Kornimate/medical-research-clean huggingface dataset:
hiv screening take-up: evaluating incentives and opt-out strategies

Conditions: HIV

Summary: over twenty percent of hiv-positive persons in the united states are unaware of their infection, leading the institute of medicine to recently urge further work to compare the effectiveness of hiv screening strategies. this study will use a randomized trial to compare several variants of emergency-room-based hiv-testing policies in order to determine how hiv test acceptance rates can be increased. the testing policies will be designed using principles from behavioral economics, varying the choice architecture and offering small monetary incentives. this will be the first study to measure differences in take-up rates across a variety of promising but largely untested approaches within a unified randomized trial. three defaults will be tested: traditional opt-in (test only those patients who request testing), opt-out (routinely testing unless patients decline), and active-choice testing (patients are required to state whether they want to be tested). the study will also be the first to test the effect of small monetary incentives ($1, $5, $10) on test take-up. an additional novel study contribution will be to test the hypothesis that compliance with large requests (accept an hiv test) increases after making a small request or pre-commitment - this "foot in the door" technique has not been previously studied in this setting. the factorial design will permit a direct comparison of all interventions, as well as interactions. the study will contribute a nuanced empirical understanding of how testing protocols from behavioral economics theory affect the effectiveness and efficiency of screening programs in an actual scaled- up setting (san francisco general hospital). this will assist in implementing and assessing recent cdc guidelines on hiv screening, while also more generally advancing scientific knowledge related to applying behavioral economics in comparative effectiveness research.


Eligibility criteria:
inclusion criteria: * patients aged 13 - 64 years who are awake, alert, not intoxicated, and understand the premise of the test will be offered the test and questionnaire according to their treatment group. exclusion criteria: * patients who have altered levels of consciousness, are critically ill (e.g., serious trauma), are known to have preexisting hiv diagnosis, or who have been tested for hiv in the past 3 months will be excluded from the study. * pregnant patients will be excluded due to alternative guidelines for incorporating opt-out testing during prenatal care. * any patients who are in police custody will also be excluded due to their lack of control over study participation decisions and ethical concerns over possible coercion.
a study of ridaforolimus (mk-8669) in combination with dalotuzumab (mk-0646) compared to standard of care treatment in estrogen receptor positive breast cancer patients (mk-8669-041 am3)

Conditions: Breast Cancer

Summary: this is a two-part study that will determine, if: 1) the combination of ridaforolimus and dalotuzumab will improve progression-free survival compared to exemestane; and 2) the combination of ridaforolimus and dalotuzumab will improve progression-free survival compared to both ridaforolimus and dalotuzumab as single agents, in participants with breast cancer.


Eligibility criteria:
inclusion criteria the prospective participant must meet, at least, all of the criteria below to be eligible for study participation. the participant: * has a confirmed diagnosis of breast cancer that is metastatic or locally advanced and is estrogen receptor positive and human epidermal growth factor receptor 2 (her-2) negative ; * is post-menopausal; * is at least 18 years of age; * has a life expectancy of at least 3 months; * has had a recurrence or progression of cancer after prior treatment and patient has received at least one line of endocrine therapy for metastatic disease, or the patient's cancer has recurred within 6 months after the last dose of anastrozole or letrozole; * has an available archival tumor specimen; * has voluntarily agreed to participate by signing informed consent. exclusion criteria if the prospective participant meets any of the criteria below (among others determined by the study staff) they will not be eligible for study participation. the participant: * is receiving any other systemic tumor therapy; * has previously received rapamycin or rapamycin analogs; * has received prior treatment with insulin-like growth factor 1 receptor (igf-1r) inhibitors, phosphoinositide 3-kinase (pi3k) inhibitors, or other experimental agents that target the pi3k, protein kinase b (akt), or mammalian target of rapamycin (mtor) pathways; * has known allergy to macrolide antibiotics; * has an active infection that requires antibiotics; * has significant or uncontrolled cardiovascular disease; * has poorly controlled type 1 or 2 diabetes mellitus; * is known to be human immunodeficiency virus (hiv) positive; * has a known history of active hepatitis b or c.

Keywords: mtor breast cancer estrogen receptor positive
atrial fibrillation recurrence in sleep apnea

Conditions: Sleep Apnea; Atrial Fibrillation

Summary: this randomized, controlled trial is designed to test whether treatment of sleep disordered breathing (sdb) with positive airway pressure (pap) therapy alters the natural history of atrial fibrillation (af). patients with recent af who are now in sinus rhythm, and found to have sdb (obstructive and/or central sleep apnea) by formal sleep study but without complaints of daytime sleepiness, are randomized to pap therapy to eradicate sdb or to usual care (medical management as prescribed by the patient's cardiologist).

sleep apnea is a common disorder which is increasingly implicated in the pathogenesis of cardiovascular disease. observational data suggest that sleep apnea may play a role in the development of atrial fibrillation (af), and may even predispose to recurrence of af following electrical cardioversion (dccv). because of biases and confounders inherent to observational studies, we propose a randomized clinical trial to assess the effects of treatment of sleep apnea in subjects with af treated with dccv. following polysomnography, subjects with sleep apnea will be randomized to positive airway pressure (pap) or usual medical care and followed for up to one year to compare a primary outcome of af recurrence rate.

Eligibility criteria:
inclusion criteria: 1. age \>18 yrs 2. successful electrical or chemical cardioversion within previous 2 weeks 3. greater than 2 episodes symptomatic af in previous 6 months exclusion criteria: 1. currently on pap therapy 2. moderate to severe pulmonary disease 3. neurologic impairment (h/o cerebrovascular accident (cva), transient ischemic attack (tia), neuromuscular disease, diaphragmatic paralysis) 4. severe cardiac disease (lvef\<40%, greater than mild to moderate valvular disease) 5. post cardiac surgery af 6. congenital heart disease 7. renal disease (scr \> 2.5) 8. excessive ethanol (etoh) use (\>2 drinks/day) 9. anatomically fixed nasal obstruction (severe septal deviation, uncontrolled rhinitis) 10. history of motor vehicle or occupational accident related to sleepiness. 11. epworth sleepiness scale score \>18 (out of maximum score of 24).
veinex : venous investigations during exercise

Conditions: Venous Insufficiency

Summary: successfully develop and confirm with the higher school of electronics west plethysmographic a multichannel recorder to perform measurements staggered volume of the lower limbs at rest, walking and recovery (6 storied measures on members lower).

validate the measurement made by eap (electroactive polymer) during walking tests in venous insufficient subjects and healthy subjects by comparing the measurement made by the reference technique by mercury gauge.

Eligibility criteria:
inclusion criteria: * present or not venous pathology exclusion criteria: * amputation of a lower limb * heart failure * severe respiratory disease * unstable angina or myocardial infarction * parkinson's disease, hemiplegia and paraplegia
evaluation of the clinical impact of ultra fast-track in patients undergoing cardiac surgery

Conditions: Cardiac Disease; Surgery; Anesthesia

Summary: single center randomized clinical trial. the main aim is to demonstrate the superiority at the clinical level of the ultra fast-track programs versus conventional early postoperative extubation in patients undergoing cardiac surgery.

the study is aimed to compare clinical superiority of ultra fast-track versus conventional early postoperative extubation in patients undergoing cardiac surgery in our center. the estimated sample size is 612 patients. they will be randomized 1:1 to any of the two arms of the study (ultra fast-track vs. fast-track). the randomization will be stratified according the type of surgery performed. the period of recruitment will start in january 2023 and is supposed to finish by september 2024 or earlier. the main outcomes of the study will be measured 1 year after the procedure.

Eligibility criteria:
inclusion criteria: * patients over 18 years of age. * patients with valvular, coronary or aortic heart disease with an indication for major cardiac surgery. * the patient's desire to participate in the clinical trial verified by signing the informed consent. exclusion criteria: 1. pregnancy. 2. emergent surgery or cardiorespiratory arrest. 3. patient in preoperative cardiogenic shock, or in need of high-dose vasoactive support. 4. aortic arch procedures. 5. procedures in which hypothermia \< 28ºc of temperature is expected during the intervention. 6. minor cardiac surgery procedures. 7. procedures with minimally invasive techniques without extracorporeal circulation (transcatheter aortic valve implantation, transcatheter mitral valve implantation, minimally invasive mitral valve repair (top-mini), totally thoracoscopic maze procedure, minimally invasive direct coronary artery bypass grafting). 8. implantation of circulatory assistance devices or ecmo (extracorporeal membrane oxygenation). 9. active endocarditis.
a proof-of-concept study assessing neo6860 in osteoarthritis pain

Conditions: Pain; Osteoarthritis of the Knee

Summary: the purpose of this study is to assess neo6860, a modality selective trpv1 antagonist, in patients with pain associated with osteoarthritis of the knee.

the study will be randomized, double blind, placebo and active control, a 3-way, 3-period crossover design, where each of the estimated 50 enrolled patients will receive alternately (i) neo6860 (500 mg bid), (ii) placebo and (iii) naproxen (500 mg bid). to ensure blinding, double dummy techniques will be used, so that at each period, patient will receive an oral liquid suspension (neo6860 or its placebo) and one capsule (naproxen or its placebo). following a screening period, a maximum of 28 days before dosing, subjects will be randomized to one of the scheduled sequences. at each dosing period, subjects will be requested to participate in 2 clinic visits: * one residential visit, the morning of investigational product dosing. subjects will stay in the clinical research unit approximately 13 hours * one end of period visit, 24 h after first dosing a total of 2 washout periods of 1 to 3 weeks will separate the dosing periods. once the 3 dosing periods will be completed, the subjects will come back to the clinic for a follow up visit (7 to 10 days post last dose). note: for a subpopulation, at one site, an assessment of heat pain threshold and tolerance will be conducted requiring a residential period of approximately 24 hours.

Eligibility criteria:
inclusion criteria: * body mass index (bmi) between 18.0 and 35.0 kg/m2 inclusive; * patients diagnosed with osteoarthritis of the knee, according to american college of rheumatology (acr) guidelines, by meeting at least 3 of the following: age \> 50, morning stiffness \< 30 minutes, crepitus on active motion, bone tenderness, bone enlargement, no palpable warmth of synovium; * grade i, ii or iii using kellgren-lawrence classification on an x-ray of the knee * womac pain subscale ≥ 8 * r square of the focused analgesia selection task (fast) outcome value greater than 0.70 exclusion criteria: * patients with, or with a history of, any clinically significant disorders (including fibromyalgia and other painful disorders) which may interfere with the primary objectives of the study * patients treated in the previous 3 months with topical capsaicin or intra-articular corticosteroids; * patients with a contra-indication for the use of naproxen or acetaminophen;
comparison of mag and fish oil efficacy

Conditions: Obesity

Summary: a potential application for unstructured monoacylglycerol (mag) containing long chain polyunsaturated fatty acids (lc-pufa)can be to provide essential fatty acids to humans who chronically consume lipases inhibitor such as orlistat® for weigh lowering reasons. indeed, it is predictable that chronic consumption of orlistat® led to a depletion of essential fatty acids with time, therefore unstructured mag containing lc-pufa can be an option as a source of lc-pufa for patients under orlistat® treatment and hypothetically for subjects with other type of maldigestion/malabsorption. potential applications of such concept are therefore related to disease conditions comprising low lipid digestion due to lipase activity insufficiency. in the present study, in order to see the response information for eicosapentanoic acid (epa) delivery, epa will be provided either as a mixture of free monoacylglycerols or as triacylglycerol (tag). the erythrocyte and plasma fatty acid composition from subjects under orlistat® consumption will be analyzed.


Eligibility criteria:
inclusion criteria: * age 18-65 * sex female * body mass index (bmi) ≥ 30kg/m2 and \< 40kg/m2 * subjects willing to undergo treatment with orlistat® (xenical). * having obtained her written informed consent before any study related procedure including the pre-inclusion period. subject exclusion criteria: * binge eating disorder * any other weight loss treatment(s) within the last 3 months * vegetarians * history of metabolic, cardiovascular, hepatic or renal diseases * obstructed bile duct * diseases that could interfere with intestinal absorption history of abdominal / gastric surgery (except appendicectomy) * use of drugs or illicit substances * consumption of alcohol \> 50 gr/week * any other clinically significant abnormalities on screening laboratory evaluation (creatinine, na, k, urique acide, asat, alat, ph. alc., ygt, glycemia, total cholesterol, hdl, ldl, triglycerides) concentrations \> 2.5 fold normal range * pregnant or lactating mothers * allergy to fish oil or other components (for e.g., gelatin or excepients of the capsule) * use of any other supplements containing fish oil for the duration of the trial or 3 month before inclusion in trial. * smokers * having donated blood or had a transfusion of blood/blood products during the trial and 3 months prior to screening or expected to do so during the study * bleeding disorders * subject who cannot be expected to comply with the study procedures. * currently participating or having participated in another clinical trial during last 8 weeks prior to the beginning of this study.

Keywords: epa lc-pufa orlistat obesity
pharmaceutical care in va nursing home

Conditions: Focus on the Elderly in a Nursing Home

Summary: this study investigates the effect of pharmaceutical care on a veteran nursing home. 100 patients will be selected into this controlled study.the hypothesis are: 1. after patients receive pharmaceutical care, their drug related problems will be decreased. 2. after patients received pharmaceutical care, their self-reported medical expenditure will be decreased.

around 200 residents in a veteran nursing home will be selected for reviewing inclusion and exclusion criteria. a total of 100 subjected are selected into this randomized controlled trial. each group will have 50 subjects and then divides into 4 subgroup, according to their drug items used (5-7 and over 8 items used). the inclusion criteria: 1. residents of the veteran nursing home. 2. over 65 years old. 3. complete comprehensive geriatric assessment (cga) 4. prescription drugs more than 4 times/day, excluding stat order. 5. with 2 or more chronic diseases. exclusion criteria: 1. residents who were in the pharmaceutical care project of taiwan pharmacists association.

Eligibility criteria:
inclusion criteria: * residents in the veteran nursing home * age over 65 years old * complete comprehensive geriatric assessment (cga) * use more than 4 drug item per day (excluding stat order) * subjects with more than 2 chronic diseases. exclusion criteria: * subjects who were in pharmaceutical care project of taiwan pharmacist association.

Keywords: elderly potential inappropriate medications pharmaceutical care quality of life medical expenditure
neoadjuvant chomotherapy with paclitaxel-albumin and s-1 for advanced gastric cancer

Conditions: Gastric Cancer

Summary: this is a interventional clinical trial to assess the efficacy and safety of combinational therapy of paclitaxel-albumin and s-1 for the neoadjuvant chemotherapy of advanced gastric cancer.


Eligibility criteria:
inclusion criteria: 1. pathologically diagnosed gastric adenocarcinoma 2. type ii and iii esophageal-gastric-junction malignancy 3. ajcc stage ii-iii 4. no contraindications for surgery, radical resection can be expected 5. kps\>60; ecog score:0-2 6. expactant survival period\>6 months 7. age 20\~75 8. no other major health issues 9. lab results within 7 days before inclusion must satisfy: 1. neutrophil≥1.5×109/l 2. plt≥100×109/l 3. hemogloblin≥90g/l 4. alt,ast\<1.5 upper limit 5. tbil≤1.0×unl 6. serum creatinine\<1.5×unl 7. pt-inr/ptt\<1.7 upper limit 10. with measurable lesion according to recist1.1 criteria 11. with consent 12. co-operative exclusion criteria: 1. with other major health issue 2. allergic to relevant drugs 3. experienced any other drug therapy with 4 weeks before inclusion 4. experienced any drug therapy for gastric cancer at anytime 5. diagnosed with any other malignancy within the past 5 years 6. women at child-bearing age; pregnant or breast-feeding women 7. with severe heart disease 8. with upper gi digestion or disrupted absorption 9. with peripheral neural disease 10. with transplated organs or organs having been resected for transplantation 11. known dpd deficiency 12. with uncontrolled infection
influence of an capsular tension ring on the rotation of an intraocular lens (aspira®-aa also known as mc 6125 as)

Conditions: Cataract

Summary: the purpose of this study is to observe the axial iol rotation after surgery with a capsular tension ring (ctr) and a mc6125 as iol. at the end of surgery the orientation of the iol is documented with a short video clip via the operating microscope unit. follow-up examinations are performed 1 hour, 1 week and 6 months after surgery. rotational stability of the iol is assessed using retroillumination images with a method to avoid bias from cyclorotation or head tilt.


Eligibility criteria:
inclusion criteria: * uni or bilateral age-related cataract necessitating phacoemulsification extraction and posterior iol implantation exclusion criteria: * preceding ocular surgery or trauma * recurrent intraocular inflammation of unknown etiology * uncontrolled glaucoma * uncontrolled systemic or ocular disease * blind fellow eye * microphthalmus * corneal abnormality * history of uveitis/iritis * iris neovascularization * pseudoexfoliation * proliferative diabetic retinopathy

Keywords: iol rotation capsular tension ring iol rotational stability
vitamin d supplementations and postoperative pain

Conditions: Postoperative Pain

Summary: in this study, effect of vitamin d supplementation on postoperative pain and sedation-agitation will investigate. children with mental motor retardation between 7-17 age which dental treatment will be performed under general anaesthesia will be included in this study. 600 iu vitamin d will apply to group d per orally during 12 weeks. group p will not take anything during 12 weeks. at first day and end of the 12 weeks, serum vitamin d, calcium level will evaluate. at the end of the 12 weeks general anaesthesia will be performed for teeth check up, flouring, scaling polishing, tooth extraction, filling applications, amputations, root canal treatment. after then postoperative pain, sedation and agitation will be evaluate. all data will be statistically evaluate at the end of the study.

vitamin d deficiency could seem in children with mental and motor retardation. some researches show that vitamin d supplementations can reduce pain. in this study, the researchers aimed to show effect of vitamin d supplementation on postoperative pain and sedation-agitation. these children which will be applied dental treatment under general anaesthesia included in this study. all subjects randomly divided to the two groups. every group will include 30 subject. group d included mentally retarded children which will take daily 600 iu orally vitamin d supplementation during 12 weeks. in the other group(group p) mentally retarded children will not take any supplementation during 12 week. at the first day and last day(after 12 weeks) of study, blood sample will take from all subject. serum vitamin d, calcium level will evaluate in this sample at the end of the study. all samples will be frozen and stored until testing. all children will be operated under general anaesthesia. propofol 2mg/kg, rocuronium 0,6 mg/kg will apply for anaesthesia induction. anaesthesia will maintain with sevoflurane and oxygen- nitrous oxide mixture. non-communicating children's pain check-list and ramsey sedation scale will apply all children after postoperative care unit. all children will be evaluate every 15 minutes. after data collection, all data will be analysed with statistically.

Eligibility criteria:
inclusion criteria: * mentally and motor retarded children * dental treatment under general anaesthesia exclusion criteria: * normally children(not mmr) * the persons who not accept the including study

Keywords: vitamin d postoperative pain mental motor retardation
effect of intraarticular steroids on bone turnover in osteoarthritis

Conditions: Osteoarthritis

Summary: oral and nasal steroids may enhance osteoporosis by suppressing bone formation. intra-articular steroids may also suppress bone formation, however, the duration or relationship to a steroid dose has not been established. it is hypothesized that intra-articular steroids suppress bone formation transiently, returning to pretreatment levels within four weeks in subjects with osteoarthritis.

oral and nasal steroids may enhance osteoporosis by suppressing bone formation. intra-articular steroids may also suppress bone formation, however, the duration or relationship to a steroid dose has not been established. it is hypothesized that intra-articular steroids suppress bone formation transiently, returning to pretreatment levels within four weeks in subjects with osteoarthritis. the purpose of the study is to determine if intra-articular steroids suppress markers of bone formation or resorption in osteoarthritis patients and whether these markers may be modified by vitamin d or dual-energy x-ray absorptiometry (dexa) bone density status

Eligibility criteria:
inclusion criteria: * age \> 40 years * male or postmenopausal female * diagnosis of knee osteoarthritis * dexa bone density done within the past 12 months * painful knee, visual analogue scale (vas) \> 4 of (10=worst) exclusion criteria: * diabetes mellitus type i or ii * systemic inflammatory illness * systemic infections which may be aggravated by steroid therapy * no current or previous (\< 3 years) biphosphate therapy * previous knee replacement surgery * no current or previous parathyroid hormone (pth) therapy

Keywords: osteoarthritis, intra articular steroids