cyrilzakka/clinical-trials huggingface dataset:
The Impact on Survival of Neo-adjuvant Transarterial Chemoinfusion (TAI) for Patients With Hepatocellular Carcinoma And Portal Vein Tumor Thrombosis (PVTT) Who Underwent Hepatectomy : A Random, Controlled, Stage III Clinical Trial.

To compare the impact on survival of neo-adjuvant TAI for patients with HCC and PVTT who underwent hepatectomy.


Eligibility Criteria:
Inclusion Criteria:

* older than 18 years old and younger than 75 years;
* ECOG PS≤1;
* proven hepatocellular carcinoma according patological examination or EASL/AASLD diagnostic criteria;
* not previous treated for tumor;
* estimated tumor and tumor thrombosis could be removed en bloc in operation;
* no distant metastasis;
* the lab test could meet: neutrophil count≥2.0×109/L; hemoglobin≥100g/L; platelet count≥75×109/L; serum albumin≥35g/L; total bilirubin\<2-times upper limit of normal; ALT\<3-times upper limit of normal; AST\<3-times upper limit of normal; serum creatine\<1.5-times upper limit of normal; PT≤upper limit of normal plus 4 seconds; INR≤2.2;
* sign up consent;

Exclusion Criteria:

* cannot tolerate TAI or surgery;
* distant metastasis exits;
* known history of other malignancy;
* be allergic to related drugs;
* underwent organ transplantation before;
* be treated before (interferon included);
* known history of HIV infection;
* known history of drug or alcohol abuse;
* have GI hemorrhage or cardiac/brain vascular events within 30 days;
* pregnancy;
Effectiveness of Flipped Learning on Nurses' Knowledge, Attitude, and Self-efficacy in Pressure Injury Prevention

The occurrence of pressure injuries mainly comes from disabled patients who are bedridden for a long time. According to a report from the Ministry of Health and Welfare, about one-tenth of chronic patients need to be bedridden for a long time, and pressure injuries account for the most in the comorbidities of bedridden for a long time. The main cause of pressure injury is the natural aging of the patient's body and long-term bed rest so that it is difficult to detect physical stress and cannot change the posture within an effective time to reduce the pressure, which is prone to pressure injury. The prevalence rates of stress injuries in various countries are 13-23% in the Netherlands, 10-15% in the United States, and 8-23% in Europe. In addition, studies have also shown that the prevalence of stress injuries in the elderly in the UK is 0.31-0.70%. The incidence rate is 0.18-3.36% and these two indicators are increasing year by year; in Taiwan, related surveys show that the prevalence rate of pressure injury in hospitalized patients is 7.53%, and the incidence rate of pressure injury in bedridden patients is 36.8%. According to a National Pressure Ulcer Advisory Panel (NPUAP) survey, the prevalence rate of stress injuries in acute wards ranges from 0.1% to 17%, and the incidence rate is 0.4% to 38%. The prevalence of intensive care units The prevalence rate is higher than 41%, the incidence rate is higher than 33%, the prevalence rate of long-term care is 2.3% -28%, the prevalence rate is 2.2%-23.9%, the prevalence rate of nursing homes is 0% -29%, and the prevalence rate is 0%- 17%. In addition, NPUAP estimates in 1989 show that the average medical cost for each stress injury case ranges from 2,000 to 30,000 US dollars, while the medical cost for each stress injury patient in Taiwan is about NT 7,000 to 80,000. If the knowledge of stress injury prevention can be improved, the number of outpatient visits will be reduced, and the occurrence of stress injury will also be reduced. In summary, under the trend of aging development, stress injury management and care are important issues of medical quality.

The purpose of this research is to integrate the past education that affects nursing staff to receive care for stress injuries and to explore the intervention of different education measures, including conventional education methods and digital flipped education methods, to measure nursing staff Effectiveness in learning about the knowledge, attitude, self-awareness and self-efficacy of pressure injury management.

Eligibility Criteria:
Inclusion Criteria:

1. Full-time or part-time nursing staff registered in the research site and engaged in front-line clinical care or nursing-related administrative services;
2. Those who agree to participate in the research and provide informed consent.

Exclusion Criteria:

Nursing student
Biobank of Lung Ultrasonography in Children Undergoing General Anesthesia

For children aged 6 months to 10 years old under general anesthesia, intraoperative lung ultrasound pictures are acquired, grades are evaluated for each pictures and machine learning is used to learn and apply it.

1. routine general anesthesia is performed in the selected children.
2. After mechanical ventilation, the degree of lung atelectasis is evaluated using transthoracic lung ultrasonography in the anterior, lateral, posterior regions of the upper and lower points of both lungs(a total of 12 regions).
3. Atelectasis is checked by the presence of B-line and juxta pleural consolidation.
4. Machine learning is used to educate the photos of 70 people and grading system, and process is checked whether it applies well to the photos of the remaining 30 people.

Eligibility Criteria:
Inclusion Criteria:

1. children aged 6 months to 10 years old under general anesthesia
2. ASA I-III

Exclusion Criteria:

1. If the parents of the patient cannot communicate in Korean
2. If mechanical ventilation is not planned (for example, A1 pulley)
3. emergency operation
4. a child whose ultrasound image quality is expected to deteriorate due to diseases such as thoracic deformity, scoliosis, or rib fractures
5. If lateral position was not available
Pharmacogenomics of New Antiretrovirals

Some genetic polymorphisms are known to interfere with ARV metabolism and are therefore likely to explain some of the inter-individual variations (efficacy,toxicity,resistance) observed during ART. The most common form of human DNA variations consists of a change of a base in the nucleotide sequence of an individual at a given position, the single nucleotide polymorphism (SNP). Therefore,the purpose of this research will be the identification and characterization of the clinical impact of several SNPs in gene coding for transport proteins (e.g.ABCB1,ABCC1) and biotransformation enzymes (e.g.CYP3A4,CYP2B6) known to be involved in the pharmacokinetic pathway of selected ARV drugs for which the therapeutic response is difficult to predict. Aside,the influence of these SNPs on the response to treatment (CD4+cell,viral load) and on the toxicity will be evaluated. Plasma concentrations of ARV drugs correlate with therapeutic efficacy but also with the risk of toxicity and of virological failure, which is the basis of the therapeutic drug monitoring. However,given the intracellular location of HIV, analyzing intracellular drug concentrations is fundamental and the investigators will also focus of this new topic.

Some genetic polymorphisms are known to interfere with ARV metabolism and are therefore likely to explain some of the inter-individual variations (efficacy,toxicity,resistance) observed during ART. The most common form of human DNA variations consists of a change of a base in the nucleotide sequence of an individual at a given position, the single nucleotide polymorphism (SNP). Therefore,the purpose of this research will be the identification and characterization of the clinical impact of several SNPs in gene coding for transport proteins (e.g.ABCB1,ABCC1) and biotransformation enzymes (e.g.CYP3A4,CYP2B6) known to be involved in the pharmacokinetic pathway of selected ARV drugs for which the therapeutic response is difficult to predict. Considering that CYP3A5 may represent up to 50% of the total hepatic CYP3A content in CYP3A5\*1 allele carriers, the CYP3A5 genetic polymorphism may be therefore the most important genetic contributor not only to interindividual but also to interracial differences in CYP3A-dependent drug clearance.

Aside,the influence of these SNPs on the response to treatment (CD4+cell,viral load) and on the toxicity will be evaluated.

Plasma concentrations of ARV drugs correlate with therapeutic efficacy but also with the risk of toxicity and of virological failure, which is the basis of the therapeutic drug monitoring. However,given the intracellular location of HIV, analyzing intracellular drug concentrations is fundamental and the investigators will also focus of this new topic.

Eligibility Criteria:
Inclusion Criteria:

* HIV-1 positive treated with drug of interest

Exclusion Criteria:

* \<18 years old
Predictors for Nasal Intermittent Positive Pressure Ventilation Failure for Premature Infants With Respiratory Distress Syndrome

Non-invasive respiratory support methods have been widely used in premature babies with respiratory distress syndrome (RDS) which has changed the basic management of premature babies in the early period. According to the 2019 European Guidelines on RDS management, early nasal CPAP is recommended as first-line therapy in infants \<30 weeks of age who are at risk of RDS who do not require mechanical ventilation (MV). However, some of the premature babies have faced non-invasive ventilation failure. Remarkably, infants who experience non-invasive ventilation failure are at increased risk of death, pneumothorax, intraventricular hemorrhage, and bronchopulmonary dysplasia (BPD), among other morbidities. In non-invasive ventilation failure, although demographic factors such as small gestational age, low birth weight, and male gender play a role, it has been suggested that surfactant deficiency may also play an important role. The most frequently reported risk factor in predicting non-invasive failure in studies is the fraction of inspiring oxygen during the first hours of life. In addition, positive end-expiratory airway pressure (PEEP) required for patient stabilization was found to be a potential predictor. However, there are still limited data to predict non-invasive ventilation failure. "Which newborns are at high risk for non-invasive ventilation failure?" and "When should the surfactant be applied?". The study is a single-center, prospective study to evaluate prognostic factors, and most importantly to define the FiO2 threshold, which is an indicator of possible non-invasive ventilation failure in infants supported with nasal intermittent positive pressure ventilation.


Eligibility Criteria:
Inclusion Criteria:

* \<32 weeks preterm babies
* Those who have received nasal intermittent positive pressure ventilation

Exclusion Criteria:

* Babies born\> 32 weeks
* Babies with congenital anomalies
* Babies who have intubated in the delivery room
* Babies whose parents refuse to participitate
The Impact of Platelet Functions on Spontaneous Ductal Closure in Preterm Infants

Although thrombocytopenia has been reported as a risk factor for patent ductus arterioses, there is lack of data on the function of platelets in ductal closure. Information on functions of platelets in ductal closure may change the known model for ductus arterioses and may affect the treatment modalities.

Patent ductus arterioses is a common problem which involves both pulmonary and cardiac outcomes in preterm infants. Although thrombocytopenia has been reported as a risk factor for patent ductus arterioses, there is lack of data on the function of platelets in ductal closure.

The investigators aim to investigate the relation between thrombocytopenia and platelet functions in pathogenesis of spontaneous ductal closure. The investigators hypothesize that Information on functions of platelets in ductal closure may change the known model for ductus arterioses and may affect the treatment modalities.

Eligibility Criteria:
Inclusion Criteria:

* gestational age lower than 30 weeks and birth weight lower than 1500 g
* obtained informed consent

Exclusion Criteria:

* any received medical treatment in first 2 days of life
* death in first 2 days
* patients who received any thrombocyte or fresh frozen plasma suspensions
* any known genetic thrombocyte disorder in the family
Non-invasive Optical Detection of Iron Deficiency

This study aims to evaluate a prototype device detecting zinc protoporphyrin-IX fluorescence non-invasively from the intact oral mucosa. Zinc protoporphyrin-IX is an established indicator of iron deficiency. The prototype device is used to measure the erythrocyte zinc protoporphyrin-IX/heme ratio for women after delivery, a study group chosen because of an elevated risk of iron deficiency. The results from the non-invasive measurements are compared to reference measurements of the erythrocyte zinc protoporphyrin-IX/heme ratio from residual blood samples from the same patients and to other indicators of iron status, including hemoglobin, ferritin, serum iron, transferrin, transferrin saturation and soluble transferrin receptor.

Funding Source - Nestec Ltd.

This trial is a proof-of-concept study using a prototype fiber optic fluorometer to acquire autofluorescence spectra from women after delivery and determine the erythrocyte zinc protoporphyrin-IX fluorescence intensity from these spectra. The non-invasively determined fluorescence spectra are evaluated to provide a quantitative measure of the erythrocyte zinc protoporphyrin-IX/heme concentration ratio. These values are primarily compared to an erythrocyte zinc protoporphyrin-IX determined by HPLC from residual blood samples from the same subjects and secondarily to erythrocyte zinc protoporphyrin-IX/heme ratios determined using a commercial hematofluorometer (AVIV, model 206d) and other indicators of iron status, including hemoglobin, ferritin, serum iron, transferrin, transferrin saturation and soluble transferrin receptor

This study could help to establish the non-invasive fluorescence measurement of zinc protoporphyrin-IX as a rapid, easy to use means for point-of-care screening for iron deficiency in resource-limited settings lacking laboratory infrastructure.

Eligibility Criteria:
Inclusion Criteria:

* Women after delivery of term infants
* Pregnancy and delivery without study-relevant complications
* Hb value pre-partum greater or equal 12 g/dL or less or equal 11 g/dL
* Regular blood withdrawal before and after delivery for clinical indications
* Informed consent to participation in the study
* Age 18 or older

Exclusion Criteria:

* Patients who are not legally competent
* Transfusion of blood products in the course of delivery
* Thalassemia and sickle cell anemia
* Any acute or chronic infectious or inflammatory disease
* Insufficient amount of residual blood in the clinically indicated post partum sample
Premolar Autotransplantation in Juvenile Dentition: Quantitative Assessment of Vertical Bone and Soft Tissue Growth

Objective:

Premolar autotransplantation represents an effective therapeutic option for the treatment of juvenile dentition in traumatic dental injury with tooth loss. Numerous studies report on the osteoinductive potency of the method, however, to date no quantitative data has been provided. The objective of this prospective clinical study was to quantitatively assess the bone and soft tissue levels after autogenous premolar transplantation by clinical and radiographic parameters.

Materials/Methods:

In the study 26 premolars were transplanted in 20 patients after traumatic dental injury (n=10) or tooth aplasia (n=16) in the upper front. Standard clinical parameters were evaluated. Based on a standardized photo documentation, the relative soft tissue level was measured in comparison to the healthy adjacent teeth. Radiographic findings involved the evaluation of root resorption, pulp canal obliterations and the relative bone height. Patient satisfaction was determined using a standardized questionnaire.


Eligibility Criteria:
Inclusion Criteria:

* premolar transplantation after tooth loss in the anterior maxilla (13-23) by aplasia or trauma
Antioxidation Medication for Noise-induced Hearing Loss

This study will examine whether oral intake of 1200mg N-Acetylcysteine/day will prevent temporary threshold shift in hearing among workers exposed to noise

Both genetic and environmental factors contribute to noise-induced hearing loss (NIHL). The cellular antioxidant system appears to protect cochlear hair cells from oxidative stress due to noise. Previous animal studies showed protective effects of anti-oxidant medicines against NIHL.The objective of this study is to test the hypothesis that preventive medication of antioxidation is related to susceptibility to NIHL.

The 53 noise-exposed workers from steel industries in Taiwan will be recruited, and divided into N-Acetylcysteine (NAC)(Acetine, 1200mg/day) group and placebo one. The duration of medication is 2 weeks initially. After washout for 2 weeks, the kinds of medications in these 2 groups will be crossover and used for 2 weeks. Firstly, questionnaires interview about noise exposure, smoking, alcohol drinking, drug habit history and calculation of Body Mass Index (BMI) will be done. The following methods would be performed individually after medication. With detailed local examination with otoscope, these subjects receive hearing tests by pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) before and after their daily works. The possible confounding factors including background noise, solvent, heavy metals, carbon monoxide and temperature in the workplaces will be assessed. The amount of noise exposure is evaluated by personal dosimeter. Early morning, Blood samples will be collected. Deletion polymorphisms in the Glutathione S-transferase (GST)T1 and GSTM1 genes will be determined. Statistical analysis will be performed to evaluate the relation between intake of anti-oxidant medicine and noise-induced temporal threshold shift (TTS).

The expected results of this study are to determine whether anti-oxidant supplements protect workers from noise-induced TTS.

We anticipate that these human studies might help elucidate the relative importance of anti-oxidant enzymes as risk factors for NIHL.

Eligibility Criteria:
Inclusion Criteria:

* workers in steel industry
* known exposure to noise at work

Exclusion Criteria:

* ever diagnosed as having diabetes mellitus
* fasting glucose of 120 or greater
MRI for the Diagnosis of Placenta Accreta Spectrum

Placenta Accreta Spectrum (PAS) is a disease associated with abnormal placental adhesion and invasion. In recent years, the incidence of PAS has increased significantly, which can cause massive postpartum hemorrhage, hysterectomy,and even maternal mortality. The research team of Peking university third hospital developed the ultrasound rating scale in china at first to conduct preliminary assessment of the PAS risk which can identify the severity of cases. In a basis of ultrasound, plan to explore the MRI for the the investigators diagnosis of PAS according to some specific PAS features, like the the uneven signal intensity , the myometrial discontinuity, and black band on T2 image, and finally established a MRI scoring system of PAS. MRI score system of PAS can reduce the subjective difference of the clinician's visual reading, and assist the clinician to assess the risk of sever PAS further, and conduct perioperative preparation to reduce the risk of maternal morbidity and mortality to achieve a better clinical outcome.

Placenta Accreta Spectrum (PAS) is a disease associated with abnormal placental adhesion and invasion. In recent years, the incidence of PAS has increased significantly, and the main risk is high hysterectomy rate,massive postpartum hemorrhage, and even maternal mortality in women at childbearing age. The research team of Peking university third hospital developed the ultrasound rating scale in china at first to conduct preliminary assessment of the PAS risk which can identify the severity of cases and guide the junior hospitals to transfer. Peking University third hospital is in the leading position in the preoperative diagnosis of PAS currently.

Magnetic resonance imaging (MRI) has become a common method for preoperative evaluation for sever cases. MRI can provide a map of the placenta and PAS features, like the uterus enlarged significantly, the uneven signal intensity , the myometrial discontinuity, and black band on T2 image. It has a high diagnostic value. At present, only Lim and Ueno reported MRI scoring system for PAS. Due to the small sample size and the limitation of the research methods, a widely applicable rating scale has not been established. MRI score system of PAS can reduce the subjective difference of the clinician's visual reading, and assist the clinician to assess the risk of sever PAS further, and conduct perioperative preparation to reduce the risk of maternal morbidity and mortality and achieve a better clinical outcome.

Eligibility Criteria:
Inclusion Criteria:

1. Patients diagnosed as scarred uterus(with a history of cesarean section)
2. "ultrasound score" of PAS≥ 6 points who undergo MRI
3. Terminate pregnancy or childbirth in Peking university third hospital. -

Exclusion Criteria:

1. Patients who didn't undergo MRI
2. Patients who didn't deliver the baby in PUTH -
Office, Home, and Ambulatory Blood Pressure

This will be a prospective observational study. The population would be pediatric patients 6 years to \<19 years of age who were referred for elevated blood pressure to investigate if home blood pressure (HBP) can determine blood pressure phenotype (normotensive, hypertensive, masked hypertension, white coat hypertension) as accurately as ambulatory blood pressure monitor (ABPM) in childhood and adolescence.


Eligibility Criteria:
Inclusion Criteria:

1. Age 6 years to \<19 years old;
2. Elevated blood pressure defined as 15% lower than the 95%ile BP based on clinical practice guidelines(CPG) but less than stage II hypertension based on CPG;
3. Tolerate ABPM 24 hours;
4. Tolerate HBP; and
5. Can have diabetes mellitus, obstructive sleep apnea, and attention deficit hyperactivity disorder managed by medication.
6. On stable doses of medications known to affect BP such as:

   1. Corticosteroids
   2. Calcineurin inhibitors
   3. Oral decongestants;
7. Clinically stable

Exclusion Criteria:

1. On antihypertension medications or treated in the last 6 months;
2. Pregnant;
3. Structural heart disease such as:

   1. Obstructive valvular disease
   2. Coarctation of the aorta
   3. Cardiomyopathy;
4. Other secondary causes such as:

   1. Renal artery stenosis
   2. Neurological condition with dysautonomia;
5. Recent initiation of medications known to affect BP such as:

   1. Corticosteroids
   2. Calcineurin inhibitors
   3. Oral decongestants;
Misoprostol Before and After Cesarean Section

comparison of the effect of misoprostol before and after cesarean on the blood loss

70 women who received 600 mg misoprostol rectally preoperatively versus 70 women who received 600 mg misoprostol postoperatively at operating theatre

Eligibility Criteria:
Inclusion Criteria:

* Women not in active labor have reactive non-stress test.
* No contraindications to prostaglandins.
* Have no history of coagulopathy.

Exclusion Criteria:

* Placenta previa.
* Maternal hypertension.
* Diabetes mellitus.
* Previous CS and those with active labor.
* Multiple Fibroid uterus.
* Multiple pregnancies or polyhydramnios.
* Previous myomectomy, previous history of PPH.