Kornimate/medical-research-clean huggingface dataset:
inopulse for covid-19

Conditions: COVID-19; Hypoxemia; Hypoxemic Respiratory Failure

Summary: this randomized, controlled trial will assess the efficacy and safety of pulsed ino in subjects with covid-19 who are hospitalized and require supplemental oxygen.


Eligibility criteria:
inclusion criteria: 1. age 18 or above 2. proven covid-19 viral infection. non-confirmed highly suspicious suspects may be enrolled. 3. presence of radiographic findings compatible with pneumonia/pneumonitis. 4. patients requiring at least 3 l/m oxygen via nasal canula to maintain o2 above 92%. 5. female subjects of childbearing potential must have a negative pre-treatment pregnancy test (serum or urine). 6. willing and able to comply with treatment schedule and study procedures. exclusion criteria: 1. patient with severe hypoxemia who are unable to maintain an oxygen saturation (spo2) \> 88% on a maximum supplemental oxygen of 6 l/m by nasal cannula and a non-rebreather facemask. 2. participating in any other clinical trial for covid-19 3. pregnancy, or positive pregnancy test in a pre-dose examination. 4. open tracheostomy. 5. clinical contra-indication, as deemed by the pi or their designee. 6. use of a nitric oxide donor agent such as nitroglycerin or drugs known to increase methemoglobin such as intravenous lidocaine, or topical benzocaine or dapsone at screening. 7. known history or clinical evidence of heart failure or left ventricular dysfunction (lvef \< 45%). 8. significant hemoptysis 9. unable to provide informed consent (proxy consent is acceptable if available) 10. any of the following conditions at time of possible enrollment: fulminant liver failure, acute coronary syndrome , renal failure requiring dialysis, bacteremia, shock, cardiac arrest, cardiac arrhythmia requiring acute treatment, delirium / encephalopathy, severe disseminated intravascular coagulation, gastrointestinal hemorrhage, hypoglycemia, pneumothorax, rhabdomyolysis / myositis, seizures, or acute stroke

Keywords: hypoxemia respiratory failure covid-19 inhaled nitric oxide
knowledge mobilization activities to support decision-making by youth, parents and adults: study protocol

Conditions: COVID-19

Summary: coronavirus disease (covid-19) recommendations are usually developed for healthcare professionals (for example doctors, health organizations, etc.). it is important to make sure that these recommendations can be used and understood by everyone. this study aims to make covid-19 recommendations more accessible and understandable for parents and caregivers, adults, and youth.

this is a two-arm superiority randomized controlled trial. the primary objective is to compare the understanding of key guideline information between the plain language recommendation (plr) (intervention) and the standard language version (slv- original recommendation as available in the published guideline) (comparison). secondary outcomes include accessibility and usability of the information, satisfaction with the presentation, intended behavior to follow the information in the recommendation, and preference toward one of the two presentations. recruitment will be global for the three populations (youth, parents, and adults), using three different online links. data will be collected using a survey with 1:1 randomization to the intervention and subsequent demographic questions. superiority will be declared if a minimal difference of 10% in understanding is achieved between the two groups (an average difference of 1 correct answer).

Eligibility criteria:
inclusion criteria: * for youth population: be between the ages of 15 to 24 years * for parents population: be 18 years and above and making decisions with or for their children (parent, caregiver, the legal guardian of a child \< 18 years) * for adults: be 21 years of age or older * need to be able to complete the survey in english exclusion criteria: * individuals not fitting any of the above age categories or language requirement

Keywords: electronic coronavirus disease recommendation map (ecovid recmap) plain language recommendation standard language versions public engagement knowledge mobilization
incidence of chronic pain after video-assisted thoracic surgery

Conditions: Postoperative Pain; Postoperative Pain, Acute; Postoperative Pain, Chronic; VATS

Summary: video-assisted thoracic surgery (vats) is frequently performed in thoracic surgery. it is widely accepted that vats causes acute pain. many factors such as postoperative analgesia treatment plan, operation time, number of chest tubes, and duration of chest tube stay can affect acute pain. this acute pain prolongs the discharge time of the patients and increases the frequency of postoperative pulmonary complications and postoperative morbidity. postoperative acute pain may cause chronic pain in the later period, and may adversely affect the quality of life of the patients. this study, it was aimed to analyze the symptoms of chronic pain in the 1st and 3rd months postoperatively in patients who had undergone vats.


Eligibility criteria:
inclusion criteria: * age between 18 and 65 years * american society of anesthesiologists physical status i-ii-iii * body mass index between 18-35 kg/m2 * patients undergoing elective vats exclusion criteria: * advanced cancer * history of chronic analgesic therapy * patients with previous thoracic surgery * patients who were operated under emergency conditions

Keywords: postoperative pain postoperative pain, acute postoperative pain, chronic vats
simvastatin as a neuroprotective treatment for moderate parkinson's disease

Conditions: Parkinson Disease

Summary: participants are randomly allocated to one of two treatment groups. in one group, participants are given capsules of simvastatin to take orally (by mouth) for 24 months. in the other group, participants are given placebo (dummy) capsules to take orally for 24 months. at the start of the study, when they receive their medication, participants complete a number of questionnaires and motor (movement) tests (a walking test and a finger tapping test). participants in both groups also attend a further 6 clinic visits after 1, 6, 12, 18 and 24 and 26 months, where they are asked about their health and any medication they are taking, as well as repeating the questionnaires and motor tests. for 4 of the clinic visits, the participants will be asked to attend in the 'off medication' state (having omitted their usual pd medication) so that the researchers can get a true picture of their disease without it being masked by their normal medication.


Eligibility criteria:
inclusion criteria: * diagnosis of idiopathic pd * modified hoehn and yahr stage ≤ 3.0 in the on medication state * age 40-90 years * on dopaminergic treatment with wearing-off phenomenon * able to comply with study protocol and willing to attend necessary study visits exclusion criteria: * diagnosis or suspicion of other cause for parkinsonism * known abnormality on ct or mri brain imaging considered to be causing symptoms or signs of neurological dysfunction, or considered likely to compromise compliance with study protocol * concurrent dementia defined by moca score \<21 * concurrent severe depression defined by madrs score \>31 * prior intracerebral surgical intervention for pd including deep brain stimulation, lesional surgery, growth factor administration, gene therapy or cell transplantation * already actively participating in a research study that might conflict with this trial * prior or current use of statins as a lipid lowering therapy * intolerance to statins * untreated hypothyroidism * end stage renal disease (creatinine clearance \<30 ml/min) or history of severe cardiac disease (angina, myocardial infarction or cardiac surgery in preceding two years) * egfr \<30 ml/min * history of alcoholism or liver impairment * creatine kinase (ck) \>1.1 x upper limit of normal (uln) * aspartate transaminase (ast) or alanine transaminase (alt) \>1.1 x uln * females who are pregnant or breast feeding or of child-bearing potential and unwilling to use appropriate contraception methods whilst on trial treatment * currently taking any medication contraindicated with simvastatin use (appendix 2) * any requirement for statin use * regular participation in endurance or high-impact sports * unable to abstain from consumption of grapefruit-based products

Keywords: neurology
a study of selexipag in participants who participated in a previous selexipag study

Conditions: Hypertension, Pulmonary

Summary: the purpose of this study is to assess the long-term safety of selexipag while providing continued selexipag treatment for participants who were previously enrolled in an actelion-sponsored study with selexipag and who derived benefit from selexipag in indications for which a positive benefit-risk has been established.


Eligibility criteria:
inclusion criteria: * treated with selexipag at the end of a parent study and: a) the parent study has established efficacy with a favorable benefit/risk profile for the indication under investigation; b) participant may continue to benefit from treatment with selexipag; c) has completed the end of treatment (eot) visit of the parent study; d) no alternative means of access to selexipag have been identified * women of childbearing potential must use an acceptable method of contraception throughout the study and until at least 1 month following the last dose of study intervention * women of childbearing potential must have a negative urine (or serum if applicable) pregnancy test at screening on day 1 or at the last visit of the parent study * must sign an informed consent form (icf) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study exclusion criteria: * suspected or known pulmonary veno-occlusive disease * known allergies, hypersensitivity, or intolerance to selexipag or its excipients * interruption of study intervention for more than 14 days since the last dose of study intervention taken in the parent study * female participant being pregnant, or breastfeeding, or planning to become pregnant at the time of screening and while enrolled in this study * uncontrolled thyroid disease * known and documented severe hepatic impairment, example, child-pugh class c * taken any disallowed therapies, concomitant therapy before the planned first dose of study intervention: a) treatment with a strong cyp 2c8 inhibitor (example, gemfibrozil); b) treatment with oral prostacyclin analogs (example, beraprost, treprostinil) since the last dose of study intervention taken in the parent study; c) any investigational treatment other than selexipag * severe coronary heart disease or unstable angina, myocardial infarction within the last 6 months, decompensated cardiac failure if not under close medical supervision, severe arrhythmia, cerebrovascular events (example, transient ischemic attack, stroke) within the last 3 months, or congenital or acquired valvular defects with clinically relevant myocardial function disorders not related to ph
resilience and exercise in advanced cancer treatment

Conditions: Pancreatic Adenocarcinoma; Gastric Adenocarcinoma; Adenocarcinoma of the Gastroesophageal Junction

Summary: this is a pilot study to evaluate the feasibility of, adherence to, and early efficacy of band together, a strength-training and walking program (intervention arm) vs. education on the benefits of exercise (control arm) in patients with aggressive gastrointestinal (gi) malignancies (gastric, gastroesophageal, and pancreatic cancer) undergoing neoadjuvant therapy.

a growing body of evidence suggests host resilience (lack of frailty, skeletal muscle reserve, etc.) may impact early healing, recovery following neoadjuvant therapy and surgery, and long-term cancer-free survival. it is well-recognized that resilience is enhanced in individuals with proper diet, sleep habits, and exercise. however, it is unknown whether such resilience can be enhanced by training programs initiated at the time of cancer diagnosis. although exercise interventions may contribute to these improvements, it is unknown how willing and able these patients are to comply with an exercise regimen during the neoadjuvant therapy period. the aim of this study, therefore, is to evaluate compliance with and the efficacy of band together, an exercise program combining strength-training and aerobic exercise, in patients with aggressive gi malignancies undergoing neoadjuvant therapy.

Eligibility criteria:
inclusion criteria: 1. age 18 years or older 2. new diagnosis of potentially resectable or borderline resectable pancreatic adenocarcinoma, gastric adenocarcinoma, or adenocarcinoma of the gastroesophageal junction. 3. patients must be evaluated at the penn state hershey medical center prior to receiving neoadjuvant chemotherapy or chemoradiation. 4. patients must be deemed appropriate for neoadjuvant therapy by their treating health care providers. 5. the ability to speak and read english. 6. the ability to provide informed consent. exclusion criteria: 1. angina (stable or unstable) 2. paraplegia or quadriplegia 3. joint or muscle conditions that prevent the patient from being able to grip and or lift resistance bands. 4. patients who have already started neoadjuvant chemotherapy at other institutions. 5. presence of metastatic disease. 6. gastric or pancreatic histologies other than adenocarcinoma. 7. pregnant women. 8. prisoners 9. patients screening positive on the physical activity readiness questionnaire (par-q)
dose sparing intradermal s-oiv h1n1 influenza vaccination device

Conditions: Influenza Infection

Summary: primary objective: to evaluate the safety and immunogenicity of low-dose id s-oiv h1n1 vaccines delivered via a novel microneedle device (micronjet600) and compare this to the full-dose standard im injection. hypothesis: low dose (20%) intradermal (id) s-oiv h1n1 vaccine delivered via a novel microneedle device (micronjet600) is equally effective as full-dose standard intramuscular (im) vaccine.

this is a prospective randomised, single-blinded trial in queen mary hospital. we aim to recruit 200 subjects \[with a minimum of 80 subjects per age group (21-65 with chronic diseases and age 65+)\] who would be qualified for the hospital authority (ha)/ centre for health protection (chp) mass vaccination program for s-oiv h1n1. these patients include all elderly at the age of 65 or above and all adult patients at the age of 21 or above with chronic illness. subjects will be randomly assigned to receive either the full-dose (1 dose) standard panenza vaccine at day 0 (15ug non-adjuvanted monovalent influenza a(h1n1) 2009 vaccine) delivered intramuscularly using a conventional needle (im group) or a low-dose (1 dose) intradermal injection of panenza vaccine at day 0 (3ug non-adjuvanted monovalent influenza a(h1n1) 2009 vaccine) delivered with the micronjet600 (id group).

Eligibility criteria:
inclusion criteria: * all participants qualified for the ha/ chp mass vaccination program for s-oiv h1n1 as stated above: including all elderly at the age of 65 or above and all adult patients at the age of 21 or above with chronic illness including hypertension, diabetes mellitus, ischemic heart disease, cerebrovascular disease, thyroid disease and chronic renal failure. * all patients give written informed consent. * subjects must be available to complete the study and comply with study procedures. * willingness to allow for serum samples to be stored beyond the study period, for potential additional future testing to better characterize immune response. exclusion criteria: * clinically significant immune-related diseases, significant recent co-morbidities and pregnant volunteers. * inability to comprehend and to follow all required study procedures. * history or any illness that might interfere with the results of the study or pose additional risk to the subjects due to participation in the study * have received an s-oiv h1n1 vaccination. * have a recent (starting may 2009) history (documented, confirmed or suspected) of a flu-like disease). * have a known allergy to eggs or other components of the study vaccines (including gelatin, formaldehyde, octoxinol, thimerosal, and chicken protein), or history of any anaphylaxis, serious vaccine reactions, to any excipients. * have a positive urine or serum pregnancy test within 24 hours prior to vaccination, or women who are breastfeeding. * female of childbearing potential, not using any acceptable contraceptive methods for at least 2 months prior to study entry or that do not plan to use acceptable birth control.

Keywords: intradermal vaccination, h1n1, microneedle
ketamine for preventing post-spinal hypotension in orthopedic surgery

Conditions: Post-spinal Hypotension; Orthopedic Surgery; Spinal Aneshtesia

Summary: this randomized, double-blind, controlled clinical trial investigates the efficacy of a sub-anesthetic dose of ketamine (0.5 mg/kg iv) in preventing post-spinal hypotension in patients undergoing elective orthopedic surgeries under spinal anesthesia. the study compares ketamine with placebo (normal saline) in terms of blood pressure stability and incidence of hypotensive episodes following spinal anesthesia.

spinal anesthesia is commonly used for orthopedic procedures due to its effectiveness and favorable recovery profile. however, spinal-induced hypotension is a frequent complication resulting from sympathetic blockade, which can compromise organ perfusion and increase perioperative risk. this study aims to determine whether a single sub-anesthetic dose of intravenous ketamine administered before spinal anesthesia can reduce the incidence of hypotension. patients will be randomly allocated to either a ketamine group (receiving 0.5 mg/kg ketamine iv diluted in ringer's lactate) or a control group (receiving volume-equivalent normal saline). both interventions are administered over 20 minutes prior to the spinal injection to ensure blinding. all patients will undergo standard spinal anesthesia with 0.5% heavy bupivacaine plus fentanyl. primary outcome is the incidence of hypotension (defined as a mean arterial pressure drop \>20% from baseline). secondary outcomes include bradycardia, nausea, vomiting, hallucinations, and total dose of vasopressors required. the findings aim to support or refute the use of ketamine as a prophylactic strategy to stabilize hemodynamics during spinal anesthesia.

Eligibility criteria:
inclusion criteria: * patients american society of anesthesiologists physical status (asa) i to ii undergoing orthopedic surgeries under spinal anesthesia. * both sexes. * patients aged equal to or above 18 years. * body mass index \<35 kg/m2 * duration of operation from 1 hour to 3 hours exclusion criteria: * patients' refusal of procedure or participation in the study. * patients with contraindication to spinal anesthesia. * patients with cardiovascular or pulmonary disease. * patients with pre-procedural hypotension (systolic arterial pressure less than 90 mmhg and/or mean arterial pressure less than 60 mmhg). * patients aged below 18 years. * duration of operation below 1 hour or above 3 hours.

Keywords: ketamine sub-anesthetic dose hypotension prevention neuraxial anesthesia hemodynamic stability regional anesthesia asa i-ii double-blind randomized trial blood pressure monitoring ephedrine use
multinational study of acinetobacter bloodstream infection: clinical outcomes and global epidemiology-pitt protocol

Conditions: Acinetobacter Infections

Summary: the objectives of this multinational study are to assess the clinical outcomes of patients with acinetobacter bloodstream infection and to further assess the predictors of mortality in this patient population. we also aim to characterize the molecular epidemiology of this remarkable organism in an attempt to further understand its transmission dynamics on a global level and to determine whether increased pathogenicity is geographically dependent.

medical records will be reviewed and information collected to assess the clinical outcomes of patients with acinetobacter bloodstream infection and to further assess the predictors of mortality in this patient population.

Eligibility criteria:
inclusion criteria: * patients with acinetobacter infections exclusion criteria: * those that do not meet entry criteria

Keywords: acinetobacter infection isolate
ventilator settings and comfort

Conditions: Obesity; Chronic Obstructive Pulmonary Disease

Summary: no studies have been done to examine whether patients with obstructive lung disease and obesity are more comfortable on some ventilator settings than on others. the purpose of the current study is to examine this question systematically.

methods: demographic and physiologic data will be recorded. investigators will begin measurements more than 60 minutes after last dose of sedative and measurements to occur when no major interventions are planned or medications are scheduled. then patients will undergo the following ventilator settings (all of which are within ranges ordinarily employed) in random order for 3 minutes of each setting (pressures measured midway i.e. 1.5 minutes - at each interval to ensure safety; stopped if static airway pressure\>30 cmh2o): 1. assist control 1. tidal volumes of 6 ml/kg, 8 ml/kg and 10 ml/kg 2. flow regimes: constant (cf) and decelerating (dec) at 40, 60 and 80 l/min; 2. pressure support (ps) 0, 10 and 20 cmh2o with peep=5 cmh2o patients will be randomized to receive the following in either forward or reverse order: cf60l/min in 6 then 8 then 10 ml/kg; then at 8 ml/kg cf40, dec40, dec60, cf60, cf80, dec80; then ps=0, 10, 20 cmh2o. in the last 30 second of each setting, patients will be asked to indicate their level of comfort (1-10 in increasing comfort) using a visual analog borg score (when they can see/write) or to indicate on their fingers when they cannot write.

Eligibility criteria:
inclusion criteria: * adult patients (\>18 y) admitted to the micu of bridgeport hospital on mechanical ventilation for: * exacerbation of copd (smoking history\>20 pkyrs and chest radiographic or function abnormalities supportive of the diagnosis); or * body mass index\>40 kg/m2 and acute on chronic hypercapnic respiratory failure. * patients must be awake, not have received narcotics for more than 2 hours and possess capacity to consent themselves. * patients must have recovered sufficiently from their acute illness to be candidates for weaning per hospital protocol i.e. not in shock, no pressors and pao2:fio2\>120. exclusion criteria: * patients extubated for comfort care only. * patients with successful weaning trial that otherwise clinically requires extubation. * patients with unresolved pneumonia, unresolved congestive heart failure, neuromuscular disease or kyphoscoliosis-related respiratory failure will also be excluded.