Kornimate/medical-research-clean huggingface dataset:
effects of an adapted ski/snowboarding program on quality of life in children with physical disabilities

Conditions: Cerebral Palsy; Traumatic Brain Injuries; Spinal Cord Injuries; Physical Disability

Summary: this study is assessing quality of life in children with a physical disability who participate in the children's hospital colorado hospital sports program (hsp), where children with physical disabilities are able to participate in more organized sports and active programs with the use of adaptive equipment. this study would assess a child's self reported and parent perceived quality of life before and after child participation in hsp for the winter season. the investigators aim to determine the level of child and parent happiness and satisfaction in specific quality of life aspects including: physical activities and health, feelings, moods, self perception, home life, friends, school, learning and bullying. the investigators believe that children with any physical disability will have a more satisfactory reported quality of life after participating in hsp for one or many years.

the purpose of this proposed research is to quantify the impact of participation in an adaptive ski/snowboarding program on parent perceived and child self-reported health related quality of life. to this effect, the study will assess children's self-perception of psychological, emotional, physical health of participants as well as their parents perception of the same, through the use of a validated self reported quality of life questionnaire, kidscreen-52, before and after participating in an adaptive ski/snowboarding program every year. primary aims: 1. to determine the level of subject and parent satisfaction and happiness, through a composite of 10 aspects in a quality of life questionnaire, following participation in the children's hospital colorado hospital sports program (hsp) for one winter season. 2. to determine the long-term impact of repeated participation in an adapted ski/snowboarding program through a composite of 10 aspects in a quality of life questionnaire, following participation in the children's hospital colorado hospital sports program (hsp) for consistent winter seasons.

Eligibility criteria:
inclusion criteria: * physical disability * participant of hsp program exclusion criteria: * completed parent and child kidscreen questionnaires are not received before the subject's first day of skiing or snowboarding with the program * completed parent and child kidscreen questionnaires are not received within 3 months after subject's completed participation with the program for that winter season

Keywords: quality of life adaptive sports therapeutic recreation mental health
geriatric assessment reporting in real time (garrt) in non-electively hospitalized older cancer patients

Conditions: Oncology

Summary: this study prospectively evaluates the impact of geriatric assessment reporting in real-time (garrt) on key hospital based outcomes in a cohort of non-electively hospitalized older (\> 70 years) adults with cancer.

this study evaluates the impact of geriatric assessment reporting in real-time (garrt) on key hospital based outcomes in non-electively hospitalized older (\> 70 years) adults with cancer. participants will be randomly assigned to the garrt group, or the control group. all participants will fill out user friendly questionnaire called the geriatric assessment. the results of the geriatric assessment will be given to the physicians of participants in the garrt group in real-time. the physicians of participants in the control group will not receive real time results. this study will compare the referral rates of participants in each group to determine if providing real-time results of the geriatric assessment impact referral rates.

Eligibility criteria:
inclusion criteria: * age 70 years or older. * english speaking. * admitted to unc hospitals non-electively within 72 hours. * biopsy proven solid tumor or myeloma or lymphoma. * newly diagnosed cancer patients for whom active cancer directed therapy is planned within the next six months or patients on active cancer directed therapy either currently or within the previous 6 months. * signed written irb-approved informed consent. exclusion criteria: * patients meeting any of the following exclusion criteria at baseline will be excluded from study participation. patients with a life expectancy \<6 weeks * patients who are \<48 hours post-surgery. * patients who are admitted to an intensive care setting. * patients with acute myeloma lymphoma (aml) or other high grade hematologic malignancies. * patients undergoing bone marrow transplant or admitted to the bone marrow transplant unit.
azithromycin before induction

Conditions: Infections

Summary: this is a double blinded randomized control trial involving administration of 2 grams prophylactic azithromycin in third trimester patients undergoing induction of labor at our institution to demonstrate reduction in maternal and neonatal infection.

induction rates have more than tripled in the last quarter century, and even more in the past five years in light of evidence that the 39th week is the optimal gestational age for birth. inductions are one of the most commonly performed medical procedures, and may span several days. one of the complications associated with induction include maternal infection, which includes chorioamnionitis, endometritis, pyelonephritis, neonatal infection, perineal and cesarean wound infections. there are many well-known risk factors for these infections that include longer duration of rupture of membrane, prolonged labor, nulliparity, internal monitoring, multiple vaginal examinations and several others. well-established guidelines are available for treating infection once diagnosed, however the role of antibiotic prophylaxis to prevent infection in patients undergoing induction of labor is less clear. in this study, we propose that administration of 2 grams oral azithromycin prior to the start of induction of labor will decrease rates of intrapartum and postpartum infections. azithromycin is the ideal antibiotic to study in this trial since it is long acting, inexpensive, well tolerated, and has proven benefits in prior studies for prevention of obstetrical infection in cesarean deliveries and spontaneous labor. this is a double blinded randomized control trial involving administration of 2 grams prophylactic azithromycin in third trimester patients undergoing induction of labor at our institution to demonstrate reduction in maternal and neonatal infection. decreasing rates of infection will improve both maternal and neonatal outcomes as well as decrease hospital length of stay and associated costs.

Eligibility criteria:
inclusion criteria: * • third trimester of pregnancy defined as 28 0/7 weeks or more * singleton pregnancy * age 18-45 * induction of labor initiated for medical or obstetrical reason or electively over 39 weeks of gestation * no contraindication to vaginal delivery * reassuring fetal heart rate tracing * able and willing to provide informed consent exclusion criteria: * • does not read or write in english or spanish * unable or unwilling to give informed consent * use of antibiotic or antiviral agent within the last 7 days * evidence of active infection at the time of initiation of induction (patients with rectovaginal group b streptococcus positive results will be allowed to participate as it is a colonizing organism, unless they show evidence of active infection) * incarcerated women * active substance abuse * age \< 18
a ct-based radiomics model to predict survival-graded fibrosis in pdac

Conditions: Pancreatic Cancer

Summary: tumor fibrosis plays an important role in chemotherapy resistance in pancreatic ductal adenocarcinoma (pdac), however there remains a contradiction in the prognostic value of fibrosis. we aimed to investigate the relationship between tumor fibrosis and survival in patients with pdac, classify patients into high- and low-fibrosis groups, and develop and validate a ct-based radiomics model to non-invasively predict fibrosis before treatment.

this retrospective, bicentric study included 295 pretreated patients with pdac. tumor fibrosis was assessed using the collagen fraction (cf). clinical-pathological variables were gathered, and radiological features were evaluated by three radiologists in consensus. the patients were followed up at 1, 3, 6, and 9 months postoperatively and every 3-6 months thereafter. all follow-up examinations included carbohydrate antigen 19-9 (ca 19-9) measurements and imaging (contrast-enhanced ct, contrast-enhanced mri, ultrasonography, or positron emission tomography). the overall survival (os) and disease-free survival (dfs) were also recorded. cox regression analysis was used to evaluate the associations of cf with os and dfs. receiver operating characteristic (roc) analyses were used to determine the rounded threshold of cf. an integrated model (im) was developed by incorporating selected radiomic features and clinical-radiological characteristics. the predictive performance was validated in the test cohort (center 2). it was hypothesized that tumor fibrosis could be classified into two survival-graded groups and that the incorporation of radiomics features and clinical-radiological features would help predict the status of fibrosis. thus, the association between fibrosis and overall survival (os)/disease-free survival (dfs) was determined, and the patients with pdac were divided into high- and low-cf groups in this study. in addition, a ct-based radiomics model was developed and validated to non-invasively predict fibrosis before treatment in patients with pdac from two centers. it was hypothesized that the performance of the integrated model would be superior to that of the clinical-radiological model.

Eligibility criteria:
inclusion criteria: * patients with suspected pancreatic tumors who underwent contrast-enhanced ct and pathological examinations at center 1 and center 2 were eligible for inclusion in this study. exclusion criteria: * (a) pathologically diagnosed pdac by resection; (b) time intervals between contrast-enhanced ct and pathology less than 2 weeks; (c) no history of previous treatment such as resection, chemotherapy, or radiotherapy. the patients were excluded as follows: (a) unavailable pathological sections for evaluating the fibrosis; (b) incomplete clinical records; (c) missing ct images or poor ct image quality; (d) coincidence of other malignant tumors
design and development of a mobile app to improve adherence to pre-exposure prophylaxis in men who have sex with men

Conditions: HIV Infections; Pre-Exposure Prophylaxis

Summary: this study is testing feasibility and acceptability of a theoretically based mobile application (app), uprepu, to increase adherence to pre-exposure prophylaxis (prep) among men who have sex with men (msm) to prevent human immunodeficiency virus (hiv).

this study aims to develop an effective mobile application (app), uprepu to recognize the factors and decisions that affect prep adherence in high-risk populations to improve prep adherence. key components of the app include a sex/prep diary using ecological momentary assessment to facilitate accurate data collection; prep taking reminder; hiv and sexually transmitted infections (sti) testing information and reminders; hiv and prep information and videos; geo-location. after eligible prep candidates agree to participate in the study, we will ask participants to install the app. then, we will begin to collect their sexual diary and prep taking log via ecological momentary assessment. participants will also complete monthly assessments. the monthly follow-up will test hiv/sti and drug concentration. the participants will be interviewed for difficulties when they use our app and giving feedback on it.

Eligibility criteria:
inclusion criteria: * male. * aged 20 or above. * resides in taiwan and able to understand, read, and speak mandarin chinese. * remains hiv negative prior to and during the study period. * the results of the laboratory tests are eligible to initiate prep. * currently taking prep or willing to initiate prep. * reports having 4 times or above anal sex with men in the past month. * owns an android or apple operating system (ios) smartphone and willing to download the study app. * willing to wear the device we provided during the study period. exclusion criteria: * with abnormal kidney function (creatinine clearance rate ≦ 60 ml/minute). * currently on medication that might interact with prep, such as drugs contain lamivudine in the pre-prep assessment.
angiotensin converting enzyme inhibitors and periprocedural myocardial infarction

Conditions: Metabolic Syndrome; Coronary Artery Disease

Summary: metabolic syndrome (ms) has been reported as a risk for cardiovascular events. the aim of the present cohort study is to investigate whether acei therapy reduces the rate of periprocedural myocardial injury (ppmi) after elective percutaneous coronary intervention (pci) among patients with metabolic syndrome.


Eligibility criteria:
inclusion criteria: 1. metabolic syndrome 2. elective percutaneous coronary intervention with angiographically successful stent implantation exclusion criteria: 1. acute coronary events 2. renal failure 3. needed the use of iv glycoprotein iib/iiia receptor inhibitors were excluded 4. left main coronary artery disease 5. chronic total occlusion 6. high levels of baseline ckmb or troponin 7. any contraindication of aspirin, clopidogrel or acei treatment

Keywords: angiotensin converting enzyme inhibitor inflammation metabolic syndrome myonecrosis percutaneous coronary intervention periprocedural myocardial injury
study of neoadjuvant gemcitabine and cisplatin in locoregionally advanced nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: the purpose of this study is to compare induction chemotherapy (gemcitabine+cisplatin) plus concurrent chemoradiotherapy with concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma (npc), in order to confirm the value of induction chemotherapy using gemcitabine and cisplatin in npc patients.

patients presented with non-keratinizing npc and stage ⅲ-ⅳb t3-4n1m0/txn2-3m0 are randomly assigned to receive induction chemotherapy (gemcitabine+cisplatin) plus concurrent chemoradiotherapy (investigational arm) or concurrent chemoradiotherapy (control arm). patients in both arms receive radical intensity modulated radiation therapy (trilogy, varian), and cisplatin (40mg/m2) every weeks for six cycles during radiotherapy. radiation is delivered to gtv at 70 gy in 30 fractions, ctv1 at at 60 gy in 30 fractions and ctv2 at 54 gy in 30 fractions. patients in the investigational arm receive gemcitabine (1000mg/m2 on day 1,8) and cisplatin (20mg/m2 on day 1-4) every three weeks for two cycles before the radiotherapy. the primary end point is response rates after radiotherapy, failure-free survival (ffs) and toxic effects and treatment compliance. secondary end points include overall survival (os), distant failure-free survival (d-ffs), locoregional failure-free survival (lr-ffs). all efficacy analyses are conducted in the intention-to-treat population; the safety population include only patients who receive their randomly assigned treatment.

Eligibility criteria:
inclusion criteria: * patients with newly histologically confirmed non-keratinizing (according to world health organization (who 2005) histologically type). * karnofsky scale (kps) \> 70. * tumor staged is according to the 7th american joint commission on cancer edition as stage iii：t1-2n2m0, t3n0-2m0 stage iva：t4n0-2m0 stage ivb：any t、n3. * adequate marrow: leucocyte count ≥4000/μl, hemoglobin ≥90g/l and platelet count ≥100000/μl. * normal liver function test: alanine aminotransferase (alt)、aspartate aminotransferase (ast) \<1.5×upper limit of normal (uln) concomitant with alkaline phosphatase (alp) ≤2.5×uln, and bilirubin ≤uln. * adequate renal function: creatinine clearance ≥60 ml/min. * patients must be informed of the investigational nature of this study and give written informed consent. exclusion criteria: * who type keratinizing squamous cell carcinoma. * age \>60 years or \<18 years. * treatment with palliative intent. * pregnancy or lactation. * prior radiotherapy, chemotherapy or surgery (except diagnostic) to primary tumor or nodes. * any severe intercurrent disease including unstable cardiac disease, chronic hepatitis, renal disease, diabetes with poor control, and emotional disturbance.

Keywords: nasopharyngeal carcinoma
carpal tunnel syndrome and amyloid cardiomyopathy

Conditions: Amyloidosis; Cardiomyopathy; Transthyretin Amyloidosis; Senile Systemic Amyloidosis; Carpal Tunnel Syndrome

Summary: the investigators will prospectively evaluate tissue samples obtained from patients undergoing carpal tunnel release surgery for amyloid in the soft tissue that is removed. patients who have tissue that stains positive for amyloid will undergo cardiac testing to look for evidence of cardiac involvement.

since the 1970s, the connection between amyloidosis and carpal tunnel syndrome has been described, with tenosynovial tissue staining positive for amyloid fibril deposition. up to 30% of patients in prior studies with idiopathic carpal tunnel syndrome have biopsy tissue that stains positive for amyloid deposition. however, the prevalence of cardiac involvement at the time of carpal tunnel syndrome surgery has not been established. furthermore, the role of ttr kinetic stability in the disease progression of amyloidosis is unclear. diagnosing ttr amyloidosis at the time of carpal tunnel involvement could lead to an earlier identification of the disease at a stage where the cardiomyopathy may be occult or less advanced. in addition, abnormal ttr kinetics may even precede tissue deposition in the flexor tendon retinaculum. as several emerging pharmacological strategies are in development that may slow or even halt ttr amyloidosis, earlier diagnosis is advantageous. identification and implementation of therapy for prevention or early disease treatment may alter the natural history of this progressive systemic disease.

Eligibility criteria:
inclusion criteria: * males ≥ 50 years of age * females ≥ 60 years of age * undergoing carpal tunnel release surgery (adequate symptoms are not responding to conservative management requiring surgery) * able to consent * underwent carpal tunnel surgery and biopsy within last 30 days, if the study was discussed prior to surgery by one of the study physicians. exclusion criteria: * secondary cts (hemodialysis, rheumatoid arthritis, trauma) * known diagnosis of amyloidosis

Keywords: amyloidosis carpal tunnel syndrome
iga-positive versus iga-negative immune complex vasculitis

Conditions: Cutaneous Vasculitis

Summary: cutaneous vasculitis due to vascular deposition of large circulating immune complexes is a disease frequently seen by general practitioners and dermatologists. the clinical symptom is palpable purpura with predilection for the lower legs. in some cases vasculitis also affects systemic organs, such as the kidneys and the intestine. when the immune complexes contain immunoglobulin class a (iga) and when there is systemic involvement, the disease has been referred to as henoch schönlein purpura. when there are no signs of systemic involvement, the disease has been referred to as cutaneous leukocytoclastic angiitis. the investigators hypothesize that palpable purpura with predilection for lower legs is a pathognomonic clinical sign for immune complex vasculitis in both iga vasculitis and iga-negative vasculitis, but that only the presence of iga in immune complexes is likely to be associated with systemic involvement and therefore warrants more extensive diagnostic procedures vice versa the investigators postulate that the presence of igg or igm without iga in immune complexes excludes systemic involvement the investigators also want to investigate to which of the 2 groups patients with palpable purpura and negative immunofluorescence should be assigned.


Eligibility criteria:
inclusion criteria: * histologically proven leukocytoclastic vasculitis * clinically palpable purpura exclusion criteria: * no histological confirmation * relevant data missing in file

Keywords: immune complex vasculitis cutaneous vasculitis iga vasculitis iga nephropathy
conflict between maternal autonomy and child health in substance-use

Conditions: Substance-Related Disorders; Alcohol-Related Disorders; Amphetamine-Related Disorders; Inhalant Abuse; Cocaine-Related Disorders; Opioid-Related Disorders; Marijuana Abuse; Substance Abuse, Intravenous; Neonatal Abstinence Syndrome; Pregnancy; Pregnancy, High-Risk

Summary: qualitative project, comprising open-ended semi-structured interviews with healthcare workers, who provide antenatal care to substance-using women.

maternal substance use during pregnancy (including legal and illicit substances) is a fairly common global phenomenon, including in the uk. this can have significant effects on pregnancy, infant outcome and enduring consequences into adolescence. babies born with neonatal abstinence syndrome may spend months in neonatal care units, requiring complex, 24hour care. here, healthcare workers may experience conflict between preserving maternal autonomy, and the challenge of caring for a withdrawing newborn. however, there is discrepancy between the objectives of policy-makers "reducing the harm to children from parental problem drug use should become a main objective of policy and practice" and those recommended in healthcare "these women need supportive and coordinated care during pregnancy." therefore, conflict arises between mother-centred and child-centred models of caring for pregnant women who use substances. the objective of the proposed project is to investigate how healthcare workers providing treatment for pregnant women who use illicit substances perceive their duty of care and whether they experience tension between the conflicting objectives of mother-centred and child-centred approaches through semi-structured qualitative interviews. the investigators will explore the ways in which healthcare workers frame problematic substance misuse in pregnant women, what they perceive to be the major challenges in providing care and their views on the responsibility of a mother to have a healthy baby. the main hypothesis is that healthcare workers providing care for pregnant women engaging in problematic substance misuse experience conflict between mother-centred and child- centred approaches to care.

Eligibility criteria:
inclusion criteria: * healthcare workers will be recruited based on their employment status; they must currently provide some form of antenatal are for women who engage in problematic use of substances (limited to illicit drugs, excluding tobacco and alcohol). * healthcare workers will not be restricted by age, and all genders will be included. as the research is qualitative, a representative same is unnecessary. exclusion criteria: * healthcare workers will be excluded if they do not have experience of providing ante-natal care for women who engage in problematic substance misuse (limited to illicit drugs, excluding tobacco and alcohol) during their pregnancy.

Keywords: [g08.686.785.760.769.500] [g08.686.785.760.769] [n02.360] [c25.775.650] [c25.775.793] [c25.775.635] [c25.775.675] [c25.775.300] [c25.775.467] [c25.775.225] [c25.775.100] [c25.775]