Kornimate/medical-research-clean huggingface dataset:
facilitating motor skill learning in parkinson's disease ii (fast-pd ii)

Conditions: Parkinson Disease

Summary: the study is designed to assess the effects of cardiovascular (aerobic) exercise on motor skill learning in parkinson patients. specifically, the investigators examine whether a single bout of moderate-intense aerobic exercise, performed immediately following motor skill practice, facilitates motor memory consolidation. in this experimental trial, participants will be randomly allocated to either an intervention group (motor skill practice + aerobic exercise) or control group (motor skill practice + seated rest).

parkinson's disease (pd) is a progressive neurodegenerative disorder that is characterized by motor control impairments, such as gait disturbances and postural instability. beneficial effects of exercise are attributed to mechanisms of neuroplasticity, and task-specific motor training (repeated practice of a skill) is consequently considered to be a motor learning process. importantly, the formation (acquisition) and consolidation of motor memories is impaired in pd compared to healthy individuals of similar age. thus, it is crucial to identify strategies to enhance motor learning in people with pd. recent studies have accumulated evidence to show that acute (single bouts of) cardiovascular exercise can facilitate motor skill learning. however, this evidence is mainly derived from studying healthy individuals. in a first study including pd patients, we recently found improved motor memory consolidation, but not skill acquisition, when practice was preceded by a single bout of cardiovascular exercise. these results suggest that acute exercise may enhance motor memory formation processes, but could potentially interfere with motor skill acquisition when performed prior to practice. consequently, the present study investigates whether performing a single bout of cardiovascular exercise immediately following skill practice will enhance motor memory consolidation without affecting skill acquisition in pd. in an experimental trial, participants will be randomly allocated to one of two groups. both groups will practice balancing on a stability platform (motor learning task). the experimental group will additionally perform a bout of aerobic exercise (cycle ergometer) immediately following motor practice, while the control group will rest. subsequently, motor skill retention will be tested after 24 hour and seven-days.

Eligibility criteria:
inclusion criteria: * parkinson's disease stage 1-3 on hoehn \& yahr scale * ability to stand unaided and walk without an assistive device * stable medication during the study period * unfamiliar to the motor learning task exclusion criteria: * on-off and wearing-off phenomena * unstable medical or psychiatric illness * clinically relevant cardiovascular or orthopaedic disease * severe polyneuropathy * cognitive impairment * smoking \> 10 cigarettes/day * caffeine \> 6 cups of coffee/day * alcohol \> 50 g (two glasses)/day

Keywords: parkinson's disease motor learning neuroplasticity aerobic exercise cardiovascular exercise balance postural instability motor memory consolidation
the pulsepoint randomized controlled trial

Conditions: Out-of-hospital Cardiac Arrest

Summary: "sudden cardiac arrest" occurs when someone's heart stops beating unexpectedly. each year, more than 45,000 canadians have a cardiac arrest. a bystander can do three things to improve survival: call 911,start chest compressions and apply a defibrillator. together, these actions can increase survival by up to 800%. the problem is that bystanders to cardiac arrest only provide cpr in about 3 of every 10 cardiac arrest cases and aed use in about 3 of every 100 cardiac arrest cases. there are many people in the community who are trained and willing to provide help for cardiac arrest victims such as off-duty paramedics, fire fighters, nurses, etc. when a cardiac arrest occurs in the city, it is likely that one of these people is nearby, but unaware of the emergency. the pulsepoint smartphone application enables these people to be notified by the local emergency 911 service when there is a cardiac arrest near to them. it can be freely downloaded to several common types of smartphones. when there is a cardiac arrest emergency, all nearby pulsepoint users are sent an alert from the 911 service. when the phones receive the alert, they ring, vibrate and display a text message saying "cpr needed". the user's current location and the exact location of the cardiac arrest are then displayed on a map. nearby public access aeds are also indicated on the map. the smartphone users can then go to provide chest compressions and use an aed while paramedics are on their way. a video at www.pulsepoint.org shows how this works. the objective of the investigators is to measure whether the pulsepoint smartphone application increases bystander cpr or aed use for victims of cardiac arrest outside the hospital. this project will happen in the city of toronto. the investigators have a plan to get as many people as possible to download the application, focusing on health care professionals who know cpr. the investigators will set up a webpage that helps people download the software to their phone. the investigators will randomize 911 calls to have a pulsepoint alert sent or not. the investigators will use statistical analysis to measure whether sending an alert to a smartphone increases the chances of bystander resuscitation.


Eligibility criteria:
inclusion criteria: 1. patients with 911 calls assigned mpds code 09-e-01 (suspected atraumatic cardiac arrest not breathing), and 09-e-02 (suspected cardiac arrest, not breathing normally), 2. out-of-hospital cardiac arrest as defined within the roc epistry database exclusion criteria: 1. trauma (including burns) associated with cardiac arrest 2. cardiac arrests occurring in prisons, etc 3. patients not treated by paramedics because of a dnr order or signs of obvious death as per ontario provincial paramedic medical directives (e.g. decapitation, decomposition, rigour mortis)

Keywords: cardiac arrest, cardiopulmonary resuscitation, automated external defibrillators, smartphones
using telemedicine to improve spasticity diagnosis rates

Conditions: Spasticity, Muscle; Muscular Diseases; Musculoskeletal Disease; Muscle Hypertonia; Muscle Spasticity; Neuromuscular Manifestations; Signs and Symptoms; Nervous System Diseases; Neurologic Manifestations

Summary: the purpose of this study is to test the reliability of using telemedicine so a neurologist can remotely identify residents of a long-term care facility who should be referred to a neurologist for an in-person spasticity consultation.

the aim of this study is to improve spasticity (a form of muscle rigidity) diagnosis through validation of telemedicine as a tool for spasticity evaluation or referral. this study will test the reliability of using telemedicine so a neurologist can remotely identify residents of a long-term care facility who should be referred to a neurologist for an in-person spasticity consultation. the telemedicine referral tool will be tested for bedside implementation in all consenting participants residing in tennessee state veteran's home, which is a long-term care facility in murfreesboro, tn. each of the 140 residents will receive one neurological examination and one physical examination guided by the teleneurologist. a medical record review will also be performed.

Eligibility criteria:
inclusion criteria: * male or female subjects of any race, aged 18 and above * resident of the selected long-term care facility * the subject, or if appropriate their medical decision maker, is willing and able to provide written informed consent. exclusion criteria: * subjects for whom participation in the study may cause medical harm
multi-component intervention to train providers to promote prep for girls and women in the deep south

Conditions: HIV Infections; Sexually Transmitted Diseases

Summary: the goal of this study is to adapt evidence-based curriculum on hiv epidemiology and prep prescription to train family medicine physician trainees to take a thorough sexual history and discuss hiv/sti prevention and prep options with adolescent patients in alabama. the primary outcomes of the study are: * feasibility of the prep pro training intervention * acceptability of the prep pro training intervention secondary outcomes include: * behavioral changes in sexual history taking performed by physician trainees * prep knowledge and prescribing practices * hiv and sti screening practices participants will receive training on sexual history taking and hiv prevention options, including prep prescription and management. they will complete a pre-training survey (enrollment) and post-training survey (6 months post enrollment) to understand differences in knowledge and practice before and after receiving the training intervention. the post training survey will also assess acceptability and feasibility of the intervention. a subset of participants will complete qualitative in-depth interviews to further discuss their experiences with the program and suggestions for future adaptations.


Eligibility criteria:
inclusion criteria: 1. licensed hcp (md, do) trainee 2. providing medical care to agyw in al 3. working in a clinic setting where at least 20% of the population is black 4. able/willing to provide informed consent exclusion criteria: (a) unable or unwilling to provide informed consent

Keywords: prep hiv hiv prevention adolescents young adults family medicine residents physician trainees training intervention sexual history sexual health sexually transmitted infections
circulating tumor dna methylation test to differentiate benign and malignant pulmonary nodules

Conditions: Pulmonary Nodule, Solitary

Summary: current state-of-the-art lung cancer early screening utilizes low-dose ct scan to identify lung nodules smaller than 3 cm in diameter. however, it's still a clinical challenge to differentiate between malignant and benign nodules. in previous studies, the investigators had taken the approach of methylation profiling by high throughput bisulfite dna sequencing in tissue samples to identify specific methylation signatures. the investigators had learned methylation patterns that differentiate malignant vs. benign lesions from tissue samples by in-depth data mining, and then used pattern matching to classify plasma samples. in this study, the investigators are going to validate the efficacy of ctdna methylation test for diagnosing early lung cancer by comparing results of the pre-surgery ctdna methylation test with the post-surgery pathology.

this is a prospective, multi-center, observational cohort study and seeks to enroll 1230 participants with pulmonary nodules 5-30mm in diameter. the assay analyzes the ctdna methylation profiles of lung cancer-specific biomarkers non-invasively using whole blood specimens collected before invasive surgery. the performance characteristics(sensitivity and specificity) of the pre-surgery ctdna methylation test for detection of early lung cancer is evaluated in comparison to post-surgery pathology.

Eligibility criteria:
inclusion criteria: * 18 years old or above * single pulmonary nodule found by ct scan. * the diameter of the pulmonary nodule is between 5mm to 30mm. * plan to accept pneumonectomy due to the pulmonary nodule. * without any sign of lymphatic or distant metastasis. * agree to sign informed consent. exclusion criteria: * pregnant or lactating women. * the diameter of the pulmonary nodule is more than 30mm * there are 2 or more pulmonary nodules in one single patient. * any sign of lymphatic or distant metastasis

Keywords: pulmonary nodule solitary
determinant of fetal growth retardation after sleeve gastrectomy: involvement of ghrelin

Conditions: In Utero Growth Retardation; Sleeve Gastrectomy; Bariatric Surgery Status Complicating Pregnancy

Summary: the aim of the study is to determine, in pregnant women who have undergone sleeve gastrectomy (sg), whether ghrelin changes could be involved in in utero growth restriction (iugr) and whether therefore a correlation between maternal ghrelin levels and birth weight is observed.

bariatric surgery (bs) has developed rapidly in recent years and the candidates are predominantly women of childbearing age. a negative impact on fetal growth (fg), has been described after bs whose mechanisms are not elucidated. the sleeve gastrectomy (sg), the most commonly practiced bs technique, is supposed to induce fewer nutritional deficiencies than gastric bypass. this is why it seems to be the technique of choice for young women, although the lack of hindsight does not allow recommendations to be made. however, latest work showed that birth weight (bw) was affected as much after sg as after rygb (roux-en-y gastric bypass), with 50% of bw z-score \<0 and 19% of small newborns for gestational age. in addition, only weight gain during pregnancy and maternal protein status were related to bw, but these parameters explained only 16% and 8% of the variance of the bw z-score, respectively, suggesting that other factors are therefore involved. sleeve gastrectomy induces the loss of the majority of gastric cells secreting ghrelin, an orexigenic hormone involved in the regulation of appetite but also in the pituitary secretion of growth hormone, which could influence fetal growth, as shown in a model of pregnant rats. however, no studies have evaluated the link between maternal ghrelin and pregnancy outcome in women undergoing bariatric surgery. the study population will include pregnant women who have undergone bariatric surgery such as sleeve gastrectomy (which is currently the most frequently performed technique) before pregnancy, coming to consult between the 3rd and 6th month of pregnancy (2nd trimester) for a nutritional check-up in a day hospital.

Eligibility criteria:
inclusion criteria: * woman previously operated of sleeve gastrectomy * pregnant from 3 to 6 months * having a mono-fetal pregnancy * coming to consult in day hospital for a nutritional assessment exclusion criteria: * twin pregnancy * identified cause of iugr apart from those related to sleeve gastrectomy * woman who has undergone another bariatric surgery technique * lack of individual information and collection of the consent form * problems of understanding * lack of affiliation to a social security scheme or state medical aid * patient benefiting from a legal protection measure (with guardians or curators)

Keywords: sleeve gastrectomy ghrelin
photodynamic therapy of actinic keratosis of the face and scalp with and without prior curettage

Conditions: Keratosis, Actinic

Summary: guidelines for photodynamic therapy (pdt) of actinic keratosis recommend pretreatment with curettage. the impact of curettage on the treatment effect is, however, not known. the present study aimed to evaluate whether daylight-pdt without curettage would reduce treatment effect compared to daylight-pdt with curettage.


Eligibility criteria:
inclusion criteria: - multiple actinic keratosis on the forehead or scalp exclusion criteria: * known allergy to methyl aminolevulinate * porphyria * pregnancy * lactation
different treatment modalities for oral lichen plan

Conditions: Oral Lichen Planus

Summary: the goal of applications of low-level laser and topical steroid in the management of oral lichen planus is to learn if intervention can by relieve pain, decreasing inflammation, and facilitating tissue healing in20 patients who were suffering from erosive oral lichen planus. the main questions it aims to answer are which is better and more effective as treatment modality. the erosion size (mm2) measured on the first day and 4 weeks later. oral health-related quality of life questionnaire manipulated. researchers will take low-level laser and topical steroid in the management of oral lichen planus to see if it could be used as separate treatment option or as combination.


Eligibility criteria:
inclusion criteria: * patients who were monitored for olp. * clinical and histopathological finding of olp in accordance with van der meij 2003. * being over 18 years old. exclusion criteria: * patients with systemic disorders, pregnancy, using drugs, smoking, lesions in contact with dental amalgams, and cutaneous or other mucosal involvement at the time of treatment were excluded.

Keywords: low-level laser topical steroid 0.1% triamcinolone acetonide management of oral lichen planus
safety and efficacy pilot study of azasite (azithromycin) in subjects with blepharitis

Conditions: Blepharitis

Summary: the purpose of this study is to evaluate the safety and efficacy of azasite ophthalmic solution, 1% on signs and symptoms of blepharitis.


Eligibility criteria:
inclusion criteria: * diagnosis of moderate to severe chronic posterior blepharitis * if female of childbearing potential, are non-pregnant and non-lactating exclusion criteria: * had ocular surface surgery (lasik, refractive, etc.) within the past year * unwilling to discontinue use of contact lenses during the study * have glaucoma * unable or unwilling to withhold the use of lid scrubs during the study * have a serious systemic disease or uncontrolled medical condition that in the judgment of the investigator could confound study assessments or limit compliance * currently using any preserved topical ocular medications (with the exception of unpreserved tear substitutes) at the time of entry into the study or during study participation
retinal adaptation to intensified insulin therapy and bariatric surgery in patients with diabetes

Conditions: Diabetes Mellitus; Diabetic Retinopathy

Summary: retinal function is highly dependent on the glucose supply. thus, functional adaptations occur in response to both acute and long-term changes in glycaemia. the purpose of this study is to examine functional and metabolic aspects of retinal adaptation to long-lasting changes in glycaemic control in patients with diabetes. the adaptational phenomena will be characterized by electroretinography, dark adaptation, measures of retinal perfusion and oximetry as well as diabetic retinopathy grading and (oct).


Eligibility criteria:
inclusion criteria: * patients with type 1 diabetes and suboptimal metabolic regulation. * patients with type 2 diabetes and suboptimal metabolic regulation. exclusion criteria: * significant cataract * glaucoma * proliferative diabetic retinopathy fulfilling etdrs treatment criteria. * clinically significant macular edema fulfilling etdrs treatment criteria. * age-related macular degeneration * prior surgery to the eye * other serious eye disease * hypertension
erector spinae block in segmental mastectomy.

Conditions: Breast Cancer

Summary: erector spinae plane block (espb) is a recently described block. although there is still no consensus of its mechanism, the published case series seems to promise a new regional anesthesia technique for both chronic and acute pain. in this clinical trial, the postoperative analgesic effect of espb will be studied in patients underwent unilateral breast cancer surgery.

in this study 30 patients will be enrolled to study between march 2018-august 2018. all patient will be randomly selected who will be operated for breast cancer surgery between determined dates. age, weight, asa score, body mass index , additional dissease ststus will be recorded. the patients will be divided in two groups. one group will have espb at the end of the operation and the second group will be treated with multimodal analgesia techniques and both groups will receive patient controlled analgesia. both groups will receive identical anaethesia protocols. perioperative analgesia protocols will provide acetaminophen 1 gr and the same dose will be repeated in every 6 hours regardless of the pain scores. in postoperative period the pain scores of the patients will be recorded according to the numeric rating scale (nrs) in every three hours. if pain score raises over 4/10 on nrs the patient will receive tramadol 100mg as rescue analgesia. in case of persisting pain first, meperidine 50 mg will be apllied and other multimodal analgesic drugs will be added to protocol. at the end of the study 24 hours total opioid usage of patients, pain scores and side effects will statistically be analyzed.

Eligibility criteria:
inclusion criteria: 1. being volunteer 2. over 18 years old 3. unilateral segmental mastectomy patients exclusion criteria: 1. emergency operations 2. younger than 18 years old, 3. non volunteers 4. asa 3 and 4 patients 5. non-cooperative patients

Keywords: regional anesthesia erector spinae plane block postoperative pain
pharmacokinetics ertapenem burns

Conditions: Burn Patients

Summary: this study will examine the pharmacokinetics of ertapenem in ventilated badly (\> 30% sct) burn patients.


Eligibility criteria:
inclusion criteria: * patients aged 18 to 70 years * burned on 30 to 60% of their body surface * mechanical ventilation * hospitalized in the intensive care unit of nantes university hospital for less than 8 days. * which the family gave consent * insured exclusion criteria: * patients whose family refused to sign the consent for participation. * patients allergic to beta lactam * patients with renal failure with creatinine clearance \<80 ml.mn-1 * pregnant women * persons protected by the law

Keywords: burns ertapenem pharmacokinetics
viruxal oral and nasal spray for treating the symptoms of covid-19

Conditions: COVID-19

Summary: viruxal oral and nasal spray is a class i ce marked medical device manufactured by kerecis hf (the "device"). a double blind clinical trial will be conducted to evaluate the device against placebo in covid-19 positive, symptomatic patients in iceland. immediate access to covid-19 patients is available through a well-organized covid-19 outpatient follow-up clinic. up to 128 patients with mild to moderate symptoms of covid-19 will be recruited (so called "higher end of the low risk group"). these patients will be positive for covid-19, be symptomatic with upper respiratory symptoms, but without involvement of the entire respiratory system. the patients will be randomized to receive treatment with the study device or to receive placebo. 64 patients will be randomized into the study device group and 64 patients into the control group. patients will administer study device or control for 14 days and will have their symptoms recorded until no further symptoms are reported, up to a maximum of 28 days follow-up.


Eligibility criteria:
inclusion criteria: * ≥18 years of age * positive for sars-cov-2 infection * has symptoms of upper respiratory infection * willing to participate in the clinical trial and gives consent * is not pregnant, nor actively trying to conceive a child. exclusion criteria: * under 18 years of age * negative for sars-cov-2 infection * severe symptoms of infection * symptoms involving the entire respiratory system, including pneumonia * requires hospitalisation prior to study start * asymptomatic * pregnant or actively trying to conceive a child * other comorbidities that would prevent administration of the device * requirement to take regular medications administered by inhalation, or via the naso- and oropharyngeal route * patients with known allergies to neem or hypericum oil * patients with asthma