Kornimate/medical-research-clean huggingface dataset:
clonidine versus midazolam for premedication

Conditions: Anxiety; Pain

Summary: alpha2-agonists like clonidine offer several useful effects that make these drugs an interesting alternative to benzodiazepines for pharmacological premedication. we therefore sought to determine the effect of pre-anesthetic medication with clonidine vs. midazolam in a randomized, double-blind, placebo controlled study. effects of pre-anesthetic medication were assessed on (1) bispectral index (bis),(2) sedation score and visual analog scales for anxiety and pain, (3) neuropsychologic tests to assess cognitive function and (4) circulating stress hormones.


Eligibility criteria:
inclusion criteria: * elective surgery * asa physical status i and ii * informed consent * weight 50 - 100 kg exclusion criteria: * cardiovascular disease * pregnancy * problems of consent due to mentally handicap or language.

Keywords: bispectral index sedation stress hormones cognitive function
tracheobronchial bioengineering using aortic matrices for airway reconstruction

Conditions: Tracheal Disease

Summary: a technic of tracheal, carinal or bronchial transplantation using a stented cryopreserved aortic has been implemented by pr e. martinod in his thoracic surgery dept. the purpose of this study is to analyze the records of all the patients who have benefited from this treatment.

in the context of end-stage tracheobronchial disease (in particular tracheal or carinal indication) this technic propose a therapeutic alternative, in the context of bronchial replacement it allows to avoid pneumonectomy. the advantages are to reduce mortality at 90 days, functional consequences and long-term complications. in this observationnel study, data were collected prospectively in the medical records of all patients who have undergone a trachea or artificial bronchus transplant.

Eligibility criteria:
inclusion criteria:eligible patients were treated by human cryopreserved (-80°c) aortic allograft after undergoing a standard preoperative evaluation and cardiopulmonary tests. a multidisciplinary team approve d the treatment based on the following criteria: patients (1) had proximal lung tumors requiring a surgical resection (pneumonectomy, carinal resection, or sleeve lobectomy) that may or may not have been treated with neoadjuvant chemotherapy and had adequate or compromised preoperative lung function tests; or (2) had significant major malignant or benign lesions of the trachea and bronchi untreated with conventional therapeutic approaches, and (3) have signed an informed consent form for this specific surgical intervention. exclusion criteria:patients were not treated by human cryopreserved (-80°c) aortic allograft if they : (1) had a lung tumor requiring a standard lobectomy; (2) had nonresectable major locally invasive tumors; (3) had contralateral lymph node invasion; (4) had metastatic disease with the exception of a unique resectable brain metastasis; (5) had tracheal lesions requiring standard resection with direct anastomosis; (6) had an iodine allergy; or (7) received a preoperative evaluation indicating an inability to undergo a standard lobectomy.

Keywords: artificial trachea tracheal reconstruction bronchial reconstruction
effect of different grafting material following surgically facilitated orthodontics therapy

Conditions: Malocclusion, Angle Class I

Summary: the purpose of this study is to quantitatively investigate the radiographic changes of alveolar bone, and gingival tissue changes of the mandibular anterior teeth in experimental group a receiving sfot using freeze-dried allograft with a collagen membrane, experimental group b receiving sfot using particulate xenograft covered by a collagen membrane and control group receiving only orthodontics therapy.


Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) i/ii * periodontal diagnosis of clinical gingival health or gingivitis on intact/reduced periodontium per 2017 american academy of periodontology (aap) classification * no history of periodontitis. * class i malocclusion * crowding of 4 mm or less on mandibular anterior incisors * incisor mandibular plane angle between 90-100 degrees * no extractions indicated as part of the orthodontic treatment plan * keratinized tissue of at least 3mm exclusion criteria: * patients who are current smokers * pregnancy * uncontrolled diabetes or other metabolic systemic conditions * presence of open bite or deep bite * spacing * excessive retroclined mandibular incisors * any contraindication to treatment or the material used if in the experimental groups

Keywords: orthodontic treatment
fmri of flight of ideas in bipolar disorder

Conditions: Bipolar Disorder

Summary: bipolar disorder is a mental disease characterized by mood dysregulation and arises from manic, depressive or mixed episodes. the observations of the patient's speech and language behaviour due to flight of ideas or loss of goal probably result from an underlying disturbance in semantic networks dealing with semantic associations. the aim of our study will be to have a better comprehension of thought disorders in bipolar disorder by cognitive exploration of semantic processing.

bipolar disorder is a mental disease characterized by mood dysregulation and arises from manic, depressive or mixed episodes. during these episodes, formal thought disorders are observed, associated to emotional perturbation, behaviour troubles and some psychotic symptoms. during mania, the type of thought disorders observed are derailment, flight of ideas, with an increase in the amount of spontaneous speech and loss of goal. these observations of the patient's speech and language behaviour probably result from an underlying disturbance in semantic networks dealing with semantic associations. these networks have been studied extensively in schizophrenia but remain unknown in bipolar disorder. in this context, the aim of our study will be to have a better comprehension of formal thought disorders in bipolar disorder by cognitive exploration of semantic activation and inhibition.

Eligibility criteria:
inclusion criteria bd patients : * men or women, right-handed * diagnosis of type 1 bipolar disorder, according to the dsm-iv criteria * aged from 18 to 65 years-old * native french speaker * affiliated to the social security healthy controls (hc): * men or women, right-handed * aged from 18 to 65 years-old * native french speaker * affiliated to the social security exclusion criteria bd patients : * recent alcohol and/or drug abuse or dependence * significant general medical illness, including neurological disorders or head trauma * sensorial impairment (visual and/or hearing) * contraindication to the use of mri hc: * first-degree-relative history of bipolar disorder, schizophrenia or schizoaffective disorder according to dsm-iv * recent alcohol and/or drug abuse or dependence * significant general medical illness, including neurological disorders or head trauma * sensorial impairment (visual and/or hearing) * contraindication to the use of mri
edof and multifocal iol study

Conditions: Age-related Cataract

Summary: the investigational devices are approved intraocular lenses (iols) intended to be implanted after phacoemulsification in individuals suffering from age-related cataract with the need of cataract surgery. cataract surgery with precedent bilateral randomized iol implantation will be performed in subjects who have signed an informed consent form. postoperative examinations will be implemented in accordance with the approved investigational plan.


Eligibility criteria:
inclusion criteria: * bilateral age-related cataract for which phacoemulsification extraction and posterior iol implantation has planned * age 50-90 * visual potential in both eyes of 20/30 or better as determined by investigators estimation * normal findings in medical history and physical examination unless the investigator considers an abnormality to be clinically irrelevant exclusion criteria: * preceding ocular surgery or trauma * relevant other ophthalmic diseases (such as retinal degenerations, etc.) * uncontrolled systemic or ocular disease
promoting atrial fibrillation screening in primary care

Conditions: Atrial Fibrillation New Onset

Summary: atrial fibrillation is the most common sustained cardiac arrhythmia in adults. due to the asymptomatic and paroxysmal nature (randomly and shortly occurring of atrial fibrillation, and can therefore remain unnoticed) of atrial fibrillation. atrial fibrillation increases the risk of stroke five fold if left untreated. screening in old populations above age 65 years is helpful to find more atrial fibrillation cases. however, screening for atrial fibrillation is not well implemented in china. thus, this project aims to promote atrial fibrillation screening in primary care centers in china. we will develop an intervention program (search-af) and examine the effects (including the clinical effects and implementation effects) of program.

six health care centers in guangzhou china will be included. we will adopt a stepped-wedge randomized trial design. two health care centers will be randomly selected to receive the search-af program at each step (a total of three steps). the search-af program will include opportunistic screening among those who aged 65 or above and screening promoting strategies. the a total of 4800 old adults will be screened for atrial fibrillation using a handheld single-lead ecg tool upon their visit to family doctor, with 800 for each health care center. the promoting strategy will be developed based on the consolidated framework for implementation research and include leadership engagement, policy support, providing screening resources, staff training on atrial fibrillation screening and management. the whole study will last for 18 months. we will examine the intervention effects including clinical effects (atrial fibrillation detection rate, anticoagulation rate, atrial fibrillation related hospital visits, and stroke related end points) and implementation effects (cost-effectiveness of the intervention, compliance to atrial fibrillation screening ).

Eligibility criteria:
inclusion criteria: * aged 65 years or above * living in community exclusion criteria: * with a previous confirmed diagnosis of atrial fibrillation * with implanted icd or pacemaker * unable to provide consent * involving in other atrial fibrillation screening program

Keywords: atrial fibrillation disease screening
optimizing vim targeting for radiosurgery in severe tremor

Conditions: Tremor; Laser Therapy

Summary: essential tremor is a common neurological disease, the most severe form of which combines postural and intention tremor, with significant physical, psychological and social repercussions. it is in these most severe forms that surgical lesioning of the ventro-intermediate nucleus of the thalamus (vim) has been proposed. the vim and its region of interest are almost impossible to identify directly on imaging (especially mri), as it is part of the thalamus, which has the same intensity. to identify it, teams use average coordinates from stereotactic atlases (imprecise due to the high inter-individual variability of brain anatomy) or retrospective series of implanted patients. the hypothesis of the present trial is that the vim-rs-lat-1.0 algorithm developed by rebrain for radiosurgery will enable targeting that is at least as effective as conventional targeting. this is a single-center, controlled study, the primary endpoint of which will be assessed at one year, in a blinded, phase 3, comparative, non-inferiority, randomized study in two parallel groups of patients with severe tremor undergoing radiosurgery. in the control group, vim will be targeted conventionally, and in the experimental group, vim will be targeted by the rebrain algorithm (vim-rs-lat-1.0 model) of radiosurgery.


Eligibility criteria:
inclusion criteria: * advanced, disabling, drug-resistant essential tremor * patient selected as part of the multidisciplinary concertation meeting on abnormal movements * patient aged 18 to 85 * brain mri showing no anatomical abnormality contraindicating radiosurgical procedure * mattis ≥ 130 * subject affiliated to or benefiting from a social security scheme * free, informed and written consent signed by the participant and the investigator (no later than the day of inclusion and before any examination required by the research). exclusion criteria: * patients with a contraindication to brain mri (pacemaker, intracerebral metal object, etc.) * pregnant or breast-feeding women
a biotype enhancing strategy for the patient undergoing accelerated orthodontics

Conditions: Class I Malocclusion; Other Periodontal Diseases; Thin Gingival Biotype

Summary: numerous treatment protocols geared towards accelerating orthodontic treatment have emerged in the past few years as an appealing alternative for patients and practitioners. in the context of a thin biotype, these approaches pose a burden that could precipitate periodontal detrimental changes. therefore, case selection and the implementation of periodontal biotype enhancing strategies become a relevant consideration to ensure long-term successful treatment outcomes. this study focuses on the biological and clinical value of the use of a porcine naturally cross-linked collagen matrix known as mucograft®. within the scope of surgically accelerated orthodontic treatment (saot) the structural and material features of mucograft® provide: 1) a protective effect to the thin biotype upon rapid orthodontic protusive/proinclination movements and 2) mucograft® enhances the therapeutic window effect that supports an increase on tooth movement rate. the designs of this randomized controlled clinical trial includes a cohort of 40 subjects distributed on the following groups i) ortho tx, ii) ortho tx + decortication, iii) ortho tx + decortication + mucograft®, and iv) ortho tx + mucograft®. comparing clinical, tomographic and digital impression derived measurements will capture the clinical phenotype; while the biologic phenotype will be derived from evaluating crevicular fluid levels of tooth movement mediators such as interleukin 1-β and interleukin-1ra. the significance and innovative value of this proposal stems from the use of mucograft® as an ideal collagen-based biotype enhancer when performed along with the corticotomy. this approach could prove to be effective to further increase the therapeutic window that allows accelerating orthodontic treatment and, at the same time, could decrease the recession risk in movements of proclination of antero-inferior incisors. besides, the use of a collagen scaffold alone could potentially trigger a comparable orthodontic acceleratory outcome that could be evaluated as an alternative to decortication.


Eligibility criteria:
inclusion criteria: * angle's class i malocclusion * little's grade ii or iii dental crowding * periodontally stable patients * patients with no more than 2 mm of keratinized gingiva in at least two sites of the antero-inferior region exclusion criteria: patient with presence of marginal tissue recessions on inferior incisors * patients with a metabolic or neoplastic alteration * history of orthopedic surgery in the last 6 months * history of fractures in the last 6 months * history of bisphosphonates use * patient with systemic compromise

Keywords: orthodontics periodontics piezosurgery accelerated orthodontics surgically accelerated orthodontic treatment
premature enhanced automated capture of comfort knowledge

Conditions: Acute Pain; Pain, Procedural; Agitation; Discomfort

Summary: the goal of this observational study is to develop methods that could provide continual monitoring of comfort levels for preterm neonates in hospitals.

as preterm neonates have not developed ways to communicate how they are feeling like children or adults do, clinicians must rely on their own understanding and professional judgements to decide how comfortable they are. it is known that preterm neonates can display emotion through ways such as facial expressions, body movements and changes in their physiology such as heart rate. the investigators will record both behavioural (audiovisual) and physiologic (heart rate, blood oxygen saturation) signals during routine clinical procedures ranging from comforting, through discomforting to painful that are necessary as part of high-quality medical care.

Eligibility criteria:
inclusion criteria: * preterm infants born \<36 completed weeks of gestation * medically stable * written informed consent from parents exclusion criteria: * infants with significant brain, spine, or congenital abnormality * parents unwilling to provide consent * infants with postmenstrual age \>36 weeks
maptrek to increase activity among patients at risk for type 2 diabetes

Conditions: Pre Diabetes; Obesity

Summary: the overarching objective of our work is to provide an inexpensive and scalable m-health tool to increase both volume and intensity of physical activity and reduce sedentary behavior in patients at risk for type 2 diabetes. the objective of this study is to pilot test maptrek, a text-messaging based intervention.

this study will randomize participants to 2 groups, an intervention group that will receive a fitbit and maptrek, and a control group that will receive a fitbit only. this study has 3 specific aims. aim 1- to determine if patients randomized to maptrek walk more than the control patients. aim 2- to determine if patients randomized to maptrek generally walk at a faster pace during the day than control patients. aim 3- to determine if patients randomized to maptrek have less sedentary time during the day than the control patients. we expect to collect sufficient data to demonstrate the effectiveness of maptrek, our prototype m-health tool, as an intervention to increase physical activity, heighten intensity of activity, and reduce sedentary behavior among a cohort of patients at risk for type 2 diabetes.

Eligibility criteria:
inclusion criteria: * at least 21 years old * english speaker * have a smart phone with texting and internet capabilities * no aversion to research studies * no active mental health conditions * 1) have a bmi \> or equal to 25 and a history of hemoglobin a1c level between 5.7 and 6.4%, or 2) have a bmi \> or equal to 30. exclusion criteria: * pregnancy * prisoner status * taking insulin or other diabetic medications
tegaderm vs. eyegard for eye protection

Conditions: Erythema

Summary: this study compares tegadermtm and eyegard® in general anesthesia.

protective eye tape is used during anesthesia in order to prevent corneal abrasion and other eye injuries. however, there is no single accepted practice of how to protect the eyes during anesthesia, and a variety of different tapes and techniques have been adopted in different institutions. in this study, investigators will compare two tapes, tegadermtm and eyegard® to determine if one is less likely to cause eyelid irritation in an effort to improve care for future patients.

Eligibility criteria:
inclusion criteria: * age ≥ 18 * surgeries scheduled for anesthesia of any duration exclusion criteria: * any patient that does not consent * any patient who has: * pre-existing eyelid erythema or other eyelid trauma * eyelid piercings * any surgery on the head, brain, neck, teeth, mouth, eyes or face * surgery in the prone position * patients \<18 years old
effects of occlusal imbalance and clenching on balance in stroke patients

Conditions: Stroke

Summary: the aim of the study is to investigate the effects of stimulated occlusal imbalance and jaw clenching on balance and fall risk in patients with stroke.

this randomized controlled study will be conducted on a minimum of 42 stroke patients who meet the inclusion and exclusion criteria. patients included in the study will be randomly assigned to one of three groups: the ipsilateral side stimulated occlusal imbalance group, the contralateral side stimulated occlusal imbalance group, or the bilateral jaw clenching group.

Eligibility criteria:
inclusion criteria: * two months or longer elapsed since the stroke, * a mini-mental state examination score of 24 or higher, * being between 45 and 75 years of age, * having a brunnstrom stage of 4 or above, * ability to stand independently for 20 seconds or more, * ability to walk independently for 10 meters, using assistive devices or orthoses if necessary. exclusion criteria: * the presence of severe osteoarthritis in the lower extremity, * the presence of cancer or diabetic neuropathy, * the presence of vestibular disorder, * the presence of lower extremity ulceration or amputation, * hemodynamic instability, * the presence of other neurological disorders (such as multiple sclerosis, parkinson's disease), * having experienced an acute lower extremity injury in the last six weeks, * history of lower extremity surgery, * alcohol consumption in the last 24 hours * posterior circulation stroke involving the basilar artery or cerebellum

Keywords: balance
a pragmatic clinical trial comparing the risk of acute kidney injury during treatment with vancomycin and piperacillin-tazobactam vs. vancomycin and cefepime in hospitalized patients

Conditions: Acute Kidney Injury

Summary: hospitalized patients with suspected or confirmed infection are commonly treated with vancomycin (vn) in combination with either piperacillin-tazobactam (pt) or cefepime (cp). although these regimens have similar effectiveness, recent observational evidence suggests they may differ in terms of the risk for acute kidney injury (aki). interpretation of existing evidence is complicated by the limitations of creatinine, the standard biomarker used to monitor kidney function, which has poor sensitivity and specificity for drug induced aki. to address this important knowledge gap, the investigators propose to conduct a pragmatic, open-label, non-inferiority trial that will examine the comparative risk of aki between these standard-of-care antibiotic combinations using sensitive and specific markers of drug-induced aki. we hypothesize that the regimen of vn in combination with pt (vn+pt) is noninferior to the regimen of vn in combination with cp (vn+cp) in terms of aki risk.


Eligibility criteria:
inclusion criteria: 1. age of at least 18 years 2. suspected or confirmed infection based on clinical criteria, for which vancomycin with piperacillin-tazobactam or vancomycin with cefepime was prescribed by the treating clinician, as evidenced by orders being placed in the electronic health record 3. the treating clinician considers both vancomycin with piperacillin- tazobactam or vancomycin with cefepime as acceptable treatment 4. the treating clinician anticipates at least 48 hours of antibiotic treatment exclusion criteria: 1. dialysis dependence or documented end stage kidney disease 2. aki at baseline 3. expected survival \<24 hours and/or presence of do not resuscitate orders 4. history of antibiotic-resistant organisms (microbiological culture results showing bacterial isolates with resistant or intermediate susceptibility to any study drug within the prior 90 days) 5. documented allergy to vancomycin, cephalosporins, or penicillin 6. suspected central nervous system infection 7. inability to provide informed consent or lack of proxy for consent 8. prisoners/incarcerated individuals 9. known pregnancy or breastfeeding 10. previous enrollment in this study 11. receipt of vancomycin, piperacillin-tazobactam, or cefepime for \>24 hours within the preceding 7 days. at the time of screening, one-time doses of vancomycin, with or without piperacillin-tazobactam, or cefepime, will be allowed prior to randomization to avoid treatment delays; such patients must be enrolled within twelve hours of antibiotic administration.

Keywords: vancomycin piperacillin-tazobactam cefepime acute kidney injury nephrotoxicity cystatin c kidney injury molecule 1 (kim1)