Kornimate/medical-research-clean huggingface dataset:
clinical pharmacists in the emergency department

Conditions: Medication Reconciliation

Summary: the purpose of this study is to investigate the effect of implementing clinical pharmacists in the emergency department team at randers regional hospital. the clinical pharmacists conduct medication history, make medical interaction screenings, -reconciliations and -reviews on unscheduled patients admitted to the emergency department during daytime.


Eligibility criteria:
inclusion criteria: * unscheduled patients admitted to the emergency department at randers regional hospital at weekdays during daytime (9 am to 16.15 pm) * 4 or more drugs prescribed exclusion criteria: * patients triage red * patients who cannot give informed consent * terminal patients * patients admitted to detoxification * patients refered to the acute outpatient department * patients remaining in the emergency department overnight

Keywords: pharmacy length-of-stay emergency department
t1d risk assessment in kids with relatives

Conditions: Type 1 Diabetes

Summary: the purpose of this study is to determine whether early immunological markers (activation of autoreactive t lymphocytes) precede and are predictive of the appearance of autoantibodies in children born from type 1 diabetic parents.

the prevalence of type 1 diabetes (t1d) is estimated between 0.2 and 0.4% in france. the incidence in france is more than 10/105 per year, with a steady increase (\~4%/year), especially in children. infants born to parents with t1d have a 15-fold higher risk to develop t1d compared to the general population. the appearance of autoantibodies precedes and is highly predictive of the later occurrence of t1d. the activation of b lymphocytes, which produce autoantibodies, is controlled by t helper lymphocytes. hence, biomarkers associated with initial t lymphocyte activation are likely to precede the appearance of autoantibodies. the aim of the trakr study is to determine whether the appearance of autoreactive t lymphocytes is predictive of the emergence of autoantibodies. the secondary objectives are: 1) to evaluate whether metagenomic, metabolic, or environmental factors are associated with the appearance of autoantibodies; 2) to evaluate the incidence and the time of autoantibody appearance in a french population of genetically at-risk children; 3) to compare the incidence of autoantibodies between infants born to t1d fathers and mothers.

Eligibility criteria:
inclusion criteria: 1. mother and/or father with type 1 diabetes * age \> 18 years * type 1 diabetes : insulin-dependent diabetes positive for autoantibodies against insulin and/or gad and/or ia-2 and/or znt8 at the time of diagnosis * planning to give birth or having given birth since less than 8 months * agreeing to participate upon written informed consent * covered by the french social security system 2. mother/father without type 1 diabetes * age \> 18 years old * with a spouse with type 1 diabetes : insulin-dependent diabetes positive for autoantibodies against insulin and/or gad and/or ia-2 and/or znt8 at the time of diagnosis * planning to give birth or having given birth since less than 8 months * agreeing to participate upon written informed consent * covered by the french social security system 3. children born to mother and/or father with type 1 diabetes * age \< 8 months * with at least one parent with t1d * with both parents agreeing to participate * both parents covered by the french social security system exclusion criteria: 1) mother/father * secondary forms of diabetes * monogenic forms of diabetes 1 or 2) for the mother * malignant neoplastic or psychiatric disease 3 ) newborns of mother/father with type 1 diabetes * severe foetal disease * severe congenital malformation * congenital measles

Keywords: type 1 diabetes risk assessment immunological marker children relatives autoantibodies lymphocytes t cells epitopes children born to mother/father with type 1 diabetes and their parents
strategy training for people with aphasia after stroke

Conditions: Strategy Training

Summary: one-third to one-half of acute strokes result in newly acquired cognitive impairments. approximately 30 to 40% of people in the acute phase of stroke also sustain communication impairments. stroke-related cognitive impairments are associated with significant functional disability, as indicated by the inability to regain independence in daily activities. the overall aim of this study is to examine the feasibility of an adapted form of strategy training for people with communication impairments who are admitted to inpatient rehabilitation. these analyses will address a critical gap in current rehabilitation research, namely the exclusion of people with communication impairments in acute stroke rehabilitation clinical trials, and provide pilot data to inform the design of future inclusive clinical trials seeking to reduce disability after stroke.

this pilot study will use a descriptive case series design with repeated measures to assess the feasibility of an adapted form of strategy training for people with communication impairments after acute stroke. the investigators will recruit people with aphasia due to stroke admitted to the inpatient rehabilitation units and administer the adapted form of strategy training one session per day 5 days per week for 10-15 sessions. the investigators will assess the feasibility of the intervention based on feedback from participants and therapists. these data will serve as pilot data to inform the design of a future clinical trials for people with cognitive impairments after stroke, including people with communication impairments. these efforts will allow the investigators to test new models to support optimal interventions for individuals with stroke-related cognitive impairments, including people with communication impairments who are among those most vulnerable for long-term disability.

Eligibility criteria:
inclusion criteria: * primary diagnosis of acute stroke * admission to acute rehabilitation * mild to moderate aphasia but able to understand and express communication with verbal, written, and/or augmentative communication (score of 1 or 2 on the national institutes of health stroke scale item 9, or score 1 to 5 on the boston diagnostic aphasia examination severity scale) exclusion criteria: * pre-stroke diagnosis of dementia * severe global aphasia (boston diagnostic aphasia examination severity scale score of 0) * dysarthria as the only communication impairment (score of 1 or 2 two on the national institutes of health stroke scale item 10, but score of 0 on item 9) * current major depressive disorder (unless treated and in partial remission), bipolar disorder, or any other psychotic disorder (indicated by prime-md)severe global aphasia (boston diagnostic aphasia examination severity scale score of 0)

Keywords: stroke aphasia rehabilitation cognition disability
epidemiology and outcome of ventilator-associated pneumonia among critically ill covid-19 patients

Conditions: Ventilator Associated Pneumonia; Corona Virus Infection

Summary: the aim of this study is to determine the risk factors for development of ventilator-associated pneumonia (vap) and to identify the prognostic factors of vap among coronavirus disease 2019 (covid-19) patients. we hypothesized that covid-19 serves as a high risk factor for the development of vap and it affects clinical outcome measures negatively.

coronavirus disease 2019 (covid-19) caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2) became a pandemic affecting thousands of individuals worldwide. a considerable proportion of covid-19 patients require admission to the intensive care unit (icu), although limited data are available on their clinical characteristics and course. the results of retrospective studies indicate older age, presence of comorbidies and secondary infections as predictors of mortality among this population. further evaluation regarding icu clinical course and predictors of mortality is needed. the aim of this study is to determine the risk factors for development of vap and to identify the prognostic factors of vap among covid-19 patients.

Eligibility criteria:
inclusion criteria: * critically ill individuals diagnosed with pcr confirmed covid-19 disease * started mechanical ventilation for \> 48 hours * informed consent signed by the patient or authorised representative exclusion criteria: * participation in an interventional trial aiming nosocomial infections * refused informed consent
graded exposure therapy for fear avoidance behaviour after concussion

Conditions: Mild Traumatic Brain Injury

Summary: concussions are very common. although many people recover well from concussion, some will have persistent symptoms and difficulties with daily activities. how people cope with their symptoms following concussion powerfully influences their recovery. fear avoidance behaviour is a particularly unhelpful approach to coping, in which people perceive their pre-injury activities as unnecessarily dangerous and take great care to avoid overexertion and overstimulation. the investigators developed and pilot tested a behavioural therapy, called graded exposure therapy, to reduce fear avoidance behaviour. our preliminary work suggested that graded exposure therapy was acceptable to patients with concussion and possibly beneficial for their recovery. the get fab after concussion study will assess the effectiveness of graded exposure therapy.

get fab is a multisite randomized controlled trial designed to evaluate a behavioural treatment (graded exposure therapy) for adults with persistent symptoms after concussion. participants in this study will be recruited from a network of concussion clinics in canada. this study follows from the investigators' prior work establishing that (1) fear avoidance behaviour is a risk factor for poor concussion outcome, (2) graded exposure therapy reduces fear avoidance behaviour, and (3) graded exposure therapy is perceived as credible and is well-tolerated by patients with persistent post-concussion symptoms. participants will be assigned at random (in a 1:2:2 ratio) to receive enhanced usual care, graded exposure therapy group, or another therapy that might have similar benefits (prescribed aerobic exercise). the investigators hypothesize that patients who participate in graded exposure therapy will have reduced fear avoidance behaviour and improved daily functioning compared to other treatment conditions and this difference will be greatest for patients who enter the study with high fear avoidance behaviour.

Eligibility criteria:
inclusion criteria: 1. aged 18-70 years; 2. sustained a concussion according to the acrm mtbi task force definition between 1 and 24 months ago 3. fluent in english, because validated translations are not available for most questionnaires and recruiting multilingual therapists is not feasible; 4. access to a computer, tablet, or smartphone with internet capability; 5. 3 or more moderate-severe symptoms on the rivermead postconcussion symptom questionnaire. exclusion criteria: 1. medical contraindication to aerobic exercise (cardiac disease, chest pain with exertion, acute bone/joint/soft tissue injury aggravated by exercise) 2. change in cardiac medication within the last month, such as beta blockers, calcium channel blockers, or ivabradine 3. involved in personal injury litigation for index mtbi 4. currently pregnant or plan to become pregnant within the next three months 5. severe/unstable medical or psychiatric condition that could worsen over the next year")
demonstrate efficacy and safety of metastatic breast cancer

Conditions: Metastatic Breast Cancer

Summary: the purpose of the study is to demonstrate equivalence

patients will receive ct-p6 or herceptin every 3 weeks.

Eligibility criteria:
inclusion criteria: * are females * have her 2 over-expression * have eastern cooperative oncology group (ecog) performance status of 0 or 1 exclusion criteria: * current clinical or radiographic evidence central nervous system (cns) metastases * current known infection * pregnant or nursing mother

Keywords: herceptin metastatic breast cancer ct-p6 her 2-positive
phase iv clinical study of pegylated somatropin (peg somatropin) to treat growth hormone deficiency children

Conditions: Dwarfism, Pituitary

Summary: this study evaluates the safety and efficiency of pegylated somatropin (peg somatropin) injection in the treatment of endogenous growth hormone deficiency (ghd) in the broad population of children. half of participants will receive the high dose, while the other half will receive the low dose.


Eligibility criteria:
inclusion criteria: * before starting treatment, according to the medical history, clinical symptoms and signs, gh stimulation test and imaging examination, patients are diagnosed as ghd. * according to the height statistical data of chinese children's physique development in nine cities in 2005, height is lower than the third percentile of growth curve of normal children with the same age and gender. * height velocity (hv) ≤5.0 cm/yr. * gh stimulation test with two different mechanisms affirms that gh peak concentration of patients' plasma \<10.0ng/ml. * bone age (ba) ≤9 years in girls and ≤10 years in boys, at least 1 year less than his/her chronological age (ca). * be in preadolescence (tanner stage 1) and have a ca ≧ 3 years. * receive no prior gh treatment within 6 months. * sign informed consent. exclusion criteria: * people with abnormal liver or kidney function (alt\> 2 times the upper limit of normal value, cr\> the upper limit of normal value). * patients positive for hepatitis b core antigen (hbc), hepatitis b surface antigen (hbsag) or hepatitis b e antigen (hbeag). * people with known highly allergic constitution or allergy to the drug of the study. * people with severe cardiopulmonary, hematological and malignant tumors diseases or general infection and immune deficiency. * potential tumor patients (family history). * diabetic. * abnormal growth and development, such as turner syndrome, constitutional delay of growth and puberty, laron syndrome, growth hormone receptor deficiency, girls of growth retardation without excluding abnormal chromosome. * subjects took part in other clinical trial study within 3 months. * other conditions which in the opinion of the investigator preclude enrollment into the study.
a clinical comparison of two soft contact lenses (c24-755)

Conditions: Hyperopia; Myopia

Summary: the aim of this study is to compare the short-term clinical performance of two soft contact lenses.

the aim of this study is to evaluate the short-term clinical performance of two soft contact lenses when compared to each other after 15 minutes of daily wear each.

Eligibility criteria:
inclusion criteria: 1. they are of legal age (18) and capacity to volunteer. 2. they understand their rights as a research subject and are willing and able to sign a statement of informed consent. 3. they are willing and able to follow the protocol. 4. they currently wear soft contact lenses, or have done so within the past two years. 5. they are expected to be able to be fitted with the study lenses within the power range available. exclusion criteria: 1. they have an ocular disorder which would normally contra-indicate contact lens wear. 2. they have a systemic disorder which would normally contra-indicate contact lens wear. 3. they are using any topical medication such as eye drops or ointment. 4. they are aphakic. 5. they have had corneal refractive surgery. 6. they have any corneal distortion resulting from previous hard or rigid lens wear or have keratoconus. 7. they are pregnant or breastfeeding. 8. they have an eye or health condition including an immunosuppressive or infectious disease which would, in the opinion of the investigator, contraindicate contact lens wear or pose a risk to study personnel; or a history of anaphylaxis or severe allergic reaction. 9. they have taken part in any contact lens or care system clinical research within two weeks prior to starting this study.
pedometer-based walking intervention in patients with chronic heart failure with preserved ejection fraction

Conditions: Diastolic Heart Failure

Summary: a multicenter randomized controlled trial, with follow-up at 6 and 12 months. physically inactive participants with chronic heart failure with preserved or mid-range ejection fraction will be randomly assigned to intervention or control arms. the six-month intervention will consist of an individualized pedometer-based walking program with weekly step goals, monthly face-to-face sessions with the physician, and monthly telephone calls with the research nurse. the intervention will be based on effective behavioral principles (goal setting, self-monitoring, personalized feedback). the primary outcome is the change in 6-minute walk distance at 6 months. secondary outcomes include changes in serum biomarkers levels, pulmonary congestion assessed by ultrasound, average daily step count measured by accelerometry, anthropometric measures, symptoms of depression, health-related quality of life, self-efficacy, and maggic risk score.


Eligibility criteria:
inclusion criteria: 1. diagnosis of heart failure with preserved (hfpef) or mid-range (hfmref) ejection fraction with new york heart association (nyha) class ii or iii symptoms. the diagnosis requires the following conditions to be fulfilled: 1. the presence of symptoms and/or signs of heart failure, 2. left ventricular ejection fraction ≥50% (hfpef) or 40-49% (hfmref), 3. elevated levels of natriuretic peptides (bnp \>35 pg/ml and/or nt-probnp \>125 pg/ml), 4. objective evidence of other cardiac functional and structural alterations underlying heart failure. 2. physically inactive, as determined by a question "as a rule, do you do at least half an hour of moderate or vigorous exercise (such as walking or a sport) on five or more days of the week?". exclusion criteria: 1. signs and symptoms of decompensated heart failure, uncontrolled arrhythmia or effort angina, severe or symptomatic aortic stenosis, persistent hypotension, recent shocks delivered by the automated implantable cardioverter defibrillator. 2. co-morbid conditions that would affect adherence to trial procedures (e.g. inflammatory arthritis, active malignancy, renal disease requiring dialysis, uncontrolled diabetes, major depression or other significant psychiatric disorders, cognitive impairment, significant hearing or visual impairment). 3. major surgery planned within the next 12 months. 4. life expectancy shorter than 12 months. 5. inability to walk from any reason. 6. baseline six-minute walking distance \>450 meters. patients covering more than 450 meters in the baseline six-minute walk test (6mwt) are excluded due to a possible ceiling effect. 7. pregnancy. 8. failure to perform the 6mwt.
effects of anticipation of pain relief on brain mechanisms

Conditions: Pain

Summary: this study will use brain imaging technology to examine chemical systems in the brain that suppress pain and stress when an individual has an expectation of pain relief.

evidence suggests that the expectation of pain relief, even if a person receives only a placebo, can provide actual therapeutic benefits. the µ-opioid receptor system, located in the brain, is activated during anticipation of pain relief; this activation suppresses stress and pain responses. this study will use brain imaging technology to examine the effects of a placebo intervention on µ-opioid neurotransmitters. examination of the factors that regulate these placebo-activated neurotransmitter responses will clarify the overall neurobiology underlying variations in the responses to placebos, as well as pain and other stressful conditions, ultimately leading to the optimization of medical and psychological interventions. this study will last several hours during one study visit. participants will receive both a painful and a painless injection while undergoing positron emission tomography (pet) brain imaging. the painful injection will consist of small amounts of hypertoninc saline (concentrated saline that causes cell shrinkage) in the jaw muscle over a 20-minute period. several minutes after participants receive hypertonic saline, they will receive an injection with isotonic saline not associated with pain in the opposite jaw muscle. after participants receive the injections, they will either be told or not be told about a pain relief intervention. pet imaging will continue as participants either anticipate or do not anticipate pain relief. participants will be asked about their pain levels repeatedly throughout the study; their responses will be entered into a computer-controlled system which will modulate rates of saline infusion.

Eligibility criteria:
inclusion criteria: * willing and able to comply with all study requirements exclusion criteria: * presence of pain at study entry * personal or first-degree (e.g., mother, father, sister, brother) family history of neurologic or psychiatric disorders * history of substance abuse or dependence * left-handed or ambidextrous * positive urine toxicology screen * acute or uncorrected medical illness that may interfere with the study * unable to tolerate brain scanning procedures * current treatment with antipsychotics, mood stabilizers, isoniazid (a drug for tuberculosis \[tb\]), glucocorticoids/mineralocorticoids, psychostimulant appetite suppressants, or centrally active antihypertensive drugs * treatment with hormones, antidepressants, or opioids within 6 months prior to study entry * treatment with sedative hypnotic medications or over-the-counter sleeping aids within 1 month prior to study entry * diagnosis of depression * competitive exercise, or exercise exceeding 1 hour each day * regular smoking within 5 years prior to study entry

Keywords: positron-emission tomography endorphins pain relief opioid receptors stress analgesia
efficacy of virtual reality in upper extremity rehabilitation for stroke patients

Conditions: Stroke

Summary: to investigate the therapeutic effect of including virtual reality-based digital content in the upper limb motor function rehabilitation of stroke patients and to develop a treatment method to improve the upper limb motor function of stroke patients in the future.


Eligibility criteria:
1. inclusion criteria for experimental group: 1. patients aged 19 to 80 years with unilateral stroke within 6 months of stroke onset 2. motor function evaluation: patients showing moderate or lower upper limb dysfunction with an upper limb fma (fugl-meyer assessment) score of less than 58 points on the affected side. 3. patients receiving or planning to receive exercise rehabilitation treatment 5 days a week 2. inclusion criteria for control group: 1) patients who have been admitted to our hospital's rehabilitation medicine department and received rehabilitation treatment within the past 5 years 2) patients with unilateral stroke within 6 months of stroke onset who are between 19 and 80 years old at the time of hospitalization 3) patients who were admitted to the rehabilitation medicine department of our hospital and received exercise rehabilitation treatment for 4 weeks, 5 days a week 4) patients with similar characteristics below compared to the test group * age: difference within 5 years * gait function: functional ambulatory category (fac) * upper extremity function: fugl-meyer assessment (fma) difference within 6 points * cognitive function: korean version of mini mental state examination (k-mmse) difference within 5 points * daily living skills: korean version of modified barthel index (k-mbi) difference within 10 points 3. exclusion criteria: 1. accompanying existing serious neurogenic disease 2. cases accompanied by existing serious psychiatric diseases such as major schizophrenia, bipolar disorder, dementia, etc. 3. cases where it is difficult to understand task performance due to severe cognitive decline (korean mini-mental state examination, k-mmse 10 points or less) 4. if there are difficulties in conducting research 5. other patients who are judged by the principal investigator to have difficulty participating in this study.