Kornimate/medical-research-clean huggingface dataset:
preventing the progression of multiple sclerosis: early rehabilitative treatment and multimodal assessment - part a

Conditions: Multiple Sclerosis

Summary: motor performance of people with multiple sclerosis (pwms) can decline since the onset of the disease. longitudinal studies are needed to detect early worsening in mobility and balance using wearable devices for activity tracking and neurophysiological techniques for investigating brain functional adaptation. similarly, neurophysiological assessment can provide evidences on the integrity of brain motor networks and mechanisms underlying cortical plasticity in the early disease phase, potentially providing a set of reliable prognostic factors of disease progression in early diagnosed pwms. furthermore, disease progression might be delayed using physical activity, which is effective in pwms with moderate disability to ameliorate mobility and promoting brain reorganization and seems promising also for pwms in the early stages of the disease. functional near-infrared spectroscopy (fnirs) measures blood flow which accompanies neuronal activity, thus, it can provide spatial information about changes in cortical activation patterns and it could represent a useful tool for studying the effect of exercise on cortical plasticity. the aims of the study in non-disabled pwms are: 1) a) to assess the presence of subclinical balance and walking impairments using wearable devices and multimodal gait analysis and b) to investigate cortical activity during exercise, 2) to define prognostic factors associated to disease progression and 3) to study the efficacy of physical activity in preventing the worsening of mobility and stimulating brain functional adaptation.


Eligibility criteria:
inclusion criteria: * age \> 17 years * stable disease course (without worsening over 1 point at the edss in the last 3 months) * expanded disability status scale (edss) \<2.5 exclusion criteria: * major depression * mini-mental state examination \< 27 * other cardiovascular or orthopedic diseases that interfere with physical exercise * undefined or not confirmed diagnosis of ms (polman criteria) * progressive course of the disease

Keywords: early phase non-disabled
prevalence of tooth wear and its association with oral health-related quality of life

Conditions: Tooth Wear; Attrition; Erosion

Summary: the aim of this study is to detect the prevalence of tooth wear (all forms of cumulative surface loss of mineralized tooth substance loss due to physical and chemico-mechanical process according to the definition of the european organization for caries research (orca) and the international cariology research group for dental research (iadr) i.e.: attrition, erosion and abrasion) among middle aged adult patients attending educational hospital at the faculty of dentistry, cairo university and to analyze the distribution of lesions by gender and age, frequency of acidic foods and drinks consumption, medicine usage, chewing habits, systemic diseases, tooth brushing habits, and family socio economic status. moreover, to evaluate the quality of life among middle aged elderly patients in relation to existence of tooth wear. the study focuses on middle-aged adult patients (31-45 years) attending the faculty of dentistry at cairo university during 2025-2026. it is an analytical cross-sectional study aimed at assessing the prevalence and risk level of tooth wear using the basic erosive wear examination index (bewe). the bewe categorizes tooth wear into four levels (0 = no wear, 3 = severe wear), and risk levels are determined by the cumulative score. primary outcome: the prevalence of tooth wear and associated risk levels. secondary outcomes: identifying predictive risk factors and assessing the oral health impact profile (ohip) for patients diagnosed with tooth wear. all participants will be examined, and those with a bewe score above 0 will be considered affected. risk levels will be stratified as no risk, low, medium, or high.


Eligibility criteria:
inclusion criteria: * 1- patients whose age between 31 to 45 years old. 2- egyptian 3- males \& females 4- provide informed consent 5- ability to comprehend asked questions exclusion criteria: * 1- patients under or over the selected age group 2- patients using fixed orthodontic appliances, 3- patients with special needs

Keywords: tooth wear attrition bewe basic erosive wear examination quality of life
trial of precision medicine in emergency departments

Conditions: Pharmacogenomic Drug Interaction

Summary: the objectives of this study are to (1) test the feasibility of the clinical implementation of preemptive pharmacogenetic (pgx) testing in the emergency department (ed) and (2) determine if pgx testing (with appropriate decision support) decreases ed return visits and hospitalizations. we will conduct a randomized, controlled, pragmatic clinical trial assessing both the real-world effectiveness as well as implementation outcomes using a targeted pgx testing panel in several uf health eds.


Eligibility criteria:
inclusion criteria: 1. adults 40 years or older presenting to a participating ed 2. receipt of a new order/prescription for a selected pgx medication (appendix 1), with a duration greater than 7 days, during the current ed visit or within 30 days prior. 3. documentation of at least 2 prior ed or urgent care visits within the past 12 months exclusion criteria: 1. prior clinical pharmacogenetic test results within the ehr for genes relevant for this study (appendix 1). 2. history of hepatic or renal transplant 3. history of severe liver disease (stage child-pugh c) or renal disease egfr \<15 ml/min. 4. any medical condition that would prohibit the ability to complete the study 5. prisoners, wards of the state, or patients being held under the baker act or marchman act 6. life expectancy less than 6 months
the effects of a multimodal approach for the treatment of ppa

Conditions: Primary Progressive Aphasia

Summary: primary progressive aphasia (ppa) is an untreatable neurodegenerative disorder that disrupts language functions. available therapies are mainly symptomatic and recently attention has been gained by new techniques that allow for noninvasive brain stimulation such as transcranial direct current stimulation (tdcs). the primary objective of this study is to evaluate whether the application of active tdcs (anode over the left dorsolateral prefrontal cortex- dlpfc with the cathode over the right supraorbital region) to the scalp during individualized language training, would improve naming abilities in the agrammatic variant of ppa (avppa) more than use of one methodology alone. the effect of treatment on the clinical symptoms will be related to changes in brain activity (magnetic resonance imaging, mri and functional near-infrared spectroscopy fnirs) and in biological markers, using a multimodal approach. finally, we will assess the long-term effects of this approach.

45 patients with avppa, will be recruited from irccs istituto centro san giovanni di dio brescia, italy and asst spedali civili brescia, italy . inclusion criteria will be a diagnosis avppa according to the current clinical criteria (gorno-tempini et al., 2011) and a ftd clinical dementia rating score \>0.5 and \<2. exclusion criteria will be the presence of any medical or psychiatric illness that could interfere in completing assessments and the presence of any medical condition that represents a contraindication to tdcs. all the patients will undergo five consecutive days a week for two weeks of treatment sessions: 15 patients will receive active tdcs over dlpfc while performing a language training; 15 patients will receive placebo tdcs during language training; 15 patients will receive active tdcs over dlpfc during unstructured cognitive training. two trained neuropsychologists will administer the neuropsychological testing in two sessions. at baseline (t0), post-treatment (t1) and 3-months (t2) follow-up assessments were conducted by the same assessor. blood sample withdrawal at baseline (t0) and after the dlpfc-tdcs intervention (t1) will be assessed. to elucidate the mechanisms underlying tdcs effects, structural imaging, functional connectivity (fmri) alterations and concentration changes of hemoglobin (fnirs) will be collected off-line. each avppa patient will undergo an mri scan at the asst spedali civili brescia, italy at t0 and t1 and a fnirs acquisition at the irccs istituto centro san giovanni di dio brescia, italy at t0, t1 and t2.

Eligibility criteria:
inclusion criteria: * diagnosis avppa according to the current clinical criteria (gorno-tempini et al., 2011) * ftd clinical dementia rating (ftd-cdr) score \>0.5 and \<2 exclusion criteria: * presence of any medical or psychiatric illness that could interfere in completing assessments * presence of any medical condition that represents a contraindication to tdcs.
wrist fracture evaluation with a desktop orthopedic tomosynthesis system

Conditions: Fracture

Summary: trauma to the extremities such wrist, ankle, limb is very common and affects all population groups. it constitutes a significant public health issue. standard radiography remains the basic imaging tool. however, as a 2-dimensional (2d) imaging modality it lacks sensitivity and specificity. misdiagnosis rates are known to be high, especially for non-displaced fractures of the scaphoid and talus as well as erosions due to rheumatoid arthritis. misdiagnosis leads to over treatment and unnecessary loss of productivity and quality of life including 6-12 weeks in a cast. missed fractures can result in a chronic, non-healing fracture that may require surgical fixation and early arthritis of the joint. from a physician perspective, a missed diagnosis can result in a lawsuit and an expensive settlement/penalty. computed tomography (ct) offers high resolution and excellent visualization of bone and joint morphology, and magnetic resonance imaging (mri) delivers soft tissue and cartilage visibility. however, cost, space and workflow related issues make them prohibitive for small orthopedic clinics. although the radiation dose of a ct scan has been reduced considerably in recent years, it is still significantly higher than a regular radiograph. the whole-body scanners also have difficulties in imaging patients in portable and weight-bearing conditions. dedicated extremity ct scanners have been commercialized recently in an attempt to address the current deficiency. they still suffer from higher cost and at such have a limited installation base.

the aim of this one-year study is to demonstrate tomo-e's clinical utility for diagnosis of wrist fractures. tomo-e is a compact and stationary device that utilizes a distributed carbon nanotube (cnt) x-ray source array that will be specially designed for extremity imaging to collect all the projection views without any mechanical motion.

Eligibility criteria:
inclusion criteria: * age 18 or older * undergone radiographic imaging of wrist for presumed or known scaphoid, wrist or distal radius fractures within 2 weeks or are scheduled to undergo such imaging. * able to provide informed consent exclusion criteria: * patients will an intervening surgical procedure performed prior to study imaging. * institutionalized subject (prisoner or nursing home patient)

Keywords: scaphoid fracture wrist fracture distal radius fracture
the influence of feeding position on pulmonary morbidity in young children

Conditions: Pulmonary Diseases; Tonsillar Hypertrophy; Otitis Media; Dental Caries

Summary: supine feeding position is associated with serous otitis media. the hypothesis is that supine feeding is associated with recurrent otitis media, tonsillar and adenoid hypertrophy and recurrent pneumonia secondary to recurrent aspiration.

the aim of the study is to compare two "mother and child health clinic" stations with similar socioeconomic background. mothers from the study station will be instructed to feed their children only in an upright position since birth. in the control station mothers will continue to feed their children as usual. pulmonary morbidity will be evaluated prospectively through the computer system of the insurance companies.

Eligibility criteria:
inclusion criteria: * newborn * mother's compliance exclusion criteria: * bronchopulmonary dysplasia (bpd) * asthma * cystic fibrosis * heart disease

Keywords: adenoid hypertrophy feeding position supine upright pneumonia wheezing otitis adenoid tonsil caries
prediction model for advanced gastric cancer in elderly

Conditions: Stomach Neoplasms; Aged

Summary: this study aims to develop and validate a nomogram (mcns) model for predicting long-term survival in elderly patients following curative resection for advanced gastric cancer. the study is a retrospective multi-center analysis involving 924 gastric cancer patients treated at the department of gastrointestinal surgery of the affiliated union hospital of fujian medical university between 2009 and 2013, and 512 patients aged 65 and above who underwent gastric resection at the affiliated zhongshan hospital of dalian university between 2011 and 2018. an online prognostic tool is introduced to assist clinicians in predicting patient prognosis and customizing treatment and follow-up strategies.

data were collected from 1436 gastric cancer patients, of which 555 elderly patients with advanced gastric cancer were ultimately included after applying exclusion criteria. patients were divided into training and testing cohorts from the fujian medical university affiliated union hospital and dalian university affiliated zhongshan hospital. the study was approved by the institutional review boards with a waiver of informed consent due to the use of anonymized secondary data. the analysis utilized the cox proportional hazards model to select key variables for predicting overall survival (os). the study also implemented rigorous data handling procedures, including multiple imputations for missing data. the development of an online prognostic tool based on the nomogram model is part of the project, designed to provide real-time survival predictions through a user-friendly interface for clinical application.

Eligibility criteria:
inclusion criteria: * confirmed as primary gastric adenocarcinoma by preoperative gastric endoscopy pathology; * underwent r0 laparoscopic radical gastrectomy for gastric cancer; * pathological stage t2-4a-n+; * age ≥ 65 years. exclusion criteria: * pathological stage t1 and t2n0; * age \< 65 years; * presence of peritoneal or distant metastasis confirmed before or during surgery; * received neoadjuvant chemotherapy before surgery; * remnant gastric cancer; * emergency surgery or palliative exploratory surgery; * preoperative abdominal ct scan not available or preoperative examination time \> 1 month; * survival time less than 1 month; * incomplete clinical and pathological data.

Keywords: stomach neoplasms prognosis elderly prediction model
alcohol cessation intervention in an acute surgical setting

Conditions: Acute Fracture Surgery; Alcohol Cessation Intervention; Postoperative Complications; Infection; Ankle Injuries

Summary: hazardous alcohol intake is an independent risk factor for postoperative complications after major and minor operations, elective and emergency procedures for men and women. the aim of this study is to evaluate the effect of a 6-week gold standard programme for alcohol cessation intervention in the perioperative period compared to the daily routine guidelines for patients with hazardous alcohol intake undergoing ankle fracture surgery.


Eligibility criteria:
inclusion criteria: * drinking 21 or more drinks(one drink containing 12 g ethanol) per week for at least 3 months * traumatic ankle fracture requiring internal fixation (osteosynthesis; more than just kirschner threads or similar minor intervention) * informed consent * randomisation within 36 hours after entering the orthopaedic department exclusion criteria: * major trauma involving other fractures or major lesions, * preoperative severe psychiatric disorders (including medicine addiction, severe alcohol dependence \[defined as experience of delirium or seizures during abstinence from alcohol\], dementia) or other conditions of reduced ability for giving informed consent * pathological fractures * pregnancy and lactation * allergy to benzodiazepines, anaesthesia, pain treatment or disulfiram * uncompensated chronic diseases (including fulminate cardiac or liver insufficiency, which are contraindications for disulfiram) * asa score 4-5 * canceled operation * withdrawal of informed consent

Keywords: risk reduction
one-year recurrence-free survival of melanoma patients eligible for a sentinel lymph node biopsy

Conditions: Melanoma, Skin; Adjuvant Treatment

Summary: melanoma is one of the most aggressive solid cancers, although mortality can be reduced with early treatment. immunotherapy has transformed the prognosis of this pathology. the sentinel lymph node technique is used to classify the severity of melanoma. it is proposed for melanomas with a breslow thickness of 0.8 mm to 1 mm, and recommended for melanomas greater than 1 mm or with ulceration, whatever the breslow index. this technique is particularly useful for assessing pathology by detecting the presence of lymph node metastases. patients with lymph node involvement (micro or macro) are eligible for adjuvant treatment. the new recommendations suggest adjuvant immunotherapy for stages iib and iic (without lymph node involvement assessed by the sentinel lymph node technique). this procedure is widely used at the chru de nancy. the aim of this study is to demonstrate the value of the sentinel lymph node in assessing the risk of melanoma recurrence at one year (or more).


Eligibility criteria:
inclusion criteria: major patient with a melanoma with a breslow index greater than 0.8mm or ulcerated melanoma, non-metastatic at diagnosis, exclusion criteria: * metastatic patient * minor patient * melanoma with a breslow index of less than 0.8mm and not ulcerated * patient objecting to data collection
screening and assessing the risk factors and complications of chronic kidney disease

Conditions: Chronic Kidney Disease

Summary: the study is an observational, cross-sectional study aimed at screening and accessing risk factors and complications for chinese chronic kidney disease (ckd) patients. to investigate the prevalence of hypertension, cardiovascular and cerebrovascular diseases, protein energy malnutrition（pem）, cognitive impairment and other complications in the ckd patients. to develop biomarkers of ckd.


Eligibility criteria:
inclusion criteria: * age≥18 years * clinical diagnosis of ckd * signed informed consent exclusion criteria: * end-stage renal disease(esrd) or dialysis * acute kidney injure(aki) * history of solid organ or bone marrow transplantation * active malignancy within 24 months prior to screening or metastatic cancer * hiv infection or aids * acute inflammation
covid-19, obesity and lifestyle in children - role of professionals

Conditions: COVID-19; COVID-19 Pandemic; Childhood Obesity; Overweight, Childhood

Summary: in this study it is researched how preventive and curative healthcare for children with overweight and obesity was conducted during the covid-19 pandemic, which barriers were noticed by professionals, and how new methods (such as e-health and telemonitorning) for coaching, communication and healthcare were used and experienced.


Eligibility criteria:
inclusion criteria: * worked during the covid-19 pandemic * works with children with overweight and / or obesity * works in the netherlands exclusion criteria: * no knowledge of the dutch language.
cannabis versus oxycodone for pain relief

Conditions: Back Pain; Neck Pain

Summary: this study investigates the ability of cannabis to reduce chronic back and neck pain and to reduce sensitivity to an acute painful stimulus. cannabis will be compared to both oxycodone and a placebo.

this study investigates the ability of cannabis to reduce chronic back and neck pain and to reduce sensitivity to an acute painful stimulus. cannabis will be compared to both oxycodone and a placebo. some inclusion/exclusion criteria are purposely omitted at this time to preserve scientific integrity. they will be included after the trial is complete.

Eligibility criteria:
overall inclusion criteria: * previous smoked or vaporized cannabis exposure * age ≥21 years overall exclusion criteria: * current substance use disorder * current alcohol use disorder * past cannabis abuse/dependence * current use of amphetamine/methamphetamine, barbiturates, benzodiazepines, cocaine, phencyclidine (pcp), mdma (ecstasy) * prior adverse reaction to cannabis exposure (paranoia, anxiety, etc.) * allergy to or prior adverse reaction to oxycodone * any condition contraindicative to opioid use (e.g. paralytic ileus) * history or diagnosis of schizophrenia or bipolar disorder * current severe depression * uncontrolled hypertension (\>139/89) * known cardiovascular disease * known immune system disorder * chronic pulmonary disease (e.g., bronchitis, asthma, copd, or emphysema) * history of seizure disorder * diagnosed inflammatory disease (e.g. rheumatoid arthritis (ra)) * clinically significant abnormal values on cbc/cmp/ekg tests * cognitive disability that interferes with ability to provide consent or understand study procedures * inability to refrain from using tobacco for at least 4 hours * pregnant females * lactating females additional exclusion criteria for spine patients * current regular use of a long acting opioid (e.g. oxycontin, ms contin, other extended release formulas) * current high-dose use of immediate release opioid * current high-dose use of nerve-targeted medication * other diagnosed chronic pain syndromes of greater severity than spine condition (e.g. knee pain ) * diagnosed fibromyalgia * neuropathy not associated with spine condition (e.g. diabetic neuropathy) additional exclusion criteria for healthy controls * current acute pain * current chronic pain condition (e.g. fibromyalgia, neuropathy)
study of pharmacodynamics of lik066 in overweight and obese women with polycystic ovary syndrome

Conditions: Polycystic Ovary Syndrome

Summary: the purpose of the study was to evaluate whether lik066 can be developed for the treatment of polycystic ovary syndrome (pcos) in overweight and obese women.


Eligibility criteria:
key inclusion criteria: * pcos (diagnosed as clinical or biochemical hyperandrogenism, amenorrhea or oligomenorrhea and exclusion of other causes of hyperandrogenism. * overweight/obese female subjects with bmi of 28 - 45 kg/m\^2, inclusive, and stable weight +/- 3 kg over previous 3 months * subjects must use non-hormonal methods of contraception during the study. key exclusion criteria: * subjects with exogenous causes of hirsutism * menstruation in the 30 days prior to screening or treatment * pregnant or nursing (lactating) women * use of prohibited medications * preexisting medical condition which may significantly alter the absorption, metabolism, or excretion of the study drug, or which may jeopardize the subject in case of participation in the study

Keywords: polycystic ovary syndrome pcos hyperandrogenism insulin resistance overweight obesity