Kornimate/medical-research-clean huggingface dataset:
early rehab with vr for first-time acute stroke

Conditions: Stroke, Acute; Acute Ischemic Stroke

Summary: the goal of this clinical trial is to confirm the efficacy and feasibility of early rehabilitation combined with virtual reality training in patients following first-time acute stroke. the main questions it aims to answer are: * the impact of virtual reality training on muscle strength; * the impact of virtual reality training on functional recovery; * the impact of virtual reality training on mood state. researchers will compare the experimental group, which received early rehabilitation combined with vr training, and the comparison group, which received only early rehabilitation, to see if vr training has clinical benefits when provided alongside early rehabilitation during hospitalization.

early rehabilitation has been shown to enhance outcomes for patients with first-time acute stroke. however, whether the addition of virtual reality (vr) training could further improve muscle strength, functional recovery, and mood state for these patients is unknown. therefore, this study aimed to investigate the effectiveness of early rehabilitation combined with vr training in patients following first-time acute stroke. patients with acute ischemic stroke will be selected and randomly assigned with a 1:1 randomization ratio to either the experimental group or the comparison group. both groups received early rehabilitation, and the experimental group received extra vr training starting 24 hours to 3 days poststroke during the stay in the hospital. muscle strength, functional status, and mood state will be collected before and after the intervention.

Eligibility criteria:
inclusion criteria: * first-time acute infarction (ischemic stroke); * admission to the hospital within three days of stroke onset; * able to communicate with verbal or nonverbal methods and understand mandarin; * had a disability that ranged from minimal to moderately severe disability and evaluated as 1-4 scores by the modified rankin scale (mrs); * agree to be randomized. exclusion criteria: * diagnosis of global aphasia, transient ischemic attack, visual or auditory impairment; * mrs over 5 (severe disability: requires constant nursing care and attention, bedridden, incontinent); * a history of cancer, end-stage renal disease with dialysis, dementia, mental health disorders (particularly major depression), based on both of medical records and assessments from the neurologist; * being unable to participate due to other comorbid neurological and musculoskeletal conditions that produce moderate-to-severe physical disability; * prolonged stay in hospital for over three weeks due to other medical diseases (e.g., myocardial infarction, septic shock, cancer) after admission or length of stay in hospital less than one week due to a decline to treatment and transferred to another hospital for further confirmation of diagnosis and other complementary or alternative therapies.

Keywords: early rehabilitation virtual reality
how common is hypoglycaemia in older people with diabetes who fall?

Conditions: Diabetes; Hypoglycaemia

Summary: the purpose of this study is to use 24 hour continuous glucose monitoring in older patients with diabetes who present with symptoms of falls, or dizziness, or confusion, that may indicate hypoglycaemia.

background and study aims patients with diabetes can be treated with medications (such as insulin or sulfonylureas) that can lower the sugar levels too much (hypos). a hypo means that the brain does not get enough energy. a person can become confused, dizzy, pass out, and/or have a fall. older people with diabetes often seek treatment in hospital for symptoms such as falls, dizziness or feeling muddled. health care professionals will order tests to investigate the possible causes for the fall, being muddled or dizzy, which can include a review of medications, checking blood pressures and the heart. however, it has previously been difficult to obtain 24-hour blood sugar monitoring in older people with diabetes to check if hypos could be an important contributing factor to their falls and dizzy spells. continuous glucose monitoring (cgm) allows non-stop monitoring with a sensor that sits just under the skin. this sends sugar readings to a smartphone every few minutes (via bluetooth) for 10 days. this enables full evaluation of the amount of time a person's sugar is in the target range, and the time in the low/high ranges. medical research with cgm has revealed that some older people are suffering from substantial periods of hypos that they are not aware of. during this study, older people with diabetes will be asked to wear a cgm device for 10 days to investigate possibility of hypos.

Eligibility criteria:
inclusion criteria: * 75 years and older with diabetes * treated with glucose-medications which carry a high risk of hypoglycaemia (sulfonylureas and/or insulin) * presenting to hospital with a fall and/or symptoms suggestive of unrecognised hypoglycaemia (such as dizziness, feeling muddled). exclusion criteria: * treatment with metformin alone * lack of capacity, * not willing to participate, * terminal illness (less than one-year life expectancy). * evidence of bruising, bleeding, cellulitis and/or skin tears on the upper arms or abdomen.
gut microbiota changes in obese individuals undergoing dedicated lifestyle modification programs

Conditions: Obesity

Summary: the human gut microbiota has become the subject of extensive research in recent years, particularly in regards to the role it plays in obesity. although lifestyle factors, diet, and lack of exercise contribute largely to this obesity epidemic, there is increasing evidence that the human gut microbiota also influences weight gain. the investigators hope to learn more information about the change in gut microbiota, especially with regards to those who are successful with weight loss, versus those who don't lose weight, after participating in a lifestyle modification program at the dan abraham healthy living center (dahlc).

the gut microbiome is altered in obesity and is being increasingly studied given its role in energy harvest and fat storage with the hopeful goal of discovering a modifiable intervention to affect obesity and its consequences. mouse models have already shown that transplantation of an obese microbiota into germ-free mice yields increased adiposity compared to transplantation of a lean microbiota. in humans, initial studies looked at the relative proportion of bacteroidetes and firmicutes in obese versus lean individuals and then followed those obese individuals who lost weight on low-calorie diets. the relative proportion of bacteroidetes was decreased in obese people, and this then increased with weight loss. while certainly provocative, the findings were not consistently reproduced. subjects will include members of the dan abraham healthy living center (dahlc) program or the healthy living program (hlp) at mayo clinic rochester, who are seeking advice for weight management concerns.

Eligibility criteria:
inclusion criteria: * adults aged 18 and above; * subjects who are overweight or obese (bmi of 25 or greater); * dahlc/hlp eligible members who are able to access dahlc support services; exclusion criteria: * known diagnosis of inflammatory bowel disease, microscopic colitis, celiac disease or other inflammatory conditions; * antibiotic use within the past 4 weeks (they can be enrolled after a four week washout period and subsequent use during the 6 month study duration does not exclude them); * bowel preparation for colonoscopy within the past week; * pregnancy or plans to become pregnant within the study time frame; * vulnerable adults; * any other disease(s), condition(s) or habit(s) that would interfere with completion of the study, or in the judgment of the investigator would potentially interfere with compliance to this study or would adversely affect study outcomes;
left atrial function after pulsed field ablation of atrial fibrillation

Conditions: Atrial Fibrillation

Summary: introduction: pulsed field ablation (pfa) has emerged in routine clinical practice as a new promising technology in catheter-based treatment of atrial fibrillation (af). the ease of pfa technology enables more extensive ablation in shorter time. on one hand, extensive ablation is advocated to decrease the af recurrence in persistent patients, on the other hand it is an important predictor of developing left atrial stiff syndrome with a reported incidence rate of 3.7 - 8.2 % in persistent patients during the era of radiofrequency ablation. goals of the study: the main hypothesis is that the la function (strain) will tend to decline after extensive pfa. it will be assessed using transthoracic echocardiography (tte) and magnetic resonance (mri). secondary endpoint analysis will include the evaluation of the distribution of late gadolinium enhancement (lge) after ablation compared to baseline scans, evaluation of heart failure biomarkers after ablation, and description of the rate of af recurrence. methods: this project is a prospective, nonrandomised, two-centre (university hospital kralovske vinohrady and university hospital motol) observational study including 50 non-paroxysmal af patients with indication for catheter ablation. before the ablation, all patients will undergo lge mri and tte (after cardioversion if af present). the ablation procedure will be performed using pulsed field technology and will include pulmonary vein isolation, posterior wall ablation and mitral isthmus ablation. patients will be followed for 6 months. 3 months after the ablation, lge mri will be performed. tte examinations will be carried out on the day after the ablation, at 3 and at 6 months. heart failure biomarkers (n-terminal proatrial natriuretic peptide, fibroblast growth factor 23, and galectin 3) levels will be analysed at baseline, and 3 and 6 months after the procedure. ecg holter monitoring will be performed at 3- and 6-months visits.


Eligibility criteria:
inclusion criteria: * non-paroxysmal af with an indication for catheter ablation * age above 18 * signed informed consent exclusion criteria: * contraindication to mri * bmi \> 35 kg/m2 * contraindication to amiodarone * left atrial size \> 60 mm * history of any la ablation * significant valvular disease (mitral regurgitation ¾ or greater, moderate or severe aortic stenosis) * severe pulmonary hypertension * pregnancy

Keywords: atrial fibrillation pulsed field ablation left atrial strain
sensory integration therapy in a sample of children with autism spectrum disorder

Conditions: Autism Spectrum Disorder; Children; Therapy

Summary: the objective of this study is to determine the effects of therapy in sensory rooms with multisensory environment on the severity of autism spectrum disorder and stereotyped and repetitive behaviours in a sample of egyptian children with autism spectrum disorder

autism spectrum disorder is a neurodevelopmental disorder characterized by deficits in social interactions, social communication and stereotyped behaviours associated with sensory disorders occurring before the age of 3. according to dsm-5, sensory processing disorders include hyper-reactivity to sensory stimuli which is an adverse response to sensory stimuli (specific sounds or textures, excessive smells), hypo-reactivity as an apparent indifference to sensory stimuli (pain or temperature-hot/cold) and sensory seeking as a strong desire for sensory intake (touching of objects, visual fascination with lights and movements) or unusual sensory interests in the environment.\] multisensory interactions in spatial processing are investigated with functional neuroimaging and electrophysiological recordings. using fmri, researchers identified candidate multisensory areas by looking for regions of cortex that are activated by visual and tactile stimuli, showing that multisensory processing in the human brain involves the multisensory areas of ''association'' cortex as well as the modality-specific areas of cortex that are specialized for the processing of stimulus features such as colour, shape and texture. ayres sensory integration therapy (asi) is an individualized intervention designed to address the specific underlying sensory-motor issues that may be affecting children's performance during daily routines and activities, including participation within the classroom and in other contexts of the school.

Eligibility criteria:
inclusion criteria: * all patients included in the study are diagnosed with autism spectrum disorder according to dsm-v criteria. * participants have to have a sensory problem in their diagnostic criteria. * age ranges between 3-10 years. (as scope of the study is focused on children) * both males and females. * parents or guardian agreed to informed consent. exclusion criteria: * parents refusing to participate in the research * children with comorbid psychiatric and/or neurological disorder * children with co-morbid sensory deficit, hearing , vision, and motor deficit * intelligence quotient level below 60 * children who scored typical performance in the sensory profile care-giver questionnaire
luteal phase-start ovarian stimulation with corifollitropin alfa

Conditions: Infertility

Summary: to evaluate the effect of random-start of ovarian stimulation initiated in the early follicular or luteal phase on the pharmacokinetics and follicular dynamics and embryo euploidy rates in oocyte donors treated with identical ovarian stimulation protocols with corifollitropin alfa and gnrh antagonist pituitary downregulation

the scope of the current prospective trial is to investigate whether luteal stimulation (ls) results in equivalent euploid embryos with follicular stimulation (fs) in young reproductive age women. the use of the "oocyte donor model" allows extrapolation of the results and application of ls routinely not only in healthy women undergoing fertility preservation but also in all patients irrespective of the menstrual date. this may indeed allow widespread introduction of ls in ivf programs which may result in proper scheduling of ovarian stimulation which is a major issue in everyday clinical practice. given that the pharmacokinetics and follicular dynamics of 150μg corifollitropin alfa for luteal stimulation has never been evaluated, the current study of luteal stimulation with corifollitropin alfa could be very interesting for several reasons: 1. potentially immediate synchronization of oocyte donors with recipients aiming to fresh oocyte donation. 2. fertility preservation patients for medical, oncological and non-medical indication 3. any situation in which endometrial receptivity is not pursued.

Eligibility criteria:
inclusion criteria: 1. healthy eligible oocyte donors 2. age 18-34 years 3. afc \>12 and amh\>1.5 ng/ml 4. bmi 19-28kg/m2 5. body weight \>60kg 6. both ovaries present 7. willing to participate in the study 8. willing to use non-hormonal contraception or not needing contraception recipients will be eligible only if their partners' sperm which will be used for icsi will be normal. couples will be excluded in case of moderate to severe oligoasthenospermia. exclusion criteria: 1. endometriosis 2. afc\>20 3. pcos 4. low ovarian reserve 5. endocrine abnormalities 6. hormonal contraception 7. contraindication of hormonal treatment 8. history of ovarian hyperstimulation syndrome or hyper-response (\> 30 follicles . 11mm)
effect of robot-assisted gait training on gait automaticity in patients with parkinson's disease

Conditions: Parkinson Disease; Gait Disorders, Neurologic

Summary: robot-assisted gait training can improve gait ability of patients with parkinson's disease by repeating a normal gait pattern with high intensity. this study is a feasibility study to investigate whether robot-assisted gait training can be applied to improve walking autonomy in patients with parkinson 's disease.

parkinson's disease is a disease caused by dopamine deficiency in the striatum resulting from the loss of dopaminergic neuronal cells in the cerebral substantia. it is a progressive neurodegenerative disease characterized by motor symptoms including gait disturbance and balance instability. in the early stages of parkinson's disease, dysfunction of the sensorimotor area of the basal ganglia typically occurs, leading to habitual control hurdles. accordingly, cognitive efforts are required to perform habitual tasks such as walking, and the automaticity of walking is reduced. walking performance in a dual-task condition has been used to assess gait automaticity in patients with parkinson's disease. robot-assisted gait training is a method of rehabilitation that repeats normal gait patterns at high intensity. recent meta-analysis has shown that robot-assisted gait training improved the recovery of independent gait after stroke compared with conventional rehabilitation therapy. on the other hand, robot-assisted gait training in parkinson's disease has been reported to improve walking speed and walking endurance compared to conventional physical therapy, but is not superior to treadmill exercise of the same intensity. in addition, it has been reported that in patients with parkinson's disease with balance impairment, robot-assisted gait training can improve balance disorder compared with physical therapy, and gait freezing has improved in some small-scale patients. however, studies on the effectiveness of robot-assisted gait training in parkinson's disease are still lacking, and the mechanism of the effect has not been elucidated. in particular, the effect on gait automaticity, which is a characteristic of parkinson 's disease, has not been studied. therefore, this pilot study is aimed to investigate whether robot-assisted gait training can be applied to improve walking autonomy in patients with parkinson's disease.

Eligibility criteria:
inclusion criteria: * clinically confirmed patients with idiopathic parkinson's disease * hoehn \& yahr stage 2.5 or 3 patients * patients with a mini-mental status examination (mmse) score of 24 or higher exclusion criteria: * patients with severe dyskinesia or on-off fluctuations due to medication * patients who need to change drugs during the study period * patients with sensory abnormalities of the lower limb * patients with vestibular disease or paroxismal vertigo * patients with other neurological or orthopedic disease involving legs, or severe cardiovascular diseases

Keywords: rehabilitation robot-assisted gait training
magnetic resonance (mr) colonography with fecal tagging

Conditions: Colorectal Cancer; Polyps

Summary: the purpose of this study is to determine if mr colonography with fecal tagging is better using air or water for distension of the colon. patients referred to colonoscopy are offered mr colonography before colonoscopy. two days before colonography, patients ingest a 200 ml barium sulfate solution 2% four times a day, which will render fecal masses "invisible" on the following mr colonography. air or water (randomised trial) is used for distension of the colon. the examinations are evaluated by two independent blinded readers.


Eligibility criteria:
inclusion criteria: * suspicion of colorectal polyps or cancer * referred for colonoscopy exclusion criteria: * suspicion of ibd * pacemaker * metal in the body * claustrophobia * pregnancy

Keywords: colorectal polyps colorectal cancer virtual colonoscopy fecal tagging mr colonography
ertapenem versus meropenem/imipenem for esbl+ gram-negative infections

Conditions: Drug Safety

Summary: adult patients with esbl-producing gram negative infections are randomized to receive ertapenem or meropenem/imipenem. clinical and microbiological responses between both groups are compared.

ertapenem is active against esbl-producing gram negative bacteria. this study is conducted to determine if ertapenem is effective against esbl-producing gram negative infections similar to meropenem/imipenem.

Eligibility criteria:
inclusion criteria: * hospitalized patients aged \>18 years with documented esbl +ve gnb infection * receive meropenem or imipenem/cilastatin as empiric antibiotic therapy exclusion criteria: * having been treated with meropenem or imipenem/cilastatin for longer than 72 hours * have active p. aeruginosa co-infection * pregnancy or breast feeding * allergy to carbapenems
macrophage markers, soluble cd163 (scd163) and soluble cd206 (scd206) in paracetamol overdose

Conditions: Drug-Induced Acute Liver Injury

Summary: paracetamol (pcm) is a widely used over-the-counter analgesic, and overdose with pcm is a condition regularly seen in everyday clinical practice. identification of the patients with early signs of liver injury that may develop into acute liver failure is important. previous research has shown that macrophages play a role in the development of liver damage in pcm-induced acute liver failure, making macrophage markers interesting possible biomarkers of this condition. in the present study, the investigators aimed to investigate the extent and timing of macrophage activation in pcm-induced liver injury by measuring levels of macrophage markers scd163 and scd206 in patients admitted with pcm overdose. the investigators also hoped to find out whether these markers are valuable as prognostic markers of severe outcome in these patients. furthermore the investigators examined the possible effect of antidote treatment with n-acetylcysteine on activation and function of macrophages by administering nac to healthy subjects and measuring levels of scd163 and scd206 prior to and after completion of treatment.

the part of the study concerning the patients with pcm overdose was strictly observational with measurement of macrophage markers and no other intervention than the nac treatment administered in the setting of management of the participants pcm overdose according to best clinical practice. the interventional part of the study which is submitted for registration here concerns only healthy controls who were exposed to nac treatment in order to assess the direct effects of nac on macrophages. the participants received nac treatment according to the same protocol as the pcm overdosed patients, and macrophage activation markers were measured prior to and after 16 hours of nac treatment. thus, the involvement of the participants in the study was limited to the 16 hours of nac treatment.

Eligibility criteria:
inclusion criteria: * age 18 to 75 exclusion criteria: * a history of previous illness

Keywords: macrophage activation, n-acetylcysteine, acetaminophen
a comprehensive self-management intervention for individuals with inflammatory bowel disease

Conditions: Inflammatory Bowel Diseases; Ulcerative Colitis; Crohn Disease

Summary: this study aims to test the feasibility, acceptability, and preliminary efficacy of a comprehensive self-management (csm) intervention for people with inflammatory bowel disease (ibd). the csm-ibd intervention is an adaption of the csm intervention initially developed for individuals with irritable bowel syndrome. the intervention has eight sessions which cover an introduction to ibd, symptom tracking, cognitive behavioral strategies, relaxation, sleep, diet, and pain management.


Eligibility criteria:
inclusion criteria: * healthcare provider diagnosis of inflammatory bowel disease * report current symptoms * able to read and write in english exclusion criteria: * live outside of washington state * bowel-related surgery within the past month

Keywords: ibd uc cd