Kornimate/medical-research-clean huggingface dataset:
immediate effects cervicothoracic manipulation versus passive upper trapezius stretch

Conditions: Neck Pain

Summary: the proposed project seeks to evaluate the influence of cervicothoracic (ct) manipulation and passive stretching to the upper trapezius on pressure pain thresholds and range of motion (rom) in individuals without recent complain of neck pain.

not needed

Eligibility criteria:
inclusion criteria: 1. no current history or past history of neck pain; able to lie on back or stomach without difficulty exclusion criteria: 1. 'red flag' items indicated in your neck medical screening questionnaire such as history of a tumor, bone fracture, metabolic diseases, rheumatoid arthritis, osteoporosis, severe atherosclerosis, prolonged history of steroid use, etc. 2. history of neck whiplash injury 3. diagnosis from your physician of cervical spinal stenosis (narrowing of spinal canal) or presence of symptoms (pain, pins and needles, numbness) down both arms 4. presence of central nervous system involvement such as exaggerated reflexes, changes in sensation in the hands, muscle wasting in the hands, impaired sensation of the face, altered taste, and presence of abnormal reflexes 5. evidence of neurological signs consistent with nerve root entrapment (pinched nerve in the neck) 6. prior surgery to your neck or upper back 7. a medical condition which may influence assessment of pain or pressure pain thresholds (i.e. taking analgesics, sedatives, history of substance abuse, or cognitive deficiency) 8. diagnosis from your physician of fibromyalgia syndrome 9. currently pregnant, or could be pregnant
community health worker-led intervention to increase cardiac rehabilitation participation

Conditions: CVD - Cardiovascular Disease

Summary: this study is being done to evaluate whether a program called heart to heart, that helps patients make a more informed decision about cardiac rehab (cr), is interesting, acceptable to participants, and whether participants would recommend it to others.

this is a prospective, single-institution pilot study to evaluate the acceptability, feasibility and preliminary efficacy of a tailored community health worker (chw) led intervention to increase cr participation called h2h. individuals hospitalized with cardio vascular disease (cvd) events (aged 21 and older) will be identified and screened for eligibility from two johns hopkins acute care sites into the pilot study. the duration of participation for each participant is up to 6 months from baseline assessments. all participants will complete a survey at baseline, 3-, and 6-months and will have medical record abstraction conducted performed by the johns hopkins (jh) research study team. for the intervention, participants enrolled in the h2h program will complete between 4 to 8 coaching sessions with the chw (delivered by telephone and/or video chat) who will provide tailored education, improve or engage the participant's existing social support network, and assistance with health system navigation over a 3-month period.

Eligibility criteria:
inclusion criteria: 1. patients hospitalized with cardiac events and eligible for cr at johns hopkins hospital and bayview medical center. cr eligibility is determined by their treating health care team . 2. low socioeconomic status defined by medicaid insurance, or top quartile of the area deprivation index in baltimore city. 3. age ≥ 21 years 4. willing to be audio-recorded exclusion criteria: 1. formal diagnosis of dementia or cognitive impairment in the electronic health record (ehr) that would prohibit completion of study activities 2. formal diagnosis of a severe psychiatric disorders by diagnostic and statistical manual (dsm-5) criteria in the ehr that would prohibit completion of study activities (e.g., schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder). 3. systemic illness limiting longevity (e.g., advanced cancer) 4. contraindications to cr as assessed by their health care team 5. unwilling or unable to follow study procedures. 6. unable to consent 7. unable to speak or understand english. assessments including in-depth interviews will be conducted in english.

Keywords: cardiac rehabilitation
telehealth intervention for ostomy self-management

Conditions: Colorectal Cancer; Bladder Cancer

Summary: over one million individuals in the u.s. have ostomies. an ostomy is a surgical procedure that creates an opening in the abdominal wall that allows bodily waste (urinary or fecal) to pass through into an external pouch; in essence, it is the externalization of the gastrointestinal or urinary structures to the abdominal wall. for cancer, ostomies are most commonly placed for rectal cancers, followed by urinary bladder cancer. the health-related quality of life impact of an ostomy is tremendous and greater than many other cancer treatments. the goal of this study is to pilot-test a perioperative ostomy self-management telehealth intervention (periop-osmt) in patients with colorectal and bladder cancer and their family caregivers. participants will receive seven group telehealth sessions before and after ostomy surgery. this pilot clinical trial will study the feasibility of the methods/interventions and determine the preliminary efficacy to support a larger confirmatory trial.

an ostomy is a disability that adversely affects the hrqol of cancer survivors and their support persons/family caregivers (fcgs) at all phases of cancer survivorship. more than half of survivors experience stoma-related challenges such as pain, troublesome odor, skin problems around the stoma, and leakage. ongoing problems include pouching care, travel out of the home (especially relevant for rural populations), social interactions, intimacy, and acceptance of/satisfaction with appearance. studies document persistent challenges including sexuality, psychological problems, and interference with work, and recreation and sporting activities. the purpose of this study is to assess the feasibility of a perioperative ostomy self-management telehealth intervention (periop-osmt) and to determine the preliminary efficacy of the intervention on participant-reported outcomes, compared to the usual care arm. we hypothesize that the intervention will be feasible, acceptable and will demonstrate preliminary improvements in outcomes compared to the usual care arm.

Eligibility criteria:
patient eligibility criteria: * patient with bladder or colorectal cancer * scheduled to undergo a surgical procedure that includes the creation of an intestinal stoma (fecal or urinary, permanent or temporary) * for bladder cancer, only patients with incontinent urostomies (ileal conduit) are eligible. * age: ≥ 18 years * ability to read and understand english for questionnaires family caregiver eligibility criteria: * a family member or friend identified by the patient and defined as a person who knows the patient well and is involved in the patient's care before and after surgery * age: ≥ 18 years * ability to read and understand english for questionnaires * pregnant fcgs are eligible for participation. participation in this behavioral/educational intervention should not impact the pregnancy/fetus.

Keywords: ostomy, colorectal cancer, bladder cancer, quality of liffffffffffffffffffffe, telehealth, family caregivers
randomized controlled cluster trial of resident pay for performance and cardiovascular outcomes

Conditions: Myocardial Infarction; Heart Failure

Summary: the purpose of this study is to determine if a pay for performance model in contrast to the traditional "fee for service" model may improve the number of patients discharged being treated in accordance with joint commission on health care jcaho (a non-for profit organization that accredits health care organizations) standards and standard of care for management of hyperlipidemia in this study the investigators will evaluate these two models by training resident physicians (doctors in training) on jcaho core measures and specific criteria related to accepted standard of care for acute myocardial infarction and heart failure. the physicians will be randomized to a pay for performance or a fee for service model. then a medical record review will be performed on patient records that received a discharge diagnosis of myocardial infarction or heart failure and were cared for by the physician subjects


Eligibility criteria:
inclusion criteria: * physician inclusion: resident physician on the acute cardiology service, the coronary care unit, or the general medicine service at the university of virginia * patient inclusion: discharge diagnosis of heart failure or myocardial infarction. exclusion criteria: * residents that are part of the study team
cervical-cranial dry needling vs. orthopedic manual therapy for cervicogenic headache

Conditions: Cervicogenic Headache

Summary: dry needling is a therapeutic modality used to treat a number of neuromusculoskeletal conditions. practice trends suggest it is becoming widely used by physical therapists to help patients manage symptoms associated with cgh, however, there is limited scientific evidence demonstrating meaningful impact for dry needling for cgh. manual therapy (thrust and non-thrust mobilizations) to the cervical spine are well researched and have an established treatment effect for managing symptoms related to cgh. the purpose of this study is to compare outcomes (1 week, 1 month, 3 months, 12 months) for patients with cgh treated with cervical-cranial dry needling or pragmatically applied orthopedic manual therapy to the cervical spine. in addition to either the cervical-cranial dry needling or manual therapy to the cervical spine, patients will also receive patient education, thoracic manipulation, and exercise.

the use of dry needling is becoming widely used by physical therapists in the united states for a number of neuromusculoskeletal conditions including cervicogenic headache (cgh). dry needling is performed by taking a mono-filament needle and inserting it into symptomatic soft tissue. in this trial, the dry needling will be performed segmentally in the neck and along the patient's headache distribution pattern. orthopedic manual therapy (omt) may include both thrust and non-thrust techniques applied to a targeted spinal level and has a well-established treatment effect for patients with cgh. in this trial, the omt will be applied pragmatically to the cervical spine at the most symptomatic level of the headache. other interventions used in this trial will include patient education, thoracic manipulation and exercise. patients will be randomized to receive either dry needling or omt 2x/week for 2 weeks and then 1-2x/week for 2 weeks totaling 6-8 visits over the course of 1 month. the 1 week and 1 month outcomes collected will be reported on separately from the 3 and 12 months.

Eligibility criteria:
inclusion criteria: * 18 years or older * meets the ihs criteria for cgh * headache frequency of at least 1 per week over a period greater than 3 months. * demonstrates segmental dysfunction with passive mobility testing. exclusion criteria: patients whose headache experience is primarily of migraine origin. tension-type headache, headache pain \<2, contraindications to the interventions (malignancy, myelopathy, fracture, metabolic disease, rheumatoid arthritis, long-term corticosteroid use), headache presentation suggesting cervical arterial insufficiency, severe metal allergy, needle phobia, history of neck or thoracic spine surgery, non-english speaking patients, therapist is unable to elicit the headache with passive accessory intervertebral movements (paivm), or pending litigation for neck pain and/or headache.

Keywords: neck pain headache dry needling manual therapy
study of tacrolimus immunosuppressive therapy after kidney transplantation

Conditions: Kidney Transplantation; Kidney Failure, Chronic; Renal Insufficiency, Chronic

Summary: to compare the efficacy and safety of tacrolimus in combination with mmf and steroids in two regimens of steroid in an adult kidney transplanted population.


Eligibility criteria:
inclusion criteria: * female subject of childbearing potential must have a negative serum pregnancy test at enrolment and must agree to maintain effective birth control during the study * has an end stage kidney disease and is a suitable candidate for primary renal transplantation or retransplantation * subject is receiving a kidney transplant, from a cadaveric or living donor between 5 and 65 years of age with compatible ab0 blood type exclusion criteria: * pregnant woman or breast-feeding mother * has an immunological high risk, defined as having a most recently measured pra grade of \> 50% within the previous six months * known allergy to the study drug or any of its components * requires ongoing dosing with a systemic immunosuppressive drug at study entry for any reason other than kidney transplantation * requires initial sequential or parallel therapy with immunosuppressive antibody preparation(s) * subject or donor is known to be hiv positive * has significant liver disease, defined as having during the past 28 days continuously elevated asat (sgot) and/or alat (sgpt) levels greater than 3 times the upper value of the normal range of the investigational site * diagnosis of malignancy or history of malignancy, except non metastatic basal or squamous cell carcinoma of the skin that has been treated successfully * has significant, uncontrolled concomitant infections and/or severe diarrhoea, vomiting, or active peptic ulcer * previously received or is receiving an organ transplant other than kidney * receiving a graft from a non-heart-beating donor * cold ischemia time of the donor kidney \>30 hours * any form of substance abuse, psychiatric disorder or condition which, in the opinion of the investigator, may complicate communication with the investigator

Keywords: organ transplantation tacrolimus prograf kidney immunosuppression
longitudinal assessment of genomic alterations and clonal evolution in alk-positive nsclc (galileo project)

Conditions: ALK Gene Mutation; NSCLC Stage IV; ALK Sensitizing Mutation

Summary: the scope of galileo project (genomic alterations and clonal evolution in alk+ nsclc) is to explore the feasibility of genomic longitudinal evaluation for alk+ nsclc patients in italian routine practice and provide a detailed overview of resistance mechanisms and clinical outcomes according to current standard treatments.


Eligibility criteria:
inclusion criteria: * a) histologically confirmed diagnosis of advanced nsclc with alk rearrangement detection by ngs (alk+ nsclcs patients detected at diagnosis by in hybridization (fish), immunohistochememistry (ihc), or reverse transcriptase-pcr (rt-pcr) can be included if adequate tissue for ngs is available) b) to have received upfront treatment with alectinib, brigatinib or lorlatinib for at least 28 days c) ecog ps 0-2 d) adult patients (aged ≥ 18 years) at the moment of diagnosis e) signing of informed consent approved by the local ethic committee exclusion criteria: a) diagnosis of lung cancer without alk rearrangement a) early withdrawn of treatment due to toxicity without evidence of radiological disease progression cannot be eligible for the study

Keywords: alk mutation nsclc
mastering diabetes pilot study

Conditions: Diabetes Mellitus

Summary: this is a pilot study looking at past results of the mastering diabetes program utilizing a survey.

adult past and present participants of mastering diabetes will be sent an email asking for their participation in the survey. the email will contain a hot link to a redcap survey which will begin with a description of the study followed by a consent form. once the consent is agreed, the survey will ask for participants' demographics and information about the variables described below no personal identifiable information is being collected. the data from this study will help develop a prospective study to better evaluate the effectiveness of mastering diabetes in controlling diabetes. future comparative studies between programs are anticipated, which will help identify the strengths and weaknesses of different programs, as well as identify subpopulations that might benefit from one program as opposed to another. data will be shared via posters and papers among the lifestyle medicine community to help contribute to better lifestyle interventions.

Eligibility criteria:
inclusion criteria: * adult past and present participants of mastering diabetes exclusion criteria: * none

Keywords: diabetes lifestyle plant-based, whole food vegetarian vegan exercise
bariatric surgery and pharmacokinetics of escitalopram

Conditions: Obesity, Morbid

Summary: changes to gastric ph, gastric emptying time, gastrointestinal transit-time or the pre-systemic metabolizing effect of enzymes secreted in the mucosa may all alter the pharmacokinetics of medicines. these factors are potentially influenced by bariatric surgery. little is so far known about how gastric bypass and sleeve gastrectomy impacts the biological availability of medication. in this study the pharmacokinetic effects of bariatric surgery on escitalopram are investigated.


Eligibility criteria:
inclusion criteria: * preparing to undergo gastric bypass or sleeve gastrectomy in central norway * being a norwegian citizen exclusion criteria: * having previously undergone resections in the gi-tract

Keywords: bariatric surgery gastrointestinal tract biological availability pharmacokinetics citalopram
the effect of permissive hypercapnia on oxygenation and post-operative pulmonary complication during one-lung ventilation

Conditions: Thoracic Surgery

Summary: permissive hypercapnia increased the survival rate in patients with acute respiratory distress syndrome (ards) who required mechanical ventilation in critical care medicine. this has been explained by its association with ventilator induced lung injury. since then, a protective lung ventilation strategy has been very important, with a low tidal volume of 4-6 ml/kg. patients undergoing surgery will inevitably require mechanical ventilation. in particular, patients undergoing one lung ventilation for thoracic surgery may have increased airway pressure and a greater chance of ventilator induced lung injury. recently, protective lung ventilation has been applied to patients undergoing one ung ventilation during thoracic surgery. the purpose of this study is to evaluate the difference in the degree of pulmonary oxygenation and the incidence of postoperative pulmonary complications in hypercapnia induced by controlling the respiratory rate with a constant tidal volume.


Eligibility criteria:
inclusion criteria: 1. adult patients aged 40-80 years who are planning to have thoracoscopic single lobectomy or segmentectomy with one lung ventilation during surgery. 2. american society of anesthesiologists (asa) classification 1\~3 exclusion criteria: 1. patients with heart failure (nyha class iii\~iv) 2. patients who are having moderate obstructive lung disease or restrictive lung disease 3. low dlco (\< 75%) 4. patients with brain disease history or increased icp 5. patients with pulmonary hypertension (mean pap\>25mmhg) 6. patients with liver disease (ast level ≥100 iu/ml or alt ≥ level 50 iu/l) or kidney disease (creatine level ≥ 1.5 mg/dl) 7. patients with pre-existing hypercapnia or metabolic acidosis 8. body mass index (bmi) \> 30 kg/m2 9. patients who have had contralateral lung surgery 10. patients who cannot read explanation and consent form 11. patients who are pregnant
impact of early goal-directed therapy to perfusion and metabolism of brain

Conditions: Septic Shock

Summary: early goal directed therapy (egdt) is an effective treatment for patients with septic shock, which is widely used in clinic. fluid resuscitation can significantly reduce the mortality of patients with septic shock and improve the prognosis of patients with egdt. however, in recent years, the standard of egdt to determine the existence of the target of septic shock. some studies have shown that there may be a manifestation of the deficiency of kidney and liver and other organs such as kidney, liver and other organs in the recovery of egdt. therefore, this experiment is to explore the brain perfusion and metabolism of the egdt when the target is reached.the aim of this study was to investigate the effects of egdt as a guide to the cerebral perfusion and metabolism in order to provide clinical evidence for the treatment of fluid resuscitation in patients with septic shock.

1. patients enrollment this project: met the inclusion criteria without exclusion criteria were entered test, and record the general information, including name, hospital number, gender, age, height, weight, admission, and in time, icu admission and in icu diagnosis, previous underlying diseases, into the group of apache ii score and sofa score 2. implement septic shock bundle: measurement the value of lactic acid of patients after administrating of icu, take blood culture before antibiotic using, give wide-spectrum antibiotic treatment and began liquid resuscitation 3. preparation： a. basic state records b. using cam-icu delirium assessment for patients, and record the assessment results c. cerebral oxygen saturation monitor d. via the jugular vein placed central venous catheter and femoral artery placed picco catheter 4. monitoring of hemodynamics and cerebral perfusion and metabolic indicators

Eligibility criteria:
inclusion criteria: * new infectious shock in accordance with the diagnostic criteria of the 2012 ssc guidelines； * liquid recovery is not fully achieved egdt standards, at least meet the following criteria: * mean arterial pressure \< 65mmhg * central venous pressure \< 8mmhg * per hour urine volume was less than 0.5ml/kg * central venous oxygen saturation \<70% * arterial blood lactic acid value \> 2.5mmol/l * signed informed consent exclusion criteria: * subjects/subjects client reject the invasive hemodynamic monitoring * have contraindications to place hemodynamic monitoring * unconsciousness state before septic shock and gcs\<12 * cannot put the electrodes on the eyebrow * pregnant or lactating women * end stage of illness or death rate is more than 80%
study evaluating the efficacy and safety with cd19car-t for relapsed or refractory acute lymphoblastic leukemia

Conditions: Relapsed Acute Lymphoblastic Leukemia; Refractory Acute Lymphoblastic Leukemia

Summary: this study is a single-arm, open label, phase i clinical trial to evaluate the safety and feasibility of cd19car-t in treatment of relapsed / refractory acute lymphoblasic leukemia.


Eligibility criteria:
inclusion criteria: 1. diagnosis with relapsed or refractory acute lymphocyte leukemia with cd19 positive 2. age 18 to 65 years old, both male and female; 3. is expected to survive more than 12 weeks; 4. physical condition is good: 0-1 score ecog score; 5. no obvious abnormal heart, liver, kidney, no large wounds that haven't healed on the body; 6. into groups to participate in voluntarily, good adherence, can cooperate test observation, childbearing age women must be 7 days before starting treatment expert pregnancy test and the results were negative, and signed a written informed consent form. exclusion criteria: 1. organ failure, such as heart: class iii and iv; liver: to child grading of liver function grade c; kidney: kidney failure and uremia stage; lung: symptoms of severe respiratory failure; brain: disorder of consciousness; 2. existing serious acute infection, uncontrollable, or have fester sex and chronic infection, wound in delay no more; 3. pregnancy and lactation women; 4. patients who have participated in other clinical trials or other clinical trials in the past 30 days; 5. the investigator believe the patients should not participate in this experiment.