Kornimate/medical-research-clean huggingface dataset:
the reinforcing value of added sugars

Conditions: Obesity

Summary: the purpose of this study is to determine how daily diet relates to eating choices.

despite the long-term emphasis on reducing intake of and added sugar, this behavioral change has been hard to instill amongst most of the population. foods with added sugars are highly reinforcing and, as such, reducing their consumption in order to adhere to the dietary guidelines (dga) may be difficult to maintain. sugar produces effects similar to some drugs of abuse such as increased extracellular dopamine release in the nucleus accumbens shell resulting in a reinforcing effect. reducing any reinforcing behavior can be challenging, but in terms of food, it is not known whether the reinforcing value of foods high in added sugar increases when access to these foods is reduced. if so, this would present a mechanistic barrier to meeting the dga and making dietary changes in general. that the reinforcing value of a behavior (e.g., eating sugar) will be increased when the rate of that behavior is decreased has strong theoretical underpinnings in the "disequilibrium approach". this theory predicts that the circumstances of reinforcement are created or limited by changing baseline access. according to the disequilibrium approach, a response deficit will result in an increase in reinforcement. applied to the proposed study, the disequilibrium approach would predict that lowering the consumption of dietary added sugar would increase the reinforcing value of foods high in added sugar. the disequilibrium approach has accurately predicted an increase in the relative reinforcing value (rrv) of snack foods among children. however, dietary changes would need to occur at the whole diet level for adults and children to meet the dga for reducing added sugar intake. it is important to know if reducing added sugars at the whole-diet level results in increases in the reinforcing value of foods high in added sugars.

Eligibility criteria:
inclusion criteria: * bmi within 18.5-24.9 kg/m2 or bmi within 30.0-50.0 kg/m2 * willing to consent to study conditions * habitually consume at least 10% of daily energy intake from added sugars exclusion criteria: * bmi 25.0-29.9 kg/m2 * currently taking drugs that change hunger * have an eating disorder * current tobacco user * have diabetes or heart disease * pregnant, lactating or planning pregnancy * low liking of all available study test foods * allergy/aversion to any of the foods provided during the diet intervention
the effect of different i:e ratio on gas exchange of patients undergoing one-lung ventilation for lung surgery

Conditions: Lung Cancer; One Lung Ventilation; Gas Exchange; Inverse-ratio Ventilation

Summary: pulmonary gas exchange disturbance is a common anesthetic problem during one-lung ventilation (olv) for thoracic surgery. the inverse-ratio ventilation (irv), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. the effect of irv is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. we tried to evaluate the effect of irv during olv with lung protective strategy.

pulmonary gas exchange disturbance is a common anesthetic problem during one-lung ventilation (olv) for thoracic surgery. continuous positive airway pressure or positive end-expiratory pressure are usually applied to improve this disorder including hypoxia, but these methods are not enough. the inverse-ratio ventilation (irv), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. the effect of irv is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. the application of irv during olv has not been performed to our knowledge, and there is a possibility of irv to improve oxygenation during olv. there is a possibility of increase of auto-peep, or air trapping in subjects with chronic obstructive pulmonary disease, but this kind of auto-peep can be overcome by external peep. therefore, we tried to evaluate the effect of irv during olv with lung protective strategy.

Eligibility criteria:
inclusion criteria: * patients undergoing elective lung lobectomy surgery. * the duration of one-lung ventilation is more than one hour. * subjects with more than twenty years old. exclusion criteria: * subjects with past history of pneumothorax, asthma * age under 20, more than 70 years. * patients with ischemic heart disease, valvular heart disease * patients with hemodynamic unstability

Keywords: one lung ventilation gas exchange inverse-ratio ventilation
cardiovascular risk markers and response to statins after kawasaki disease

Conditions: Kawasaki Disease

Summary: the purpose of this study is to determine whether chilean children with history of kawasaki disease have endothelial dysfunction years after the acute phase of the disease, and if this condition can be modified by treatment with statins.

kawasaki disease (kd) in its acute phase produces endothelial inflammation that can lead to dilatation and aneurysms of coronary and peripheral arteries. this initial injury leads to persistent endothelial dysfunction several years after having the disease. as a consequence, these patients may have a higher cardiovascular risk than general population. studies with hmg-coa reductase inhibitors (statins) have suggested that these have an anti-inflammatory effect over the endothelium, that may be independent of its lipid-lowering effects. the hypothesis of this study is that kd produces endothelial dysfunction that is persistent years after acute disease, and that this dysfunction can be modified by treatment with statins.the study consists of two phases. on the first we will perform ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery and evaluate other cardiovascular risk markers in patients and healthy controls. on the second phase patients with history of kawasaki disease will be randomized and allocated to treatment with pravastatin or placebo, after which a new evaluation of flow-mediated dilation of the brachial artery and cardiovascular risk markers will be performed. comparison(s): children older than 8 years of age with history of kawasaki disease more than 12 months before enrollment, compared with paired by age children without history of kd or other cardiovascular risk factors.

Eligibility criteria:
inclusion criteria: * history of kawasaki disease more than 12 months before enrollment * present age of 8 years or older exclusion criteria: * diabetes mellitus * not controlled hypertension * treatment with drugs thay modify endothelial function such as angiotensin converting enzyme inhibitors, angiotensin ii receptor antagonists, and calcium channel blockers * smokers of more than 5 cigarettes per day * total cholesterol higher than 250 mg/dl * triglycerides higher than 300mg/dl * chronic treatment with statins * chronic renal insufficiency (creatinine \> 1.5 mg/dl)

Keywords: mucocutaneous lymph node syndrome kawasaki disease endothelial dysfunction pravastatin statin therapy
effect of intravenous ceftriaxone and oral doxycycline for lyme neuroborreliosis

Conditions: Lyme Neuroborreliosis

Summary: the aim of this study is to compare parenteral ceftriaxone and oral doxycycline in the treatment of neuroborreliosis in a randomized controlled trial.


Eligibility criteria:
inclusion criteria: * neurological symptoms and/or findings consistent with neuroborreliosis and at least one of the following fulfilled: * intrathecal production of borrelia antibodies; * white cell count in cerebrospinal fluid (csf) \> 5/mm3; * significant rise in borrelia antibodies in two serum samples collected from a patient with at least 3 weeks interval; * verified acrodermatitis chronica atrophicans. exclusion criteria: * allergy to the contents in the medication, or earlier type i reaction to penicillin. * treatment with cephalosporins, penicillin or tetracyclins during the last 14 days * pregnancy or breastfeeding * age \< 18 years

Keywords: neuroborreliosis
use of high flows in pediatric cardiac surgical patients

Conditions: Congenital Heart Disease

Summary: humidified high flow nasal prong oxygen therapy is a method for providing oxygen and cpap. the delivery of high flows decreases dilution of the inhaled oxygen and, by matching patient's peak flow, allows accurate delivery of the set fio2 throughout the whole inspiratory phase. in addition, a flow-dependent effect of continuous positive airway pressure, possibly due to an air entrainment mechanism, has been documented in healthy volunteers and in patients with copd. the investigators working hypothesis is that the use of post-extubation cpap delivered via nasal cannulae in infants less than 18 months, post-bypass surgery will have better paco2 values than infants extubated on to oxygen therapy.

after cicu admission, infants with no bleeding, normothermic and hemodynamically stable will be switched from prvc to simv+psv (10-15cmh20) which should be maintained for 4 hours. an arterial gas analysis will be performed after 20 minutes. infants with normal gas-exchange are gradually weaned from mechanical ventilation at each weaning step an arterial hemogasanalysis is performed after 20 minutes, to assess if the decreased ventilatory support is tolerated. increased work of breathing and respiratory acidosis (ph\ 60 mmhg) are considered criteria to withhold the weaning process. after a 4 hour period on simv+psv the child should be switched to psv for 30 minutes and then extubated. the following extubation criteria should be reached: * satisfactory blood gases with pco2 under 45mmhg, ph greater than 7.30. * fractional inspired oxygen concentration of 65% and or less than the baseline value * adequate respiratory frequency according to age without dyspnea at this point criteria for extubation are reached. once extubation has taken place the child will be placed either on traditional oxygen therapy or high flow nasal cannulae according to randomization.

Eligibility criteria:
inclusion criteria: * age: 0-18 months * mechanical ventilation via an endotracheal tube * elective surgery * post-bypass procedure * rachs 2 and above exclusion criteria: * presence of major congenital malformations * presence of neuromuscular disease * presence of non drained pneumothorax * absent respiratory drive or recurrent apneas * hemodynamic instability * glasgow coma score (gcs) less than 8 * ecg with evidence of ischaemia or arrhythmias * active bleeding
toolbox detect: low cost detection of cognitive decline in primary care settings

Conditions: Cognitive Dysfunction; Dementia

Summary: our study objective is to widely implement and evaluate a user-centered, scalable, electronic health record (ehr)-linked strategy for the routine detection of cognitive decline among diverse primary care settings. this strategy, called toolboxdetect, will provide an efficient and sensitive cognitive screen that can be easily implemented in everyday clinical settings, and is responsive to patient, family, and caregiver concerns for potential symptoms of cognitive decline (cd) and cognitive impairment (ci).

our study objective is to widely implement and evaluate a user-centered, scalable, electronic health record (ehr)-linked strategy for the routine detection of cognitive decline among diverse primary care settings. we will conduct a large-scale, primary care practice-randomized trial to implement and comprehensively evaluate toolboxdetect as a standard of care with awvs, linked to an ehr (epic). diverse, academic and community settings are included to optimize future dissemination efforts. toolboxdetect is an ipad-based, self-administered assessment that leverages two well validated measures from the nih toolbox cognition battery: dimensional change card sorting (for executive function) and the picture sequence memory (for episodic memory). it takes approximately 7-8 minutes to administer, and for practices randomized to the toolboxdetect arm, this will be used as the practice standard to fulfill the requirement for cognitive testing as part of the medicare annual wellness visit (awv). the aims of our investigation are to: 1. evaluate the effectiveness of toolboxdetect, compared to enhanced usual care, to promote timely detection of cognitive decline and its care management. 2. disseminate and implement toolboxdetect among a large federally qualified health center network and assess its feasibility and acceptability for use; 3. investigate the fidelity of toolboxdetect, and identify any patient, caregiver, healthcare provider and/or system barriers to its optimal, sustained implementation; 4. determine costs associated with implementing toolboxdetect from a primary care perspective.

Eligibility criteria:
inclusion criteria: 1. individuals aged 65 and older will be considered. 2. adults who may or may not have cognitive impairments. 3. practices affiliated with northwestern medicine and access community health network. exclusion criteria: 1. severe, uncorrectable vision or hearing impairment
a retrospective study on the effect of male progressive sperm count after semen pretreatment on icsi fertilization outcome

Conditions: Sperm Count, Low; Reproductive Sterility

Summary: the investigators plan to retrospectively analyze clinical data from 14,189 fresh icsi cycles in reproductive and genetic hospital of citic-xiangya from january 2016 to december 2017.the investigators will regard total progressive sperm number of 2 x 10\^6 after pretreatment as the boundary value, and will divide total progressive sperm number of 2 x 10\^6 after pretreatment into 2 x 10\^6 or higher and \< 2 x 10\^6 groups, and will further divide \< 2 x 10\^6 group into: = 0, (0,10\^6\], (10\^6, 2 x 10\^6) three groups. propensity score matching will be used to balance the baseline data between four groups. the matching variables are age, female bmi, afc, amh and icsi.


Eligibility criteria:
inclusion criteria: * infertility female and sterility male for reproductive treatment exclusion criteria: * chromosomal abnormalities * none retrieval oocyte * none oocyte for icsi * recurrent abortion * female age≥37 years * assisted hatching * abnormal oocyte zona pellucida * in vitro maturation * azf microdeletion

Keywords: icsi, progressive sperm count, embryo
perioperative hemodynamic optimization using the photoplethysmography in colorectal surgery

Conditions: Polyp of Large Intestine; Colorectal Neoplasms; Crohn Disease

Summary: the purpose of this study is to determine whether hemodynamic optimization with photoplethysmography (clearsight, edwards lifesciences, irvine, ca) during colorectal surgery could decrease the incidence of perioperative complications.

all patients received the photoplethysmography monitoring, but the monitor was blinded in the control group.

Eligibility criteria:
inclusion criteria: * age\> 18 years * colorectal surgery exclusion criteria: * pregnant women * black skin * chronic renal insufficiency (mdrd \<30 ml/min)
prevention, management and rehabilitation of knee osteoarthritis at the workplace

Conditions: Knee Pain Chronic; Knee Osteoarthritis; Knee Discomfort

Summary: the goal of this intervention study is to assess the effect of blood flow restricted (bfr) exercise integrated into the daily work tasks among hospital workers with or at increased risk of chronic knee pain. the main questions are: can bfr exercise integrated into the daily work tasks reduce knee pain (primary outcome) and improve function and work ability among hospital workers with or at increased risk of chronic knee pain? participants in the intervention group will for shorts bouts during their workdays integrate bfr into their daily work tasks involving walking, whereas the control group will continue as usual.


Eligibility criteria:
inclusion criteria: * hospital workers working at least 20 hours per week with or without chronic knee pain (\>3 months) exclusion criteria: * life-threatening disease * conditions where bfr training may be contraindicated, e.g. pregnancy, cancer, diabetes, major cardiovascular disease, current, previous or family history of clotting disorders, recent immobilization, major surgery or injections into the joint (i.e. corticosteroid injection) * systolic/diastolic blood pressure above 160/100 mmhg
cohort of patients presenting unexplained recurrent miscarriages and identification of early miscarriage recidivism factors

Conditions: Miscarriage

Summary: about 1 to 3% of women of childbearing age have repeated early spontaneous miscarriages (rcf) defined by at least 3 fetal losses before 14 weeks of gestation. rcfs may be related to parental chromosomal abnormalities, congenital or acquired uterine abnormalities, hormonal causes (e.g. type 1 and 2 diabetes, ovarian failure), infectious etiology, constitutional or acquired thrombophilia or sickle cell disease. the presence of antiphospholipid antibodies, antithyroid and anti-transglutaminase antibodies in approximately 10% of cases suggests an autoimmune origin for these fetal losses. the role of other antibodies, in particular unconventional antiphospholipid antibodies, remains to be established. indeed half of rcf cases would be due to an immunological dysregulation of the mother leading to a decrease in tolerance to the fetus. several studies have shown immune abnormalities, such as an imbalance of pro and anti-inflammatory cytokines, an increase in cytotoxic cells and a defect in regulatory cells in the blood of patients. the assessment of these immune abnormalities is not currently carried out routinely in france in women with recurrent early miscarriages. when one of these known causes is excluded, it is unexplained rcf which represents 50% of rcf. in these women with unexplained rcf, slightly more than half could be linked to aneuploidies and primary recurrent spontaneous abortions. the evaluation of the degree of aneuploidy and the genetic origin of fetal losses remains difficult, the examination of the sample of tissue from the miscarriage being rarely available, due to the spontaneous nature of the loss. the constitution of a prospective cohort of patients with rcf is an essential step in exploring the factors associated with the success of treatment.

on the day of inclusion, if the patient accepts the ancillary study, a blood sample will be taken for the biological collection if the patient becomes pregnant during the follow-up period, the blood sample for the ancillary study will be repeated each trimester of pregnancy (if applicable). at the inclusion visit and during pregnancy, the patient will complete a baecke questionnaire and a questionnaire to measure perceived stress the study population will be followed as part of usual care, identical to all patients presenting with rcf. as part of the routine care of the internal medicine department of saint antoine, patients with rcf have a complete check-up in the day hospital (complete blood test, stomatologist consultation, ecg) and are seen in consultation twice a year.

Eligibility criteria:
inclusion criteria: * age 18 to 50 years * patients with at least 3 recurrent miscarriages * signed consent form exclusion criteria: - patients who don't accept the use of their data

Keywords: miscarriage prognostic factors biological collection
using health-related quality of life (hrql) in routine clinical care

Conditions: Chronic Obstructive Pulmonary Disease; Pulmonary Fibrosis; Pulmonary Hypertension; Cystic Fibrosis

Summary: the objective of this study is to assess the effects of using hrql measures in the clinical care of pre- and post-lung transplant patients. the hypotheses are that the inclusion of hrql measures, the health utilities index system mark 2(hui2) and mark 3 (hui3), in routine clinical care of pre- and post-lung transplant patients, will: 1) improve patient-clinician communication;2) affect patient management; 3) improve patients' hrql.

recently there has been increasing interest in the use of health-related quality of life (hrql) measures in routine clinical practice. traditionally, patient care has been based on laboratory results, medical history, and signs and symptoms diagnosed by clinicians. the inclusion of hrql measures in routine practice may provide important and often otherwise missing information, revealing the impact of the disease or its treatment on the patient's physical, emotional and social well-being, and may assist in patient management. hrql assessments may assist in changing the medical paradigm from a disease-centered approach to a patient-centered one. several studies in mental health and oncology discuss the application of hrql measures in clinical practice. taenzer et al (2000) and detmar et al. (2002) provide evidence that using hrql measures improves patient-clinician communication. velikova et al (2004) detected impacts on communication and the emotional well-being of patients. using a framework based on these previous studies and the methods for the health technology assessment of diagnostic technologies (guyatt et al. 1986), we will assess the effects of including hrql assessments in the routine clinical care of patients undergoing solid organ transplantation (lung). we expect that the routine use of hrql measures in clinical practice will affect patient-clinician communication, patient management, and patient outcome. lung transplantation trades a fatal disease (end-stage pulmonary disease) for a chance at prolonged survival and improved quality of life, albeit with immunosuppression. in this context, generic preference-based measures such as hui2 and hui3 are preferred to specific measures, because they measure a broader range of health dimensions, including pain, ambulation and emotional issues that are expected to be relevant. preference-based measures provide scores on the conventional 0.00 (dead) to 1.00 (perfect health) scale that allows for the integration of morbidity and mortality effects and calculation of quality adjusted life years (qalys) and health-adjusted life expectancy (hale).

Eligibility criteria:
inclusion criteria: * pre-lung transplant:subjects who are included on the waiting list and are being seen at the out-patient clinic * post-lung transplant subjects. exclusion criteria: * younger than 18 years of age * diagnosed as being cognitively impaired * unable to complete questionnaires in english

Keywords: lung transplantation, health-related quality of life.
application of three-dimensionally printed navigational template in lung biopsy

Conditions: Lung Neoplasms

Summary: this is a prospective, randomized, controlled study to evaluate the diagnostic yield and safety of three-dimensionally printed navigational template in percutaneous transthoracic lung biopsy.

the feasibility of three-dimensionally printed navigational template-guided percutaneous transthoracic fine-needle aspiration was validated by a phase i study. to further investigate the non-inferiority of navigational template-guided lung biopsy to conventional ct-guided modality in terms of diagnostic yield, this prospective, randomized, controlled, noninferiority trial was conducted.

Eligibility criteria:
ⅰ. inclusion criteria: a. ct confirmed peripheral lung lesion; b. nodule size larger than or equal to 30 mm; c. scheduled for percutaneous transthoracic fine-needle aspiration; d. percutaneous transthoracic lung biopsy was conducted at supine or partially lateral decubitus; e. eastern cooperative oncology group (ecog) performance status 0-2; f. written informed consent provided. ⅱ. exclusion criteria: a. biopsy needle insertion route impeded by skeletal structures; b. lesion within 3 cm above diaphragmatic dome; c. insertion route longer than the biopsy needle; d. lung biopsy needed to be conducted at vertically lateral decubitus; e. any contraindication of percutaneous transthoracic lung biopsy; f. women who are pregnant or in the period of breastfeeding.

Keywords: biopsy, needle printing, three-dimensional image-guided biopsy