Kornimate/medical-research-clean huggingface dataset:
feasibility of an activity regimen in patients with advanced stage lung cancer

Conditions: Lung Neoplasm Malignant

Summary: the investigators will evaluate the feasibility of implementing a low-intensity, patient-centered activity regimen (pcar) that prioritizes education and communication over a 12-week period in advanced stage lung cancer patients. the primary outcomes will include number of patients increasing their overall step count over the study period and adherence to step count recommendations. secondary outcomes will include quality of life (qol), dyspnea, and depression scores before and after the intervention as well as a patient feedback questionnaire (to guide further interventions). the goals are to increase overall step count and obtain adherence of \>50% of participants. the investigators will also assess whether the physical activity regimen influences markers of inflammation and glucose control and novel markers of cancer.


Eligibility criteria:
inclusion criteria: * pathologic evidence of advanced non-small cell stage lung cancer (nsclc) * approval of the treating clinician * adult patients (age \>21 years) willing to wear a fitbit® device (fitbit, inc., san francisco, ca) * access to a smartphone, agree to receive twice/daily text messages for 12 weeks (including any costs), and willingness to download the fitbit application to their smartphone. * low activity level as judged by a brief physical activity questionnaire (i.e., \<150 minutes/week of moderate-intensity exercise, \<75 minutes/week of vigorous aerobic exercise, or an equivalent combination). exclusion criteria: * memory impairment (as judged by the treating clinician) * communication impairment (as judged by the treating clinician) * treating clinician's request not to alter physical activity * physical inability to safely walk (as judged by the treating clinician)
atorvastatin in moderate active crohns disease

Conditions: Crohns Disease

Summary: open pilot study to collect information regarding the effect of atorvastatin on patients with active crohns disease.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of crohns disease * c-reactive protein level \> 2 mg/l in absence of an infection * fecal calprotectin \> 250 mg/kg or cdai \> 150 exclusion criteria: * cdai \> 450 * prednisolone dosage above 15 mg/day
pharmacogenetics of vinorelbine in malignant pleural mesothelioma patients

Conditions: Malignant Pleural Mesothelioma

Summary: this is a multicenter retrospective analysis .the aim of the present study is to investigate the molecular predictors of vinorelbine response in tumor samples of a series of mpm patients and evaluate the possible impact on clinical outcome. sample size: around 150 patients based on the availability of tumor size

vinorelbine has recently become an alternative option for palliation in selected pemetrexed-pretreated patients with malignant pleural mesothelioma (mpm). however, nowadays there are no definitive data about vinorelbine predictors of response in mpm patients. the identification of molecular predictors of effective therapy is important for maximizing therapeutic efficacy and minimizing useless treatment in cancer patients. in oncology a pharmacogenetic approach to customize the chemotherapy treatment according to individual as well as tumour genetic characteristics represents a modern and intriguing challenge. recent studies have suggested that the expression levels of class iii β-tubulin (tubb3) or brca1, are related to a survival benefit from vinorelbine chemotherapy among patients with advanced solid malignancies, especially non-small cell lung cancer. there are no data about the predictive factors to vinorelbine in mpm patients. the identification of molecular predictors of effective therapy may allow in the future the development of better therapies.

Eligibility criteria:
inclusion criteria: * mpm patients treated with vinorelbine in the ≥ second line setting will be retrospectively analyzed * patients will be selected based on the availability of tumor tissue exclusion criteria: * na
sub-chronic neurostimulation delivered in the middle ear for tinnitus suppression

Conditions: Tinnitus

Summary: the objectives of this study are to evaluate the safety and efficacy of applying electrical stimulation on the promontorium (eps) for the suppression of tinnitus in a sub-chronic stimulation regimen.


Eligibility criteria:
inclusion criteria: 1. total score on the handicap inventory (thi) of at least 40. 2. visual scale over 5. 3. tinnitus origin is peripheral (related to long term noise exposure, or to a sudden exposure to a very loud noise etc.) 4. tinnitus is on-going; present for more than 50% of the time over the past 12 months. 5. unilateral tinnitus 6. tinnitus prevalent at least 12 months. 7. willingness to abstain from part taking in other, non-study procedures indicated to lessen tinnitus and/or its perception. 8. willing and able to refrain from engaging in activities or work involving loud noise exposure. 9. male or females 18-60 years of age exclusion criteria: 1. prior history of sudden hearing loss and/or fluctuating hearing levels. 2. tinnitus prevalent more than 3 years. 3. history of frequent middle ear infections 4. patient under immunosuppressant therapy 5. auditory nerve damage. 6. vestibular schwannoma 7. cochlear implant. 8. pregnant or lactating. 9. developmental disability or cognitive impairment that would make it difficult for the subject to partake in the clinical study, including adequate comprehension of the informed consent form and ability to record the necessary measurements. 10. involvement in litigation and/or a worker's compensation claim and/or receiving disability benefits related to tinnitus and/or hearing loss. 11. not being physically or geographically capable of returning for scheduled follow-up visits. 12. any physical, psychological, or emotional disorder that would interfere with the planned surgical operations 13. mentally retarded, developmentally delayed or suffering from organic brain dysfunction.

Keywords: severe ongoing unilateral present for more than 6 months
treatment of early immunoglobulin a nephropathy by angiotensin converting enzyme inhibitor - a randomized controlled trial

Conditions: Biopsy-confirmed IgA Nephropathy; Proteinuria Less Than 0.5 g Per Day; Normal Blood Pressure; Serum Creatinine Below 120 Umol/l

Summary: immunoglobulin a (iga) nephropathy is the most common type of primary glomerulonephritis in the world. the treatment of iga nephropathy with normal renal function and minimal proteinuria is unknown. since angiotensin-converting enzyme (ace) inhibitors reduce proteinuria and retard the rate of decline of renal function in chronic proteinuric nephropathies, including iga nephropathy. the investigators conduct a randomized control study to evaluate the efficacy of ace inhibitor in the treatment of early iga nephropathy. sixty patients with biopsy-proven iga nephropathy and minimal proteinuria are recruited. they will be randomized to ramipril for 5 years or no treatment. blood pressure, proteinuria and renal function will be monitored. this study will explore the effects of ace inhibitor in the treatment of early iga nephropathy, which is a major cause of dialysis-dependent renal failure.


Eligibility criteria:
inclusion criteria: * age between 18 and 65 * biopsy-confirmed iga nephropathy * proteinuria less than 0.5 g per day, normal blood pressure, and serum creatinine below 120 umol/l * willingness to give written informed consent and willingness to participate in and comply with the study protocol exclusion criteria: * expected survival less than 2 years * pregnant or nursing mother, or women of childbearing potential without an effective method of birth control * history of myocardial infarction, congestive heart failure, or any other medical indication that necessitate the use of ace inhibitor * evidence of clinically significant hepatic, gastrointestinal, autoimmune disease * history of malignancy, drug or alcohol abuse * participation in any previous trial on ace inhibitor * taking other investigational drugs within the past 30 days * history of non-compliance to medical regimens and patients who are considered potentially unreliable * known history of sensitivity / allergy to ace inhibitor
the efficacy of incobotulinum toxin a injections for treatment of tinnitus: a randomized controlled trial

Conditions: Tinnitus

Summary: tinnitus is a persistent non-physiologic, non-psychiatric, ringing in the ear that affects up to 20% of the general us population. the purpose of this study is to assess the patient reported effectiveness of xeomin (incobotulinumtoxina) injections into the auricular muscles for relief of tinnitus with use of the tinnitus handicap inventory questionnaire.


Eligibility criteria:
inclusion criteria: * adults age 18 or older * unilateral or bilateral tinnitus present for ≥ 2 months * a score \>16 on the tinnitus handicap inventory * participants must be willing and able to provide informed consent. exclusion criteria: * patients with known hypersensitivity to any botulinum toxin product or to any of the components in the formulation. * patients who have received botulinum toxin injections for any medical reason within 4 months prior to screening. * patients with infection at proposed injection sites. * patients scheduled for neurological or otological surgery for chronic ear disease, vestibular schwannoma, meningioma, or skull base tumors. * significant psychiatric history or associated diagnosis of major depression. * women who are pregnant or breastfeeding.
evaluation of factors affecting the tear-film lipid layer thickness

Conditions: Dry Eye Syndrome

Summary: in this study, the investigators aim to determine the effects of age, sex, history of ocular surgery and contact lens use, and ocular surface and meibomian gland parameters on the lipid layer thickness (llt) in normal subjects and patients with dry eye syndrome. patients with dry eye syndrome and subjects with a healthy ocular surface will be enrolled. all participant will underwent llt measurement with a lipiview interferometer, tear meniscus height measurement using optical coherence tomography, tear film break-up time (tbut) determination, corneal and conjunctival staining, schirmer's test, examination of the lid margins and meibomian glands, and assessment using the ocular surface disease index(osdi) questionnaire.


Eligibility criteria:
inclusion criteria: 1. age over 19 years old, patients with dry eye syndrome and normal subjects exclusion criteria: 1. patients less than 18 years of age and patients with histories of ocular surgery within 3 months; ocular injury; and ocular diseases such as ocular infection, allergy, and autoimmune disease; and patients with the use of a punctal plug or topical ocular medications other than artificial tears. 2. patients who used artificial tears were instructed not to apply them for at least 12 hours 99 before the examinations

Keywords: dry eye lipiview tear lipid layer meibomian gland dysfunction
metformin for the treatment of diabetes in pregnancy

Conditions: Gestational Diabetes; Diabetes Mellitus Type 2

Summary: the purpose of this study is to determine whether metformin is effective and safe in the treatment of diabetes in pregnancy.


Eligibility criteria:
inclusion criteria: * pregnant women * gdm a2 * diabetes mellitus type 2 * singleton pregnancy exclusion criteria: * diabetic nephropathy or proliferative retinopathy * cannot swallow tablets
the effects of dog therapy on ambulance staff burnout scores.

Conditions: Burn Out; EMS Exposures or Injuries of EMS Personnel

Summary: problem during the covid 19 pandemic, nhs staff have become increasingly burned out. mental health is the leading cause of staff sickness and absence in the nhs. ambulance trusts have the highest rates of sickness across all nhs professions. reduced staffing levels directly impacts service delivery. staff struggling with poor mental health are more likely to make errors, have reduced empathy, and patients have lower patient satisfaction. the solution? dog therapy is used in hospital settings around the world for patient benefit and staff welfare. evidence suggests dog therapy improves mood and reduces anxiety. yorkshire ambulance service (yas) has a small, but established dog therapy scheme, organised by the health and wellbeing team. this research aims to observe if dog therapy affects symptoms of burnout in yas staff. we will use two sets of staff: patient facing staff staff with remote patient contact what will participants need to do? participants will be given a copenhagen burnout inventory - a questionnaire focusing on three factors: personal burnout work related burnout client related burnout burnout will be measured in 4 categories; no/low, moderate, high and severe burnout. the questionnaire will be completed at the beginning and end of 8 weeks of dog therapy. * some optional demographic questions * number of sessions attended * engagement with occupational health services * dog ownership we will calculate the difference in severity of burnout between baseline and after 8 weeks of dog therapy. a ppi group has been consulted on methodology, wording of plain english summary and the dissemination plan. this research will be distributed to all interested participants, published in an appropriate journal presented at conferences, and presented in the ica dissemination event.


Eligibility criteria:
inclusion criteria: yorkshire ambulance service (yas) employee with patient contact. patient contact includes face to face to face or remote patient contact. taking part in yas dog therapy scheme. completed no more than 2 dog therapy sessions to date. - exclusion criteria: staff with no patient contact as part of their role. staff on bank contract -
neutrophil gelatinase-associated lipcalin (ngal) evaluation along with b-type natriuretic peptide in acutely decompensated hf

Conditions: Acute Decompensated Heart Failure

Summary: this is a multi-center prospective pilot clinical study to assess the utility of the triage ngal test - alone and in conjunction with the triage bnp test - as an aid in the early risk assessment for heart-failure-related adverse clinical outcomes (deaths, readmissions, and additional emergent outpatient visits) through day 30 and day 90 in patients presenting with acutely decompensated heart failure (hf). its utility as an aid in the early risk assessment for renal dysfunction in patients with acutely decompensated heart failure undergoing treatment with iv diuretics will also be assessed.

approximately 200 adults presenting to the emergency department (ed) / hospital with acutely decompensated hf will be enrolled. edta anti-coagulated blood samples will be collected for measurement of blood ngal levels (using the triage ngal test) at the point of care in all subjects at up to 8 different time points from presentation until discharge. the results of these ngal assessments will be blinded to the medical team during the study and will not impact the medical management of the subject. blood samples for unblinded assessment of both serum creatinine (analyzed at the hospital's laboratory) and whole blood bnp (analyzed with the triage bnp test at the point-of-care or laboratory) will also be obtained at some of the same time points. dialysis, emergent outpatient visits for hf, hospitalizations and mortality will be recorded through day 30 and day 90. if an additional serum creatinine has been obtained as standard care near day 30, it will also be recorded.

Eligibility criteria:
inclusion criteria: * males and females 18 years of age or older; * patients presenting to the emergency department / hospital with symptoms of new or decompensated heart failure and who will be treated with at least one dose of iv diuretic; * ability to draw blood samples for baseline ngal, bnp and creatinine levels either prior to the administration of the first dose of iv diuretic or within 1 hour after the first dose of an iv diuretic * ability to provide written informed consent from subject or their authorized representative. exclusion criteria: * acute myocardial infarction or active ischemia; * patients who are intubated or otherwise not able to communicate or comply with study assessments; * cardiogenic shock or any other clinical condition that would contraindicate the administration of an iv agent with potent vasodilating properties; * known history of marked renal insufficiency (e.g., usual serum creatinine ≥ 3.0 mg/dl), on dialysis (either acute of chronic) or in imminent need of dialysis at enrollment; * prisoners or other institutionalized or vulnerable individuals; * participation in an interventional clinical study within the previous 30 days; * unlikely to be willing or able to comply with study procedures, including the follow-up at 30 and 90 days .

Keywords: acutely
developmental care program in neonatal intensive care unit

Conditions: Premature Birth

Summary: this project is a randomised clinical trial that includes a family centred education intervention and/or non-directive active listening counselling intervention with families of preterm infants at risk for sensori-motor disorders.

preterm babies, specifically with gestational age \< 33+6 weeks, will be recruited and assigned (randomized) into an a family education + active listening group (intervention a) or a family education only group (intervention b). when the clinical condition of the child is stable the parents are approached for consent and randomised. all families (in intervention a and intervention b) will receive the evidence-based program of family education which is based on the promotion of the parent-child relationship through the recognition of behavioral states, methods of interaction, facilitation strategies in the relationship. it takes its conceptual basis from the mother infant transaction program (mitp). it is a specific and re-adapted version for the preterm infant hospitalized in nicu the family education sessions involve about 6 meetings (1-2 a week) of 30-45 minutes that are carried out during the hospitalization in the nicu directly at the child's bed between the operator and one or both parents. each meeting involves the discussion of one of the following topics. the families in intervention group a will also receive 4-6 weekly meetings with a psychologist for an active listening counselling session.

Eligibility criteria:
inclusion criteria: * parents of preterm \<34 weeks without brain lesion exclusion criteria: * parents of infants with brain lesions * parents of clinically unstable infants, based on standard medical evaluation of preterm infants (eg: children with mechanical ventilation or under sedation) * parents of infants with genetic-malformative conditions * parents with severe psychiatric disorders

Keywords: family-centered care neonatology early intervention counseling
spinal stenosis and listhesis treated with percutaneous interspinous spacer: a non-surgical trial

Conditions: Lumbar Spine Degeneration; Lumbar Spine Instability; Lumbar Spondylolisthesis; Lumbar Spinal Stenosis

Summary: symptomatic lumbar spinal stenosis is the most common indication for spinal surgery. however, more than one-third of the patients undergoing surgery for lumbar stenosis report dissatisfaction with the results. on the other hand, conservative treatment has shown positive results in some cases. this trial will compare the outcomes of surgical versus non-surgical treatment for lumbar stenosis.

this is a three-centre randomised controlled trial in which 200 patients with symptomatic lumbar spinal stenosis will be randomised into one of two treatment arms. the patients in the surgical arm will undergo decompression of the neural structures by use of any open or minimally invasive (mis) technique with or without fusion; the patients in the non-surgical arm will undergo imaging assisted percutaneous interspinous spacer insertion with fusion. the primary outcome of the study will be the oswestry disability index. secondary outcomes will include motor amplitude and degree of denervation activity obtained by means of nerve conduction studies and electromyography. patient-reported outcome measures will be also used as secondary outcomes.

Eligibility criteria:
inclusion criteria: 1. age 50-85 years. 2. clinical symptoms of lumbar spinal stenosis (pseudoclaudication) indicating and motivating surgery. numeric rating scale in lower limbs ≥3. 3. mri with finding of lumbar spinal stenosis at 1-3 lumbar levels. dural sac area ≤75 mm2 or degree of stenosis c or d according to schizas's classification.34 4. the patient has given oral and written informed consent to participate. exclusion criteria: 1. degenerative deformity with cobb angle \>20°. 2. symptomatic osteoarthritis in the lower limbs that affects and limits the patient's function. 3. arterial insufficiency (claudication intermittent). 4. former lumbar surgery other than disc hernia. 5. conditions that affect the spine, such as ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, spondylodiscitis/infections, malignancy and neurological diseases. 6. heart and lung diseases presenting a significant risk for surgery or making it impossible for the patient to take part in a percutaneous arm of treatment (american society of anesthesiologists (asa) score \>3). 7. polyneuropathies. 8. psychological factors rendering the patient incapable of inclusion in the trial (eg, drug addiction, dementia).

Keywords: spondylolisthesis lumbar spine stenosis
pocus and respiratory failure prognosis based on diaphragmatic dysfunction

Conditions: Respiratory Failure; Diaphragm Disease

Summary: this study aims to evaluate the use of pocus to assess diaphragmatic function and its association with clinical outcomes in patients with respiratory failure who are admitted to the emergency department.

respiratory failure is a common condition that requires prompt diagnosis and treatment in the emergency department. diaphragmatic dysfunction (dd) is a potential contributor to respiratory failure, but it is often underdiagnosed and undertreated. point-of-care ultrasound (pocus) is a non-invasive and feasible tool that can measure diaphragmatic function using parameters such as diaphragm excursion and diaphragm shortening fraction (dsf). however, the prognostic value of pocus for dd in patients with respiratory failure is unclear. this study is a prospective observational cohort study that will enroll consecutive patients with respiratory failure who are admitted to the emergency department of a tertiary hospital. all patients will undergo pocus examination of the diaphragm within 6 hours of admission by trained emergency physicians. the primary outcome will be the composite of mortality, intubation, or noninvasive ventilation failure within 30 days of admission. the secondary outcomes will include length of hospital stay, intensive care unit admission, and ventilator-free days. the association between pocus parameters of diaphragmatic function and clinical outcomes will be analyzed using multivariate logistic regression and cox proportional hazards models.

Eligibility criteria:
inclusion criteria: * respiratory failure defined as one or more of the following: respiratory rate \>24 breaths/min, oxygen saturation \<90% on room air, pao2/fio2 ratio \<300 mmhg, or need for supplemental oxygen * ability to provide informed consent or availability of a legal representative exclusion criteria: * pregnancy * history of thoracic surgery or trauma * known neuromuscular disease affecting the diaphragm * contraindications for pocus examination such as chest wall deformity, subcutaneous emphysema, or skin infection

Keywords: point of care ultrasound diaphragm disease