Kornimate/medical-research-clean huggingface dataset:
the effect of treadmill training with visual feedback and rhythmic auditory cue on gait and balance in cerebral palsy

Conditions: Hemiplegic Cerebral Palsy

Summary: the development of efficient and independent walking is an important therapeutic goal for many children with cerebral palsy (cp). consequently, there has been growing interest in determining the effects of treadmill training programs for these children. this study helped to investigates the effect of treadmill training with visual feedback and rhythmic auditory cue (vf+rac) for walking symmetry and balance ability. participants were chosen from sehat medical complex and they were randomly allocated to either the vf+rac or the control group. the vf+rac group received treadmill training with vf and rac, and the control group undergo treadmill training without any visual and auditory stimulation. vf+rac and control groups was trained five times per week for eight weeks. after eight weeks of training the gait pattern and balance were evaluated by the gait parameters, 6min walk test, pediatric balance scale and berg balance scale.

cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. cerebral palsy is a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. the clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. auditory entrainment can influence gait performance in movement disorders. the entrainment can incite neurophysiological and musculoskeletal changes to enhance motor execution. biofeedback systems have been extensively used in walking exercises for gait improvement.

Eligibility criteria:
inclusion criteria: * children having gmf level 1 and 2, * willing to participate, * pediatric subjects diagnosed with cerebral palsy, receiving neurodevelopmental * rehabilitation program regularly. exclusion criteria * child using any sort of auditory aid * children with visual limitation, * child using orthosis for lower extremity

Keywords: treadmill training visual feedback and rhythmic auditory cue gait and balance hemiplegic cerebral palsy
effect of eit-guided peep on clinical outcomes in ards patients: a pilot randomized controlled trial

Conditions: ARDS (Acute Respiratory Distress Syndrome)

Summary: acute respiratory syndrome distress (ards) is a clinical common syndrome with high mortality. mechanical ventilation (mv) is the cornerstone of management of ards but can lead to ventilator-induced lung injury. positive end-expiratory pressure (peep), as one of main component of mv, has been widely used in the clinical practice. however, the peep selection is still a difficult problem for moderate to severe ards patients. eit, an imaging tool evaluating the regional ventilation distribution at the bedside, can achieve the individual peep selection for all mechanically ventilated patients. our previous study found that moderate to severe ards patients with higher recruitability could benefit from eit-guided peep. this article compared the effect of peep titrated guided by eit with fraction of inspired oxygen (fio2)-peep table on the clinical outcomes in patients with higher recruitability.


Eligibility criteria:
inclusion criteria: 1. age≥18 years 2. moderate-to-severe ards, defined by the ards definition task force in the berlin definition (partial pressure of arterial oxygen \[pao2\]:fio2 ratio ≤200 mmhg with a peep ≥5 cmh2o) 3. patients with tidal volume of 6 ml/kg would require a driving pressure of ≥ 13 cmh2o and the percentage of collapse monitoring by eit \>25% 4. diagnosis of ards less than 72 hours exclusion criteria: 1. expected to be mechanically ventilated for less than 48 hours 2. severe chronic respiratory diseases requiring long-term home oxygen therapy or noninvasive mv 3. undrained pneumothorax or subcutaneous emphysema 4. undergoing extracorporeal membrane oxygenation (ecmo) before enrollment 5. contraindication to the use of eit (pacemaker, automatic implantable cardioverter defibrillator, and implantable pumps) 6. severe neuromuscular disease 7. hemodynamic instability 8. contraindications to hypercapnia, such as intracranial hypertension or acute coronary syndrome 9. severe other organs dysfunction with a low expected survival (7 days) or palliative care 10. solid organ or hematologic tumors with the expected survival time less than 30 days 11. participating in other clinical trials within 30 days 12. pregnancy 13. refusal to sign the informed consent
enhancing stdp after spinal cord injury

Conditions: Spinal Cord Injury

Summary: the overall goal is to develop new clinical approaches to restore limb function after spinal cord injury (sci). corticospinal tract (cst) axons are involved in controlling limb function. paired pulse induced spike-timing dependent plasticity (stdp) enhances synaptic strength between residual cst axons and spinal motoneurons (smns) resulting in temporary improvements in limb function in humans with incomplete sci. motor training will be combined with paired-pulse stdp stimulation to further enhance plasticity and behavioral recovery.

to induce stdp with paired pulse, corticospinal volleys evoked by either transcranial magnetic stimulation over the primary motor cortex for upper extremities or electrical stimulation over the thoracic spine for lower extremities arrive at corticospinal-motor neuronal synapses of upper- or lower-limb muscles, 1-2 ms before antidromic potentials were elicited in motor neurons by electrical stimulation of corresponding peripheral nerves.

Eligibility criteria:
inclusion criteria: participants who are unimpaired healthy controls: * male and females between ages 18-85 years * right handed * able to complete precision grips with both hands * able to complete full wrist flexion-extension bilaterally * able to walk unassisted * able to complete full ankle flexion-extension bilaterally participants who have had a spinal cord injury: * male and females between ages 18-85 years * sci ( 6 months of injury) * spinal cord injury at or above l5 * the ability to produce a visible precision grip force with one hand * able to perform some small wrist flexion and extension * the ability to perform a small visible contraction with dorsiflexion and hip flexor muscles * no subjects will be excluded based on their race, religion, ethnicity, gender or hiv status. * asia a,b,c, or d exclusion criteria: exclusion criteria for enrollment for sci and healthy control subjects (4-8 exclusion for non-invasive brain stimulation only): * uncontrolled medical problems including pulmonary, cardiovascular or orthopedic disease * any debilitating disease prior to the sci that caused exercise intolerance * premorbid, ongoing major depression or psychosis, altered cognitive status * history of head injury or stroke * metal plate in skull * history of seizures * receiving drugs acting primarily on the central nervous system, which lower the seizure threshold (see appendix 2) * pregnant females * ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinal cord disease such as spinal stenosis, spina bifida, ms, or herniated disk * individuals with scalp shrapnel, cochlear implants, or aneurysm clips.

Keywords: spike timing dependant plasticity
influence of social determinants on lifestyle modification adherence in people with prediabetes

Conditions: PreDiabetes

Summary: a sequential explanatory mixed-methods study analyzing the influence of social determinants on adherence to healthy lifestyle recommendations in individuals with prediabetes.

type 2 diabetes (t2d) is a major risk factor for adult morbidity and mortality and represents a public health burden due to its rising global prevalence. t2d is preceded by prediabetes, a phase characterized by higher-than-normal blood glucose levels that do not reach the threshold required for a t2d diagnosis. it is estimated that 70% of people with prediabetes will eventually develop t2d, with a mean annual incidence rate ranging from 5% to 10%. importantly, socioeconomic status exacerbates the risk of developing chronic diseases such as t2d, as people from underprivileged social classes are significantly more susceptible to the development of the disease and its complications, when compared to the more privileged. in fact, it has been observed that the risk of developing t2d extends beyond physiological factors. social determinants (sd) such as age, gender, ethnicity, postal code, or socioeconomic status, and health beliefs are strong predictors of disease onset and progression. populations with a low socioeconomic status (i.e., economically disadvantaged backgrounds, lower health literacy levels, lower educational status, and often, from ethnic and racial minorities), are known to experience reduced access to healthcare including health promotion programs. they also have lower adoption rates of health behaviors, such as physical activity (pa) and healthy diet, and thus be at increased risk of chronic diseases such as t2d, which finally increases their likelihood to suffer inequalities in mortality. for all of the above, this study aims to explore the influence of sd on adherence behaviors in individuals with prediabetes included in the prediphone trial, using a mixed-methods sequential explanatory design. the findings from both the quantitative and qualitative phases will be integrated to offer a comprehensive understanding of the complex phenomenon of adherence.

Eligibility criteria:
inclusion criteria: * participants of the prediphone trial assigned to the intervention group and who complete the 9-month intervention period exclusion criteria: * participants from the control group or those who withdrew from the trial.

Keywords: healthy lifestyle social determinants of health prediabetes therapeutic adherence and compliance
patient outcomes of staged ridge-splitting using piezo-electric surgery in atrophic posterior mandible

Conditions: Alveolar Ridge Augmentation

Summary: this study aims to evaluate the clinical and radiographic outcomes of different staged ridge-splitting techniques for management of severely resorbed lower jaws in the posterior region. the study is designed as a clinical trial, so that three different interventions would be compared for a conclusion highlighting the relative best of them.

in the context of the care of severely resorbed lower jaws in the posterior region, the purpose of this study is to evaluate the clinical and radiographic outcomes of several stepwise ridge-splitting procedures. the study is supposed to be a clinical trial, with the purpose of comparing three distinct therapies in order to get a result that highlights which of them is the most effective in comparison to the others.

Eligibility criteria:
inclusion criteria: * patients were free from any relevant systemic diseases according to american society of anesthesiologists classifications. * patients of single or multiple missing teeth in the posterior mandible. * a ridge width of minimum 4mm and a 10 mm ridge height with 2mm minimum above inferior alveolar nerve (ian) were present in cbct images. * absence of buccal concavities at the planned implant site. exclusion criteria: * history of any systemic diseases or medication that alters bone metabolism. * poor oral hygiene. * heavy smoker (more than 20 cigarettes/day) or alcoholic patients. * chemotherapy or radiation therapy to the head and neck region in the last 12 months prior to the proposed implant therapy. * patients currently on or with a history of bisphosphonate therapy.
can vena cava ultrasound guided volume repletion prevent spinal induced significant hypotension in elective patients?

Conditions: Fluid Overload; Anesthesia; Adverse Effect, Spinal and Epidural; Regional Anesthesia Morbidity

Summary: aim of this study is to determine whether inferior vena cava analyzed by trans-thoracic echocardiography is an effective method to guide titrated fluid repletion in non critical patients, in order both to decrease post procedural significant hypotension rate and to avoid unnecessary fluid overload in patients undergoing spinal anesthesia for elective surgical procedures

the setting is standard spinal anesthesia and corresponds to our first arm of the study, used as the control sample and statistical reference. during the induction phase, the patient is fitted with non-invasive blood pressure monitoring, three-lead ecg, pulse-oximetry and peripheral intravenous device. data and vital signs are recorded and an infusion of crystalloid (nacl 0.9% or ringer's acetate) is given during the procedure until the beginning of the operation. total amount of fluid is also recorded before and after the spinal anesthesia. in addition to the current clinical standard, for the second arm of the study, a trans-thoracic echocardiography is performed before spinal anesthesia, with the aim of assessing the patient's volume status; the exam is performed to assess size and collapsing of the inferior vena cava during breathing cycle. according to different pre-established parameters, the patient is defined as fluid-responsive or unresponsive. if the patient is not responsive, investigators proceed to spinal anesthesia; otherwise they proceed to administration of crystalloid bolus (500 ml of nacl 0.9% or hartmann's solution). the patient may receive another bolus so as to reach a non-responsive pattern for echocardiographic evaluation.

Eligibility criteria:
inclusion criteria: * both sexes * grater than 18 year old * requiring spinal anesthesia * classified according to american society of anesthesiology (asa) level as 1, 2 or 3 exclusion criteria: * patients required invasive blood pressure monitoring (arterial/pulmonary catheter, thermodilution catheter), * patients show signs of pre-procedural hypotension (defined as two measurements of systolic arterial pressure less than 80 mmhg and/or mean arterial pressure less than 60 mmhg), * patients unable to give informed consent to language barriers, mental retard or any reduction in own ability to understand or give their informed consent, * patient in which is not possible to perform spinal anesthesia for patient's refusal or technical difficulties in sampling, * patients with international normalized ratio (inr) greater than 1.5 and/or activated partial thrombin time in therapeutic range (more than 1.5 - 2 times the patient's normal values) and/or anti-factor x activity in therapeutic range * patients with thrombocytopenia less than 50 g/l.

Keywords: fluid replacement trans-thoracic echocardiography spinal anesthesia empirical volemic repletion
the study is about the inﬂuence of the combination of music and noise cancelling as a non-pharmacological aid in reducing anxiety and discomfort during wisdom tooth removal. the level of fear is measured by a questionnaire which the patients answer twice and a measurement of the heartbeat

Conditions: Fear Anxiety; Wisdom Tooth Removal; Heart Rate

Summary: the goal of this clinical trial is to learn if the reduction of the noises (through head phones with music and noise cancelling) that occur during wisdom teeth removal, leads to a significant reduction in fear levels in patients compared to patients who do not have any noise reduction. the main questions it aims to answer are: do music and noise cancelling help patients to have less fear during wisdom teeth removal surgery by reducing the sounds of the surgery? is there a difference between just the noise cancelling function or is it better to combine noise cancelling and music together? participants will: just come to their regular appointment (wisdom teeth removal) to our clinic, no follow ups needed. all participants will answer one questionnaire before and one after the surgery. all of them will have their rate of heartbeat measured for three times (before, during and after surgery, measured by a puls oximeter on the finger). they will be allocated to one of the three study groups (no headphones, headphones with noise cancelling or headphones with noise cancelling and music).

the headphones that will be used are sennheiser overear headphones with modern noise cancelling function. pulse oximeter is by braun and ce-certified. observational study model: randomised controlled, unblinded clinical trial, parallel group design sampling method: randomisation by a online randomizer tool

Eligibility criteria:
inclusion criteria: * willing to participate in the clinical trial, understood and signed the information sheet exclusion criteria: * younger than 18 years old * hearing impairment

Keywords: fear level wisdom teeth removal noise reduction by music and noise cancelling
safety and effectiveness of collagen-phosphorylcholine bioengineered cornea in patients requiring lamellar keratoplasty

Conditions: Corneal Ulcer; Leukoma

Summary: in this study the safety and effectiveness of biosynthetic cornea, comprising interpenetrating networks of recombinant human collagen and phosphorylcholine, will be tested in patients with severe corneal pathology (corneal ulcers or corneal opacification from corneal injury, burn or infection) - diseases, where human donor cornea transplantation (the only widely accepted treatment) carries a high risk of rejection.

collagen-phosphorylcholine corneal substitute will be implanted in patient's corneas with severe pathology (corneal ulcer, corneal leukoma after burn, trauma or infection) using anterior lamellar keratoplasty technique, i.e. when patient's diseased cornea is removed it will be substituted with proposed transparent implant. usually these patients are grafted with human donor cornea, but the latter frequently fails due to graft-versus-host problems. we will test the safety (incidence of adverse events, biocompatability) and the effectiveness (ability to promote healing and increase vision) of developed biosynthetic corneas in 10 patients with corneal pathology, where human donor cornea carries a high risk of rejection. the patients will be follow-uped for 12 months.

Eligibility criteria:
inclusion criteria: 1. subjects must sign and be given a copy of the written informed consent form. 2. subjects with best corrected distance visual acuity 20/200 or worse as a result of corneal ulcer or corneal scar due to burn, injury or infection in the operative eye. 3. subjects must be willing and able to return for scheduled follow-up examinations for 12 months after surgery. exclusion criteria: 1. subjects with severe or life-threatening systemic disease. 2. subjects with uncontrolled hypertension. 3. subjects with uncontrolled diabetes or insulin-dependent diabetes. 4. subjects with glaucoma in either eye. 5. subjects with marked microphthalmos or aniridia in either eye. 6. subjects with any other serious ocular pathology, serious ocular complications at the time of corneal transplant underlying serious medical conditions, based on the investigator's medical judgment. 7. subjects which are or lactating or who plan to become pregnant over the course of the clinical investigation.
effect of premeal protein-bar on glycemic control in patients with type 2 diabetes

Conditions: Patients With Type 2 Diabetes

Summary: the aim of this study is to evaluate the effect of premeal protein-enriched bar in long-term glycemic control in patients with type 2 diabetes mellitus. glucose levels in subjects who intake premeal protein-enriched bar with dietary modification will be compared to those in subjects who only do the dietary modification.

forty subjects with type 2 diabetes will be recruited. every subject will be randomized in two groups, which are premeal protein bar with dietary modification group and dietary modification only group. the study will be conducted for 12 weeks for each participants. all participants will receive diabetes diet education. intervention group will consume protein-enriched bar before each meals (at least twice a day) and control group will follow diabetes diet education without other additional supplements. primary outcome is change of hba1c from baseline for 12 weeks, and secondary outcomes are changes of fasting blood glucose level, body weight, waist circumference, blood lipid level, homa-ir and homa-beta from baseline for 12 weeks.

Eligibility criteria:
inclusion criteria: * bmi 18.5\~35 kg/m2 * type 2 diabetes patients * fasting blood glucose ≥ 126 mg/dl or * hba1c ≥ 6.5% or * subjects who were previously diagnosed with type 2 diabetes and who have been treated with lifestyle modification only, oral anti-diabetic drugs or basal insulin. exclusion criteria: * hba1c \ 10% * subjects using insulin other than basal insulin * subjects who have newly started or have changed anti diabetic drugs within 3 months * subjects who are allergic to grains, nuts, legumes and milk * previous history of gastrointestinal surgery (except for hemorrhoid surgery, appendectomy surgery and hernia surgery) * subjects with chronic unstable disease * subjects with cognitive impairments who are not able to follow the study protocol * females who are pregnant or doing breast feeding * subjects with aspartate aminotransferase (ast) or alanine aminotransferase (alt) levels of higher than 3 times of upper normal ranges * subjects with hemoglobin level of less than 10.0 g/dl * subjects with alcohol addiction or drug abuse

Keywords: protein-enriched bar glycemic control type 2 diabetes long term
memory and attention disorders and malnutrition in hospital setting

Conditions: Dementia; Delirium; Cognitive Impairment; Malnutrition

Summary: this is a cross-sectional observational study that investigates the prevalence of memory disorders, attention disorders (suggesting delirium), and malnutrition in hospitalized older adults (aged 70 years or over) in a tertiary care centre, using rapid screening toos (six-item screener for memory disorders, months of the year backwards test for delirium, and nrs-2002 and mini nutritional assessment short form for malnutrition).


Eligibility criteria:
inclusion criteria: * hospitalized in tampere university hospital (excl. psyciatry, pediatrics, icu) * able to communicate in finnish exclusion criteria: * unable to communicate because of unconciuousness, critical health status, or communication difficulties * having a (surgical) procedure at the time of data collection