Kornimate/medical-research-clean huggingface dataset:
technology-based analysis of movement disorders

Conditions: Movement Disorders

Summary: objectives: to generate pilot data to investigate the feasibility and the potential use in clinical practice of technology based objective measures of motor performances in patients affected by different movement disorders. to correlate kinematics findings with demographic and clinical details. trial design and methods: participants enrolled in prof. bhatia's movement disorders clinic, will be classifies according to the main movement disorder, specifically, tremor, parkinsonism, dystonia, chorea, ataxia. in the study visit (one day only), they will undergo a clinical evaluation using the appropriate clinical scales (respectively, fahn-tolosa-marin tremor rating scale, mds-updrs part iii, toronto western spasmodic torticollis rating scale 2, unified hungtington disease rating scale and scale for the assessment and rating of ataxia) and a kinematic evaluation, using wearables and an infra-red and led markers system. then the protocol is concluded and they will continue the routine clinical follow-up


Eligibility criteria:
inclusion criteria: * clinical diagnosis of parkinsonism and/or dystonia and/or tremor due to: 1. idiopatic parkinson's disease 2. atypical parkinsonism 3. sporadic or inherited/genetic dystonia 4. young-onset parkinson's disease 5. ataxia syndrome 6. choereic syndrome 7. essential tremor 8. dystonic tremor * 18 to 80 years of age * willing and able to provide informed consent * able to walk unassisted exclusion criteria: * change in pharmacological therapy in the last 3 months. * participated in a clinical drug trial up to 3 months before inclusion into the present study * orthopaedical comorbidities affecting gait or posture. * cognitive deficit
ventilator induced diaphragm dysfunction in pediatric critically ill patients (vidd)

Conditions: Respiratory Failure; Respiratory Distress Syndrome; Mechanical Ventilation Complication

Summary: evaluation of diaphragmatic disfunction eventually occurred in pediatric patient undergoing mechanical ventilation therapy

physician will perform us diaphragm measurements within 36 hours of initiation of mv. measurements will be repeated daily for the duration of mv for the first week, then every 48 hours and 24 hours after the extubation. exposure to and duration of continuous nmba infusion during the course of mv and use of cs will be recorded. ventilator logs and arterial gas analysis will be checked at the time of each us measurement to ascertain ventilator settings and sbf for the 24 hours preceding each us measurement. extubation success will be defined as no requirement for reintubation within 48 hours following extubation. the use of niv immediately after extubation will be decided by the physician in charge according to the patient clinical history (presence of withdrawal syndrome, ect) and not according to dtf measurement.

Eligibility criteria:
inclusion criteria: * patients younger than 18 years old * expected clinical requiring of invasive mv for more than 36 hours exclusion criteria: * neonates * subjects with preexisting diagnoses of neuromuscular weakness * diaphragm paresis * chronic respiratory failure with ongoing requirement for invasive mv, or continuous positive airway pressure (cpap) or bilevel positive airway pressure (bipap) or with likely death within 48 hours.

Keywords: ultrasound assessment diaphragm disfuncion
hippocampal-sparing whole brain radiotherapy for brain metastases from breast cancer

Conditions: Breast Cancer Metastatic; Brain Metastases

Summary: based on evidence that radiation-induced damage to the hippocampus plays a considerable role in neurocognitive decline after cranial irradiation, hippocampal-sparing whole brain radiation therapy (hs-wbrt) has been proposed. this study will investigate the neurocognitive function and prognosis between hs-wbrt and conventional wbrt for the treatment of brain metastases from breast cancer.


Eligibility criteria:
inclusion criteria: * female patients with advanced breast cancer who is confirmed historically. * new developing brain metastases (bm) is confirmed by gadolinium contrast-enhanced magnetic resonance imaging (mri), with or without clinical symptoms and pathology, and without a history of bm treatment. * at least 2 bm lesions with the diameter of the largest lesion \< 40 mm is eligible. and the distance from the border of a mass to the hippocampal margin should be more than 15 mm. * the eastern cooperative oncology group (ecog) is from 0 to 2, and the expected life expectancy is ≥3 months. exclusion criteria: * concurrent chemoradiation. * patient who had received cranial irradiation previously. * patient who are enrolled in other clinical trial at the same time. * patient who has severe co-morbidity or infection.

Keywords: breast cancer brain metastasis whole brain radiotherapy hippocampal avoidance neurocognitive function intracranial failure
surgical tourniquets and cerebral emboli

Conditions: Osteoarthritis; RA; Trauma

Summary: background in 2012 76,497 primary total knee (tkr) replacements were performed in england, wales and northern ireland . traditionally tkr surgery is undertaken with the aid of a surgical tourniquet. a surgical tourniquet is an occlusive device applied around a patient's leg. the tourniquet squeezes the leg (including blood vessels within the leg) and can therefore reduce the amount of bleeding that occurs while it is inflated. an intraoperative tourniquet can therefore help to improve the surgical field of view. although the majority of surgeons prefer to undertake tkr surgery using a tourniquet a small but increasing number are now not pursuing these devices. there is robust evidence that the risk of deep vein thrombosis is increased if a tourniquet is used for tkr surgery. in addition embolic material in the venous system have been observed following tkr surgery and have been noted to be present in the right atrium with transoesophageal (toe) echo intra-operatively. , significant and potentially life threatening emboli have been documented to enter the cerebral circulation via pulmonary arterio-venous shunts and patent foramen ovale (pfo) (27% of patients at autopsy) , . the clinical manifestations of cerebral emboli post tourniquet deflation in tkr are not fully understood. fat embolism syndrome and post-operative confusion in tkr patients may be the result of emboli formed during a tkr. , aim * is there evidence of emboli entering the cerebral circulation following tourniquet deflation in tkr surgery? * is there evidence of mri detectable brain lesions and or any clinical change in cognition compared in patients undergoing tkr surgery with a tourniquet compared to those that do not have a tourniquet?


Eligibility criteria:
inclusion criteria: * i.aged \>18 * ii.undergoing elective tkr * iii.able to give written informed consent * iv.no contraindications to mr imaging exclusion criteria: * i. ages \<16 * ii. not able to give written informed consent * iv. contraindications to mr imaging
the carma technique study

Conditions: Colonic Polyp; Colonic Sessile Serrated Lesion

Summary: colonoscopic removal of polyps is an important and well-established tool in the prevention of colorectal cancers. however, high polyp recurrence rates after endoscopic resection, with resultant development of interval cancers, remains a problem; this most commonly stems from unrecognised incomplete polyp resection. thus, a standardised endoscopic technique is needed that will allow endoscopists to consistently achieve a clear margin of resection. the investigators believe the cap assisted resection margin assessment (carma) technique will address this problem. this novel technique focuses on a standardised assessment of the resection margin after endoscopic polypectomy utilising available standard high-definition video endoscopes with imaging features including narrow band imaging (nbi) and magnification endoscopy.


Eligibility criteria:
patients with colonic polyps will be considered following below criteria inclusion criteria: - any polypectomy (though only a maximum of two polyps from one individual participant) exclusion criteria: * polyps less than 10mm which were resected under endoscopic view with a definite \> 1mm clear margin * scar site recurrence polyps * polyps with endoscopic evidence of invasion * pedunculated polyps * pseudopolyps * participants who will not be available for follow up endoscopy
effects of glucagon like peptide 1 (glp-1) analogues on fluid intake

Conditions: Thirst; Water-Electrolyte Imbalance

Summary: the aim of this study is to elucidate whether glp-1 analogues influence not only appetite but also thirst perception. it is hypothesized that glp-1 analogues reduce fluid intake in healthy volunteers compared to placebo.

glp-1 analogues are well known to stimulate glucose-induced insulin secretion and to reduce energy intake. recent findings from animal and human studies suggest a role of glp-1 in regulating water and salt homeostasis. glp-1 has been shown to reduce fluid intake after an oral salt load or during a meal - pointing to a hypodipsic effect. the aim of this study is to elucidate whether these putative hypodipsic properties of glp-1 analogues reduce fluid intake in healthy volunteers compared to placebo assessed during an evaluation visit of 8 hours.

Eligibility criteria:
inclusion criteria: - age 18 to 65 years exclusion criteria: * known or probable central or nephrogenic diabetes insipidus, based on patient's history * polyuria secondary to diabetes mellitus, hypokalemia, hypercalcemia * primary polydipsia, defined as more than 4 liters fluid intake per day * bmi \ 30kg/m2 * pregnancy * previous treatment with glp-1 agonists within the last 3 month * history of pancreatitis * severe renal insufficiency (egfr (ckd epi) \<30 ml/min/1,73 m2) * cancer
development of a personalized discussion prioritization tool for older adults considering adjuvant chemotherapy for breast cancer

Conditions: Breast Cancer

Summary: the investigators have developed a discussion prioritization tool (dpt) for older adults consider adjuvant chemotherapy that utilizes conjoint analysis (ca) methodology and the objective of the current study is to assess usability of this dpt in the target population, older adults with breast cancer and to adapt the tool to optimize usability for the target population.

given the complexity of adjuvant chemotherapy decision making for older adults with breast cancer, enhancing support and promoting treatment discussions in the context of patient's goals and preferences is an important need. with this need in mind, the investigators have completed interviews with patients with cancer patients who are considering adjuvant therapy. as a result of these interviews, the investigators have developed a common list of attributes (variables found to be important in decision making) that were used to create the discussion prioritization tool (dpt) using conjoint analysis (ca) methodology. ca which is a method that can assess the relative importance that patients place on different aspects of care by asking patients to make a series of trade-offs between competing options. the purpose of this study is to assess the usability of a discussion prioritization tool, administered through a tablet, laptop, or computer, for its ability to aid in treatment decision-making. the investigators would like to gather feedback from individuals to improve and adapt the communication tool.

Eligibility criteria:
inclusion criteria: * age ≥65 * diagnosis of stage i-iii bc * being considered for adjuvant chemotherapy * able to speak and read english * able to participate in study procedures. exclusion criteria: * lacking medical decision-making capacity as determined by their oncologist * evidence of metastatic disease

Keywords: breast cancer discussion prioritization tool (dpt)
a clinical trial for the treatment of depression with repetitive transcranial magnetic stimulation (rtms)

Conditions: Depressive Disorder, Major

Summary: the purpose of this study is to determine whether the cervel neurotech rtms device is safe and effective in the treatment of depression in people who do not get better with antidepressant medications or cannot take antidepressant medications.


Eligibility criteria:
inclusion criteria: * current major depressive disorder (mdd) * resistance or intolerance to antidepressant medication in the current depressive episode, or intolerance to antidepressant medication in a past depressive episode * on a stable psychotropic regimen prior to screening and be willing to maintain the current regimen and dosing for the duration of the study * weight less than 350 pounds exclusion criteria: * current major depressive disorder episode of more than three years * seizure disorder * history of brain injury, stroke or active central nervous system disease * cardiac pacemaker, implanted device (deep brain stimulation) or metal in the brain, cervical spinal cord, or upper thoracic spinal cord unless deemed mri-safe * active suicidal intent or plan * other significant psychiatric disorder * alcohol or substance dependence or abuse * prior treatment with transcranial magnetic stimulation * have failed to clinically remit to an adequate trial of electroconvulsive therapy or vagus nerve stimulation * if female, pregnant or lactating or planning to become pregnant within the next three months

Keywords: depression depressive disorder major depression major depressive disorder mdd treatment resistant depression treatment intolerant depression trmd timd transcranial magnetic stimulation tms
effects of homocysteine in myocardial infarction patients in a tertiary care hospital of pakistan

Conditions: Homocystine; Metabolic Disorder

Summary: raised plasma homocysteine (hcy) was 1st proposed as a cause of vascular pathology in patients with inherited disorders of homocysteine metabolism.leading to the hypothesis that individuals with slight to moderate elevated levels of homocysteine may have an increased hazard for vascular disease. as an amino acid with a reactive sulfhydryl group, homocysteine has been proposed to intermediate vascular inflammation and damage by stimulating oxidative stress secondary to reactive oxygen species accumulation. which in turn leads to an rise in cardiac and vascular disease risk by stimulating endothelial dysfunction, smooth muscle cell proliferation, and vascular calcification. consistent with this hypothesis, hyperhomocysteinemia a has been associated with an increased risk for coronary heart disease (chd), heart failure, atrial fibrillation, stroke, and mortality.

excess of low density lipoproteins, high blood pressure, obesity, excess of blood sugar levels, smoking and sedentary life style are the known modifiable risk factors causing cardiovascular disease specifically coronary disease. there can be some other substances which can additionally affect the human cardiac physiology as well i.e. high levels of homocysteine molecule in the blood. the adverse effects of this component on multiple system of human body are evidenced in the literature since 1962 involving nervous system, brain, renal system, liver functioning, venus system and endothelial system and are still under debate. this biochemical agent has a strong relevance with the physiology of cardiovascular system and causes disturbance in the arterial supply of the heart in young population. homocysteine has been under a lot of discussion it is an amino acid which is synthesized by the demethylation of dietary methionine. it is a highly reactive, sulfur-containing amino acid as a by-product of metabolism of essential amino acid specifically methionine. it was proved to be a strong risk factor causing many cardiovascular diseases, neurological disturbances and other health related issues. homocysteine has a strong relation with the diseases involving hardening of arteries and blood clots related vascular problems.

Eligibility criteria:
inclusion criteria: * aged between 18 and 45 years. * enough ability to complete the blood sampling procedure. * residents lived in the community and can walk to hospital. exclusion criteria: * participants outside the age range. * history of malignancy, infection and other comorbidities

Keywords: blood sedimentation cardiovascular diseases diabetes mellitus homocysteine leukocytes cholesterol
youth nominated support team

Conditions: Psychosis; Suicide; Health Care Utilization; Family Members

Summary: this study aims to adapt the current youth-nominated support team (yst) manual used to treat suicide risk for people at clinical high risk for psychosis.

psychotic disorders are characterized by high rates of suicidal ideation and behavior, and the risk for suicide appears to be greatest during the earliest stages of psychosis. a recent meta-analysis showed that the majority of youth at clinical high-risk (chr) for psychosis experience suicidal ideation, and that approximately one in five make at least one suicide attempt. there are, however, no suicide prevention interventions specifically tailored to the needs of transition-aged youth at chr, and no current best practice guidelines for how to respond to suicide risk in this population. the youth-nominated support team (yst) intervention has recently been shown to reduce mortality among adolescents and is potentially highly adaptable within the context of existing chr services. yst is intended as an adjunctive treatment and is primarily delivered towards support persons rather than the youth themselves, and therefore would not interfere or overlap with the already extensive direct services provided in chr treatment settings. the proposed project intends to adapt the yst intervention for chr populations. specifically, the investigators aim to: (1) adapt yst for chr based on stakeholder input (i.e., clients, family/friends, clinicians) and to develop a new treatment manual and submit an additional irb to cover the next two aims -- (2) to implement yst in a single chr clinic and to revise the intervention based on input from clients, providers, and support person and (3) conduct a pilot randomized clinical trial at four samhsa funded chr sites to test the efficacy of the adapted yst intervention and to identify underlying mechanisms of change. the investigators hypothesize that the revised intervention will be superior to existing practice for the reduction of suicidal ideation and behavior.

Eligibility criteria:
inclusion criteria: * a person with suicidal ideation in the past 3 months or suicidal attempt in the past year * a person who is receiving or has received treatment for psychosis risk symptoms * between the ages of 12-25 exclusion criteria: * cannot have participated in the first 2 phases of the study (focus groups and adaption of the yst-chr manual)
interdisciplinary value-based cognitive behavioral treatment for people with traumatic spinal cord injury

Conditions: Spinal Cord Injury (SCI)

Summary: the goal of this clinical trial is to address the critical need for effective interventions by developing and testing an interdisciplinary values-based cognitive behavioral therapy (v-cbt) program for individuals with spinal cord injury. the main question it aims to answer are: * what is the treatment effect of the interdisciplinary values-based cognitive behavioral therapy (v-cbt) program on individuals with spinal cord injury? * what are the temporal relationships between primary and secondary outcome measures in the context of the v-cbt program? participants will undergo a replicated multiple baselines single-case experimental design (sced). nine participants who meet specific eligibility criteria will be block-randomized to a 1, 2, or 3-week baseline phase, serving as their own controls. the intervention involves an interdisciplinary team delivering a manualized adapted v-cbt program over ten sessions, focusing on psychological and physical rehabilitation. participants will be required to attend these sessions either in person at specialized hospital for polio and accident victims or virtually via secure videoconferencing as part of the treatment protocol. data collection includes daily online self-reports and comprehensive measurements at pre-treatment, post- treatment, and a three-month follow-up.


Eligibility criteria:
inclusion criteria: * be 18 years or older * speak and read danish * aquired spinal cord injury * paraplegia or tetraplegia (either complete or incomplete) * daily pain * therapy-ready and motivated for this treatment type * willing to engage in homework * willing to respond to daily questionnaires * able to attend weekly sessions without payment exclusion criteria: * any red flags during physiotherapeutic examination * acute or sub-acute stage * current pressure ulcers * known and unstable psychiatric disorder * syringomyelia * pregnancy
blood-retinal barrier imaging and neuropsychiatric sequela in type 2 diabetes mellitus

Conditions: Type 2 Diabetes Mellitus; Non-Proliferative Diabetic Retinopathy; Diabetic Macular Edema

Summary: in type 2 diabetes mellitus patients we will: 1. quantify vasculopathy and blood-retinal barrier (brb) leakage 2. measure blood-brain barrier (bbb) permeability and neuroanatomical changes 3. correlate brb pathology with bbb breakdown, inflammatory markers and neuropsychiatric sequela


Eligibility criteria:
inclusion criteria: 1. t2dm patient suffering from non-proliferative diabetic retinopathy (npdr), proliferative diabetic retinopathy (pdr) and diabetic macular edema (dme) who are in the clinical database of the ophthalmologic department , above 18 years old at the time of diagnosis and underwent fa examination in the past three years 2. patients which their medical records are available via a computerized data base control group: 1. t2dm patients who are in the clinical database of the ophthalmologic department 2. above 18 years old at the time of diagnosis 3. underwent fa examination in the past three years and their examination was interpreted as "normal", i.e. without suspected diabetic retinopathy
study evaluating acc-001 in japanese patients with mild to moderate alzheimer's disease

Conditions: Alzheimer Disease

Summary: the study is to evaluate the safety, tolerability and whether there is an immune system response to multiple doses of acc-001 with or without the use of a substance that may increase the response to the drug.


Eligibility criteria:
inclusion criteria: * diagnosis of mild to moderate alzheimer's disease * mini mental status exam (mmse) of 16-26 exclusion criteria: * significant neurological disease * major psychiatric disorder * clinically significant systemic illness

Keywords: phase iia multiple ascending dose study of acc-001