Kornimate/medical-research-clean huggingface dataset:
therapeutic resistance prediction of tyrosine kinase inhibitors

Conditions: Non-small Cell Lung Cancer

Summary: the investigators propose a non-invasive prognostic tool for tkis resistance in patients with stage iv egfr-mutant non-small cell lung cancer (nsclc) by computed tomography phenotypic features, which can be conveniently translated to facilitate the pre-therapy individualized management of egfr tkis in this disease.

the investigators develop a multi-ct-phenotypic-feature-based classifier to predict tki benefit and therapeutic resistance for stage iv egfr-mutant non-small cell lung cancer (nsclc). the investigators also compared its prognostic and predictive efficacy with single features and clinicopathological risk factors. an individualized nomogram integrated the classifier and three clinicopathological risk factors was built for clinical use. the prognostic accuracy of the proposed model was evaluated in two independent validation sets. nearly 500 patients will be enrolled in this clinical trial. eligible patients were diagnosed with nsclc, and stage iv according to the tnm system classification of the american joint committee on cancer, presence of activating egfr mutations, age 20 years or older, and no history of systemic anticancer therapy for advanced disease. patients who underwent first-line or second-line egfr tkis were eligible for inclusion. all patients had to be capable of undergoing contrast-enhanced ct, and pretreatment ct was strictly controlled in two weeks before the egfr tkis starts. patients who underwent resection for local advanced or metastatic disease were withdrawn from the study. therapeutic resistance was measured by pfs, as the time from the initiation of egfr tkis therapy to the date of confirmed disease progression or death. pfs was censored at the date of death from other causes, or the date of the last follow-up visit for progression-free patients. the investigators will use extracted 1000 phenotypic features on the region of interest manually segmented by radiologists. the lasso cox regression model and nomogram will be used to build a prognosis model for the therapeutic resistance prediction of egfr tkis for stage iv egfr-mutant nsclc. the harrell's concordance index(c-index) of the proposed nomogram will be used to quantify the discrimination performance.

Eligibility criteria:
inclusion criteria: * eligible patients were diagnosed with nsclc, and stage iv according to the tnm system classification of the american joint committee on cancer. * presence of activating egfr mutations. * age 20 years or older, and no history of systemic anticancer therapy for advanced disease. * patients who underwent first-line or second-line egfr tkis were eligible for inclusion. * all patients had to be capable of undergoing contrast-enhanced ct, and pretreatment ct was strictly controlled in two weeks before the egfr tkis starts. exclusion criteria: * based on the criteria above, patients who underwent resection for local advanced or metastatic disease were withdrawn from the study.

Keywords: stage iv egfr-mutant egfr tkis progression-free survival prognosis computed tomography
a retrospective study to assess the clinical efficacy and safety of trientine in wilson's disease patients

Conditions: Trientine Treatment for Wilson's Disease

Summary: this is a retrospective study to assess the clinical efficacy and safety of trientine in wilson's disease patients

in this retrospective study, the investigators will collect and analyze data from reviewing medical history files of larger and long-term follow-up cohorts with wilson's disease in taiwan to assess the efficacy and safety of trientine in taiwanese wilson's disease patients.

Eligibility criteria:
inclusion criteria: * diagnosis of wilson's disease. * male or female patients, aged 3 years to 75 years exclusion criteria: * patients with comorbidity which is not related to wilson's disease.

Keywords: trientine wilson's disease
exposure, relaxation, & rescripting therapy-child

Conditions: Nightmares Associated With Trauma and Stress

Summary: untreated trauma-related nightmares and sleep-related disorders are associated with chronic health problems, burdening both the suffering individual and the health-care system. the study implements an innovative, cost-efficient, nightmare treatment for trauma-exposed children. it is the first randomized clinical trial with children, adapting an efficacious adult therapy to a 5-session nightmare treatment for 5-17 year-olds. trauma nightmares are a mechanism in development and maintenance of secondary post-trauma psychopathology, medical problems and family dysfunction. therefore, this treatment may prevent long-term secondary health and behavioral problems. it provides a viable healthcare option to oklahomans, lessening long-term financial medical and behavioral health expenses. scientific models currently view ptsd treatment as primary, often leaving nightmares untreated. that approach does not address the pernicious impact of trauma-nightmares in individuals with sub-threshold ptsd or whose nightmares are a primary condition. the theoretical innovation of this therapy can advance the field's understanding of the development of trauma sequelae.


Eligibility criteria:
inclusion criteria: * children age 5-17 with traumatic or potentially traumatic/adverse experiences and nightmares occurring at least once per week over a minimum of one month * have a parent or legal guardian who is able to participate in treatment assignments at home and be able to read and speak english exclusion criteria: * adult, no traumatic experience, no nightmares, apparent psychosis, pervasive developmental disorder, or mental retardation, not able to read and speak english * in order to ensure the verbal comprehension of the child, the ppvt will be used to help evaluate if a child is suitable for treatment, as an index to ensure they can verbally comprehend the cognitive component of treatment

Keywords: nightmare ptsd trauma children cognitive behavior therapy stress sleep
residual platelet activity despite aspirin utilization in coronary heart disease

Conditions: Coronary Heart Disease; Non ST-elevation Acute Coronary Syndromes

Summary: the purpose of this study is to compare the response to aspirin in the acute phase with the late phase of an acute coronary syndrome.

the purpose of this study is to compare, in the same population, the response to aspirin in the initial phase (first 48 hours) with the late phase (after 3 months of discharge)of a non st elevation acute coronary syndrome (angina or acute myocardial infarction).

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * confirmed diagnosis of acute coronary syndrome without st segment elevation, in the first 48 hours after the onset of the clinical symptoms * regular use of aspirin for at least seven days. exclusion criteria: * previous use, in the last 7 days, of another antiplatelet agent than aspirin * use of antivitamin k in the last 3 weeks * hemoglobin \ 50%, platelets count \ 500.000/mm3, creatinine clearance \< 30 ml / minute * killip class iii or iv * need for vasopressor or inotropic parenteral medication at inclusion in the study * percutaneous coronary intervention within 30 days or cabg in the last 90 days prior to study entry * current malignancy * hematologic diseases * refusal to sign the inform consent form * unable to attend the second visit (follow-up) for any reason except for death

Keywords: platelet aggregation aspirin
endocation: trial of an endometriosis education program

Conditions: Endometriosis

Summary: endometriosis is a common condition that affects 10% of females, causing chronic pain and other health concerns. currently, it takes 8-12 years to be diagnosed with endometriosis, in part because there is low awareness of this condition. this research is designed to test whether providing endometriosis education in schools can help increase early awareness of the condition.


Eligibility criteria:
inclusion criteria: * 8-12 grade level class exclusion criteria: * instruction offered in a language other than english
secondary cytoreduction followed by chemotherapy versus chemotherapy alone in relapsed ovarian cancer after parpi maintenance treatment: a multicentre, open-label, randomised, phase 3 trial

Conditions: Relapsed Ovarian Cancer

Summary: this study aims to carry out a multi-center, randomized controlled study on patients with recurrent ovarian cancer after parpi maintenance, to explore the clinicopathological and molecular characteristics of patients with recurrent ovarian cancer after parpi maintenance, and to clarify whether patients with recurrent ovarian cancer after parpi maintenance for more than 6 months are sensitive to platinum drugs, and the value of secondary tumor cell reduction in such treatment, in order to provide evidence-based medicine basis for the standardized treatment mode of recurrent ovarian cancer after parpi maintenance treatment.


Eligibility criteria:
inclusion criteria: 1. patients with diagnosis of first-line or second-line recurrent epithelial ovarian carcinoma, peritoneal carcinoma, or fallopian tube carcinoma, who has previously received at least 4 cycles of platinum-based chemotherapy in initial treatment; 2. relapse occurred after 6 month since platinum-based chemotherapy; 3. parpi maintenance therapy for more than 6 months before relapse; 4. r0 ideal debulking in initial surgery; 5. pet-ct indicate the recurrence lesion is isolated and not exceed 5 sites, and the ascites is less than 500ml; 6. ecog/who performance score of 0 to 1; 7. no hepatic failure, bilirubin ≤ 1,5 time the normal limit, asat and alat ≤ 3 time the upper normal limit 8. no renal insufficiency (serum creatinine \ 80 ml/min). calculated with mdrd method 9. hematology function: pnn ≥ 1,5x10⁹/l, platelets ≥ 100x10⁹/l 10. no contraindication to general anaesthesia for heavy surgery 11. patients having read, signed and dated informed consent before any study procedure exclusion criteria: 1. platinum-refractory/uncontrolled epithelial ovarian cancer; 2. non-epithelial ovarian tumor, mucinous, serous-mucinous (mainly mucinous), malignant brenner tumor, low-grade serous carcinoma, borderline tumor; 3. suffering from other malignant tumors that have not achieved complete remission in the past 2 years; 4. received radiotherapy within 2 weeks before the start of the study intervention; 5. general conditions cannot tolerate secondary cytoreduction; 6. severe hypersensitivity reactions (≥ grade 3) to paclitaxel or platinum and/or any of its excipients.
vaginal flora for treatment of bacterial vaginosis

Conditions: Recurrent Bacterial Vaginitis

Summary: bacterial vaginosis (bv) is the most common vaginal infection in women. it is caused by a vaginal bacterial imbalance. treatment with antibiotics is the standard of care but there is a high rate of recurrence. almost half of women successfully treated suffer a recurrence within three months. complications include risk factors for premature birth, increased transmission of sexually transmitted diseases and higher risk for carcinoma of cervix. the investigators proposed study is a cost effective treatment based on returning the normal microbial balance to the vagina. the investigators propose to transfer normal vaginal flora from healthy individuals to women with bv and thus restore normal vaginal flora and cure this disorder.


Eligibility criteria:
inclusion criteria: * recurrent bv (4 or more incidences in the past year) * recurrence of bv in less than 2 months of antibiotic treatment or need for prophylactic antibiotic * 3/4 amsel criteria and nugent criteria greater or equal to 7 exclusion criteria: * pregnancy or planned pregnancy during the study period * other known diseases * carriers of hep b and c * hiv or syphilis positive

Keywords: bacterial vaginitis vaginal flora microbiome
immunohistochemistry role in better prognosis of endometrial carcinoma patients

Conditions: Endometrial Cancer

Summary: the incidence of endometrial cancer (ec) is increasing .different risk classifications are used to direct the primary and adjuvant therapy. the european society for medical oncology - european society of gynaecological oncology -european society for radiotherapy \& oncology (esmo-esgo- estro) could guide the need for lymph node surgery pre-operatively, and also post-operatively to determine adjuvant treatment. low-risk patients are managed with surgery alone, while higher-risk group patients undergo more aggressive surgical options. so, it is important to identify new prognostic markers for better stratification of patients to avoid under- or over treatment of ec patients.


Eligibility criteria:
inclusion criteria: * aged 36 -72 years; * previously diagnosed with endometrial carcinoma; * histological type of the tumor; * myometrial invasion; * lymph node invasion; * cervical invasion; * biomarkers expression. exclusion criteria: * lack of tumor tissue in tissue block
vaginal progesterone for treatment of threatened miscarriage

Conditions: Threatened Miscarriage

Summary: the purpose of the study is to assess the efficacy of vaginal micronized progesterone in the treatment of threatened miscarriage. all eligible pregnant women will be randomized to either receive vaginal progesterone or no treatment.evaluation will be two weeks after intervention, then every 4 weeks up to 28 weeks gestation or termination of pregnancy.


Eligibility criteria:
inclusion criteria: 1. pregnant with gestational age less than 24 weeks 2. presented by bleeding with or without pain 3. single viable fetus (confirmed by ultrasound examination) 4. accepting to have vaginal medication exclusion criteria: 1. currently under medication for any chronic diseases (dm, thyroid, liver, renal, cardiac and autoimmune disease). 2. hypersensitivity to progesterone 3. any documented congenital fetal anomaly in the current pregnancy 4. women received hormonal treatment in the current pregnancy 5. patients conceived via art

Keywords: progesterone threatened abortion
intermittent oral tube in alzheimer's patients

Conditions: Alzheimer Disease

Summary: this is a prospective multicenter study with alzheimer's patients with dysphagia. patients enrolled are randomly divided equally into the observation group and the control group. all patients receive conventional care, and the observation group received intermittent oral-esophageal tube feeding while the control group received nasogastric tube feeding for enteral nutrition support. baseline information (demographics, medical history, etc.), nutritional status at admission and after treatment, depression, dysphagia, and quality of life after treatment are compared.

the alzheimer's disease in the elderly exhibits the high prevalence.this is a prospective multicenter study with alzheimer's patients with dysphagia. patients enrolled are randomly divided equally into the observation group and the control group. all patients receive conventional care, and the observation group received intermittent oral-esophageal tube feeding while the control group received nasogastric tube feeding for enteral nutrition support. baseline information (demographics, medical history, etc.), nutritional status at admission and after treatment, depression, dysphagia, and quality of life after treatment are compared.

Eligibility criteria:
inclusion criteria: * age between 18 years and 85 years, meeting the diagnosis of alzheimer's disease. * presence of no contraindication for enteral nutrition. * with dysphagia verified by imaging materials. * with stable vital signs and no severe liver or kidney dysfunction, metabolic disorders, cardiovascular diseases, or multiple complications * minimum mental state examination ranging from 10-26 exclusion criteria: * unable to cooperate in completing treatment and assessment due to personal reasons or other disorders. * complicated with other intracranial lesions, such as stroke. * abnormal structure of swallowing-related organ and tissue.
how does medical clown intervention affect the length of hospitalization in children with pneumonia

Conditions: Community-Acquired Pneumonia (CAP)

Summary: background and objectives: community-acquired pneumonia (cap) is a leading cause of hospitalization in children. the hospitalization duration depends on factors as child's well-being, vital signs, need for parenteral treatments, and development of complications. medical clowns (mcs) are known to assist in reducing pain and alleviating anxiety and have been integrated into many aspects of hospital treatment routines. the aim of this study is to evaluate the effect of mc intervention on length of hospitalization in children admitted with cap.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of pneumonia. * ages 2-18 years. exclusion criteria: * hemodynamically unstable patients. * other systemic comorbidities or chronic respiratory diseases * children from families unable to comprehend and sign an informed consent form.

Keywords: medical clowns community-acquired pneumonia (cap)
transcutaneous auricular vagus nerve stimulation (tavns) for food craving in obese individuals.

Conditions: Obesity; Craving

Summary: background: obesity is one of the most important diseases around the globe; with a continuous increase and public health concern. current treatments present some limitations. craving is a symptom usually noticeable and has been described as a "strong desire or urge to use", especially with foods. the vagus nerve and its relations to the neurocircuitry of the reward system play essential roles in food intake regulation and this can be done transcutaneously trough the auricular branch of the vagus nerve (tavns). based on the neurobiology of food craving and on the initial data on tavns demonstrating safety and efficacy in open-label and randomized sham controlled trials, the investigators propose the first randomized, sham controlled, triple-blind trial on tavns for food craving in obesity. methods: this will be a two-arm, triple-blinded, randomized controlled trial with 54 subjects with food craving assigned to either: 1) a 10-session treatment protocol of real tavns, or 2) a 10-session treatment protocol of sham tavns, besides qualitative electroencephalogram (qeeg) and heart rate variability (hrv). participants will be evaluated for primary outcome measures (food craving questionnaire - state \[fcq-s\] and food craving questionnaire - trait \[fcq-t\]) before and after intervention, with a follow-up visit of 30 days after the end of treatment. a comparison between sham and active groups will be performed in three occasions \[baseline (t1), at the end of the stimulation protocol (t2) and 30 days after the last day of stimulation (t3)\]. discussion: given the epidemiological situation and economic and social burdens, the possibility of modulating the reward system neurocircuitry trough the vagus nerve with an easy-to-use, low-cost, safe and potential at-home use could represent a breakthrough in treating obesity. the investigators hypothesized that food craving in obese individuals would decrease at least 50%, as well as their intake of high fat, high sugar and processed food, commonly described as palatable foods. beyond that, the investigators expect that these individuals would improve anxiety symptoms.


Eligibility criteria:
inclusion criteria: * body mass index (bmi)\>29 * age between 18 and 55 years old * food craving questionnaire-state and trait (fcq-s and fcq-t)\>108 * agreement to participate and sign the informed consent term before any procedure is conducted. exclusion criteria: * history of head injury or epilepsy * body metallic implants and pacemaker * current use or in the previous six months of psychotropic or anorexigenic medications, recreational drugs and/or participation in weight-loss programs * pregnancy or breastfeeding * indication of hospitalization * substance dependence * psychiatric disorder, except for anxiety disorders * personality disorders * suicidal ideation * non-controlled clinical comorbidities.

Keywords: vagus nerve obesity craving food
applying artificial intelligence in developing personalized and sustainable healthcare for spinal disorders

Conditions: Low Back Pain; Neck Pain; Disc Herniation; Disc Degeneration; Spinal Stenosis; Radiculopathy

Summary: the primary objective is to use machine learning methods on large survey and health register data to identify participants with different treatment trajectories and health outcomes after surgical and/or conservative treatment for spinal disorders. secondary objectives are to 1) conduct external validation of the prediction models, and 2) explore how the prediction models can be implemented into ai-based clinical co-decision tools and interventions.

three work packages are conducted. in the first, the investigators will use data from three general population surveys in norway (hunt, tromsø, and ullensaker) linked to administrative health registry data (norwegian patient registry (for secondary care) and norwegian registry for primary health care) and clinical registers on spinal disorders (the norwegian registry for spine surgery, norspine, and the norwegian registry for neck and back pain) to explore treatment trajectories and health outcomes following an episode of back and/or neck pain. the investigators will use different combinations of these data sets to assess the impact of a wide range of risk/ prognostic factors and to develop prognostic models for different health and welfare outcomes. four major outcomes will be adressed; a) unfavourable outcomes, b) use of prescribed medication, c) use of sickness absence and other disability benefits, and d) patient-reported outcomes. in the second work package, the investigators will conduct external validation studies of the prediction models by using danish and swedish data. there is a large overlap and similarities in health and welfare registers across the nordic countries. in the third work package the investigators will first conduct a feasibility study in a secondary care hospital setting in which surgeons examine and assess referred patients with disc herniation and spinal stenosis for surgical treatment (or not). qualitative interviews will be used to gain a better understanding of today's clinical decision-making process.

Eligibility criteria:
inclusion criteria: patients referred to secondary care for assessment of surgery or not due to disc herniation (lumbar or cervical). - exclusion criteria: ambulant cases who needs immediate treatment -

Keywords: prognosis trajectories risk factors prognostic factors prognostic model prediction model health outcomes work outcomes