Kornimate/medical-research-clean huggingface dataset:
virtual reality treatment for phantom limb pain

Conditions: Lower Limb Amputation Above Knee (Injury); Lower Limb Amputation Below Knee (Injury); Phantom Limb Pain

Summary: patients with limb amputations experience the sensation of the missing extremity, which is sometimes coupled with a persistent and debilitating pain in the missing limb, a condition known as phantom limb pain (plp). this study will test the use of virtual reality (vr) training as a possible treatment of plp.

approximately 90% of patients with limb amputations experience the persistent sensation of the missing extremity, a phenomenon known as phantom limb (pl). most patients with pl also experience a persistent and debilitating pain in the missing limb, a condition known as phantom limb pain (plp).plp is often attributed to a disruption of the primary sensory-motor representation, generating "noise" in the representation of the missing extremity, manifesting as pain. if loss of sensory feedback causes degradation of the these cortices, interventions that provide visual feedback about the missing extremity might fine-tune the primary sensory-motor cortices, thereby reducing pain. within this framework, the present study explores the use of virtual reality (vr) training as a possible treatment of plp. twenty-five subjects with lower-limb amputation and chronic plp will undergo a virtual reality (vr) treatment (17 one-hour sessions) consisting in two phases: a distraction vr phase (5-7 sessions) in which they will explore vr environments using a joystick and a lower-limb vr treatment phase (10-12 sessions) in which they will participate in a variety of games and activities using their vr lower-limbs. a comprehensive battery for the assessment of the characteristics, intensity and the daily-life implication of plp will be presented before and after the treatment and in three follow up testing sessions (1,4, 8 weeks). furthermore, pain intensity will be assessed before and after each vr session. a dramatic reduction of plp is expected after the vr treatment and that these beneficial effects remain stable in time.

Eligibility criteria:
inclusion criteria: * subjects will have undergone amputation of one leg (either above or below the knee) at least 4 months before the enrollment in the study; * will have chronic pain in the phantom limb: exclusion criteria: * history of stroke or traumatic brain injury; * major active psychiatric illness that may interfere with required study procedures or treatments as determined by the pi on the study, who is a behavioral neurologist; * subjects with major medical illness that would be expected to interfere with their ability to complete the study will be excluded. * subjects with implanted electronic devices.
neuropsychological assessment of cognitive decline in patients with a definite parkinson's disease

Conditions: Parkinson Disease Dementia

Summary: cognitive disorders in parkinson's disease (pd) are not as obvious as cognitive disorders in alzheimer disease and their diagnosis tends to be delayed. if neuropsychological assessment of cognitive decline in parkinson's disease is well established, the thresholds of cognitive testing corresponding to a dementia are unknown. recently, new diagnosis criteria of dementia associated with pd have been proposed by the movement disorder society. in this study two groups of patients with idiopathic pd will be separated and compared according to their mini mental state examination (mmse) score (upper or lower than 26). included patients will have clinically idiopathic pd, will be over 65 years old and will present cognitive complain. cognitive and mood disorders as well as motor symptoms will be assessed using validated scales and a neuropsychological assessment dispatched in two visits will be performed . differences in the distribution of data from the two groups of patients will be assessed in statistically analysis with non parametric tests. the purpose of this study is to determine the most effective tests and their threshold value corresponding to a pathological cognitive decline.


Eligibility criteria:
inclusion criteria: * mmse ≥ 16 * impact of cognitive disorders in daily living * criteria of the ukpdsbb for pd * steady state in pd * benign delusions or treated psychosis are tolerated * informed consent obtained exclusion criteria: * dementia from other origin than pd * cognitive decline without impact on daily living * mmse \< 16 * delirium in the last 3 months * severe depression * central anticholinergic medication * inability to perform the cognitive testing * major cerebrovascular disease * inability to give an informed consent (patients with protective measures)

Keywords: parkinson disease dementia observational case control neuropsychological assessment
efficacy of once-daily budesonide/formoterol turbuhaler 4.5/160 µg in step down asthma

Conditions: Asthma

Summary: this study will evaluate the efficacy of once-daily budesonide/formoterol turbuhaler 160/4.5 µg/d in the period of step down in well controlled asthmatic patient.

the study will measure the efficacy of once daily low dose ics/ laba in well controlled asthmatic patient comparing with low dose ics in step down circumstance.

Eligibility criteria:
inclusion criteria: * asthmatic patients who have well controlled asthma at least 12 weeks with using budesonide/formoterol (160/4.5 μg/d) twice daily * age more than 18 year-old * patients who able to do spirometry without contraindication * history smoking less than 10 pack-years exclusion criteria: * history of using systemic steroid previous 4 week and respiratory infection * history of pulmonary tuberculosis with residual lung lesion by chest radiograph * recent serious medical condition such as myocardial infarction, stroke, pneumonia etc.
use of degarelix in controlled ovarian hyperstimulation (coh) protocol for women with policystic ovarian syndrome (pcos)

Conditions: PCOS; OHSS; INFERTILITY

Summary: in this study the effectiveness of degarelix, a long acting gnrh antagonist administered in a unique administration of 20 mg the first day of menstrual cycle, to prevent ovarian hyperstimulation syndrome (ohss) in pcos women at risk to develop ohss.

women with pcos are at risk to develop ohss when stimulated with gonadotrophins for ivf. for this reason in this study the degarelix was tested in order to minimize the risk of ohss as well as to improve the pregnancy rate in these patients. the use of long acting gnrh antagonist promotes a deep suppression of lh and consequently the activity of theca cells, which secrete androgens (the precursors of estradiol), and consequently the levels of estradiol remains low. comparing the long acting gnrh antagonist at the first day of cycle with a flexible gnrh antagonist protocol in a group of patients with pcos will be useful in order to establish the best way to perform controlled hyperstimulation in ivf cycles and minimize the risk of ohss.

Eligibility criteria:
inclusion criteria: * women with pcos * previous ohss * infertility exclusion criteria: * more than 38 years old * body mass index pore than 30 * other systemic diseases

Keywords: gnrh antagonist pcos ohss coh ivf
drug eluting balloon in peripheral intervention sfa

Conditions: Peripheral Arterial Disease

Summary: the purpose of this study is to evaluate the efficacy of drug-eluting balloon angioplasty followed by nitinol stent implantation versus nitinol stent implantation in superficial femoral artery and popliteal artery stenosis.


Eligibility criteria:
inclusion criteria: * age\>18 years * intermittent claudication(fontane iii or iv) * angiographic stenosis\>50% or occlusion of superficial femoral-popliteal artery\>40mm * at least one below-knee vessel to the ankle exclusion criteria: * allergy to paclitaxel * contraindication for combined antiplatelet treatment * life expectancy \<1 year * hypersensitivity or contraindication to one of the study drugs * lack of consent

Keywords: peripheral arterial disease drug-eluting balloon restenosis
a laboratory evaluation of the humoral immune response in adults and children to the h1 hemagglutinin (ha) stalk domain and other influenza a virus protein epitopes, after administration of glaxosmithkline (gsk) biologicals' pandemic influenza vaccines

Conditions: Immunologic Tests

Summary: the purpose of this exploratory, retrospective laboratory study is to assess the humoral immune response to h1 hemagglutinin stalk domain and other influenza a virus protein epitopes following administration, in adults and children, of gsk biologicals' adjuvanted and unadjuvanted pandemic influenza vaccines, using archived serum samples from previously completed clinical trials.


Eligibility criteria:
inclusion criteria: not applicable since no subjects will be actively enrolled in this study; only the sera samples of the subjects who were a part of previously conducted primary trials will be used for testing. however, the archived serum samples of only those subjects who satisfy the following criteria will be included in this study: * subjects who received two doses of influenza vaccine 21 days apart and were included in the atp cohort for immunogenicity and persistence cohort (depending on the study) in the primary studies listed. * subjects who had agreed that their blood samples could be used for further research while giving informed consent for any of the primary studies listed. * subjects who have sufficient residual sample volume (i.e., ≥0.5 ml) of serum at all time points. * subjects with vaccine homologous neutralizing antibody result available at day 0 and at 21 (25 samples available per group in study h9n2-001) exclusion criteria: * not applicable since no subjects will be actively enrolled in this study; only the serum samples of the subjects who were a part of previously conducted trials will be used for testing.

Keywords: supra-seasonal influenza vaccine pandemic exploratory protein epitopes laboratory evaluation retrospective
comparative bioavailability between two tramadol formulations: study of the better controlled release of a new 200 mg once a day (oad) formulation versus zytram® 200 mg

Conditions: Pain

Summary: the main purpose of this study is to compare the pharmacokinetic profile to establish the better controlled liberation of the test product (tramadol hcl oad tablets of 200 mg, labopharm) and its bioavailability in relation with the commercialised reference (zytram® tablets of 200 mg, zambon), single dose administered.


Eligibility criteria:
inclusion criteria: * healthy subjects of either gender * age between 18 and 45 years * body mass index between 19 and 27kg/m2 * normal medical history * normal or no clinically significant physical examination findings * normal or no clinically significant findings in analytical tests * negative hepatitis b, hepatitis c or hiv serology * negative drugs of abuse in urine * negative pregnancy test in females * the subject understands and accepts the study procedures and grants in writing his/her informed consent exclusion criteria: * did not fulfill the inclusion criteria * organic disorders or underwent major surgery, within 90 days before study screening * psychiatric history * alcohol drink intake greater than 30gr/day * cigarette smoking greater than 10 cigarettes/day * excessive consumption of food or beverages containing xanthines (more than five units of coffee, tea or cola per day) * medical treatment within 30 days before screening, and/or any medication 7 days before starting the study * participation in other clinical study or donate blood within 90 days before starting this study * antecedents of gastric, hepatic, renal and other kind of disorder that could affect adme (absorption, distribution, metabolism or excretion of the study drug) * hepatitis b, hepatitis c or hiv positive serology * pregnant or breastfeeding * clinically relevant hypersensitivities (in particular to drugs) * woman taking oral contraceptive drugs * incapable of communicating and cooperating with investigators
early warning system for clinical deterioration on general hospital wards

Conditions: Escalation of Care; Cardiopulmonary Arrest; Respiratory Arrest; Severe Sepsis; Septic Shock

Summary: the goal is to develop a two-tiered monitoring system to improve the care of patients at risk for clinical deterioration on general hospital wards (ghws) at barnes-jewish hospital (bjh). the investigators hypothesize that the use of an automated early warning system (ews) that identifies patients at risk of clinical deterioration, with notification of nurses on the ghws when patients are identified, will reduce the risk of icu transfer or death within 24 hrs of an alert. as a substudy, the investigators will pilot the use of a wireless pulse oximeter to establish feasibility and to develop algorithms for a real-time event detection system (rds) in these high-risk patients.


Eligibility criteria:
inclusion criteria: * all patients age 18 and above, hospitalized in ghws at barnes jewish hospital. exclusion criteria: * minors, patients younger than 18 years old.

Keywords: clinical deterioration detection algorithms automated warning systems
analgesic effect of erector spinae plane block after caesarean section

Conditions: Ceserean Section and Postoperative Pain

Summary: background: our hypothesis was that bilateral esp block applied from the transverse process of t9 in women who underwent elective cesarean section with pfannenstiel incision under spinal anesthesia could provide effective postoperative analgesia.the primary outcome in this study was total opioid consumption for 24 hours. material and method: this randomized prospective study was carried out on 50 pregnant women who was scheduled for elective cesarean delivery via a pfannenstiel incision with spinal anesthesia.patients were randomly allocated in to two equal groups.group sa was categorized as the group which spinal anaesthesia alone (sa) was performed, group sa+esp was categorized as group which sa+esp block was performed. all groups received 7 mg isobaric bupivacaine +15 µg fentanyl intrathecally through spinal anesthesia. the sa+esp group, esp block was performed at the ninth thoracic transverse process with 20 ml 0.25% bupivacaine + 2 mg dexamethasone immediately after the operation. total fentanyl consumption in 24 hrs, visual analogue scale (vas) score for pain, time to the first analgesic request were evaluated postoperatively.


Eligibility criteria:
inclusion criteria:pregnant women,38-42 gestational weeks, asa i-ii exclusion criteria: * ≤18 or ≥45 age, has emergency obstetric surgery, pregnancy induced hypertension, significantly systematic disease, foetal or placental abnormality, hypersensitivity or allergy history to medicine to be used in the study, bmi≥35, autonomic neuropathy, diabetic, contraindicate to apply neuroachylic anaesthesia, who was transferred to general anaesthesia, could not decide or did not want to participate in the study, had severe respiratory and cardiac disease, was transferred to general anaesthesia, has infection, spine or chest wall deformity in operation area, has opioid dependence, chronic analgesic usage, inability to use a patient-controlled analgesia (pca) device, couldn't be able to cooperative and express their pain with visual analogue scale score (vas).

Keywords: ceserean section, esp block, postoperative pain
improving pediatric obesity practice using prompts

Conditions: Pediatric Obesity

Summary: this study compares the effectiveness of electronic health record (ehr)-based tools to support the management of pediatric obesity in primary care. all clinicians will receive an interruptive "pop-up" alert we will examine the impact -- the added value versus unintended consequences -- of the interruptive alert on the quality of obesity management in pediatric primary care.

the primary specific aims of this study are to: 1. to assess the impact of ehr-based tools for pediatric obesity in primary care. hypotheses: ehr-based clinical decision support tools that interrupt but support clinical workflow will (1) improve measures of pediatric obesity care quality delivered by clinicians (e.g., addition of obesity to the problem list, recommended screening for comorbidities, and follow-up/referral plans) and (2) result in a reduced rate of bmi increase over one year among children with obesity. 2. to utilize a mixed methods approach with surveys and semi-structured qualitative interviews with clinicians to (1) examine the extent to which the ehr tools positively impact clinicians' awareness, knowledge and adherence to expert guidelines for pediatric obesity management, and (2) to explore the barriers to and facilitators of clinicians' use of the ehr tools and factors that influence adoption.

Eligibility criteria:
all pediatric primary care providers providing well child care for patients ages 2-17 years-old in the boston children's hospital primary care practices will be eligible for the study. there are no exclusion criteria.

Keywords: pediatric obesity electronic health record clinical decision support
a safety and efficacy study of a dexamethasone drug delivery system for postoperative inflammation and pain after cataract surgery

Conditions: Cataract

Summary: this is a safety and efficacy study of a dexamethasone drug delivery system for anterior segment inflammation and pain following cataract extraction with lens implantation.


Eligibility criteria:
inclusion criteria: * planned single cataract extraction with lens implant * best-corrected visual acuity of 20/200 or better in the opposite eye exclusion criteria: * glaucoma or history of intraocular hypertension in the study eye * history of chronic ocular allergy in the last year requiring treatment * scheduled for cataract surgery in the non-study eye during study participation
copd patient-powered research network

Conditions: Chronic Obstructive Pulmonary Disorder; Chronic Obstructive Lung Disease; Emphysema; Chronic Bronchitis

Summary: the copd patient-powered research network (copd pprn) is a patient research registry with the goal of enrolling 75,000 or more copd patients and those at risk who are willing to share their heath information over several years and participate in research. the copd pprn has built an online platform to allow volunteers to enroll electronically, complete surveys, be contacted about studies they qualify for and become connected to copd resources. the goal of the registry is to speed research to find better treatments for copd and ultimately a cure.


Eligibility criteria:
inclusion criteria: * 18 years or older that says yes to one of the following: * copd diagnosis * current or former smoker * family history of respiratory disease * symptomatic of respiratory disease exclusion criteria: * non-english speaking

Keywords: copd emphysema bronchitis bronchiectasis
anesthesia, tiva, balanced anesthesia, nk cell

Conditions: Colorectal Cancer

Summary: anesthetic method was reported to have an impact on postoperative long-term outcome in cancer patients. in this study, we will investigate the effect of different anesthetic methods on nk cell activity, cytokine response and postoperative outcome in colorectal cancer patients undergoing crs and hipec. we will compare propofol-based total intravenous anesthesia (tiva) with balanced anesthesia to determine the effect of propofol, inhalation agent, and opioid on tumor genesis, recurrence, nk cell activity, cytokine response, and postoperative outcome.


Eligibility criteria:
inclusion criteria: 1. colorectal cancer patients undergoing elective cytoreductive surgery and hipec (20-70 yrs old) 2. american society of anesthesiologists physical status i, ii, iii exclusion criteria: 1. patients under 20 years old. 2. patients with long-term steroid therapy or immunosuppressive therapy. 3. patients with long-term nsaids therapy. 4. patients who cannot communicate with other person or with cognitive disorder. 5. patients who cannot read the consent form.
accurate diagnosis and grading of pediatric solid tumors based on pathological large models

Conditions: Neuroblastoma; Medulloblastoma; Wilms Tumor; Hepatoblastoma; Rhabdomyosarcoma

Summary: pediatric malignancies are the second leading cause of death in the pediatric population, with solid tumors accounting for approximately 60% of all pediatric malignancies. the pathological diagnosis of pediatric solid tumors is highly complex and specialized, because of its diverse tissue morphology, rare tumor subtypes and lack of labeling data, the traditional pathological diagnosis relies on the experience of senior pathologists, but in actual clinical practice, due to the lack of expert resources and inconsistent diagnostic standards, more efficient and accurate auxiliary diagnostic tools are urgently needed. in this study, we aim to construct a multimodal dataset by collecting high-quality pathological images and pathological diagnosis results of pediatric solid tumors (neuroblastoma, medulloblastoma, wilms tumor, hepatoblastoma, rhabdomyosarcoma, etc.), and introduce medical knowledge enhancement strategies on this basis, and improve the medical reasoning ability and adaptability to fine-grained pathological tasks by injecting domain knowledge (such as molecular characteristics of tumors, pathological grading standards, diagnostic rules, etc.) into the model. through the model, the representation space of images and texts is unified, and diversified diagnostic tasks of pediatric solid tumors such as tumor region segmentation, cancer detection, and tumor subtype identification are realized, providing intelligent support for the accurate diagnosis and personalized treatment of pediatric solid tumors.

diagnosis test

Eligibility criteria:
inclusion criteria: 1. neuroblastoma (nb): for newly diagnosed patients with nb aged 0-18 years, the diagnosis criteria are one of the following two items: (1) the patient's tumor tissue has obtained a positive pathological diagnosis under the light microscope; (2) bone marrow biopsy or aspiration revealed characteristic neuroblastoma cells, which were small round cells, arranged in a nested or chrysanthemum clump or positive staining for anti-gd2 antibodies, and accompanied by an increase in urinary vanillylmandelic acid (vma) and an increase in blood neuron-specific enolase (nse). 2. wilms tumor (nephroblastoma): patients aged 0-18 years old who have been diagnosed with wilms tumor by histopathology. 3. hepatoblastoma (hb): patients aged 0-18 years who have been diagnosed with hepatoblastoma by histopathology. 4. medulloblastoma (mb): patients aged 0-18 years with a confirmed histopathological diagnosis of medulloblastoma. 5. rhabdomyosarcoma (rms): patients aged 0-18 years old who have been diagnosed with medulloblastoma by histopathology. exclusion criteria: 1. the patient's medical record and treatment follow-up information are incomplete; he is not stained or faded 2. those who have 2 or more types of tumors at the same time; 3. those who do not meet the enrollment criteria. 4. tumor subtype with less than 3 wsi images

Keywords: machine learning diagnosis pathological classification