Kornimate/medical-research-clean huggingface dataset:
icbt with tms in patients with mdd

Conditions: Major Depressive Disorder

Summary: major depressive disorder (mdd) is a common mental health diagnosis. while there are many approaches to the treatment of mdd, current treatments of mdd often do not substantially reduce depressive symptoms among those in need of care. prior research suggests that combining cognitive-behavioral therapy (cbt) and psychopharmacology can produce optimal treatment outcomes compared to the use of either treatment individually. transcranial magnetic stimulation (tms) is one promising brain stimulation approach used to treat mdd, especially among patients with treatment-resistant symptoms. like psychopharmacological interventions, tms may produce optimal treatment outcomes when paired with cbt. however, standard tms protocols are time-intensive, typically requiring daily doctor visits for one hour of six to eight weeks. therefore, an internet-delivered cbt protocol may augment the effects of tms without substantially increasing patient burden. to that end, the present study assesses if a combined tms and internet-delivered cbt protocol may produce superior treatment outcomes compared with tms alone.


Eligibility criteria:
inclusion criteria: subjects with major depressive disorder who are receiving a full course of tms treatment in at the ucla tms clinic. eligibility is determined by tms physicians who are co-investigators on this study. exclusion criteria: any indications of metal implants, pregnancy, psychosis, autism spectrum disorders, complex regional pain syndromes, substance use dependence and comorbidities that would interfere with treatment response. the criteria are assessed using mini interview and hamilton depression scale conducted by trained and certified interviewers. participants may not participate if they are currently completing cbt outside of the study.

Keywords: depression tms brain stimulation internet-based cbt
the effect of early total thyroidectomy in the course of graves' orbitopathy

Conditions: Graves' Ophthalmopathy

Summary: the relationship between the method of the treatment of hyperthyroidism due to graves' disease and the course of graves' ophthalmopathy is debated. the investigators aimed to compare the results of total thyroidectomy done in 6 months following the appearance of the symptoms of ophthalmopathy and the antithyroid drug therapy in patients with moderate to severe graves' ophthalmopathy. the inclusion criteria: 1)hyperthyroidism and moderate to severe graves' ophthalmopathy within 6 months, 2)thyroid volumes greater than or equal to 15 ml in thyroid ultrasonography, 3)patients taking no treatment except local medications for graves' ophthalmopathy, 4)clinical activity score of 3/7 or more, proptosis greater than or equal to 21 mm in one eye or 2 mm difference between two eyes, presence of diplopia, the opening of the eye lid greater than or equal to 9 mm. all patients will be treated with antithyroid drug until tsh levels of the patients are between 0.4-1. during this period all the patients will take pulse methyl prednisolone treatment of a total dose of 4.5 gr. after pulse steroid treatment the patients will be randomised to two groups: one group will be sent to surgery for total thyroidectomy, and their tsh levels will be kept between 0.4-1 with levothyroxine treatment; the other group will be followed under antithyroid drug treatment and their tsh levels will be kept between 0.4-1 also. the smoking habits will be asked. serum tsh, ft4 levels, hertelmeter and eye lid opening measurements, clinical activity scores, diplopia will be evaluated monthly; tsh receptor antibody, anti-thyroid peroxidase and anti-thyroglobulin levels will be measured in 3 months intervals for a period of 12 months.


Eligibility criteria:
inclusion criteria: * hyperthyroidism and moderate to severe graves' ophthalmopathy within 6 months, * thyroid volumes greater than or equal to 15 ml in thyroid ultrasonography, * patients taking no treatment except local medications for graves' ophthalmopathy, * clinical activity score of 3/7 or more, proptosis greater than or equal to 21 mm in one eye or 2 mm difference between two eyes, presence of diplopia, the opening of the eye lid greater than or equal to 9 mm. exclusion criteria: * patients taking treatment other than local medications for graves' ophthalmopathy (eg: steroid treatment)

Keywords: graves' ophthalmopathy total thyroidectomy anti-thyroid drug treatment clinical activity score
nsclc liquid biopsies and exhaled voc

Conditions: Lung Cancer; Circulating Tumor DNA

Summary: the objective of the study is to determine the feasibility of recruiting participants and using sputum, bronchoalveolar lavage (bal) and exhaled volatile organic compounds (voc) in addition to blood, as biological samples for detecting mutations in extracted cell-free dna in non-small cell lung cancer (nsclc) patients, before and after surgery, and any recurrence within a 24-month postoperative follow-up period. this is a pilot feasibility study, proposed as a 24-month prospective, single-center, non-interventional, observational trial with nsclc-adenocarcinoma patients indicated for resection surgery with curative intent.

circulating tumor dna (ctdna) is increased in patients with lung cancer, and may allow detecting minimal residual disease and disease recurrence, preceding radiological detection. detecting ctdna in bronchoalveolar lavage/sputum was never validated and may offer advantages over blood ctdna, and serve as a novel biomarker for lung cancer surveillance. lung cancer detection is possible with enose systems with a high negative predictive value and allows prediction of treatment response to pd1 inhibitors, monitoring response to pd1 inhibitors and predicting the presence of egfr mutations. it is reasonable to anticipate exhaled voc to aid in detection of cancer recurrence. the study propulsion is patients undergoing surgical resection with curative intent for nsclc, adenocarcinoma subtype at st. joseph's healthcare hamilton and the firestone institute of respiratory health , above 18 years, able to provide consent. the study procedure is collecting blood, sputum, bal samples, exhaled voc will be collected at the following time-points/visits: (i) visit 1 (v1): pre surgical resection; (ii) v2: immediately before discharge from hospital post-resection; (iii) v3,4,5 : 6, 12, 24 months post-surgery; (iv) v6: unscheduled at any sign of recurrence. to note, blood sputum and bal will be collected at visit 1 and 2 from everyone and at visits 3-6 only from those who harbor a mutation of interest.

Eligibility criteria:
inclusion criteria: * patient must be at least 18 years of age * patient must be able to provide consent * patients undergoing surgical resection with curative intent for non-small cell lung cancer at st. joseph's healthcare hamilton and firestone institute for respiratory health. exclusion criteria: * resection done with non-curative intent or metastatic disease * other malignancies * patients with previously treated malignancy less than 5 years prior to current resection (not including skin cancer).
a description of bacteria in the mouths of patients with severe aplastic anemia

Conditions: Severe Aplastic Anemia (SAA)

Summary: background: - this research is being done to describe the types of bacteria found in the mouths of patients who have severe aplastic anemia (saa) and are treated with drugs that suppress the immune system or with stem cell transplant. people with saa who receive these treatments are more likely to get infections. studies show that there might be a link between the bacteria in your mouth and those bacteria that can cause infections. the bacteria found in the mouths of patients with saa will be described. objectives: - to understand the changes in mouth bacteria that are related to treatment and to describe the oral bacterial environment. eligibility: * adults at least 18 years of age who are going to be treated for saa. * healthy volunteers at least 18 years of age. design: * participants will answer questions about their medical history and dental care. their mouths will be examined. * participants with saa will be tested during treatment for their disease, over the course of 1 year. all participants with saa will be tested at 3 scheduled appointments. any participants who require a breathing tube will receive additional tests. * healthy volunteers will be tested during 1 visit. * participants will give two samples each time. a saliva sample will be taken with a disposable padded tool. skin cells will be collected from the tongue with a small plastic brush.

the mouth is a complex biological ecosystem normally containing over 700 different species of bacteria. some of these bacteria live in an exopolysacchride matrix biofilm and occupy specific niches in this complex oral environment. understanding the oral environment and the microbiota that inhabit it will assist in determining their impact on health and disease. there are several studies in critically ill patients demonstrating changes in oral bacteria related to acute illness. identification of respiratory pathogens in the mouth has led researchers to hypothesize that a relationship exists between the oral cavity and pulmonary infections. this descriptive study will characterize the oral microbiota of patients who have severe aplastic anemia (saa). patients will be followed for 1 year after treatment for development of respiratory symptoms that require intubation. a difference in the oral microbiome will be identified in specimens collected before and after treatment.

Eligibility criteria:
* all adult patients who are scheduled to receive treatment for saa will be screened for this protocol. these patients will be recruited from the numerous protocols that are actively accepting new research participants at the clinical center, nih. inclusion criteria any adult patient (greater than or equal to18 years of age), diagnosed with saa. exclusion criteria any saa patient found to have significant tooth loss from decay or is edentulous are excluded. this exclusion criteria will be assessed by the pi or her representative prior to signing the informed consent.

Keywords: oral microbiome next generation sequencing
prospective deployment of a cardiac arrest response system (edicars) in the emergency department

Conditions: Cardiac Arrest

Summary: based on data from the american heart association's (aha) get with the guidelines-resuscitation (gtwg-r) registry, the incidence of adult treated in-hospital cardiac arrest (ihca) was about 10 per 1,000 bed-days (290,000 patients per year), and 15 to 20% of adult ihca patients survived to hospital discharge (i.e., \~80% mortality). despite the significant morbidity and mortality caused by ihca, ed-based ihca is surprisingly less studied. the investigators have utilized electronic medical record (emr)'s big data (\>700,000 visits) from our hospital to investigate, for the first time, the epidemiology and outcome of ihca in the ed in taiwan. the investigators also have developed and validated a simple prediction tool for ed-based ihca, the emergency department in-hospital cardiac arrest score (edicas). this tool has also been externally validated using far eastern memorial hospital's ed data. in addition, the investigators also have developed and validated a vital-sign trajectory-based longitudinal model (group-based trajectory modeling \[gbtm\]) to predict ed-based ihca. based on these studies, the investigators now propose to (1) embed the edicas into our hospital information system (his) in real-time at ed triage to identify high-risk patients (edicas 6+); and (2) distribute wearable smart wristbands to high-risk patients to augment vital signs monitoring and send alerts based on gbtm results. the detection and intervention components together form the rapid response system, the emergency department in-hospital cardiac arrest response system (edicars). in this study, the investigators will enroll and randomize 10 attending physicians into the edicars or the usual care arm for 3 months, with each of them treating 100 patients (patients clustered within physicians). the trial will stop for 2 months as a wash-out period, and an interim analysis will be performed. the physicians will then cross over, and each of them will treat 100 patients for another 3 months. a total of 2,000 adult patients will be enrolled. the primary outcome is a composite rate of ed-based ihca and intensive care unit (icu) admission. the secondary outcomes include time from ed triage to ed-based cardiac arrest, icu and hospital length of stay, early ward-based ihca, and early icu transfer.


Eligibility criteria:
inclusion criteria: * ed patients aged 20 years at recruitment exclusion criteria: * inability to sign informed consent; * diagnosis of psychiatric disorders that would limit the ability to comply with the study protocol (e.g., wearing a wristband); * intending to leave ed against medical advice; * already enrolled or planning to enroll in a research study that would conflict with full participation in the study.
investigation of the efficiency of spinal mobilization in patients with adolescent idiopathic scoliosis

Conditions: Adolescent Idiopathic Scoliosis

Summary: in this study, it was aimed to evaluate the effect of spinal mobilization techniques applied in addition to core stabilization exercises in adolescent idiopathic scoliosis (ais) patients. consecutive adolescents with idiopathic scoliosis, aged 10 to 16 years, without a brace, and with a cobb curvature of 10 to 25 degrees were randomly divided into two groups using the closed envelope method: spinal mobilization and core stabilization exercise were applied to the experimental group; only core stabilization exercises were applied to the control group. both groups received interventions twice a week for 10 weeks. outcome measurements were made before treatment and after 10 weeks of treatment.

this study was a randomized controlled trial in which participants and assessor were blinded. this study was carried out in amasya university ruhi tingiz physical therapy and rehabilitation hospital rehabilitation unit between august 2022 and january 2023. ethics committee approval was obtained from amasya university (e-76988455-050.01.04-83314) on 05.08.2022 to conduct the study. before the study, face-to-face interviews were conducted with the all participants and parents and informed about the subject and purpose of the study. verbal and written consent was obtained from the all participants and parents. sample size: the sample of the study was calculated with the g\*power 3.1 program, and the effect size (d=1.0) was calculated according to the double-tailed hypothesis method, taking into account the study. (d=1.0; α=0.05; 1-ß=0.80). confidence interval was determined as 80% and margin of error was 5% (α=0.05). as a result of the calculation, it was determined that there should be 17 adolescent scoliosis patients for the control group, 17 for the experimental group, and a total of 34 adolescent scoliosis patients. considering the possible data losses of the participants, we planned to include a total of 40 participants, 20 in both groups.

Eligibility criteria:
inclusion criteria: * patients diagnosed with ais * age 10-16 years * cobb angle was between 10° and 25 * risser sing did not exceed 4 * informed consent forms were signed by the parents and children exclusion criteria: * used brace, * had previous spinal surgery, inferior limb length difference, * could not exercise due to another injury/diagnosis, * had neuromuscular, psychiatric, cardiovascular, respiratory insufficiency and mental disability

Keywords: adolescent idiopathic scoliosis core stabilization exercises spinal mobilization manual therapy pulmonary function
perampanel for sporadic amyotrophic lateral sclerosis (als)

Conditions: ALS

Summary: to investigate the safety and the efficacy of perampanel in patients with sporadic amyotrophic lateral sclerosis

to evaluate the effect of peramanel for 48 weeks on progression of disease in subjects with als, as measured by als functional rating scale-revised (alsfrs-r)

Eligibility criteria:
\[eligibility criteria for interim registration\] * patients who are able to submit written informed consent. if patients are duly capable of study consent but are unable to sign by themselves due to aggravation of disease condition, written informed consent can be obtained from a legally authorized representative who can sign on behalf of the patients after confirming the patients' agreement to study participation. * patients who are male or female aged 40 years to 78 years at the time of obtaining informed consent * patients who have clinically definite als, clinically probable als, or clinically probable-laboratory supported als as specified in the revised el escorial airlie house diagnostic criteria. * the sum of the 3 respiratory items of the alsfrs-r must total 12 points or more * patients within 2-year elapsed time period from disease onset at the time of obtaining informed consent * patients who can visit study site for out-patient treatment \[eligibility criteria for registration\] subjects who meet the following criteria in addition to the inclusion criteria for the interim registration * the progression on score of alsfrs-r during 12 weeks of observation period must be between -2 and -5 * patients who has not initiated newly introduced riluzole therapy after starting the observation period. or those who has not received dose escalation or resumed administration of riluzole therapy after previous down titration or discontinuation * patients who has not initiated newly introduced edaravone therapy after starting the observation period * patients who are judged to be eligible for continuation of the study by the investigators \[exclusion criteria\] * patients who underwent tracheostomy. * patients who experienced non-invasive positive pressure ventilation. * patients whose percent-predicted forced vital capacity (%fvc) is ≤80%. * patients with progressive bulbar palsy type. * patients with cognitive impairment, severe disease in the renal, cardiovascular, or hematological system. * patients with hepatic disease. * patients with malignant tumor. * pregnant women or women with a possibility of becoming pregnant. * patients who participated in another clinical study within 12 weeks before starting the observation period. * patients who has initiated perampanel therapy in the past or at present. * patients who are judged to be ineligible for study entry by the investigators.

Keywords: sporadic als perampanel
a study of home-based pulmonary rehabilitation and health coaching to treat bronchiectasis

Conditions: Bronchiectasis

Summary: the purpose of this study is to gather information on the effectiveness on a home-based pulmonary rehabilitation in patients with bronchiectasis.

the purpose of this study is to gather information on the effectiveness on a home-based pulmonary rehabilitation in patients with bronchiectasis. we hope that by participating in home-rehab that patients with bronchiectasis will become more physically active in their daily lives. pulmonary rehabilitation in a medical center has proven to have a positive impact on physical activity and shortness of breath in patients with chronic lung disease. however, travel and access can make going to a center difficult. study participation involves completing gentle flexibility exercises and walking practice using a provided computer tablet, pulse oximeter and an activity tracker for 12 weeks. during that time, you will talk to a health coach once a week on the phone. at the end of the 12 weeks, someone will call you and ask you questions about your experience with the home-based rehab. health coaching calls will be recorded so that it can later be transcribed. all identifying information will be removed and the answers will be lumped together.

Eligibility criteria:
inclusion criteria: * having a diagnosis of non-cystic fibrosis bronchiectasis (primary inclusion criteria) ,confirmed by records, that are symptomatic. * ability to communicate in english. exclusion criteria: * inability to walk (orthopedic/neurologic/cardiac limitation causing immobility). * cognitive impairment or inability to understand and follow instructions. * traditional pr completed within 3 months of study recruitment. * hospice or end-of-life care at the time of screening. * acute exacerbation at the time of screening.
adherence in global airways - steroid intake and effects on chronic rhinosinosinutis

Conditions: Chronic Rhinosinusitis Without Nasal Polyps; Asthma; Chronic Rhinosinusitis With Nasal Polyps; Steroid-Induced Osteopenia (Diagnosis); Steroid-Induced Diabetes; Steroid-Induced Hyperglycemia

Summary: the purpose of this study is to investigate the relationship between long-term use of systemic steroids in patients with upper and lower respiratory tract diseases and their own production of cortisol (cross-sectional), as well as whether those with low cortisol levels have an impact on bone density. as patients with crswnp have a high use of steroids, they routinely undergo a dexa scan at the respiratory clinic, department of ear-nose-throat surgery and audiology (ent) - rigshospitalet (rh) to examine whether their bone density and structure are affected. the scan will be included as a clinical secondary outcome to assess whether systemic steroid use has an impact on this. the purpose of the study is therefore to compare steroid intake, baseline p-cortisol, the body's response to acth (measured by cortisol levels after the test), and bone density in patients with chronic sinusitis (crs) with and without asthma in an unselected population at the respiratory clinic (cross-sectional). in addition, at the 4-month follow-up (exploratory follow-up, pilot project), it will be investigated whether good adherence (\>80%) to inhalation therapy (nasal steroid and lung steroid) and additional treatment with biologicals has a negative effect on the body's own production of p-cortisol.


Eligibility criteria:
inclusion criteria: cross sectional study * diagnosed with chronic rhinosinusitis (crs) * possibly asthma * aged over 18 years exclusion criteria - cross sectional study * unable to read or speak danish * presence of severe psychiatric comorbidities * patients who have never taken systemic steroids * inability to participate or comply with local treatment according to the investigators' assessment * does not provide consent for lookup in fmk-online in/exclusion criteria for exploratory study - 4-month follow-up (pilot project) inclusion criteria: * diagnosed with crs and possibly asthma * age over 18 years * low adherence: foster score, i.e. the number of treatments taken compared to prescribed \< 80% (4 weeks out of 16 weeks) and/or measured on mars-5 l/n ≤35 at the first visit (corresponding to less than 80%). if the patient does not have asthma, it is mars-5n ≤ 19 * if asthma: acq ≥1.2 or act ≤ 17 (partly uncontrolled asthma) * snot-22 score ≥35 (partly uncontrolled crs) * participation in the cross-sectional study at the initial visit to the respiratory clinic exclusion criteria: adherence: * foster score \>80% and/or on mars-5-l/n \>35 points at the first visit * cannot read or speak danish * severe psychiatric comorbidities * patients who have never taken systemic steroids * after investigators' experience, will not be able to participate or comply with local treatment * does not give permission to look up data in fmk-online.

Keywords: adherence nurse global airways steroids