Kornimate/medical-research-clean huggingface dataset:
exploring the optimal timing of minimally invasive surgery for esophageal squamous cell carcinoma

Conditions: Time

Summary: the optimal interval between neoadjuvant chemradiotherapy and esophagectomy is still a question that needs to be explored for patients with esophageal squamous cell carcinoma. in this study, based on previous studies, the investigators divided patients into two groups with a cutoff value of 50 days. by comparing the overall survival and disease-free survival of the entire population and non pcr population, the investigators ultimately obtained the optimal surgical timing suitable for clinical use

background：neoadjuvant chemoradiotherapy has gradually become a first-line treatment for esophageal squamous cell carcinoma patients. after the completion of neoadjuvant chemoradiotherapy, patients usually undergo minimally invasive surgery to ensure complete removal of the tumor and lymphatic tissue. however, the optimal interval between neoadjuvant chemoradiotherapy and minimally invasive surgery is still an unknown factor, and whether it affects postoperative disease-free survival (dfs) and overall survival (os) of patients remains unknown. therefore, the main purpose of this study is to explore the specific impact of the interval between neoadjuvant chemoradiotherapy and minimally invasive surgery on patients, and to find the optimal interval time. methods：patients who underwent neoadjuvant chemoradiotherapy and minimally invasive surgery from two institutions between october 2010 and september 2019 were included in this study. the time interval is defined as the days between the last time a patient receives neoadjuvant chemoradiotherapy and the execution of surgery. based on past research, the interval between the two groups was determined to be 50 days. the main research result is the os and dfs of different interval groups in the overall population and non-pcr population. a multivariate cox regression model was established to determine the main factors affecting patient's os and dfs.

Eligibility criteria:
inclusion criteria: * (i) thoracic escc * (ii) no history of concomitant or prior malignancy * (iii) completed one cycle of ncrt * (iv) received endoscopic radical surgery for esophageal cancer exclusion criteria: * (i)other histological subtypes * (ii)received esd treatment * (iii) radiation dose greater than 50gy * (iv) metastatic esophageal squamous cell carcinoma
study of fk463 for the treatment of invasive aspergillosis

Conditions: Aspergillosis

Summary: the purpose of the study is to evaluate the safety and efficacy of fk463 in patients with proven or probable invasive infections due to aspergillus species.

this will be an open-label, non-comparative study of intravenous fk463. enrollment will include at least 100 patients evaluable for efficacy.

Eligibility criteria:
inclusion criteria * has proven or probable systemic infection with aspergillus species exclusion criteria * has abnormal liver test parameters, e.g., ast or alt \> 10 times upper limit of normal * has bronchopulmonary aspergillosis, aspergillomas, sinus aspergillosis or external otitis but does not have histologic evidence of tissue invasion * has life-expectancy judged to be less than 5 days

Keywords: aspergillus anti-fungal
white matter hyperintensities subtypes in cerebral small vessel disease : 7 tesla ultra-high resolution imaging mri

Conditions: Cerebral Small Vessel Diseases

Summary: cerebral small vessel diseases (svd) are a very frequent group of disorders all characterized by alterations of the structure and/or function of small arteries, veins and capillaries. in these disorders, brain tissue lesions accumulate years before the occurrence of clinical symptoms which can be devastating such as stroke, cognitive disturbances and gait disorders. so far, chronic hypoperfusion was considered to be responsible for the accumulation of such lesions. however, recent results have suggested that the lesions underlying white matter hyperintensities (wmh), the most common mri marker of svd visible on conventional mri in quite every subject with svd long before the occurrence of clinical events, may depend on the considered brain area and may correspond to various mechanisms. some wmh may even be associated with less severe clinical manifestations.the aim of the present study is to identify different types of wmh by studying 100 patients with different forms of svd with the most advanced mri (including ultra-high-resolution imaging at 7 tesla, new diffusion protocol, sodium mri, contrast-enhanced angiography and relaxometry and post-processing techniques), and post-processing techniques (machine learning, deep learning, artificial intelligence).


Eligibility criteria:
inclusion criteria: * subjects or patients with mri defined cerebral small vessel disease including different extents of white matter hyperintensities, presumably related to hypertension (30 patients), cerebral amyloid angiopathy (30 patients), cadasil (30 patients) or any other monogenic form of cerebral small vessel disease (htra1 ad, coliva1... 10 patients) * age ≥ 18 years * no dementia (mmse \> 24 and absence of dependence in daily activities) * no disability (modified rankin's scale \< 2) * no history of severe allergic reaction, in particular to gadolinium infusion * no history of severe asthma * no renal insufficiency (clearance \< 60 ml/mn/1.73 m2) exclusion criteria: * contraindications to mri * standard mri of bad quality due to movement artefacts * dementia or disability * patient without affiliation to the french social security
ai-supported occupational therapy for handwriting

Conditions: Occupational Therapy

Summary: aim: this study investigates the impact of an ai-supported occupational therapy program, developed using the model of human occupation (moho), on handwriting skills in children at risk for developmental coordination disorder (dcd). method: a randomized controlled trial was conducted with 42 children aged 8-12 years, identified as being at risk for dcd using the developmental coordination disorder questionnaire (dcdq). participants were randomized into an intervention group (n=21) and a control group (n=21). the intervention group received an ai-supported occupational therapy program twice weekly for 8 weeks. handwriting performance was assessed pre- and post-intervention using the minnesota handwriting assessment (mha). keywords: artificial intelligence, occupational


Eligibility criteria:
inclusion criteria: 1. being between the ages of 8-12 years 2. being at risk for dcd according to the developmental coordination disorder questionnaire (dcdq) 3. having the ability to understand the questionnaires 4. continuing formal education 5. having similar motor skill performance (having similar results from the bruininks-oseretsky motor proficiency test 2 brief form (bot2-bf)) and having similar visual perception level (having similar results from the motor-free visual perception test-3(mvpt-3) exclusion criteria: (1) having another neurodevelopmental, orthopedic and chronic problem (2) continuing any rehabilitation program -

Keywords: artifical intellegence occupational therapy developmental coordination disorders handwriting rehabilitation
paf-heft (permanent atrial fibrillation in heart failure trial)

Conditions: Atrial Fibrillation; Heart Failure

Summary: examination of crt efficacy in patients with progressive heart failure and atrial fibrillation at the same time


Eligibility criteria:
inclusion criteria: * lvef \<35% * qrs time ≥150ms lbb * nyha classification ≥ nyha iii * permanent (\> 6 months) atrial fibrillation * sinus rhythm (control group) * condition after implantation of a medtronic crt device * written informed consent exclusion criteria: * exchange of the current crt device * mitral incompetence (2. degree) * no compliance * participation in another study * pregnancy * patients with av node * patients after heart transplant or those who are on the transplant list

Keywords: atrial fibrillation heart failure
study of clinical and immune severity profiles of patients infected with sars-cov2 (covid-19)

Conditions: Respiratory Tract Infections; Respiratory Tract Disease

Summary: the sars-cov2 virus causes severe or even fatal disease in a fraction of infected people. the clinical severity is based on a complicated pneumopathy with acute respiratory distress syndrome that can lead to multi-visceral failure. the underlying mechanism is a cytokinergic storm, an emerging facet of immunological dysregulation. this clinical trial is aimed to understand the mechanisms of this immunological dysregulation in order to identify therapeutic levers. the main objective is to understand the relationships between clinical severity, death or morbidity of resuscitation management, and immune status (i.e., immune pathways activated or not). immune status will be investigated at many levels of organization (i.e., circulating leukocytes, cytokines and chemokines, transcripts). the secondary objectives are : * to understand what is responsible for clinical severity, viral load, or immune activation; * to highlight the consequences of immunological dysregulation on associated risks (i.e., immunosuppression leading to the emergence of infectious comorbidities) as well as the functioning of neurotransmission through metabolic pathway diversions. the impact of dysimmunity on these biological pathways will be assessed with a metabolomic analysis; * to understand the mechanisms of vulnerability related to the field. moreover, while co-morbidities are likely to be a risk factor for severe disease progression, there are many situations in which they do not occur. stress, with its neurovegetative and endocrinological dimensions, modulates the immune response. it is essential to know whether the stress response plays a role in immunological dysregulation. this analysis is a prerequisite for understanding the conditions of treatment with glucocorticoids. angiotensin converting enzyme type 2 (ace2) also plays a likely role in host viral infection. it is also thought to play an important role in the emergence of severe syndromes by affecting the quality of vascular response.


Eligibility criteria:
inclusion criteria: * patient admitted to intensive care unit with confirmed sars-cov2 infection * patient older than 18 years old exclusion criteria: * patient coming from another intensive care unit after more than 5 days in the intensive care unit * known immunosuppression: * known or suspected hiv * known or suspected immunosuppression : * organ transplantation * marrow transplant * congenital deficit * received immunosuppressive therapy within 30 days (azathioprine, methotrexate, tacrolimus, cyclosporine, sirolimus, cyclophosphamide, rituximab, anti-tnf, jak inhibitors, corticosteroids \>10mg/day over the last 30 days, recent covid-19 corticosteroid therapy \>1mg/kg prednisolone or equivalent \>5 days) * administration of chemotherapy within the last 3 months * current pregnancy or breastfeeding * patient under 18 years of age * incapacitated adults and persons deprived of their liberty * refusal by the patient or his/her support person
prospective trial of two hypofractionated radiotherapy regimens versus conventional radiotherapy in diffuse brainstem glioma in children

Conditions: Pediatric Brain Stem Glioma

Summary: this trial offers a reduction in patient burden, which is especially preferable in children with a poor compliance and poor performance status. this prospective randomized trial was extension to the previous controlled prospective study performed in children's cancer hospital, egypt and registered at clinicaltrials.com (nct01635140). the ultimate aim of this work is to demonstrate noninferiority of the hypofractionated regimens relative to the conventional regimen in a controlled randomized clinical study.

in this study will add a third arm in which we will increase in the total dose to 4500 cgy in 15 fractions in 3 weeks may lead to improvement in over-all survival or progression-free survival.

Eligibility criteria:
inclusion criteria: 1. newly diagnosed patients with a diffuse intrinsic brainstem glioma 2. aged 2-18years, 3. have symptoms for less than 3 months and at least two findings of the neurologic triad: cranial nerve deficits, ataxia, or long tract signs. 4. no performance criteria were required for entry onto the study. exclusion criteria: * children were not eligible if they had received any prior therapy other than steroids treatment

Keywords: diffuse intrinsic pontine glioma (dipg) hypofractionated radiotherapy radiotherapy median survival
extension study of long-term safety and efficacy of pregabalin as monotherapy (lyrica) in patients with partial seizures

Conditions: Epilepsy

Summary: this study will evaluate the long term safety and efficacy of pregabalin (lyrica) when administered by itself (without any other anti-epileptic medication) to epilepsy patients for the treatment of partial seizures. this is an extension study to a previous clinical trial.


Eligibility criteria:
inclusion criteria: * completed the previous protocol and wish to continue to receive pregabalin. * diagnosis of epilepsy with partial seizures exclusion criteria: * early withdrawal from the previous protocol, an episode of status epliepticus, or primary generalized epilepsy.

Keywords: open-label extension study pregabalin partial epilepsy
customized foot orthoses with orthotic wedges for plantar heel pain

Conditions: Foot Orthoses; Fasciitis, Plantar

Summary: the present study will use a randomized controlled trial (rct) to determine the effectiveness of customized foot orthosis (cfo) for the treatment of patients with php. three treatment groups including the cfo without wedge, the cfo with wedge type 1 (w1), and the cfo with wedge type 2 (w2) will be randomly assigned to each participant by a computer-generated randomization. the opaque-sealed envelopes will be used to allocate the groups of participant.

participants will be allocated to the control (cfo without wedge) or experimental (cfo with w1 or w2) groups according to the seal-envelop randomization technique. then, they will be assessed all outcomes for the baseline including pain intensity, foot function, plantar fascia thickness, balance outcomes, and gait parameters by the 2nd physical therapist. and the participants will receive the assigned treatment by the 1st physical therapist. all participants will be asked to use the cfo in daily life during weight-bearing activities, and logbook, chat line, or phone call will be used to monitor the participants during the treatment program. they will be asked about activity they done in daily and a number of hour they used cfo per day in diary book. at least 4 hours per day of wearing cfo will be required to each participant. after 3 months, and 6 months of the cfo use, all outcomes will be re-assessed by the 2nd physical therapist. and such outcomes will be then statistically analyzed.

Eligibility criteria:
inclusion criteria: * reaching the specific criteria of php including * a complaint of tenderness from the palpation of the medial calcaneal tubercle and the medial aspect of the proximal portion of the plantar fascia, or pain along the plantar fascia at medial longitudinal arch side * the presence of heel pain immediately during the first few steps of walking in the morning or after a prolonged period of inactivity; and gradually decreased throughout the day with ordinary walking, and worsened with prolonged activity * having the symptom of heel pain for at least 6 weeks, indicates the chronic condition * having the maximum level of pain intensity during last week using the visual analog scale (vas) at least 3 out of a full 10 scores exclusion criteria: * having positive sciatica test, indicating the l5-s1 nerve root irritation * having a history of lower extremity fracture * having a history of lower extremity surgery * having been diagnosed with gout, diabetic neuropathy, rheumatoid arthritis, systemic lupus erythematosus (sle), cancer, infectious disease, and tumor
optimizing gait biomechanics for posttraumatic osteoarthritis prevention

Conditions: Anterior Cruciate Ligament Injuries; Post-traumatic Osteoarthritis; Knee Osteoarthritis; Knee Injuries; Cartilage, Articular; Gait

Summary: the purpose of this study is to report the feasibility and determine the initial effects of 18 sessions of real-time gait biofeedback delivered over a 6-week period on retention and transfer of normalized gait biomechanics and improvements in indicators of early post-traumatic osteoarthritis development in those with an anterior cruciate ligament reconstruction (aclr) at 6 and 8-week posttests.


Eligibility criteria:
inclusion criteria: * have completed all other formal physical therapy * are between the ages of 18 and 35 * underwent an aclr between 6 and 24 months prior to enrollment. * demonstrate underloading during gait (vgrf- impact peak \<1.09 x bw) * demonstrate clinically relevant-knee symptoms (koos-qol \<72) * have undergone aclr surgery exclusion criteria: * aclr revision surgery * a multiple ligament surgery * a lower extremity fracture * knee osteoarthritis * the participant has a bmi ≥ 36.

Keywords: biofeedback
fast-track perioperative program for laparoscopic colorectal surgery

Conditions: Colorectal Cancer

Summary: background: laparoscopic colorectal surgery has been shown by randomized trials to be associated with better short-term clinical outcomes when compared with open surgery. however, in a traditional perioperative care setting, the reduction in hospital stay following laparoscopic surgery in these trials was modest. fast-track perioperative programs have been introduced in the west to optimize perioperative factors to reduce the physiological/psychological stress of open colorectal surgery. however, few studies have evaluated the impact of fast-track programs on the outcomes after laparoscopic colorectal surgery. objective: to compare the clinical and immunological outcomes of hong kong chinese patients undergoing laparoscopic surgery for colorectal cancer with a "traditional" vs. a "fast-track" perioperative program. design: prospective randomized trial. subjects: one hundred and twenty-eight consecutive patients undergoing elective laparoscopic resection of non-metastatic colonic and upper rectal cancer will be recruited. interventions: patients will be randomized to a "traditional" or a "fast-track" perioperative program. outcome measures: primary outcome: total postoperative hospital stay, including hospital stay of patients who are readmitted within 30 days after surgery. secondary outcomes: immunological parameters (including systemic cytokine response and cell-mediated immune function), morbidity and mortality, quality of life, and medical costs.


Eligibility criteria:
inclusion criteria: * consecutive patients undergoing elective laparoscopic resection of colonic and upper rectal cancer, * age of patients between 18 and 75 years * patients with american society of anesthesiologists grading i-ii * patients with no severe physical disability * patients who require no assistance with the activities of daily living * informed consent available exclusion criteria: * patients undergoing laparoscopic low anterior resection with total mesorectal excision, abdominoperineal resection, or total/proctocolectomy * patients with planned stoma creation * patients undergoing emergency surgery * patients with known metastatic disease * patients with previous history of abdominal surgery * patients with known immunological dysfunction * patients who are taking steroids or immunosuppressive agents * patients with chronic pain syndrome

Keywords: laparoscopic surgery
the relationship between nlr and ponv and espb

Conditions: Erector Spinae Plane Block; Neutrophil to Lymphocyte Ratio

Summary: this study aims to investigate whether preoperative nlr (neutrophil-to-lymphocyte ratio) serves as a biomarker for ponv (postoperative nausea and vomiting). it also examines the impact of erector spinae plane block on nlr and ponv. furthermore, the research explores the effect of erector spinae plane block on postoperative pain relief in spinal surgery and its influence on the usage of opioid medications.


Eligibility criteria:
inclusion criteria: 1. patients undergoing elective posterior lumbar spine surgery in a prone position under general anesthesia. 2. asa classification grades i to ii. 3. age between 18 and 80 years old. 4. signed the informed consent for this study. exclusion criteria: 1. preoperative blood transfusion. 2. uncontrolled systemic diseases. 3. gastrointestinal system disorders. 4. history of antiemetic and anticholinergic drug use. 5. adverse reactions related to surgery. 6. severe spinal deformities. 7. infection at the puncture site. 8. coagulation disorders. 9. long-term use of sedatives and analgesic drugs before surgery. 10. patients with mental illness or communication barriers. 11. allergic to ropivacaine. 12. participants involved in other clinical studies within the past 3 months. 13. history of previous lumbar surgeries. 14. subjective unwillingness to participate in this study.

Keywords: neutrophil to lymphocyte ratio postoperative nausea and vomiting erector spinae plane block postoperative analgesia lumbosacral spine surgery
procellera and negative pressure therapy for acute wounds

Conditions: Wound

Summary: the purpose of this study is to determine if procellera speeds wound healing. the study will examine colonization (bacterial growth), pain and pain medication and reduced cost of care by using procellera (an antimicrobial agent) under negative pressure therapy placed on the wound after abdominal wall surgery. procellera is a single layer dressing that helps to kill germs that cause infections. negative pressure therapy is a vacuum device with a sponge that is placed in your wound to help heal the wound faster.

the study will consent 30 patients undergoing surgery through the abdominal wall and the skin incision will intentionally be left open. subjects will be randomized using a random number generator. each number will be placed in an envelope numbered 1-30. arm 1 will be even numbers and arm 2 will be odd numbers. a researcher not affiliated with the study will generate the numbers and place them in the envelopes. arm 1 will place fifteen subjects on negative pressure therapy only and arm 2 will place fifteen subjects on negative pressure and procellera. arm 1 (negative pressure only) will have their dressing changed 3 times per week which is the standard of care for negative pressure therapy. arm 2 (negative pressure therapy and procellera) will have their dressing changed every 5 days. arm 1 and 2 will have a tissue specimen taken on the 5th day only. the tissue will be taken from debrided material and sent for culture. the negative pressure therapy sponge, which is discarded after each dressing change, will be collected, lavaged with saline and the cells will be examined for macrophage function and the wound fluid will be tested for inflammation response. photographs, wound measurements, pain scale and pain medication will also be completed at each dressing change. we will check the progress of the wound along with your surgeon during the subject's 30 day surgical follow up in the surgeon's office. the wound will be measured (if not healed), photograph's taken and their pain level assessed.

Eligibility criteria:
inclusion criteria: * 18 years old that are undergoing abdominal wall surgery exclusion criteria: * below 18 years old and not having abdominal wall surgery

Keywords: procellera