Kornimate/medical-research-clean huggingface dataset:
classification of adult-onset diabetes in five subgroups in pakistani population

Conditions: Diabetes Mellitus; Diabetes Mellitus, Adult-Onset; Diabetes Mellitus Type 1 and 2

Summary: this study aims to classify adult-onset diabetes patients into distinct data-driven clusters, such as severe insulin-deficient, severe insulin-resistant, mild obesity-related, and mild age-related diabetes, based on clinical and biochemical characteristics. using a cross-sectional design, data will be collected from individuals attending outpatient diabetes clinics at tertiary care hospitals in pakistan. the study will analyze the distribution of metabolic and demographic characteristics within each cluster and assess subgroup-specific risks for diabetic complications. additionally, the relationship between clustering variables and the risk of complications will be evaluated to enhance the understanding of diabetes heterogeneity and its impact on patient outcomes.


Eligibility criteria:
inclusion criteria: * patients of both genders whose age of disease onset was older than 16 years * patients newly diagnosed with or previously diagnosed with t2d * able and willing to provide written informed consent and to comply with the study exclusion criteria: * patients with other medical comorbidities (not a complication of diabetes), such as malignancies. * pregnancy
frequency and e-field enhancement of itbs for depression (freed)

Conditions: Major Depressive Disorder

Summary: the investigators propose a randomized 3-arm double-blinded parallel experimental trial (20 sessions over 4 weeks) in 75 patients with trd. the three arms include (1) the combination of a fully individualized form of intermittent theta burst stimulation (itbs) (using both the frequency and electric field (e-field) targeting approaches) (ind-itbs)), (2) itbs individualized using e-field targeting only (targeted-itbs) and (3) standard itbs treatment (i.e., typical itbs localized to the dorsolateral prefrontal cortex (dlpfc) using the beam f3 method). electroencephalography (eeg) data will be collected at rest and during a working memory task, at baseline, and at the end of treatment along with clinical assessments of depression severity. the target engagement dependent variable of interest in these three arms will be fronto-parietal theta connectivity measured through resting-state eeg. the investigators hypothesize that stimulation with ind-itbs will lead to greater changes in fronto-parietal theta connectivity than that produced with targeted-tbs and standard itbs. aim: to evaluate the effects of two individualized forms of itbs (i.e., using both the frequency and e-field individualization; ind-itbs) compared to itbs individualized for e-field targeting only (targeted-itbs) and standard itbs on fronto-parietal theta connectivity. hypotheses: (1) ind-itbs will lead to greater changes in fronto-parietal theta connectivity compared to both targeted-itbs and standard itbs. (2) ind-itbs will also lead to a greater reduction in depressive symptoms (as defined by the mean reduction in montgomery åsberg depression rating scale scores (madrs)) compared to both targeted-itbs and standard itbs.


Eligibility criteria:
inclusion criteria: * diagnosis of major depressive episode (mde, in accordance with the diagnostic and statistical manual of mental disorders 5th edition (dsm-5), in the context of unipolar major depressive disorder disorder. * 18-80 years of age. * male or female. * at least one failed antidepressant medication trial at level 3 in the antidepressant treatment history form: short form (athf-sf) classification. * montgomery-asberg depression rating scale (madrs) score of \>19 (moderate - severe depression). * no increase or initiation of new antidepressant therapy in the four weeks prior to screening. * demonstrated capacity to give informed consent. exclusion criteria: * inability to provide informed consent. * medically unstable patients. * concomitant neurological disorder or a history of a seizure disorder. * patients who are pregnant or breastfeeding. * any psychotic disorder or current active psychotic symptoms. * patients who have intracranial implants, other medical device or condition deemed unsafe for tms. * contraindication to mri scanning.
retrospective study of the effects of sub-pathologic phenotypes of bp on clinical management and prognosis

Conditions: Bullous Pemphigoid

Summary: bullous pemphigoid (bp) is a chronic autoimmune subepidermal blistering disease primarily affecting the elderly with a significant risk of mortality and morbidity. various inflammatory cells such as eosinophils, lymphocytes, neutrophils and their granulopoiesis play an important role in the pathogenesis of bp. infiltration of peripheral blood eosinophils, lymphocytes, and neutrophils into the skin is considered a major feature of bp, making it a heterogeneous disease with different histologic and clinical subtypes. this clinical study was conducted to further investigate the impact of different pathologic phenotypes of bp on the treatment and prognosis of the disease. a retrospective epidemiologic investigative approach was used，and case collection included demographic information, medical history, clinical manifestations, and histopathologic features. including gender, age, duration of disease, number of days of hospitalization, mucosal involvement, clinical diagnosis before admission, histopathological diagnosis, laboratory tests, concomitant diseases, treatment and its changes in laboratory indexes before and after treatment.


Eligibility criteria:
inclusion criteria: * (1) patients with bullous pemphigoid who were first hospitalized in the department of dermatology of xijing hospital * (2) age 0-100 years old, gender is not limited. * (3) diagnosis is confirmed by clinical, histopathologic, immunopathologic and/or anti-bp180 antibody tests. * (4) complete skin histopathology information exclusion criteria: * (1) patients with bullous pemphigoid who were not first diagnosed in our hospital. * (2) those who have received systemic glucocorticoid, immunosuppressant, biologic, or other drug therapy within the past month.
intravenous gentamicin therapy for recessive dystrophic epidermolysis bullosa (rdeb)

Conditions: Recessive Dystrophic Epidermolysis Bullosa

Summary: recessive dystrophic epidermolysis bullosa (rdeb) is an incurable, devastating, inherited skin disease caused by mutations in the col7a1 gene that encodes for type vii collagen (c7), the major component of anchoring fibrils (afs), structures that mediate epidermal-dermal adherence. thirty percent of rdeb patients have nonsense mutations. the investigators recently demonstrated in 5 such patients that intradermal and topical gentamicin induced "read-through" of their nonsense mutations and created robust and sustained new c7 and afs at the dermal-epidermal junction (dej) of their skin and also stimulated wound closure and reduced new blister formation. no untoward side effects occurred. herein, the investigators propose evaluating the safety and efficacy of intravenous gentamicin in these patients. in theory, this intravenous administration has the possibility of treating simultaneously all of the patients' skin wounds. the milestones will be increased c7 and afs in the patients' dej, improved eb disease activity scores, and absence of gentamicin side effects.


Eligibility criteria:
inclusion criteria: * provision of signed and dated informed consent form * stated willingness to comply with all study procedures and availability for the duration of the study * male or female, aged 7 and up can participate in the 14 day iv gentamicin trial. male or female, aged 18 and up can participate in the 3 month iv gentamicin trial. * been diagnosed with recessive dystrophic epidermolysis bullosa (rdeb) and with a nonsense mutation in the col7a1 gene. * immunofluorescence evaluation of skin biopsies reveals absence or decreased intensity of c7 expression at their dej (dermal epidermal junction) compared with normal human skin biopsies. * cultured fibroblasts from patient skin synthesize and secrete full-length, 290kda c7 alpha chains in the presence of supplemented gentamicin (400 μg/ml in culture). * ability to sit or lie down for over 30 minutes for iv infusions. for those in the 3 month trial, to be willing to continue treatment at home under the supervision of licensed and trained infusion nurses. exclusion criteria: * recent exposure to gentamicin within the past 6 weeks. * pre-existing known auditory impairment. * pre-existing known renal impairment. * pre-existing known allergies to aminoglycosides or sulfate compounds. * pregnancy or lactation * current use of medications with known ototoxicity or nephrotoxicity. * current enrollment in another experimental clinical trial involving systemic treatment with c7 or c7 producing products for the treatment of rdeb.

Keywords: nonsense mutations
quality of life in patients having a prosthetic joint infection

Conditions: Quality of Life; Prosthetic Joint Infection

Summary: bone and joint infections (bji) are rare serious pathology which can lead to a very heavy handicap and sometimes to the life threatening. these are devastating diseases whose diagnosis is difficult. they are known to be associated with high mortality rates (5%) and significant morbidities responsible for functional sequelae (40% of patients) with an individual cost (prolonged hospitalization, altered quality of life) and societal (work stoppage, partial or total disability, temporary or permanent) extremely high. these bone and joint infections have a significant impact on the quality of life of those affected who, in addition to their infection, are reduced in their autonomy and often need to be taken care of outside their home, sometimes away from home. to the knowledge of investigators, there are few studies on the measurement of quality of life in patients with osteoarticular infection. the aim of this study is to implement the eq-5d-3l validated quality of life questionnaire and the eva scale (created by euroqol group) for each patient with a prosthetic joint infection (ipa) on prosthesis during their medical care in the department of infectious and tropical diseases.


Eligibility criteria:
inclusion criteria: * patient having prosthetic joint infection * patient who did not object to participate in the study * patients over 18 years of age exclusion criteria: * patient with additional psychological or psychiatric support outside the service. * patient benefiting from a system of legal protection (safeguard of justice, guardianship, curatorship) * patient participating in another study on measuring quality of life * patients with cognitive impairment to understand the questionnaire * impossibility of giving the patient informed information * patients with no infection diseases follow up at the croix rousse hospital * patients with amputation as initial surgery for infection management
study of neurotidine® intake on life quality of patients with glaucoma

Conditions: Glaucoma

Summary: the purpose for the study consists in the assessment of the role of neurotidine® (citicoline oral solution) on the dopaminergic pathway and particularly its potential implications on psychophysical performance and quality of life. other objectives are the assessment of the tolerability and safety of neurotidine®.

primary open angle glaucoma is a chronic progressive neurodegenerative disease and the only proven effective therapy involves reduction of intraocular pressure (iop). although treatment effect is quite large, a significant proportion of patients show disease progression with apparently controlled iop. given the similarities with other neurodegenerative diseases - particularly in the mechanisms of cell death -neuroprotective treatments have been tried also in glaucoma. interesting results from experimental studies and weak evidence from human glaucoma trials have been published in recent years. citicoline is one of the promising molecules with a putative neuroprotective action and has been tried on patients with a number of neurodegenerative diseases with encouraging results. pilot studies on glaucomatous patients showed a possible effect of citicoline in reducing progression of visual field changes, though these findings need to be confirmed by larger randomized clinical trials. the aim of this randomized, double-masked, placebo-controlled, cross-over study is to test whether the intake of neurotidine® (citicoline free acid in oral solution) can be associated with an improvement of quality of life in patients with glaucoma.

Eligibility criteria:
inclusion criteria: patients must meet all the following criteria to be eligible for the study: * signed written informed consent. * age ≥ 18 years. * patients with bilateral open-angle glaucoma (oag). pex and pigmentary glaucoma will be included. * controlled iop * patients with moderate damage in the better eye, with mean deviation from normal value (md) ranging from -6 to -12 db in the 6 months prior to enrollment. at the screening assessment, md must range from -5 to -13 db. glaucoma definition will be based on visual field (vf) damage (24-2, sita standard strategy) corresponding to glaucomatous changes at the optic nerve head. values of iop will not be an inclusion criterion, though a "controlled iop" based on the clinician's judgement will be required. exclusion criteria: patients must meet none of the following criteria to be eligible for the study: * single-eyed patients (visual acuity \<0.1 in one eye). * patients without the psychophysical requirements to adequately participate and complete the trial. * patients with chronic angle-closure glaucoma (cacg) or other types of glaucoma. * patients with other ocular comorbidities interfering with the correct assessment of the glaucomatous damage to the vf. * patients who have undergone surgery within 6 months. * patients taking other potential neuroprotectors, including topical, competing with neurotidine®. * patients with parkinson's disease, dementia or a diagnosis of stroke in the last 6 months.
transfusion ratio of fresh frozen plasma (ffp) to packed red blood cell (prbc) during burn excision and grafting

Conditions: Burn Injury

Summary: the purpose of this study is to determine if burn injured patients who receive blood transfusions in the operating room have better outcomes when given transfusions at a set ratio (1:1)of prbc to ffp. traditionally, patients that need blood transfusions during surgery are given mostly packed red blood cells (prbc) and some fresh frozen plasma (ffp). this is usually about 1:4 ratio of ffp to prbc. in this study, we will compare this traditional approach (1:4) to a 1:1 ratio of ffp to prbc during the operative period. the hypothesis of the study is that the use of ffp/prbc ratio of 1:1, compared to a ratio of 1:4 will result in a(n) 1. decrease in the amount of blood transfused in the operating room 2. decrease in the amount of blood transfused during hospitalization 3. improvement in coagulation parameters (pt/ptt, inr, antithrombin iii, protein c and fibrinogen in the operative period (from operation start to 12 hours post operatively) and at 24 hours postoperatively 4. decrease the hospital length of stay, lung dysfunction, infections, and mortality

the hypothesis of the study is that the use of a fresh frozen plasma/packed red blood cells (ffp/prbc) ratio of 1:1, compared to a ratio of 1:4 during operative excision of \>20% tbsa will: result in a decrease in the amount of blood transfused in the operating room, a decrease in the amount of blood transfused during hospitalization, an improvement in coagulation parameters (pt/ptt, inr) in the operative period (from operation start to 12 hours postoperatively) and at 24 hours postoperatively, and a decrease in hospital length of stay, lung dysfunction, number of infections, and mortality. the primary objective of the study is to determine if aggressive correction of intraoperative coagulopathy during burn excision and grafting results in improved outcomes.

Eligibility criteria:
inclusion criteria: * patient is 1 month to \</= 18 yrs of age * admitted to shriners hospitals for children northern california * patient has a third degree burn \>/= 20 % total body surface area (tbsa) exclusion criteria: * infants \< 5 kg * pregnancy * 18 years of age * inability or unwillingness to receive blood products * pre-existing need for hemodialysis * brain death or imminent brain death * non-survivable burn as determined by the attending burn surgeon * pre-existing hematologic disease * closed head injury with glasgow coma score \<9

Keywords: ffp prbc burn
timing of corticosteroids in covid-19, ii. post covid-19 follow-up

Conditions: Covid19; Corticosteroids

Summary: timing of of corticosteroids administration is very important in covid19 cases for the recovery and decrease the mortality.

the sickest patients with covid-19 suffer a hyperinflammatory state-a cytokine storm-that has features in common with a rare haematological condition called haemophagocytic lymphohistiocytosis. immune suppression should help such patients. by contrast, immune suppression during the early phase of the viral infection might allow increased viral replication and aggravate the disease. the 3c-like proteinase on sars-cov-2 (nsp5) inhibits hdac2 transport into the nucleus, and so impairs the way in which it mediates inflammation and cytokine responses, so activation of histone deacetylase by dexamethasone may directly oppose the action of sars-cov-2. timing of of corticosteroids administration is very important in covid19 cases for the recovery and decrease the mortality.

Eligibility criteria:
inclusion criteria: * any case with covid-19 more than or equal to 18 years * mild and moderate severity exclusion criteria: * severe to critical covid-19 * any contra-indication for the interventional drug * mentally disabled cases

Keywords: covid19 dexamethazone methylpredisolone early recovery
contact allergy to rubber accelerators - a clinical study

Conditions: Contact Allergy

Summary: this study will investigate what concentrations of the most common thiurams and carbamates that elicit allergic contact dermatitis under patch test and what concentrations of the rubber accelerators that elicit allergic contact dermatitis by repeated exposures under simulated use conditions. further, it will investigate whether a damaged skin barrier as caused by wet work increase the severity of the allergic contact dermatitis. the participants will be assigned to either the sls (sodium lauryl sulfate)-group or non sls-group. for the participants of the sls-group, one volar forearm will be randomized to be pre-irritated with a soap i.e. detergent: sodium lauryl sulfate (sls) for 24 hours to simulate wet work. the participants of the non sls-group will not be pre-irritated with sls. following this, the participants' volar forearms will be exposed to thiurams or carbamates and a control solution every night for 7 nights to simulate the repeated exposure to rubber gloves with accelerators. the skin reactions will be read cf. current international guidelines and further quantified using laser doppler flowmetry. during the study, all participants will be patch tested on the upper back with rubber accelerators to investigate their current degree of sensitization and the dose-response relationships.


Eligibility criteria:
allergic participants inclusion criteria: * adults ≥18 years old * sensitized to thiurams, carbamates or both. * received written and oral information about the study. * signed written consent form exclusion criteria: * dermatitis on back or arms * tattoos or significant scar tissue on exposure areas * pregnancy * breast feeding * recently given birth * treatment with systemic immunomodulators within the last 4 weeks * treatment with local immunomodulators on arms or back within the last 4 weeks * excessive ultraviolet light on arms or back within the last 4 weeks healthy controls: inclusion criteria: * adults ≥18 years old * received written and oral information about the study. * signed written consent form exclusion criteria: * sensitized to thiurams, carbamates or both. * occupational or domestical use of rubber gloves. * history of atopic dermatitis or contact dermatitis * dermatitis on back or arms * tattoos or significant scar tissue on exposure areas * pregnancy * breast feeding * recently given birth * treatment with systemic immunomodulators within the last 4 weeks * treatment with local immunomodulators on arms or back within the last 4 weeks * excessive ultraviolet light on arms or back within the last 4 weeks
clinical trial of qizhu yuling prescription in the prevention and treatment of esophagus cancer

Conditions: Esophagus Cancer

Summary: the purpose of this study is to evaluate the efficacy and safety of qizhu yuling prescription for postoperative esophagus cancer.

this study include a multi-center, randomized, double-blind, placebo, parallel controlled clinical trial.the randomized clinical trial will enroll approximately 310 patients. participants will be randomly divided into experimental (n=155) and placebo groups (n=155).patients in the experimental group was treated with qizhu yuling prescription within 6 months after esophagus cancer r0. patients in the control group will receive the placebo.the primary endpoint is 1-year dfs (disease-free survival) rate after surgery, that refers to the proportion of patients who do not have recurrence, metastasis or death (from any cause) within 1 years after surgery. the research protocol was approved by the relevant ethics committees, and the study was conducted according to the declaration of helsinki and good clinical practice guidelines. patients gave written informed consent to participate in the trial.

Eligibility criteria:
inclusion criteria: * 1. esophageal cancer without esophagogastric junction pt1-4an + m0 (stage iib-iva) meeting the diagnostic criteria without recurrence or metastasis; 2. patients who have completed adjuvant therapy (including adjuvant radiotherapy, adjuvant chemotherapy, adjuvant chemotherapy + radiotherapy) within 6 months after r0 resection for esophageal cancer; 3. ecog score 0-2; 4. 18-75 years old; 5. expected survival ≥ 3 months; 6. subjects voluntarily signed informed consent. exclusion criteria: * 1. combined with primary tumor at other sites; 2. patients complicated with severe primary diseases of heart, cerebral vessels, liver, kidney and hematopoietic system; 3. patients with mental illness and mental and language disorders; 4. participation in other clinical trials within 3 months; 5. patients with known hypersensitivity or intolerance to study drug.

Keywords: postoperative esophagus cancer qizhu yuling prescription chinese herbal medicine randomized controlled trial 1-year disease-free survival rate
mindful coloring to reduce nurses' stress

Conditions: Stress (Psychology); Burn Out (Psychology)

Summary: the purpose of this study was to investigate whether nurses who did mindful coloring for at least five working days during a 10-day period experienced stress reduction afterwards.

enrolled participants who met inclusion criteria (full-time clinical nurses working for at least five days during a specified 10-day period) were randomized in 1:1 ratio to the coloring or control groups. a third party did the allocation sequence and concealment. after giving informed consent, participants completed the baseline questionnaire and the coloring group watched an instructional video on mindful coloring. the coloring group were asked to color for any length of time on at least five working days during a 10-day period (period a) while the control group were asked to do it on a subsequent 10-day (period b). the post-intervention questionnaire was completed by both groups at the end of period a. the study was completed after period b.

Eligibility criteria:
inclusion criteria: * full time clinical nurses working under the hospital authority who would be working for at least 5 days during a specified 10-day study period. exclusion criteria: -

Keywords: nurses coloring brief mindfulness-based intervention mental well-being mindfulness