Kornimate/medical-research-clean huggingface dataset:
ambulatory blood pressure and prognosis

Conditions: Cardiovascular Diseases; Heart Diseases; Hypertension

Summary: to continue a prospective study of the ability of ambulatory blood pressure to predict cardiovascular morbidity in patients with mild hypertension.

background: this was a continuation of a prospective study of the ability of ambulatory blood pressure to predict cardiovascular morbidity in patients with mild hypertension, which was first started in 1978. design narrative: predictor variables evaluated at entry to the longitudinal study included clinic and ambulatory blood pressures (including measures of pressure level and variability in different settings), left ventricular mass index (lvmi, determined by echocardiography), renin-sodium profile, and other cardiovascular risk factors (e.g., cholesterol and smoking). during follow-up, blood pressure, treatment status, bmi, and clinical course were evaluated. outcome measures were definite cardiovascular morbid events, defined as sudden cardiac death, myocardial infarction, stroke, congestive heart failure, and coronary artery revascularization. the main hypotheses tested were that ambulatory blood pressure would give a better prediction of outcome than clinic pressure, and that patients with white coat hypertension (defined as a high clinic pressure and normal ambulatory pressure) would be at low risk relative to patients with sustained hypertension. initial results in 729 patients initially studied between 1978 and 1985 using cox survival analysis showed that the four most significant predictors of morbid events were daytime blood pressure variability, age, male sex, and serum cholesterol. patients with white coat hypertension appeared to be at a level of risk intermediate between normotensives and sustained hypertensives, but the differences were not yet significant. expansion of the cohort size to include patients evaluated initially between 1985 and 1990 provided nearly 2,000 patients altogether, which together with the longer follow-up of the initial cohort provided a sufficient number of morbid events to identify the predictive significance of the different blood pressure measures, and their interaction with other risk factors. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
artificial intelligence self harm application

Conditions: Self-harm; Suicide

Summary: this is a mixed-methods study. the quantitative component will comprise of a multicentre rater-blind, randomized controlled trial to evaluate the feasibility and acceptability of aisha in addition to treatment as usual (tau) compared to tau alone in pakistan. in-depth interviews and focus groups with other stakeholders will take place to consider the wider implementation of aisha in mental health services in pakistan.

mental health resources in lmics, including pakistan, do not match the burden of mental illness, resulting in a massive mental health treatment gap. interventions delivered on mobile platforms (m-health) have the potential to overcome these barriers. evidence supports the acceptability and efficacy of interventions delivered on digital platforms for a variety of mental disorders. mobile-based interventions have been developed to target self-harm, however, there is paucity of research supporting their efficacy in lmic. to our knowledge there are currently no clinical trials examining the feasibility, acceptability and preliminary efficacy of a culturally adapted cbt informed problem solving intervention delivered on a digital platform for self-harm prevention.we have developed an artificial intelligence self-harm prevention application (aisha) to deliver an evidence-based problem solving intervention (cmap) for people presenting with self-harm.

Eligibility criteria:
inclusion criteria: * all patients presented to the participating family physicians, community health centres, emergency departments or admitted to a general hospital after an episode of self-harm at participating sites. * age 16 to 25 years * participants must be familiar with functioning of handheld mobile devices (mobile phones, tablets). * able to read urdu or english language. * individuals able to provide written informed consent. * have an android mobile phone/device exclusion criteria: * participants with icd-i0 mental disorder; due to a general medical condition or substance misuse, dementia, delirium, alcohol or drug dependence, schizophrenia, bipolar disorder, learning disability which prevents participation. * participants needing inpatient psychiatric treatment as determined by their clinical teams

Keywords: self-harm suicide adolescents young people artificial intelligence problem-solving cbt pakistan lmic digital
use of spectral oct in combination therapy

Conditions: Choroidal Neovascularization

Summary: this study will investigate the safety and efficacy of treatment of choroidal neovascularization (cnv) due to age-related macular degeneration (amd) with a combination of ranibizumab (lucentis) and verteporfin pdt (visudyne), as compared with ranibizumab monotherapy.


Eligibility criteria:
inclusion criteria: * ability to give informed consent * patients with visual acuity of 20/40-20/320 in the study eye * subfoveal choroidal neovascularization (cnv) must be at least 50% of the total lesion size. * total area of lesion components other that cnv must be less than 50% of the total lesion size. * the lesion must be \< 5400microns in greatest linear dimension (gld). * lesion size \< 10 da * occult with no classic cnv lesions must have presumed recent disease progression: 1. blood associated with the lesion at baseline 2. loss of visual acuity in the previous 3 months: a: \> 5 letter loss (etdrs equivalent) or b: 2 or more lines using a snellen or equivalent chart 3. \> 10% increase in gld as assessed by fluorescein angiography in the previous 3 months exclusion criteria: * presence of angioid streaks, presumed ocular histoplasmosis syndrome, pathologic myopia (-8 or more with evidence of posterior segment abnormalities consistent with pathologic myopia), or cnv secondary to causes other than amd * geographic atrophy in the study eye * tear (rip) of the retinal pigment epithelium * presence of fibrosis, hemorrhage, pigment epithelial detachments, or other hypofluorescent lesions obscuring greater than 50% of the cnv lesion * intraocular surgery within 6 weeks of enrollment * active or history of ocular inflammation or infection in the study eye within the last 30 days * subretinal hemorrhage \> 50% of the total lesion * history of submacular surgery, or transpupillary thermotherapy in the study eye * patients with intraocular pressure greater than 30 mm/hg on 2 pressure-lowering medications * patients with severe disciform scarring * history of intraocular surgery in the study eye including pars plana vitrectomy, except for uncomplicated cataract surgery within 60 days prior to screening * history of yag laser posterior capsulotomy in the study eye within 30 days prior to screening * inability to make study visits * advanced glaucoma, uncontrolled glaucoma in the study eye (defined as intraocular pressure, iop ≥ 25 mmhg) despite treatment with two or more topical pharmacological anti-glaucomatous medication) * allergies to porphyrins or a known hypersensitivity to any component of visudyne® * patients with porphyria * pregnancy or lactation

Keywords: spectral oct choroidal neovascularization lucentis visudyne pdt anti-vegf
a clinical study evaluating nivolumab-containing treatments in patients with advanced non-small cell lung cancer after failing previous pd-1/(l)1 therapy and chemotherapy

Conditions: Carcinoma, Non-small Cell Lung Cancer

Summary: this study is for participants with non-small cell lung cancer that has spread or has reoccurred after failure of chemotherapy and immunotherapy


Eligibility criteria:
for more information regarding bristol-myers squibb clinical trial participation, please visit www.bmsstudyconnect.com. inclusion criteria * histologically or cytologically-documented stage iv a/b non-small cell lung cancer, stage iiib/c disease failed concurrent chemort. * ecog performance status of ≤ 1. * radiologically-documented disease progression on one anti-pd-1/anti-pd-l1 therapy and one platinum-based doublet regimen given either concurrently or sequentially within 90 days after the last dose of anti-pd-(l)1. * all participants must have tumor tissue submitted prior to randomization, either a recent archival sample obtained on/after the date of disease progression of the last prior anticancer therapy and within 3 months prior to enrollment, or a fresh biopsy obtained during the screening period. * prior toxicities must have resolved to grade ≤1. * women of childbearing potential (wocbp) must have a negative serum or urine pregnancy test and must not be breastfeeding. * males who are sexually active with wocbp must agree to follow instructions for method(s) of contraception. in addition, male participants must be willing to refrain from sperm donation during this time and must agree to follow instructions for method(s) of contraception. azoospermic males are exempt from contraceptive requirements as well as wocbp who are continuously not heterosexually active, however, a pregnancy test will still be required. exclusion criteria * prior treatment with docetaxel. * untreated cns metastases, carcinomatous meningitis or leptomeningeal metastases. * any tumor invading the superior vena cava other blood vessel, gi tract or trachea. * egfr mutations, alk translocations, ros1 translocations which are sensitive to inhibitor therapy. * history of cerebrovascular accident and coagulation disorders. * participants with interstitial lung disease, history of cerebrovascular accident or history of abdominal fistula, gastrointestinal perforation, bowel obstruction, intra-abdominal abscess or grade 3-4 bleeding event within 6 months prior to randomization. * known toxicity on prior checkpoint inhibitor treatment. * participants who received more than one line of anti- pd-1/pd-l1 treatment. * participants who received previous ctla-4 inhibitor treatment. * participants with known braf v600e mutation which are sensitive to available targeted inhibitor therapy are excluded. * other protocol-defined inclusion/exclusion criteria apply.
reall: a retrospective observational study to compare the effectiveness and cost-effectiveness between different step-3 asthma treatment strategies

Conditions: Asthma

Summary: this is a retrospective observational study utilising anonymised individual patient clinical and prescribing information routinely collected by uk general practitioners (gps). this information will be observed for two years, one year pre and one year post- "index prescription date" (ipd). the ipd is the date when a patient was first switched to any option of the step-3 asthma treatment regimen. the one year before the ipd is the baseline period and will be reviewed for risk factors and confounding factors. the one year after the ipd is the outcome period and will be observed to see the outcomes of the new treatment.


Eligibility criteria:
inclusion criteria: 1. patients with a physician diagnosis of asthma who have stepped-up to any option of step-3 asthma treatment (trial therapy), and; 2. patients with the trial therapy who have data in their records for at least one year for the baseline period and at least one year for the outcome period. exclusion criteria: 1. patients who were not prescribed with any option of step-3 treatment (the trial therapy) during the study period. 2. patients treated with the trial therapy, but do not have data in their records for at least one year for the baseline period and at least one year for the outcome period. 3. patients treated with long-acting anticholinergic drugs, either alone or in combination with other therapy. 4. patients with a physician diagnosis of copd with or without asthma. 5. patients who have resolved from asthma; i.e. patients who were previously diagnosed as having asthma, have now been undiagnosed.
autologous serum skin testing in patients with atopic dermatitis autologous serum skin testing in patients with atopic dermatitis

Conditions: Atopic Dermatitis, Serum Skin Test

Summary: recently, ige-type autoantibodies against self proteins have been detected in the serum of the atopic dermatitis patients. the role of this ige autoantibodies involved in the pathogenesis of atopic dermatitis is not known, yet. but, there may be a correlation between the severity of the disease and the serum levels of this autoantibodies. the autologous serum skin testing is applied to both atopic dermatitis patients and healthy control and the results are estimated in this study.the investigators detected 70% positive autologous serum skin testing in atopic dermatitis patients and test positivity was higher in patients with atopy history, moderately severe disease calculated by scorad index and high serum ige levels.


Eligibility criteria:
inclusion criteria: * sixty ad patients and 30 healthy individuals exclusion criteria: * . the patients showing evidence of any other disease are not included to our study. no drug was allowed fourteen days prior to the test, including antihistamines and steroids.

Keywords: atopic dermatitis, autologous serum skin testing, ige autoantibodies
effect of genetic variation in starch-digesting enzymes on digestibility and glycemic index of cold and hot rice

Conditions: Carbohydrate Intolerance

Summary: this study evaluates the effect of different methods of preparation (cooked and consumed hot vs cooked, cooled overnight and consumed cold) and variation in the activity of salivary amylase on the glycemic index and carbohydrate digestibility in healthy human subjects. the effect of genetic variation in small intestinal starch digesting enzymes on glycemic index and starch digestibility will also be assessed.


Eligibility criteria:
inclusion criteria: * males or non-pregnant females aged 18-75 years and in good health * eligible to receive income in canada * have ontario health insurance plan or equivalent medical coverage. * previous donor of saliva using protocol reference number # 31093 or gil-1670 (in which subject consents to measurement of salivary amylase activity and genetic variation in amy1, si and mgam genes). * salivary amylase activity in the lowest tertile (\ 105 u/ml) of salivary amylase activity of 40 subjects previously measured. exclusion criteria: * known history of aids, hepatitis, diabetes or a heart condition * allergy to rice, canola oil or sesame oil. * use of medications (including, but not limited to, insulin or other antidiabetic drugs, systemic steroids, antipsychotics, protease inhibitors, antivirals, immunosuppressive agents and drugs affecting gut motility or digestion) or with any condition which might, in the opinion of dr. wolever, the medical director or gi labs, either: 1) make participation dangerous to the participant himself (or herself) or to others, or 2) affect the results. * individuals who cannot or will not comply with the experimental procedures or do not follow the instructions of gi labs staff related to the safe performance of the experimental procedures
functional outcomes of stay strong stay healthy program

Conditions: Quality of Life; Aging; Memory Loss; Cardiovascular Diseases

Summary: strength training can increase muscle mass and strength while improving bone density and reducing risk for osteoporosis and related fractures. strength training can also lead to reduced risk for diabetes, heart disease, arthritis, depression, and obesity; and improves self-confidence, sleep and vitality. research demonstrates that strength training is extremely effective in helping aging adults with chronic conditions prevent further onset of disease and, in many instances, actually reverse the disease process. in stay strong, stay healthy program elderly subjects perform resistance exercise training (ret) twice every week. past literature suggests that resistance training improved muscle activity, muscle strength, muscle mass, and bone mineral density and total body composition, and adiponectin, insulin sensitivity, fasting blood-glucose (bg), hba1c1 (long-term marker of bg), blood pressure (bp), blood triglycerides (tgs) and low density lipoproteins (ldl) in healthy and diabetic subjects. the purpose of this study is to measure the changes in the above discussed variables after 8-weeks of resistance exercises.

participants will perform resistance exercise for 8 weeks and measurements (anthropometric, electromyography, pulse wave velocity, strength test, dual x-ray absorptiometry, blood enzymes/hormones, and sleep, diet, memory surveys) will be performed pre- and post-exercise program.

Eligibility criteria:
inclusion criteria: * age 60 or above * enrollment in stay strong stay healthy program * strength training \< 2 hours/week for past 3 months exclusion criteria: * not enrolled in stay strong stay healthy program * strength training \> 2 hours/week for past 3 months * donated more than 463 ml of blood in past 8 weeks * physician discouraged to participate

Keywords: elderly older adults resistant exercise strength training cognitive function
analgesia for insertion of intrauterine contraception

Conditions: Insertion of Intrauterine Contraception

Summary: use of long acting reversible contraception (larc) such as implants or intrauterine contraception (iuc) has been shown to reduce repeat abortions. larcs have the advantage of being independent of user error and are considered to be underused, especially among young individuals where oral methods have high rates of user failure. iuc is often underused in young or nulliparous women due to fear of pain at insertion. 10 ml of mepivacaine (10mg/ml) or 10ml of sodium hydrochloride will be injected into the uterine cavity through a hydrosonography catheter before the tenaculum has been applied but prior to sounding and to insertion of the iuc. the investigators' hypothesis is that instillation of 10 ml (10mg/ml) mepivacaine though a hydrosonography catheter prior to any instrument placement will provide more effective pain relief than instillation of 10 ml placebo (sodium chloride 9mg/ml). primary objective: to evaluate the difference in pain score at the time of the insertion of the iuc between treatment and control group. secondary objectives: to evaluate acceptability of the procedure.


Eligibility criteria:
inclusion criteria: * over 18 years of age and * opting for iuc for contraception * with a negative pregnancy test * willing to participate in the study after it has been explained orally and in written exclusion criteria: * previous conisation, * known cervical stenosis, * signs of ongoing genital infection, * known uterine abnormality, * any condition resulting in bleeding disorder or contraindication to any local anestetic will be excluded
anonymous testing of pathology specimens for brca mutations in ashkenazi jewish individuals who have cancer

Conditions: Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Lung Cancer; Melanoma; Non-Hodgkin's Lymphoma; Uterine Cancer; CORPUS UTERI,ENDOMETRIUM; LUNG; OVARY

Summary: the intent of the proposed study is to describe the prevalence of the most common recurring mutations in brca1 and brca2, blmash , and the a636p msh2 mutation among ashkenazi jewish individuals with a variety of cancer diagnoses. if a substantial proportion of these samples contain such mutations, future patients presenting with these diseases may wish to undergo genetic counseling and, if appropriate, formal genetic testing. the benefit from such a process would pertain mainly to the families of these individuals.

germline mutations in the genes brca1 and brca2 have been demonstrated in the majority of hereditary breast and ovarian cancer families. the increased risk to develop both breast and ovarian cancer associated with inheriting a brca1 or brca2 mutation has been well established. it has also been suggested that is an overrepresentation of other cancers such as colon, prostate and pancreatic cancer present in brca1 or brca2 families. population specific mutations in brca1 and brca2 have been identified. in the ashkenazi jewish population, 3 specific mutations have been seen in 2% of the population. this study will anonymously screen archived tissue samples of ashkenazi jewish individuals diagnosed with cancer between 1993 and 1996 at mskcc for the three founder mutations seen in the ashkenazi jewish population. results will be stratified by tumor type and compared with the population frequency to determine whether individuals inheriting mutations in brca1 or brca2 may have an increased risk to develop other cancers, in addition to breast and ovarian cancer. this information will be useful in helping to identify individuals who may benefit from genetic counseling and possibly genetic testing who to date are not typically referred. it will also be useful in developing high-risk cancer screening strategies and determining appropriate options for prophylactic surgery.

Eligibility criteria:
inclusion criteria: * diagnosis of cancer made at mskcc or collaborating institutions, and * tissue block of tumor or normal margin or extracted dna available for study and sufficient material present to allow study without exhausting block or dna, * individual self-identified as jewish on intake.

Keywords: ashkenazi jewish cancer 00-087
clinical evaluation of the sequredx trisomy test in low risk pregnancies

Conditions: Aneuploidy; Down Syndrome; Noninvasive Prenatal Screening

Summary: pregnant women with low risk indicators for fetal chromosomal aneuploidy will be enrolled. study blood will be collected in the first or second trimester at a scheduled prenatal screening visit, processed to plasma, and stored frozen until analysis. each pregnancy will be followed until delivery and the birth outcome recorded.


Eligibility criteria:
inclusion criteria: * pregnancy is 10-22 weeks gestation * between 18-34 years of age inclusive at estimated date of delivery * no prenatal screening indicators for high risk including serum biochemical and ultrasound screening * no personal or family history of down syndrome * willing to provide written informed consent * willing to provide a whole blood sample * willing to provide access to medical records supporting fetal outcome exclusion criteria: * fetal demise at the time of the blood draw * previous specimen donation under this protocol