Kornimate/medical-research-clean huggingface dataset:
trusted messengers: intervention to promote covid-19 vaccination

Conditions: Covid19; Vaccination

Summary: the study aims to assess the impact of a multicomponent intervention to support primary care provider (pcp) outreach to promote covid-19 vaccination among vulnerable patients in and near worcester, ma via a pragmatic, cluster randomized trial.

the goal of this study is to increase uptake of the covid-19 vaccine among vulnerable populations through systematic primary care (pcp or clinic) text message outreach to unvaccinated patients, information provision via a study website, and resources to support pcps. the clinical trial will randomize 14 primary care clinics from three health systems in the worcester, massachusetts area to intervention or control. eligible patients seen at a study clinic randomized to the intervention will receive a series of text messages from their pcp or primary care clinic recommending a study website as a trusted source of information about the covid-19 vaccines and information on how and where to schedule a vaccination. providers at a study clinic randomized to the intervention will be provided resources to support their conversations with unvaccinated patients during the intervention. resources will include access to the study website, factsheets to share with vaccine hesitant patients, prescription pads to be used to "prescribe' the website, and an electronic "smartphrase" that can automatically add information about the study website and how to schedule a covid-19 vaccination to patients' after visit summary and/or clinic note.

Eligibility criteria:
inclusion criteria: * patients seen by a pcp at a participating clinic site within 3-years prior to study start * age \> / = 18 years exclusion criteria: * patients who have received at least one dose of a covid-19 vaccine series prior to the start of the intervention * non-massachusetts residents

Keywords: covid-19 vaccine hesitancy vaccine confidence
pef-block & ribs fractures

Conditions: Chest Trauma With Ribs Fractures

Summary: rib fractures are frequent injuries found approximately in 10% severe trauma patient. rib fractures were correlated in many studies with a higher morbidity and mortality. this impaired outcome is mainly due to pulmonary complications consequences including especially pulmonary contusions. frequently, patients present difficulty deep breathing and coughing. these adverse effects can lead to the development of atelectasis, hypoxia, and respiratory failure with mechanic ventilation recourse. effective pain management may prevent these complications and reduce the likelihood of developing chronic pain. a multi-modal analgesia regimen is widely employed combining regional and systemic analgesia. epidural analgesia is considered by many authors to be the gold standard of pain relief although many side-effects are frequently describe including hypotension, urinary retention nausea and vomiting. paravertebral nerve blockade is an adequate alternative that provide similar quality of analgesia with lower incidence of complication. however, the failure rate associates with pvb is about 13% and it may be associated with hypotension (4.6%), accidental vascular puncture (3.8%), accidental pleural puncture (1.1%) and rarely pneumothorax (0.5%). recently, a description of the intercostal paraspinal nerve block. this technic was performed for patients undergoing thoracic surgery without complications.more recently, a description of a new approach to provide thoracic analgesia named the posterior paramedian subchoroidal (pops) block. the authors consider this technique provide an analgesia of the anterior and the posterior branch of adjacent thoracic nerves. the investigators propose to investigate the effect of posterior exothoracic fascial block.


Eligibility criteria:
inclusion criteria: * major patients (18-80 years old) * affiliated to the social security * hospitalized following severe trauma associated with at least 2 unilateral ribs fractures * eva greater than or equal to 3 when coughing or when mobilizing care. * management of the patient in the first 24 hours post trauma. * patient not intubated. * collection of informed written consent, notification on the anesthesia sheet. exclusion criteria: * minor patients, * patients under guardianship * pregnant or lactating women * allergy known to local anesthetics, * severe coagulopathy, * infection of the puncture site * neuromuscular pathology * chronic pain patients (long-term treatment with non-inflammatory steroidal, opioid, neuroleptic, antidepressant, antiepileptic), * intubated patient
early revalvulation after fallot repair improves clinical outcome

Conditions: Tetralogy of Fallot

Summary: aim with this retrospective study, the investigators would like to evaluate and, if possible confirm, whether earlier revalvulation of the right ventricular outflow tract is better than late revalvulation. up to now, no analysis is done to validate this policy change. patient selection all patients registered in the database of paediatric and congenital cardiology of the university hospitals in leuven, with sufficient follow-up data, and who underwent transannular patching at repair will be included in the study. methodology and statistical analysis all files will be reviewed for demographic, electrocardiographic, echocardiographic, and outcome data. besides descriptive statistics, cox regression will be performed to detect whether the time period between repair and revalvulation influences clinical outcome (defined as death, heart failure hospitalization, redo-revalvulation, implantation of automatic defibrillator, endocarditis).


Eligibility criteria:
inclusion criteria: * tetralogy of fallot patients repaired with transannulaire patch. exclusion criteria: * none.
a study to test the pain-relieving effect of laughing gas in infants

Conditions: Analgesic Affect

Summary: our proposal is to study infants in the neonatal intensive care unit (nicu) who are undergoing a heel stick for blood sampling, a standard procedure in patient care. currently, these infants do not get any pain relief for this procedure. several recent clinical studies have shown the usefulness of nitrous oxide (laughing gas) for treating pain for minor procedures in children 0 to 18 years, but these effects have not been exclusively studied in the newborn and infant populations. animal studies have questioned the anti-nociceptive (pain-blocking) effect of nitrous oxide in very young animals. it is unclear if this also applies to humans. the reason for this difference may be due to an immaturity of the neural pathways that modulate pain in the very young. the purpose of this study is to investigate whether or not nitrous oxide has an analgesic (pain-relieving) effect in infants undergoing minor procedures in the neonatal period (less than 3 months).


Eligibility criteria:
inclusion criteria: - full-term babies up to three months old scheduled for heel stick blood draw. exclusion criteria: * preterm, difficult airway (micrognathia, cranio-facial malformation, choanal atresia, pierre robin syndrome, or treacher collins syndrome), sedated, intubated (including tracheostomy), have an oxygen requirement (fio2\>40%), anemia, bone marrow suppression, or cardiac defect
remote monitoring for equity in advancing control of hypertension

Conditions: Hypertension

Summary: the goal of this study is to support patients with hypertension self-management using both home blood pressure monitors and digital messaging programs. the investigators will first engage patients with technology training to use home monitors, online portal websites to view their medical record information online, and texting and mobile phone applications. then investigators will assess the effectiveness of home blood pressure monitors and enhanced patient-clinician digital communication on blood pressure control during a 12-month intervention.

this study aims to launch an effectiveness-implementation hybrid randomized trial to adapt a multi-faceted hypertension (htn) management program shown to work in integrated healthcare delivery systems to a safety net healthcare system, san francisco health network (sfhn). in aim 1 of this study, investigators will offer patients brief in-person training to support their use of the online patient portal and basics about text messaging. investigators will examine pre-post training changes in technology use overall as well as by specific patient subgroups with known differences in technology uptake. in aim 2 investigators will conduct a three-arm randomized controlled trial to compare varying levels of implementation support: 1) cellular-enabled blood pressure (bp) monitors (with minimal implementation support), 2) cellular-enabled bp monitors with protocol-based implementation support (text reminders for patients; aggregated bp summaries sent to primary care providers), and 3) cellular-enabled bp monitors and pharmacist-led support (pharmacist coaching and independent medication adjustments). in aim 3 investigators will use a mixed methods approach to evaluate key implementation outcomes, guided by the reach, effectiveness, adoption, implementation, and maintenance (re-aim) framework, of adapting an existing, evidence-based home bp monitoring program.

Eligibility criteria:
inclusion criteria: * english-and spanish-speaking patients * patient within the san francisco health network (sfhn) * has seen primary care provide within the past 2 years * uncontrolled hypertension (htn) in the htn registry * complete aim 1 training, in addition to patients who have not completed aim 1 training * over the age of 18 exclusion criteria: * under the age of 18 * controlled htn

Keywords: blood pressure telehealth telemedicine patient generated health data remote patient monitoring
sexual functioning in endometrial cancer

Conditions: Endometrial Cancer; Sexual Function

Summary: the purpose of this study is estimate how sexual function in endometrial cancer survivors varies with severity of disease.


Eligibility criteria:
inclusion criteria: * history of stage i-iiia endometrial adenocarcinoma of any grade * 1-5 years out from primary surgical treatment * adjuvant therapy may only have consisted of radiation or hormonal therapy * no evidence of disease exclusion criteria: * previous treatment for other malignancies * did not undergo surgery for primary treatment of endometrial cancer * inability to read, write and speak fluent english * major cognitive impairment affecting ability to provide consent

Keywords: endometrial cancer sexual function
dexmedetomidine in children having transthoracic echocardiography

Conditions: Heart Disease

Summary: sedation techniques for children undergoing transthoracic echocardiography (tte).

the goal in this study is to determine if there is a significant difference in the quality of sedation between two standard sedation techniques and between two doses of dexmedetomidine for children undergoing (tte).

Eligibility criteria:
inclusion criteria: * outpatients scheduled to receive sedation for transthoracic echocardiography * subject must be a candidate for both types of anesthetic and both doses of dexmedetomidine * must be 3 months to 36 months of age exclusion criteria: * the subject has a history of cardiac conduction system disease (e.g. 1st or 2nd degree av block) or channelopathy (e.g. long qt). * the subject is taking digoxin, alpha-adrenergic or beta-adrenergic agonist or antagonist (e.g., clonidine, propranolol, albuterol), anti-arrhythmic medications, or vasodilators (e.g. ace inhibitors) * the subject has received a dose of any other sedative within 48 hours. * the subject has life-threatening, medical conditions (american society of anesthesiologists physical status 4, 5). the american society of anesthesiologists (asa) classification scale is a measure of physical status or how healthy the patient is. for our study, we will focus on children which are defined as asa i, ii or iii which means a healthy child (asa i), a child with a systemic disease that is mild and well controlled (asa ii) or a child with systemic disease that is severe and controlled (asa iii). * the subject is allergic to or has a contraindication to any of the drugs used in the study. * the subject has previously been treated under this protocol. * the subject has severe coarctation of the aorta (risk of exaggerated vasoconstriction) * the subject has moyamoya disease (risk of recurrent stroke)

Keywords: transthoracic echocardiography echo tte
excitatory rtms to the left dorsolateral pre-frontal cortex to reduce cannabis-cue induced craving

Conditions: Cannabis

Summary: this is a double-blind, crossover trial that will recruit a cohort of non-treatment seeking cannabis use disordered participants. participants will then undergo either active, or sham rtms to the ldlpfc, and cue-induced craving, and risky decision making will be assessed.

our primary aims are to determine the effect of a single session of 10 hz l dlpfc rtms on cannabis cue induced craving (aim1), and behavioral tasks of impulsive decision making (aim2), in non-treatment seeking individuals with cannabis use disorder. the aims of the study will be accomplished by performing a double-blind, sham-controlled crossover trial. non-treatment seeking individuals with cud will be recruited through media advertisements, as well as via a pre-established database of non-treatment seeking individuals who have participated in previous cannabis trials and agreed to be re-contacted. interested individuals will undergo a brief phone screen to determine if they meet general inclusion/exclusion criteria, and if so will be invited to meet with study personnel in order to sign informed consent, and undergo a screening visit. there will then be two experimental visits separated by at least one week. during each of these visits participants will undergo either a real, or sham rtms treatment, as well as a cannabis cue paradigm. data on craving as well as on impulsive decision making will be collected before and after each treatment.

Eligibility criteria:
inclusion criteria: 1. participants must be able to provide informed consent and function at an intellectual level sufficient to allow accurate completion of all assessment instruments. 2. participants must be between the ages of 18 and 60. 3. participants must meet dsm-v criteria for cannabis use disorder, with use of at least 20 days/month. 4. participants must agree to abstinence from cannabis for at least 24 hours prior to each visit. 5. participants must have a positive uds for cannabis (confirming they are regular users), and a negative salivary cannabis test (confirming no use within 10-14 hours) exclusion criteria: 1. participants must not be pregnant and participate in the study. 2. participants must not test positive for any substance other than cannabis on uds. 3. participants must not meet criteria for any other substance use disorders with the exception of nicotine use disorder. 4. participants must not be on any medications that have central nervous system effects. 5. participants must not have a history of/or current psychotic disorder. 6. participants must not have a history of dementia or other cognitive impairment. 7. participants must not have active suicidal ideation, or suicide attempt within the past 90 days. 8. participants must not have any contraindications to receiving rtms as assessed by the tms safety sheet. 9. participants must not have any unstable general medical conditions.

Keywords: cannabis rtms craving decision making
real-time fmri neurofeedback in patients with mci

Conditions: Mild Cognitive Impairment

Summary: increased activity in the hippocampus (i.e., hyperactivity) during a fmri memory task was found in patients with mild cognitive impairment due to alzheimer's disease (mci). those with increased hippocampal activity exhibited elevated clinical progression. reducing hippocampal hyperactivity with pharmacological treatment reduced hyperactivity and improved memory performance. the investigators of this study will test whether real-time fmri neurofeedback will also downregulate hippocampal activity and thereby improve memory performance.

alzheimer's disease (ad) is an insidious and progressive neurodegenerative disorder accompanied by extracellular deposits of beta-amyloid ( aβ) and the increase of cognitive dysfunctions. several functional magnet resonance imaging (fmri) studies in the prodromal stage of ad (i.e., in mci) have found increased hippocampal activity during a memory task to be predictive of memory worsening and disease progression. in this study the investigators are aiming to reduce hippocampal hyperactivity with real-time fmri neurofeedback and test whether this will improve memory performance. this study will use a randomized, single-blind, parallel group design. patients with mci and healthy participants will be assigned to receive feedback from either the hippocampus (experimental group, n=42) or from another brain area (alternate roi feedback group, n=42). all participants will be instructed to downregulate activity.

Eligibility criteria:
inclusion criteria: * intact activities of daily living * fluent in german * normal/corrected-to-normal vision * written informed consent exclusion criteria: * dementia * current/lifetime severe psychiatric or neurological disorder * history of seizures * psychotropic medication * currently/lifetime drug or alcohol abuse * brain damage * magnetisable implants
heart rate variability (hrv) analysis in patients with nocturnal epileptic seizures

Conditions: Heart Rate; Nocturnal Seizures; Autonomic Nervous System; Epilepsy

Summary: epilepsy is disabling and costly to patients and the health service. nearly 400,000 people in england suffer from epilepsy. about 40% of these patients are known to have seizures predominantly in sleep. all seizures pose risk to the individual both physical and psychological. nocturnal seizures pose extra risk as the diagnosis may be missed or delayed. patients with nocturnal seizures are also thought to be at particular risk of sudden unexpected death in epilepsy (sudep), especially if their seizures are unobserved. in patients with poor seizure control, the risk of sudep has been found to be as high as 9 per 1,000 patient years. previous studies show that many seizures are associated with changes in the autonomic nervous system (ans) tone. the ans tone can be assessed using heart rate variability parameters (hrv). a few studies suggest that ans tone changes tend to precede the onset of epileptic seizure related surface electroencephalographic (eeg) changes, suggesting that ans tone changes could be used in seizure alarm or intervention systems. this prospective study intends to focus on seizures from sleep and study hrv parameters in the immediate preictal state of the seizure and compare these with resting hrv parameters in the same patient with the aim of finding hrv metrics which could help to identify the presence of seizures in longterm electrocardiographic (ecg) recordings, or help predict seizure occurrence, or provide information about the current risk of seizures. this study will also investigate whether there are differences in the alterations of hrv parameters between different forms of epilepsy and whether seizure lateralisation has an impact on hrv parameters.


Eligibility criteria:
inclusion criteria: 1. clinically firm diagnosis of epilepsy. 2. 18 years of age 3. having the capacity to consent to this project. exclusion criteria: 1. patients who are on medication for cardiac conditions like beta blockers, anti arrhythmic agents, calcium channel blockers. 2. patients who have other neurological disorders which may be associated with an autonomic neuropathy 3. patients who have diabetes, renal failure or another general medical disorder associated with autonomic neuropathy. 4. patients unable to complete self-report measures unaided.
" effect of single-nucleotide polymorphism of cd40 gene rs1883832 c/t on the risk of immune thrombocytopenic purpura "

Conditions: Immune Thrombocytopenic Purpura

Summary: immune thrombocytopenia is an acquired autoimmune disease, in which platelets are opsonized by auto-antibodies and destroyed by phagocytic cells .genetic polymorphisms in the immune mediators have been suggested to play a pivotal role in the pathogenesis of many autoimmune disorders . several genetic polymorphisms of the immune system genes have been described in itp such as interleukins, tumor necrosis factors (tnf) alpha and beta, and interferon-gamma., these polymorphisms were found to be associated with an increased risk of itp progression or exacerbation .cd40 is a co-stimulatory 4348 kda glycoprotein molecule composed of 277 amino acid residues which belongs to the tumor necrosis family. it is encoded by a gene which is located at chromosome 20q11-13, expressed mainly on antigen presenting cells (apcs), some non-immune cells and tumors.antinuclear antibodies (ana) is a collective term for a large and heterogeneous group of circulating autoantibody. reflecting their clinical importance, ana are diagnostic, prognostic or classification criteria for many autoimmune diseases.


Eligibility criteria:
inclusion criteria: * sign an informed written consent from the patients or their parents * patient with newly diagnosed itp * patient age \> 1 year and \< 65 years and both sexes are included. exclusion criteria: * refusal to sign an informed written consent * patient with persistent itp, patient with secondary immune thrombocytopenia * patient age \ 65 years.