Kornimate/medical-research-clean huggingface dataset:
preoperative radiotherapy for sarcomas of the extremities with intensity-modulation, image-guidance and small safety-margins

Conditions: Soft Tissue Sarcoma of the Limb; AJCC Stage II and III

Summary: rationale: modern radiotherapy techniques in a neoadjuvant setting have the potential to minimize morbidity and maximize efficacy. an additional boost dose can be provided locally by hdr-brachytherapy in patients with positive margins after tumor resection. purpose: this phase ii trial is studying the safety and efficacy of a combination of modern radiotherapy elements applied to the tumor and small volumes of surrounding normal tissue (imrt, igrt; brachytherapy in case of positive resection margin) and see how well it works in treating patients with high-risk soft tissue sarcoma of the extremities.


Eligibility criteria:
inclusion criteria: histologic and radiographic proof of localized high-risk soft tissue sarcoma meeting the following criteria: * lesion originates in extremity * upper extremity lesions may occur from the medial border of the scapula to tumors as far distal as the finger tips * lower extremity regions include hip girdle tumors commencing at the iliac crest, excluding lesions arising from within the pelvis, and extends to include lesions as far distal as the toes * ajcc stage ii or iii disease (except t1a-tumors or n1) * primary presentation or local recurrence * after biopsy or inadequate surgery resulting in residual tumor in cross-sectional imaging * tumors must be considered resectable according to cross sectional imaging, or potentially resectable after preoperative radiotherapy * ecog performance status 0-2 * informed consent exclusion criteria: * diagnosis of the following: * primitive neuroectodermal tumor * soft tissue ewing's sarcoma * extraskeletal osteo- or chondrosarcoma * aggressive fibromatosis (desmoid tumors) * dermatofibrosarcoma protuberans * regional nodal disease or unequivocal distant metastasis * life expectancy \< 1 year * pregnancy * major medical illness that would preclude study treatment * history of major wound complication or recurrent skin infection * known hiv positivity * \< 2 weeks elapsed from prior surgery or cytotoxic chemotherapy * persisting acute toxicities \> grade 1 in tumor-bearing limb resulting from prior treatment with anti-cancer modalities * cytotoxic chemotherapy, targeted therapy or investigational agents concurrent to study treatment * prior radiotherapy to the site of present sts. * chronic requirement for treatment with immuno¬suppressive agents or steroids.

Keywords: soft tissue sarcoma intensity-modulated radiation therapy (imrt) tomotherapy safety margins image-guided radiation therapy brachytherapy interstitial
prognostic role of ai-echo

Conditions: Atrial Cardiomyopathy

Summary: left atrial cardiomyopathy (lacm) is frequently underdiagnosed but plays a key role in increasing the risk of atrial fibrillation (af) and thromboembolic events. while atrial strain is a validated marker of lacm, its measurement with conventional echocardiography can be time-consuming and less feasible in acute settings. the use of ai-assisted echocardiography (ai-echo) may help streamline image acquisition and analysis, offering faster and potentially more accurate assessment. this study aims to compare the time required for atrial strain analysis using ai-echo versus standard methods. it also explores how changes in strain parameters (lasr, lasct, lascd) relate to the onset of af and in-hospital adverse outcomes, adjusting for comorbidities and conventional echo variables. main endpoints include time reduction with ai-echo and the association between strain changes and af, complications, or mortality during hospitalization.


Eligibility criteria:
inclusion criteria: 1. age between 18 and 85 years. 2. hospitalization in ccu for acute cardiac pathology (e.g. acute coronary syndrome, acute or exacerbated heart failure, malignant arrhythmias, etc.). 3. ability to provide written informed consent. exclusion criteria: 1. severe hemodynamic instability, history to contraindicate the execution of the echocardiographic examination. 2. severely inadequate echocardiographic window that precludes atrial or ventricular morpho-functional assessment. 3. inability to continue the study for clinical reasons, logistics or patient refusal.
a study of imaging in demyelinating diseases

Conditions: Multiple Sclerosis; Inflammatory Demyelinating Disease

Summary: this purpose of this study is research the usefulness of mri with pet/ct imaging for measuring brain inflammation and its relation to multiple sclerosis (ms).


Eligibility criteria:
inclusion criteria: * meet the requirements for one of the case or control groups. * ms patients undergoing neurologic evaluation procedures as part of understanding sex differences in multiple sclerosis spectrum of demyelinating disorders (irb# 19-002807) study or the mayo clinic neurology multiple sclerosis clinic. * control participants without inflammatory-demyelinating diseases of the central nervous system * capacity to sign consent. exclusion criteria: * participants unable to lie down without moving for 20 minutes. * women who are pregnant or cannot stop breast feeding for 24 hours. * for all patients and controls, any acute glucocorticoid (e.g., iv methylprednisolone or po prednisolone) use within 2 weeks is an exclusion to limit medication interaction but preserve possible chronic systemic inflammation interaction with microglia activation metrics. chronic disease modifying treatments in ms are allowed as these medications are not known to impact microglia activation. * standard safety exclusionary criteria for mri such as metallic foreign bodies, pacemaker, etc., since the quantitative pet data analysis is based on anatomic criteria that are established uniquely for each subject by registration to his/her mri.
study of iron absorption and utilization in asymptomatic malaria

Conditions: Malaria, Falciparum

Summary: anemia is still a main public health problem in sub-saharan africa. anemic women have an increased maternal and perinatal mortality and anemic adults have diminished work capacity. in sub-saharan africa, the etiology of anemia is multifactoral; the major causes are low dietary bioavailability and chronic parasitic infections such as malaria. these causes are likely to interact because infection and infection-associated inflammation may impair the utilization and absorption of iron. therefore, the control of parasite infections may be important to improve iron bioavailability from foods. malaria infections are endemic in northern benin. to investigate the contribution of asymptomatic malaria (a positive blood smear for malarial parasites but without clinical symptoms of fever, headache or malaise) to anemia, we are planning a human iron absorption study in benin. we will recruit adults with asymptomatic malaria infection. the iron absorption and utilization of the study subjects will be studied while infected, then they will be treated to clear their infections, and then iron absorption and utilization will be restudied. iron absorption will be determined by incorporation of labeled iron into erythrocytes, 14 days after the administration of a test meal containing labeled iron (stable isotope technique). subjects will be men and non-pregnant, non-breastfeeding women with a body weight \< 65 kg and between the age of 18 - 30 years. the results of this study will provide important information on the influence of malaria infections on iron absorption and utilization in humans. the study will provide insight into the potential necessity of malaria control to ensure iron bioavailability from foods in developing countries.


Eligibility criteria:
inclusion criteria: * age 18-35 y * body weight \< 65 kg * a positive malaria smear (asexual p. falciparum parasitemia \> 500/μl blood) without clinical symptoms (fever or self-reported fever in last 7 days, headache, malaise) * if female, not pregnant (tested by pregnancy test) and not breastfeeding * no mineral and vitamin supplements two weeks before and during the study exclusion criteria: * severe anemia (hemoglobin \< 8.0 g/dl) * chronic medical illnesses * blood donation or transfusion in the last 6 months before study time * soil-transmitted helminth infections (positive kato-katz-smear) * tuberculosis (tb): the potential presence of tb will be excluded by a short health questionnaire (cough? night sweats? weight loss? close relative with tb?). if this questionnaire raises the possibility that the subject may be at risk for tb, he/she will be referred to the local medical service

Keywords: malaria, iron absorption, iron utilization, benin
post-operative emesis and pain outcomes after cesarean delivery

Conditions: Pain, Postoperative; Cesarean Section; Nausea, Postoperative; Vomiting, Postoperative

Summary: approximately 20% women who undergo cesarean delivery would suffer from severe post-operative pain, which may further increase their risks from developing postpartum depression. predictive factors such as pre-operative pain, age and anxiety could significantly contribute to post-operative nausea and vomiting (ponv) and pain in general surgery, however little information is available with regards to cesarean delivery. the investigators would investigate the risk factors of causing post-operative emesis after cesarean delivery, and to reaffirm that there is a positive correlation between pain on local anesthetic injection, presence of mechanical temporal summation (mts) and post-cesarean pain scores.

previous studies demonstrated that pain scores upon local anesthetic injection is positively correlated to post-cesarean pain scores. anxiety, anticipated post-operative pain score and anticipated medication need are also found to be promising risk factors to post-cesarean pain management. the investigators would investigate the risk factors of causing post-cesarean emesis, and to reaffirm that there is a positive correlation between pain on local anesthetic injection, presence of mechanical temporal summation (mts) and post-cesarean pain scores. 470 parturients undergoing cesarean delivery and requiring regional anaesthesia will be recruited. pain and anxiety assessment will be conducted via visual analogue scoring (vas), mts assessment and a series of questionnaires. after delivery, patients will be given appropriate analgesia, and pain score at movement will be recorded. secondary outcomes include pain scores at rest, analgesia consumption, time-to-first-rescue analgesia, opioid-related side effects, patient satisfaction and postpartum depression. a separate 125 patients will be recruited to evaluate the feasibility and patient acceptability of the use of headspace, a mindfulness mobile application during the pre- and postnatal period to improve the maternal outcomes (emesis, pain, anxiety, depression).

Eligibility criteria:
inclusion criteria: * pregnant and going to have caesarean delivery (36 weeks gestation or more; nulliparous and multiparous); * healthy or have mild medical problems that are well-controlled (american society of anesthesiologists physical status 1-2). exclusion criteria: * history of intravenous drug or opioid abuse; * previous history of chronic pain syndrome; * emergency cesarean section; * undergo general anaesthesia during cesarean delivery; * non-english speaking.

Keywords: postoperative pain cesarean delivery postoperative nausea and vomiting
role of mosapride in patients with gastroesophageal reflux disease

Conditions: Gastroesophageal Reflux Disease

Summary: gastroesophageal reflux disease (gerd) is a very common disease in the western world. in taiwan, this disease is increasing gradually because the investigators' eating style is closing to western world. proton pump is the main drug for patients with gerd in the past two decades. prokinetic agent is an important adjuvant to the therapy of gerd. this study aims to evaluate the role of prokinetic agent in the management of gerd.

this is a randomized, double-blind, cross-over study. fssg is obtained at the beginning, one month and two months of the study. this study plans to enroll 100 patients with symptoms of gerd (acid regurgitation, belching, dysphagia). after receiving endoscopic examination, a frequent scale for the symptoms of gastroesophageal reflux disease (fssg) is obtained from these patients. fifty patients receive lansoprazole 30 mg once plus mosapride 5 mg tid daily in the first month; and lansoprazole 30 mg once plus placebo tid daily in the second month. another fifty patients receive lansoprazole 30 mg once plus placebo tid daily in the first month; and lansoprazole 30 mg once plus mosapride 5 mg tid daily in the second month.

Eligibility criteria:
inclusion criteria: * aged between 18 and 90 years old * outpatients * characteristic gerd symptoms: acid regurgitation, heart burn, or belching * erosive esophagitis on upper digestive endoscopy, based on los angeles classification exclusion criteria: * history of allergy to lansoprazole or mosapride * pregnant or lactating women * uremia * decompensated liver disease * age under 18 and over 90 years-old * lack of informed consent

Keywords: gastroesophageal reflux disease mosapride lansoprazole
ames treatment of the proximal arm in chronic stroke

Conditions: Stroke; Cerebrovascular Accident

Summary: subjects will receive 30 treatments with ames, to the proximal arm which has been affected by a chronic stroke.

this study seeks to determine whether 30 treatments with ames, to the proximal affected arm of subjects with chronic stroke, will improve subjects' proximal arm active range-of-motion. we hypothesize that the combination of assisted movement, torque biofeedback, and muscle vibration will reduce impairment (i.e., increase strength and range-of-motion; decrease inappropriate patterns of muscle contraction) and, thereby, lead to more accurate reaching with the proximal arm.

Eligibility criteria:
inclusion criteria: * ischemic or hemorrhagic stroke affecting the right arm * one year or longer since stroke * severe impairment of right arm with a baseline upper extremity fugl-meyer score between 8-24 * right elbow and shoulder spasticity (ashworth score ≤3) * right shoulder abduction-elbow flexion dyssynergia exclusion criteria: * exercise intolerance * co-morbidities limiting arm movement (e.g. shoulder subluxation) * chronic pain * cognitive dysfunction preventing compliance with instructions * participation in other ongoing research studies * plans to initiate or discontinue any physical/occupational therapy during the period of enrollment

Keywords: stroke rehabilitation dyssynergia robotics ames cerebrovascular accident
effect of transcranial magnetic stimulation on visual functions of adult amblyopia: a preliminary study

Conditions: Amblyopia

Summary: amblyopia, with a prevalence rates of 3% in adult population, is a common cause of vision impairment. it is characterized by impaired vision in one or both eyes because of disruption of normal visual stimuli and underdevelopment of the visual cortex, leads to lifelong visual deficits affecting both monocular and binocular visual function. common causes of amblyopia include refraction error, anisometropia, strabismus and visual deprivation arising from ptosis or congenital cataract. our previous studies had shed light on the relationship between abnormal early visual experience, and development of later amblyopia and possible neural developmental disorders. functional recovery is difficult when neuroplasticity slows down at the end of the critical period. to date, there is no established effective treatment for adult amblyopia. repetitive transcranial magnetic stimulation (rtms) is one of the non-invasive stimulations had been used widely as a research tool to understand the brain functions and an established treatment modality in neuropsychiatric diseases. theta burst stimulation (tbs) is a newer form of rtms protocol which have a major advantage over traditional rtms in their reduced administration duration and allowing stimulation at significantly lower intensities to attain comparable effects. tbs had been demonstrated to able to improve functions in participants with visual disorders. however, studies of its use on adult amblyopia are scarce. due to lack of efficient treatment at present, it is of scientific significance to conduct placebo-controlled experiments on this topic. investigators will evaluate the effect of three regimens of tbs (intermittent, continuous and sham), after one session and accumulative sessions, on visual functions of amblyopia adults shortly after treatment and 2 weeks later (lasting effect), in order to evaluate its potential role in amblyopia and find out the best paradigm for amblyopia treatment.


Eligibility criteria:
inclusion criteria: 1. adult amblyopia participants, aged 20-50 years old. 2. based on inclusion criteria, there was a minimum of 2 lines difference in bcva between the 2 eyes. 3. an amblyogenic factor and history of amblyopia treatment was recorded exclusion criteria: 1. unstable vital sign 2. history of brain injury and/or head trauma 3. neurological and psychiatric disease 4. seizures or family history of seizure 5. pregnancy 6. uncontrolled migraine or the presence of metallic implants or shunt in the head or torso 7. wide region of ischemic cicatrix, multiple sclerosis, taking tricycle antidepressants, 8. analgesics or any drugs may decrease the threshold for inducing seizure 9. experienced sleep disorders during the rtms treatment 10. severe alcoholism or taking seizure drugs 11. severe heart diseases or uncontrollable migraine caused by high intracranial pressure

Keywords: transcranial magnetic stimulation amblyopia neuroplasticity
effect of short-term theta frequency stimulation of the vagus nerve on cognition in patients with refractory epilepsy

Conditions: Refractory Epilepsy

Summary: the purpose of this investigation is data pilot study of the effect of theta frequency stimulation of the vagus nerve on cognitive performance in patients with refractory epilepsy. we will compare the effects of no stimulation, theta frequency (5 hz), and 'standard' beta frequency stimulation (25-30 hz) on cognitive measures. we hypothesize that theta frequency vns will have a positive effect on memory retention. the goal of this study to provide initial data to inform the design of a larger clinical trial to examine the efficacy of theta vns.


Eligibility criteria:
inclusion criteria: 1. diagnosis of refractory epilepsy 2. previously implanted vagal nerve stimulator 3. willingness and ability to undergo temporary changes to their vns device settings exclusion criteria: 1. \<18 years of age 2. adults unable to consent 3. pregnant women 4. prisoners 5. \>20 on the beck depression inventory (bdi) 6. \<24 on the montreal cognitive assessment (moca) 7. adults with diagnosis of developmental delay, intellectual disability, or traumatic brain injury (tbi). 8. adults with reported history of learning disability. 9. adults unable to use a computer with their dominant hand. 10. status epilepticus within the past 6 months
to study the influence of genomic factors on metabolism and effects of clomiphene in asian normogonadotrophic anovulatory patients.

Conditions: Infertility, Female

Summary: the purpose of this study is to match the genetic component and clinical attributes of anovulatory patients with response to clomiphene treatment. by improving our understanding on patient-specific clomiphene response will allow optimization of treatment, reduction of side-effects and shorten the time-to-pregnancy.

anovulation is the commonest cause for infertility, with clomiphene being the standard treatment. pharmacogenetic causes of variability in the pharmacokinetics and pharmacodynamics of clomiphene is not well characterized in anovulatory asian women. although recent findings suggest that the pharmacokinetics and pharmacodynamics of clomiphene may be influenced by several polygenic pathways involving genes regulating its metabolism (cyp3a4, cyp3a5, cyp2b6, cyp2c8, cyp2c19, cyp2d6), thus contributing significantly to the wide variability in dose-response relationships observed in clinical practice. there has not been objective evidence thus far from an unbiased genome-wide perspective. it is likely that polymorphisms at the cyp cluster of genes encoding for their respective cytochrome proteins may not explain all of the variability with regards to clomiphene's dose-response relationship. the investigators hypothesize that the pharmacokinetics and pharmacodynamics of clomiphene is under strong control by genetic loci and that these genetic variants could also strongly determine the therapeutic outcome in asian normogonadotrophic anovulatory patients. the contribution by candidate genes mentioned above will also be clarified in a definitive manner by this study.

Eligibility criteria:
inclusion criteria: * women of reproductive age with ovulatory dysfunction desiring pregnancy, * willing to discontinue any form of herbal or traditional chinese medicines for at least three weeks before starting clomiphene * ability to provide written and informed consent taken from participating patients, and * willingness to cooperate with study instructions exclusion criteria: * pregnant at the time of recruitment, * ovarian cysts more than 5cm, * abnormal menorrhagia at the time of study recruitment, * abnormal liver function or active liver disease, * presence of neoplastic lesions of any type, * primary pituitary or ovarian failure (type i and iii world health organisation \[who\] infertility) * patients with previous treatment with ovulation inducing agents such as follicle stimulating hormone (fsh) and luteinising hormone releasing hormone-analogues (lhrh-analogues); * infertility due to other endocrine abnormalities such as hyperprolactinaemia, hypo/hyperthyroidism, premature ovarian failure, diabetes or male factor * allergy to clomiphene. * fallopian tubal pathology (hydrosalpinges, previous salpingectomies) * patients on any drugs with potential to interact with cyp2d6 such as the selective serotonin receptor uptake inhibitors (ex. venlafaxine, paroxitene, fluoxetine)

Keywords: anovulatory clomiphene
long-term bilateral theta burst stimulation for the treatment of major depression

Conditions: Major Depression

Summary: repetitive transcranial magnetic stimulation has been shown to be moderately effective in the treatment of major depression. theta burst stimulation (tbs) is a new form of rtms that may exert larger effects. this sham-controlled study examines the effectivity of daily bilateral tbs to the dorsolateral frontal cortex over 6 weeks in 2x16 patients with major depression add on to the local standard of a combined pharmacological/psychotherapeutical treatment.


Eligibility criteria:
inclusion criteria: * major depression * informed consent exclusion criteria: * seizures in medical history * metallic implants * deep brain stimulation * cardiac pacemaker * brain trauma * psychotic symptoms * substance abuse * pregnancy * benzodiazepines other than lorazepam \>1mg/d

Keywords: transcranial magnetic stimulation depression theta burst stimulation