Kornimate/medical-research-clean huggingface dataset:
impact of anxiety on the decision-making processes of anesthesiologists

Conditions: Anxiety; Decision Making; General Anesthesia

Summary: except for exaggerated situations in which aspiration risk seems obvious (or absent), the choice of a rapid sequence induction protocol for general anesthesia is often made under uncertainty, according to the individual assessment of the balance between the aspiration risk on one hand and the anaphylaxis risk induced by short-acting curares on the other hand. the impact of anxiety and impulsivity on the choice of induction protocols under uncertainty has never been studied before. in order to investigate this issue, an online anonymous survey has been designed and will be sent to the anesthesiologists of the bourgogne franche-comté and grand est regions in france. the primary objective of this study is to assess the impact of trait-anxiety using the stai-y2 form on the decision-making process of anesthesiologists during the choice of an induction protocol for patients at risk of aspiration. the secondary objectives are to characterize decision-making profiles, to measure the implicit dimension of anxiety using an implicit association test, to study the impact of impulsivity on decision-making processes under uncertainty using the short version of upps-p scale and to study the role of socio-demographic data and professional history in these decisions.


Eligibility criteria:
inclusion criteria: * all anesthesiologists who have completed their phd * working in france * in a public or private healthcare facility exclusion criteria: * residents * retired anesthesiologists
low-dose ketamine as an adjunct to morphine for acute pain in the ed

Conditions: Acute Pain; Opioid Use

Summary: the ketmo study is an investigator-initiated, randomized, parallel group, double blinded trial investigating if ketamine as an adjunct to morphine improves pain treatment in the ed. patients in pain (assessed on nrs, 5 or more) will be randomized to low-dose ketamine or placebo as an adjunct to morphine. patients with or without prior use of opioids will be randomized separately. the primary outcome will be pain reduction, assessed on nrs, after 10 minutes. secondary outcomes include pain reduction until 120 minutes after injection of study medicine, need for rescue opioid, side effects and patient- and provider satisfaction.


Eligibility criteria:
inclusion criteria: 1. emergency department admission 2. age ≥ 18 years 3. nrs ≥ 5 4. stable vital signs defined as systolic blood pressure ≥ 90 mmhg, heart rate between 60 and 150 per minute, respiratory rate between 8 and 26 per minute, oxygen saturation greater than or equal to 92% exclusion criteria: 1. initial management by trauma-team 2. systolic blood pressure ≥ 180mmhg, severe untreated arrhythmia, unstable angina, recent myocardial infarction (\< 30 days), severe heart-failure (ejection fraction \< 40 %) 3. symptoms of untreated hyperthyroidism 4. cirrhosis with ascites 5. known/suspected pregnancy or breastfeeding 6. patients for whom consent is not obtainable or psychiatric forced treatment. 7. previously enrolled in the trial 8. psychiatric illness prior to admission defined as prior psychosis/schizophrenia 9. untreated diagnosed glaucoma 10. known hypersensitivity to ketamine or to any excipient or prior use of ketamine with a negative experience (i.e. hallucinations) 11. patient clearly influenced by drugs or alcohol

Keywords: low dose ketamine opioid use acute pain emergency department
effectiveness of biofeedback-assisted relaxation training in children with eosinophilic duodenitis

Conditions: Abdominal Pain; Duodenitis

Summary: the purpose of this study is to determine whether the addition of biofeedback-assisted relaxation to standard medication treatment improves outcomes for children with a specific type of recurrent abdominal pain (i.e., eosinophilic gastroenteritis).

recurrent abdominal pain (rap) is the most common type of pain in school age children and young adolescents. previous studies suggest that stress plays an important role in the activation of specific cells that can produce pain within the stomach and intestines. medication is the standard approach to the treatment of rap in children. although medication is helpful for many children, medication alone is not always enough. biofeedback trains individuals to use relaxation strategies effectively to relieve emotional and physical symptoms, and has been used successfully for stress and pain reduction with both children and adults. it has shown promising results when used alone in the treatment of children with rap. research is needed, however, to determine whether biofeedback training is helpful when used in conjunction with medication. information about how biofeedback training affects the central nervous system and the cells that produce pain also would be useful in refining treatments for this large group of children. the current research will be done in three steps, with phase 1 designed to evaluate the time, resources, technical support, and sample size needed for successful completion of the full research study. twenty children (ages 8-18) with eosinophilic duodenitis, a specific form of rap, will be enrolled and randomly assigned to one of two groups: 1) standard of care; or 2) biofeedback (standard medical care plus 10 sessions of biofeedback training). measures of pain, functional disability, quality of life, physiological arousal, and global treatment response will be collected pre- and post-intervention, as well as 3 and 6 months later. data collected will be used to determine how many participants will be needed for the full research study. if biofeedback training is ultimately found to be a positive addition to standard medical treatment, this could lead to improved health outcomes for children with rap. this information also could result in greater treatment efficiency and reduced health care costs for families, insurance providers, and the hospital system.

Eligibility criteria:
inclusion criteria: * a current diagnosis of eosinophilic duodenitis per biopsy. * ability to participate in the biofeedback training protocol. * transportation available to attend twice weekly visits to children's mercy hospital (cmh). exclusion criteria: * previous biofeedback training. * previous failure of medications used as standard of care in this study. * allergy to medications prescribed in this study. * co-morbid chronic illness requiring regular medical care.

Keywords: biofeedback
blood flow restriction training in patients with weight bearing restrictions after knee surgery

Conditions: Cartilage, Articular; Tibial Meniscus Injuries

Summary: after a cartilage or meniscus repair in the knee joint, the patients experience a pronounced and persistent decrease of knee-extension strength in the operated leg, which negatively affect patients' functional performance and quality of life. a possible novel exercise modality to increase muscle strength early is a moderate blood flow restriction with low-load strength training (bfr-llst) exercise. bfr-llst involves application of a wrapping device to restrict the blood flow to the muscle(s) during exercise. bfr- llst requires much less load than traditional strength training and has shown to produce positive training adaptations such as muscle hypertrophy and strength in the lower extremity in healthy subjects and patients with a knee surgery. to our knowledge, early rehabilitation with bfr-llst has never been investigated in a population with weight bearing restrictions, such as patients recovering from cartilage or meniscus repair in the knee joint. fear of symptom exacerbation and adverse events have precluded bfr-llst early after knee surgery. the purpose of this study is to examine the feasibility of 9 weeks of supervised rehabilitation with bfr-llst early after cartilage or meniscus repair in the knee joint.


Eligibility criteria:
inclusion criteria: * patient has a cartilage and/or meniscus repair in 1 or 2 knee(s). * patient is between 18 and 70 years. * patient is able to speak and understand danish. * patient has given informed consent to participate in the study. exclusion criteria: * patient has problems that severely limits ambulatory function from unstable orthopaedic (besides cartilage repair and meniscal fixation in the knee joint), neurological, vascular or cardiac conditions. * patient has a history of diagnosed major psychiatric disorder. * patient has a history of illicit drug use; be currently abusing alcohol or currently withdrawing from alcohol abuse. * patient has a history of endothelial dysfunction, peripheral vascular disease, hypertension, diabetes. * patient has a history of heart disease and deep vein thrombosis. * patient is pregnant. * patient has cancer (current diagnosis). * patient has an active infection.

Keywords: menisci, tibial cartilage, articular blood flow restriction training resistance training physical therapy modalities feasibility studies
impact of acute leg cycling at various intensities on rls severity in persons with ms

Conditions: Multiple Sclerosis; Restless Legs Syndrome

Summary: the purpose of this study is to evaluate the impact of acute leg cycling conditions at three different intensities versus a control condition condition on symptoms of restless legs syndrome (rls) in persons with multiple sclerosis (ms). this study includes a proposed sample of 24 participants diagnosed with both ms and rls that will complete four sessions of supervised exercise or rest conditions in the lab, one session per week, over the course of four weeks.

the aim of this study is to evaluate the impact of acute leg cycling conditions at three different intensities (i.e., light, moderate, and vigorous) versus a control condition (i.e., quiet rest) on symptoms of rls in persons with ms. this study involves a within-subjects, repeated measures design that includes a proposed sample of 24 participants diagnosed with both ms and rls. participants will complete four sessions with supervised exercise or rest conditions in the lab, one session per week, over the course of four weeks. the order of the three conditions will be randomized and counterbalanced and include: (1) leg cycling with no resistance (i.e., light), (2) leg cycling at moderate intensity, (3) leg cycling at vigorous intensity, and (4) seated, quiet rest (i.e., control condition). the primary study outcome includes the objective measure of rls severity using the suggested immobilization test (sit) that will be administered immediately before and immediately after each condition (i.e., light, moderate, vigorous, and quiet rest).

Eligibility criteria:
inclusion criteria: * 18-54 years of age * diagnosis of multiple sclerosis * has not experienced a relapse in the last 30 days * positive screening for restless legs syndrome * restless legs syndrome severity of moderate or greater * ambulatory with or without an aide exclusion criteria: * moderate or high risk for undertaking strenuous or maximal exercise * diagnosis of: radiculopathy, peripheral edema, peripheral neuropathy, iron deficiency (i.e., anemia), renal disease, or diabetes

Keywords: exercise
application of remimazolam combined with esketamine in painless gastroscopy and colonoscopy in elderly patients

Conditions: Gastrointestinal Disease

Summary: the objective of this clinical trial is to assess the feasibility of the remimazolam combined with esketamine ofa (opioid-free anesthesia) protocol for painless gastroscopy and colonoscopy in elderly patients and to determine if it is non-inferior to the traditional oa (opioid-containing anesthesia) protocol. the main questions it aims to answer are: * is the remimazolam combined with esketamine protocol feasible for painless gastroscopy and colonoscopy in elderly patients? * is the ofa protocol superior to the oa protocol? participants will: * during anesthesia induction, the experimental group will receive remimazolam combined with esketamine for anesthesia, while the control group will receive remimazolam combined with remifentanil. * record respiratory and circulatory indicators and adverse reaction times.

elderly patients undergoing painless gastroenteroscopy were randomly divided into remazolam + esketamine group (re group) and remazolam + remifentanil group (rr group). in re group, anesthesia induction was as follows: remazolam 0.2mg/kg, esketamine 0.15mg/kg, lidocaine 0.5mg/kg, changtonine 0.2mg. rr group: anesthesia induction: remazolam 0.2mg/kg, remifentanil 0.2μg/kg, lidocaine 0.5mg/kg, changtonine 0.2mg. remazolam and esketamine/remifentanil were added during the operation according to the depth of sedation and movement of the patient. the outcome measures included success rate of sedation, incidence of respiratory depression, incidence of hypotension and bradycardia, postoperative recovery time, incidence of adverse reactions, postoperative satisfaction of patients and gastroenteroscopists.

Eligibility criteria:
inclusion criteria: 1. patients undergoing painless gastroenteroscopy in outpatient clinics; 2. aged 65 years and above; 3. american society of anesthesiologists (asa) grades i - iii. exclusion criteria: 1. patients with abnormal liver or kidney function; 2. known respiratory or endocrine diseases; 3. patients with uncontrolled hypertension and nyha classification ⅲ-ⅳ; 4. taking monoamine oxidase inhibitors, sedatives, analgesics, hypnotics, antipsychotics, antiemetics or antidepressants; 5. addiction to tobacco and alcohol; 6. patients allergic to the investigational drug; 7. expected difficult airway; 8. body mass index (bmi) \>35kg/m\^2; 9. have participated in other clinical trials within the past three months; 10. patients with psychosocial illness or cognitive dysfunction and inability to cooperate or communicate.

Keywords: remimazolam esketamine painless gastroscopy and colonoscopy success rate of calming down
comparative analysis of adherence and effectiveness outcomes between rheumatoid arthritis (ra) patients treated with tofacitinib modified release (mr)

Conditions: Rheumatoid Arthritis

Summary: the purpose of this study is to compare adherence, persistence, and effectiveness among patients initiating tofacitinib modified release (mr) with tofacitinib immediate release (ir).


Eligibility criteria:
inclusion criteria: * at least one claim for tofacitinib between 01 january 2014 and 31 january 2017 (the identification period). * presence of the international classification of diseases, 9th revision, clinical modification (icd-9 cm) code for ra (in any position) during the one-year pre-index period or on the index date. icd-9 = 714.0x-714.4x \& 714.81 or icd10 = m05.\* \& m06.0\*-m06.3\* or m06.8\*-m06.9\*. * at least 18 years old as of the index date. exclusion criteria: * patients with claims for other conditions for which biologics are used during the one-year pre-index period or on the index date: ankylosing spondylitis, crohn's disease, psoriasis, psoriatic arthritis, or ulcerative colitis will be excluded from the study. * patients with evidence of the index medication during the one-year pre-index period will be removed from the analysis. patients will be allowed to have been treated with other biologics approved for ra (tumor-necrosis factor-alpha inhibitors (tnfi) \[adalimumab (humira), etanercept (enbrel), certolizumab pegol (cimzia), golimumab (simponi), infliximab (remicade)\] and non-tnfi's with alternative mechanisms of action \[abatacept (orencia), and rituximab (rituxan), anakinra (kineret), tocilizumab (actemra)\]) during the one-year pre-index period.
assessment of safety of air travel in patients with pulmonary langerhans cell histiocytosis

Conditions: Pulmonary Langerhans Cell Histiocytosis

Summary: the aim of this study is to conduct survey-based assessments for the safety of air travel in patients with pulmonary langerhans cell histiocytosis (plch). the study will enroll patients through the clinic network at rare lung disease consortium (rldc) and through the histiocytosis association website. patients will have access to the questionnaire via redcap (an online data management system) and each patient will be provided with a link to complete the survey. the investigators plan on enrolling approximately 200 patients with plch for the purpose of this study. secondary aims of this study include further characterization of the clinical aspects of disease and to establish a contact registry for these patients, in order to facilitate future studies.

the study will enroll participants through the clinic network at the rare lung disease consortium (rldc) and through the histiocytosis association websites. participants will have access to the questionnaire via redcap (an online data management system) and each participant will be provided a link to complete the survey. in case of lack of internet access or inability to complete the online questionnaire, a paper survey will be mailed out with a pre-paid envelope to return the survey. primary study objective(s): to define the risk of pneumothorax associated with air travel in patients with plch. secondary study objective(s): to establish a contact registry for patients with plch to facilitate future trials to assess the rate of pneumothorax recurrence in patients with plch to assess the efficacy of pleurodesis in preventing recurrent pneumothoraces among patients with plch

Eligibility criteria:
inclusion criteria: * adult, age 18 or older * english literate * signed, dated informed consent; either given electronically or via paper form * confirmed diagnosis of plch based either on characteristic radiologic findings, or histopathological confirmation exclusion criteria: * inability, or refusal, to sign informed consent.

Keywords: plch air travel pneumothorax pleurodesis
impact of hot flashes on sleep and mood disturbance

Conditions: Menopause; Depression; Hot Flashes

Summary: we plan to enroll premenopausal women in a trial investigating the impact of hot flashes developed in response to an injection of a gonadotropin-releasing hormone agonist (gnrha), leuprolide (brand name: lupron), on sleep disruption and mood. this study is designed to mimic the menopause transition. we will collect data on sleep disruption and mood changes to assess their relationship to the development of hot flashes.


Eligibility criteria:
inclusion criteria: * women 18-45 years old * premenopausal * willingness to use barrier methods of contraception during study and after completion of study until menses resume * good general health exclusion criteria: * pregnancy or currently breastfeeding * hot flushes * mid-luteal phase progesterone \<3ng/ml * clinically significant abnormalities in screening blood tests * bmi \> 35 kg/m2 * previously diagnosed osteoporosis or osteopenia * clinically significant depressive symptoms * psychiatric illness * sleep apnea or periodic limb movement of sleep (plms) * contraindication, hypersensitivity, or previous allergic reaction to gnrh agonists * current or recent use of centrally active medications * current or recent use of systemic hormone medications * night shift workers * current use of over-the-counter (otc) medications that may affect hot flashes, sleep, or mood * abnormal vaginal bleeding * history of any medical diseases that may put subject at risk when treated with study medication.

Keywords: hot flashes sleep disturbance lupron menopause
application of machine learning based approaches in emergency department to support clinical decision managing sars-cov-2 infected patients

Conditions: Covid19

Summary: the aim of the study is to develop a prognostic prediction model based on machine learning algorithms in patients affected by coronavirus disease 2019 (covid-19), the prediction model will be capable to recognize patient with favorable prognosis or patient with poor prognosis by intelligent systems data analysis.


Eligibility criteria:
inclusion criteria: * patients aged over 18 positive for covid-19 by polymerase chain reaction assay for rhino-pharyngeal swab exclusion criteria: * under 18 aged

Keywords: covid19 machine learning prediction model convolutional neural network
effect of mental and physical training on blood pressure

Conditions: Elevated Blood Pressure

Summary: elevated blood pressure or prehypertension is highly associated with increased risk of developing hypertension, cardiovascular event, and type ii diabetes. many physically inactive young adults, particularly in malaysia have blood pressure higher than normal range, therefore it is important to control the blood pressure within normal range as prophylactic measure. this experimental research will be carried out to study the effect of physical training (aerobic exercise) and mental training (mindfulness meditation) with diet as a control group on the systolic blood pressure, diastolic blood pressure and resting heart rate among young adult with elevated blood pressure living a sedentary lifestyle. participant will be divided into 2 experimental groups (mental and physical training) and 1 control group (dietary approaches to stop hypertension -dash diet plan) who need to complete the prescribed intervention for 6 weeks. results will be analysed by repeated measures anova followed by post-hic test.


Eligibility criteria:
inclusion criteria: * male adults aged 18-25 years * normal bmi (18.5-24.9) * physically inactive * sbp between 120-139 mmhg and/or dbp between 60-89 mmhg * no hearing abnormalities * willing to participate exclusion criteria: * participants who have cardiovascular, musculoskeletal, and neurological disorders or any other medical condition that would restrict them to participate in the exercise * those who are taking antihypertensive medications or other medications that will affect their bp and heart rate * participants who are currently engaging in any form of relaxation techniques such as yoga or meditation * individuals who are actively engaged in physical activities
study of value of cardiac pet scans with or without ct angiography and/or measurement of coronary flow reserve

Conditions: Chest Pain; Coronary Artery Disease

Summary: how does pet myocardial perfusion imaging involving ct angiography and measurement of coronary flow reserve affect patient care.

the purpose of this research is to determine how pet myocardial perfusion imaging involving ct angiography and measurement of coronary flow reserve affects patient care. this research will also compare the effectiveness of these scans to other similar tests and compare the cost-effectiveness of these scans to other similar tests over time.

Eligibility criteria:
inclusion criteria: * patients referred to kettering medical center for pet myocardial perfusion imaging with or without cta and/or coronary flow reserve measurement. * patients over 18 years of age. exclusion criteria: * patients who do not consent to participate.

Keywords: pet myocardial perfusion imaging cardiac pet rubidium coronary artery ct angiogram coronary flow reserve adenosine stress test