Kornimate/medical-research-clean huggingface dataset:
system-level monitoring of immune activation concerning susceptibility to sepsis in trauma patients

Conditions: Trauma; Sepsis

Summary: sepsis remains a common entity in critical care patients with remarkable mortality. despite extended research activities, no reliable bio-markers or scoring systems attributing the individual risk of developing sepsis have been found so far. patients with multiple trauma are at high risk of developing sepsis. due to local and systemic immune reactions, high plasma levels of known pro-inflammatory cytokines can be found. simultaneously, certain anti-inflammatory reactions such as changes in immune cell activity and serum cytokine levels, known as "compensatory anti-inflammatory response syndrome" (cars) take place. in addition to changes of cytokine levels and immune cell activity, underlying genetic reactions are present. for instance, expression of mirna (as an potential important step of immune cell activation) is likely changed during systemic and local immune reactions. in the present study levels of pro- and antiinflammatory cytokines, a detailed assay of immune cell activation and the various expression of mirna will be evaluated in patients of multiple trauma on day 1 and day 4. additionally, clinical parameters of organ function, current infection markers as crp and procalcitonin, cardiovascular function such as indocyanin clearance and hemodynamic measures delivered with picco-system and heart rate variability will be assessed. parameters of local tissue perfusion will be measured with transcutaneous laser doppler.


Eligibility criteria:
inclusion criteria: * multiple trauma, * iss \> 16 exclusion criteria: * resuscitation * pregnancy * malignancy * chronic renal insufficiency * steroid intake

Keywords: sepsis immune cells immune reaction trauma immune activation
effect of obesity on tear film and ocular health among diabetic patients

Conditions: Tear Film Deficiency

Summary: to evaluate the effect of obesity on tear film and ocular health in diabetic patients. research design an observational cross-sectional study will be conducted.


Eligibility criteria:
inclusion criteria: * adults (18+ years) * diagnosed with type 1 or type 2 diabetes * categorized as obese or non-obese (bmi \>30 or \<30) * stable glycemic control, and willing to provide consent. exclusion criteria: * non-diabetic individuals * pregnant/lactating women * those with recent ocular surgeries * systemic medications affecting tear film, or severe unrelated diseases.
topical cannabis for chronic musculoskeletal pain

Conditions: Chronic Pain; Musculoskeletal Pain; Joint Pain

Summary: our proposal objective is to evaluate if state-regulated topical cbd-based products relieve chronic musculoskeletal pain and/or absorb into the bloodstream.

the goal of this study is to learn more about the analgesic efficacy of state-regulated topical cannabinoid products (creams, lotions, salves, etc) and to determine if these topical products are absorbed systemically and can be detected in blood samples. given that state-regulated dispensary products cannot be brought onto the university campus, this observational study design utilizes a mobile pharmacology laboratory that will go to study participants' homes. blood samples and other assessments will taken in the mobile lab prior to use of a topical cannabinoid product and at several time points afterwards (4 hours, 24 hours, and 2 weeks). participants will also collect microsamples of blood using a small device at home at three time points during the first 2-72 hours after application of the product.

Eligibility criteria:
some inclusion/exclusion criteria are purposely omitted at this time to preserve scientific integrity. they will be included after the trial is complete. inclusion criteria: * chronic peripheral joint pain * desire and intent to use a topical cannabinoid product containing cannabidiol (cbd) or a combination of cbd and tetrahydrocannabinol (thc) to alleviate this pain exclusion criteria: * current or prior use of topical cannabis * unwilling or unable to discontinue other (non-topical) cannabis use for four weeks prior to and during study participation through week two * intent to use a thc-predominant topical product (ratio greater than 1:1 of thc to cbd) * current or history of substance use disorder * history or diagnosis of schizophrenia, bipolar or a psychotic disorder * surgery on the affected musculoskeletal location within the 3 months prior to enrollment * planned surgery or procedure on the affected musculoskeletal location during participation in the study * allergy or prior severe adverse reaction to cannabis (cardiovascular event, psychosis, etc) * current or prior cannabis abuse/dependence * cognitive disability that interferes with ability to provide consent or understand study procedures * history of seizure disorder * pending legal action or workers compensation * pregnant females or females intending to become pregnant during the study period * lactating females * chronic/severe medical illness (renal disease, liver disease, cancer, significant cardiovascular disease, or history of myocardial infarction) * active component military

Keywords: topical cannabis
the effect of exercise training on mental stress-induced silent ischemia

Conditions: Myocardial Ischemia

Summary: coronary artery disease (cad) remains the leading cause of death in the elderly. silent myocardial ischemia (si) is a manifestation of cad in which there is a transient alteration in myocardial perfusion, function, and/or electrical activity not accompanied by chest pain. mental and emotional stress, in particular hostility and anger are potent inducers of si, individuals with si are at a 3-5 fold higher risk for the development of angina, myocardial infarction and death than subjects without si.

the hypothesis of this study is that older individuals with occult cad, mental stress/ emotional arousal (anger) increases sympathetic nervous system activity resulting in vasoconstriction thereby eliciting transient episodes of si. therefore an aerobic exercise intervention that reduces the response to anger/hostility and improves vascular compliance will decrease the ischemic burden in si patients. the specific objectives are: to determine if non-smoking older individuals with exercise-induced si have increased vasoreactivity (blood pressure, heart rate) responses to the laboratory presentation of mental stressors, decreased vascular compliance and brachial artery endothelial reactivity compared to matched non-ischemic controls; 2) to perform a randomized clinical trial that will examine the effects of 9 months of aerobic exercise training versus usual care on vasoreactivity, vascular compliance and ischemic burden on holter monitor. older individuals without a history of overt cad will be recruited and evaluated for the presence of exercise-induced si. baseline cross-sectional comparisons of vasoreactivity and cardiovascular function will be performed between those with si and non-ischemic controls. the individuals with si will be enrolled in a randomized clinical trial of exercise vs usual care. exercise treadmill testing with measurement of maximal aerobic capacity will be used to determine fitness. vasoactivity will be quantified during a mental stress test with real time 2d echo imaging. vascular function will be assessed using high frequency ultrasound measurements of flow-mediated brachial artery endothelial reactivity.

Eligibility criteria:
older individuals without a history of overt cad.
strategy training on improving executive functions in persons following acquired brain injury

Conditions: Cognitive Impairment; Stroke; Acquired Brain Injury

Summary: about two-third individuals with acquired brain injury (abi) experience cognitive impairments. deficits in executive functions is one of the most prevalent cognitive impairments following abi which result in decline of recovery and independence. lack of intervention shows evidence of immediate and long-term effect on executive function which is critical after returning to the community. the overall aim of this study is to examine the efficacy of strategy training intervention on executive functions and participation on community-dwelling people with abi. findings of the study will provide unequivocal evidence on the duration of effectiveness of strategy training and support the development and application of the program in rehabilitation practice.

the study will use a double-blinded, parallel-group randomized controlled trial to assess the efficacy of the strategy training intervention program in comparison to the control group. the investigators will recruit community-dwelling individuals with abi in outpatient rehabilitation units and randomly assign them to the intervention group and the control group at a 1:1 ratio. participants in the intervention group will receive strategy training 2 times per week for 10-15 sessions and participants in the control group will receive dose-matched non-active intervention carried out by a trained therapist. these efforts will allow the investigators to address the gap in rehabilitation research by demonstrating the effectiveness of strategy training on rebuilding and maintaining executive functions and lessening disability. this evidence will be important for rehabilitation practitioners to provide effective treatment to patients with cognitive impairments and will contribute to the improvement of quality of care of rehabilitation services.

Eligibility criteria:
inclusion criteria: * ages 20 years and older * has a diagnosis of acquired brain injury * understand mandarin * has cognitive impairment * provide informed consent exclusion criteria: * have severe aphasia * have a pre-stroke diagnosis of dementia, current major depressive disorder, substance use, or other psychiatric disorders that may impede them from continually participating in the study.

Keywords: stroke cognition rehabilitation
evaluation of a scalable decision support and shared decision making tool for lung cancer screening

Conditions: Early Detection of Cancer; Lung Neoplasms

Summary: the purpose of this project is to increase appropriate low-dose computed tomography (ldct) lung cancer screening through the development and wide dissemination of patient-centered clinical decision support (cds) tools that (1) are integrated with the electronic health record (ehr) and clinical workflows, (2) prompt for shared decision making (sdm) when patients meet screening criteria, and (3) enable effective sdm using individually-tailored information on the potential benefits and harms of screening. the study will promote standard of care that is endorsed by the centers for medicare \& medicaid services (cms) and the us preventive services task force (uspstf).

the purpose of this project is to increase appropriate low-dose computed tomography (ldct) lung cancer screening through the development and wide dissemination of patient-centered clinical decision support (cds) tools that (1) are integrated with the electronic health record (ehr) and clinical workflows, (2) prompt for shared decision making (sdm) when patients meet screening criteria, and (3) enable effective sdm using individually-tailored information on the potential benefits and harms of screening. the study will promote standard of care that is endorsed by the centers for medicare \& medicaid services (cms) and the us preventive services task force (uspstf). this project is supported both operationally and by an agency for healthcare research and quality (ahrq) r18 grant. this project will leverage decision precision, a validated web-based tool for ldct sdm developed at the veterans health administration, as well as an initial version of decision precision+, an ehr-integrated version of the tool which can be accessed directly in the ehr and auto-populate relevant patient data in the tool instead of requiring manual data entry. this study will be an 18-month interrupted time series study conducted at the university of utah health primary care clinics.

Eligibility criteria:
inclusion criteria: * receives care at university of utah primary care clinics; * does not already have lung cancer; * meets uspstf criteria for ldct screening (currently, age \>= 55 years and \<= 80 years old at the time of the visit; 30+ pack-year smoking history and current smoker or quit in the past 15 years). exclusion criteria: * none

Keywords: lung cancer screening clinical decision support shared decision making
tumor hypoxia and proliferation in patients with high-grade glioma

Conditions: Glioma

Summary: this is a pilot study to assess a new methodology developed for high grade glioma (hgg). fmiso pet (fluoromisonidazole-pet) allows researchers to study whether tumor cells lack oxygen (hypoxia). flt pet (fluorodeoxythymidine-pet) allows researchers to study the increase in the number of cells as a result of cell growth and cell division (proliferation). tumors that have low oxygen levels and/or are dividing fast shall resist to standard cancer treatment. the study will compare fmiso pet and flt pet imaging techniques with molecular biomarkers of hypoxia, angiogenesis, and cellular proliferation in tissue. proliferation).this information could help researchers develop new treatment techniques to better treat cancer.

this is a pilot study to assess a novel methodology recently developed to simultaneously image tumor hypoxia and proliferation by means of simultaneous fmiso and flt pet acquisition. fmiso (18f-fluoromisonidazole) pet is a non-invasive method for detecting tumor hypoxia in solid tumors. flt (3'-deoxy-3'\[(18)f\]-fluorothymidine) pet is a non-invasive method to image cell proliferation rate. imaging of tumor hypoxia and proliferation with fmiso and flt pet respectively are two very well established techniques in in high-grade glioma. the long-term goal of this proposal is to establish clinically robust methodology to simultaneously image multiple tumor hallmarks. the central hypothesis is that combined information from multiple tumor hallmarks will offer complementary information about the underlying physiological processes, and will yield synergistic prognostic and predictive values. the rationale is that these findings will enhance the understanding of the underlying biology and pathophysiology, and will open new therapeutic strategies to target radioresistant and highly aggressive regions within the tumor, as well as aiding in the development of imaging theragnostics. the method used in this proposal is based on our previous work on simultaneous imaging of fmiso/flt pet, and is facilitated by prior knowledge of the tissue pharmacokinetics, and an ability to distinguish the two radiotracers fractions in blood by thin-layer chromatography (tlc). the study will compare fmiso and flt imaging findings with those from molecular biomarkers of hypoxia, angiogenesis, and cellular proliferation in tissue.

Eligibility criteria:
inclusion criteria: * male or female ≥ 18 years of age * documentation of a suspected hgg diagnosis based on clinical and mri findings exclusion criteria: * pregnant or breastfeeding * contraindications to receiving positron emission tomography (pet) imaging (e.g. claustrophobia)
stereotactic pelvic brachytherapy with hdr boost for dose escalation in high tier intermediate and high risk prostate ca

Conditions: HIGH RISK PROSTATE CANCER

Summary: hdr brachytherapy in conjunction with pelvic sabr in high tier intermediate and high risk prostate cancer patients can provide a safe and effective means of radiotherapy dose escalation. utilizing multiparametric mri to focally boost the dominant intraprostatic lesion during hdr brachytherapy is safe and feasible.

hdr brachytherapy: under general anesthetic, prostate will be implanted transperineally using up to 18 catheters. three gold seed fudicials will also be implanted transperineally at base, midgland and apex forsabr treatment. prostate will be contoured as clinical target volume (ctv) on the transrectal ultrasound (trus) based oncentra planning system. rectum and urethra will be contoured as organs at risk. 15gy will be prescribed to ctv as the mpd (minimal peripheral dose). treatment delivery-sabr there will be a 2 week interval between hdr and sabr component to allow for normal tissue recovery and radiotherapy planning time. daily image guidance will be performed using the implanted fiducials to calculate patient shifts to ensure proper positioning. post-treatment images will be taken to estimate intrafraction motion. androgen deprivation therapy twelve to 18 months of luteinizing-hormone releasing hormone agonists (lhrha) will be used. anti-androgen and neoadjuvant lhrha can be used according to physician discretion follow-up and toxicity assessment time zero will be the start of radiotherapy. baseline rectal and urinary function will be recorded using common toxicity criteria adverse effect (ctcae v3.0) and expanded prostate cancer index composite (epic). ctcae v3.0 and epic assessments will be done at weeks 3, 5 and 12 weeks. bloodwork (psa and testosterone), quality of life (epic) and late gi and gu toxicity evaluation (using the rtog/eortc late radiation morbidity scheme) will be performed every 6 months for the first 5 years.

Eligibility criteria:
inclusion criteria: * informed consent obtained * men \>18 years * histologically confirmed prostate adenocarcinoma (centrally reviewed) * high tier intermediate risk defined as : clinical stage t1-t2c and psa 10-20ng/ml and {psa\>10ng/ml and (t2b-2c or gleason 7)} or gleason 4+3 -high-risk prostate cancer, defined as at least one of: clinical stage t3, or gl 8-10, or psa \> 20 ng/ml inclusion criteria: * prior pelvic radiotherapy * anticoagulation medication (if unsafe to discontinue for gold seed insertion) * diagnosis of bleeding diathesis * large prostate (\>50cm3) on imaging * no evidence of castrate resistance (defined as psa \< 3 ng/ml while testosterone is \< 0.7 nmol/l. patients could have been on combined androgen blockade but are excluded if this was started due to psa progression. * definitive regional or distant metastatic disease on staging investigations.
hirschsprung's disease: surgical techniques and quality of life

Conditions: Quality of Life

Summary: this is an observational study examining the long-term quality of life in patients with hirschsprung's disease in relation to the choice of surgical technique.

hirschsprung's disease (hd) is a developmental defect causing functional obstruction of bowel. it is a condition that almost always requires surgical intervention. this study aims to examine the relation between quality of life and surgical technique in patients with hirschsprung's disease in hopes of providing insight into advantages and disadvantages of different surgical techniques employed at ouh, department for general surgery in the time between 1985 and 2012. this will be done based on answers given on a set of validated questionnaires that has been sent to all patients diagnosed with hd in the years 1985 to 2012 at ouh, department for general surgery.

Eligibility criteria:
inclusion criteria: * all patients diagnosed with hd at the surgical department at odense university hospital from 1985 to 2012 will be invited to enroll in the study. exclusion criteria: * lack of informed consent, pregnancy, wrong diagnosis and inability to understand or answer the questionnaires.
a phase 2, 3 arm study of nvn1000 gel and vehicle gel in subjects with acne

Conditions: Acne Vulgaris

Summary: this is a 12 week clinical trial in subjects with acne vulgaris. subjects will be randomized to nvn1000 1% gel, nvn1000 4% gel or vehicle gel twice daily. safety, tolerability and efficacy will be assessed over the course of the study.

this is a multi-center, evaluator and subject blinded, randomized, vehicle-controlled, parallel group, dose-ranging study to be conducted in approximately 150 subjects with acne vulgaris. subjects who satisfy the entry criteria at the baseline visit will be randomized to nvn1000 1% gel, nvn1000 4% gel or vehicle gel in a 1:1:1 ratio. efficacy assessments will include inflammatory and non-inflammatory lesion counts and investigator global assessments (iga). tolerability and safety assessments include cutaneous tolerability evaluation, adverse event collection, physical exams, and laboratory studies. subjects will return for post-baseline evaluation at weeks 2, 4, 8, and 12.

Eligibility criteria:
inclusion criteria: * subjects with acne vulgaris and at least 20 but no more than 40 inflammatory lesions, 25-70 non-inflammatory lesions, no more than 2 nodules on the face * baseline iga score of mild, moderate or severe * women of child-bearing potential must agree to use an effective method of birth control during the study and for 30 days after their final study visit exclusion criteria: * any dermatologic condition or other medical problem that could interfere with clinical evaluation or requires the use of topical or systemic therapy that make evaluations and lesion count inconclusive * female subjects who are pregnant, nursing, or considering becoming pregnant * methemoglobin \> 2% at baseline * clinically significant anemia at baseline * use of topical or systemic medications to treat acne * use of medications that make acne worse, associated with methemoglobinemia, or nitric oxide donors

Keywords: acne
head position on preventing emergence cough

Conditions: Gallbladder Diseases

Summary: the purpose of this study is to investigate the effect of head position on prevent the emergence cough followed by endotracheal extubation.

during endotrachl intubaion, the sniffing postion is most commonly recommended. however, the head position to reduce the emergence cough followed by endotracheal extubation was not confirmed yet. considering the endotracheal tube vector, head elevation with pillow is thought to be acceptable more.

Eligibility criteria:
inclusion criteria: * operation schedule of laparoscopic cholecystectomy * must be performed under general anesthesia exclusion criteria: * bmi \> 30 kg/m2 * respiratory infection * uncontrolled hypertension
is it possible to predict pre term labor by measuring cervical length in the non-pregnant uterus?

Conditions: Preterm Birth

Summary: working hypothesis and aims: to investigate the association between cervical length in non-pregnant women, and the risk of premature birth. the participants will be recruited from the haemek medical center delivery room registration. women delivered between 24-37 pregnancy weeks will be allocated to the study group. the investigators will invite them 3 month or more after delivery to ultrasound examination of the cervical length. the participants in the control group will be the women whom term delivery follows by chronological manner to those in study group. data of the cervucal length will be collected at the time of the examination.

women will be invited to undergo an examination in ultrasound unit of department of obstetrics and gynecology, haemek medical center. ultrasound examination will be performed using the voluson e8 device, general electric. the cervical length,between the external and internal orifice will be measured using conventional technologies available including: doppler, three dimensional and two dimensional ultrasound.

Eligibility criteria:
inclusion criteria: * nonpregnant women aged 18-40 years. * singelton last pregnancy. * last birth, spontaneous premature (24-37 week) * last birth at least 3 months ago. exclusion criteria: * presence of uterine malformations. * sonographic pathologic findings. * technical failure (failed appropiate sonographic visualisation) * presence of fetal malformations ( in preterm delivery ) * presence of comorbidities including diabetes, hypertension, collagen disease, thrombophilia * presence of risk factors for premature delivery (amniotic fluid infection, * cervical surgical treatments - conization, polyhydramnios, etc.).