Kornimate/medical-research-clean huggingface dataset:
restrictive versus liberal red blood cell transfusion in patients of cirrhosis with septic shock

Conditions: Cirrhosis

Summary: consecutive cirrhotics who present to emergency department of ilbs with documented or suspected sepsis induced hypotension with hb \<8 gm/dl will be randomly assigned to restrictive (target hb 7-8 gm/dl) to liberal (target hb 10-11 gm/dl) group in a 1:1 proportion at admission, all patients will undergo physical examination and baseline investigations to identify site of sepsis. enrolled patients will be given prbc-transfusion (not more than two units of prbc/day) when they reach their assigned trigger value (hb 7-8 g/dl or 10-11 g/dl ) during the entire icu stay. all other interventions will be at the discretion of clinicians.


Eligibility criteria:
inclusion criteria: 1. cirrhosis with septic shock. 2. age \>18 years exclusion criteria: 1. previous severe adverse reaction with blood products, 2. disseminated intravascular coagulopathy 3. hcc 4. pregnancy 5. malignancy 6. active gastrointestinal bleeding 7. intracranial bleeding 8. chronic kidney disease with maintenance hemodialysis 9. pulmonary edema 10. congestive heart failure 11. lack of informed consent
an online intervention to reduce e-cigarette use and susceptibility to smoking in young adults

Conditions: E-cigarette Use

Summary: the goal of this intervention development and pilot clinical trial is to determine whether receiving the brief online intervention results in greater reductions in past 7-day e-cigarette use frequency and smoking susceptibility over an 8-week period compared to receiving the control condition in young adults who currently use e-cigarettes. participants in the experimental condition will be asked to complete the 30-minute mobile-based program. participants in the assessment-only control will be given the option to access the intervention after they complete their final survey at 8 weeks. all participants will complete our online surveys at baseline as well as 2-weeks, 4-weeks, and 8-weeks post-randomization. researchers will compare outcomes among the intervention and control groups to determine the efficacy of the intervention.


Eligibility criteria:
inclusion criteria: * be between the ages of 18 to 24 * be able to read english * report vaping at least one day per week in the past month * report no history of cigarette use at screening and baseline. exclusion criteria: * reporting severe mental health, illicit drug use, or alcohol use disorder * currently receiving nicotine cessation services
the effect of dietary nitrate supplementation on linear running sprint performance, agility and vertical jump performance in a rested and fatigued state

Conditions: Exercise Performance

Summary: dietary nitrate (no3-) supplementation has been shown to improve skeletal muscle contractility and fatigue resistance, particularly in fast-twitch (type ii) muscle fibers. furthermore, no3- supplementation has been shown to speed reaction time. taken together, these findings suggest that no3- ingestion may be ergogenic during all-out sprint running and reactive agility tasks. moreover, increasing muscle force production at high contraction speeds would be expected to translate into improved muscle power and, subsequently, improved performance in very explosive forms of exercise, such as vertical jumping. therefore, the purpose of this investigation is to assess the effect of short term (5 days) no3- supplementation on linear running sprint performance, reactive agility and vertical jump performance in a rested and fatigued state.


Eligibility criteria:
inclusion criteria: 1. male and female participants in self-reported good general health as assessed by the standard procedures described below and specifically meeting normal blood pressure range (systolic: 100-135, diastolic: 60-90) and body mass index (bmi) range (16.0-29.9) 2. range of 18-45 years of age 3. participants must participate in an intermittent exercise based sport (e.g. soccer, rugby, hockey), at a competitive level (i.e. competes in officiated matches/games). 4. understanding of the procedures to be undertaken as part of the study 5. willingness to participate in exercise testing and follow supplementation guidelines and other instructions provided by the experimenter 6. informed, voluntary, written consent to participate in the study exclusion criteria: 1. known pulmonary, cardiovascular or metabolic disease 2. food allergies including phenylketonurea (pku) 3. current regular use of any dietary supplement (excluding macronutrient based supplements) or previous use of any dietary supplement in the past 6 months that is known to have a lasting effect. 4. blood donation within 3 months prior to the start of the study 5. substance abuse within 2 years of the start of the study 6. smoking 7. any prescription and non-prescription medication which may impact saliva production (antidepressants, diuretics, analgesics, antihistamines, anti-hyper/hypo-tensives, anti-anxiety, appetite suppressants). 8. current or previous use of phosphodiesterase 5 (pde5) inhibitors. 9. participation in another clinical trial within past 4 weeks.
northwest adult congenital heart disease observatory

Conditions: Congenital Heart Disease

Summary: the incidence of congenital heart disease is about 8 per thousand live births. thanks to advances in cardiac surgery, 90% of children born with heart defects reach adolescence and adulthood. congenital heart defects are the leading cause of heart disease in young adults and expectant mothers in western countries. the number of patients increases continuously as life expectancy increases. an increasing number of patients with complex heart defects survive to adulthood. the medico-surgical management of this highly specialized growing number of patients is difficult and requires a multidisciplinary collaboration. in france, an estimated 200,000 patients the number of carrier patients with congenital heart disease. half of them will require monitoring, medical procedures, catheterizations and/or surgical re-intervention. no objective demographic data are currently available on the french patients. so, the investigators decided to set up an epidemiological project to better understand this cohort of patients. the main objective of this project is to obtain accurate epidemiological data needed to adapt the supply of care.


Eligibility criteria:
inclusion criteria: * patient, male or female, aged 18 years * congenital heart disease operated or non-operated * followed by a cardiologist specializing in congenital heart disease in the inter northwest region of france exclusion criteria: * patient refusal
non-invasive filling pressure(nifp) device based on low frequency heart sound in assessment of congestion in heart failure patients

Conditions: Heart Failure

Summary: congestion plays a key role in heart failure (hf) trajectory .clinical congestion refers to the signs and symptoms resulting from elevated cardiac filling pressures. hemodynamic congestion refers to elevated cardiac filling pressures, which may occur days or weeks before the presentation of symptoms , , . serial assessment of congestion is required in each encounter of the hf patients, while in current clinical practice, serial assessment of congestion relies on physical examination, sometimes supported by bnp test. both physical and bnp test are reported to be unreliable in some cases ， . echocardiography is good tool, but it requires skilled physician to operation and is more time consuming. in general, there is unmet needs of better tools for serial assessment of congestion in hf patient management. in this study, we aim to prospectively observe and evaluate the feasibility of using a novel non-invasive device in assessment of congestion in hf patients.


Eligibility criteria:
inclusion criteria: * acute heart failure；stabilized outpatient chronic heart failure patients；willing to sign the inform consent exclusion criteria: * 1.patients under 18 years old 2.patients with congenital heart diseases (e.g., tetralogy of fallot, atrial septal defect, fontan disease, single chamber disease) 3.patients with implanted artificial mechanical valves, pacemaker or icd. 4.patients with significant back issues that prevent them from lying supine on the bed 5.pregnant patients 6.patient wight under 35 kg or over 150 kg 7.patients who are attaching to other medical device that prevent them to receive a test by the study device.
study on the staging and prognosis model of bladder cancer

Conditions: Bladder Cancer

Summary: firstly, we retrospectively gathered the patient information who compliant with the criteria from 2012 to 2023, encompassing basic information, clinical information, along with mri images, blood/urine samples, and tissue samples, for conducting relevant analyses of radiomics. subsequently, based on artificial intelligence technology, deep learning and machine learning models were established on the basis of mri radiomics and pathological histomics. ultimately, the following research aims were accomplished: 1. primary research objective: to explore the role of artificial intelligence and multimodal omics features in the staging and prognosis monitoring of bladder cancer. 2. secondary objective: to explore the correlations among radiomics, case histomics, and test omics.


Eligibility criteria:
inclusion criteria: * 1. patients with bladder cancer in preoperative examination; 2. gender is not limited; 3. age≥ 18 years old; 4. be able to provide mri images, pathological data and laboratory examination data before the operation; 5. agree to provide basic personal clinical information and pathological and imaging data for scientific research use, and sign the informed consent form; 6. agree to provide monitoring results during follow-up recurrence monitoring; exclusion criteria: * 1. incomplete clinicopathological data; 2. combined with upper tract urothelial carcinoma or previously diagnosed upper tract urothelial carcinoma; 3. is participating in the rest of the clinical studies; unable to cooperate with the relevant examinations of this project, and do not agree to sign the informed consent form.

Keywords: multimodal omics features artificial intelligence staging and prognostic models bladder cancer
efficacy and safety of covid-19 convalescent plasma

Conditions: Convalescent Plasma; COVID-19; SARS-CoV 2

Summary: administration of convalescent plasma obtained from donors with prior documented sars-cov-2 infection

there are currently no proven therapeutic options for coronavirus disease (covid-19), the infection caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2). human convalescent plasma is an option for treatment of covid-19. experience from prior outbreaks with other coronaviruses, such as sars-cov-1, mers and h1n1 shows that convalescent plasma can be effective. convalescent plasma will be obtained by plasmapheresis or regular whole blood donation in subjects who recovered from covid-19 and who are otherwise eligible for donation according to the institutional protocol. recipients will be covid-19 patients requiring hospitalization. a blood-type matched transfusion of convalescent plasma will be infused and recipients will be followed up.

Eligibility criteria:
inclusion criteria blood donors: 1. age: \>18 and \<60 years 2. body weight : \>55 kg 3. confirmed previous sars cov-2 infection 4. minimum 28 days after the last symptom or finishing of the isolation, or 5. 21 day without symptoms from the date of the negative sars cov-2 test 6. written informed consent to participate in this clinical trial, to donate plasma and to store the specimen for future testing. 7. concentration of covid-19 igg antibodies more than 5 au/ml (because measurement of neutralizing antibody titers is not available now, storing of retention sample from the convalescent plasma donation is performed for determining antibody titers at a later date) 8. male donors, or female donors who have not been pregnant, or female donors who have been pregnant tested negative for hla antibodies 9. individuals who meet all regular voluntary donor eligibility requirements patients/recipients: 1. age: \>18 years 2. admitted to an acute care facility for the treatment of covid-19 complications 3. patients with severe or immediately life-threatening covid-19, or 4. patients who are judged by a healthcare provider to be at high risk of progression to severe or life-threatening disease. 5. informed consent provided by the patient or healthcare proxy exclusion criteria: blood donors: 1. age : \ 60 years 2. female subjects who are pregnant 3. hiv1,2 hepatitis b,c or syphilis infection 4. donors ineligible for regular voluntary blood donation patients/recipients: 1. age : \<18 years 2. contraindication to transfusion (severe volume overload, history of anaphylaxis to blood products) 3. patients who received in the past 30 days immunoglobulin therapy 4. females who are pregnant or breastfeeding

Keywords: covid-19 anti sars-cov-2 convalescent plasma covid-19 convalescent plasma
novel sepsis sub-phenotypes based on trajectories of vital signs

Conditions: Sepsis

Summary: sepsis is a dysregulated host response to infection resulting in organ dysfunction. over the past three decades, more than 30 pharmacological therapies have been tested in \>100 clinical trials and have failed to show consistent benefit in the overall population of patients with sepsis. the one-size-fits-all approach has not worked. this has resulted in a shift in research towards identifying sepsis subphenotypes through unsupervised learning. the ultimate objective is to identify sepsis subphenotypes with different responses to therapies, which could provide a path towards the precision medicine approach to sepsis. the investigators have previously discovered sepsis subphenotypes in retrospective data using trajectories of vital signs in the first 8 hours of hospitalization. the team aims to prospectively classify adult hospitalized patients into these subphenotypes in a prospective, observational study. this will be done through the implementation of an electronic health record integrated application that will use vital signs from hospitalized patients to classify the patients into one of four subphenotypes. this study will continue until 1,200 patients with infection are classified into the sepsis subphenotypes. the classification of the patients is only performed to validate the association of the subphenotypes with clinical outcomes as was shown in retrospective studies. physicians and providers treating the patients will not see the classification, and the algorithm classifying the patients will in no way affect the care of the patients. further, all the data needed for the algorithm (vital signs from the first 8 hours) are standard of care, and enrollment in the prospective study does not require any additional data.

the primary goal of this study is to investigate the feasibility of implementing a prospective sepsis subphenotyping tool in the electronic health record and evaluating the characteristics and outcomes of the sepsis subphenotypes. during this study, clinicians will not see the results of the algorithm or have access to its predictions. instead, the algorithm will run silently in the background and continuously compute the subphenotypes of patients who are presenting to the emergency department (ed). for each patient, the probability of subphenotype membership over the first 8 hours of presentation to the ed will be calculated using an algorithm previously validated on retrospective data. differences in clinical characteristics and outcomes between the subphenotypes will be compared. investigators will seek to classify 1,200 patients with suspected infections. since it will not be apparent on ed presentation who has suspected infection, all patients will be classified into subphenotypes using the algorithm, but the primary subgroup who will be analyzed will be patients with suspected infection.

Eligibility criteria:
inclusion criteria: * all adults who present to the emergency department exclusion criteria: * none

Keywords: phenotypes sub-phenotypes infection vital signs subphenotypes
docosahexaenoic acid (dha) supplementation during pregnancy reduces the risk of preterm birth in threatened preterm labor

Conditions: Pregnant Women Diagnosed With Threatened Preterm Labor

Summary: the goal of this clinical trial is to learn about the effects of docosahexaenoic acid (dha) in reducing the incidence of premature birth in threatened preterm labor the main questions it aims to answer are: * can dha supplementation reduce the incidence of premature birth in threatened preterm labor? * how does dha supplementation affect pregnancy outcomes? participants were organized into two groups * group 1 (intervention) participants will be asked to take a dha 1000mg per day * group 2 (control) participant will not need to take a dha

threatened preterm labor is defined as regular uterine contractions occurring before 37 completed weeks of gestation, without any cervical dilation.

Eligibility criteria:
inclusion criteria: * singleton pregnancy * between 24 wk to 34 wk of gestational age * pregnant women diagnosed threatened preterm labor (with no cervical change) exclusion criteria: * fetal anomalies * multiple pregnancy * premature rupture of membrane * placental disorders: placenta previa, placental abruption * fetal growth restriction * pregnancy complication: gestational diabetes mellitus, chronic hypertension * allergic reaction to dha

Keywords: dha threatened preterm labor docosahexaenoic acid
supporting family carers' mental health

Conditions: Feasibility

Summary: brief summary: background: feasibility and acceptability of the carers-id intervention to improve mental health outcomes in family carers of people with intellectual disabilities. objective: 1. to conduct a phase ii feasibility randomised controlled trial and process evaluation of the carers-id programme. 2. to determine the acceptability of outcome measures of stress, anxiety, depression, resilience and well-being in assessing the impact of the programme on family carers. 3. to determine the recruitment and retention rates of participants in the trial. 4. to identify potential effect sizes and estimate appropriate sample size for use in an effectiveness trial. 5. to determine if progression to a phase iii effectiveness trial is warranted. methodology: family carers (n = 120) will be randomised to receive the programme (n=60) or assigned to a wait-list control (n=60) group. the intervention (carers-id) consists of ten modules which cover topics including: promoting resilience, reducing anxiety, managing stress, accessing local supports, managing family conflict and information for siblings who are carers. participants (n=12) who have taken part in the intervention arm of the research will be invited to participate in the process evaluation. outcome: 1. retention of subjects in study assessments (\>80% of family carers) 2. recruitment of subjects into study (\>90 carers) 3. acceptability and feasibility of the outcome measures (\>80% of family carers) 4. depression, anxiety and stress scale - 21; the warwick-edinburgh mental well-being scale; the resilience scale; and the social connectedness scale revised. number of participants to be enrolled: 120 family carers main inclusion criteria: participants will be uk adults \>18 years of age and will be caring for a family member with an intellectual disability. statistical analysis: descriptive statistics will be used to summarise baseline data including demographic variables and questionnaire responses. inferential statistics (t-tests or anova) will be used as indicators of difference between the intervention and control arms and will be used to determine effect sizes for sample size calculation in a future phase iii trial. study duration: 24 months


Eligibility criteria:
inclusion criteria: * resident of the uk; * \>18 years of age; * caring for a family member with an intellectual disability.

Keywords: family carer intellectual disabilities feasibility mental health intervention
effectiveness or orthopedic intervention in osteoporosis management after a fracture of the hip with cost-benefit analysis

Conditions: Osteoporotic Fracture

Summary: patients who present with fragility fractures are consistently under-evaluated and under-treated for underlying osteoporosis. this point of care represents a lost opportunity to prevent future fractures. the medical field treats the fracture as if the fall is the problem, but bone quality is the real problem. studies have consistently shown that the recommendations of the international osteoporosis foundation and world health organization are not being followed. orthopedics treats the patients for their fractures and primary care physicians focus on general health but no one is taking responsibility for bone health. strategies to convince primary care to assume care have not succeeded. on the other hand, strategies where orthopedics takes some responsibility have shown success. this prospective 2-arm study will evaluate the success of effort by an academic orthopedic department in osteoporosis evaluation and treatment. we hypothesize that with greater effort by the orthopedic department, the better the adherence to standards of care. a cost benefit analysis will be made in parallel.

patients who present to the orthopedic department in a level i trauma center will be prospectively randomized into one of two groups: letter group: at time of discharge, patients will be sent home with a discharge letter that includes standard recommendations for evaluation and treatment. they will be asked to give the letter to their primary care physician. intervention group: there will be 4 interventions. the patient will be given a short pamphlet with explaining osteoporosis and the importance of treatment. the orthopedic department will perform a bone density testing (dexa). they will be given a letter with a specific medication recommendation based on a protocol determined by our endocrinology department. they will be asked to give both dexa and medication recommendation to their primary care doctor to initiate treatment. finally, a research assistant will contact the patient monthly to encourage them to start treatment.

Eligibility criteria:
inclusion criteria: * all patients over age 50 with fragility fracture defined as a fall from standing or walking position exclusion criteria: * patients with metastatic cancer * known metabolic bone disease * end-of-life care * inability to provide consent * known mrsa carriers * fractures of the trochanter alone, shaft or peri-prosthetic fractures

Keywords: pathologic fracture insufficiency fracture secondary fracture fracture with bone fragility osteoporosis bone loss osteopenia metabolic bone disease fragility fracture