Kornimate/medical-research-clean huggingface dataset:
traumatic brain injury - knowledge translation

Conditions: Traumatic Brain Injury

Summary: blunt head trauma (bht) accounts for \>450,000 emergency department (ed) visits for children annually in the us. fortunately, \>95% of head trauma in children is minor in nature. although most children have minor head trauma, clinicians obtain cranial cts in 35-50% of these children, which carries a radiation risk of malignancy. recently, the investigators conducted a study of 44,000 children in the pediatric emergency care applied research network (pecarn) in which the investigators developed and validated clinical prediction rules that identify which children with minor bht are at very low risk of having clinically-important traumatic brain injuries (tbi) and, therefore, do not require a ct scan. in this proposal, the investigators aim to assess whether implementing the pecarn tbi prediction rules (one for preverbal, one for verbal children) via computerized clinical decision support (cds) decreases the number of (unnecessary) cranial ct scans obtained by ed physicians for children with minor bht at very low risk of clinically-important tbis. after a two-site pilot phase to test and refine the cds, the investigators will conduct a seven-center prospective trial. the investigators will measure cranial ct use prior to and after the intervention implementation of cds and clinician education. the investigators will study the use of ct by practitioners for children \<18 years for 12 months pre- and post-intervention.


Eligibility criteria:
clinicians: our target study population includes clinicians with training in pediatrics (particularly pediatric emergency medicine)or general emergency medicine. as clinical practice is likely to vary among physicians with different training and in different settings, we will include two types of sites for this trial: 1. pediatric emergency departments with \>80% of children cared for by pediatric emergency medicine physicians or general pediatricians. 2. general emergency departments with \>80% of children cared for by general emergency medicine physicians. patients: inclusion: * children younger than 18 years who * sustained minor blunt blunt head trauma defined by glasgow coma scale (gcs) scores of 14 or 15 on initial ed evaluation exclusion: patients who have any of the following: * blunt head trauma \> 24 hours prior * penetrating trauma * brain tumors * coagulopathy * ventriculoperitoneal shunts * preexisting neurological disorders complicating assessment * neuroimaging obtained at an outside hospital before transfer to a study site

Keywords: prediction rules computerized clinical decision support traumatic brain injury blunt head trauma
partnership optimizes weight management in primary care

Conditions: Obesity

Summary: the purpose of this study is to examine whether a primary care weight management intervention delivered by peer coaches produces greater weight loss than a self-directed program without peer coach support.


Eligibility criteria:
inclusion criteria: * age 21-75 years * body mass index (bmi) 30-50 kg/m2 * receiving primary care services at one of the practices participating in this study exclusion criteria: * uncontrolled hypertension (blood pressure \>160/100 mm hg at screening) * any of the following other medical conditions: myocardial infarction or cerebrovascular accident within the last six months; unstable angina within the past six months; nyha class iii or iv congestive heart failure; type 1 diabetes; cancer requiring treatment in past five years (exception: non-melanoma skin cancer); and chronic lung diseases that limit physical activity * current use of any of the following medications: antipsychotic agents, monoamine oxidase inhibitors, systemic corticosteroids, or chemotherapeutic drugs; prescription weight loss medications (past six months) * unwilling or unable to do any of the following: give informed consent; read/understand english; accept random assignment; travel to the intervention site * likely to relocate out of the area in the next 2 years * participation in another randomized research project * weight loss \> 10 pounds in past six months * history of bariatric surgery

Keywords: weight loss behavioral primary care lifestyle
efficacy and safety of crosslinked hyaluronan gel for preventing intrauterine adhesion

Conditions: Intrauterine Adhesion

Summary: intrauterine adhesion (iua) is the adhesion of intrauterine tissues due to the exposure of myometrial tissues caused by the endometrial basal injury. iua is clinically manifested as symptoms such as abdominal pain, hypomenorrhea or amenorrhea, sterility and habitual abortion, which seriously affect the patients quality of life. preventing iua has been tried using different methods such as barrier or stent in order to separate the opposing endometrium during the tissue healing processes. although some successes have been reported there are still some challenges need to be dealt with. one of the barrier materials for preventing iua is made of hyaluronic acid (ha). ha is a natural ecm of human tissue with excellent biocompatibility and promotes the scar-free wound repair. the self-crosslinked esterified ha gel has demonstrated the capacity to prevent iua in clinical studies. a novel self-crosslinked ha gel is developed by bioregen biomedical（changzhou）co., ltd with proprietary technologies. this product is a highly viscoelastic crosslinked gel that overcomes the shortcoming of sodium hyaluronate with high motility and too quick degradation in vivo. for this product, the results of animal experiments and various safety features have been designed and tested conforming to the national regulations and standards. in order to launch this product to the market, this prospective, randomized and controlled clinical trial is designed and will be performed to verify its safety/efficacy.


Eligibility criteria:
inclusion criteria: * female patients who are 20-40 years old who is diagnosed as intrauterine adhesion, and did not receive adhesiolysis surgery. * patients who signed the informed consent form (icf) and agreed to take contraceptive measures within 3 months after the surgery. * physical examination and routine laboratory tests demonstrated no systemic diseases. * according to the afs scoring system on the iua (1988) only those patients with moderate to severe iua (i.e. total afs score larger than 4 points) were enrolled in this clinical trial. exclusion criteria: * patients who is allergic to hyaluronan or its derivatives. * patients with inflammation of reproductive organs, pelvic cavity inflammation, malignant tumor of reproductive organs and other systemic diseases that could cause metrorrhagia. * patients with malformation of reproductive organs. * patients who may not take effective contraceptive measures within 3 months after the surgery. patients who were suffering severe systemic diseases such as coagulative disorders, cardiovascular diseases and long-term alcoholism and drug abuse were also excluded from this clinical trial.

Keywords: intrauterine adhesion crosslinked hyaluronan gel hysteroscopy clinical trial
french covid cohort

Conditions: Coronavirus Infections

Summary: infectious disease is the single biggest cause of death worldwide. new infectious agents, such as the sars, mers and other novel coronavirus, novel influenza viruses, viruses causing viral haemorrhagic fever (e.g. ebola), and viruses that affect the central nervous system (cns) such as tbev \& nipah require investigation to understand pathogen biology and pathogenesis in the host. even for known infections, resistance to antimicrobial therapies is widespread, and treatments to control potentially deleterious host responses are lacking. in order to develop a mechanistic understanding of disease processes, such that risk factors for severe illness can be identified and treatments can be developed, it is necessary to understand pathogen characteristics associated with virulence, the replication dynamics and in-host evolution of the pathogen, the dynamics of the host response, the pharmacology of antimicrobial or host-directed therapies, the transmission dynamics, and factors underlying individual susceptibility. the work proposed here may require sampling that will not immediately benefit the participants. it may also require analysis of the host genome, which may reveal other information about disease susceptibility or other aspects of health status.


Eligibility criteria:
inclusion criteria: - any patient admitted to a health care facility, with an infection confirmed by sars-cov-2 (virologically confirmed diagnosis by pcr). non inclusion criteria: * subject deprived of freedom, subject under a legal protective measure * refusal by participant, parent or appropriate representative. exclusion criteria: - confirmed diagnosis of another pathogen than sars-cov-2 and no indication or likelihood of co-infection with sars-cov-2.

Keywords: coronavirus 2019-ncov covid-19 sars-cov-2 cohort
αdherence and persistence to oral anticoagulation in αf patients with previous ischemic stroke

Conditions: Ischemic Stroke

Summary: the aims of this project are to: 1. investigate the adherence and persistence to anticoagulation (and in specific, to vkas and noacs) in af patients with previous ischemic stroke; 2. identify predictors of poor adherence and persistence and 3. assess whether the same-tt2r2 score predicts adherence and persistence to anticoagulation

patients with ischemic stroke and atrial fibrillation (af) have a high risk of stroke recurrence, which is the highest among all other pathogenetic subtypes of stroke. this risk is substantially reduced with anticoagulant treatment. for many decades, vitamin-k antagonists (vka) were the only anticoagulant choice for these patients. however, a number of limitations such as narrow therapeutic window, need for frequent inr measurements and consequent dose adjustments, risk of haemorrhagic complications, food-drug and drug-drug interactions, and others, have undermined the use of anticoagulation by both patients and physicians with apparent influence on the risk of stroke recurrence. during the last decade, four non-vitamin k antagonist oral anticoagulants (noac) have been successfully introduced and showed superior safety and efficacy profile than vkas, more convenient dosing schemes (i.e. no need for adjustments) and minimum interactions with food and drugs. these advantages of noacs vs. vkas may have obvious implications to patient adherence to treatment and, consequently, to the efficacy of secondary stroke prevention. nevertheless, there are only very scarce data available yet that the adherence and persistence to noacs is higher than the adherence and persistence to vkas in the specific population of patients with ischemic stroke and atrial fibrillation. recently, the same-tt2r2 score has been introduced as a means to identify those af patients who have inadequate quality of anticoagulation with vkas expressed as time within therapeutic range (ttr)5. in specific, vka-anticoagulated af patients with a same-tt2r2 score of 0-2 are expected to have a ttr \>65%, whereas patients with a score of \>2 are expected to have lower ttr levels. in this context, one could hypothesize that increased same-tt2r2 score may be associated with inadequate adherence and persistence to vkas. other parameters associated with inadequate adherence and persistence in the general af population include education, employment, social status, and cognitive function. however, this is not well investigated in the specific population of patients with previous stroke where other conditions such as age and functional neurological status may also play an important role in adherence and persistence.

Eligibility criteria:
inclusion criteria: * previous ischemic stroke * atrial fibrillation * age \>18 years * informed consent exclusion criteria: -

Keywords: adherence to oral anticoagulation persistence to oral anticoagulation af patients previous ischemic stroke
impact of rifampicin in treatment outcome of cutibacterium acnes prosthetic joint infections

Conditions: Infections Joint Prosthetic

Summary: cutibacterium acnes is involved in nearly 40% of shoulder prosthetic joint infections (pji). after shoulder prothesis, c. acnes mainly affects hip prosthesis. one recent work from the lyon (france) bone and joint infections reference center with data focusing mainly on hip and knee pji has reported that c. acnes is the leading cause of late-onset pji after coagulase negative staphylococci (cns) (late acute pji not considered). in such late-onset device-related infection, biofilm, as produced by c. acnes during pji represents a major hurdle on the path to patient's cure. because biofilm-associated bacteria have a slower metabolism and a lower multiplication rate than planktonic bacteria, antibiotic susceptibility can be hampered. rifampicin is an antibiotic with low minimal bactericidal concentration against s. aureus and cns biofilm-associated bacteria8 which significantly influence patient's outcome during staphylococci pji.


Eligibility criteria:
inclusion criteria: * age: \> or =18 years old; * monomicrobial, rifampicin susceptible cutibacterium acnes late total knee arthroplasty (tka) or hip arthroplasty (total, tha or hemiarthroplasty, hh) or shoulder arthroplasty (total, tsa or hemiarthroplasty, sh) infection treated surgically with single-stage or two-stage revision; * isolation of c. acnes on two distinct per-operative samples collected during the single-stage or the two-stage revision * based on the antimicrobial susceptibility test of the c. acnes and the medical history of the patient, the pji can be treated with amoxicillin or moxifloxacin; * women considered of childbearing potential (wocbp) requires use of a highly effective contraceptive measure as intrauterine device (iud), intrauterine hormone-releasing system (ius), documented bilateral tubal occlusion, documented vasectomised partner, sexual abstinence. contraception should be maintained during treatment and until the end of relevant systemic exposure. exclusion criteria: * contraindication to rifampicin (included ongoing treatment contraindicated with rifampicin) * contraindication to amoxicillin and moxifloxacin (included ongoing treatment contraindicated with these medicines) * empirical antibiotic treatment not administered during the 24 hours following revision surgery; * inactive empirical antibiotic treatment following surgery according to the ast of the bacteria; * disease-modifying treatment incompatible with the inducer effect of rifampicin * liver cirrhosis; * pregnancy: a pregnancy blood test will be performed on all women of childbearing age. the results will be sent to the patient by the doctor of their choice; * porphyria; * renal insufficiency with gfr \< 30ml/min/1.73 m2 (ckd-epi);
chinese fmds registry

Conditions: Functional Movement Disorders

Summary: the purpose of the chinese functional movement disorders registry (fmds-china) is to develop a database of patients with functional movement disorders (fmds) in china.

functional movement disorders (fmds), also known as psychogenic movement disorders (pmds), formerly known as "hysteria or hysteria", is a representative functional nervous system disease. it has been reported in europe and america that fmds patients account for 3% - 6% of all patients in the outpatient department of motor disorders, but there is no relevant data report in china so far. from the current research, the incidence rate has gradually increased significantly. however, the research about the pathogenesis and diagnosis of such diseases is rare. these studies have the problem of small sample size and still lack large randomized controlled studies to demonstrate the long-term efficacy of different treatments. and in china, there are nearly no reliable research and the lack of basic understanding makes it a "gray area" for the diagnosis and treatment of fmds. the purpose of this observational study is to prospectively register the information of patients with fmds nationwide, establishing a chinese multicenter fmds china cohort; understanding the demographic characteristics, clinical characteristics and symptom characteristics, neuropsychological test, electrophysiological and imaging characteristics, drug use, etc. what's more, it lays a foundation for the research on the etiology and treatment in the second stage of this study.

Eligibility criteria:
inclusion criteria: * male or female; * age 18-80; * patients clinically diagnosed with functional movement disorders according to the fahn-williams criteria; * patients who are willing to provide information such as disease history and cooperate with physical examination and examination; exclusion criteria: * patients with definite organic dyskinesia; * there are other causes of dyskinesia such as fatigue, pain, hyperthyroidism, chronic alcoholism, and drug use; * those who suffer from serious physical diseases and are unable to cooperate; * those who do not cooperate or refuse to sign informed consent.
the clinical trial to evaluate the efficacy and safety of luphere depot inj. 3.75mg(leuprolide acetate 3.75mg) in patients with precocious puberty

Conditions: Central Precocious Puberty

Summary: the purpose of this clinical trial was to evaluate the efficacy and safety of luphere depot inj. 3.75mg(leuprolide acetate 3.75mg) in patients with precocious puberty.


Eligibility criteria:
inclusion criteria: * 4\~8 years \& tanner stage ≥ 2 exclusion criteria: * previous treatment with gnrh analog therapy
acute stroke complicating tavi - management and outcomes

Conditions: Stroke; Aortic Valve Stenosis; Periprocedural Complication

Summary: periprocedural complications of trans catheter aortic valve implantation, and particularly the occurrence of stroke has a marked impact on survival and quality of life. the characteristics of periprocedural stroke complicating tavi, and particularly of interventions aimed to treat stroke complicating tavi have not been systematically described. we therefore aimed is to explore the incidence and characteristics of acute stroke complicating tavi and to describe the safety and efficacy of emergent interventions to treat acute stroke complicating tavi.


Eligibility criteria:
inclusion criteria: * patients who have had a stroke within 30 days of tavi exclusion criteria: * none

Keywords: periprocedural stroke transcatheter aortic valve implantation transcatheter aortic valve replacement
improve sudden cardiac arrest study

Conditions: Sudden Cardiac Arrest; Ventricular Arrythmia

Summary: the purpose of this study is to demonstrate that primary prevention patients with one or more additional risk factors (1.5 prevention criteria: syncope/pre-syncope, non-sustained ventricular tachycardia (nsvt), frequent pre-ventricular contractions (pvcs), and low left ventricular ejection fraction (lvef)) are at a similar risk of life-threatening ventricular arrhythmias (ltva) when compared to secondary prevention patients, and would receive similar benefit from an implantable cardioverter defibrillator (icd), or cardiac resynchronization therapy- defibrillator (crt-d) implant.

devices allowed in the study include any medtronic single, dual, or triple chamber defibrillator that has received appropriate license or regulatory approval and is commercially available by medtronic in the geography in which the implant will take place. any market-released, commercially available lead(s) can be used in the study.

Eligibility criteria:
inclusion criteria: * subject has a class i indication for implantation of an icd according to the american college of cardiology (acc)/american heart association(aha)/heart rhythm society (hrs) or european society of cardiology (esc) guidelines * subject (or subject's legally authorized representative) is willing and able to sign and date the patient informed consent form. exclusion criteria: * subject is ≤ 18 years of age * subject with any exclusion criteria as required by local law (e.g., age, pregnancy, breast feeding) * subject is enrolled in a concurrent study that has not been approved for concurrent enrollment by the medtronic clinical trial leader * subject has any contraindication for icd/crt-d

Keywords: sudden cardiac arrest (sca) syncope non sustained ventricular tachycardia (nsvt) premature ventricular contractions (pvc) left ventricular ejection fraction (lvef) primary prevention secondary prevention antitachycardia pacing (atp) shock appropriate therapy
pcle for the diagnosis of gastric intestinal metaplasia, intraepithelial neoplasia, and carcinoma

Conditions: Diagnostic Yield of Gastric Neoplasia

Summary: early detection of gastric intestinal metaplasia (gim) intraepithelial neoplasia (in), and gastric cancer are essential to improve patients' outcomes. this study aims to compare the diagnostic yield of gim, in and early gastric cancer (egc) by iscan combined probe-based confocal laser endomicroscopy (pcle) and iscan alone.


Eligibility criteria:
inclusion criteria: * aged between 18 and 80; * patients with previous pathologic diagnosis of atrophic gastritis, gastric intestinal metaplasia, and low-grade intraepithelial neoplasia; * agree to give written informed consent. exclusion criteria: * patients with gastrectomy, acute gi bleeding, and known gastric neoplasia; * patients under conditions unsuitable for performing cle including coagulopathy (prothrombin time \ 50 s), impaired renal function (creatinine level \>1.2 mg/dl), pregnancy or breastfeeding, and known allergy to fluorescein sodium; * inability to provide informed consent
liver transplantation with adv-tk gene therapy improves survival in patients with advanced hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma; Liver Transplantation

Summary: previous rather poor results in liver transplantation (lt) of patients with advanced hepatocellular carcinoma (hcc) have made the application of lt very limited in treatment of hcc. the advantages of adv-tk gene therapy highlight its potentiality as adjuvant treatment for hcc patients after lt. we reported here the improved outcome of lt with combined treatment of adv-tk gene therapy in patients with intermediate or advanced hcc.

the overall survival in the lt with adv-tk gene therapy group was 54.8 % at three years, and the recurrence-free survival in the same group was 56.5 %, both being higher than those in the transplantation only group (p=0.0001 for overall survival and p=0.0000 for recurrence-free survival). in no-vascular invasion subgroup treated with lt with adv-tk therapy, both overall survival and recurrence-free survival were 100 %, significantly higher than those with vascular invasion subgroup treated with the combined lt and adv-tk therapy (p=0 for each group). vascular invasion was an important factor affected survival and recurrence, hazard ratio=3.687; p=0.014 and hazard ratio=12.961; p=0.000, respectively.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of advanced hepatocellular carcinoma with no metastasis in lungs and bones * accept liver transplantation exclusion criteria: * small hepatocellular carcinoma * advanced hepatocellular with metastasis in lungs and bones

Keywords: hepatocellular carcinoma liver transplantation adenovirus-thymidine kinase enzyme gene therapy immunosuppression