Kornimate/medical-research-clean huggingface dataset:
implicit versus explicit motor training for upper extremity rehabilitation in chronic stroke patients

Conditions: CVA (Cerebrovascular Accident)

Summary: training methods that improve proprioception of the shoulder joint involve specific tasks targeting joint position sense, kinesthesia, or sense of force. these exercises can involve explicit or implicit motor learning. explicit learning involves verbal knowledge of movement performance, while implicit learning involves minimal verbal knowledge and learning in a less conscious manner. the purpose of the study is to identify the efficacy and difference between implicit and explicit motor training in improving upper extremity functions in chronic stroke patients. the study will use laser pointer pattern tracking exercises and precise repositioning tasks for explicit motor training and a cognitive-motor dual-task training for implicit motor training. the laser-pointer assisted angle reproduction test, wolf motor function test and arm motor ability test will be used for evaluation.


Eligibility criteria:
inclusion criteria: 1. age is ranging between 50 to 65 years 2. diagnosis of a single stroke 6 months to 2 years prior to study entry confirmed by neuroimaging reports (to minimize the chance that improvements occur because of spontaneous recovery). 3. sufficient cognitive and language abilities to understand and follow multiple-step instructions (a score of 24 or more on the mini mental state examination). 4. adequate vision to track the laser beam. 5. muscle strength of ≥ 3/5 for all upper extremity joints on manual muscle testing. 6. subjects are able at least to partially move outside of synergies at the affected elbow (brunnstrom recovery stage in the upper limb following stroke is 4 or greater) 7. spasticity at the paretic elbow, wrist, or fingers, defined as a score less than 2 on the modified ashworth scale. exclusion criteria: 1. uncontrolled seizure disorders. 2. additional neurological impairments, for example, parkinson disease that (severely) influence their upper limb functions. 3. excessive spasticity at the paretic upper limb muscles defined as a score equal or more than 2 on the modified ashworth scale. 4. excessive pain in the affected ue, as measured by a score of 5 or higher on a 10-point visual analog scale. 5. patients with musculoskeletal disorders of upper limb joints, such as severe arthritis, fractures, or fixed deformities. 6. patients with cognitive, visual, or auditory impairments.
team-based home blood pressure monitoring

Conditions: High Blood Pressure; Hypertension

Summary: the overall goal of this study is to identify and rigorously evaluate strategies for implementing and sustaining team-based home blood pressure monitoring (tb-hbpm) within primary care. the tb-hbpm intervention is a multifaceted program involving patient transmission of blood readings to ehr and clinical decision support. implementation strategies include group-based education on hypertension measurement, target blood pressure goals, drug and lifestyle management, referral to community resources, and team training designed to optimize the coordination of hypertension care, and monthly audit and feedback reports to teams and clinicians. hypertension control rates are suboptimal in many primary care practices with persistent racial disparities in control. team-based home blood pressure monitoring (tb-hpbm) involving patient transmission of their home blood pressure readings in real-time to their clinical team has been shown to improve blood pressure control. there is an urgent need to implement tb-hbpm into practice. the overall objective of this research is to assess implementation strategies that mitigate barriers and leverage facilitators to tb-hbhm on hypertension control and disparities between black and white patients. the study team and investigators will use mixed methods to assess the process and generate knowledge to facilitate broader uptake of tb-hbpm.

aim 2: deploy theorized implementation strategies using a type-2 hybrid stepped-wedge randomized cluster trial the department of family medicine will roll out the clinical intervention (tbhbpm). to improve rigor in evaluation, the study biostatistician will use computer-generated numbers to randomly assign each of the eight suites to when they will begin the intervention during one of three wedges (figure 1). the study team and investigators will randomize two suites in the first wedge and three each to the second and third wedge. aim 3: assess the impact of implementation strategies using specific metrics based on re-aim aim 4: test theoretical assumptions underlying the implementation strategies

Eligibility criteria:
eligibility criteria clinicians and staff eligibility criteria practice employees (practice leaders, administrators, clinicians, or staff) that work with hypertensive patients during the study period (scheduling appointments, coordinating care, measuring blood pressure, responding to questions, and/or treating their blood pressure) patient inclusion criteria * current hfm patient 18-85 years of age with hypertension diagnosis * diagnosis of hypertension based on icd-10 codes of i10-i14 * at least one hfm health visit and hypertension diagnosis beginning no later than 7/1/2021. patient exclusion criteria * not current patient in the participating practices * diagnosis of dementia, end-stage renal disease, and/or in hospice * currently pregnant

Keywords: home blood pressure monitoring hypertension control primary care teams implementation research health equity clinical trial
177lu-eb-psma617 in patients with metastatic castration-resistant prostate cancer

Conditions: Metastatic Castration-resistant Prostate Cancer

Summary: this is an open-label, non-controlled, non-randomized study to assess the safety and measure image-based absorbed dose of 177lu-eb-psma-617 in patients with metastatic castration-resistant prostate cancer (mcrpc) who will undergo radioliagnd therapy using 177lu-eb-psma-617. all patients underwent whole-body 68ga-psma pet/ct for selection and accepted intravenous injection with single dose 0.80-1.1 gbq (21.5-30 mci) of 177lu-eb-psma-617 within one week, then monitored at 2, 24, 72, 120 and 168 h after 177lu-eb-psma617 administration with serial whole body planar and spect/ct imaging.

prostate cancer is the most frequent malignant tumor in men worldwide. prostate-specific membrane antigen (psma), is a surface molecule specifically expressed by prostate tumors which was shown to be a valid target for radiotherapy. 177lu-psma-617, a urea-based compound, provide an effective target for the treatment of metastatic castration-resistant prostate cancer. however, a major problem in the therapeutic use of 177lu-psma-617 has been its short half-life and fast rate of clearance. this study was designed to investigate the safety, dosimetry and preliminary effects of 177lu-eb-psma-617 in patients with metastatic castration-resistant prostate cancer.

Eligibility criteria:
inclusion criteria: * all the patients had progressive metastatic castration-resistant prostate cancer that did not respond to androgen-suppression therapy and/or systemic chemotherapy. distant metastases with high psma expression were confirmed on 68ga-psma pet/ct within one week before the injection of 177lu-eb-psma-617. exclusion criteria: * the exclusion criteria were a serum creatinine level of more than 150 μmol per liter, a hemoglobin level of less than 10.0 g/dl, a white-cell count of less than 4.0× 109/l, a platelet count of less than 100 × 109/l, a total bilirubin level of more than 3 times the upper limit of the normal range and a serum albumin level of more than 3.0 g per deciliter, cardiac insufficiency including carcinoid heart valve disease, a severe allergy or hypersensitivity to radiographic contrast material, claustrophobia, and pregnancy or breastfeeding.
efficacy of lymphovenous bypass in the treatment of extremity lymphedema

Conditions: Lymph Leakage

Summary: background: lymphedema is a pathologic soft tissue swelling that arises secondary to disruption of the lymphatic system. lymphedema affects approximately 250 million people worldwide and causes significant physical and psychological morbidity. there is no definitive treatment for lymphedema. lymphovenous bypass - microsurgically anastomosing lymphatic channels and venules - has demonstrated promising results in the treatment of lymphedema. purpose: the purpose of this study is to determine the efficacy of lymphovenous bypass in treating extremity lymphedema. methods: this is a prospective, single-arm, cohort study. eligible patients between 18-70 years of age with extremity lymphedema will undergo lymphovenous bypass. the primary outcome measure will be extremity volume and the secondary outcome measure will be quality of life assessed by a validated assessment tool for lymphedema of the limbs (lymqol). patients will be assessed preoperatively and at 3, 6, 9, and 12-months postoperatively. each participant will serve as their own control. primary and secondary outcome measures will be assessed with paired t-tests. with a sample size of 9 patients we will have at least 80% power to reject the null hypothesis assuming an alpha level of 0.01. to further increase the power and to account for patients lost to follow-up the investigators will target a patient recruitment of 20. the findings of this study will help further elucidate the role of lymphovenous bypass in the treatment of extremity lymphedema.


Eligibility criteria:
inclusion criteria: 1. 18-70 years. 2. lymphedema of the upper or lower extremity. 3. international society of lymphology stage i-ii. exclusion criteria: 1. significant comorbidities that would preclude a patient from receiving a general anesthetic.

Keywords: lymphedema lymphovenous bypass
a virtual reality platform simulating visual impairment for testing of electronic travel aids and performing orientation and mobility training

Conditions: Visual Impairment; Age-Related Macular Degeneration; Diabetic Retinopathy; Glaucoma

Summary: in this study, the study team utilize virtual reality (vr) to simulate visual impairments of different types and severity in healthy subjects. the platform implements three of the most widespread forms of visual impairment in the united states (us): age-related macular degeneration (amd), diabetic retinopathy (dr), and glaucoma, each with three levels of severity, (mild, moderate, and severe). at present, glaucoma is further developed toward a multidimensional visual impairment simulation. the platform is utilized: i) to provide a safe, controllable, and repeatable set of environments for development and preliminary testing of electronic travel aids (etas) in a variety of conditions (i.e., using the eta to navigate in the immersed environment); and ii) to equip blind and low vision (bvi) professionals, inclusive of orientation and mobility (o\&m) instructors, with a controlled, tunable training platform for skill/capacity building, assessment, and refinement of o\&m techniques, as well as visually impaired trainees with a safe and immersive environment to improve their o\&m skills and learn novel techniques. two sets of hypothesis-driven experiments are proposed to assess the feasibility of the platform with respect to these two objectives.


Eligibility criteria:
inclusion criteria (patients with visual impairment) 1. aged 18-80; 2. people with glaucoma of all different levels and etiologies. inclusion criteria (healthy controls) 1. aged 18-80; 2. gender neutral: male or female. exclusion criteria (patients with visual impairment \& healthy controls) 1. significant cognitive dysfunction (score \<24 on folsteins' mini mental status examination) 2. previous neurological illness or psychiatric disorders, or suffer from a heart condition or other serious medical conditions 3. significant mobility restrictions; people using walkers and wheelchairs 4. pregnancy 5. elderly 6. seizures (people who previously have had a seizure, loss of awareness, or other symptom linked to an epileptic condition) 7. interference with medical devices (the headset and controller(s) may contain magnets or components that emit radio waves, which could affect the operation of nearby electronics, including cardiac pacemakers, hearing aids, and defibrillators)
a study of the safety and effectiveness of ustekinumab (stelara) in chinese patients with psoriasis

Conditions: Psoriasis

Summary: the purpose of this study is to evaluate the efficacy (good or bad effects) and safety of ustekinumab in the treatment of patients with moderate to severe psoriasis in china.

in this study, 220 patients will be divided into two groups randomly (by chance), like flipping a coin. each group will receive a different treatment. the results for each group are compared to each other. there are 2 treatment groups in this study, group 1 and group 2. group 1 will receive placebo at weeks 0 and 4, ustekinumab 45 mg at weeks 12 and 16. group 2 will receive ustekinumab 45 mg at weeks 0, 4, and 16 and placebo at week 12. all patients in the study will eventually receive ustekinumab after week 12. the patients will be in the study for about 36 weeks, with study visit approximately 10 times. effectiveness evaluations will be conducted throughout the study and include the psoriasis area and severity index (pasi), physician's global assessment (pga) and dermatology life quality index (dlqi). safety assessments will also be performed throughout the study and include obtaining and evaluating laboratory tests, vital signs (e.g., blood pressure) and the occurrence and severity of adverse events. group 1: placebo at weeks 0 and 4, ustekinumab 45 mg at weeks 12 and 16. group 2: ustekinumab 45 mg at weeks 0, 4, and 16. placebo at week 12

Eligibility criteria:
inclusion criteria: * must be of chinese ancestry * have had a diagnosis of plaque-type psoriasis at least 6 months prior to study start * have plaque-type psoriasis covering at least 10% of total bsa at screening and at the time of study start * have a psoriasis area and severity index (pasi) score of 12 or greater at study start * must be candidates for phototherapy or systemic treatment of psoriasis (either naive or history of previous treatment) exclusion criteria: * currently have nonplaque forms of psoriasis * have current drug-induced psoriasis * have used any investigational drug within the previous 4 weeks * have used any biologic within the previous 3 months * be known to be infected with human immunodeficiency virus (hiv), hepatitis b virus (hbv), hepatitis c virus (hcv), or syphilis

Keywords: psoriasis asian patients chinese ustekinumab cnto 1275 stelara
effect of dialysate cooling versus sodium profiling in management of intradialytic hypotension among chronic hemodialysis patients

Conditions: Intradialytic Hypotension

Summary: chronic kidney disease (ckd) is a worldwide public health issue. dialysis patients have a tenfold greater relative risk of cardiovascular death than the general population. dialysate cooling prevents intradialytic hypotension (idh). this is achieved by inducing vasoconstriction and activating the sympathetic nervous and therefore improving hemodynamic stability . intradialytic hypotension (idh) is a common complication of hd. there is no consensus on the definition of idh, but (idh) is commonly defined as a drop in blood pressure during dialysis procedure and/ or hypotensive symptoms such as dizziness, weakness, nausea, cramps, blurred vision, and fatigue . the pathophysiology of idh is diverse. it could be the result of an inadequate cardiovascular response to the reduction in blood volume that occurs when the ultrafiltration volume is large . one process may involve an imbalance between a reduced effective circulating volume and the compensatory plasma refilling mechanism, wherein fluid from the interstitial and intracellular space is translocated into the intravascular compartment . cold dialysis reduces hd-induced brain damage by protecting the cerebral vascular beds from harmful perfusion . in the heart, long- term cold dialysis improved resting ejection fraction and reduced left ventricular mass and end-diastolic volumes while preserving aortic distensibility, decreasing the risk for future cardiovascular events . risk factors associated with idh include old age, female gender, hispanic ethnicity, long dialysis vintage, high intradialytic weight gain, high dialysis dose, anemia, diabetes, low pre-dialysis bp, high osmolarity, and high body mass index . it can be applied universally and reduce the need for nursing involvement . further, no additional cost is needed to conduct fixed reduction of dialysate temperature. while there are various methods of reducing dialysate temperature, optimal temperature or methods of temperature reduction to prevent idh remain uncertain to study the effect of dialysate cooling (0.5- 1 c lower than pre- dialysis core body temperature) vs traditional sodium profiling on: 1. reduction the episodes of idh . 2. net dry weight achievements. 3. post dialysis fatigue.


Eligibility criteria:
inclusion criteria: * • patients age 18-70 years old. * maintained on hd for not less than 6 months * documented episodes of idh exclusion criteria: * • severly anemic patients (hb\<7 g/dl) * patients taking more than 3 antihypertensive (on days other than dialysis day). * patients with documented ihd. * patients on midodraine therapy prior dialysis session. * patient refusal, incompliance or ineffective dialysis.
retrospective evaluation of cml patients in the national compassionate program

Conditions: Chronic Myeloid Leukemia; Philadelphia Positive

Summary: this observational study aims at assessing the tolerability and safety profiles of ponatinib, a drug used for chronic myeloid leukemia patients who are philadelphia positive. this drug is used during the chronic phase of the disease, according to the italian national compassionate law 648/96.

this observational study aims at assessing the tolerability and safety profiles of ponatinib, a drug used for chronic myeloid leukemia patients who are philadelphia positive. this drug is used during the chronic phase of the disease, according to the italian national compassionate law 648/96.

Eligibility criteria:
inclusion criteria: * cml ph+ patients in chronic phase * 18 years old or older * patients have received either dasatinib or nilotinib and resulted resistant or not tolerant to the drugs or have developed the t3151 mutation * patients have started ponatinib at least 12 months before registration * informed consent signed at registration exclusion criteria: * cml ph+ patients in accelerated or blast phase with acute lymphoblastic leukemia

Keywords: chronic myeloid leukemia philadelphia positive compassionate use
conventional with stereotactic radiotherapy for pain reduction and quality of life in spinal metastases

Conditions: Spinal Metastases

Summary: a randomized, multicentre, phase iii study comparing conventional radiotherapy (1x8gy) with stereotactic radiotherapy (1x20gy) for pain reduction and quality of life in spinal metastases.

study population: patients with painful spinal metastases from solid tumors without spinal cord compression or cord instability. objective: this study will test the hypothesis that stereotactic radiotherapy gives a better and longer lasting reduction of pain, local control and therewith a better quality of life. this in order to optimize and to individualize the treatment options for the patient. study design: complaints due to pain will be analysed using the validated dutch brief pain inventory (bpi) and side-effects will be recorded using the common toxicity criteria for adverse events (ctcae). in addition to this the quality of life will be analysed using the eortc qol-c15-pal and eortc qlq-bm22 questionnaires. for analysis of cost-effectiveness the eq-5d will be used.

Eligibility criteria:
inclusion criteria: * solid tumor with radiological diagnosis of spinal metastases * pain score minimum 2 on 11-point scale * maximum of 2 consecutive or noncontiguous spinal vertebra involved by tumor at current level of interest * no or mild neurological signs (radiculopathy, dermatomal sensory change and muscle strength of involved extremity) * karnofsky performance ≥60 * who ≤2 * life expectancy \> 6 weeks * age ≥18 * non-pregnant, non-lactating female patients exclusion criteria: * history of previous radiotherapy to the spine at current level of interest * spinal instability or neurological deficit * pathological fracture or impending fracture needing fixation * prior surgery to the spine at current level of interest * clinical signs of spinal cord compression or severe neurological deficits * patients with a pacemaker such that mri cannot be performed or the treatment cannot be delivered safely * patients unable to undergo mri * earlier nuclear medicine treatment * pregnancy * altered mental status that would prohibit the understanding and giving of informed consent

Keywords: stereotactic radiotherapy pain reduction quality of life
impact of exercise medicine on lower limb amputees according to the international classification of functioning

Conditions: Lower Limb Amputees

Summary: the purpose of this study is to determine whether exercise medicine in lower limb amputees has a impact on the three domains of the international classification of functioning of the who (function, activities and participation), and on quality of life.

exercise medicine in lower limb amputees has a positive impact on physical condition and on some cardiovascular aspects (first domain of icf). but as the investigators know, there is no evidence that this improvement is connected with a significant benefit on the performance of daily live activities and social participation (second and third domains of the icf). the investigators want to determine benefits of exercise medicine on all of these domains.

Eligibility criteria:
inclusion criteria: * unilateral lower limb amputation * amputees with prothesis * after learning how to walk with the prothesis * walking with or without technical aids exclusion criteria: * previous exercise training

Keywords: sequelae of; amputation, traumatic, limb, lower