Kornimate/medical-research-clean huggingface dataset:
efficacy and safety of auricular acupuncture in treating insomnia post-stroke

Conditions: Insomnia, Secondary; Post-stroke Depression

Summary: the goal of this clinical trial is to learn if auricular acupuncture works to treat insomnia post-stroke patients. it will also learn about the safety of auricular. the main questions it aims to answer are: * does auricular acupuncture reduce the time it took participants to fall asleep? * dose auricular acupuncture increase the number of hours participants slept? * dose auricular acupuncture improve sleep quality as measured by the pittsburgh sleep quality index (psqi)? * what medical problems do participants have when taking auricular acupuncture? researchers will compare auricular acupuncture to a sham auricular acupuncture (a look-alike acupuncture needles that contains no needles) to see if auricular acupuncture works to treat insomnia post-stroke. participants will: * take auricular acupuncture or sham auricular acupuncture every 5 days for 4 weeks. * checkups and evaluate sleep onset time, sleep hours, and sleep quality every 5 days for 4 weeks. * keep a diary sleep of their symptoms and the number of times they use sleeping pills.


Eligibility criteria:
inclusion criteria: * patients aged 18 years or older, with a post-stroke period of 03 months or more, based on discharge papers or medical records. * patients who meet the diagnostic criteria for insomnia according to the dsm-v of the american psychiatric association for at least 3 months. exclusion criteria: * patients with insomnia before the stroke. * patients diagnosed with other sleep disorders such as sleep apnea syndrome, narcolepsy. * patients diagnosed with neurological diseases or psychiatric disorders such as: anxiety disorders, autism spectrum disorders, depression, obsessive-compulsive disorder, behavioral disorders affecting sleep before the stroke. * patients are using antidepressants, psychiatric drugs. * patients participating in other clinical trials with behavioral, psychological or complementary medical interventions during the study period. * patients not cooperating during data collection

Keywords: insomnia
effects of an acp programme for older people with early dementia

Conditions: Dementia, Mild

Summary: advance care planning (acp) has been widely advocated for persons with early stage dementia (pweds). this proposed study attempts to promote the uptake of acp for this population and their family caregivers in the community and to examine the effects of an acp programme "have a say" for this population. it is hypothesized that participants in the intervention group will be more engaged in acp and their dyadic concordance on end-of-life care preference with their family caregivers will be significantly higher than that in the control group.

this study aims to evaluate the effects of an advance care planning (acp) programme "have a say" for persons with early stage dementia (pweds) and their family caregivers in the community. a randomized controlled trial with repeated blinded outcome assessment will be conducted to assess the effects of an acp programme on dyads of pweds and their family caregivers recruited from elderly community centres. individuals who have a clinical diagnosis of any form of dementia at the early stage or have a global deterioration score (gds) 3 or 4 will be eligible to this study. participants in the experimental group will receive a 4-session acp programme. it includes an educational component, guided reflection and acp discussion through a series of group-based activity and dyadic discussion delivered by trained acp facilitator and guided by an acp booklet. dyads of participants will be provided with information about the trajectory of dementia, their future healthcare needs and caring options. their values and care preferences on future care will be elicited in a consistent manner. they will be supported to have an individualized acp discussion. individuals assigned to the control group will receive attention-control health talks. the primary study outcome is the acp engagement level of pweds. secondary outcome is the dyadic concordance on end-of-life care preference. adverse outcomes such as depression and caregivers' burden will also be evaluated. data collection will be conducted at baseline, immediately after, and one-month after the intervention.

Eligibility criteria:
inclusion criteria: * being chinese, * being a cantonese speaker, * having a formal diagnosis of any form of dementia at the early stage, or having a global deterioration scale score 3-4, * having a designated family caregiver in direct contact and willing to participate in this study. exclusion criteria: * non-communicable, * mentally incompetent, * received an acp intervention, * have previously signed an advance directive, * have other life-limiting chronic illnesses. a family caregiver involved in primary responsibility for caring and care-related decisions for the pwed will also be recruited. paid caregivers are to be excluded.

Keywords: advance care planning
effects of a machine learning-based lower limb exercise training system for knee pain

Conditions: Pain

Summary: the study will be a 12-week randomized controlled trial that aims to examine the effects of a machine learning-based lower limb exercise training system for older adults with knee pain. participants will be randomly allocated to either the machine learning-based lower limb exercise training system group (intervention arm), video-based exercise training system group (intervention arm), or usual care group (control arm). data will be collected at baseline, and at 4, 8, and 12 weeks after randomization.

knee pain, often caused by osteoarthritis, is a prevalent musculoskeletal disorder among older adults and significantly reduces physical function and quality of life. exercise therapy has been shown to be an effective form of treatment for knee pain. however, the traditional delivery of exercise therapy requires that individuals attend clinics to participate in face-to-face exercise sessions, which can be expensive and inconvenient. in recent years, information technologies have been used to support the delivery of exercise programs. the programs have also shown great benefits in improving the management of knee pain. however, it remains a concern that physical therapists are not able to provide the patients with direct and immediate supervision when exercises are taken place remotely at home or in community centers, which can be detrimental to exercise performance and the management of knee pain. thus, the research team has developed a machine learning-based exercise training system to provide evidence-based lower limb exercise videos, real-time movement feedback, and tracking of exercise progress for older adults with knee pain. in this study, a proof-of-concept randomized controlled trial will be conducted to examine the effects of the machine learning-based exercise training system, comparing with the effects of video-based exercise training system (providing exercise videos alone but no real-time movement feedback or tracking of exercise progress) and effects of usual care.

Eligibility criteria:
inclusion criteria: participants will be recruited if they * age ≥ 55 years, * have knee pain, stiffness, or both in one or both knees on most days for at least one month during the past 12 months, or have consulted healthcare professionals with their pain, stiffness, or both in one or both knees during the past 12 months, * are able to perform the exercises required in physical assessments and exercise training, * are able to speak and read chinese, * are able to provide written informed consent. exclusion criteria: individuals will be excluded if they have * inflammatory arthritis, * acute trauma, * malignancy, * history of knee replacement, * being on the waiting list for knee surgery, * physical therapy for knee problems during the past three months, * intra-articular injection to the knee within six months.

Keywords: knee pain, physical therapy, exercise
the role of endoscopic ultrasound in evaluation of patients with indefinite cause of bile duct dilatation

Conditions: Bile Duct Diseases

Summary: in the era of diagnostic imaging advances, bile duct dilatation becomes a common incidental finding in patients present with either gastrointestinal symptoms or undergone the imaging study for any other complaints. endoscopic ultrasound enables high resolution views of the biliary system, so it can help detection of different pathologies which cause bile duct dilatation and difficult to be detected by other imaging studies.

the normal diameter of the common bile duct (cbd) varies by age, imaging modality, prior cholecystectomy, and previous biliary obstruction, but 7 mm or more is considered widely accepted cutoff for biliary dilatation, and 10 mm or more among post-cholecystectomy patients. bdd with unclear etiology detected on trans abdominal ultrasound (tus), computed tomography (ct), or magnetic resonance cholangiopancreatography (mrcp). although, these imaging techniques have a good sensitivity and specificity in detecting biliary tract diseases, limitations are still present in the detection of intraductal small stones, ampullary lesions and small masses. as regard tus, overlying bowel gas and operator-dependence, often harshen an adequate visualization of the biliary duct to identify the etiology, and ct could miss tumors less than 2 cm in size, while the sensitivity of mrcp decreases in stones 3 mm or less in size. endoscopic ultrasound (eus) enables high resolution views of the biliary tree as it joins the pancreatic duct and duodenum, so it helps detection of biliary pathologies difficult to be diagnosed by external radiograph. in addition, eus is less invasive than the competitive endoscopic retrograde cholangiopancreatography (ercp) as a diagnostic modality and it avoids the patients the post-ercp pancreatitis which is a very common complication, as well as providing a unique opportunity of tissue sampling and staging of any detected malignant lesions. previously, eus has proven it's high ability to the detect the stones in the extrahepatic ducts with a sensitivity as high as of 94% and specificity of 95%. besides, it's well performance in the evaluation of biliary strictures with a sensitivity 80%, and a specificity of 97% in detecting malignant biliary strictures. when it comes to ampullary and pancreatic lesions, direct endoscopic visualization with a side-viewing endoscope can effectively evaluate the periampullary area and detect ampullary mass and diverticulum, as well examine the pancreas for chronic pancreatitis, masses, and cysts.

Eligibility criteria:
inclusion criteria: 1. prior inconclusive imaging studies of bile duct dilation. 2. common bile duct diameter of \>10 mm with prior cholecystectomy or \>7 mm without exclusion criteria: definite cause of obstruction stone, stricture, or mass on imaging studies (tus, ct, mrcp or ercp). -
easy: extended access to sollpura over years

Conditions: Exocrine Pancreatic Insufficiency; Cystic Fibrosis

Summary: liprotamase consists of 3 soluble, non-porcine digestive enzymes, lipase, protease, and amylase, combined in a fixed ratio. liprotamase is stable in the stomach and can be formulated without enteric coating for administration either as a capsule or as a dosing solution dissolved in water or juice.

the purpose of the present study is to evaluate the safety of long-term use of liprotamase in the management of cystic fibrosis-related exocrine pancreatic insufficiency

Eligibility criteria:
inclusion criteria: * male or female subjects with cystic fibrosis-related exocrine pancreatic insufficiency who received liprotamase and completed study an-epi3331 (solution: study of oral liprotamase unit-matched therapy of non-porcine origin in patients with cystic fibrosis) exclusion criteria: * any medical, psychological, or social condition that may put the subject at increased risk by participating in this study. * females who are nursing, pregnant, intending to become pregnant, or intending to nurse during the time of the study.

Keywords: exocrine pancreatic insufficiency cystic fibrosis pancreatic enzyme replacement therapy
intravenous access using infrared laser

Conditions: Obesity, Morbid; Obstetric Anesthesia Problems

Summary: peripheral venous access is a prerequisite for anesthesiological for surgical patients.it is often difficult to establish and potentially painful in obese patients (body mass index \> 35). av300 uses near infrared laser light to improve visibility of peripheral veins and could help cannulating them. the aim of this study was to examine if use of accuvein(®) av300 vein viewer could facilitate venous cannulation in obese patients (surgical and obstetric).


Eligibility criteria:
inclusion criteria * \> 18 years * surgery that need double intravenous perfusion exclusion criteria: * \< 18 years * body mass index\< 35 * refusal * minor surgery that need only one intravenous access
intravaginal treatment of disturbances of vaginal flora among hiv infected and uninfected women in malawi

Conditions: Bacterial Vaginosis; Trichomonas Vaginitis; Urogenital Diseases

Summary: the purpose of this intervention is to find out whether intravaginal treatment with a gel containing an antibiotic (metronidazole), compared to a similar placebo gel (without antibiotic), can reduce the frequency of bacterial vaginosis, a common vaginal infection among african women who are hiv uninfected or hiv infected. the study will also determine the effect of these vaginal gels on genitourinary symptoms.

this is a phase 3, randomized, double masked, two arms study conducted in malawi, southeast africa. the study is conducted among nonpregnant hiv infected or uninfected women of reproductive age. intermittent mass treatment approaches are followed where women are randomized to antibiotic intravaginal treatment or placebo at enrollment. women receive assigned product every three months for one year.

Eligibility criteria:
inclusion criteria: nonpregnant hiv-uninfected hiv-infected exclusion criteria: pregnant

Keywords: genitourinary symptoms
effectiveness of activity oriented therapy and traditional therapy in cervical discopathic pain syndrome

Conditions: Neck Pain Chronic; Depression Disorders; Forward Head Posture; Anxiety Disorders

Summary: title: effectiveness of activity oriented therapy and traditional therapy in cervical discopathic pain syndrome procedures: you will be asked to complete a form containing questions characterizing the study group and several questionnaires before starting treatment, such as: ndi, cesd-r, stai and the nrs scale. a photo of the head and shoulder area will also be taken in a front and side standing position. after completing the two-week treatment, you will be asked again to complete questionnaires and pose for photos. you will be informed about a follow-up visit 3 months after the end of therapy, during which you will be asked for the last time to complete questionnaires and pose for a photo. benefits: there are no direct benefits to you other than participating in a therapy more commonly used for cervical pain syndromes and the opportunity to discuss your experience with neck pain with a specialist. the information we obtain will help scientists better understand the problem of treating neck pain. risk: there are no physical risks to you while conducting this research. all information obtained from you will be anonymous. your name and image will not be used in this study or reports. confidentiality: all research records will be confidential and appropriately secured. records will only be published with your consent or by court order or as required by law. any publication resulting from this research will not use identifying information, such as your name or likeness. freedom to opt out: participation in the study is completely voluntary and free of charge. you may withdraw from this study at any time without any consequences.

the purpose of the study was to evaluate the effectiveness of the activity oriented therapy (n.a.p. therapy) and traditional therapy during disc-related neck pain in terms of pain intensity, disability, forward head posture (fhp), anxiety as a condition and level of depression. patients were qualified based on a medical examination. respondents were randomly divided into two groups. the therapies were performed by experienced physiotherapists in cooperation with a psychologist. treatment in both groups included 10 therapy sessions held daily from monday to friday over a two-week period.

Eligibility criteria:
inclusion criteria: * qualifying: non-traumatic, disc-like, chronic (symptoms lasting more than 3 months) cervical pain of mechanical origin, localized in the cervical region with the possibility of radiation to the upper edge of the scapula and head (without root symptoms and neurological disorders), classified as syndrome no. 1 according to the quebec task force (qtf) classification, and a condition not requiring surgery. exclusion criteria: * comorbid advanced neurological, rheumatic, urological, psychiatric diseases, and unsystematic participation in in therapy.

Keywords: n.a.p. therapy, breathing exercises, neuroplasticity, forward head posture, chronic neck pain, psychosomatic diseases.
multi-parametric imaging in personalized radiotherapy

Conditions: Skull Base Chordoma

Summary: the study consists in the retrospective and prospective collection of imaging data (along with clinical information related to treatment) of skull-base chordoma patients treated with particle therapy, to derive imaging biomarkers which, integrated with advanced mathematical models, will allow predicting treatment outcome on a multi-scale basis.

the study design consists of the retrospective collection of routinely-acquired data (ct, mri and dose maps, along with relevant clinical information) and the prospective acquisition of optimized non-invasive mr imaging data, of skull-based chordoma patients treated with particle therapy (pt) at the national center for oncological hadrontherapy (cnao, pavia, italy). this data will be stored in a proper repository under cnao's control, shared with politecnico di milano through encrypted channels, and it will be used to implement mathematical models able to predict treatment outcome at different scales (macroscopic, microscopic and radiobiological).

Eligibility criteria:
inclusion criteria: * patients with histologically confirmed diagnosis of chordoma of the skull base * particle therapy with curative intent * karnofsky performance status greater than or equal to 60 * patients with macroscopic disease detectable at pre-radiotherapy imaging * patients undergoing pt with standardized treatment procedures * patients who have signed the written informed consent for research exclusion criteria: * metastatic disease * palliative treatment * other malignancies with disease-free interval \< 5 years (excepting pre- cancerous lesions) * pregnancy * simultaneous cht or immunotherapy * extensive metal instrumentation/implants * patients with autoimmune diseases (ads) -including collagen-vascular (cvd) and inflammatory bowel (ibd)
ultrasound in assessing antiangiogenic treatment in patients with advanced kidney cancer

Conditions: Kidney Cancer; Metastatic Cancer

Summary: rationale: diagnostic procedures, such as contrast-enhanced ultrasound, may help measure a patient's response to treatment with drugs such as sunitinib malate, sorafenib tosylate, or bevacizumab, and allow doctors to plan better treatment. purpose: this clinical trial is studying ultrasonography in assessing antiangiogenic treatment in patients with advanced kidney cancer.

objectives: primary * to determine if contrast-enhanced ultrasonography (ceus) study of target metastasis from renal cancer leads to early assessment of pharmacodynamic effects of antiangiogenic treatment in patients with advanced renal cancer. secondary * to determine the association between functional changes of microvascularization and the target lesion by ceus and the early objective response for this lesion indicated by the time to progression. * to determine the association between functional changes of microvascularization and the target lesion by ceus and the early objective response for this lesion indicated by the global survey. * to determine the tolerance to antiangiogenic treatments in these patients. * to determine the relationship between functional changes of microvascularization and the target lesion and the objective response for the other lesions (recist criteria) in cases of other metastasis other than the target lesion. outline: patients undergo contrast-enhanced ultrasonography (ceus) before and after stabilized sulphur hexafluoride microbubble-based contrast agent injection. ceus is done within 8 days prior to, 30 days after the first administration, and after 3 months of receiving antiangiogenesis treatment (e.g., sunitinib malate, sorafenib tosylate, or bevacizumab). patients also undergo computed tomography and magnetic resonance imaging to evaluate tumoral targets. after completion of study treatment, patients are followed up for 2 years.

Eligibility criteria:
disease characteristics: * diagnosis of advanced renal cancer * planning to receive antiangiogenic treatment * detection of a target hepatic metastasis that is visible, located, and sized with conventional sonography and ct scan and/or mri patient characteristics: * no active cardiac disease * no severe arterial hypertension prior concurrent therapy: * see disease characteristics

Keywords: recurrent renal cell cancer stage iv renal cell cancer liver metastases
effect of vitamin d3 and omega-3fa on estradiol

Conditions: Vitamin D Deficiency

Summary: the effect of vitamin d3 and omega-3 fatty acids on estradiol levels.

the data about effect of vitamin d3 (vd3) and omega-3 fatty acids (omega-3fa) on serum levels of estradiol (e2) are scarce and conflicting and nothing is published in the literature about the effect of the combination of vd3 and omega-3fa on the e2 levels. this study was conducted to investigate effect of vd3 and omega-3fa alone and with each other on serum e2 levels in premenopausal females with vitamin d deficiency (vdd). this randomized, placebo-controlled clinical trial was designed to test effects of 50,000 iu vd3 weekly and 300 mg omega-3fa daily for eight weeks, separately and with each other, on the mid-follicular serum levels of e2 and 25-hydroxy vitamin d (25ohd). this study was conducted during winter in 86 healthy premenopausal jordanian females with vdd with a mean age of (32.8 ± 8.9) years. fasting serum levels for 25ohd, e2, pth (parathyroid hormon), calcium, phosphate, alt (alanine aminotransferase), and urea were assessed at baseline and the end of the trial.

Eligibility criteria:
inclusion criteria: * premenopausal females * medical diagnosis of vitamin d deficiency (vd \< 30 ng / ml) exclusion criteria: * women previously diagnosed with any chronic disease such as kidney diseases were excluded from the study due to the effect of prolonged administration of vd3 on kidney stones formation. women who are pregnant, breastfeeding or using hormonal contraceptives were also excluded.

Keywords: vitamin d3 vitamin d deficiency estradiol omega-3 fatty acids menopausal