Kornimate/medical-research-clean huggingface dataset:
post-discharge outcomes of pediatric acute respiratory distress syndrome

Conditions: Pediatric Acute Respiratory Distress Syndrome

Summary: in this study, the investigators aim to better characterize the outcomes of pediatric acute respiratory distress syndrome (pards) survivors, to examine whether subgroups of children with pards can be identified, and to determine whether an earlier diagnosis of pards using a computerized decision support system will improve the care of these children.

pediatric acute respiratory distress syndrome (pards), a heterogeneous clinical syndrome characterized by acute lung injury and hypoxemia, affects up to 10% of pediatric intensive care unit (icu) patients and has a mortality rate of 18-27%. because children who survived pards are still developing, long-term morbidities are highly relevant, although data on the outcomes of pards survivors is lacking. previous studies were limited by their sample size, were outdated in pards management strategies, and used the adult ards diagnostic criteria. some studies focused on pulmonary function but not on other patient-oriented outcomes such as respiratory symptoms, mental health issues, quality of life, and health care resource use, all of which have been identified as prevalent issues in adult ards survivors. recently, adult studies have identified 2 distinct ards subphenotypes with differential responses to treatment using clinical and limited biological data, providing insight on the pathophysiology of ards. whether these phenotypes are present in pards is unknown. furthermore, integrating newer technologies such as transcriptomics in the identification of subphenotypes may improve our understanding of disease mechanisms. finally, delays in ards diagnosis are common and compliance with current ards ventilation management guidelines is poor, ranging from 20-39% even in patients selected for clinical trials. thus, novel methods such as decision support systems may play a role in the diagnosis and management of pards patients, although this remains to be evaluated.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of pards, as defined by palicc * aged less than 18 years * admitted to the intensive care unit exclusion criteria - none

Keywords: respiratory health
improving mental health and school performance in urban eighth graders

Conditions: Depressive Symptoms; Trauma, Psychological; Disruptive Behavior

Summary: this study assesses: (1) the impact of the relax, be aware, do a personal rating (rap) club, a school-based prevention program for urban eighth graders, on students' emotional functioning and education outcomes; (2) potential moderators and mediators of rap club's effects; and (3) factors related to the implementation of rap club, including cost of delivery and perceptions of key stakeholders.

youth in low-income urban communities are often exposed to chronic stress and trauma, which poses risk for emotional, behavioral, and academic problems. this study will evaluate the impact of rap club, a trauma-informed school-based prevention program intended to promote positive emotional and academic development for eighth graders. participants will be randomly assigned within schools to receive rap club or healthy topics, a health education active control condition. the study will achieve the following specific aims: 1. test whether students randomized to rap club have improved academic, social-emotional, and behavioral outcomes as compared to those randomized to healthy topics (e.g., student-reported mood and stress; teacher-rated academic performance; academic record data). 2. explore potential moderators (e.g., baseline trauma exposure, emotional regulation) and mediators (e.g., changes in self-regulation and emotional symptoms) of rap club's effects. 3. evaluate factors related to program implementation, including cost of delivering rap club versus healthy topics and perceptions of key stakeholders (teachers, group facilitators, students) regarding intervention acceptability and sustainability.

Eligibility criteria:
inclusion criteria: * subject is attending eighth grade at a participating baltimore city public school * subject is not in a self-contained special education classroom * subject provides written parent permission and written assent exclusion criteria: * non english-speaking

Keywords: prevention urban youth mindfulness
phase iii open label first line therapy study of medi 4736 (durvalumab) with or without tremelimumab versus soc in non small-cell lung cancer (nsclc)

Conditions: Non-Small-Cell Lung Carcinoma NSCLC

Summary: this is a randomized, open-label, multi-center, global, phase iii study to determine the efficacy and safety of medi4736 + tremelimumab combination therapy and medi4736 monotherapy versus platinum-based soc chemotherapy in the first-line treatment of patients with epidermal growth factor receptor (egfr) and anaplastic lymphoma kinase (alk) wild-type locally advanced or metastatic nsclc

patients will be randomized in a 1:1:1 ratio to receive treatment with medi4736 + tremelimumab combination therapy, medi4736 monotherapy, or standard of care (soc) therapy.

Eligibility criteria:
inclusion criteria: for inclusion in the study, patients should fulfill the following criteria: * aged at least 18 years * documented evidence of stage iv nsclc * no sensitizing egfr mutation or alk rearrangement * no prior chemotherapy or any other systemic therapy for recurrent/metastatic nsclc * world health organization (who) performance status of 0 or 1 exclusion criteria: patients should not enter the study if any of the following exclusion criteria are fulfilled: 1. mixed small-cell lung cancer and nsclc histology, sarcomatoid variant 2. brain metastases or spinal cord compression unless asymptomatic, treated and stable (not requiring steroids) 3. prior exposure to immunomodulatory therapy (imt), including, but not limited to, other anti-cytotoxic t-lymphocyte-associated antigen 4 (ctla-4), anti-programmed cell death1 (pd-1), anti-programmed cell death ligand 1 (pd-l1), or anti pd-l2 antibodies, excluding therapeutic anticancer vaccines 4. active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease \[eg, colitis or crohn's disease\]

Keywords: nsclc, pd-l1, medi4736, tremelimumab, pfs, os
effectiveness of a brief intensive trauma treatment for adolescents with (s)ptsd: a multi-center rct

Conditions: Post-traumatic Stress Disorder

Summary: the primary objective of this study is to examine the effectiveness of a brief intensive trauma treatment (bitt) for adolescents with (s)ptsd.

this study is a multi-center, single-blinded rct. adolescents (12-18 years old) with (s)ptsd will be randomly allocated by an independent researcher to the bitt (n=50) versus a waitlist control group (wlcg; n=50), stratified by center. measurements are done at comparable time intervals for both groups: at pre-treatment (t0), directly after bitt or wlcg (t1) and at 3 (t2), 6 (t3) and 9 (t4) months follow-up. the wlcg receives bitt after the 3 months follow-up.

Eligibility criteria:
inclusion criteria: in order to be eligible to participate in this study, a subject must meet all of the following criteria: * 12-18 years of age; * with a history of psychological trauma (conform the life events checklist of the clinician administered ptsd scale for children and adolescents dsm-5 (caps-ca dsm-5) (nader, 2004; van meijel et al., 2019); * at least subthreshold ptsd criteria, conform the caps-ca dsm-5, i.e.; * fully meeting criterion a, f and g and at least one symptom of criteria b, c, d and e; * or fully meeting criterion a, f, g and at least the b, c, d or e symptom clusters; * and written informed consent must be provided by the adolescent and, for adolescents aged 12-15 years, all legal guardians. exclusion criteria: a potential subject who meets any of the following criteria will be excluded from participation in this study in case of: * inability to speak and write dutch; * estimated or determined mental retardation (iq \<70); * suffering from ongoing trauma by a parent who is part of the adolescent's current primary-care system.

Keywords: ptsd trauma intensive treatment bitt adolescents
remote use of the asthma control test (act) to improve care of children with asthma

Conditions: Asthma

Summary: this study will assess whether adaption of the asthma control test (act) and childhood asthma control test (cact) for mobile devices improves rate of completion and improves control of asthma in children and adolescents

asthma is the most prevalent chronic disease of childhood with an overall prevalence of 10%. while effective therapies exist to control symptoms and prevent exacerbations, many asthma patients experience significant morbidity including limitations on daily activities as well as asthma exacerbations that lead to missed school (and work for care givers) and necessitate emergency department visits and hospitalizations. among children from lower socioeconomic statues and in black and hispanic families, asthma incidence and severity are even greater. reasons for this disparity included decreased access to effective asthma care, increased exposure to tobacco smoke and environmental allergens, and underutilization of controller medicines. these groups have significantly increased resource utilization due to emergency department visits and hospitalizations. optimal care for asthma patients, especially those with at highest risk, will therefore require new strategies for evaluating ongoing control and providing direct feedback to patients. we propose to transform the way asthma care is provided through the use of an innovative patient centered technology -trivox asthma - to improve quality of care and outcomes for asthma patients while reducing the cost of care. specifically we will extend trivox health to facilitate closer monitoring of patients with asthma through the existing web platform and a new mobile interface. this will allow asthma patients, their parents and school nurses to remotely input data on asthma control through smartphones and/or tablets. we will use the act+, an expansion of a validated measure currently utilized in both primary care and specialty clinics, to measure both asthma control and risk. effectiveness of this intervention will be measured by examining resource utilization and ongoing asthma control.

Eligibility criteria:
inclusion criteria: * diagnosis of asthma * cared for at boston children's hospital (primary or secondary care) exclusion criteria: * age \ 21
the treatment of knee osteoarthritis with balanced buttress absorbable spacer

Conditions: Osteoarthritis, Knee

Summary: the investigators randomly divided the knee osteoarthritis patients met the inclusive criteria into two groups (study group and control group). placement of balanced buttress absorbable spacer and total knee arthroplasty were conducted. the clinical outcome of two groups were compared in this study.

knee osteoarthritis, caused by non-uniform settlement of medial and lateral tibial plateau, was not uncommon in clinic. medial stenosis was the most type of the disease. the symptoms included knee pain during walking and varus deformity of lower limbs. total knee arthroplasty and tibial osteotomy were two common conventional treatment of the knee osteoarthritis, which were not minimally invasive and bring great financial burden to patients' family. the investigators planned to recruit 150 patients of knee osteoarthritis into this study, which were randomly divided into two groups (study group and control group). for the patients of study group, a balanced buttress absorbable spacer was placed into the gap after the osteotomy of tibia and fibula to modify the lower limb line. however, total knee arthroplasty was conducted for the patients of control group. the patients were followed up and the clinical outcomes were compared in this study.

Eligibility criteria:
inclusion criteria: * 40-80 years old * medial stenosis of the knee * varus deformity less than 20 degrees exclusion criteria: * lateral stenosis of the knee * hepatic renal dysfunction * refuse to participate the study
the rehabilitation effect of exercise training in cruciate ligament reconstruction patients.

Conditions: ACL Injury; ACL - Anterior Cruciate Ligament Rupture; ACL - Anterior Cruciate Ligament Deficiency

Summary: after anterior cruciate ligament (acl) injury, the involved quadriceps may demonstrate weakness due to decrease in quadriceps activation. however, elapsed time from the injury may affect muscle strength by restoration of the quadriceps activation. the injury is characterized by joint instability that leads to decreased activity, unsatisfactory knee function, and poor knee-related quality of life in the short term, and it is associated with an increased risk of osteoarthritis on the knee. this study was designed to compare muscle strength, questionnaire and knee function in patients with different exercise training.


Eligibility criteria:
inclusion criteria: * cruciate ligament rupture patients exclusion criteria: * central nervous or peripheral neuropathy, or those with cardiovascular disease.
evaluating adjunctive cryopreserved amniotic membrane treatment in herpes simplex dendritic keratitis

Conditions: Herpes Simplex Dendritic Keratitis

Summary: to prospectively evaluate the effectiveness of prokera slim in adults with primary or recurrent herpetic epithelial keratitis in terms of visual function, corneal opacity, time to resolution, cost of care, number of patient visits.

cryopreserved amniotic membrane (am) contains anti-inflammatory, anti-scarring and antiangiogenic effects known in treating many ocular surface diseases. this notion is further strengthened by many studies showing that amniotic membrane can effectively control inflammation in hsv stromal keratitis in a murine model of hsv necrotizing keratitis and surgical application in \~7 human studies of epithelial and stromal hsv keratitis with or without an adjuvant antiviral therapy. more importantly, prokera slim in conjunction with oral acyclovir has been shown to facilitate the ease of early intervention to accelerate restoration in herpetic keratitis in 2 case series of 5 eyes. however, a formal prospective study has not been performed.

Eligibility criteria:
inclusion criteria: 1. the subject (male or female) is at least 18 years of age. 2. the subject is presenting with primary or recurrent herpetic dendritic epithelial keratitis based on investigator judgement 3. the subject is presenting with acute (within 30 days) herpetic dendritic epithelial keratitis 4. the subject is willing to comply with all study procedures and is able to consent. exclusion criteria: 1. clinical signs of a cause other than herpes simplex virus 2. presence of corneal ulcer with or without microbial infection 3. lid surface abnormalities or conjunctival scarring that affect lid function in either eye 4. atopic disease 5. history of penetrating keratoplasty 6. active stromal keratitis or iritis 7. presence of systemic or ocular infection or inflammation that is not related to herpes simplex virus (such as sarcoidosis, cogan syndrome, atopy, lyme disease, syphilis, mumps, epstein-barr virus) 8. ocular surface malignancy 9. history of recent ocular surgery/trauma, which could affect corneal sensitivity, e.g., corneal transplantation, lasik 10. a medical or ocular condition, or a personal situation, which in the principal investigator's opinion, is not appropriate for participation in the trial 11. current enrollment in another interventional drug or device study or participation in such a study within 30 days of anticipated entry into this study 12. not capable of providing informed consent

Keywords: prokera adjunctive cryopreserved amniotic membrane prokera slim
single dose antibiotic treatment of acute watery diarrhea, rifaximin versus azithromycin, with loperamide adjunct

Conditions: Diarrhoea;Acute; Diarrhea Travelers

Summary: the purpose of this study is to compare a single dose of rifaximin with loperamide to the current standard approach of single dose azithromycin with loperamide for the treatment of acute watery traveler's diarrhea (td). the study requires 1) taking a single dose antibiotic plus loperamide to treat td, 2) providing blood and stool samples at different time points to evaluate infection and immune responses, 3) completing a daily symptom diary following treatment, 4) being seen by the study doctor to monitor illness and recovery, and 5) completing a brief electronic questionnaire at 3 months. participants will be randomly assigned to one of the two treatment groups. the two groups are 1) rifaximin 550 mg as a single dose with loperamide 4 mg initially followed by 2 mg after each unformed stool or 2) azithromycin 500 mg as a single dose with loperamide 4 mg initially followed by 2 mg after each unformed stool. both groups will take the antibiotic dose and 4 mg of loperamide.


Eligibility criteria:
inclusion criteria: 1. active duty military, 18-60 years old 2. presence of acute watery diarrhea (3 or more loose/liquid stools in 24 hours or 2 loose/liquid stools in 24 hours and associated symptoms such as nausea, vomiting, abdominal cramps or tenesmus) lasting \<96 hours in duration that impacts function in activities and/or performance of primary duties. refer to recruitment decision tree below. 3. eligible for ambulatory management. (note: ambulatory management in this study means that the patient can be treated on an outpatient basis to include up to 23 hours of medical observation and iv therapies.) 4. able to comply with follow-up procedures. 5. will remain in country for at least 7 days or an assurance that follow-up can be arranged elsewhere. exclusion criteria: 1. allergy to rifamycins, macrolides, or loperamide (not including mild gastrointestinal upset). 2. antibiotic therapy in the 72 hours prior to presentation (excluding malaria prophylaxis with mefloquine, malarone, chloroquine/proguanil, tafenoquine, or doxycycline). 3. concomitant medications with known drug-drug interactions with any of the study drugs (includes theophylline, digoxin, warfarin, chloroquine and hydroxychloroquine). 4. current or history of liver disease or other serious health conditions based on review by study physician. 5. acute dysentery and/or febrile illness (temperature \> 100.4°f \[38.1°c\]). 6. presence of symptoms \>96 hours prior to initiating treatment. 7. use of \>4 mg loperamide or use of any amount of loperamide for greater than 24 hours prior to enrollment. prior use of bismuth subsalicylate or other anti-diarrheal, non-antibiotic therapy in the 48 hours prior to enrollment. 8. positive pregnancy test at presentation (unknown effects with rifaximin). all female participants will be administered a urine pregnancy test prior to enrollment. 9. previously screened or randomized in this study.
the effects of use of mirror image on radiation exposure during fluoroscopically guided transforaminal epidural injection

Conditions: Lumbar Radiculopathy Due to Spinal Nerve Compression

Summary: lumbar transforaminal epidural injection is helpful for the treatment of lumbosacral radicular pain. tunnel view technique is the basis of x-ray assisted intervention. in this technique, it is necessary to handle the block needle in order to adjust the direction of needle to the tunnel view toward target. if a mirror is used during needle handling, overall procedure time and radiation exposure can be reduced.

1. a planned fluoroscopically guided lumbar transforaminal epidural injection should be performed after receiving the informed consent of the patient. 2. this study is single-blind because it is not possible to blind the practitioner performing the injection. 3. subjects were randomly assigned to the normal method group (group a) and the mirror use group (group b) by a random random number table, and the possibilities for belonging to any group were all the same and can not be artificially controlled by researchers. 4. after the procedure, a resident who does not know of this study records the radiation exposure time displayed on the monitor and the overall procedure time

Eligibility criteria:
inclusion criteria: 1. magnetic resonance imaging (mri) and clinical manifestations of adult men and women over 20 years of age are eligible for radiculopathy due to back nerve root compression and subject to fluoroscopically guided lumbar transforaminal epidural injection at the suspected spinal nerveroots level. exclusion criteria: 1. blood clotting disorder 2. infection around the site 3. contrast agent allergy 4. uncontrolled cardiovascular, cerebrovascular, kidney disease 5. past history of spinal surgery (ex, spinal fusion) 6. if can not block due to non-cooperation with subjects (ex, if you can not take the stomach) 7. patients taking narcotic analgesics

Keywords: epidural steroid injection radiation exposure mirror
caries-associated saliva biomarkers among different races

Conditions: Caries,Dental

Summary: discover possible differences and develop effective preventative interventions by examining the relationship between salivary biomarkers and caries prevalence across different racial groups and detect risk factors involved in caries incidence .

dental caries is a multifactorial condition that is influenced by both external and internal variables. tooth decay progression is directly influenced by host factors, including the individual's immune competence, saliva flow rate and buffering capacity, tooth form, and bacterial makeup . while salivary biomarkers are essential for predicting the risk of dental caries, little is known about how they relate to caries in a variety of populations. by examining the relationship between salivary biomarkers and caries prevalence across several racial groups, this study seeks to close this gap and enhance culturally appropriate preventive approaches . there have been contentious discussions over the causes of differences in oral health during the past forty years. the term "structural inequities" refers to the social, environmental, economic, and cultural determinants of health, which are frequently impacted by racial or ethnic background, gender, work status, immigrant status, and geographic location. racialized populations have demonstrated greater rates of untreated dental decay (caries), severe periodontal disease, and total or partial edentulism . typically, "race" refers to an individual's physical characteristics, such as skin tone or hair type, which may indicate their ancestry. white, african american, or asian descent are some examples of classifications that are frequently used to characterize race .

Eligibility criteria:
inclusion criteria: * age : 19-25 * we will have 2 groups according to icdas classification : not severe (icdas score ≤3) / severe (icdas score ≥3) exclusion criteria: * : those who reported daily use of alcohol or tobacco . * those who used antibiotics or other systemic drugs within the previous three months . * those who regularly used antiseptics