Kornimate/medical-research-clean huggingface dataset:
body composition and prognosis in head and neck squamous cell carcinoma (hnscc)

Conditions: Head and Neck Squamous Cell Carcinoma

Summary: this is a retrospective study in patients with cancer of the oral cavity, pharynx, and larynx. imaging exams of these patients will be analyzed with the objective of developing and validating a clinically applicable method for evaluation of cachexia and/or sarcopenia in a patient with head and neck cancer from musculature imaging of the neck. indeed, the prognostic influence of body composition will be evaluated.

epidermoid carcinoma (scc) is the predominant histology of cancers of the oral cavity, pharynx, and larynx. in brazil, 11,200 new cases of oral cavity cancer are estimated in men and 3,500 in women for each year of the 2018-2019 biennium. the disease causes high mortality and morbidity, affecting swallowing and dysphagia, leading to weight loss and cachexia. cancer cachexia is marked by involuntary muscle loss leading to progressive functional impairment and can not be reversed by traditional nutritional support. recent publications show that muscle mass can predict certain outcomes such as survival. methods for assessing body composition have been developed and validated for research, and the area of a skeletal muscle, which can be measured by cross-sectional images, is a valid marker of total body mass. the ct evaluation of the region of the third and fourth lumbar vertebra (l3-l4) are accurate and accepted as a method for evaluating body composition. however, given the locoregional nature of the dissemination of this scc, usually the l3-l4 level is not available on ct, and this is a limitation for the use of ct to assess cachexia in these patients. this study will be divided into three steps. in the first step, 20 patients with cross-sectional ct images of patients with head and neck cancer diagnosis will be selected to verify the intra-class variation at different evaluation times. the second step aims to evaluate the correlation of the muscular area obtained through the l3 region with the area of the neck muscles. the third step will evaluate the prognostic role of the neck muscle area of hnscc patients. the area of the neck muscle of the first ct scan obtained prior to the beginning of treatment will be evaluated and the ratio of this area with the survival rate will be calculated.

Eligibility criteria:
inclusion criteria: * patients who have histological or cytological evidence of oropharynx squamous cell carcinoma, oral cavity, larynx or hypopharynx, locally advanced treated only at sao paulo cancer institute (icesp). exclusion criteria: * patients with no tomography available. * head and neck cancer with tumor at other sites such as thyroid, paranasal sinus, skin and nasopharynx, or other histology other than squamous cell carcinoma
the drinking dashboard study

Conditions: Alcohol Drinking

Summary: this study aims to develop and pilot test the efficacy of a "drinking dashboard" providing participants weekly feedback on the risk factors and consequences of blackout.

approximately 50% of young adults who drink alcohol experience alcohol-induced "blackouts," defined as permanent (en bloc) or temporary (fragmentary) memory loss for events that occurred while they are drinking. this experience of alcohol-induced blackout is associated prospectively with alcohol-related harm, including emergency room visits and sexual coercion, with medical care costs exceeding $469,000 per year. while young adults who have recently experienced a blackout report less favorable evaluations of drinking events and increased motivation to decrease their drinking, they do not actually change their drinking behavior as a result of the blackout alone. collectively, these data suggest that blackouts may serve as an opportunity for intervention, after which young adults are more likely to respond to alcohol feedback. this r34 aims to develop an intervention tailored to individuals who experience blackouts. in the trial phase, 162 young adults (50% female, ≥50% non-college) who report a history of blackout will be randomly assigned to receive the intervention (n=81) or assessment only (n=81). outcomes will be assessed immediately post-intervention and at 3-month follow-up.

Eligibility criteria:
inclusion criteria: * 18-30 years of age * binge drinking in a typical week * any form of alcohol-induced memory impairment in the past month at baseline exclusion criteria: * psychiatric disorder requiring immediate clinical attention (e.g., psychosis, suicidal ideation with intent and plan)
adaptive intervention for adolescents following inpatient psychiatric care

Conditions: Suicide; Suicide, Attempted; Suicidal Ideation; Self Harm

Summary: this study is being completed to examine different combinations of technology-augmented strategies to identify an effective adaptive intervention (ai) addressing post-discharge suicide risk with high implementation potential.

the proposed study is a sequential multiple assignment randomized trial (smart) to identify an effective adaptive intervention (ai) for adolescents at elevated suicide risk transitioning from acute psychiatric care. participants will be initially randomized to motivational interview (mi)-enhanced safety planning (mi-sp) or to mi-sp with supportive text messages delivered for four weeks after discharge (texts) (phase 1 intervention). adolescents who are classified as phase 1 non-responders at the end of the first or at the end of the second week post-discharge, based on their responses to daily surveys , will be re-randomized to either added booster call or portal follow-up (phase 2 intervention). those classified as phase 1 responders at the end of the second week post discharge will continue with the initially assigned intervention options. thus, participants will receive one of six treatment sequences resulting from the different intervention components or their combinations. these six treatment sequences, in turn, will form four ais. the study team anticipates that ais that begin with mi-sp plus text-based support will have: * lower odds of suicidal behavior 3 months post discharge * longer time to suicidal behavior over the 6 month follow-up * less severe suicidal ideation over the 6-month follow-up additionally, the study team anticipates that the ai that begins with mi-sp + texts followed by portal follow-up for non-responders will lead to: * lowest odds of suicidal behavior within 3 months * longest time to suicidal behavior over the 6 month follow up * least severe ideation over the 6-month follow-up

Eligibility criteria:
inclusion criteria: * a suicide attempt in the last month or (2) past-week suicidal ideation (based on the columbia-suicide severity rating scale (c-ssrs). in the absence of c-ssrs ratings in the chart, attending physician indication in the chart of the presence of suicidal ideation within the last week or the presence of a suicide attempt in the last month will be used. exclusion criteria: * adolescent presenting with severe cognitive impairment or with altered mental status (acute psychosis or acute manic state) * transfer to medical unit or residential placement * no availability of a legal guardian * adolescent not owning a cell phone.

Keywords: adaptive intervention technology-based interventions in-patient sequential, multiple assignment, randomized trial (smart) adolescent safety planning mobile technology
endoscopic ultrasound-guided coil with cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration in managing patients with gastric varices

Conditions: Gastric Varix

Summary: gastrointestinal bleeding is a common complication of liver cirrhosis which caused by esophageal and gastric varices. the risk of bleeding from gastric varices is relatively low. however, the bleeding is usually significant and severe. current guidelines recommend endoscopic glue injection as the first line of treatment for gastric variceal bleeding. although this technique has been shown to be effective, it is associated with many severe adverse events including systemic embolization, fever, chest pain, and even death. the rate of hemostasis has been reported to be as high as 91-100% but the rebleeding rate from gastric varices still present. endoscopic ultrasound (eus) guided therapy has recently been introduced as a more effective and safer option than endoscopic therapy for gastric varices. eus-guided therapy includes eus guided cyanoacrylate injection alone or in combination with eus-guided coiling. it offers the advantage of directly visualizing the varices and delivering targeted therapy. a standard endoscopic examination only allows the evaluation of superficial varices. the use of endoscopic ultrasound facilitates evaluation of peri-gastric and perforating vessels, which are directly involved in variceal development. eus also facilitates accurate placement of the coil and preserves the naturally formed splenorenal shunt. balloon-occluded retrograde transvenous obliteration(brto) has been reported to achieve satisfactory bleeding control rates for isolated gastric varices with high hemostasis rates and low rebleeding rate. despite all these promising results, there are scarce studies describing and comparing the efficacy of eus-guided therapy and brto in patients with gastric varices. further prospective comparative studies are needed.


Eligibility criteria:
inclusion criteria: • presence of fundal gastric varices either: high risk for rupture; diagnosed by upper endoscopy i.e. large size or presence of red color spot. bleeding varices; diagnosed by upper endoscopy with good hemostasis achieved with endoscopic treatment. bleeding varices; diagnosed by upper endoscopy but hemostasis could not be achieved with endoscopic treatment. * fundal gastric varices with presence of contraindication for tips such as repeated attacks of hepatic encephalopathy due to portosystemic shunt, model of end stage liver disease score (meld) \>18. * fundal varices with catheterizable portosystemic shunt such as gastrorenal shunt or gastrocaval shunt. exclusion criteria: * complete portal vein thrombosis * splenic vein thrombosis * intractable ascites (tips is better) * uncontrolled esophageal varices (high risk for bleeding) and tips is better
the effects of blood pressure on renal function and oxygenation in septic shock

Conditions: Septic Shock; Acute Kidney Injury

Summary: the purpose of this study is to evaluate renal effects of 3 different levels of mean arterial pressure in early case of septic shock. in 8 patients diagnosed with early septic shock, we will adjust mean arterial pressure (map) to three different levels, using norepinephrine. at each level of map, central and renal hemodynamics and oxygenation states will be measured. analysis will be made to describe the pathophysiology at map 75 mmhg, and then to evaluate at which map renal function and oxygenation is least affected negatively.

it is under debate what level of mean arterial pressure is the most appropriate for organ perfusion in septic shock. the kidneys are usually used for end-organ evaluation of appropriate perfusion and appropriate blood pressure level. what "adequate blood pressure" means is today unclear. the purpose of this study is to chart the renal perfusion, oxygenation and function, and moreover to evaluate renal effects of 3 different levels of mean arterial pressure, in early phase of septic shock. patients will be included within the first 24 hrs after admission to the icu diagnosed with septic shock. the patients will be sedated, mechanically ventilated and in need for norepinephrine for adequate blood pressure levels. after 60 mins of steady state at map 75 mmhg, norepinephrine will be adjusted achieve map of 60 and 90 mmhg respectively, map being held at each level for 30 mins. at the end of each 30 mins period, central and renal hemodynamics will be measured, blood and urine samples will be collected. central hemodynamics will be measured by, and blood samples collected via a pulmonary catheter and an arterial line. renal hemodynamics will be measured using a renal vein catheter for retrograde thermodilution giving at hand renal blood flow (rbf), renal vein blood samples and urine collection provides extraction of cr-edta for filtration fraction (ff) and glomerular filtration rate (gfr), renal oxygen consumption, and renal oxygen extraction as a measure of balance between renal oxygen delivery and consumption. via renal vein catheterisation and retrograde thermodilution, the study group have the unique possibility to actually evaluate renal blood flow, renal oxygenation and renal function in humans in vivo. after finishing the data collection, analysis will be made to answer the question: which map is the most optimal concerning rbf, gfr and renal oxygenation in patients with septic shock?

Eligibility criteria:
inclusion criteria: * stable septic shock * normovolemic * norepinephrine * intubated/ventilated * normal s-creatinine according to local laboratory regards.

Keywords: renal blood flow renal oxygenation glomerular filtration rate filtration fraction blood pressure
rhythm effect on dance learning in children with and without cerebral palsy.

Conditions: Cerebral Palsy (CP)

Summary: cerebral palsy (cp) leads to motor impairments and impacts activities of daily living and academic and social achievement (american psychiatric association, 2013). children with cp present impaired procedural learning abilities that is the ability to acquire cognitive-motor skills with practice (gagliardi et al., 2011; gofer-levi et al., 2013). however, some rehabilitative rhythmic interventions, such as adaptive dance training, appear to improve motor, cognitive, psycho-emotional, and social functions in these children (cherriere, martel, et al., 2020; cherriere, robert, et al., 2020). rhythm seems to be an important factor in these benefits, probably because regular rhythm improves motor control and learning (thaut, 2015; lagarrigue et al., 2021; ghai et al., 2022). to validate this hypothesis, the investigators propose to evaluate the effects the presence of a regular rhythm on learning of a danse choreography in typically developing children and children with cp.


Eligibility criteria:
inclusion criteria: for all the participants: * aged from 8 to 16 include. * free, informed, written, and signed consent of the holders of parental authority * free and informed consent of the minor * affiliation with or benefiting from a social security scheme. * ability to understand the instructions (investigator's assessment) for the participant with cp: * cp diagnosis * gross motor function classification system level between i to iv. * manual ability classification system level between i to iv. for the participant with typical development: * no cp diagnosis * no neurological trouble nor functional disfunction including developmental coordination disorder. exclusion criteria: * -autism spectrum disorder diagnosed according to the dsm-5 (apa, 2015) * hearing deficiency diagnosed according to the dsm-5 (apa, 2015) or uncorrected hearing deficiency that doesn't allows the participant to hear a music with a sound level between 45 and 70 decibels. * visual deficiency diagnosed according to the dsm-5 (apa, 2015) * intellectual developmental disorder diagnosed according to the dsm-5 (apa, 2015) * behavioural disorders diagnosed according to the dsm-5 (apa, 2015) * diagnosed epilepsia * pregnancy (check in young pubescent and sexually active women) or breastfeeding. * children already include in ongoing interventional study. * children with both parent who benefit of legal protection (guardianship, curatorship, safeguard of justice).
does protein and fat content of meal increase glucose concentrations

Conditions: Type 1 Diabetes Mellitus

Summary: the study investigated the effects of fat protein counting (cfp) in addition to carbohydrate (carb) counting for calculating prandial insulin dosage on blood glucose profile in patients with type 1 diabetes (t1d) on basal-bolus insulin therapy.

in this single center, crossover, randomized, controlled study, control meal (sm: standard meal using carbohydrate counting method) and three test meals (hpm: high protein meal using carbohydrate counting method, hpfm-a: high protein-fat meal using carbohydrate counting method and hpfm-b: high protein-fat meal using carbohydrate and fat-protein counting method) were compared on postprandial early (0-120 minutes), late (120-240 minutes) and total (0-240 minutes) glucose response.

Eligibility criteria:
inclusion criteria: subjects: * had type1 diabetes for at least 1 years; * use multiple dose (basal-bolus) insulin therapy; * use fast-acting insulin analogs (lispro, glulisine, and aspart) and basal insulin analogs (detemir, glargine); * daily inslin dose ≥0.5 iu/kg/day. exclusion criteria: subjects: * had any restrictive food intake disorders (eg celiac disease or food allergy); * had any diabetes complications (eg neuropathy, nephropathy or retinopathy); * diagnosed for \<1 year; * were using corticosteroid or any medication that could effect gastric emptying; * did exercise or had hypoglycemia or ketoacidosis within 24 hour before the test meals; * had overweight or obese (bmi z score: ≥ 1sd and ≥ 2sd respectively); * had not on follicular or peri-ovulatory phases of their menstrual cycles (for females).

Keywords: fat-protein counting type 1 diabetes postprandial glucose level
improving appetite self-regulation in african american adults with type 2 diabetes

Conditions: Type 2 Diabetes; Binge Eating

Summary: the purpose of this 6-month randomized clinical trial is to examine the feasibility of recruitment, attendance, retention, program adherence, and satisfaction of a digital application designed, centering appetite to improve glucose scores (hba1c) and binge eating in african american adults with type 2 diabetes. intervention participants will receive type 2 diabetes education and web-based lessons on appetite self-regulation. participants will also receive a fitbit to monitor daily physical activity. the investigators will follow up with participants at six months.

using a randomized clinical trial design examine the feasibility and acceptability of a 6-month digital diabetes self-management education program plus an appetite self-regulation intervention for (n=60) african americans (aa) with type 2 diabetes who report uncontrolled eating in north carolina. sixty aas will be randomized to the centering appetite intervention or the control group. over the 6 months, centering appetite participants will have two intervention sessions supplemented by monthly booster sessions and weekly messages related to the program. the control group will also receive two intervention sessions and weekly nutrition tutorials. the study will examine the following: recruitment feasibility, attendance/retention, treatment adherence, intervention, hba1c, and binge eating.

Eligibility criteria:
inclusion criteria: individuals are eligible if they * identify as a non-hispanic, aa * are over 18 years of age * have an a1c value \> 7.5 * have a working smartphone * complete binge eating screening exclusion criteria: individuals will be excluded if they: * have major end-organ type 2 diabetes mellitus complications * have a history of weight loss surgery * are currently pregnant * in substance use treatment or are involved in another weight reduction program.

Keywords: bing eating type 2 diabetes african americans digital
a trial to evaluate the safety and efficacy of ps433540 to treat hypertension

Conditions: Hypertension

Summary: the purpose of the study is to see if ps433540 lowers blood pressure better than placebo and to see how safe ps433540 is compared to placebo.


Eligibility criteria:
inclusion criteria: * males or females 30 - 80 years * mean seated systolic blood pressure (sbp) ≥ 150 - ≤ 179 mmhg and mean seated dbp \< 110 mmhg at two consecutive qualifying visits. the mean difference in sbp between the two consecutive qualifying visits must be ≤ 10 mmhg. * mean daytime (8am - 4pm) ambulatory sbp must be between ≥ 140 - ≤ 179 mmhg and mean daytime (8am - 4pm) diastolic blood pressure (dbp) ≤ 110 mmhg * subjects must have a usual daytime schedule. night shift workers are excluded from participation. * women of child-bearing potential (wocbp) and male subjects must use two reliable forms of contraception if sexually active. alternatively, female subjects must be postmenopausal (for at least 1 year) exclusion criteria: * subjects with serious disorders which may limit the ability to evaluate the efficacy or safety of ps433540, including cardiovascular, renal (including the absence of one kidney), pulmonary, hepatic, gastrointestinal (including clinically significant malabsorption), endocrine/metabolic, hematologic/oncologic (including an active malignancy other than basal cell carcinoma), neurologic and psychiatric diseases. * subjects with a history of myocardial infarction, angina, coronary angioplasty, bypass surgery or new york heart association (nyha) class ii-iv heart failure within the last 6 months. * subjects with a history of cerebrovascular accident or transient ischemic attack within the last 1 year. * subjects with diabetes mellitus (type i and type ii).

Keywords: hypertension high blood pressure
effects of thai dance meditation exercise on renal and cerebrovascular function in elderly with diabetic kidney disease

Conditions: Diabetic Kidney Disease

Summary: elderly with diabetic kidney disease who practiced thai dance meditation training more favorable adaptations than normal daily life in improving glycemic control, kidney function, vascular function and cerebrovascular function.

this cross-sectional study was to compare glycemic control, kidney function, vascular function, cerebrovascular function, physical fitness and quality of life between elderly with diabetic kidney disease who practiced thai dance meditation training and normal daily life.

Eligibility criteria:
inclusion criteria: * the inclusion criteria included diabetic kidney disease (dkd) (as defined by the kdigo (kidney disease improving global outcomes 2012), a baseline glycosylated hemoglobin (hba1c) value of 7-9%, albumin-to creatinine ratio (acr): a3 \[\>300 mg/day; acr, \>300 mg/g (\>30 mg/mmol)\], gfr category 3 (moderately decreased) has now been divided into categories g3a \[45-59 ml/ min1 /(1.73m2) and g3b \[30 -44 ml/ min1/(1.73 m2) which represent mildly to moderately decreased function and moderately to severely decreased function and no previous exercise training in the past 6 months. * all participants were free from diabetic retinopathy, severe diabetic neurophathy, severe cardiovascular and cerebrovascular diseases. * participants had montreal cognitive assessment - thai (moca-t) scores between 18 24 points. * not having uncontrolled high blood pressure (systolic blood pressure; sbp) \>159 mmhg and diastolic blood pressure; dbp) \> 99 mmhg exclusion criteria: - participants were excluded if they dropped out or completed less than 80% of the training schedule

Keywords: diabetic kidney disease cerebrovascular reactivity renal function thai dance meditation