Kornimate/medical-research-clean huggingface dataset:
supportive understanding and patient-centered partnership for optimizing renal treatment

Conditions: Chronic Kidney Diseases; Racism, Systemic; Trauma, Psychological

Summary: black and hispanic people face higher risks of chronic kidney disease (ckd) but have unequal access to the highest-quality kidney care. black adults with ckd face 1.5 times higher hospitalization risks than non-black adults with ckd. once reaching end stage kidney disease (eskd), black patients are half as likely to receive a transplant and are often excluded from home dialysis. structural racism creates complex barriers to optimal ckd care, providing an explanation for these findings. the penn medicine impact community health worker (chw) program is a rigorously tested approach to employ people from local communities to dismantle structural racism within health care systems and improve outcomes for marginalized patients. this trial will innovate by training chws to focus specifically on ckd care for minoritized people. the investigators will also train primary care clinicians caring for ckd patients on how to provide trauma-informed care (tic). the first aim is to determine the feasibility, acceptability, and reach of a clinic-level tic training to address the needs and concerns of black and other minoritized patients. the second aim will be to conduct a three arm trial comparing individuals in usual care to individuals randomized to either our tailored chw intervention in conjunction with clinic-level tic training or to clinic-level tic intervention only. the investigators will examine whether patients in the intervention arms have greater improvements in quality of life (primary). the investigators will also explore the impact of the interventions on patient activation, hospitalizations, and eskd treatment preferences.


Eligibility criteria:
inclusion criteria: * chronic kidney disease stage 4 or 5 * patient at participating general internal medicine or family medicine clinic * medicaid-eligible or uninsured * reside in high poverty philadelphia zip code exclusion criteria: * no history of kidney transplant * not receiving any form of dialysis * not previously enrolled with a community health worker in the past 2 years
new protein biomarkers and technology for improving diagnosis and outcome prediction in mild tbi

Conditions: Mild Traumatic Brain Injury

Summary: mild traumatic brain injury(mtbi) is a common cause of consultation to the emergency rooms worldwide and is the most common form of traumatic brain injury. though classified as mild, as many as 40% of patients suffering mtbi do not make complete recoveries or present persistent symptoms. the present study is intended to determine long term outcome of patients suffering mtbi and to establish new prognostic models with the use of serum and saliva based biomarkers. for this purpose this study will not exclude patients regarding their comorbidities.


Eligibility criteria:
inclusion criteria: * mild tbi (gcs 13-15 on admission) * blood sample obtained ≤24h after injury exclusion criteria: * gcs 3-12 on admission * time of injury unknown * time to injury exceeding 24 hours * primary admission for non-traumatic neurological disorder (e.g., stroke, spontaneous, intracranial hematoma) * penetrating head trauma * patient with mechanical ventilation from the trauma scene or prehospital management. * venipuncture not feasible * subject under judiciary control
translation and cultural adaptation of the dysfunctional attitude scale (das) into urdu

Conditions: Depression; Anxiety

Summary: translate and adapt the dysfunctional attitude scale (das) into urdu language and establishing the psychometric properties (reliability, validity, and norms) of the translated scale

the present study aims to translate and culturally adapt the dysfunctional attitude scale (das) into urdu language. this study aims to increase the accessibility and accuracy of clinical assessments, ultimately improving the quality of mental health care delivery and advancing research in the field of clinical psychology within urdu-speaking communities.

Eligibility criteria:
inclusion criteria: individuals aged 18 to 65 years at least 5 years of education individuals with symptoms of depression and anxiety - exclusion criteria: * substance use disorder according to dsm-5 tr criteria significant cognitive impairment (for example, profound learning disability or dementia) active psychosis as determined by their primary care clinician

Keywords: das cbt
a feasibility study using four-dimensional ct imaging for primary lung cancer

Conditions: Lung Cancer

Summary: eligible lung cancer patients: undergo pre-treatment 4d-ct study for treatment planning external beam radiation: standard fractionation (2gy per day) or stereotactic body radiation therapy evaluation: repeat 4d-ct study at 3 months and 6 months post-treatment primary objectives: to assess pre-treatment global and focal lung strain and correlate with changes post-treatment

the study will be a prospective, non-randomized, single center, trial to assess and quantify lung strain using four dimensional ct (4d-ct) treatment planning scans. patients with newly diagnosed lung cancer will be planned using 4d-ct to assess lung and tumor motion. standard radiation treatment plans will to delivered based on tumor stage. patients will be reassessed both clinically and radiographically using 4d-ct imaging at 3 months and 6 months post-treatment. following the initial imaging time points, standard surveillance will be employed with clinical assessment and imaging at 3 month intervals for the first 2 years post-treatment.

Eligibility criteria:
inclusion criteria: 1. age \>/= 18 years 2. ecog performance status 0-1 3. pathologic or clinical diagnosis of lung malignancy 4. patients must have a reproducible tidal volume sufficient for 4d-ct imaging 5. negative serum pregnancy test within 2 weeks prior to registration for women of childbearing potential. 6. women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control 7. patients must provide study specific informed consent prior to study entry. exclusion criteria: 1. patients with severe pulmonary dysfunction with non-reproducible tidal volumes sufficient for 4d-ct imaging. 2. pregnant women or lactating women

Keywords: lung cancer
a research study looking at specific tissue of the umbilical cord

Conditions: Varices of Umbilical Cord

Summary: the purpose of this study is to isolate umbilical cord wharton's jelly matrix to be used as a scaffold for tissue regenerative applications, including avascular necrosis.

our working hypothesis is that umbilical cord blood wharton's jelly matrix has all the biochemical and biomechanical characteristics needed in an ideal scaffold for tissue engineering. accordingly, we expect matrix to support the growth and differentiation of transplanted mesenchymal stem cells. the first step in this effort is to isolate wharton's jelly matrix by decellularization. the second step will be to test the ability of this matrix to support the growth and differentiation of transplanted mesenchymal stem cells. the third step will be to pursue preliminary animal testing to study the ability of this matrix to support bone tissue regeneration in vivo.

Eligibility criteria:
inclusion criteria: * pregnant women * 18 years of age or older * willing to donate umbilical cord units exclusion criteria: * less than 18 years of age * has hepatitis or hiv * considered high risk * scheduled for c-section due to complications during current pregnancy * delivered prior to full term

Keywords: wharton's jelly umbilical cord decellularization
prucalopride versus placebo in gastroparesis

Conditions: Gastroparesis

Summary: controlled cross-over study of prucalopride 2 mg daily or placebo in gastroparesis (idiopathic or diabetic). patients will be randomized to 4 week treatment with the first regimen (double-blind), followed by a 2-week washout and 4 week treatment with the second regimen in cross-over.

to assess the influence of prucalopride (resolor®) 2mg daily, 30 patients with idiopathic and 30 patients with diabetic gastroparesis will undergo two gastric emptying breath tests with concomitant assessment of meal-related symptoms, at the conclusion of two consecutive, 4-week treatment periods of prucalopride or placebo. the order of prucalopride and placebo treatment will be randomised at the initiation of the study. medication for both patient groups, 30 patients with idiopathic and 30 patients with diabetic gastroparesis, will be randomized separately. half of the subjects will receive placebo first; the other half will receive prucalopride first. treatment periods will be separated by a wash-out period of 2 weeks. all drugs potentially affecting gastrointestinal motility or sensitivity will be discontinued at least two weeks prior to the initiation of the study. informed consent will be obtained from each participant. in order to establish the gastrointestinal symptom and quality-of-life profile of this cohort, each patient will complete the following validated self-reported instruments at baseline and at each of the two testing visits (table 1): patients assessment of gastrointestinal symptoms (pagisym), patients assessment of gastrointestinal quality of life impact (pagiqol) gastrointestinal and global severity score, patient health questionnaire (phq-15), appetite questionnaire, hospital anxiety and depression scale, visceral sensitivity index, short form nepean dyspepsia index (sf-ndi). the pagi-sym is a comprehensive questionnaire of upper gi symptoms, and it includes a gastroparesis questionnaire module: the gastroparesis cardinal symptom index (gcsi), which has been validated in (idiopathic) gastroparesis.26 furthermore, during the entire study duration patients will complete a daily symptom diary, incorporating a separate horizontal 100-mm visual analogue scale (vas) for each of 9 upper abdominal symptoms. as prucalopride has a well-known therapeutic effect in chronic constipation, patients will also register information about their stool frequency and stool type in the daily diary (bristol stool scale).

Eligibility criteria:
inclusion criteria: * consecutive patients with a previously established diagnosis of diabetes or functional dyspepsia according to rome iii criteria, and with delayed gastric emptying (t1/2 for solids ≥ 109 min) on a breath test exclusion criteria: * the presence of oesophagitis, gastric atrophy or erosive gastroduodenal lesions on endoscopy * the presence of lesions on small bowel x-ray * major abdominal surgery * underlying psychiatric illness * use of non-steroidal anti-inflammatory drugs, steroids, or drugs affecting gastric motility. * major co-morbidities
stem cell therapy for outer retinal degenerations

Conditions: Age Related Macular Degeneration; Stargardt's Disease; Exudative Age-related Macular Degeneration

Summary: this study is a phase i/ii , open label,non randomized, prospective study to determine the safety of human embryonic stem cell derived retinal pigmented epithelium (hesc rpe) sub retinal injections versus hesc rpe seeded on a polymeric substrate implanted in the sub retinal space,

to determine whether the surgical implantation of a human embryonic stem cell-derived retinal pigmented epithelium (hesc-rpe) monolayer seeded onto a polymeric versus hesc-rpe injections into the sub retinal space is a safe procedure. 6 patients will receive hesc-rpe cell injections (100000 cells) in the sub retinal space (2 dry age-related macular degeneration (amd), 2 wet amd with disciform scar and 2 with stargardt's disease). also 5 patients dry amd, 5 patients with wet amd with disciform scar and 5 patients with stargardt's disease with receive a subretinal implantation of the hesc-rpe seeded in a monolayer in a polymeric substrate. patients will be enrolled sequentially, and after the procedure the patients will be followed for 1 year.

Eligibility criteria:
inclusion criteria: * patients with amd ( dry , wet after failure of treatment, disciform scars) * patients with stargardt's disease bcva on the selected eye: worse than 20/200 exclusion criteria: * other ophthalmological diseases( glaucoma, diabetic retinopathy, previous retinal surgery, uveitis) * systemic diseases with contraindication for surgical procedures with local anaesthesia
trans-perineal repair with or without limited internal sphincterotomy for treatment of type i anterior rectocele

Conditions: Rectocele

Summary: comparison between transperineal repair of rectocele with or without posterior internal sphincterotomy.

transperineal repair of anterior rectocele is performed in two groups of patients, the first will undergo limited posterior internal sphincterotomy, the second group will not have internal sphincteroromy. the two groups are compared regarding recurrence of rectocele and improvement of symptoms.

Eligibility criteria:
inclusion criteria: * patients with anterior rectocele exclusion criteria: * pregnant females * rectocele with pelvic organ prolapse * any patient with previous anorectal surgery * pudendal nerve neuropathy * anal fistula and sepsis * patients with sphincter defect proved by endo-anal sonography * patients proved to have colonic inertia either by colon transit time and/or history * patients with defecography anomalies causing obstructed defecation other than rectocele (e.g. anismus). * also patients with vascular diseases, scleroderma, malnutrition, and coagulopathy were excluded.
the impact of a low or high phosphate diet on phosphate and calcium excretion in healthy people

Conditions: Cardiovascular Diseases; Aging; Nutrient; Excess

Summary: phosphate is present in many of the foods that the investigators eat and is required by many cellular processes. the kidneys are the only organ that excrete the extra phosphate from the diet that the body does not require. phosphate is linked to vascular calcification and cardiovascular disease. measures of serum phosphate do not reflect the burden of phosphate and are not sensitive to early changes in the way the kidneys eliminate phosphate. this study will determine whether the kidneys handle an oral phosphate load differently after 5 days of a low phosphate diet compared to 5 days of a high phosphate diet.

in this study, participants will follow a low-phosphorus diet (750 mg) with a 500 mg calcium supplement for 5 days keeping a detailed diary of the foods eaten during this period. on the 5th day, the participant will undergo a 24 hour urine collection. participants will present after an overnight fast for baseline blood and urine measurements. then they will consume water containing 500 mg of phosphorus. urine and blood will be collected every hour for 3 hours for measurement of phosphate and calcium and for measurement of hormones known to regulate phosphate and calcium including fibroblast growth factor-23, parathyroid hormone and vitamin d. one week later, participants will follow the same diet but will also receive a 1250 mg phosphorus supplement for 5 days. on the 5th day, urine will be collected for 24 hours. participants will present again after an overnight fast and undergo the identical testing.

Eligibility criteria:
inclusion criteria: * healthy * between ages of 20 and 40 exclusion criteria: * known heart disease * known diabetes * pregnant * breast-feeding
risk factors for morbidity after incisional hernia repairs

Conditions: Incisional Hernia

Summary: the danish ventral hernia database (dvhd) registers 37 different perioperative parameters. the aim of present study is to use large-scale data from dvhd to uncover risk factors for readmission, reoperation (any indication), death and reoperation for recurrence after incisional hernia repair.

all principal incisional hernias registered in the danish ventral hernia database are included in the study. the included patients will be followed in up to 4 years in order to identify correlation between technical aspects of the hernia repair and postoperative morbidity.

Eligibility criteria:
inclusion criteria: * incisional hernia repair

Keywords: incisional hernia recurrence longterm
prognosis in patients with chronic respiratory failure receiving domiciliary noninvasive positive pressure ventilation (nppv)

Conditions: Chronic Respiratory Failure

Summary: the purposes of the present study are (1) to analyze baseline patient characteristics cross-sectionally, (2) to analyze the prognosis and its predictive factors, and (3) to examine longitudinal clinical course in patients with chronic respiratory failure receiving domiciliary nppv.

limited data are available about the prognosis and its predictive factors in patients with chronic respiratory failure receiving domiciliary nppv. in addition, their health status, psychological status and sleep quality seem to be highly disturbed due to severe respiratory insufficiency. therefore, in the present study, we aim to examine (1) contributive factors to health status based on baseline data, (2) whether patient reported measurements such as health status, dyspnea and psychological status would predict patient's future outcomes, and (3) how they would change for 3 years as compared to physiological measurements.

Eligibility criteria:
inclusion criteria: * patients with chronic respiratory failure receiving domiciliary nppv for more than 3 months exclusion criteria: * uncontrolled severe comorbidities * patients with tracheotomy.

Keywords: nppv prognosis health-related quality of life patient reported outcomes
myocardial damage and microbiota study

Conditions: Chronic Stable Angina; Periprocedural Myocardial Damage

Summary: myda-mi study is a randomized, placebo controlled, double blind study performed in san filippo neri hospital, roma, italy. the planned study duration is 18 months. the objectives are to assess the effects of pre-treatment with probiotic ecoviesel on the incidence and magnitude of peri-procedural myocardial damage caused by coronary angioplasty in stable patients. 250 patients with chronic stable angina scheduled for a coronary angiography and possible ad hoc angioplasty will be randomized to receive pre-treatment with ecoviesel sachets (each sachet contains 200 billions bacteria) or placebo. the pre-treatment dosage will be 4 sachets of probiotic ecoviesel or placebo for at least 2 weeks before the planned procedure. in patients undergoing angioplasty the same treatment will be continued for 4 weeks after pci with secondary outcome measures performed at the end of this second stage.


Eligibility criteria:
inclusion criteria: * patients with chronic stable angina scheduled for coronary angiography and possible ad hoc percutaneous coronary intervention exclusion criteria: * age \>75 y.o * diabetes requiring treatment * abnormal c-tni level before angiography * immunodeficiency status * need for oral vitamin k antagonists * need for antibiotics * use of antibiotics or probiotics within 4 weeks of enrollment * cancer and diseases affecting 1 year prognosis * participation in other clinical trials
effectiveness of influenza vaccination among general practitioners

Conditions: Influenza

Summary: besides the personal protection, influenza vaccination especially needs to prevent transmission of influenza between gps and their patients. the question remains if the vaccine is adding substantial benefit to the natural acquired immunity of gps. doubts are raised if an inactivated vaccine, which elicit especially humoral immune response, can give enough protection against virus replication and subclinical influenza infections. until now no effectiveness studies of influenza vaccination were performed among gps. this study will assess the effectiveness of an inactivated influenza vaccine in gps against clinical respiratory tract infections and more particular against influenza cases with influenza positive nose and throat swabs (diagnosed by rt-pcr).

two important aspects emerge when considering influenza vaccination of general practitioners as advocated by many guidelines. besides the personal protection the vaccine especially needs to prevent transmission of influenza between gps and their patients. in long-term elderly hospitals a possible benefit of influenza vaccination of the healthcare workers was noticed in reducing mortality among the elderly. but this specific situation is not fully transmissible to the general practice. gps, having yearly close contact with several influenza cases, built up a high basic immunity and probably only suffer from minor symptoms. the question remains if the vaccine is adding substantial benefit to this natural acquired immunity. in addition doubts are raised in the literature if an inactivated vaccine, which elicit especially humoral immune response, can give enough protection against virus replication and subclinical influenza infections. until now no effectiveness studies of influenza vaccination were performed among gps. high time to look more closer to these issues. comparisons: the effectiveness of an inactivated influenza vaccine compared with no vaccine in gps against clinical respiratory tract infections and more particular against influenza cases with influenza positive nose and throat swabs (diagnosed by rt-pcr), besides serological defined influenza cases and taking important independent variables into account

Eligibility criteria:
inclusion criteria:general practitioner with an active practice in flanders, belgium - exclusion criteria:other specialists in medicine -

Keywords: influenza vaccine general practitioner
expression of tim-3 on lymphocytes in sepsis

Conditions: Sepsis; Immunosuppression

Summary: the current project was designed to examine the express tim-3 on lymphocytes and monocytes and its role in immunosuppression during sepsis.

immunosuppression is the leading cause of death in septic patients.lymphocyte apoptosis has been recognized as an important step in the pathogenesis of sepsis. previous studies indicated that t cell immunoglobulin and mucin protein 3 (tim-3) is a type i cell surface protein and was identified as a marker of lymphocyte dysfunction. the current project was designed to examine the express tim-3 on lymphocytes and monocytes and its further role in immunosuppression during sepsis.

Eligibility criteria:
inclusion criteria: * patients with severe sepsis * patients undergo invasive spine surgery * healthy volunteers exclusion criteria: * patients with immunodeficient diseases * patients who accept glucocorticoid or immunosuppressant * patients with an age older than 18 years * patients providing the informed consent
probiotics and infections in children attending day care centres

Conditions: Respiratory Tract Infections; Gastrointestinal Diseases

Summary: the purpose of this study is to evaluate the effect of regular consumption of probiotic milk in preventing illnesses in finnish children attending day care centres, and possible cost-benefits that could be associated with fewer illnesses.


Eligibility criteria:
inclusion criteria: * age 2 to 6 years in the beginning of the intervention * attendance at a day care centre participating in the study (5 days a week) exclusion criteria: * milk allergy or lactose intolerance * congenital heart diseases that requires regular medication * malign diseases * cytostatic treatment * use of biological rheumatic medication * continuous microbial medication * regular use of oral corticosteroids (inhalable accepted) * diabetes * simultaneous participation in other clinical trials

Keywords: costs and cost analysis