Kornimate/medical-research-clean huggingface dataset:
non invasive brain stimulation for ptsd

Conditions: Posttraumatic Stress Disorder (PTSD)

Summary: this study is designed to identify changes in the brain that underlie symptoms of combat-related ptsd using brain imaging (fmri). then, the investigators will administer mild electrical stimulation to the side of the head (using a method called tdcs) in an attempt to reduce the symptoms of ptsd.

being involved in combat is a horrific experience that substantially increases the risk of developing posttraumatic stress disorder (ptsd). although several effective treatments have been identified for ptsd a substantial number of patients (up to 50%) continue to experience symptoms. the field of neuroscience has revealed that patients with ptsd demonstrate altered functioning within, and interactions between, several brain regions; findings that are consistent with animal models of chronic stress. despite this evidence, existing treatments are generally not designed using this neuroanatomical knowledge. the central premise of the proposed study is that neuroscientifically-based information can be used to develop more precise and effective treatments. transcranial direct current stimulation (tdcs) will be used in an attempt to "correct" the dysfunctional brain regions (and communication between these regions), with the expectation that this modulation will result in symptom improvement. the primary goals of the study are to verify the maladaptive brain networks and then establish evidence that tdcs modulates these networks. subsequent studies, performed during the later study years, will examine dose-response relationships and synergistic effects of tdcs and existing treatments. outcome will be assessed using a multi-method approach that includes functional connectivity using resting-state functional magnetic resonance imaging data, neuropsychological tests, and self-report measures of emotional functioning. the combined results will provide vital methodological, mechanistic, and practical information necessary for a formal clinical trial of tdcs in ptsd.

Eligibility criteria:
inclusion criteria: * male * combat veteran - both veterans with and without ptsd will be included at different points in this study * right-handed * between the ages 18-88 * stable on medications for a minimum of 2 weeks exclusion criteria: 1. a history of neurological disease (e.g., dementia, epilepsy, stroke, moderate - severe traumatic brain injury) 2. "severe" axis i diagnoses (e.g., bipolar disorder, schizophrenia) 3. presence of axis ii disorders 4. current alcohol or drug abuse/dependence (in the past 8 weeks) 5. participants will also be excluded if they are not mri compatible (assessed using the guidelines of the american college of radiology) 6. imminent risk of harm to self or others 7. history of hiv or sickle cell anemia, as these can cause neuropsychological issues .
open label of clinical trial of sulforaphane in children with autism

Conditions: Autism

Summary: this is an open-label, 4-month study examining the effects of sulforaphane (sf) on behavior in children with asd and the correlation between behavior change and urinary metabolites. the goal is to determine a potential mechanism of action of sf in this population.

sulforaphane (sf) is an isothiocyanate found in high levels in crucifers belonging to the family brassicaceae (including broccoli, cabbage, cauliflower, brussels sprouts, chinese cabbage and turnips). many previous studies have documented that consumption of these vegetables is associated with a reduced risk of cancer (lung, breast, colon, rectum, and prostate).(juge et al. 2007) the mechanism of action of these beneficial effects is believed to be due to the ability of sf to up-regulate genes that improve cellular response to oxidative stress, inflammation, dna-damaging electrophiles, and radiation.(singh et al. 2014) in a recent small, randomized controlled trial in children with autism, sf was shown to have beneficial effects on aberrant and social behavior.(singh et al. 2014) the mechanism of action of this beneficial effect has not been established in children with asd. our primary goal is to examine changes in urinary metabolites in children with autism who receive sf to determine if changes in behavior are associated with changes in urinary metabolites.

Eligibility criteria:
inclusion criteria: * male or female, enrolled at ohs, age 6-22 and with a diagnosis of asd. * asd diagnosis will be established by standard criteria (dsm-iv criteria and expert clinician review of medical records and child observation). * written informed consent obtained from the subject's legal representative and ability for subject to comply with the requirements of the study. exclusion criteria: * presence of a condition or abnormality that in the opinion of the investigator would compromise the safety of the patient or the quality of the data.
evaluation of emergency triage using a computerized simulator

Conditions: Emergencies

Summary: a four-level triage scale (the geneva emergency triage scale, gets) has been used since 1997 in our emergency department (ed). a recent evaluation of this scale showed that our instrument had an excellent intra-rater reliability but insufficient inter-rater reliability. we also observed a wide variability in the way triage nurses perform (j clin epidemiology, 2006 in press). these variations in the triage process are mainly explained by a poor standardization of vital signs measurement. therefore, we have recently modified our triage instrument and introduced explicit criteria for vital signs evaluation during the triage process. the objectives of this study are: * to evaluate the inter- and intra-rater reliability of our modified triage scale using a computer simulator * to measure the impact of visual clues on the triage decisions when using the triage simulator * to evaluate the performance of triage nurses and chief physicians in their triage decisions. we expect to observe: * an improvement of the inter-rater reliability of our instrument compared to the previous version * a better standardization and more systematic use of vital signs measurement * a higher reliability when visual clues are given to the evaluator * lower rates of under- and over-estimation of emergency levels.

a four-level triage scale (the geneva emergency triage scale, gets) has been used since 1997 in our emergency department (ed). a recent evaluation of this scale showed that our instrument had an excellent intra-rater reliability but insufficient inter-rater reliability. we also observed a wide variability in the way triage nurses perform (j clin epidemiology, 2006 in press). these variations in the triage process are mainly explained by a poor standardization of vital signs measurement. therefore, we have recently modified our triage instrument and introduced explicit criteria for vital signs evaluation during the triage process. the objectives of this study are: * to evaluate the inter- and intra-rater reliability of our modified triage scale using a computer simulator * to measure the impact of visual clues on the triage decisions when using the triage simulator * to evaluate the performance of triage nurses and chief physicians in their triage decisions. we expect to observe: * an improvement of the inter-rater reliability of our instrument compared to the previous version * a better standardization and more systematic use of vital signs measurement * a higher reliability when visual clues are given to the evaluator * lower rates of under- and over-estimation of emergency levels.

Eligibility criteria:
inclusion criteria: * triage nurses * emergency physicians

Keywords: triage
1.5t intraoperative mr imaging in craniopharyngiomas

Conditions: Craniopharyngioma

Summary: purpose of this study is to investigate whether intraoperative imaging using a 1.5t mri in craniopharyngioma surgery is useful in order to increase the rate of complete tumor removal.


Eligibility criteria:
inclusion criteria: * complex craniopharyngioma \> 1cm extension within 2 or more cranial fossae or ventricular system * patient or legal representative able to provide written informed consent exclusion criteria: * tumor size\< 1 cm * patients with any condition considered a contraindication to mri * patients with any condition considered a contraindication for surgery * hypothalamic disturbances * hypothalamic edema

Keywords: craniopharyngioma surgery intraoperative imaging rate of total removal
role of topical tranexamic acid in total hip arthroplasty

Conditions: Post Operative Blood Loss

Summary: total hip arthroplasty (tha) is a procedure associated with perioperative blood loss, requiring blood transfusions in some patients. the major cause of this blood loss is due to surgical trauma that induces the clotting cascade and fibrinolysis. several previous studies and meta-analyses have shown that tranexamic acid is an effective antifibrinolytic agent that reduces blood loss in a variety of situations. tranexamic acid given in an intravenous form has been extensively studied and shown to be efficacious in cardiothoracic, spine surgical procedures as well as total knee arthroplasty (tka) and tha. similarly, topical tranexamic acid has been associated with decreased blood loss in cardiac surgeries as well. recently, results from a prospective randomized study on the topical use of tranexamic acid in total knee arthroplasty found it to be effective for reducing postoperative blood loss. taking all of the above into consideration we have proposed a study to evaluate effects of topical application of tranexamic acid on postoperative blood loss and blood transfusion on patients undergoing total hip arthroplasty. the aim of this study is to evaluate the efficacy of the topical application of tranexamic acid on blood loss in patients undergoing a primary unilateral total hip arthroplasty.


Eligibility criteria:
inclusion criteria: * 18-80 years of age. * male or female. * degenerative joint disease of hip joint. * primary uncemented total hip arthroplasty. * willingness to participate in the study, follow up at regular intervals exclusion criteria: * known allergy to tranexamic acid * history of any acquired disturbances of color vision * preoperative anemia on basis of pre-operative lab work up (a hemoglobin value of \<11 g/dl in females and \<12 g/dl in males) * history of previous myocardial infarction * history of arterial or venous thromboembolic disease * history of fibrinolytic disorders requiring intraoperative antifibrinolytic treatment, coagulopathy in the past and/or as identified by a preoperative platelet count of \ 1.5, or a prolonged partial thromboplastin time * pregnancy (h/o any missed menstrual periods in a women of reproductive age group) * breastfeeding * refusal of blood products * preoperative use of anticoagulant therapy within five days before surgery * medical issues that may pose complications for surgery and would disqualify patient for surgery regardless of clinical trial (e.g. renal and hepatic failure) * major comorbidities (e.g. severe ischemic heart disease ) * severe pulmonary disease * preoperative blood donation * participation in another clinical trial involving pharmaceutical drugs

Keywords: blood loss tranexamic acid total hip arthroplasty post op post operative prevent post operative blood loss
advanced breast cancer study of cdk4/6 inhibitor combined with endocrine therapy endocrine therapy in hr+/her2- advanced breast cancer

Conditions: Advanced HR+ HER2 Negative Breast Carcinoma

Summary: by retrospectively collecting and arranging real-world data of multi-center hr+/her2- advanced breast cancer in china combined with cdk4/6 inhibitor and endocrine therapy, we analyzed different her2 expression levels (her2 0, 1+, 2+ and fish-), especially clinical outcomes of endocrine therapy for metastatic breast cancer with low her2 expression (her2 1+, 2+ and fish-), exploring potential biomarkers of cdk4/6 inhibitors, and understanding the outcome characteristics of her2 heterogeneity in mbc through multivariate analysis , and guide clinical application.


Eligibility criteria:
inclusion criteria: * 1) female patients with advanced breast cancer aged ≥18 years. 2) for breast cancer patients diagnosed as hr-positive and her2-negative by pathological examination, the expression levels of er, pr, and her2 were reported by immunohistochemistry in the primary or metastatic lesions. 1. er positivity and/or pr positivity is defined as: the proportion of tumor cells with positive staining accounts for ≥ 10% of all tumor cells (confirmed by the investigator of the trial center); 2. her2 negative is defined as: standard immunohistochemistry (ihc) test is 0/1+; her2 (2+) needs to be tested by fish, her2/cep17 ratio is less than 2.0 or her2 gene copy number is less than 4 (by the test center of the test center) investigator review and confirmation). 3) cdk4/6 inhibitors combined with endocrine therapy can conduct complete efficacy evaluation and follow-up information collection. 4) postmenopausal or premenopausal/perimenopausal female patients can be enrolled. postmenopausal status, defined as meeting at least one of the following criteria: prior bilateral ovarian surgery; age ≥60 years; age \<60 years, menopause for at least 12 months (not due to chemotherapy, tamoxifen, toremide) fen or ovarian suppression) and follicle-stimulating hormone (fsh) and estrogen levels are in the postmenopausal range. premenopausal or perimenopausal women may also be enrolled, but must be willing to receive lhrha during the study period. 5) according to recist 1.1 criteria, patients must have: a) measurable lesions; b) unmeasurable osteolytic or mixed (osteolytic + osteoblastic) bone lesions in the absence of measurable lesions. exclusion criteria: * 1) early breast cancer patients receive cdk4/6 inhibitor drug therapy. 2) her2 overexpression or gene amplification, such as immunohistochemical score 3+ or positive fluorescence in situ hybridization. 3) pregnant or lactating female patients. 4) patients deemed unsuitable for inclusion by the investigator.
efficacy and safety of sofosbuvir plus ribavirin in adults with chronic hcv infection

Conditions: Chronic HCV Infection

Summary: the primary objectives of this study are to evaluate the efficacy, safety and tolerability of treatment with sofosbuvir (sof)+ ribavirin (rbv), with or without pegylated interferon alfa (peg-ifnα-2a/ peg)) in participants with chronic genotype (gt)-1, 2, 3, and 6 hepatitis c virus (hcv) infection.


Eligibility criteria:
key inclusion criteria: * willing and able to provide written informed consent * hcv rna ≥ 10\^4 iu/ml at screening * hcv treatment-naive (hcv genotype 1, 2, 3 or 6), defined as no prior exposure to any interferon (ifn), rbv, or other approved or experimental hcv-specific direct-acting antiviral agent, or hcv treatment-experienced (hcv genotype 1, 2, 3, or 6 only) with medical records that include sufficient detail of prior treatment with ifn to allow for categorization of prior response as either ifn intolerant, non-responder, or experiences viral breakthrough or relapse * hcv infection documented by anti-hcv antibody test, genotyping test, or liver biopsy key exclusion criteria: * current or prior history of any clinically-significant illness (other than hcv) * pregnant or nursing female or male with pregnant female partner * chronic liver disease of a non-hcv etiology * infection with hepatitis b virus (hbv) or human immunodeficiency virus (hiv) note: other protocol defined inclusion/exclusion criteria may apply.
ct-p13 (infliximab) subcutaneous administration in patients with moderately to severely active ulcerative colitis (liberty-uc)

Conditions: Ulcerative Colitis

Summary: this is phase 3, randomized, placebo-controlled study to demonstrate superiority of ct-p13 sc over placebo sc in patients with moderately to severely active ulcerative colitis


Eligibility criteria:
inclusion criteria: * patient is male or female aged 18 to 75 years, inclusive. * patient has moderately to severely active uc with a modified mayo score of 5 to 9 points with endoscopic subscore of ≥ 2 points exclusion criteria: * patient who has previously received 2 or more biologic agents and/or jak inhibitors * patient who has previously received either a tnfα inhibitor or biologic agent within 5 half-lives
a video-based hcv curriculum for active injection drug users

Conditions: Hepatitis C; Opiate Dependence

Summary: the investigators hypothesize that a well-designed hepatitis c (hcv) video education curriculum for active drug injectors will lead to measurable improvements in hcv testing rates, hav and hbv vaccination rates, as well as knowledge and attitudes about this condition. the investigators will use a short 10 minute video designed for active drug users to and assess its impact vs. a usual-care counseling intervention. the investigators will measure and compare its impact at baseline, 4 weeks after video viewing, and 12 weeks after intervention.

active drug injectors are at high risk for contracting and transmitting hcv. very few culturally-specific tools have been developed to improve outcomes in this population. we hypothesize that measurable improvements in hcv testing rates, hepatitis a and b vaccination rates, and knowledge, attitudes, and motivations toward behavior change may be elicited by such a curriculum. in this study, we will investigate the impact of a short hcv education video on active drug injectors at a syringe exchange program. subjects will be enrolled in one of two cohorts: a usual-care cohort, which will receive the program's standard hcv counseling; vs an intervention cohort, which will view the education video. subjects will undergo written testing for knowledge, attitudes about transmission behaviors, and motivations toward behavior change before the intervention, immediately after the intervention, 4 weeks after the intervention, and 12 weeks after the intervention. additionally, we will measure and compare the rates of hcv testing and hav/hbv vaccinations before and at the end of the 12 week time point in both cohorts.

Eligibility criteria:
inclusion criteria: * age 18 and older * attendance at syringe exchange program exclusion criteria: * unable to provide informed consent * not interested in study * not able to speak or understand english

Keywords: hepatitis c heroin populations at risk testing vaccination
appropriate timing of surgery after neoadjuvant chemoradiation for locally advanced rectal cancer

Conditions: Neoplasm, Rectum

Summary: this study aimed to compare the outcomes of early versus late surgical resection in patients who underwent curative total mesorectal excision after neoadjuvant chemoradiation. half of the participants will undergo surgery before 8 weeks, while the other half will undergo surgery after 8 weeks.


Eligibility criteria:
inclusion criteria: 1. clinic stage ii-iii cancer ( t3- t4 tm or/and n(+) disease ) 2. patients with histologically confirmed adenocarcinoma of the rectum 3. tumor distal border located within 15 cm. from anal verge (as measured by rigid rectoscopy) 4. standardized total mesorectal excision surgery 5. tumor must be clinically resectable with curative intent (r0 resection must be most likely) 6. elective operation 7. the patient must consent to be in the study and the informed consent must be signed exclusion criteria: 1. clinic stage i and iv cancer disease 2. patients with malignant disease of the rectum other than adenocarcinoma 3. recurrent rectal cancer 4. emergency cases (mechanical bowel obstruction, perforation) 5. other previous or concurrent malignancies 6. any contraindication for radiochemotherapy 7. previous chemotherapy or radiotherapy to the pelvis 8. tumor has arisen from chronic inflammatory bowel disease or hereditary polyposis disease 9. american society of anesthesiologists score \>3 patients

Keywords: locally advanced rectal cancer neoadjuvant chemoradiation
pilot study on shear-induced platelet aggregation in acute coronary syndromes

Conditions: Angina, Unstable

Summary: the purpose of this study is to determine whether shear-induced platelet aggregation is able to discriminate first acute coronary syndrome (acs) from recurrent acs

predictive factors of recurrence of acs are not well determined. platelet aggregation and leucocyte activation seem to be involved in the pathogenesis. the aim of our study is to compare sipa, platelet activation and platelet-leucocytes aggregates on the onset of the acs and 3 months later in 2 groups of patients scheduled for a first episode of acs or recurrent acs .

Eligibility criteria:
inclusion criteria: over 18 years old. informed consent signed. acute coronary syndrome not associated with co-morbidity as bleeding diathesis or myocardial infarction during the procedure. clinical symptoms in agreement with myocardial infarction during the preceding 24 hours. ck or troponin elevation and one or more of the following criteria: ecg modifications transient st elevation\>1 mm. new inversion of st \<1 mm on 2 contiguous derivations. exclusion criteria: acute coronary syndrome with persistent st elevation. angioplasty in emergency before blood sampling. inflammatory disease or cancer. coagulation abnormalities. antiphospholipid syndrome. treatment by vitamin k antagonist. severe disease with life expectancy lower than 2 years. one-year follow up impossible.

Keywords: sipa acute coronary syndrome
evaluation of cd47, "do not eat me" signal expression in chronic myeloid leukemia

Conditions: Chronic Myeloid Leukemia (CML)

Summary: chronic myeloid leukemia is a myeloid neoplasm characterized by the overproduction of mature granulocytes . cluster of differentiation 47 (cd47) is a membrane protein, which is over-expressed by virtually all cancers and regulates many signaling systems associated with tumor growth and invasion. following cd47 binding to the inhibitory receptor (signal regulatory protein, sirpα) on macrophages, the cd47-receptor complex sends a "do not eat me" anti-phagocytic signal to prevent phagocytosis . this balance is tipped by cancer cells, which adopt the "self" signal and upregulate cd47 expression to evade immune surveillance and subsequent destruction. elevated expression of cd47 has been observed in ovarian carcinoma cell lines , murine myeloid leukemias , leukemic stem cells and several solid tumors . flow cytometry revealed high surface expression of cd47 on 73% of samples collected from the bone marrow of multiple myeloma (mm) patients . high cd47 expression on six different primary effusion lymphoma (pel) cell lines compared to peripheral blood mononuclear cells (pbmc) was found . additionally, in acute myeloid leukemia (aml), acute lymphoblastic leukemia (all), and several non-hodgkin's lymphoma (nhl) subtypes, increased cd47 expression is correlated with adverse clinical outcomes . hematological malignancies, even at onset, present with widespread bone marrow and peripheral blood involvement and many are still without effective systemic curative therapies . most cml patients have deep and durable responses when treated with bcr::abl1 tyrosine kinase inhibitors, which might be influenced by long-term toxicities during the treatment . cd47 "don't eat me signal" expression not evaluated in cml. the aim of the study to detect cd47 expression by flow cytometry in cml patients. to study the correlation between bcr::abl1 gene and cd47 expression in cml patients . evaluation of the role cd47 as predictor of cml patient outcome


Eligibility criteria:
inclusion criteria: * age more than 18 years * both sex * cml patients, who fulfill the who 2022 criteria exclusion criteria: * patients with other haematological neoplasms (all,cll, plasma cell myeloma)