Kornimate/medical-research-clean huggingface dataset:
palatal versus buccal protraction using plates assisted with facemask in growing class iii patients

Conditions: Class III Malocclusion

Summary: to compare palatal and buccal protraction using plates assisted with facemask in growing class iii patients

a randomized controlled clinical trial was adopted in this study. a total of 20 growing class iii patients were selected from patients seeking orthodontic treatment. the participants were recruited from the department of orthodontics at faculty of dentistry, mansoura university. no active advertisement was used for participant recruitment, and instead, a convenience sample was formed. prior to participating in the study, the purpose of the study was explained to the parents of the children and informed consents and assents were obtained according to the guidelines on human research adopted by the research ethics committee faculty of dentistry, mansoura university

Eligibility criteria:
inclusion criteria: * growing patients with age ranged between 8-13 years old. * patients should have examination: class iii malocclusion due to maxillary retrusion as verified by clinical and radiographic examination; sna \<79 and anb angle \< -1. * good likelihood of recall availability. exclusion criteria: * vertical skeletal mal relationship. * history of previous orthodontic/orthopedic treatment. * bad habits that may jeopardize the appliance. * patients with systemic diseases * congenital deformities such as cleft lip and/or palate.
exploratory study of pd-1 neoadjuvant treatment of recurrent meningioma

Conditions: Meningioma, Malignant

Summary: this research study is studying a drug as a possible treatment for high grade meningioma.

meningioma is one of the most common primary intracranial tumors, accounting for 13% to 26% of all intracranial tumors. although most meningiomas are benign tumors and can be cured by surgical resection, more than 20% of who ii (atypical) and about 3% of who iii meningiomas are more likely to have local recurrence after initial treatment , and the lifetime is poor. the immunotherapy represented by pd-1 has achieved remarkable efficacy in the treatment of solid tumors, but the application of pd-1 in recurrent meningioma is rarely reported. the study found that the expression of pd-l1 mrna and protein in high-grade meningioma cells increased, and the total number of t cells, including cd4+ and cd8+ cells, was significantly reduced, suggesting an inhibitory tumor immune microenvironment. recent studies have shown that giving patients anti-pd-1 antibody immunotherapy prior to conventional treatment can improve the pathological response, enable the body to produce an enhanced and sustained anti-tumor immune response, and form a tumor microenvironment conducive to immunotherapy. therefore, giving pd-1 antibody before surgery is a new idea for the treatment of meningiomas. this project aims to investigate whether patients with recurrent meningioma will change their immune function and prolong survival after preoperative pd-1 antibody treatment. it is planned to use flow cytometry, multiple immunofluorescence histochemistry technology, t cell receptor sequencing, etc to detect the changes in the patient's immune function before and after treatment, observe the pathological remission rate of pd-1 monoclonal antibody neoadjuvant treatment of recurrent meningioma, and identify potential response biomarkers, and conduct in-depth discussions on this treatment plan to further determine the treatment mode clinical value and specific mechanism of action in order to improve the clinical treatment level of patients with recurrent meningioma.

Eligibility criteria:
inclusion criteria: * pathologically diagnosed as a patient with who grade iii recurrent meningioma * age ≥ 18 years * kps≥70 * able to accept second surgery * ecog performance status \< 2 * glucocorticoid dosage dexamethasone ≤5mg/ day or equivalent dose exclusion criteria: * participants who have had chemotherapy, targeted small molecule therapy or study therapy within 14 days of protocol treatment, or those who have not recovered (i.e., ≤ grade 1 or at baseline) from adverse events due to agents administered more than 2 weeks earlier. * participants who are receiving any other investigational agents. * participants who have a diagnosis of an immunodeficiency. * requires treatment with high dose systemic corticosteroids defined as dexamethasone \>2mg/day or bioequivalent within 7 days of initiating therapy. * has received prior therapy with an anti-pd-1, anti-pd-l1, or anti-pd-l2 agent. unable to undergo brain mri.

Keywords: sintilimab
a modified placement of two additional pedicle screws at the fracture level for the treatment of thoracolumbar burst fractures--a study protocol of a randomised controlled trial

Conditions: Posterior Short-segment Pedicle Instrumentation

Summary: controversies exist about the best treatment of burst fractures of the thoracolumbar spine. adding screws in fractured segment has been proved in many literatures that can improve construct stiffness but sometimes aggravate the trauma of fractured vertebra. therefore, we are eager to find an optimized placement of two additional pedicle screws at the fracture level for the treatment of thoracolumbar burst fractures. this is the first randomised controlled study investigating efficacy of diverse orders of pedicle screws placement and will provide recommendations for treating patients with thoracolumbar burst fractures.

a blinded randomised controlled trial (blinding for the patient and statistician, rather than for the clinician and researcher) will be conducted. a total of seventy patients with single thoracolumbar ao type a3 or a4 fractures who are candidates for application of short-segment pedicle screws of fractured vertebrae will be randomly allocated to either the ds group (distraction-screws ) or the sd group (screws-distraction) at a ratio of 1: 1. the primary clinical outcome measures are compression ratio of anterior border of vertebral body height, depth of nail into injured vertebrae and kyphosis (cobb) angle. secondary clinical outcome measures are complications, visual analogue scale (vas) of back and leg pain, neurological function, operating time, intraoperative blood loss, japanese orthopaedic association (joa) scores and oswestry disability index. these parameters will be evaluated preoperatively, intraoperatively, on day 3 postoperatively and then at 1, 3, 6, 12 and 24 months postoperatively.

Eligibility criteria:
inclusion criteria 1. 18 years of age or above. 2. single thoracolumbar burst fractures 3. ao type a3 or a4 fractures 4. thoracolumbar injury classification and severity score (tlics) of more than 4 and duration of \< 2 weeks 5. application of posterior short-segment pedicle screws instrumentation at the fracture level exclusion criteria 1. previous pedicle instrumentation at the same level 2. multi-segmental thoracolumbar fractures or not ao type a3 or a4 are found 3. pregnancy 4. active infection or surgical site of the previous infection 5. planned emigration abroad within 2 years after inclusion 6. suffering from illness or long-term use of certain drugs affecting the stability of the spinal environment, such as metabolic bone disease, spinal tuberculosis and so on 7. the current use of anticoagulant (such as warfarin) or postoperative heparin for more than 6 months
a multi-component behavioral nutrition intervention for homebound elderly

Conditions: Undernutrition

Summary: the purpose of this study is to evaluate the efficacy and feasibility of a multi-level self-management intervention to improve nutritional intake in a group of homebound older adults (hoas) who are at especially high risk for undernutrition. the study will be guided by the theoretical approaches of the ecological model and social cognitive theory and will use a prospective randomized controlled design to estimate whether individually tailored counseling focusing on social and behavioral aspects of eating results in increased caloric intake and improved nutrition-related health outcomes in a sample of 104 hoas. the investigators hypothesize that intervention at these levels will improve caloric intake and indirectly improve health outcomes.


Eligibility criteria:
inclusion criteria: 1. at least 65 years of age 2. homebound (based upon medicare's definition of homebound status) 3. able to communicate or have a caregiver who is able to communicate 4. living in a private residence 5. experiencing either an acute illness or chronic condition 6. not consuming enough calories to maintain body weight or weight loss of \> 5% over past 6 months (if known) exclusion criteria: 1. significantly cognitive impaired (mmse \< 24 if living alone or mmse \< 15 if living with caregiver) (if known) 2. terminally ill 3. any cancer diagnosis within the past five years (melanoma excluded) 4. end-stage renal disease 5. gastric or enteral tube-feedings 6. dependent on a ventilator
cognitive rehabilitation in parkinson's disease

Conditions: Parkinson's Disease

Summary: we are testing a computer game-style rehabilitation program for people with parkinson's disease (pd). people with pd often have difficulty with motor planning, such as initiating or starting movements. we believe that our program will improve performance on a movement initiation task as well as on activities of daily living, such as walking, preparing a meal or opening a medicine bottle. we will measure brain function using functional mri before and after training to identify brain areas that are involved in improved performance. if effective, computer based training will be an inexpensive treatment for motor planning deficits in pd that is free from side effects and easy to administer to a large number of patients.

our approach is to use pd-based adaptive training to improve performance on ig movement initiation in patients with pd. we have three aims, 1) to systematically evaluate cognitive rehabilitation in people with parkinson's disease (pd), 2) to examine the neural mechanisms subserving cognitive rehabilitation in pd and 3) to assess the ecological validity of cognitive rehabilitation in pd. we will focus on a single aspect of cognitive function, the decision to initiate a movement. movements can be internally generated (ig) or externally cued, and motor deficits in pd are typically linked to ig movements. the protocol is designed to drive beneficial neuroplastic changes using a paradigm similar to those that have shown promising results in traumatic brain injury patients. in addition, we will use fmri to measure activity in underlying basal ganglia-thalamocortical circuits. finally, because the goal of any research regarding the pathophysiology of disease is to improve the lives of patients with the disease, behavioral and neuropsychological measures will be correlated with fmri measured functional abnormalities before and after training. improvement in the initiation of movement has the potential to dramatically improve daily functioning including reducing falls, improving language production and improving proficiency of activities of daily living.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of pd dominant on the right side with a hx of response to dopamine replacement. exclusion criteria: * contraindication to mri * history of stroke or significant head trauma * significant vision impairment * hx of brain surgery or claustrophobia * medication change \<4 weeks * atypical pd * severe tremor * presence of motor fluctuations or dyskinesia * significantly impaired limb or joint function * significant memory impairment * depression or daytime sleepiness

Keywords: parkinson's disease cognitive deficits fmri neuro rehabilitation age matched controls
prevention of type 2 diabetes mellitus in children

Conditions: Diabetes Mellitus, Type 2

Summary: this is a pilot study to examine the short-term effects of supervised exercise on metabolic risk factors for type 2 diabetes mellitus in children from a population that is at high risk for this disease. we hypothesize that exercise will significantly improve insulin sensitivity in all children, especially in children who are already insulin resistant, thereby lowering the risk that they will go on to develop type 2 diabetes mellitus. the specific hypotheses being tested are: 1. insulin resistance will be most evident in overweight children while an impaired ability of the pancreas to release insulin will be most evident in children with a family history of type 2 diabetes mellitus. 2. exercise will significantly improve insulin resistance (as measured by the fasting glucose/insulin ratio) with little or no effect on insulin secretory capacity (as measured by circulating insulin concentration at 1, 3, and 5 minutes following an intravenous glucose load) in children. 3. participation in a school-based health, nutrition, and exercise education program will have long-term beneficial effects on health-related behaviors and on insulin resistance.


Eligibility criteria:
early adolescent

Keywords: diabetes adolescent
prostate cancer: family care for patients and spouses

Conditions: Prostate Cancer; Quality of Life; Cancer Survivorship

Summary: the purpose of this study is to determine if a family-based intervention (the focus program) can improve the long-term quality of life and other psycho-social outcomes of men with prostate cancer and their spouses.

the purpose of this study was to determine if a family-based intervention (the focus program) could improve the long-term quality of life and other psycho-social outcomes of men with prostate cancer and their spouse/partners. aim 1. the first aim was to determine if the family intervention could improve several proximal clinical outcomes (less negative appraisal of illness or caregiving, less uncertainty, less hopelessness, better family communication, higher self-efficacy, and more problem-focused coping) and improve the distal clinical outcome, quality of life, in a culturally and economically diverse sample of men with prostate cancer and their spouses. aim 2. the second aim was to test a stress-coping model designed to predict which prostate cancer patients and their spouses are at higher risk of poorer long-term quality of life.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of prostate cancer * willing spousal partner * speaks and understands english * mentally and physically able to participate * minimum life expectancy of 12 months * lives within 70 miles exclusion criteria: * multiple primary cancers * watchful waiting status * spouse with cancer diagnosis in previous year

Keywords: randomized clinical trial coping quality of life family family caregiver cancer survivorship communication uncertainty support family education caregivers
albumin-bound paclitaxel plus s-1 versus sox as first-line treatment in advanced or recurrent gastric adenocarcinoma

Conditions: Gastric Cancer

Summary: it is a trial to compare the efficacy and safety of albumin-bound paclitaxel plus s-1 versus oxaliplatin plus s-1 (sox) as first-line treatment in advanced or recurrent gastric adenocarcinoma.


Eligibility criteria:
inclusion criteria: 1. age of 18-75 years; 2. cytological or histological diagnosis of recurrent or metastatic gastric adenocarcinoma; 3. at least one measurable lesion as defined by recist 1.1 criteria; 4. ecog performance status of 0-1; 5. estimated life expectancy of at least 3 months; 6. left ventricular ejection fraction (lvef) ≥ 50%; 7. bone marrow function: absolute neutrophil count(anc) ≥1.5×109 /l, platelet count(plt) ≥90×109 /l, hemoglobin(hb) ≥90 g/l; 8. liver and kidney function: creatinine(cr)≤1.5 x upper limit of normal range(uln); alanine glutamate transaminase (alt) and glutamate transaminase (ast) ≤2.5 x upper limit of normal range (uln), or ≤5 x upper limit of normal range (uln)when with hepatic metastases，total bilirubin (tbil)≤1.5 x upper limit of normal range (uln), or≤2.5 x upper limit of normal range (uln) when with gilbert's syndrome; 9. not be breast-feeding; men and women of reproductive age are willing to take reliable contraceptive measures during the study; 10. able and willing to comply with the study plans in this protocol and sign the informed consent; exclusion criteria: 1. have received chemotherapy before；patients that received neoadjuvant or adjuvant chemotherapy are eligible provided the treatment is completed\>6 months prior to first recurrence or metastasis; 2. her-2 positive; 3. patients with symptomatic brain metastases; 4. ii-iv peripheral neuropathy \[nci-ctcae 4.03\]; 5. anti-hcv antibody positive and hcv-rna positive; anti-hbv antibody positive with active hepatitis ; anti-hiv antibody positive; 6. patients with serious systemic infection or other diseases; 7. allergic to the chemotherapy drugs or the materials in this study; 8. patients with gastrointestinal bleeding that need clinical intervention; 9. patients with digestive tract obstruction or oral nutrition difficulty; 10. have a second malignancy within 5 years prior to registration except for cured carcinoma in situ of cervix uteri, non-melanoma skin cancer; 11. have participated in other clinical trials within 28 days prior to the first dose of this study; 12. contraindications to chemotherapy; 13. patients that researcher consider cannot sign informed consent or complete the study plan due to medical science factor, social factor or psychological reasons.

Keywords: gastric cancer albumin-bound paclitaxel
effects of primal reflex release technique in chronic non-specific low back pain

Conditions: Chronic Non-specific Low Back Pain

Summary: low back pain is a major disorder which occurs from chronic over use and injury to lumbar musculoskeletal system. sometimes the source of pain is non-specific leading to pain and spasm due to muscle imbalance. primal reflex release technique is a novel concept to decrease pain and muscle spasm by resetting reflexes using reciprocal inhibition following the concept of rebooting the autonomic nervous system. this study aims to determine the effects of primal reflex release technique on pain, flexibility and disability in chronic nonspecific low back pain patients. this study will be a randomized controlled trial and will be conducted at arif memorial hospital in lahore. a sample size of total 32 patients will be taken in this study using consecutive sampling technique. patients will be randomly assigned into two groups. group a will be treated by conventional therapy and group b will be treated by conventional therapy and primal reflex release technique. numeric pain rating scale and ronald morris disability questionnaire will be used to evaluate pain and disability respectively. flexibility of low back, iliopsoas, hamstring, piriformis and gastrocnemius will be measured by schober's test, modified thomas test, active knee extension test, fair test and active dorsiflexion, respectively. the evaluation will be on day 1 as pretreatment values and at 2nd and 4th week as post treatment values respectively. the collected data will be analyzed on spss - 25.


Eligibility criteria:
inclusion criteria: age 25-45 * both males and females * lower cross syndrome diagnosed by straight leg raise, modified thomas test, piriformis stretch test. * history of lbp for more than 6 weeks before the study, or had on-and-off pain having suffered at least 3 episodes of lbp during the year before the study, each lasting more than a year * the diagnosis confirmed on the presence of -pain experienced between the costal margins and the inferior gluteal folds which is influenced by physical activities and postures, usually accompanied by painful limitation of motion‖ exclusion criteria: no recent history of injury to lower limb * no experience with surgical treatments for disc herniation, spina bifida, or spinal stenosis, * no nerve root compression or no neurological problems. * sij compression test positive

Keywords: low back pain disability flexibility primal reflex autonomic nervous system
a study to evaluate the safety and tolerability of virtual reality to treat gastroparesis

Conditions: Gastroparesis

Summary: the purpose of this study is to determine if virtual reality therapy is safe and tolerable in treating gastroparesis.

after informed consent patients will be randomized to a 4 week treatment program comparing active vr treatment to sham vr treatment. symptoms will be measured at baseline and at 2 and 4 weeks using validated questionnaires. a short questionnaire will be answered daily to evaluate changes in nausea.

Eligibility criteria:
inclusion criteria: * adult patients, men and women ages 18-75. * documented gastroparesis (idiopathic or diabetic). * patients who have had an upper endoscopy within the past 3 years not showing evidence of an organic disorder that could cause symptoms and a 4-hour scintigraphic gastric emptying scan showing evidence of delayed gastric emptying. * patients will be identified as direct referrals to the general gi clinic or the motility clinic, and will undergo screening history and physical examination by the pi or co-investigator. exclusion criteria: * patients whose symptoms are thought to represent an organic disorder (e.g., peptic ulcer disease, hepatitis, pancreatitis, inflammatory bowel disease, a known malignancy, radiation-induced injury, an active infection, vasculitis, celiac disease). * if the patients have known uncontrolled diabetes (hgba1c \> 11), gerd, esophagitis, eosinophilic esophagitis, h. pylori, cannabinoid hyperemesis syndrome, celiac artery compression syndrome, or sma syndrome. * patients with prior surgery to the esophagus, stomach or duodenum. * patients taking opioids will also be excluded. * alcohol and tobacco use will be assessed, as will the presence of psychiatric conditions, such as anxiety, depression, post-traumatic stress disorder, bipolar disorders, and eating disorders, such as anorexia nervosa and bulimia. however, no patient will be excluded based on reported substance use or presence of a psychiatric comorbidity, unless their psychological status represents potential harm to themselves, others, or represents an impediment to treatment. * any patient identified as having a significant problem with alcohol or anxiety or depression will be referred back to their primary care provider for further evaluation and treatment. * patients with motion sickness, vertigo, or a seizure disorder will be excluded to prevent the theoretical risk of inducing or exacerbating symptoms related to the aforementioned conditions with vr.