Kornimate/medical-research-clean huggingface dataset:
clinical feasibility of transcranial direct current stimulation [tdcs] with standard aphasia therapy

Conditions: Aphasia; Stroke

Summary: study design: this is a within-subjects crossover design. subjects will participate in the procedures twice, once under each condition (active vs. sham stimulation). the order of conditions will be counter-balanced across subjects. stimulation will target ventral inferior frontal gyrus (ifg) and will be paired with standard speech-language therapy. outcome measures will be acquired at the beginning and end of a semester of standard speech-language therapy.

baseline behavioral assessment: medical and neurological history will be taken. western aphasia battery-revised, communication activities of daily living-2, and philadelphia naming test (short form) will be administered. narrative will be elicited (cinderella story). some of these procedures will be videorecorded for later transcription. subjects will also complete a pre-tdcs safety screening questionnaire. tdcs: participants will undergo placement of 2 tdcs electrodes. for all subjects, the anodal electrode will be placed at the following locations (eeg 10-20 system): (i) over the left inferior frontal gyrus (crossing point between t3-fz and f7-cz) the cathodal electrode will be placed at the second site: (ii) over right frontal pole (fp2) two types of stimulation will be given, an active condition and a sham condition. in the sham condition, stimulation is ramped up over the first 30 seconds (as in the active condition), but then discontinued. this gives the physical perception of stimulation without the modulatory effects. stimulation will be delivered by a tdcs device with the following parameters for intensity and duration: * intensity: 2 ma * duration: 20 minutes tdcs will be provided for the first 20 minutes of each aphasia therapy session provided at the lsu speech-language-hearing clinic. the therapy sessions last for one hour and are provided twice weekly for 8 weeks over the course of an academic semester (fall and spring). post-therapy/stimulation assessment: western aphasia battery-revised, communication activities of daily living-2, and philadelphia naming test (short form) will be administered as before therapy. cinderella narrative will again be elicited. some of these procedures will again be videorecorded for later transcription. a tdcs sensations survey will also be completed at the final assessment to determine the effectiveness of blinding.

Eligibility criteria:
inclusion criteria: * single, unilateral stroke resulting in aphasia * competency to provide written informed consent * ability to participate in standard aphasia therapy exclusion criteria: * serious psychological condition * serious neurological condition, other than stroke * serious medical condition * pregnancy * history of seizures * presence of electronic or metal implants (e.g., pacemaker, vagal nerve stimulator, etc.).

Keywords: aphasia stroke tdcs language stimulation brain speech therapy
effects of cannabis abstinence on symptomology and cognition in bipolar disorder

Conditions: Cannabis Use Disorder; Bipolar Disorder; Cognition

Summary: the objective of this study is to assess the changes in symptoms and cognition that occur after a 28-day abstinence period in patients with comorbid cannabis use disorder (cud) and bipolar (type i or ii) disorder. stabilized bipolar patients (n=52) with cud will be randomly assigned to one of two groups: 1) a contingent reinforcement (cr) group (n=26); 2) a non-contingent reinforcement (ncr) group (n=26). the study will include a total of 8 visits to the camh russell site (screening, training, baselines, week 1-4, follow-up). participants should be between the ages of 18-60, meet criteria for cud (moderate to severe), meet criteria for bipolar disorder, be on a stable dose of mood stabilizing medication(s), and be non-treatment seeking cannabis user. the visits will take up a total of approximately 22.5 hours with compensation for time provided for both groups. these visits will involve multiple clinical, substance use, and cognitive assessments. abstinence will be maintained by weekly behavioural coaching sessions and contingency reinforcement for the cr group.


Eligibility criteria:
inclusion criteria: * all participants must be between the ages 18-60 * meet scid for dsm-5 diagnostic criteria for cannabis use disorder, moderate to severe * meet scid for dsm-5 diagnostic criteria for bipolar disorder (type i or ii) * be an outpatient receiving a stable dose of mood stabilizing medication(s) for at least one month * have a hamilton depression rating scale (hdrs-17) baseline assessment in the range of 12-25 * have a full-scale iq of at least 80 as determined by the wtar * be a non-treatment seeking cannabis user * evidence of sufficient motivation and effort as measured by a test of memory malingering (tomm) score of at least 45 * y-mrs baseline score in the range of 0-15 exclusion criteria: * meets criteria for abuse or dependence of alcohol or other illicit substances within the past 6 months (with the exception of cannabis, nicotine, or caffeine) * positive urine screen for illicit substances other than cannabis, nicotine, or caffeine * current suicidal or homicidal ideation * psychotic disorder diagnosis (e.g. schizoaffective disorder, major depression with psychotic features) as determined by the scid * treatment seeking for cannabis use * head injury \> 5 minutes loc * exceed upper and lower cut-offs on hsrd-17 and ymrs

Keywords: bipolar disorder cannabis use disorder cognitive function
charité™ artificial disc compared to anterior interbody fusion for treatment of degenerative disc disease

Conditions: Degenerative Disc Disease

Summary: the study is designed to evaluate the safety and effectiveness of the charite artificial disc compared to anterior lumbar interbody fusion for treatment of degenerative disc disease at one level of the lumbar spine (either l4/l5 or l5/s1).

treatments for disc degeneration have historically included conservative modalities, such as rest, heat, electrotherapy, physical therapy, and analgesics to surgery. currently, there are two main surgical techniques for treatment of disc degeneration: (1) nucleotomy or diskectomy, i.e., excision of part or all of the degenerated disc, which is typically performed for treatment of radicular syndrome in the case of disc herniation; and (2) spinal fusion, i.e., grafting bone between the vertebrae adjacent to the degenerated disc to eliminate articulation at the damaged segment, which is typically performed for treatment of degeneration together with instability and reduction of the intervertebral space. rigid internal fixation may also be used to promote fusion. the charité artificial disc is designed to provide a new therapeutic option for treatment of degenerative disc disease as an alternative to spinal fusion to preserve function in the lumbar vertebral region. each institution participating in the study was to treat the first 5 consecutive study participants with the charite to as it involves a modification to the technique used for anterior fusion. data will be collected on these "training" cases but will not be included in the comparison with the control (fusion) treatment. comparison: outcomes for patients treated with the charité artificial disc will be compared to outcomes for patients treated with anterior lumbar interbody fusion.

Eligibility criteria:
inclusion criteria: * 18 to 60 years of age inclusive * symptomatic degenerative disc disease confirmed by provocative discogram * single level disease l4/l5 or l5/s1 * leg or back pain without nerve root compression * vas pain score \>= 40 * oswestry disability index score \>= 30 * six months prior conservative treatment * appropriate for anterior surgical approach exclusion criteria: * previous lumbar or thoracic fusion * other spinal surgery at target level * symptomatic multiple level degeneration * non-contained or extruded nucleus pulposus * compression or burst at l4, l5, or s1 due to trauma * mid-sagittal stenosis \< 8mm * osteoporosis, osteopenia, or other metabolic bone disease of the spine * spondylolisthesis \> 3mm, scoliosis \> 11 degrees * facet joint arthrosis * isthmic spondylolisthesis * positive straight leg raise for radiculopathy

Keywords: arthroplasty lumbar spine
single-use negative pressure wound therapy system vs. traditional negative pressure wound therapy system (tnpwt)

Conditions: Venous Leg Ulcers; Diabetic Foot Ulcers

Summary: the aim of this study is to compare the clinical efficacy of two types of npwt systems; the traditional negative pressure wound therapy (tnpwt) system and the single-use negative pressure wound therapy (pico) system.

the two types of npwt systems include the tnpwt system that has successfully completed a coding verification request with cms and has the following capabilities (e.g., range of negative pressure, connective tubing, canister, foam or gauze filler, and approved for home use), and a portable, canister-less, battery operated, disposable pico system to see if there are any observed differences with regard to the clinical efficacy of the two devices.

Eligibility criteria:
inclusion criteria: * provide informed consent * age ≥ 18 years and of either sex * willing to comply with protocol instructions, including allowing all study assessments * have a venous leg ulcer (vlu) between the knee and ankle (at or above the malleolus), with a surface area ≥ 2.0 cm2 and ≤ 36.0 cm2 * target ulcer duration ≥ 4 weeks but ≤ 104 weeks (24 months) * have a diabetic foot ulcer (dfu) present on any part of the plantar or dorsum surface of the foot, with a surface area ≥ 0.5 cm2 and ≤ 10.0 cm2 * target ulcer involves a full thickness skin loss, but without exposure of tendon, muscle, or bone * target ulcer duration ≥ 4 weeks but ≤ 52 weeks (12 months) * acceptable state of health and nutrition exclusion criteria * therapy with another investigational agent within thirty (30) days of screening, or during the study ulcers which are deemed as highly exuding, per the investigator's discretion. * current diagnosis of osteomyelitis at the target wound location that is not currently receiving treatment \[documented history of resolved osteomyelitis is allowed\]. * subjects with a vlu: refusal of or inability to tolerate compression therapy. * clinical evidence of target ulcer infection * current systemic therapy with cytotoxic drugs. * current therapy with chronic (\> 10 days) oral corticosteroids. * previous treatment with npwt device or hyperbaric oxygen within 7 days of screening. * malignancy in the target ulcer, or history of cancer in the preceding 5 years (other than carcinoma in situ of the cervix or adequately treated non-melanoma skin cancers)

Keywords: venous leg ulcer ulcer venous stasis compression diabetic foot ulcers dfu vlu
comparative study of ceftaroline vs. ceftriaxone in adults with community-acquired pneumonia

Conditions: Bacterial Pneumonia

Summary: the purpose of the study is to determine if the antibiotic ceftaroline is safe and effective in the treatment of community-acquired pneumonia in adults.

clinical trials is being held in different countries. the purpose of the study is to determine if the antibiotic ceftaroline is safe and effective in the treatment of community-acquired pneumonia in adults.

Eligibility criteria:
inclusion criteria: subjects with community-acquired pneumonia requiring: * initial hospitalization or treatment in an emergency room or urgent care setting * infection requiring initial treatment with iv antimicrobial exclusion criteria: * community-acquired pneumonia suitable for outpatient therapy with an oral antimicrobial agent * respiratory tract infections not due to community-acquired bacterial pathogens * infections resistant to ceftriaxone * any condition requiring concomitant systemic corticosteroids * history of any hypersensitivity or allergic reaction to any ß-lactam antimicrobial

Keywords: ceftaroline community-acquired pneumonia cap streptococcus pneumoniae haemophilus influenzae mycoplasma pneumoniae chlamydophila spp legionella ssp multi-drug resistant streptococcus pneumoniae (mdrsp) antimicrobial resistance pneumococci beta-lactam ceftaroline fosamil ceftriaxone antibiotic
the treatment of pd-1 antibody combined with peg-ifnα in nas-suppressed chb patients

Conditions: Chronic Hepatitis B

Summary: this is a prospective, open-labled, randomized controlled study to assess efficacy and safety of treatment with sintilimab (pd-1 antibody) combined peg-ifnα-2b in chb patients on stable nas treatment.


Eligibility criteria:
inclusion criteria: 1. 18 - 65 years old; 2. chronic hepatitis b patients with clear diagnosis of hematology, etiology and clinical (for example: hbsag positive for more than 6 months); 3. treatment with nas (etv, tdf or taf）at least 1 years and continue nas therapy during screening; 4. hbv dna and hbeag turn negative after nas treatment; 5. hbsag ranged 200-1000 iu/ml. exclusion criteria: 1. cirrhosis; 2. platelet count \ uln（40u/l）, total bilirubin \> 2uln; 3. history of or suspicion of hepatocellular carcinoma 4. patients received interferon therapy within 12 months; 5. patients received immunosuppressive therapy or other therapy influenced study within 12 months; 6. hepatitis a, hepatitis c, hepatitis d, hiv infection or other active infections; 7. alcohol or drug abuse/dependence; 8. investigator judges that the participants are not suitable for this study.
noninvasive spinal stimulation to restore hand function in children with spinal cord injury

Conditions: Spinal Cord Injury Cervical

Summary: the main goal of this pilot study is to find the best ways to use transcutaneous spinal cord stimulation (scts) to improve hand function in children with spinal cord injuries (sci). the investigators will start by exploring the best places and strengths for applying scts on the neck, the added benefits of applying scts on the lower back (t11-t12), and comparing the effects of using activity based upper extremity training (a control treatment) alone versus combining it with scts to help children with chronic sci regain hand function.

after learning about the study and potential risks, parents/legal guardians and their eligible children with sci will sign consent and assent forms, respectively. for the first two aims of the study, the investigators will recruit and enroll 10 participants. in the first week, participants will undergo clinical assessments from day 1 to day 4 to categorize the severity and level of their injuries and assess their current arm and hand function. on day 5, eligible participants will have experimental assessments to measure hand grip and control, both with and without spinal cord stimulation (scts) at one or two neck sites optimized to improve hand grip. on day 6, participants will have similar assessments, this time adding stimulation to the trunk area to help with upright sitting and study its impact on hand grip and control. for the third aim, 4 participants who showed improved hand grip and control with stimulation in aims 1 and 2 will be selected on a first-come, first-served basis. they will undergo 20 sessions of activity-based upper extremity training, followed by 20 more sessions with the optimal stimulation sites identified from aims 1 and 2. after completing the training, participants will be asked to follow up and repeat experimental and clinical assessments to determine how long the improvements last.

Eligibility criteria:
inclusion criteria: for aim 1 and 2, 10 participants with sci: 1. age 7-12 years; 2. chronic (\>6 months), acquired upper motor neuron sci; 3. cervical sci at or above c8 neurological level with motor score of 1-3 for finger flexors 4. pediatric neurorecovery scale score of ≥2b and ≤ 4c for impaired grip for aim 3, 4 participants with sci who: 1. complete aim 1 and 2; 2. consent/assent for aim 3 3. demonstrate a minimum of 10% increase in hg force with scts (aim1-2) 4. confirmed volitional activation in hand muscles during hang grip assessment without scts exclusion criteria: for all 3 aims will include: 1. botox use within past 3 months (for upper or lower extremity); 2. current oral baclofen (or pump); 3. musculoskeletal impairment limiting range of motion; 4. unhealed fracture or other medical condition limiting participation in ab-uet; 5. etiology of spina bifida; 6. total ventilator dependence.

Keywords: pediatric onset transcutaneous spinal cord stimulation hand and arm function chronic spinal cord injury
long-term outcomes in older patients with physical restraint

Conditions: Physical Restraint; Biological Sex Diffrences; Morality

Summary: the worldwide population is ageing. biological sex is first and foremost a genetic modifier of disease. to prevent self-arm many techniques can be used in older patients. among them coercive measure consisting of physical restraint (pr) is one of the techniques. this study aims to assess the effects of the biological sex on the long-term survival after pr in geriatric patients during the initial emergency department (ed) visit. this retrospective study included patients between november 2019 to march 2021. all consecutive hospitalized patients after emergency department visit older than 75 years with pr were included. the population was compared according to the biological sex. one-year all-cause mortality was plotted with the kaplan-meier curve. hazard ratios (hrs) for 1-year mortality were calculated using a cox proportional hazards regression model. mortality was monitored over a 3-year period.


Eligibility criteria:
inclusion criteria: * all consecutive older patients ≥ 75-year-old hospitalized to the observation unit or to the ward from the ed were included from november 2019 to march 2021 if pr were mentioned in their medical records exclusion criteria: * if patients were less than 75 years old, without pr or not hospitalized. if a patient was admitted more than once, only the first episode was taken as index admission

Keywords: physical restraint emergency department biological sex long-term mortality
improving sleep health in adults with overweight or obesity

Conditions: Sleep Disturbance; Sleep Wake Disorders; Sleep Disorder

Summary: this study will examine the feasibility and acceptability of the transdiagnostic intervention for sleep and circadian dysfunction (trans-c) in adults with poor sleep and excess weight. additionally, the study will explore if trans-c improves sleep health and cardiovascular outcomes.

aim 1 (primary): examine the feasibility and acceptability of trans-c among adults with poor sleep health and excess weight. aim 2 (exploratory): explore the effect of trans-c on the sleep health of adults with poor sleep and excess weight. aim 3 (exploratory): explore the effect of trans-c on the cardiometabolic health of adults with poor sleep and excess weight.

Eligibility criteria:
inclusion criteria: * currently own and regularly use a smart phone * body mass index \>27 and ≤ 43 * poor sleep health on one or more of the sleep health dimensions exclusion criteria: * presence of an unstable condition requiring physician-supervised diet and exercise * physical limitations precluding ability to engage in moderate-intensity physical activity * pregnant or intention to become pregnant during study * current treatment for a serious mental illness * being a current shift worker * reported alcohol intake \> 4 drinks/day for males and \> 3 drinks/day for females * current participation in a formal weight loss program, loss of ≥ 5% weight in past 6 months, or current use of weight loss medication * history of bariatric surgery * planned extended vacations, absences, or relocation during study * another member of household is a participant in the study * score \> 32 on the eating habits checklist, an eating disorder scale
cognitive training for depression

Conditions: Major Depressive Disorder

Summary: this study is evaluating the effects of two brain training exercises on: memory, cognitive processing and depression symptoms.

there is an urgent public health need to develop more effective and well tolerated treatments for patients with major depressive disorder (mdd); cognitive training interventions aiming to modify cognitive and affective processing abnormalities underlying mdd represent a promising new strategy. this research project translates a well established cognitive bias in major depressive disorder (mdd), working memory bias, into a novel intervention target. in a double-blind, randomized, controlled study, mdd participants undergo 4 weeks of cognitive training sessions, with two sessions per week.

Eligibility criteria:
inclusion criteria: * primary, current axis i diagnosis of major depressive disorder according to dsm-iv criteria and ham-d-17 score between 16-27 * age 18-55 * able to give informed consent exclusion criteria: * a history of drug or alcohol abuse or dependence (dsm-iv criteria) within 6 months * visual impairment that would affect the ability to observe the computerized presentation of faces. * motor impairment that would affect the ability to provide a response by quickly pressing a button. * lifetime history of bipolar spectrum disorders or schizophrenia spectrum disorders. * primary, current axis i diagnosis other than major depressive disorder * primary, current axis ii personality disorder. * currently attending a cognitive-behavioral psychotherapy regimen * acute suicidal or homicidal risk (evidenced by suicidal or homicidal attempt within 6 months of screening) * pregnancy in women. subjects must exhibit no or only moderate alcohol use. subjects with current excessive use of alcohol (\> 8 ounces/day for men and \> 6 ounces/day for women) are ineligible for participation, as such drug use could confound the results.

Keywords: cognitive training depression
impact of homeopathy for persistent insomnia in patients with cancer

Conditions: Chronic Insomnia; Cancer

Summary: persistent insomnia is highly prevalent complaint in cancer survivors, but is seldom satisfactorily addressed. the adaptation to cancer care of a validated, cost-effective intervention may offer a practicable solution. the aim of this study was to investigate the clinical effectiveness of homeopathy for insomnia.


Eligibility criteria:
inclusion criteria: * scheduled to begin chemotherapy or radiotherapy * chemotherapy or radiotherapy * meet diagnostic criteria for chronic insomnia (i.e., lasting for at least one month) * chronic insomnia has been defined in previous research:as the presence of (1) three or more episodes of insomnia (i.e., ≥ 30minutesol, ≥ 60minute wake after sleep onset (waso), or ≤ 6.5 hour total sleep time (tst) per night) of per week and (2) daytime effects of insomnia, such as irritability, difficulty concentrating, or fatigue for at least one month. * have the permission of their oncologists to participate. exclusion criteria: * untreated alcohol or substance abuse or dependence, * bipolar, or psychotic disordermedical conditions such as seizure disorder, restless leg disorder, or parkinson's disease * untreated sleep disorders such as sleep apnea * taking other alternative medicines