Kornimate/medical-research-clean huggingface dataset:
community-engaged optimization of covid-19 rapid evaluation and testing experiences

Conditions: COVID-19; COVID-19 Pandemic

Summary: throughout the coronavirus disease (covid-19) pandemic, rates of covid-19 have been persistently high in san diego county's central and southern communities near the united states/mexico border. these regions predominantly house latino residents, the ethnic minority community most impacted by covid-19 in san diego. in the phase i project, university of california, san diego (ucsd) partnered with san ysidro health (syh) and the global action research center, to co-create and demonstrate the impact of a covid-19 testing program in san ysidro, one of the most impacted areas from covid-19 in san diego county. to date, the project tested \>10,000 community members (92% latino) and received requests to scale-out the testing program to additional primary care clinic sites. in this phase iii project, community-engaged optimization of covid-19 rapid evaluation and testing experiences (co-create-ex) will extend work with the phase i community and clinical partners to refine, specify, implement, and evaluate an implementation strategy bundle that optimizes covid-19 testing, expanding beyond current polymerase chain reaction (pcr) testing to fda-authorized covid-19 rapid antigen testing.

co-create-ex will roll-out our implementation using 3 strategies: 1. keeping the current, walk-up free testing protocol 2. offering community health worker (chw) to lead covid-19 test counseling, preventive care reminders, and offer testing support 3. installing vending machines that will dispense fda-authorized self-testing kits. for each strategy, participants will consent into study, provide demographics and test history, and receive a free rapid antigen test (rat) kit. after receiving the test kit, participants will be prompted to return their results and fill out a survey about their covid-19 experiences. study subjects will be contacted up to three times over a course of 4 weeks to return their results and complete the survey. study coordinators will use participants' preferred method of contact.

Eligibility criteria:
inclusion criteria: * speak english and/or spanish * affiliated with san ysidro health as a patient at select clinics (san ysidro, chula vista, lincoln park, and logan heights) or * a member of a community near a san ysidro health clinic (san ysidro, chula vista, lincoln park, and logan heights). exclusion criteria: * institutionalization for psychiatric disorder, developmental delay, or criminal activity. * unable to provide informed consent.

Keywords: covid-19 testing vaccine hesitancy implementation vending machine
enteral zinc to improve growth in infants at risk for bronchopulmonary dysplasia

Conditions: Infant,Premature; Bronchopulmonary Dysplasia; Growth Failure

Summary: multiple factors contribute to growth failure in infants with bpd, including poor nutrient stores, inadequate intake, increased losses, and increased needs. furthermore, compared to infants without bpd, those with bpd have increased resting metabolic rates and energy expenditure. growth deficits manifest as lower weight, length, and head circumference, as well as changes in body composition. these deficits precede the development of bpd and persist post-discharge. while similar rates of growth are observed in very low birth weight infants with and without bpd once receiving equal calories, catch up growth does not occur in the bpd group. thus, early growth deficits remained uncompensated. after iron, zinc is the most metabolically active trace element in the human body. it has a critical role in growth, through its actions on growth hormone, igf-1, igfbp-3, and bone metabolism. prematurity is a risk factor for zinc deficiency, as 60% of zinc accretion occurs in the third trimester. impaired intake and absorption or excess excretion can further increase this risk. finally, periods of rapid growth, as seen in preterm infants, increase the need for zinc. biochemically, zinc deficiency is defined by a serum zinc level less than 55mcg/dl. however, while zinc depletion is associated with deficiency, the opposite may not be true. for example, in starving patients, clinical symptoms of zinc deficiency occur during re-feeding, suggesting overall requirements are related to needs, regardless of overall zinc status. this may be the case in preterm infants, who may have a subclinical deficiency despite serum zinc level. thus, zinc deficiency should be considered in infants with poor growth despite receiving adequate protein and calories. the objective of this study is to determine whether enteral zinc supplementation leads to improved growth in infants at risk for bronchopulmonary dysplasia (bpd). the investigator's hypothesis is that enteral zinc supplementation in very preterm infants at high risk for bpd will significantly improve growth compared to standard of care.


Eligibility criteria:
inclusion criteria: 1. 23 0/7 to 29 6/7 weeks ga 2. birth weight 501 to 1000g, inclusive 3. 14 to 28 days of life, inclusive 4. 14 day bpd risk score ≥ 50% for death or moderate-severe bpd, calculated using the algorithm on the neonatal research network website (https://neonatal.rti.org/index.cfm?fuseaction=bpdcalculator.start).- exclusion criteria: 1. major congenital and/or chromosomal anomalies 2. inability to reach 80ml/kg/day enteral feeds by 28 days of life

Keywords: zinc
serum-ascites albumin gradient analysis in cancer patients in palliative care

Conditions: Solid Cancer in a Palliative Situation With Ascites

Summary: current recommendations do not recommend the concomitant administration of albumin after ascites puncture in patients with ascites neoplasia unlike cirrhotic ascites. the etiology of ascites in cancer patients is multifactorial, particularly by hepatic invasion that can lead to ascites loaded with albumin. ascites punctures therefore lead to undernutrition, recurrent early ascites by decreasing the oncotic pressure by hypo albuminemia and a state of anasarca affecting the quality of life.

according to the recommendations, each ascites fluid must be sent for biochemical and bacteriological analysis. demonstrate the high gradient proportion (percent only, no threshold of significance required). the literature has already validated the importance of supplementing albumen with cirrhotic ascites. demonstrating that some cancer patients have high gradients, this will be enough to make the practitioner think to supplement.

Eligibility criteria:
inclusion criteria: * patient over 18 years of age followed for a solid cancer in a palliative metastatic situation who had a puncture of ascites. exclusion criteria: * minor patient * known cirrhosis

Keywords: palliative solid tumor ascites
evaluation of the overall quality of life after the neck dissection retro-spinal sector (iib), in squamous cell carcinomas clinical and radiological n0 vads

Conditions: SCCHN

Summary: the nodal involvement in squamous cell carcinomas of the upper aerodigestive tract (vads) is one of the main factors of poor prognosis, justifying the surgical management of neck dissection as a reference treatment. under the influence of the american hayes martin, it was considered until the 1960s that "over the intervention was, the greater the chance of recovery was". but has since been developed by the argentine osvaldo suarez the concept of functional course, which consists of resection of lymph node tissue while retaining the main structures (muscles, nerves, vessels), as opposed to the recess radical which is reserved for the invasive metastasis. in addition to these notions, our job is to evaluate the quality of life of patients with scchn, n0 clinical and radiological, enjoying a functional neck dissection including iib sector to support the approach which would be to stop the systematic inclusion of this territory.


Eligibility criteria:
inclusion criteria: * patient with scchn histologically proven n0 clinical and radiological * neoplastic location: oral cavity, oropharynx, hypopharynx, larynx * patient candidate for a neck dissection fonctonnel * life expectancy\> 3 months * stable patient not exhibiting at the time of recurrence sign of examination or other scalable neoplasia * age over 18 ans * patient was informed of the study * patient fluent french exclusion criteria: * patients with a history of malignancy, outside a basal cell cancer or cancer of the neck treated and cured * patient has at the time of examination of recurrence of signs or other scalable neoplasia * uncontrolled infectious diseases * neoadjuvant radiotherapy * patient nursing or pregnant or lack of contraception during their reproductive * intercurrent pathology involving life-threatening * any medical or psychological condition associated that could compromise the patient's ability to participate in the study * inability to submit to medical follow-up study for geographical, social or psychic

Keywords: n0 clinical and radiological dissection iib sector
effect of synapse medicine decision support on inpatient pharmacist efficacy and efficiency

Conditions: Infections; Heart Diseases; Lung Diseases; Kidney Diseases; Liver Diseases; Gastrointestinal Diseases

Summary: adverse drug events (ade) are common and dangerous in the hospital and following discharge to the ambulatory setting. one cause of ades in both settings is medication regimen inappropriateness, including polypharmacy, drug-drug interactions, and medications that are inappropriate or inappropriately dosed given patients' age, renal, and hepatic function. hospitalization provides a good opportunity to investigate medication appropriateness given new or worsening conditions and available expertise. inpatient pharmacists are medication experts and often round with medical teams, but they may not always have all the information available at their fingertips to make optimal recommendations regarding medication appropriateness for each patient. clinical decision support to pharmacists at the point of care has potential to improve the speed, quantity, and quality of medication recommendations to inpatient teams; any subsequent improvements to medication regimen appropriateness have the potential to reduce ades in the hospital and after discharge. specific aims and objectives aim 1: implement real-time decision support regarding medication regimen appropriateness among pharmacists who round with inpatient medical teams. aim 2: determine the effects of this intervention on the number of medication regimen recommendations and time spent per recommendation aim 3: evaluate the use and usability of the decision support tool and develop strategies to mitigate barriers and promote facilitators of implementation using mixed methods implementation science approaches.

this will be a prospective pre-post mixed methods hybrid type 2 effectiveness-implementation study. the study will take place at bwh and at vanderbilt university medical center (vumc). the direct subjects will be the inpatient pharmacists (4 at each site) who round with general medicine teams. patients will be indirect subjects as pharmacists provide medication recommendations regarding these patients to the clinicians on each team with or without the synapse software. we estimate this number of patients to be 3 new admitted patients per day per team x 56 days x 8 teams = 1344 patients (672 at mgb sites). patients can be any patients admitted to these general medicine service teams at bwh and vumc. the pharmacists are trained hospital pharmacists who round with general medicine service teams and approve inpatient medication orders. there are no local site restrictions. vumc will cede irb approval to the mgb irb.

Eligibility criteria:
inclusion criteria: * any patient that the inpatient pharmacists care for on the inpatient medical team they round with exclusion criteria: * n/a

Keywords: hospitalized patients
outpatient nurse managed counseling program for patients with diabetic foot ulceration

Conditions: Diabetic Foot Ulcer

Summary: the purpose of the study is to evaluate the effectiveness of a nurse led intervention for high risk patients with diabetic foot ulceration and/or amputation. the effectiveness is defined in two ways 1) as a reduction in complication rates (time till ulceration recurrence, new ulcerations, amputation or reamputation) and 2) as a reduction in hospital readmissions for foot-related complication (one year survival probability: failure = readmission for ulceration recurrence, new ulcerations, amputation or re-amputation).

diabetes mellitus (dm) is associates with numerous complications. one of these is decreased peripheral circulation impaired sensation leading to the development of foot ulcers that lead to amputations of toes, feet and limbs. these complications not only have devastating effects on the individual in terms of loss of functionality but also impact the patient's ability to carry out and enjoy occupational, recreational and family functioning activities. furthermore, foot ulcers and associated problems often lead to prolonged hospitalization and loss of productivity. all of these have personal as well as societal economical implications. this pilot randomized clinical trial (rct) aims to evaluate the feasibility of an additional patient education program to current management of foot care in patients with dm. the study aims to test an alternative to current standard of care for patients with foot ulcers. a rct is the preferred method to establish efficacy for this alternative nurse managed intervention; and if found to be effective, the current study will also allow an evaluation of the cost effectiveness of this intervention and the potential economic reduction in cost to the health care system. the potential implications are major in terms of quality of life, reduction in morbidity in disability days, and cost savings. it is anticipated that this intervention is at least as effective as hospital stay, and being surrounded by their own loved ones without the threats that a hospital setting presents. the findings will be important to consider whether clinical practice can be changed to benefit patients. if the study results show that the subjects in the ig have better skills in monitoring and treating their diabetic foot ulcerations and eventually avoid developing further complications the intervention can be applied to future patients.

Eligibility criteria:
inclusion criteria: * patients age 18 or older * in current treatment for ulceration and/or amputation of a lower limb * are able to understand german oral and in writing * are able to give written informed consent exclusion criteria: * severe psychiatric diagnoses * subjects living in dependent living facilities (nursing home or rehabilitation) * subjects lacking supporting family members and incapable of selfmonitoring their feet due to impairment (vision or physical movement)

Keywords: diabetes nursing counseling foot ulceration outpatient advanced practice nurse
effect of implementation of enhanced recovery after surgery on 3-year survival after colorectal surgery for cancer

Conditions: Colorectal Cancer

Summary: several recent studies have shown that the enhanced recovery after surgery (eras) protocol reduces morbidity and mortality and shortens the length of stay compared to conventional recovery strategy (pre-eras). the aim of this study was to evaluate the effect of the implementation of this protocol on 3-year overall survival and postoperative outcome in patients undergoing colorectal resection for cancer.


Eligibility criteria:
inclusion criteria: * aadult patients, who had undergone resection for colorectal cancer or a precancerous lesion and were cared for using the eras protocol or received conventional care (pre-eras). * informed patients exclusion criteria: * patients presenting or developing peritoneal cancer, * patients having resection for palliative reasons, * patients those under curatorship or tutelage * opposed patients
vk2735 for weight management phase 2 (venture oral dosing)

Conditions: Weight Loss

Summary: this is a phase 2, 13-week randomized, double-blind, placebo-controlled, parallel arm dose-finding study that will evaluate the safety, tolerability, weight loss efficacy, pharmacodynamic effects, and pharmacokinetics of vk2735 oral formulation in adults who are obese (bmi ≥30 kg/m2) or who are overweight (bmi ≥27 kg/m2) with at least one weight-related co-morbid condition. vk2735 or matched placebo will be administered once daily.


Eligibility criteria:
inclusion criteria: 1. age ≥18 years of age at the time of signing the informed consent. 2. body mass index (bmi) ≥30 kg/m2 or ≥27 kg/m2 with at least one weight-related co-morbid condition (treated or untreated), and bmi \<50 kg/m2 * weight-related co-morbid conditions include hypertension, dyslipidemia, obstructive sleep apnea or cardiovascular disease. * bmi calculated at the screening visit will be used to determine eligibility. exclusion criteria: 1. history of or current clinically significant medical or psychiatric disorder that, in the opinion of the investigator, does not support study participation 2. self-reported body weight change of 5% or more within 3 months of screening 3. current or past diagnosis of diabetes mellitus (including type 1, type 2, gestational) 4. current or past diagnosis of chronic pancreatitis 5. calcitonin ≥50 ng/l measured by central laboratory at screening (individuals with elevated calcitonin at initial screening may be re-screened) 6. any glp-1 receptor agonist or glp-1/gip dual agonist within 6 months of screening 7. any prescription or over-the-counter medications intended for weight loss within 6 months of screening

Keywords: overweight obese
effects of continuous infusion of intravenous nefopam on postoperative pain and opioid consumption after vats

Conditions: Postoperative Pain

Summary: this prospective, randomized, double-blinded study is designed to evaluate the postoperative analgesic effect of the continuous infusion of intravenous nefopam in patients undergoing video-assisted thoracic surgery (vats). we hypothesize that the continuous infusion of intravenous nefopam can significantly reduce postoperative opioid consumption and pain severity in patients with vats.

adult patients undergoing elective unilateral vats segmentectomy or lobectomy are randomly allocated to receive continuous nefopam infusion (n=45) or not (n=45), in addition to a standard postoperative analgesic regimen comprising of iv fentanyl-based patient-controlled analgesia (pca). at the end of induction, the nefopam group will receive intravenous nefopam 20mg mixed with 50ml of normal saline, and at the end of surgery this group will receive intravenous nefopam 60mg mixed with 50ml of normal saline at a rate of 2ml/hr. the control group will receive intravenous normal saline 50ml at the end of induction and receive intravenous normal saline 50ml at a rate of 2ml/hr.

Eligibility criteria:
inclusion criteria: * patients scheduled to undergo elective unilateral vats segmentectomy or lobectomy under general anesthesia * american society of anesthesiologists (asa) physical classification i-ii * consent to iv-patient controlled analgesia use * willingness and ability to sign an informed consent document exclusion criteria: * do not understand our study * allergies to anesthetic or analgesic medications * continuous local anesthetics infiltration for postoperative pain control * patients who receive mechanical ventilation more than 2 hours after surgery * pregnancy/breast feeder * medical or psychological disease that can affect the treatment response

Keywords: postoperative pain
paclitaxel plus chemoprotection with amifostine in treating patients with recurrent or refractory solid tumors

Conditions: Unspecified Adult Solid Tumor, Protocol Specific

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. chemoprotective drugs, such as amifostine, may protect normal cells from the side effects of chemotherapy. purpose: phase i trial to study the effectiveness of paclitaxel plus chemoprotection with amifostine in treating patients with recurrent or refractory solid tumors.

objectives: i. determine the maximum tolerated dose of weekly paclitaxel following amifostine in patients with recurrent or refractory solid tumors. ii. assess tumor response rate and survival in these patients. outline: this is a dose escalation study of paclitaxel. patients receive amifostine iv over 5 minutes or less on day 0, followed by paclitaxel iv over 1 hour once a week for 6 weeks followed by 2 weeks of rest. patients with complete or partial response may receive additional courses of therapy. cohorts of 3-5 patients each receive increasing doses of paclitaxel. the maximum tolerated dose is defined as the dose level prior to the cohort at which 1 of 3-5 patients experience dose limiting toxicity. projected accrual: approximately 20 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: histologically proven recurrent or refractory solid tumors evaluable disease patient characteristics: age: 18 and over performance status: ecog 0-2 life expectancy: greater than 4 months hematopoietic: neutrophil count at least 2,000/mm3 platelet count at least 100,000/mm3 hemoglobin at least 8 g/dl hepatic: bilirubin less than 1.5 g/dl alkaline phosphatase less than 3 times upper limit of normal (uln) ast less than 3 times uln renal: calcium greater than 8 mg/dl creatinine clearance greater than 60 ml/min cardiovascular: no active congestive heart failure other: not pregnant or nursing fertile patients must use effective contraception no grade 2 neuropathy no intolerability for hydration prior concurrent therapy: biologic therapy: prior biologic therapy allowed chemotherapy: no more than 3 prior failed chemotherapy regimens prior paclitaxel as a radiosensitizer allowed no prior weekly paclitaxel infusion failure prior platinum or paclitaxel therapy allowed endocrine therapy: prior endocrine therapy allowed radiotherapy: prior radiotherapy allowed surgery: prior surgery allowed other: no concurrent dilantin therapy no antihypertensive/diuretics within 24 hours prior to chemotherapy

Keywords: unspecified adult solid tumor, protocol specific