Kornimate/medical-research-clean huggingface dataset:
combining non-invasive brain stimulation with cognitive behavioral intervention in substance use disorder

Conditions: Active tDCS; Sham tDCS

Summary: the current study aims to examine the safety and feasibility of utilizing tdcs to enhance affect-laden episodic memory consolidation among adults with co-occurring alcohol use and anxiety disorders who have recently undergone detoxification as a step toward the translational clinical application of this approach.


Eligibility criteria:
inclusion criteria: * dsm iv diagnosis of panic disorder (with or without agoraphobia), generalized anxiety disorder, or social anxiety disorder within the past 30 days * dsm iv diagnosis of alcohol dependence within the last 30 days * inpatient treatment at lodging plus primarily for alcohol (vs. other drug) dependence * alcohol use in the 30 days preceding the study * willingness to provide informed consent * minimum of a sixth grade english reading level (deemed necessary to complete study materials); as determined by their being able to read and understand the consent form. * living within reasonable driving distance (1 hour or less) of the twin cities to allow for in-person follow-up interviews exclusion criteria: * lifetime history of psychosis or mania by history. * cognitive (e.g., dementia) or physical impairment (e.g., blindness) that interferes with study participation report or as judged by pi/study physician. * current suicide risk as deemed by the pi and study physician to be serious and ongoing * any medical condition or treatment with neurological sequelae (e.g., stroke, tumor, loss of consciousness of more than 30 minutes, hiv, seizures) * history of ect * document loss of consciousness (loc) for longer than 30 minutes or loc with neurological sequelae * pregnancy * although seizures are not a known risk of tdcs intervention (fregni et al., 2006; nitsche et al., 2008), anyone with a history or a risk for seizures will be excluded from the study * anyone with metal objects implanted in their head or neck * anyone taking stimulant medications for any reason as we wish to avoid two sorces of neurostimulation

Keywords: neurostimulation comorbidity tdcs cbt anxiety alcohol
psychological distress and outcomes in hip preservation patients

Conditions: Psychological Distress

Summary: this is an investigatory study to determine whether high levels of pre-operative psychological distress predict worse outcomes after hip preservation. this is a low risk study and does not alter the treatment or course of care for patients undergoing this procedure

the correlation between increasing psychological distress and worsening surgical outcomes has been extensively documented in patients undergoing spine surgery. however, we have no reason to believe that patients with hip pathology are uniquely exempt from the influence of psychosocial factors. to our knowledge, no study has been done to evaluate the effect of pre-operative psychological distress on outcomes after hip preservation surgery. we therefore propose to use the dram to measure pre-operative distress in patients undergoing open or arthroscopic hip preservation surgery and to compare these pre-operative distress scores with post-operative outcomes. we hope the information we gain will allow clinicians to comprehensively evaluate the patient with hip pain and to make more informed choices about operative treatment.

Eligibility criteria:
inclusion criteria: 1. primary presenting complaint of hip pain 2. hip arthroscopy, surgical dislocation and debridement, and/or periacetabular osteotomy performed by dr. aoki or dr. peters for hip pathology diagnosed by history, clinical examination and/or imaging exclusion criteria: 1. unable to complete the dram questionnaire 2. patients who do not undergo surgery

Keywords: hip preservation hip arthroscopy hip pain psychological distress
comparative effects of hold relax technique and mulligan mobilization in post operative knee joint

Conditions: Post Operative Pain

Summary: the aim of this study is to investigate the comparative effects of hold relax technique and mulligan mobilization on pain, rom and function in post operative knee joint.

stiffness or restricted rom of the knee joint is a term used commonly to describe any traumatic condition occurring within or around the knee joint. it can result from direct and indirect below and is experienced as pain with activity, local tenderness to palpation, and decreased ability to tolerate tension, which results in decreased movement and functional strength. post-traumatic knee stiffness and loss of range of motion is a common complication of injuries to the knee area. immobilization of human knees for several weeks or more can result in stiffness and loss of range of motion in the joints. after knee arthroplasties, cruciate ligament repairs and trauma may lead to contracture of muscles and knee instability. limitations of joint movements both flexion and extension suggests intraarticular pathology.

Eligibility criteria:
inclusion criteria: * both male and female of age 20 to 40 years * knee pain 3 or more on vas * patients with grade 3 or more than 3 power of knee muscle * subjects with post traumatic stiffness of knee joint having a minimum of 70 degree of knee flexion exclusion criteria: * hypermobile and unstable joint * soft tissue injuries * joint infection and loosening * other complication of post fracture/ tk

Keywords: mulligan mobilization with movement post-operative knee joint hold relax technique knee stiffness range of motion
his alternative ii - uk site

Conditions: Heart Failure; Left Bundle-Branch Block

Summary: the study will investigate the feasibility of using direct his pacing or left bundle branch pacing (lbb pacing) as an alternative to biventricular pacing in patients with symptomatic heart failure and an ecg with a typical left bundle branch block pattern.

biventricular pacing has for more than a decade been standard of care for patients with hfref, lvef \< 35%, nyha ii-iv despite optimal medical treatment and an ecg with left bundle branch block (lbbb). however, it is not always ideal because of several drawbacks such as phrenic nerve capture, inability to reach late activated areas and many more. direct his pacing can in many cases capture the left bundle and provide normal electrical activation of the left ventricle but sometimes with high pacing thresholds. recently direct left bundle branch pacing has shown promise with synchronous activation of the left ventricle at low pacing thresholds. in the present study the investigators randomize 125 patients in one center to either conventional crt (45 patients) or his/lbb pacing (80 patients). in the his/lbb arm, direct his-pacing is attempted first but if its not possible or the pacing threshold for capturing the left bundle branch is \> 2.5 v at 1 ms the investigators switch to placing a lbb-lead. power calculation for non-inferiority: with the 50 patients in the first his alternative study (25 biv-crt og 25 his-crt) the investigators observed a fall in systolic volumes of 34% and 46% with a standard deviation of 13-16%. using these numbers it would take at least 108 patients to be 90% sure that the lower limit of a one-sided 97.5% confidence interval (equal to a 95% two-sided confidence interval) would be over the non-inferiority limit of -10%.

Eligibility criteria:
inclusion criteria: * patients over 18 years of age, ischemic or non-ischemic cardiomyopathy with lvef ≤ 35% assessed by echocardiography, nyha class ii-iv heart failure symptoms despite optimal medical treatment and * either planned new implantation of a biventricular pacing system (crt-p or crt-d), where the ecg is with sinus rhythm and a typical left bundle branch block (see definition below) * or planned upgrade of an existing pacemaker or icd to a biventricular pacing system (crt-p or crt-d), where the ecg is with sinus rhythm and a typical left bundle branch block or there has been\> 90% right ventricular pacing from an existing pacemaker for at least 2 months prior to enrollment * signed informed consent * typical left bundle branch block: * qrs width \> 130 msec for women and \> 140 msec for men qs or rs pattern in leads v1 and v2, and mid-qrs plateau phase with or without extras in at least 2 of leads v1, v2, v5, v6, i, and avl exclusion criteria: * existing biventricular pacing system * permanent atrial fibrillation * severe renal failure with egfr \< 30 ml/min * ami or cabg within the last three months * the patient does not want to participate
association between functional impairment and parenting stress among children diagnosed with diplegic cerebral palsy

Conditions: Cerebral Palsy; Parent-Child Relations

Summary: 1. to find out the relation between the severity of adl limitation in diplegic cp children and the level of parents' stress. 2. to detect the correlation between the ps level to the different domains of adl limitation. 3. to determine the substantial factors that underlying the parents' stress of those diplegic cp children.

the health and well-being of children are intimately related to their parents' physical, emotional and social health in addition to child-rearing practices. the way parents of cp children deal with their stress may adversely affect their parenting ability, which in turn leads to difficulties for the child, which may lead to more parenting stress. the extent to which parents of cp children adjust and the resources to meet the needs of their children is of primary concern to professionals working in children's healthcare. to support parents, it is important to determine the level of independence of diplegic cp children in their daily lives. this is necessary to identify predictors of their stress, which may be a mentally debilitating factor in their lives. in return, it may support us as physiotherapists to make more informed decisions about treatment planning, as well as facilitate conversations with parents around identifying sources of stress and developing healthy coping strategies that lead to a better quality of life for their children. finally, this will have a direct positive impact on the children's abilities

Eligibility criteria:
inclusion criteria: * diplegic cp children. * their age ranges from 18 months to five years old. * all levels of gmfcs will be included. * both sexes will be included. * all children were medically and clinically stable. * parents must be able to write and read. exclusion criteria: * diplegic cp children, who might have one or more of the following: * history of chronic cardiac or chest disease. * any behavioral disorders. * current hospitalization for urgent medical reasons. * significant visual or auditory impairment. * previous history of botox injection within last six months.
stentless endoscopic transnasal transseptal choanoplasty

Conditions: Otolaryngological Disease

Summary: congenital choanal atresia is an abnormality of the posterior nasal passages resulting in complete or partial obstruction of the nasal airways. it has an incidence of 1: 5000 to 8000 live births, with a female predominance. 41% - 72% occur in conjunction with non-syndromic facial abnormalities such as arched palate, cleft lip, and auricular deformities. about 4% present as a component of chromosomally-based syndromes such as (coloboma, heart defect, atresia choanae, retarded growth, genital abnormality, and ear abnormality" and treacher collins syndromes. previous reports have described the ratio of bony to membranous choanal atresia as 9:1. however, a detailed review of computed tomography study combined with histopathological studies has shown mixed bony-membranous atresia in about 70% of cases and purely bony atresia in 30% of cases.

common choanal atresia repair techniques include puncture and dilatation of the atretic area. endoscopic drilling combined with dissection of the atretic plate and its surrounding structures has been introduced more recently. the approaches have been through transnasal, transpalatal, and transseptal routes. each of which have experienced varying popularity through time. regardless of the access route and repair technique used, re-stenosis is a common postoperative complication. to prevent re-stenosis and subsequent re-operation, many authors advocate meticulous preservation of mucosa for use as flaps, which in most cases are combined with postoperative stenting. however, stenting, is controversial the surgical procedure is performed under general anesthesia. preoperatively, cotton pledgets soaked in a solution of topical vasoconstrictors are placed against the nasal mucosa for topical decongestion. local anesthesia is infiltrated into the nasal septum, the atretic plate, the middle turbinate, and the superolateral nasal wall. an endoscopic view of the surgical field is maintained at all times during the procedure using a 4-mm nasal endoscope with 0-degree or 30-degree visual angulation. firstly, mucosa is elevated bilaterally from the underlying cartilaginous and bony septum on both sides. then the posterior half of the septum including the vomer is removed using blakesley forceps and a 1-mm or 2.5-mm diamond burr. after that, the flaps are fashioned using the preserved mucosa. at last, the flaps are secured in position with a thin layer of fibrin glue or gel foam. no packing or stenting is used. the patient is extubated immediately following the procedure and early oral feeding encouraged. the intended length of stay is overnight.

Eligibility criteria:
inclusion criteria: * • denovo cases of unilateral congenital choanal atresia. * revision cases of unilateral congenital choanal atresia. * denovo cases of bilateral congenital choanal atresia. * revision cases of bilateral congenital choanal atresia. exclusion criteria: * • any associated medical comorbidity that contraindicates general anesthesia. * refusal of enrollment in the research by care givers.
machine learning enabled time series analysis in medicine

Conditions: Atrial Fibrillation; Heart Failure, Systolic

Summary: the goal of this observational cohort study is to investigate the potential of fitness trackers in combination with machine learning algorithms to identify cardiovascular disease specific patterns. two hundred participants will be enrolled: 1. 50 with heart failure 2. 50 with atrial fibrillation 3. 100 (healthy) individuals without the former two conditions all participants are given a fitbit device and monitored for three months. researchers will compare differences in heart rate variability patterns between the groups and devise a machine learning algorithm to detect these patterns automatically.


Eligibility criteria:
inclusion criteria: * systolic heart failure (lvef \< 35%) * atrial fibrillation without heart failure * individuals without cardiovascular disease exclusion criteria: * \> 85 years old * recent pulmonary venous antrum isolation procedure (\<1 year) * (end stage) kidney failure * (end stage) liver failure * study participants with known systemic active inflammatory disease * study participants with impaired mental state * inability to use a fitness tracker or mobile phone * impaired cognition and inability to understand the study protocol

Keywords: cardiovascular disease artificial intelligence machine learning
poc in rheumatoid arthritis with methotrexate

Conditions: Rheumatoid Arthritis, NOS

Summary: the purpose of this study is to find out if 300 mg of bms-582949 given once daily will be more effective than placebo after 12 weeks of treatment in subjects with rheumatoid arthritis who are also taking methotrexate


Eligibility criteria:
inclusion criteria: * must have a diagnosis of ra for at least 6 months * must be taking methotrexate for at least 3 months \& on a stable dose of 7.5-30 mg weekly) for 4 weeks before dosing with study medication * must have at least 6 swollen and at least 8 tender joints * crp above upper limit of normal or esr \> 28 mm/hr * must wash-out (stop taking) other immunosuppressant medications to treat ra (except for methotrexate) before dosing with study medication exclusion criteria: * any infection including tb, hiv, hepatitis b or c * recent infection requiring antibiotics within 4 weeks * history of gastrointestinal disease (such as gerd, gastrointestinal ulcers, heartburn) requiring medical or surgical treatment within 3 months * chronic use of proton pump inhibitors (such as losec, prilosec, prevacid, nexium), h2 blockers (such as tagamet, pepcid, zantac, axid) or antacids (such as mylanta, maalox)
changes in haemostasis after therapeutic plasmapheresis with citrate anticoagulation

Conditions: Humoral Rejection; Guillain-Barre Syndrome; Miller Fisher Syndrome; CIDP; Good Pasture Syndrome; Hyperviscosity Syndrome

Summary: plasma exchange procedures remove procoagulant and anticoagulant factors. every procedure increases the risk of bleeding and repeated procedures increase the risk of bleeding mostly because lower fibrinogen levels. the aim of study is to define coagulation status of patient after plasmapheresis with different laboratory tests and to investigate the possibility of fibrinogen concentrate replacement for the correction of induced coagulation disorder.


Eligibility criteria:
inclusion criteria: * every patient who will need repeated plasmapheresis treatment in ukc ljubljana exclusion criteria: * pregnancy * coagulation disorders * hypertriglyceridemia-induced acute pancreatitis * hepatic disorders

Keywords: fibrinogen concentrate fresh frozen plasma rotem fibrinogen overall coagulation potential
prospective cohort study of children with gsd1b receiving empagliflozin

Conditions: Glycogen Storage Disease Type IB

Summary: this is a prospective cohort study of children with gsd1b to evaluate their outcome after using empagliflozin for neutrophil defects.

glycogen storage disease type 1b (gsd1b) is an ultra-rare inborn error of carbohydrate metabolism, characterized by low neutrophil count, neutrophil dysfunction, and the associated recurrent infections and inflammatory bowel conditions. the current standard treatment with granulocyte colony-stimulating factor (gcsf) only increases neutrophil count but does not improve neutrophil function. it achieves only partial clinical response. fever, recurrent infections, and gastrointestinal upset remain significant problems. long-term regular gcsf injection is needed to sustain the clinical effect, but is also associated with development of serious complications including massive spleen enlargement, acute myeloid leukemia and myelodysplastic syndrome. accumulation of a toxic metabolite called 1,5-anhydroglucitol-6-phosphate (1,5ag6p) is recently discovered as the cause of neutrophil problems in gsd1b. empagliflozin, a sodium-glucose co-transporter 2 (sglt2) inhibitor widely used as anti-diabetic drug, is known to promote excretion of 1,5-anhydroglucitol (1,5ag) in kidney. since 1,5ag is the precursor of 1,5ag6p, empagliflozin also reduces the accumulation of 1,5ag6p. this is confirmed by animal studies that empagliflozin is shown to improve neutrophil count and function in gsd1b mouse model. similar benefits are also recently reported in human cases (3 adults and 2 children with gsd1b), that gcsf dose could be significantly reduced or even stopped. this is a prospective cohort study of children with gsd1b to examine their outcome after receiving empagliflozin treatment. the objective is to evaluate the short to medium term safety and efficacy of empagliflozin. the ultimate goal is to assess if sglt2 inhibitor could be an effective alternative of gcsf with less side effects and risks, and to improve the clinical outcomes and quality of life for patients and families with gsd1b.

Eligibility criteria:
inclusion criteria: - subject (aged 6 months to 18 years) is enzymatically/genetically confirmed to have gsd 1b and has been on regular gcsf treatment for \>= 1 month exclusion criteria: * subject fails to provide relevant background medical information, or comply with all requirements of the clinical trial, or sign the informed consent * subject has any co-morbidity or condition that could increase the risk of empagliflozin treatment (e.g. renal failure with egfr \<30 ml/min/1.73m2 or requiring dialysis, diabetes requiring insulin \&/or oral hypoglycemic agents, dyslipidemia requiring pharmacological intervention) * subject is pregnant, or a sexually active female who does not consent to use effective contraception during the study * history of liver transplantation is not an exclusion criterium
safety and efficacy of c21 in subjects with covid-19

Conditions: COVID-19

Summary: this is a randomised, double-blind, placebo-controlled phase 2 trial investigating the safety and efficacy of c21 in subjects who are hospitalised with covid-19 infection, but not in need of mechanical invasive or non-invasive ventilation. in total, approximately 100 subjects will be enrolled and randomised to receive twice daily oral administration of either standard of care (soc) + placebo (n=50) or soc + c21 (n=50). subjects will be treated for 7 days.


Eligibility criteria:
inclusion criteria: 1. written informed consent, consistent with ich-gcp r2 and local laws, obtained before the initiation of any trial related procedure 2. diagnosis of coronavirus (sars-cov)-2 infection confirmed by polymerase chain reaction (pcr) test \< 4 days before visit 1 with signs of an acute respiratory infection 3. age \> 18 and \< 70 years 4. crp \> 50 and \< 150 mg/l 5. admitted to a hospital or controlled facility (home quarantine is not sufficient) 6. in the opinion of the investigator, the subject will be able to comply with the requirements of the protocol exclusion criteria: 1. any previous experimental treatment for covid-19 2. need for mechanical invasive or non-invasive ventilation 3. concurrent respiratory disease such as copd (chronic obstructive pulmonary disease), ipf and/or intermittent, persistent or more severe asthma requiring daily therapy or any subjects that have had an asthma flare requiring corticosteroids in the 4 weeks (28 days) prior to covid-19 diagnosis 4. participation in any other interventional trial within 3 months prior to visit 1 5. any of the following findings at visit 1: * positive results for hepatitis b surface antigen (hbsag), hepatitis c virus antibody (hcvab) or human immunodeficiency virus 1+2 antigen/antibody (hiv 1+2 ag/ab * positive pregnancy test (see section 8.2.3) 6. clinically significant abnormal laboratory value at visit 1 indicating a potential risk for the subject if enrolled in the trial as evaluated by the investigator 7. concurrent serious medical condition with special attention to cardiac or ophthalmic conditions (e.g. contraindications to cataract surgery), which in the opinion of the investigator makes the subject inappropriate for this trial 8. malignancy within the past 3 years with the exception of in situ removal of basal cell carcinoma and cervical intraepithelial neoplasia grade i 9. treatment with any of the medications listed below within 1 week prior to visit 1: 1. strong cytochrome p450 (cyp) 3a4 inducers (e.g. rifampicin, phenytoin, st. john's wort, phenobarbital, rifabutin, carbamazepine, anti hiv drugs, barbiturates) 2. warfarin 10. pregnant or breast-feeding female subjects 11. female subjects of childbearing potential not willing to use contraceptive methods as described in section 5.3.1 12. male subjects not willing to use contraceptive methods as described in section 5.3.1 13. subjects known or suspected of not being able to comply with this trial protocol (e.g. due to alcoholism, drug dependency or psychological disorder)

Keywords: covid-19