assisted frax® based osteoporosis screening and management model. 2) base on the study results and expert consensus, investigators will provide policy suggestions of frax® based reimbursement modifications.

this is an observational study. the study outcomes might base on clinical physician opnions to provide policy suggestion of frax® at which cut-point is considering for treatment.

Eligibility criteria:
inclusion criteria: * age 40-90 * screen high risk from frax exclusion criteria: * treated with anti-osteoporosis medications within last 3-12 months (depends on medication types)

Keywords: osteoporisis fracture risk cost effectiveness frax mobile device
mercuri analysis contribution on handicap evaluation in arthrogyposis, a congenital neuromuscular disease

Conditions: Diagnosis of Arthrogryposis Amyoplasia or Distal Arthrogryposis; 5 Day Multidisciplinary Evaluation in AMC Clinic of the National Reference Center; With Physical Medecin, Medical Genetic and Imaging Departments at the Hospital Grenoble Alpes

Summary: the aim is to evaluate the correlation of quantified fibro-adipous infiltration of muscles, using the mri-based mercuri score, with deficiencies, activity limitations and social participation in patients with arthrogryposis multiplex congenita.

arthrogryposis multiplex congenita (amc) refers to a rare disease spectrum characterized by the presence of joint contractures at birth in at least two different body areas. causes are multiple. amyoplasia and distal arthrogryposes are the most frequent causes. phenotypes consist of muscle weakness and atrophy of variant severity and joint deformities. the impact on mobility, activities or daily living and participation is variable (dai et al, 2018). mercuri et al. (mercuri et al, 2002) have developed a semi-quantitative score to mesure fibro-adipous muscle infiltration on muscle mri. correlations between fibro-adipous infiltration and muscular deficits have already been studied in other neuromusclar diseases such as pompe disease (figueroa-bonaparte et al, 2016) or duchenne muscular dystrophy (brogan et al, 2018). these studies revealed good correlation between disease onset, muscle strength and the degree of muscle fibro-adipous infiltration, calculated using the mercuri score. the authors concluded that muscular mri can be used to follow the neuromuscular disease progression as it is correlated with muscle function. contrary to these progressive diseases, amc is a congenital non progressive condition. it is therefore tempting to hypothesize that the muscular fibro-adipous infiltration in these patients could be of prognostic value for future capacities. our aim is to evaluate the fibro-adipous muscle infiltration in a thoroughly phenotyped cohort of adult patients with amyoplasia and distal arthrogryposes using the mercuri score, based on muscular mri, in order to evaluate the correlation with deficiencies, activity limitations and social participation.

Eligibility criteria:
inclusion criteria: * adults * with a diagnostic of amyoplasia or distal arthrogryposis * evaluated by a all body mri * functionnal evaluation during day hospitalisation in neurorehabilitation department * between 2010 and october 2020 exclusion criteria: * other aetiology of arthrogryposis multiplex congenita (amc) * incomplete mri or medical files * interaction with other disease

Keywords: arthrogryposis multiplex congenita mri mercuri score fibro-adipous infiltration fonctionnal capacity rehabilitation retrospective observationnal study
clinical outcomes of novoseven® treatment in severe postpartum haemorrhage - a study at the university hospital of bern

Conditions: Severe Postpartum Haemorrhage

Summary: this non-interventional study will compare the clinical outcomes in women with an event of severe postpartum haemorrhage treated with novoseven® to clinical outcomes in women with an event of severe postpartum haemorrhage not treated with novoseven®. the study will be a single centre retrospective cohort study of women with an event of severe postpartum haemorrhage, defined as 1.5 l of blood loss within 24 hours of delivery, in the period of 2005-2016.


Eligibility criteria:
inclusion criteria: * females * spph, defined as continuous bleeding of more than 1500 ml within 24 hours after delivery * inclusion in one of the four cohorts (historical cohort 1, historical cohort 2, study cohort and new cohort) exclusion criteria: * there are no exclusion criteria
treatment of high-risk cerebral primitive neuroectodermal tumors in children aged over 5 years

Conditions: Metastatic, Cerebral Primitive Neuroectodermal Tumors

Summary: primary objective : to increase the 3 year progression-free survival from 40% to 60%. patients included : metastatic, cerebral primitive neuroectodermal tumors in children aged over 5 years.


Eligibility criteria:
inclusion criteria: 1. type of tumor: * metastatic medulloblastoma whatever the quality of the initial resection (radiologically visible metastases by mri and/or csf invaded by at least one mass of tumoral cells). * incompletely resected local medulloblastoma with a residue \> 1.5 cm2. * anaplastic, large cell medulloblastoma whatever the risk criteria (localized or metastatic, complete or incomplete resection). * medulloblastoma with amplification of c-myc or n-myc whatever the risk criteria (local or metastatic, complete or incomplete resection). * local and/or metastatic sustentorial pnet. 2. age at diagnosis of the medulloblastoma of more than 5 years and less than 20 years. 3. age at diagnosis of s-pnet of more than 10 years and less than 20 years. 4. nutritional and general status compatible with treatment, lansky score \> 60. 5. estimated life expectancy \> 1 months. 6. radiographs must be available for the second reading in dicom format on a cd-rom. 7. hematological function at diagnosis: pmn \> 1.0 x 109/l and platelets \> 100 x 109/l. 8. hepatic function at diagnosis: serum bilirubin \ 50%; fibrinogen \> 1.5 g/l. 9. renal function at diagnosis: serum creatinine according to age in a correctly hydrated child: 1 to 15 years \< 65 micromol/l; 15 to 18 years \< 110 micromol/l. 10. no organ toxicity (grade \> 2 according to nci-ctc coding, version 2.0) 11. no other concomitant anti-cancer treatment. 12. no prior anti-cancer therapy. 13. no prior irradiation. 14. written informed consent signed by both parents or legal guardians exclusion criteria: 1. failure to comply with one of the inclusion criteria. 2. severe or life-threatening infection. 3. uncontrolled active or symptomatic intracranial hypertension. 4. refusal of parents or legal guardian. 5. patients incapable of undergoing medical follow-up for geographical, social or mental reasons
the effect of wound care education using the jigsaw iv learning technique on nursing students' knowledge, collaborative learning, and academic motivation

Conditions: Nursing Students; Nursing Education; Jigsaw Technique; Wound Care

Summary: this study aims to investigate the effects of wound care education given with the jigsaw iv learning technique on the knowledge, collaborative learning and motivation levels of nursing students. second-year nursing students will be divided into two groups with simple randomization. the intervention group will be given a wound care training program with the jigsaw iv technique. the control group will be given wound care training with traditional education. pre-test data will be collected before the training and post-test data will be collected after the training.


Eligibility criteria:
inclusion criteria: * not having taken a wound care education before * willing to participate in the study voluntarily exclusion criteria: * being a nurse who graduated from secondary school and working in the clinic, * having previously established an associate degree program related to health, * not participating in theoretical lessons, demonstrations and group work, - the student wants to withdraw from the research at any stage, * not filling out the data collection forms or filling them incompletely.

Keywords: jigsaw iv nursing students wound care collaboration motivation
colposcopy and dynamic spectral imaging (dsi)

Conditions: Cervical Dysplasia; Cervical Disease; Cervical Lesion; Cervix Cancer; Cervical Cancer; Cervical Neoplasm

Summary: this study evaluates the dynamic spectral imaging (dsi) colposcope (dysis) in it's ability to diagnose cervical dysplasia. half of participants with be examined by the dysis colposcope, there the other half will be examined by standard colposcopy.

colposcopy has been shown to be a subjective exam, and is dependant on the colposcopists. sensitivity for colposcopy has been shown to be as low as 50%. to improve this, different adjunctive technologies have been introduced to add a more objective approach to the colposcopy exam. one of these devices is the dysis colposcope, which measures the aceto-white reaction that may occur on the cervix uteri after the application of acetic-acid. the device provides the examiner with a colour-coded map indicating areas of interest. studies have shown promising results indicating that using this device together with the colposcopists own interpretation of the cervix uteri can potentially lead to an increase in the performance of the colposcopy exam. in denmark all women referred for colposcopy have 4 biopsies taken, according to the danish national guidelines. in our study these 4 biopsies are as following: 1. the area the colposcopists views as the worst before the dsi-map is seen. colposcopy-directed biopsy (cdb) 2. the area indicated as the worst by the dsi-map (dsi-directed biopsy) 3. additional biopsy 4. additional biopsy all biopsies are placed in separate containers and analysed separately by specialized pathologists.

Eligibility criteria:
inclusion criteria: * referred for colposcopy due to a cervical smear test of atypical squamous cells of undetermined significance (ascus), low-grade intraepithelial lesion (lsil), atypical squamous cells, cannot exclude a high-grade lesion (asc-h), high-grade intraepithelial lesion (hsil), atypical glandular cells (acg) or carcinoma in situ (cis) * referred for colposcopy due to follow-up of previously diagnosed cin (if there has been a minimum of 6 months since previous cervical biopsies) exclusion criteria: * cervical biopsies taken within the last 6 months * previous cone procedure * currently pregnant * pregnant within the last 6 months

Keywords: colposcopy dynamic spectral imaging, dysis colposcopy directed biopsy
psc clinical epidemiology in china

Conditions: Primary Sclerosing Cholangitis

Summary: primary sclerosing cholangitis (psc) is a rare disease but is increasingly reported in china (mainly in the chinese language). however, most of the psc literatures reported from china are case reports, small case series, and review articles. up to now, there is no information on the epidemiology and disease burden of psc in china. this study would use emr/his and research databases to investigate the epidemiology, cascade, and treatment pattern of psc in china.

identify the psc cases diagnosed from the earliest date available to the present in the suvalue research database and the his/emr from clinical sites through diagnostic icd codes, laboratory, pathology, imaging, endoscopy, surgery, medication, hospitalization, and health outcomes. collect information on psc cases' key demographic, the time of psc diagnosis, hematological/biochemical variables (alt, ast, alp, ggt, alp tbil, alb), mrcp or ercp or pathological report, ibd (uc or cd) symptoms, or colon, medication information, clinical outcomes (including cirrhosis, decompensated cirrhosis, death or liver transplantation) as well as current or past treatment.

Eligibility criteria:
inclusion criteria: 1. retrospectively review psc cases before april 1, 2002 will be identified by diagnostic codes from the international classification of diseases (icd)-9, and for those after april 1, 2002, we used icd-10. 2. we identified patients using an electronic search of suvalue research database and his of bfh-cmu and byh-cmu using psc related icd codes (icd-9: 576.1; icd-10: k83.016/k83.016(china version)). to supplement the icd search, an electronic keyword search for "primary sclerosing cholangitis" or "seclerosing cholangitis" was conducted on all radiology, endoscopy, pathology reports beginning on earliest date available in the database of suvalue research database and his of bfh-cmu and byh-cmu. we reviewed the medical charts of identified patients and diagnostic criteria including cholestatic biochemistry (alp, ggt elevations), and typical imaging (mrcp or ercp) or pathological features, excluding other known etiology. for patients with multiple visits for psc, we reviewed only the index visit. to ensure consistency, chart review was independently assessed by two hepatologists. discrepancies in compliance were resolved by discussion between the two main reviewers. any unresolved discrepancies were decided by a third expert hepatologist. exclusion criteria: 1. the cases with secondary sclerosing cholangitis caused by cholelithiasis, igg4 related disease, malignancy or other known etiologies. 2. the cases with missing key results on clinical, biochemical (alp, ggt, bilirubin), radiological (mrcp or ercp) or histological investigations.

Keywords: epidemiology cascade treatment