Kornimate/medical-research-clean huggingface dataset:
embolic signals detection study (esds) in candidates for surgical carotid revascularisation

Conditions: Carotid Stenosis; Carotid Artery Diseases; Carotid Atherosclerosis; Carotid Artery Plaque; TCD; Stroke

Summary: about 20% of strokes are caused by emboli deriving from a carotid plaque. in symptomatic patients with carotid stenosis grater than 70% the carotid endarterectomy (cea) reduces stroke risk by about 75% and is generally accepted as being cost effective. however also in these cases there is a part of the population that, according to the morphological plaque characteristics, could better benefit from a conservative medical treatment. improving the best medical treatment, the situation seems to be even less clear in asymptomatic patients, where probably it would need to treat at least 32 patients in order to prevent one single ictus. different parameters have been considered in order to determine, among the asymptomatic patients the ones that more than others could benefit from a surgical revascularisation instead of a medical treatment. between these parameters, the quality of the plaque (vulnerability) and the micro-embolic signals (mes) detection with the transcranial doppler (tcd) holter seems to be the most relevant. another interesting aspect is trying to establish whether plaques can determine a different embolic risk in relation to the different histological findings. therefore, it seems interesting and reasonable trying to establish a correlation between these two parameters in asymptomatic patients as in the symptomatic ones in order to make more and more appropriate a surgical plaque removal according to the specific risk of each patient in a set of tailored surgery. it consists in a descriptive observational study, since it intends to describe the embolic signals detection (mes) counted in automatic way with the tcd holter, in patients affected by carotid stenosis, before and after the surgical operation. in particular it consists in a monocentric, longitudinal, prospective cohort study since it intends to analyse a group of patients (already candidates to cea) that experiences a specific event (mes) before and after the surgical plaque removal, in a precise span of time. since the treatment, removing the plaque, should remove the embolic focus too, a significant reduction of microembolic signals in post-operative time is expected. this reduction has been esteemed around about the 70% among candidates to cea. patients taken on responsibility of the equipe will undergo an ultrasonographic investigation for the carotid stenosis, histological characterization of the plaque based on the gray-weale classification and tcd-holter for mes.


Eligibility criteria:
inclusion criteria: * informed consent signed * age\>18y.o. * carotid stenosis \>70% and/or vulnerable plaque exclusion criteria: * inability to give the informed consent * age\<18y.o. * carotid stenosis \< 70 % * patients already treated with cea in the same seat * impossibility to find the insonation window * patients not in best medical treatment therapy

Keywords: carotid carotid stenosis plaque stroke risk transcranial doppler tcd histology
neurovascular coupling in subjects with amblyopia

Conditions: Amblyopia ex Strabismus; Amblyopia ex Anisometropia

Summary: amblyopia is a developmental condition that is characterized by reduced vision of the eye due to the presence of a sensory impediment during visual development, such as strabismus (ocular misalignment) or anisometropia (unequal refractive error), occurring early in life. recent studies in humans and animals point towards a cortical locus for the processing deficit in amblyopia, revealing sensory deficits at the signal cell level. if changes in retinal neuronal function are also present, is unknown. like in the brain, blood flow in the retina is coupled to neuronal activity. this phenomenon has been measured by different study groups with non invasive techniques in the brain and retina. it has been shown in previous studies that stimulating the retina with diffuse luminant flickering light increases retinal vessel diameter and blood flow. however, it is unknown whether this is also the case in the retina of amblyopic eyes. additionally, the introduction of blood oxygen level dependent (bold) fmri also makes it possible to directly access the vascular response in the brain to visual stimuli. therefore, the aim of the present study is to investigate the effect of luminant flickering light on retinal vessel diameter and retinal blood flow in subjects with amblyopia. also, oxygen saturation in retinal vessels will be assessed as well as pattern erg for assessment of retinal function. additionally, a high resolution image of the visual pathway will be taken with 7 tesla mri to investigate whether anatomical or functional alterations are present.


Eligibility criteria:
inclusion criteria: * men and women aged between 18 and 55 years * non-smokers (for at least 6 months) * normal findings in the medical history and physical examination unless the investigator considers an abnormality to be clinically irrelevant * normal ophthalmic findings except amblyopia on one eye resulting from anisometropia or strabismus with a visual acuity of snellen ≤ 0.3 with best correction on the amblyopic eye and snellen 0.9 or better in the contralateral eye (for subjects with amblyopia) * normal ophthalmic findings with visual acuity of snellen ≥ 1.0 in both eyes (for control subjects) exclusion criteria: * symptoms of a clinically relevant illness in the 3 weeks before the first study day * presence or history of a severe medical condition as judged by the clinical investigator * regular use of medication, abuse of alcoholic beverages, participation in a clinical trial in the 3 weeks preceding the study (except oral contraceptives) * blood donation during the previous three weeks * pregnancy, planned pregnancy or lactating * any metallic, electric, electronic or magnetic device or object not removable except dental fillings * claustrophobia * epilepsia, history or family history of seizures

Keywords: retinal vessel diameter retinal oxygen saturation high resolution functional and anatomical imaging inner retinal function flicker response
detection cell free dna in lung cancer patients

Conditions: Non-small Cell Lung Cancer

Summary: third generation of egfr-tkis is the newest target therapy for nsclc. however, we did not known the specific mechanisms for those non-responders and patients grow resistance.next generation sequencing is current the most sensitive and specific method to exam gene mutation, diversion etc. by consistently detect the cf-dna, we could possibly find out the mechanisms of response and resistance.

study backgroud: third generation of epidermal growth factor receptor tyrosine kinase inhibitors (egfr-tkis) is the newest target therapy for non small cell lung cancer (nsclc). two major study published in nejm show that the overall response rate is about 60%-70%, with a progression free survival about 10 months. however, we did not known the specific mechanisms for those non-responders and patients grow resistance. next generation sequencing is current the most sensitive and specific method to exam gene mutation, diversion etc. by consistently detect the cf-dna, we could possibly find out the mechanisms of response and resistance. eligible patients received 3rd generation egfr-tkis (azd9291 and avitinib) were enrolled into this study. tumor tissue sample within 6 months, and 10ml periphereal blood samples were collected at baseline. after treatment initiation, 10ml periphereal blood would be collected at every image testing time point until disease progression. blood samples will be draw using edta tube and centerfuged within 2 hours and store in -80 refrigerator. ngs testing will cover target genes of nsclc.

Eligibility criteria:
inclusion criteria: * pathologically confirmed non small cell lung cancer. * harboured with positive egfr mutation (19 exon deletion, l858r、g719x、l861q mutation) * reliable patients history data. exclusion criteria: * pathologically not confirmed non small cell lung cancer. * multiple primary cancer.
laryngeal preservation in pyriform sinus carcinoma

Conditions: Squamous Cell Carcinoma

Summary: patients were eligible if they had biopsy proven, previously untreated t3 with fixed cord involvement squamous cell carcinoma of the pyriform sinus. the study compare conventional radiotherapy with concurrent cisplatin to induction chemotherapy with cisplatin fluorouracil followed by conventional radiotherapy. the primary end point was the preservation of the larynx. the secondary end points included toxicity, causes of death and survival rates.

objectives: to compare conventional radiotherapy with concurrent cisplatin to induction chemotherapy with cisplatin fluorouracil followed by conventional radiotherapy. the primary end point was the preservation of the larynx. the secondary end points included toxicity, causes of death and survival rates. design: multicenter prospective randomized phase iii trial. setting: academic tertiary care center. patients: seventy one adult patients with biopsy-proven previously untreated resectable t3 with fixed cord involvement squamous cell carcinoma of the pyriform sinus. main outcomes measures: patients were evaluated for toxic reactions, and organ preservation and survival rates. statistical analysis of overall survival and event free survival was performed using the kaplan meier method.

Eligibility criteria:
inclusion criteria: * patients were eligible if they had biopsy proven, previously untreated t3 with fixed cord involvement squamous cell carcinoma of the pyriform sinus. patients also had to have a performance status (ps)\ 1500 cells/microl, platelet count \> 100 000 cells/microl and a calculated creatinine clearance of more than 50 ml/min. exclusion criteria: * patients with t1, t2 or t4 or m1 (metastatic disease) were ineligible.

Keywords: squamous cell carcinoma of the pyriform sinus laryngeal preservation patients with biopsy-proven previously untreated resectable t3 with fixed cord involvement squamous cell carcinoma of the pyriform sinus
school-based intervention program to promote healthy eating and physical activity

Conditions: Obesity, Childhood; Health Behavior; Physical Activity; Dietary Habits

Summary: the purpose of this research is to develop, apply, and evaluate a school-based intervention program in east jerusalem schools, designed to increase knowledge and to improve the attitudes and healthy behavior of schoolchildren, their teachers and their mothers' with regard to healthy eating and physical activity habits. the study tested the hypothesis that the impact of the entire school intervention program on students' lifestyles is mediated by their teachers' engagement in health promotion and by their mothers' involvement in school activity.

a randomized controlled intervention program trial was carried out in 14 females' schools in east jerusalem, selected randomly by a stratified sampling of four groups of schools. the primary target population was the students, while the secondary target populations were the mothers and the teachers at these schools. from the schools operating in east jerusalem (palestinian authority, jerusalem municipality, private, and united nations relief and works agency) grades 4 and 5 were considered eligible to participate in the pre- and post-intervention studies. the study process was designed, using the ecological model, in three stages; stage one: need assessment stage (pre-intervention, march-jun 2011): a semi-structured interview was used with all 14 school principals, and a structured self-administered questionnaire was used with all teachers. a random sample of a 4th and 5th grade classes was selected, in which all mothers and their daughters were eligible to answer a self-administered questionnaire. the height and weight of the children were measured during this stage. these measurements were the baseline for assessing the current situation. in addition to school inspection tours was done to assess the school's health environment. stage two: action stage (intervention, september 2011-june 2013): a random allocation of schools into intervention and control groups was done, followed by participatory planning and administration of the intervention in each of the 7 schools based on their needs assessments and assets. the program was implemented and administered by a steering committee in each of the schools, consisting of teachers, mothers, and children. teachers underwent trainings in nutrition and physical activity. the program activities were monitored by regular visits twice a month. the implementation team met every four to six weeks to review the progress. stage three: evaluation (post intervention, february-april 2013): evaluation of the program was done after eighteen months of intervention using the same assessment questionnaires for both intervention and control schools among a different sample of children from grades 4 and 5, their mothers, and all of the teachers.

Eligibility criteria:
inclusion criteria: * east jerusalem female schoolchildren exclusion criteria: * none

Keywords: school-based intervention ecological model participatory approach palestinian female schoolchildren
alimta plus carboplatin as front-line chemotherapy for patients with locally advanced or metastatic non-small cell lung cancer: a phase 2 clinical trial.

Conditions: Carcinoma, Non-Small-Cell Lung

Summary: the purpose of this study is to evaluate the effects (good and bad) of ly231514 (alimta) and carboplatin on you and your non-small cell lung cancer.


Eligibility criteria:
inclusion criteria: * you have a diagnosis of non-small cell lung cancer. * you have received no prior chemotherapy. * you have at least one measurable lesion. * you have an adequate performance status. * you are at least 18 years of age. exclusion criteria: * you have previously received chemotherapy for your lung cancer. * you have received radiation within the last 30 days. * you have active infection or other serious condition. * you have brain metastasis. * you have recently lost a significant amount of weight.

Keywords: non-small cell lung cancer lung cancer nsclc advanced non-small cell lung cancer
application of machine learning method in validation of screening cognitive test for parkinsonisms

Conditions: Primary Parkinsonism; Secondary Vascular Parkinson Disease; Multiple System Atrophy; Supranuclear Palsy, Progressive

Summary: based on a prospectively collected data analysis, a new tool, namely comda (cognition in movement disorders assessment) is developed by merging each item of mini-mental state examination (mmse), montreal cognitive assessment (moca) and frontal assessment battery (fab). a machine learning, able to classify the cognitive profile and predict patients' at risk of dementia, is created.

a prospectively data-base was setting up, collecting comda and in-depht-neuropsychologocal-battery scores, obtained from the evaluation of 500 patients with parkinsonisms. data were analyzed to compare the classification of patient cognition profile, obtained with comda, mmse, moc and fab, with that obtained from in-depth neuropsychological evaluation. a very high percentage of false negative emerged, for mmse, moca and fab. conversely, the comda score significantly reduces the rate of false negative. this new tool, namely "comda" (cognition in movement disorders assessment), was composed, by merging each item of mini-mental state examination (mmse), montreal cognitive assessment (moca) and frontal assessment battery (fab). moreover, we created a machine learning, namely "neural net 91classification" able to classify the cognitive profile and predict patients' at risk of dementia, providing a prediction of the findings resulting from a in-depht neuropsychological evaluation. comda and the related neural net 91classification represent a reliable, time-sparing screening instrument, which is much more powerful of other common, widely-adopted tools.

Eligibility criteria:
inclusion criteria: diagnosis of idiopathic pd according to the mds clinical diagnostic criteria (postuma et al. 2015); b) diagnosis of psp according to the mds clinical diagnostic criteria (höglinger et al. 2017); c) diagnosis of msa according to the second diagnostic consensus statement (gilman et al. 2008); d) diagnosis of vp according to zijlmans et al (zijlmans et al. 2004). exclusion criteria: a) any focal brain lesion detected with brain imaging studies (ct or mri); b) diagnosis of clinically relevant psychiatric disorders, psychosis (evaluated with neuropsychiatric inventory) and/or delirium; c) diagnosis of dementia or mci; d) diagnosis of neurological diseases other than pd or atypical parkinsonian syndromes; e) other medical conditions negatively affecting the cognitive status; f) disturbing resting and/or action tremor, corresponding to scores 2-4 in the specific items of mds unified parkinson's disease rating scale (mds-updrs) iii, such as to affect the psychometric evaluation; g) disturbing dyskinesia, corresponding to scores 2-4 in the specific items of mds-updrs iii, such as to affect the psychometric evaluation; h) auditory and/or visual dysfunctions impairing the patient´s ability to perform cognitive tests.
use of percutaneous tibial nerve stimulation with solifenacin or placebo to treat refractory overactive bladder

Conditions: Overactive Bladder

Summary: the null hypothesis for this study is that the combination of solifenacin and percutaneous tibial nerve stimulation (ptns) is not different from ptns alone. however the investigators anticipate a 20% improvement in patients receiving combination therapy as measured by the oab-q (overactive bladder questionnaire) scores.


Eligibility criteria:
inclusion criteria: 1. 18 years of age or older 2. history of overactive bladder 3. history of inadequate response to prior or current treatment with anti- muscarinic medication, or unacceptable side effects from higher dose of anti-muscarinic medication 4. ptns-naive 5. willing to discontinue the use of anti-muscarinic agents for 2 weeks before start of study medication ("washing out") 6. able to swallow and retain oral medication 7. able and willing to participate in the full duration of the study 8. able to read and write (health outcomes questionnaires are self-administered)and understand instructions related to study procedures and give written informed consent 9. oab-q (items 1-8) score of 30 or higher exclusion criteria: 1. presence of cardiac pacemaker and/or defibrillator 2. history of urinary retention 3. history of gastric retention 4. uncontrolled narrow angle glaucoma 5. any unstable, serious co-existing medical condition(s) including, but not limited to, myocardial infarction,coronary bypass surgery, unstable angina, cardiac arrhythmias, clinically evident congestive heart failure, or cerebrovascular accident within 3 months prior to screening visit 6. abnormal liver function test (greater than 3 times the upper limit of normal for alanine aminotransferase \[alt\], aspartate aminotransferase \[ast\], or alkaline phosphatase \[alp\]); or bilirubin \> 3 times the upper limit of normal 7. history of any illness (including psychiatric) that, in the opinion of the investigator, might confound the results of the study or pose additional risk to the subject 8. known hypersensitivity to solifenacin 9. participation in any investigational or marketed drug trial within the 30 days prior to the first dose of study drug or any time during the study period 10. pregnancy or trying to become pregnant 11. breast-feeding

Keywords: overactive bladder
effect of vitamin d on retinal changes in patient with optic neuritis by optic coherence tomography

Conditions: Optic Neuritis

Summary: this study examines the effect of vitamin d on retinal changes in patient with optic neuritis.


Eligibility criteria:
inclusion criteria: * age 15-50 years * no history of demyelinative events * level of vitamin d below 20 ng/ml * no pass 10-32 day from starting symptom exclusion criteria: * using vitamin d supplement

Keywords: vitamin d
the impact of oral health in hiv patients on antiretroviral therapy

Conditions: HIV; Periodontal Diseases; Caries; Non-communicable Disease; Xerostomia

Summary: this is a prospective cohort study designed to investigate the range of metabolic abnormalities observed in patients living with hiv on antiretroviral therapy. this study will also explore the concurrent role of poor oral health in supporting and driving chronic immune activation and inflammation in hiv infection.

this is a prospective cohort study designed to investigate the range of metabolic abnormalities observed in patients living with hiv (plwh) on antiretroviral therapy (art). this study will also explore the concurrent role of poor oral health in supporting and driving chronic immune activation and inflammation in hiv infection. following enrollment in study, patients will be followed up every 6 months for approximately 2.5 years (30 months). during this period, comprehensive medical records will be obtained, and study data will be updated every 6 months; questionnaires will be handed to patients periodically to assess quality of life and effects of xerostomia on qol; social history will be assessed using taps; oral health will be evaluated every 6 months and blood, saliva, and oral swabs collected every 6 months. dxa scan and panoramic radiographs will also be taken at baseline and 24 months. at the end of the study, caries rate, periodontal health, bone loss, qol, salivary quantity and composition, presence or absence of white/red lesions, as well as inflammatory cytokines and immune activation markers will be assessed.

Eligibility criteria:
inclusion criteria: * age ≥18 years * has been diagnosed with hiv (as documented by a prior laboratory report of positive hiv-1/2 antibody and/or detectable hiv rna, available for review by the study team) * has received antiretroviral therapy for at least 12 months * able and willing to provide informed consent prior to initiation of study procedures * willing and able to comply with all study procedures, and likely to be available for the duration of the study exclusion criteria: * has been diagnosed with the following xerostomia-related autoimmune conditions: sjorgen's and sarcoidosis * has never received radiation therapy to the head or neck (including radioactive iodine therapy) * was taking anti-osteoporotic agents (biphosphonates, denosumab) prior to hiv diagnosis. * women who are pregnant at the time of enrollment.
preemptive low-dose epidural ketamine for preventing chronic post-thoracotomy pain

Conditions: Chronic Post-thoracotomy Pain

Summary: chronic post-thoracotomy pain is the most common long-term complication that occurs after a thoracotomy with a reported incidence of up to 80%. while thoracic epidural analgesia has become the mainstay for managing acute post-thoracotomy pain, its effect on the chronic post-thoracotomy pain seems questionable. the objective of this prospective, double-blinded, randomized, controlled trial was to assess the effect of preemptive low-dose epidural ketamine in addition to preemptive thoracic epidural analgesia on the incidence of chronic post-thoracotomy pain.


Eligibility criteria:
inclusion criteria: * patients undergoing surgery with a thoracotomy incision exclusion criteria: * history of previous thoracic surgery, chronic pain, psychiatric disease, cardiac or vascular disease, neurologic deficits, or contraindications to epidural catheterization such as coagulopathy, or localized or systemic infection

Keywords: preemptive epidural ketamine prevention of chronic post-thoracotomy pain