Kornimate/medical-research-clean huggingface dataset:
study on the treatment of hepatitis b virus(hbv) infected individuals with peginterferon α-2b combined with na.

Conditions: HBV

Summary: this is a retrospective prospective, open-label, multicenter clinical study aiming to recruit 400 individuals with a family history of liver cancer to explore the clinical cure rate and the effectiveness, feasibility, and safety of pegylated interferon α-2b combined with nucleos(t)ide analogues in treating chronic hbv carriers with a family history of liver cancer for reducing the risk of liver cancer occurrence. patients will enrolled into group a (peg-ifnα-2b combined with na treatment group) or group b (na monotherapy group) based on their medication choices. each group is expected to enroll 200 patients, with all patients followed up to 240 weeks. the dosage, frequency, and duration of treatment with peg-ifn α-2b and na will be prescribed by the researchers according to clinical practice and standard treatment protocols.


Eligibility criteria:
inclusion criteria: * age18-65 years (inclusive of 18 and 65), no restriction on gender; * hbsag positive history for at least 6 months; * family history of liver cancer \[including first-degree and second-degree relatives; first-degree relatives are parents, children, and siblings (same parents), while second-degree relatives are uncles, aunts, grandparents, and great-grandparents; a family history of liver cancer means that one or more first-degree or second-degree relatives have had liver cancer\]; * planning to or already receiving treatment with peginterferon alpha-2b in combination with nucleoside (acid) analogs, or receiving nucleoside (acid) analogs treatment alone; * negative urine or serum pregnancy test within 24 hours before the first dose (for women of childbearing age); * willing to receive treatment and sign an informed consent form. exclusion criteria: * allergy to interferon; * history of using telbivudine for antiviral treatment; * alt(alanine aminotransferase) greater than 10 times the upper limit of normal, total bilirubin greater than 2 times the upper limit of normal; * decompensated liver cirrhosis; * neutrophil count \< 1.5 x 10\^9/l or platelet count \< 80 x 10\^9/l; * presence of severe lesions in vital organs such as the cardiovascular, pulmonary, renal, brain, and fundus; * those with autoimmune diseases, psychiatric disorders, poorly controlled diabetes, or thyroid dysfunction (hyperthyroidism or hypothyroidism); * confirmed or suspected liver cancer or other malignant tumors; * post-organ transplant or preparing for organ transplantation; * currently using immunosuppressants; * pregnant or planning to become pregnant within 2 years; * alcohol or drug addicts; * hiv co-infection; * other conditions deemed unsuitable for interferon use by the attending physician.

Keywords: peginterferon α-2b injection nucleotide analogues hbv
inpatient link to addiction recovery

Conditions: Substance Use Disorders

Summary: the objective of this proposal is to link inpatients to a certified peer support specialist through favor-greenville and determine the effectiveness of recovery coaching on patient outcomes.this study will evaluate the impact of initiating peer recovery coaching during sud patients' hospitalization on engagement in recovery services, addiction severity, and quality of life compared to the current standard of care.

the united states is in the midst of a drug overdose crisis: the rate of substance use, overdose, and substance abuse-related economic costs is rapidly increasing. despite the prevalence of substance abuse disorder (sud), only 10% of sud patients receive treatment. the initial link into care is often one of the hardest barriers to overcome due to wait times, complex systems to navigate, and fluctuating motivation. hospitalization is often a time when patients are more receptive to sud treatment. one potential effective treatment approach is peer recovery support services. currently at greenville memorial hospital, there is no direct link between hospitalization and outpatient care for patients with sud, making it difficult to start or continue the recovery process. thus, the goal of this study is to evaluate the impact of the initiation of peer recovery services during hospitalization on addiction severity and quality of life. by establishing a successful inpatient link to recovery treatment, this study may lead to the development of an effective method of care that can readily be implemented into the healthcare system.

Eligibility criteria:
inclusion criteria: * age 18 or older * english speaking; * identified by healthcare provider as having substance use disorder * recent substance use * currently admitted to the medical teaching services, general medicine hospitalist services, or infectious disease consult service at greenville memorial hospital exclusion criteria: * are unable to provide informed consent (intubation, confusion, etc.) during hospitalization * are admitted for marijuana use only * are pregnant

Keywords: recovery coaching substance abuse
screening of adult urban population to diagnose heart failure

Conditions: Heart Failure

Summary: screening of adult urban population to diagnose heart failure (sobota-hf) is a cross-sectional prevalence study in a representative sample of murska sobota residents aged 55 years or more. individuals will be invited to participate in a screening with nt-probnp. all subjects with nt-probnp ≥ 125 pg/ml will be invited for a diagnostic visit that will include history and physical examination, electrocardiogram, echocardiography, ankle brachial index, pulmonary function tests, body composition measurement, physical performance tests and questionnaires. to validate the screening procedure, a control group (nt-probnp \< 125 pg/ml) will undergo same diagnostic evaluation. an external center will validate echodardiography exams and the hf diagnosis will be adjudicated within an independent hf expert panel. overall and age specific hf prevalence will be calculated in individuals ≥ 55 years and extrapolated to the whole population.


Eligibility criteria:
inclusion criteria: * age \>55 * living in murska sobota * part of representative sample as selected by statistical office of the republic of slovenia exclusion criteria: none.

Keywords: heart failure prevalence
how does magnesium status influence calcium homeostasis?

Conditions: Magnesium Deficiency; Calcium Metabolism Disorders

Summary: the investigators aim to recruit 60 women who have agreed to participate in an existing randomized, double-blind, placebo-controlled trial (treatment of vitamin d insufficiency, hsc 2009-0055). in this trial, the investigators propose to evaluate the associations between magnesium intake, magnesium stores, fractional magnesium absorption and calcium homeostasis. the investigators will stratify 60 subjects in the sub-study, ensuring that approximately 20 subjects are randomized into each treatment arm (placebo, low-dose and high-dose vitamin d). the investigators already assess calcium homeostasis throughout the study by measuring bone mineral density, fractional calcium absorption, serum and urine calcium levels, among other tests. in the sub-study of 60 women, the investigators will evaluate whether habitually higher magnesium intake increases or decreases fractional calcium absorption. the investigators will evaluate the interplay between magnesium stores, vitamin d levels and serum parathyroid hormone levels. the investigators will directly assess magnesium stores using serum magnesium and 24-hour urine magnesium levels, and will measure magnesium absorption using the dual stable isotope approach.

use of serum magnesium isotopes to measure fractional magnesium absorption four day food diaries to assess magnesium intake standard urine and serum chemistries for remaining labs as noted above

Eligibility criteria:
inclusion criteria: * participants eligible for the study "treatment of vitamin d insufficiency" are eligible for participation in the current sub-study exclusion criteria: * identical to those covered in hsc #2009-0055

Keywords: vitamin d cholecalciferol bone mineral density magnesium deficiency calcium metabolism disorders
a study of outcomes in patients with fractured neck of femur during the covid-19 pandemic

Conditions: Femoral Neck Fractures; SARS-CoV 2

Summary: in early 2020 the evolving covid-19 pandemic provided the world and medical community with a generational challenge. as a novel disease, countries were left with strategic decisions and many went into social lockdown. initial resources and research were directed at upscaling internal medicine and intensive care services, understanding the disease pathophysiology, and testing treatments. it soon became evident that covid-19 had multi-system effects at it's worst. in orthopaedics one of the most vulnerable groups to covid-19 were the elderly, specifically those who suffered fractured neck of femur at this time. more literature is needed urgently if we are to understand and mitigate the negative impacts in this group of patients. this observational study assesses the early morbidity and mortality of patients with this diagnosis during the evolving covid-19 pandemic.

many elderly patients admitted to hospitals during the evolving covid-19 pandemic after falls or being generally unwell, were considered to have a possible diagnosis of covid-19. this was extremely relevant to the subgroup of patients who suffered from fractured neck of femurs during this time, with most of them elderly, frail, and more likely to have multiple co-morbidities. covid-19 was considered a precipitating factor for falls, but also anecdotally, an indicator of potentially poor recovery and rehabilitation. with regards to orthopaedic and trauma surgery, a limited amount of literature is available pertaining to covid-19 and specifically it's potential effects on patient outcomes in patients requiring surgery. we performed a multi centre observational study across london, united kingdom, looking at the demographics and details of patients admitted with fractured neck of femur during the evolving pandemic. all data collected was non identifiable. data was also collected as to the covid-19 status of these patients, either positive or negative. data was analysed to assess the morbidity and mortality of this patient group and search for any prognostic factors.

Eligibility criteria:
inclusion criteria: * fractured neck of femur * received operative intervention for fractured neck of femur exclusion criteria: * open fracture * fracture of femoral shaft * periprosthetic fracture * revision surgery

Keywords: covid-19 coronavirus neck of femur morbidity mortality prognosis
differential diagnosis for the causes of subclavian steal for patients with vascular access in the forearm

Conditions: Subclavian Steal

Summary: subclavian steal phenomenon is normally observed in patients with stenosis of subclavian artery proximal to orifice of vertebral artery(v0). however, uremic patients undergoing hemodialysis using vascular access in the arm or forearm may also develop dialysis associated steal syndrome(dass).for patients with symptomatic subclavian steal phenomenon, the treatment for these two groups is different. the investigators want to see if the investigators can use noninvasive duplex examination instead of invasive conventional angiography to do the differential diagnosis.

carotid duplex is widely used for diagnosis of subclavian steal syndrome. we have a patient who suffered from acute brain stem stroke after receiving hemodialysis for months. he has dm related uremia and the vascular access is in the forearm. subclavian steal was found on duplex in the same arm for hemodialysis. we used standard cuff test for diagnosis of subclavian steal by carotid duplex examination. accidentally, we found the flow of subclavian artery was back to normal when the cuff is on that stops the flow. we want to see if this phenomenon can be used to serve as a differential diagnostic tool for differentiation of subclavian steal caused by stenosis of subclavian artery or due to dass.

Eligibility criteria:
inclusion criteria: * patients who revealed subclavian steal in the duplex study exclusion criteria: * patients who has vascular access in the arm instead of the forearm

Keywords: subclavian steal carotid duplex subclavian stenosis hemodialysis with vascular access in the upper limbs the focus of this study is to see if duplex can be used as an tool to differentiate the different causes of subclavian steal syndromes
effect of nasal spray dexmedetomidine on emergence delirium prevention in total hip replacement

Conditions: Delirium

Summary: emergence delirium (ed) is a common postoperative complication refers to an acute brain dysfunction that occurs during the recovery from general anesthesia, which is mainly characterized by sudden attention and consciousness disorders. the occurrence of ed increases the risk of self-injury, wound dehiscence, accidental catheter dislocation, and postoperative delirium, and is also associated with postoperative cognitive deterioration and increased utilization of medical resources after discharge.

the incidence of hip fracture after surgery in patients over 55 years old is about 45%, and ed is highly predictive of delirium during postoperative hospitalization, which occurs in about 1/3 of ed patients during postoperative hospitalization. it has been suggested that if delirium is monitored only on the first postoperative day and not at the pacu stage, up to 53% of delirium cases may be missed. studies have shown that perioperative application of dexmedetomidine can reduce the risk of postoperative delirium to a certain extent. however, intravenous dexmedetomidine usually leads to problems with delayed extubation, residual sedation, and prolonged pacu stay. previous studies have shown that intranasal dexmedetomidine improves perioperative sleep quality and neurocognitive deficits in elderly patients undergoing laparoscopic gynecologic surgery. compared with intravenous administration, intranasal administration of dexmedetomidine resulted in milder hemodynamic fluctuations. however, stable nasal spray bioavailability is superior to intravenous dosage forms for nasal use. based on the above background, this study aims to investigate the effect of nasal spray of dexmedetomidine on the prevention of emergence delirium after total hip replacement in elderly patients.

Eligibility criteria:
inclusion criteria: 1. age ≥60 years old 2. total hip arthroplasty under general anesthesia 3. asa ii-iii 4. informed consent was obtained from patients or their guardians exclusion criteria: 1. allergy or contraindication to dexmedetomidine 2. severe rhinitis and nasal deformity 3. severe bradycardia (heart rate \<50 beats/minute) or atrioventricular block of grade 2 or higher, permanent pacemaker implantation, severe heart failure or ejection fraction \<30% 4. patients with previous myocardial infarction, unstable angina pectoris, severe arrhythmia, and cardiac insufficiency 5. emergency surgery 6. severe hepatic and renal dysfunction (child-pugh class b and c, ckd3-5) 7. preoperative mental illness, cognitive impairment, and communication difficulties could not be evaluated in the study 8. preoperative delirium was present
effect of speed-dependent treadmill training in patients with subacute stroke

Conditions: Stroke

Summary: this study aimed to explore whether speed-dependent treadmill training is more effective at improving walking and balance performance than speed-stable treadmill training in patients with subacute stroke. twenty-six patients with stroke completed 2 weeks of treadmill training. results showed that speed-dependent treadmill training is more effective at improving walking speed and step length than speed-stable treadmill training in patients with subacute stroke.

objectives: to compare the effects of speed-dependent treadmill training (sdt) on gait and balance performance in patients with sub-acute stroke. design: double-blinded randomized controlled trial. subjects: twenty-six patients with sub-acute stroke were randomly assigned to sdt (n=13) and control (n=13) groups. methods: subjects in the sdt group underwent short interval of walking trials with stepwise increases in the treadmill speed, following the principles of sprint training. control subjects received gait training on the treadmill with a steady speed (sst). gait speed, stride length, cadence, and berg's balance score (bbs) were recorded and analysed before and after the 10 training sessions. results: results of two-way repeated measures anova showed significant group x time interactions for gait speed and stride length (p \< 0.05). within each subject group, there were improvements in all gait parameters and bbs (all p \< 0.001) after the training program. in addition, the sdt group showed significantly larger percentage increases in gait speed (by 72.8%) and stride length (by 29.2%) than the control subjects (p \< 0.02). conclusions: sdt in patients with sub-acute stroke resulted in larger gains in gait speed and stride length compared with sst. the positive findings provide evidence for clinical practice of sdt in enhancing gait function after stroke.

Eligibility criteria:
inclusion criteria: * first episode of stroke * within 1 month of stroke onset * hemiparesis resulting from unilateral ischemic stroke * ashworth score of 0 or 1 indicating no spasticity or slight spasticity over the affected lower limb respectively * mini-mental status examination score of ≥ 23 * the ability to walk on level ground without physical assistance and to walk on a treadmill with a minimum speed of 22.2 cm/s for 30s exclusion criteria: * neurological diseases other than stroke, * active cardiovascular disease (i.e. american heart association class c or above), * lower limb fractures * total hip replacement * active rheumatoid arthritis that affected their gait performance * patients who required assistance to ambulate before the stroke were also excluded

Keywords: gait hemiplegia treadmill physiotherapy rehabilitation
an online intervention addressing mental health and substance use in university students

Conditions: Anxiety; Depression; Alcohol Use; Substance Use

Summary: the purpose of this study is to assess the effectiveness of mobile app containing a range of evidence based tools to improve the mental health and substance use outcomes of university students.

there is a need for scalable interventions to support the mental health and substance use challenges experienced by university students. one means of addressing this need is through the use of e-mental health tools that facilitate self-management and connect students to in-person supports as needed. this is a randomized controlled trial of a mobile app designed to help university students manage their mental health and substance use via a set of evidence-based tools that have been integrated into a single mobile app. the recruitment of approximately 1500 students will occur through social media, promotion by faculty members and administrators, and other in-person recruitment methods. assessments will be conducted using self-report web surveys at baseline, 14 days (interim assessment) and 30 days (follow-up assessment). the goal of the trial is to assess the effectiveness of the app in improving a range of mental health and substance use outcomes of university students from baseline to follow-up.

Eligibility criteria:
inclusion criteria: 1. must be currently enrolled at participating university 2. must be 17 years or older 3. must have access to and be able to use a smart phone with wi-fi and/or mobile data 4. must be english speaking exclusion criteria: 1) any participants that self-identify as currently having a suicidal plan at the time of study enrollment

Keywords: student mental health anxiety depression alcohol use substance use cannabis use opioid use stimulant use online intervention e-mental health
daphne scale validation in frontotemporal lobar degeneration

Conditions: Frontotemporal Lobar Degeneration

Summary: psycho-behavioral disorders assessment is crucial for the diagnosis and follow-up of patients with frontotemporal degeneration (ftd). daphne scientific staff have therefore developed a quantification and follow-up scale specifically dedicated to patients with ftd in current clinical practice. this scale is called daphne to disinhibition, apathy, perseveration, hyper orality, negligence and loss of empathy.

psycho-behavioral disorders assessment is crucial for the diagnosis and follow-up of patients with frontotemporal degeneration (ftd). daphne scientific staff have therefore developed a quantification and follow-up scale specifically dedicated to patients with ftd in current clinical practice. this scale is called daphne to disinhibition, apathy, perseveration, hyperorality, negligence and loss of empathy. this study aims to validate this scale. this validation will include methodological steps required to develop a new clinical tool, by studying internal consistency, loyalty, and concurrent validity in comparison with validated existing tools. complementarily, sensitivity and specificity will be assessed via a control population including patients with alzheimer's disease, , progressive supranuclear palsy and bipolar disorder with cognitive disorders.

Eligibility criteria:
inclusion criteria: group 1: 1. patients with ftd according neary (1998) and raskowsky (2011) diagnostic criteria. 2. mini-mental state examination ≥ 18 3. consent group 2 control: 1. patients with alzheimer's disease (mackahn, 2011), patients with supranuclear palsy (litvan, 1996) and patients with bipolar disorder with cognitive disorders. criteria. 2. mini-mental state examination ≥ 18 3. consent exclusion criteria: * minor patient
dexamethasone intravitreal implant after vitrectomy for epiretinal membrane

Conditions: Epiretinal Membrane; Macular Edema

Summary: the purpose of this study is to evaluate the effect of dexamethasone intravitreal implant (ozurdex) in combination with pars plana vitrectomy and membrane peeling for idiopathic epiretinal membrane (erm).

pars plana vitrectomy with membrane peeling has been used for years to successfully to treat erm (epiretinal membrane). however, despite successful surgery, approximately 10-30% of patients may not experience any improvement in visual acuity (ref. 1-7). macular causes of unsatisfactory visual outcome following vitrectomy include persistent macular edema and reoccurrence of epiretinal membrane (ref. 1-7). concomitant administration of intravitreal corticosteroids (triamcinolone acetonide) after pars plana vitrectomy and membrane peeling for epiretinal membrane has been reported to speed up and improve the anatomic and functional outcome (ref 8). given that intravitreal triamcinolone has been reported to last approximately 113 days ina post-vitrectomy eye (ref. 9); the investigators postulate that a longer-acting corticosteroid such as ozurdex could not only have the benefits of improved anatomic and functional outcomes, but also a longer sustained effect.

Eligibility criteria:
inclusion criteria: * patients with idiopathic epiretinal membrane * preoperative visual acuity of snellen equivalent 20/32 or worse exclusion criteria: * history or presence of any of the following: * uveitis * macular hole * previous vitreoretinal surgery * any other retinal pathology that could affect anatomic or functional results * age related macular degeneration * diabetic retinopathy * diabetic macular edema * retinal vein occlusion * pre-existing macular disease

Keywords: epiretinal membrane macular edema dexamethasone intravitreal implant (ozurdex) pars plana vitrectomy