Kornimate/medical-research-clean huggingface dataset:
comparison of two insulin regimens in optimally-controlled patients with dm2.

Conditions: Diabetes Mellitus 2 Type

Summary: intensive insulin therapy (iit) may be given in type 2 diabetes (t2dm) in two different ways : * as basal/bolus therapy (b/b) in four-five injections per day . * as modern premixed insulins( mpi's) three times per day . the better diabetes control is achieved, the more likely patient would suffer from hypoglycemic episodes. we propose that the probability of hypoglycemia and its severity has no difference in two main insulin therapy schemes mentioned above. the objective of the study is to compare the incidence of hypoglycemia and its severity in well-controlled ( hba1c less than 7%) diabetic individuals treated by two different regimens, through analysis of data received by continuous glucose monitoring (cgm, free style navigator).


Eligibility criteria:
major inclusion criteria: * diabetes mellitus type 2 diagnosis confirmed by endocrinologist. * diabetes mellitus type 2 history of one year at least. * hab1c \< 7% and less * age 18-80 yrs * normal liver function tests major exclusion criteria: * history of substance use * pregnancy or breastfeeding mothers * abnormal liver or kidney functional tests * type 1 diabetes or lada * any active disease ( like viral) at the period of investigation

Keywords: continuous glucose monitoring system hypoglycemia insulin regimen basal bolus therapy modern premixed insulin diabetes control
benefits of optiflow® device for preoxygenation before intubation in acute hypoxemic respiratory failure : the preoxyflow study

Conditions: Acute Hypoxemic Respiratory Failure

Summary: oro-tracheal intubation in intensive unit care(icu) in acute hypoxemic respiratory failure after crash induction remains a critical event. the aim of this study is to determine whether nasal high flow therapy (hft) optiflow ® is more efficient than the face mask for preoxygenation before orotracheal intubation after crash induction in acute hypoxemic respiratory failure

this study will be designed as followed : patients will be randomized in 2 groups :"preoxyflow" or "standard face mask". patients randomized in "preoxyflow" group will received a four minutes preoxygenation period with nasal high flow therapy (hft) (60 l/mn fio2 = 1) before orotracheal intubation under laryngoscopy after crash induction. patients randomized in "standard face mask" group will received a four minutes preoxygenation period with standard face mask (15 l/mn) before orotracheal intubation under laryngoscopy after crash induction

Eligibility criteria:
inclusion criteria: * adults older than 18 years regardless of the gender * acute hypoxemic respiratory failure defined as : respiratory rate \> 30/mn and hypoxemia with spo2 \ fio2 0,5 and pao2/fio2 \<300 mmhg exclusion criteria: * contraindication to oro-tracheal intubation * intubation without anesthetic delivery * intubation during cardiac arrest * asphyxia with immediate intubation needed * nasopharyngeal obstacle with contraindication to use optiflow device * patients with a documented cormack iv exposition before inclusion * protected adult * pregnancy * lack of consent * patient already enrolled in an other randomized study.

Keywords: acute hypoxemic respiratory failure preoxygenation crash induction
surgical treatment of obstructed defecation syndrome

Conditions: Sensation of Inadequate Defecation; Rectal Prolapse; Rectocele

Summary: obstructed defecation is a profoundly disabling condition. many different surgical procedures has been introduced to treat patients affected by this disease. the most used are starr and ventral rectopexy. because of the heterogenity of studies and overall the lack of comparison trials, there is no accepted standard surgical treatment.pro-rest aimed to compare these two procedures (starr and ventral rectopexy) evaluating functional and anatomical results.


Eligibility criteria:
inclusion criteria: * patients affected by obstructed defecation with ods score \>11 * symptomatic rectal intussusception and/or defecographic finding of rectocele\>2 cm * failure of at least 6 months of medical therapy * exclusion of neoplasm by rectosigmoidoscopy/colonoscopy exclusion criteria: * patients affected by complete rectal prolapse * patients affected by slow transit constipation * patients affected by anismus * patients affected by pelvic organ prolapse * patients with previous rectal or anal surgery

Keywords: obstructed defecation rectal rectocele intussusception starr ventral rectopexy
nbi combined with mri to guide ctv optimization in eccentric nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma by AJCC V8 Stage

Summary: this is a prospective, single-center clinical trial in eccentric nasopharyngeal carcinoma (npc) patients. the aim of this study is to evaluate the efficacy and safety of nbi combined with mri-guided optimized ctv compared with conventional ctv, and to compare the radiotherapy-related adverse events and quality of life between the two groups.

all patients with eccentric nasopharyngeal carcinoma were selected on the basis of mri findings and nbi endoscopy was performed in these patients. the patients were enrolled if both nbi endoscopy and mri showed eccentric npc. patients with contralateral tissue mucosal abnormalities detected by nbi and confirmed by biopsy were excluded. then the patients were randomly divided into an experimental group (optimized ctv) or a control group (conventional ctv) to evaluate the efficacy and safety of the two groups, as well as radiotherapy-related adverse events.

Eligibility criteria:
inclusion criteria: 1. males and females ≥18 years of age; 2. ecog performance status 0,1 or 2; 3. pathologically diagnosed as nasopharyngeal carcinoma; 4. pretreatment nasopharynx and neck mri imaging; 5. nasopharyngeal suspected lesions were examined by nbi endoscopy; 6. meeting the definition of eccentric npc with ipsilateral (affected side) staging of t1-4 and contralateral (healthy side) staging of t0; 7. patients evaluated without contraindications to radiotherapy; 8. voluntary participation in clinical research, and signed informed consent. exclusion criteria: 1. patients who did not successfully undergo all three examinations (mri, nbi, and endoscopic biopsy); 2. other rare pathological types, such as adenocarcinoma; 3. patients with tumor invasion of the clivus; 4. patients whose contralateral retropharyngeal lymph nodes met the diagnostic criteria; 5. invasion of paranasal sinuses (except simple sphenoid invasion).
impact of food carbohydrate and insulin dose computing by on smart phone on glucose control in patients with diabetes

Conditions: Type 1 Diabetes

Summary: during this study, we will assess a new smart phone application which aims at helping patients with type 1 diabetes to compute food carbohydrates and meal insulin doses. patients, already trained to carbohydrate counting, will be recruited among those who have been using this method daily for at least 6 months. they will complete two one-month study phases, using the application in one phase and counting carbohydrate and insulin doses without the application in the other phase, with randomized order of each phase. visits are scheduled at the start and at the end of each phase to collect data on glucose control and insulin doses. questionnaires assessing health-related quality of life and ability of self-management of diabetes will also be filled by patients before and after each study phase.

during this study, we will assess a new smart phone application which aims at helping patients with type 1 diabetes to compute food carbohydrates and meal insulin doses. patients, already trained to carbohydrate counting, will be recruited among those who have been using this method daily for at least 6 months.

Eligibility criteria:
inclusion criteria: * type 1 diabetes since more than 1 year * basal-bolus insulin regimen since more than 6 months * daily practice of food carbohydrate counting since more than 6 months * hba1c level below 12% exclusion criteria: * type 2 diabetes * no ability to use a smart phone * pregnancy or lactation * severe psychiatric disorders * eating disorders * alcohol abuse or recreational drug use

Keywords: type 1 diabetes smart phone application carbohydrate counting meal insulin dose
intratympanic n-acetylcysteine for prevention of cisplatin-induced ototoxicity.

Conditions: Ototoxic Hearing Loss

Summary: although many intratympanic agents have been attempted, n-acetylcysteine (nac) appears to be the most promising and is a powerful, commonly used anti-oxidant. the goal of this prospective phase 2 randomized controlled trial is to determine the optimal dosage and effectiveness of intratympanic nac injection in reducing hearing loss in head \& neck cancer patients receiving cisplatin chemotherapy with curative intent.

a prospective randomized controlled trial phase 1 using a standard 3+3 design, followed by a randomized controlled phase 2 to determine dosage, safety, and efficacy of intratympanic nac to treat hearing loss in head \& neck patients receiving high-dose cisplatin chemotherapy. participants will complete various pre-treatment hearing tests. one ear will be randomly chosen for the experimental treatment and the other ear will serve as the control ear. participants will receive intratympanic nac injections 60 minutes prior to their scheduled chemotherapy sessions in the experimental ear. the control ear will not receive any injection. follow up hearing tests will be performed 2 months following completion of their primary cancer treatment.

Eligibility criteria:
inclusion criteria: * advanced stage head and neck cancer * receiving high dose systemic cisplatin (100mg/m2) with concurrent radiation therapy as part of their curative intent treatment * willing to provide informed consent * ecog performance status 0-2 * histological confirmation of squamous cell carcinoma exclusion criteria: * age less than 18 * metastatic disease * tympanic membrane perforation or the presence of tympanostomy tubes as this may impact the retention and absorption of nac when inserted into the middle ear * preexisting severe to profound sensorineural hearing loss (unilateral or bilateral) * pretreatment interaural discrepancy of greater than 10db at three frequencies * history of meniere's or fluctuating hearing loss * previous hypersensitivity to nac * patient unable to follow the protocol for any reason

Keywords: hearing loss deafness cisplatin-induced ototoxicity sensorineural hearing loss ear diseases antioxidant n-acetyl cystein
effects of aerobic exercise training on nurses' sleep quality, fatigue, attention and cortisol profile

Conditions: Nurse; Attention; Aerobic Exercise; Sleep Quality; Fatigue; Cortisol

Summary: shift work in nursing has been found to result in sleep disruption and sleep deprivation, and in sleepiness or fatigue at work. slow reaction, insufficient attention and poor judgement often come with increased fatigue, which contributes to a high risk of accident and patient safety. studies have shown that aerobic exercise is helpful in promoting high sleep quality. the study is conducted a prospective parallel randomized trial is performed to 60 nurses with low sleep quality. the subjects are randomly assigned to: (i) the experimental group, in which aerobic exercise training is given; (ii) the control group, in which the subjects kept their original lifestyles. the study aims to investigate the effects of aerobic exercise training on nurses' sleep quality, fatigue, attention and cortisol profile.

when work shifts and lifestyles change, the synchronous relationship between the body's biological clock and the environment, i.e., circadian rhythms, is disrupted, resulting in insufficient sleep and insomnia. shift work in nursing has been found to result in sleep disruption and sleep deprivation, and in sleepiness or fatigue at work. slow reaction, insufficient attention and poor judgement often come with increased fatigue, which contributes to a high risk of accident and patient safety. studies have shown that aerobic exercise is helpful in promoting high sleep quality, whereas few researchers have argued over how aerobic exercise training improves sleep quality in nurses. the study is conducted in two stages. previous stage, we conducted with a cross-sectional study design with convenience sampled 200 participants to fill out the chinese pittsburgh sleep quality index (cpsqi) questionnaire for screen the low sleep quality (cpsqi \> 5) participants. a total of 200 nurses were recruited, and 199 valid samples were collected, 108 participants were found to have low sleep quality (cpsqi \> 5). the study will adopt a prospective, longitudinal, parallel-group comparative study, randomly sample from previously screen low sleep quality participants, then random assign to experimental (aerobic exercise) and control (routine activity) groups, and actigraphy sleep recording, saliva samples and attention data will be collected. the study aims to investigate the effects of aerobic exercise training on nurses' sleep quality, fatigue, attention and cortisol profile. the findings of the study could provide guidelines on improving nurses' fitness and sleep quality.

Eligibility criteria:
inclusion criteria: * full-time * female nursing staff members * worked 8 hours per shift * had at least 1 year of work experience. exclusion criteria: * had used sedatives, hypnotics, antihistamines, or hormonal drugs within the 4 weeks before commencing the study * pregnant * were diagnosed as having sleep or stress disorders, or experienced sleep problems owing to concurrent insomnia or sleep apnea.
immediate implant placement in the esthetic zone with and without using autogenous mixed with xenograft

Conditions: Badly Decayed Teeth

Summary: xenografts are graft materials derived from the inorganic portion of animal bones; the most common source is bovine the removal of the organic component are processed to remove their antigenicity, while the remaining inorganic components provide a natural matrix as well as an excellent source of calcium. the disadvantage of xenografts is that they are only osteoconductive and the resorption rate of bovine cortical bone is slow. however leaving the jumping gap empty has been the gold standard for immediate implantation as the formed blood clot will allow bone fill in that area.

not using a grafting material in the jumping gap was chosen as a comparator as it's the standard procedure usually applied and showed high success rates. this should allow us to assess whether the chosen grafting material would have a positive influence on the study outcomes as compared to it. intraoral and extraoral autologous bone grafts could be considered as the "gold standard" pre-prosthetic dentoalveolar reconstruction of atrophic jaws with cortico-cancellous bone grafts from intraoral and/or extraoral donor sites as a predictable technique for the facilitation of dental rehabilitation of atrophic ridges, associated with high bone survival rate and long term implant success. autogenous bone corresponds to bone graft obtained from the same individual. it is considered the gold standard for filling of bone defects since it allows (i) osseointegration: direct contact with bone tissue without fibrous tissue ; (ii) osteoconduction: support to bone growth (iii) osteoinduction: differentiation of mesenchymal cells of surrounding tissue (receptor site) into osteoblastic cells ; and (iv) osteogenesis: bone neoformation by osteoblastic cells present in the graft material. although few mature osteoblasts survive to grafting, precursor cells are responsible for the osteogenic potential

Eligibility criteria:
inclusion criteria: * age from 20-60 years * both sexes * non-restorable maxillary incisors, canine and premolars * good oral hygiene * adequate bone height apical to the alveolus of the failing tooth exclusion criteria: * systematic disease which affect osseointegration (uncontrolled diabetes, cancer, etc...) * bad oral hygiene * bruxism, clenching, deep bite, edge to edge and abnormal habits * non-treated periodontal diseases * pregnancy and smokers * severe infection * absence of labial plate of bone (fenestration, dehiscence).
ultrasound-assessed diaphragmatic dysfunction as a predictor of weaning outcome

Conditions: Weaning Failure; Sepsis

Summary: this study aims to assess whether the degree of diaphragm excursion and diaphragm thickening measured by ultrasound during a weaning trial may be used to predict successful weaning from mechanical ventilation in patients with sepsis in intensive care unit

after being informed about the study and giving written informed consent, intubated and mechanically ventilated patients with sepsis on admission and fulfilling criteria of weaning from mechanical ventilation (mv), will undergo diaphragm ultrasound during spontaneous breathing trial on t-piece. we will measure diaphragm excursion (de), diaphragm thickness (dt) and calculate diaphragm thickness fraction (dtf): dt during inspiration - dt during expiration / dt during expiration according to weaning outcome, patients will be divided into 2 groups: * successful weaning group * weaning failure group by statistical analysis we will define the cut off value and area under curve (auc) for de and dtf and we can confirm if de and dtf using ultrasound can be used as predictors for weaning from mv or not

Eligibility criteria:
inclusion criteria: * patients of both sexes, aging 18 - 60 years after written informed consent * patients with sepsis on admission according to the new sepsis definition in 2016 (life-threatening organ dysfunction due to a dysregulated host response to infection) * hemodynamically stable without or with low dose support * patients on mechanical ventilation for at least 48 hours and not more than 1 week * patients ready for start of weaning protocol, fully conscious, on continuous positive airway pressure (cpap) mode with positive end expiratory pressure (peep) 3-5 centimetre water (cmh2o), pr. supp. \ 200, rapid shallow breathing index (rsbi) is less than 105 exclusion criteria: * patients aged less than 18 years or more than 60 years old * patients in septic shock, hemodynamically unstable or on high dose support * patients on mechanical ventilation for more than 1 week or less than 48 hours * patients not ready for start of weaning from mechanical ventilation * patients with neuromuscular disorders * pregnant females in the second and third trimester, patients with tense ascites or morbidly obese with body mass index more than 40 kg/m2

Keywords: diaphragm ultrasound weaning predictor
interaction research on cognitive impairment and emotional disorder in end-stage renal disease

Conditions: End-stage Kidney Disease; Brain Damage

Summary: end stage renal disease (esrd) is the last stage (stage 5) of chronic kidney disease (ckd). abnormalities of cognitive function and high levels of depression or anxiety incidence are characteristic of hemodialysis patients. in this research project, the investigators subject in esrd patients starting hemodialysis as the carrier. based on the longitudinal research design, using multimodal neuroimaging data，combining with the interact relationship between changes of brain morphology, the dysfunction of resting-state and-task state with cognitive impairment and abnormal emotions.establish brain structure-function change model associated with dialysis progression, explore imaging markers of central and disease development characteristics in esrd patients. the investigators attempt to clarify the core mechanism of kidney-brain axis damage, thus provide evidence for early cognitive-behavioral therapy to ckd patient.


Eligibility criteria:
inclusion criteria: 1. age 18-50 years; 2. esrd patients who will start hemodialysis 3. high quality mri scan; 4. dextromanual exclusion criteria: 1. diabetes,brain tumor,brain trauma 2. neuropsychiatric disease

Keywords: cognitive impairment esrd functional mri
nmba reversal and postoperative urinary retention

Conditions: Neuromuscular Blocking Agents; Urinary Retention After Procedure; Urinary Retention Postoperative; Neuromuscular Blockade Reversal Agent; Neuromuscular Blockade; Costs; Atropine; Sugammadex; Glycopyrrolate; Neostigmine; Anesthesia

Summary: in this single-center retrospective cohort study of adult patients who underwent surgery under general anesthesia at beth israel deaconess medical center between september 2016 and january 2024, the association between the choice of neuromuscular blocking agent (nmba) reversal strategy, comparing sugammadex with neostigmine (combined with a muscarinic antagonist), and postoperative urinary retention (pour) will be evaluated. in secondary analyses, the effects of nmba reversal strategy and pour on costs of care and unplanned hospital visits will be analyzed.


Eligibility criteria:
inclusion criteria: * adult patients * non-urinary system surgery * general anesthesia * use of rocuronium or vecuronium for neuromuscular blockade * neuromuscular blockade reversal with sugammadex or neostigmine (with atropine and/or glycopyrrolate) * postoperative admission to the post-anesthesia care unit (pacu) exclusion criteria: * american society of anesthesiologists (asa) physical status ≥ v * emergency reversal with sugammadex (≥ 16 mg/kg of sugammadex) * presence of foley or suprapubic catheter before or after the procedure * prior history of bladder resection surgery * observations with missing data for pre-specified confounding variables

Keywords: neuromuscular blockade neuromuscular blocking agents sugammadex neuromuscular blockade reversal agent urinary retention postoperative urinary retention urinary retention after procedure costs neostigmine anesthesia atropine glycopyrrolate
roco - self-help for people with psychological distress due to the covid-19 situation

Conditions: Psychological Distress; Adjustment, Psychological; Coronavirus

Summary: as part of the roco project, the university of bern is investigating an online self-help program for people who are psychologically distressed due to the situation surrounding covid-19. the roco program offers support in overcoming this psychological distress. roco stands for a 3-week online self-help program comprising 6 modules. the aim of the study is to investigate the efficacy of an online self-help intervention for people with psychological distress due to the situation surrounding covid-19. all participants will be randomized to one of two groups: the first group receives direct access to the online self-help intervention and the second group is a waiting control group that receives access to the program 3 weeks later. in both conditions additional care or treatment is allowed. there are 4 assessments, which all take place online: baseline, post assessment (after 3 weeks) and two follow-up assessments (after 6 and 18 weeks). all participants from both groups are asked to fill out all assessments.


Eligibility criteria:
inclusion criteria: * be at least 18 years old * give a declaration of consent to participate in the study * have access to the internet * understand and master the german language to the degree that they understand the contents and instructions of the study * exceed a cut-off value of 4 points on the brief patient health questionnaire (phq-9; löwe, spitzer, zipfel, \& herzog, 2002) * be able to specify an emergency address in the event of an acute crisis exclusion criteria: * suicidal tendencies (sbq-r score ≥ 8) * existence of a known diagnosis of a psychotic or bipolar disorder