Kornimate/medical-research-clean huggingface dataset:
improving colon cancer screening for diverse populations

Conditions: Colorectal Cancer

Summary: this study is a multi-site randomized, controlled trial testing the effect of a combined intervention that includes a colorectal cancer (crc) screening decision aid plus patient navigation in a diverse, primary care patient population in clinical sites in north carolina and new mexico. our primary aim is to determine the effect of the intervention on crc screening completion six months after the index visit among all enrolled participants and among latinos. secondarily, we will determine how this intervention affects screening-related knowledge, self-efficacy, intent, and clinical communication, and examine whether these factors mediate the effect of the intervention on screening test completion. lastly, we will explore whether insurance status, ethnicity, and patient language preference moderate the effect of the intervention on screening.


Eligibility criteria:
inclusion criteria: * patients 50 to 75 years old who are not current with colorectal cancer (crc) screening, defined as not having completed a home fecal occult blood test (fobt) within the past year; a flexible sigmoidoscopy within the past five years; or a colonoscopy within the past ten years. * have an appointment at one of the clinic sites exclusion criteria: * will include: inability to speak either english or spanish, severe illness at the time of the clinic visit, co-morbidity that is estimated to limit life-expectancy to less than 5 years as estimated by the treating nurse or provider, severe cognitive, visual, or hearing impairment that would preclude decision aid (da) viewing. we will also exclude patients who are at elevated risk for crc, defined as having ever been diagnosed with crc, a precancerous (adenomatous) polyp, or inflammatory bowel disease.
closed loop programming evaluation using external responses for deep brain stimulation

Conditions: Parkinson Disease

Summary: the objective of this study is to evaluate the performance of novel dbs programming methods compared to traditional programming methods.


Eligibility criteria:
key inclusion criteria: * implanted bilaterally in stn or gpi with a vercise™ dbs system for parkinson's disease, including directional leads, for at least four months and programming optimized according to standard of care with no changes to electrode configuration of primary settings for at least four weeks. * able to understand the study requirements and the treatment procedures and provides written informed consent before any study-specific tests or procedures are performed. * be at least 18 years of age. * device must have been implanted on label or must be on label by the time the subject gets enrolled. key exclusion criteria: * any significant psychiatric problems, including unrelated clinically significant depression as determined by the investigator.
efficacy and mechanism of rtms in children with asd: an open-label clinical trial

Conditions: Autism Spectrum Disorder

Summary: this study is a 6-week open-label clinical trial involving 20 children aged 6-10 years with autism spectrum disorder. during the study, subjects received repeated transcranial magnetic stimulation（rtms）intervention at the left primary motor cortex (m1) 5 times per day for 10 days. from the beginning of intervention to the end of 4 weeks after the completion of intervention, the subjects's clinical symptomatology, cognitive psychology, neuroimaging, and adverse events will be followed up.our purpose is to explore whether rtms can improve the clinical symptoms of children with autism spectrum disorder in china, and to explore the neurophysiological mechanism of rtms for autistic children.

participants will receive continuous theta burst stimulation (ctbs) for a 10-day period (10 sessions). if feasible for the participant, all stimulation sessions will be held at the same time of the day. during this study，participants' clinical symptomatology, cognitive psychology, neuroimaging, and adverse events will be followed up for four times, specifically，before intervention, 5 days after intervention, immediately after the completion of intervention , and 4 weeks after the completion of intervention.

Eligibility criteria:
inclusion criteria: * children aged 6-10 years. * meeting the diagnostic criteria of the diagnostic and statistical manual of mental disorders, edition 5 (dsm-5) . * confirmed by the ados and/or adi-r diagnostic tool. * iq ≥70. * informed consent. exclusion criteria: * patients with metal implants . * patients with neurological diseases such as epilepsy . * patients requiring surgical treatment due to structural abnormalities indicated by brain mri . * genetic or chromosomal abnormalities . * suffering from mental disorders (such as mood disorders, etc.) * suffering from serious heart disease . * hearing-impaired . * intracranial hypertension . * participating in other clinical trials. * participants who received other interventions within 4 weeks prior to enrollment.

Keywords: repetitive transcranial magnetic stimulation（rtms） continuous theta burst stimulation （ctbs）
transbronchial vs transthoracic ablation for early-stage peripheral lung cancer

Conditions: Stage IA Lung Cancer

Summary: the purpose of this study is to investigate the efficacy and safety of rfa through a transthoracic or transbronchial approach in the treatment of early-stage peripheral lung cancer.

this study is designed as a prospective, randomized controlled trial with 110 participants, randomized in a 1:1 ratio to ct-guided rfa and bronchoscopy-guided rfa groups. the primary study endpoint is the complete ablation rate at 6 months post-ablation. secondary study endpoints are technical success rate, complete ablation rate at 12 months post-ablation, local control rate at 1, 2, and 3 years post-ablation, progression free survival, overall survival, and safety. demographic data, clinical baseline characteristics, ct follow-up data, and safety data will be collected and recorded.

Eligibility criteria:
inclusion criteria: 1. age greater than 18 years. 2. primary peripheral lung cancer diagnosed by pathology, and preoperative staging reveals clinical stage t1n0m0, stage ia. 3. the planned ablation lesions are assessed to be amenable to ct-guided and bronchoscopy-guided ablation. 4. assessed as inoperable or refused surgery, agree to undergo initial ablation therapy, and sign informed consent. exclusion criteria: 1. patients with platelet \< 50 × 10 9/l, severe bleeding tendency and coagulation dysfunction that cannot be corrected in a short period of time. 2. patients with severe pulmonary fibrosis and pulmonary hypertension. 3. perilesional infection and radiation inflammation, puncture site skin infection is not well controlled, systemic infection, high fever \> 38.5℃. 4. patients with severe liver, kidney, heart, lung and brain dysfunction, severe anemia, dehydration and severe nutritional metabolism disorders that cannot be corrected or improved in a short period of time. 5. patients with poorly controlled malignant pleural effusion. 6. anticoagulation therapy and/or antiplatelet agents (except novel oral anticoagulants such as dabigatran and rivaroxaban) are discontinued for less than 5\~7 days before ablation. 7. eastern cooperative oncology group (ecog) score \> 2. 8. combined with other tumors with extensive metastasis, expected survival \< 6 months. 9. patients with episodic psychosis. 10. patients with implantable electronic devices (such as pacemaker or defibrillator). 11. pregnant women, or patients who have pregnancy plans during the study. 12. participation or ongoing participation in another clinical study within the past 30 days. 13. other situations that the investigator deems inappropriate to participate in this study.
eeg spectral pattern of deep sedation-induced airway adverse effects

Conditions: Procedural Sedation

Summary: to investigate the associations bewteen the sedation level and the airway adverse effects by using the eeg, airmod breath sound monitor and the capnography.

deep sedation is mandatory for many invasive procedures such as the digestive endoscopy, bronchoscopy and cystoscopy. however, deep sedation may induce respiratory adverse effects including airway obstruction, hypoventilation and apnea. these respiratory adverse effects, which may occur in more than 20% of high-risk groups (eg, children, the elderly, and patients with sleep apnea), hence, are the major concerns of the anesthetic care. however, it is difficult for clinicians to objectively quantify the sedation level and find the associations of inadequate sedation level and the occurrence of respiratory adverse effects. airway obstruction and respiratory rate decline during deep sedation are conventionally monitored by using capnography(etco2 waveform). however, previous studies have tracheal breath sound monitoring can achieve better detection accuracy than the capnography. the novel airmod smart breathing monitor has the functions of breath sound recording, anti-noise signal processing, event recording and respiratory rate analysis and research. through the continuous breath sound recording, airway adverse effects during sedation may be detected, and these breathing spectrogram can be presented for image analysis. this is helpful for researcher to identify associations between airway adverse effect and the sedation level. the state-of-art anesthetic depth is determined by using the electroencephalogram (eeg). both eeg raw data or the eeg spectrogram graphs may be used for quantify the sedation level with respiratory adverse effects. accordingly, this study aims to investigate the associations between the sedation level and the airway adverse effects by using the eeg monitor, airmod breath sound monitor and the capnography.

Eligibility criteria:
inclusion criteria: patients undergoing procedural sedation with expected produre time longer than 30 minutes * pediatric group: age 4-8 year-old * geriatric group: age\>= 65 year-old exclusion criteria: * preoperative active brain conditions (dementia, parkinsonism, seizure) * a history of nasal or oral tumor
connectivity alterations after levetiracetam application

Conditions: Glioma; Epilepsy

Summary: this study aimed to analyze the connectivity alterations in brain networks of lgg patients with epilepsy who take levetiracetam at short-term preoperatively.

glioma-related epilepsy (gre) is a very common symptom in patients with diffuse gliomas. approximately 60% of patients with low-grade gliomas (lggs) and 40-64% of patients with high-grade gliomas presented with gre at the onset. although beneficial for the control of gre, the overall therapeutic effect was unsatisfied and over 20% of patients still suffered from seizures. gre was found to be associated with brain network and functional connectivity. and it has been reported that temporal lobe seizures could induce functional connectivity and decreased network efficiency of brain networks. however, the alterations in functional networks induced by gre were still unclear. and lgg patients with gre usually take levetiracetam (lev) preoperatively, which could effectively reduce abnormal spike activity and further cause connectivity alterations. this makes it more complex to reveal the connectivity alterations of brain networks in lgg patients with gre. this study aimed to collect the resting-state functional mris of 30 lgg patients who presented with gre at the onset. through further applied graph theory analysis, investigators tend to reveal the connectivity alterations of brain networks caused by levetiracetam. the findings of this study will provide a theoretical basis for further study of connectivity alterations of brain networks in patients with gre.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * histopathological diagnosis with lgg according to the 2016 world health organization (who) criteria; * participants received more than 6 years of school education; * presence of gre, take levetiracetam less than 1 month; or do not take any medicine and receive any treatment; * no history of biopsy, radiotherapy, or chemotherapy. exclusion criteria: * contraindications for mri; * head motion greater than 3 mm in translation or 3° in rotation;

Keywords: glioma glioma-related epilepsy levetiracetam connectivity alteration
safety of qmf149 twisthaler® in adolescent and adult patients with asthma

Conditions: Asthma

Summary: study cqmf149a2210 evaluated the safety of qmf149 twisthaler® 500/400 μg, a fixed dose combination of indacaterol 500 μg, a once daily β2 agonist, and mometasone furoate 400 μg, an inhaled corticosteroid (ics) that is approved for use in the treatment of asthma. the objective of this safety trial was to assess the effect of treatment on the incidence of serious asthma exacerbations, defined as asthma related hospitalization and/or intubation and/or death. this was an event driven trial.


Eligibility criteria:
inclusion criteria: * patients with a documented diagnosis of persistent asthma and who were currently treated with or qualified for treatment with both ics and long-acting beta2-agonist (laba) combination * patients demonstrating an increase in forced expiration volume in 1 second (fev1) of ≥ 12% or ≥ 200 mls within 30 minutes after administration of short-acting beta2-agonist (saba) * patients with an fev1 ≥ 50% of predicted normal exclusion criteria: * patients with a previous diagnosis of chronic obstructive pulmonary disease (copd) * patients who had an asthma attack/exacerbation requiring hospitalization/emergency room visit or respiratory tract infection within 1 month prior to randomization * patients who had ever required ventilator support for respiratory failure * patients with diabetes type i or uncontrolled diabetes type ii * patients with concomitant pulmonary disease * patients with certain cardiovascular co-morbid conditions * patients with any significant medical condition that might compromise patient safety, interfere with evaluation or preclude completion of the study other protocol-defined inclusion/exclusion criteria may apply

Keywords: asthma laba safety
effects of exenatide on overweight adolescents with prader-willi syndrome

Conditions: Prader-Willi Syndrome

Summary: prader-willi syndrome (pws) is one of the most common genetic causes of obesity. obesity is a major source of morbidity and mortality in this population. it can lead to sleep apnea, cor pulmonale, diabetes mellitus, and atherosclerosis. pws has distinct characteristics that set it apart from other forms of obesity including insatiable appetite and food-seeking behavior which can be disruptive to home and school activities, and can cause severe social and psychological turmoil within families. pws is also associated with unique hormonal abnormalities, most notably hyperghrelinemia. ghrelin is a gut hormone produced in the stomach that stimulates food intake during a fast. it is hypothesized that the extremely high ghrelin levels in patients with pws may cause or contribute to their insatiable appetite. exenatide, a medication used in the treatment of type 2 diabetes mellitus in adults, appears to suppress ghrelin levels and cause weight loss. it was designed to mimic glucagon-like peptide 1 (glp-1), an incretin hormone that stimulates insulin secretion and delays gastric emptying, among other effects. in the present study, the investigators will investigate the effects of a 6 month trial of exenatide in overweight adolescents with pws. the investigators will quantify the changes in weight and body composition, as well as subjective measures of appetite, and concentrations of appetite-associated hormones. the investigators hypothesize that exenatide will improve weight, body composition, appetite, and plasma ghrelin levels during the treatment period.

background: prader-willi syndrome (pws) is associated with hyperphagia and hyperghrelinemia with major morbidity because of obesity without effective medical treatment targeting hyperphagia. exenatide (byetta \[synthetic exendin-4\]; astrazeneca, wilmington de) is a glp-1 receptor agonist which reduces appetite and weight and may be an effective treatment in pws. objective: the objective of this study is to determine the effect of a 6-month trial of exenatide on appetite, weight and gut hormones in youth with pws.

Eligibility criteria:
inclusion criteria: * diagnosis of prader willi syndrome confirmed by genetic testing (dna methylation or fish) * ages 13-20 years * body mass index (bmi) \> 85th percentile for age and gender exclusion criteria: * is currently using or has previously used a glucagon-like peptide-1 (glp-1) agonist * history of pancreatitis, or renal failure * history of familial pancreatitis * amylase, or lipase levels \> 2.5 times the upper limit of normal any time in the previous 2 years * creatinine clearance \< 30 ml/min * other syndromic diagnoses * gastrointestinal (gi) or renal illness in the 1 month prior to entering study * inability to take study drug * pregnancy * initiation of growth hormone (gh), estrogen, or testosterone or change \> 25% of dose/kg/day during the 6 months prior to starting study * non-english speaking

Keywords: prader-willi syndrome obesity weight exenatide byetta pediatrics adolescents
islet autotransplantation in patients at very high-risk pancreatic anastomosis

Conditions: Postpancreatectomy Hyperglycemia

Summary: the goal of the proposal is to demonstrate that, in patients with disease of the pancreatic head with very high-risk of complications of pancreatojejunal reconstruction (soft pancreas and pancreatic duct diameter \<3 mm), total pancreatectomy with islet autotransplantation (iat) is associated with a lower morbidity (in terms of surgical or medical complications) and mortality compared with pancreaticoduodenectomy and pancreatojejunal anastomosis.

complications of the pancreatic anastomosis still represents a significant risk for death after the resection of the pancreatic head. in an effort to decrease morbidity and mortality, the referral of patients who need a pancreaticoduodenectomy to institutions (and surgeons) performing a high volume of this surgical procedure has been championed. nonetheless, the role of prophylactic medications and the best surgical technique(s) for the removal of the pancreatic head are still debated. however, very few prospective randomized clinical trials have been conducted to compare different surgical techniques. our study will address for the first time the role for preemptive total pancreatectomy and iat in selected patients undergoing pancreaticoduodenectomy that are considered high risk for pancreaticojejunostomy disruption (eg, small pancreatic duct, soft pancreas). the information expected is the identification of total pancreatectomy and the iat as the standard treatment in a subgroup of patient with pathologies of the pancreatic head at high risk for leakage of pancreatic anastomosis. ultimately this project will lead to reserve more innovative cell therapy for patients with the highest risk of anastomosis failure reducing pancreatojejunal reconstruction related morbidity and mortality

Eligibility criteria:
inclusion criteria: * patients \>18 years of age * ability to provide written informed consent * mentally stable and able to comply with the procedures of the study protocol * fasting glycaemia \<126 mg/dl without glucose-lowering medications. exclusion criteria: * any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial * diagnosis of intraductal papillary mucinous cancer, unless the absence of multifocal lesion is demonstrated by endoscopic us * presence of multifocal or residual disease at the pancreatic margin.

Keywords: diabetes islet transplantation pancreas pancreatectomy
magnetic resonance thermal image guided laser interstitial thermal therapy in treating patients with breast cancer

Conditions: Ductal Breast Carcinoma in Situ; Invasive Ductal Breast Carcinoma; Stage IA Breast Cancer; Stage IB Breast Cancer

Summary: this pilot clinical trial studies magnetic resonance thermal image guided laser interstitial thermal therapy in treating patients with breast cancer. magnetic resonance thermal image guided laser interstitial thermal therapy may be able to kill tumor cells by heating up the tumor cells without affecting the surrounding tissue

primary objectives: i. to evaluate the procedural success rate of using the visualase magnetic resonance (mr)-guided laser system to target, access, thermally monitor, and focally ablate mr-visible breast cancer lesions. 2. to obtain preliminary data on ablative success using pathologic assessment for specimen excised subsequent to the ablation. outline: patients undergo mr-thermal image guided laser interstitial thermal therapy (litt) over 1 hour. after completion of study treatment, patients are followed up at 3-7 days.

Eligibility criteria:
inclusion criteria: * postmenopausal state * histological diagnosis of breast invasive ductal carcinoma with receptor profiles obtained * mri visible breast lesion * unifocal cancer, less than 1.5 cm in maximum diameter (clinical stage t1), with no evidence of extensive in situ cancer surrounding the main tumor; the eligibility will be determined by the mr imaging appearance of the tumor; if the tumor (proven invasive ductal carcinoma) is a unifocal mass without additional enhancement, it will be judged eligible; however, if the tumor is associated with additional enhancement and/or a satellite focus, it will not judged ineligible, as these are signs of additional in situ or invasive cancer * clinical stage n0 (no metastatic axillary lymph node on physical examination or imaging work-up) * ability to give informed consent exclusion criteria: * previous surgery or radiation for the ipsilateral breast cancer * presence of any condition (e.g., metal implant, shrapnel) not compatible with mri * tumor located less than 1 cm from the skin or the pectoralis muscle
efficacy of antibiotic short course for bloodstream infections in acute myeloid leukemia patients with febrile neutropenia

Conditions: Bloodstream Infection; Acute Myeloid Leukemia; Febrile Neutropenia

Summary: there is no specific recommendation about antimicrobial treatment length for documented infections in chemotherapy induced febrile neutropenia. the aim of this study was to compare long versus short antibiotic course for bloodstream infection treatment in acute myeloid leukemia patients during febrile neutropenia. this monocentric retrospective comparative study included all consecutive bloodstream infection episodes among acute myeloid leukemia patients with febrile neutropenia for 3 years (2017-2019). episodes were classified regarding the length of antibiotic treatment, considered as short course if the treatment lasted ≤7 days, except for nonfermenting bacteria and staphylococcus aureus or lugdunensis for which the threshold was ≤10 days and ≤14 days, respectively. the primary outcome was the number of bloodstream infection relapses in both groups within 30 days of antibiotic discontinuation.


Eligibility criteria:
inclusion criteria: * acute myeloid leukemia * chemo-induced febrile neutropenia * bloodstream infection exclusion criteria: * lack of data * endovascular infections * surgical treatment required * central nervous system infections * antibiotic treatment \< 4 days * death before the end of antibiotic treatment * unappropriated antibiotic treatment at 48h * relapses of bloodstream infection episodes already included * hematopoietic stem cell transplant

Keywords: antibiotic short course, appropriate use of antibiotics