Kornimate/medical-research-clean huggingface dataset:
investigating women's views on the management of a breech pregnancy

Conditions: Presentation; Breech, Complicating Pregnancy

Summary: the investigators aim to perform a qualitative study to explore the views of women with a breech presentation on their management in general, and the use of anaesthesia or analgesia for ecv in particular.

background women undergo external cephalic version (ecv) in order to turn a baby in a breech (bottom, or feet down) presentation to a head down position. the procedure traditionally has about a 40% success rate and may be painful, issues that recent literature suggests puts some women off. pain relief using a short acting morphine-like painkiller, called remifentanil, can significantly reduce the pain experienced but does not seem to improve ecv success rates. alternatively, a spinal anaesthetic (similar to that used for a caesarean section) can be used. this increases success rates to around 60% and very effectively reduces pain; however, it is an invasive procedure with potential complications and requires a hospital stay of at least half a day. aims and objectives the investigators aim to perform a qualitative study to explore the views of women with a breech presentation on their management in general, and the use of anaesthesia or analgesia for ecv in particular. methods the investigators will use a semi-structured interview to explore the views of 10-15 expectant mothers recruited from the breech clinic at chelsea and westminster hospital. interviews will be recorded and then transcribed for thematic analysis by two researchers. dissemination of output to our knowledge, this will be the first report on how women view the use of regional anaesthesia and remifentanil analgesia for ecv. in addition, we will add the views of our patient population to the existing literature concerning the management of ecv in general. the investigators anticipate that this information will be used to plan services and to guide future research.

Eligibility criteria:
inclusion criteria: * breech presentation * eligible for an external cephalic version attempt exclusion criteria: * multiple pregnancy * previous caesarean section * english not sufficient to carry out the interview

Keywords: breech presentation external cephalic version anaesthesia qualitative pregnancy
ramelteon vs placebo for prevention of delirium and improvement of sleep in hospitalized older adults

Conditions: Delirium in Old Age

Summary: this study evaluates whether ramelteon can prevent delirium, decrease the severity of incident delirium and improve sleep wake cycle in hospitalized elderly surgical patients. half of the patients will be assigned to ramelteon, while other half will be assigned to placebo.

delirium is a common clinical syndrome characterized by acute cognitive dysfunction with core features of inattention, disorganized thinking, perceptual disturbances and sleep-wake cycle disruption. it is typically multifactorial and can be triggered by acute infection, metabolic derangements, surgery, and certain medications. older adults have a much higher incidence of delirium. delirium increases in-hospital mortality, length of stay, rate of institutionalization and may cause or exacerbate cognitive impairment. the present pilot study investigates sleep loss as potentially important contributing factors in delirium and an opportunity for intervention. sleep disruption is prevalent among hospitalized patients. sufficient sleep is important for recovery from illness, management of pain, wound healing, and a variety of other biologic functions integral to recovery in addition to its putative role in delirium prevention. melatonin plays an important role in circadian rhythms and sleep-wake cycle regulation. melatonin secretion is altered in hospitalized older patients in comparison with community-living older individuals. melatonin and the melatonin-receptor agonist ramelteon have been studied and have shown promise in delirium prevention, in addition to promoting sleep. we propose to test the use of ramelteon to decrease delirium and improve sleep/wake cycles in the elderly surgical patients.

Eligibility criteria:
inclusion criteria: * 65 years of age or older. * admitted to bwh vascular surgical service. * able to provide informed consent or a surrogate is available to provide informed consent. * absence of delirium at time of consent. exclusion criteria: * expected stay or life expectancy less than 48 hours * unable to take medications orally * advanced liver disease (child-pugh class b or worse) * active treatment with fluvoxamine * active treatment with antipsychotic medications, benzodiazepines or other hypnotic agents (i.e. trazodone, mirtazapine, zolpidem, zaleplon) * known or suspected diagnosis of lewy body dementia * any dermatological condition that may be aggravated by using a wrist sensor. * known pre-existing sleep disorder other than insomnia.

Keywords: delirium insomnia ramelteon
comparison between c3-6 laminoplasty and c3 laminectomy with cervical laminoplasty

Conditions: Myelopathy Cervical; Kyphosis Post Surgical; Neck Pain; Ossification of Posterior Longitudinal Ligament; Cervical Spondylosis With Myelopathy

Summary: investigators performed a prospective randomized controlled trial for comparing postoperative clinical and radiological outcomes between c3 laminectomy with laminoplasty and c3-6 laminoplasty.

cervical laminoplasty is widely performed surgical techniques to cervical myelopathy patients. but it is well known that c3-6 cervical laminoplasty often results in injury of the semispinalis cervicis inserted into the axis, which possibly causes postoperative cervical kyphosis and neck pain. c3 laminectomy with cervical laminoplasty is the modified technique preserving the semispinalis cervicis to reduce such complications of conventional c3-6 laminoplasty. there has been a number of retrospective studies comparing c3 laminectomy with laminoplasty and c3-6 laminoplasty, however, there's no prospective randomized controlled study yet. investigators performed a prospective randomized controlled trial for comparing postoperative clinical and radiological outcomes between c3 laminectomy with laminoplasty and c3-6 laminoplasty. primary end points include the c2-7 spine cobb anlge, neck disability index(ndi) at postoperative 1\~3 year

Eligibility criteria:
inclusion criteria: * cervical stenosis patients with or without cervical myelopathy. exclusion criteria: * metastatic cancer patients. * any combined fracture. * previous surgery to cervical spine. * inflammatory joint disease * psychiatric illness

Keywords: laminoplasty laminectomy
social factors in the mental health of young adults: bridging psychological and network analysis

Conditions: Anxiety; Depression; Loneliness; Stress

Summary: the central goal of this project is to produce a novel, precise, and comprehensive account of social factors in young adult mental health - using a novel combination of network nominations, ecological momentary assessment, and neuroimaging methods. to that end, the investigators will collect data from two successive classes of college undergraduates (i.e., classes of 2023 and 2024) over the course of their collegiate tenure.

the proposed work will consist of four key components. the investigators will collect data from the class of 2023 in each of their remaining years at college, producing (i) longitudinal data that will allow them to probe the long-term mental health effects of connections made during the transition to college, as well as mental health issues and resilience in the wake of the covid-19 pandemic as a function of social connectedness. the investigators will leverage this rich dataset to build (ii) prospective quantitative models to predict mental health outcomes later in college based on a range of social factors measured early in college. they will further collect (iii) a longitudinal replication cohort, the class of 2024, allowing to establish the robustness of their initial findings across samples. finally, the investigators will add (iv) a neuroimaging component to this dataset in a subset of the class of 2024. this will allow them to examine brain "markers" of connectedness, and add them to a prospective model, providing a novel integration across brain, behavior, and community levels of analysis, and a synthetic assessment of social factors in long-term mental health.

Eligibility criteria:
inclusion criteria: stanford undergraduate students in the classes of 2023 and 2024, as well as all students who reside in their dorms. - exclusion criteria: people under the age of 18 -
comparison for pethidine requirement in patients received spinal morphine 0.2 and 0.3 mg for post lobectomy analgesia

Conditions: Solitary Mass; Lung Diseases

Summary: the purpose of the study is to evaluate the amount of total pethidine requirement during the 48 hour postoperative period after receiving spinal morphine 0.2 and 0.3 mg.

thoracotomy causes severe pain to the patients. continuous thoracic epidural is a gold standard for postoperative pain. however, it needs skill. there are many alternatives such as spinal morphine, intercostal nerve block, cryoalangesia or interpleural block.

Eligibility criteria:
inclusion criteria: * age \> 18 year and \< 70 year * patient asa physical status i-iii. * scheduled for thoracotomy with lobectomy. * can operate a patient-controlled analgesia (pca) device. exclusion criteria: * known hypersensitivity to morphine or pethidine * history of bleeding tendency. * known case of infection at the back * patient refuse for spinal anesthesia * history of cerebrovascular disease. * scheduled for video-assisted thoracoscopic lobectomy. * need mechanical ventilatory support during postoperative period

Keywords: thoracotomy postoperative pain spinal morphine
acceptability of telehealth triage using robotic systems in covid-19

Conditions: COVID-19; Telemedicine; Robotics; Emergencies; Emerging Infectious Disease

Summary: the overall objective of this investigation is to understand the patient response to a robotic platform used to facilitate telehealth triage in the emergency department during the covid-19 pandemic. the covid-19 pandemic has altered the manner in which emergency department triage is completed. attempts at cohorting individuals with potential covid-19 disease in order to prevent disease transmission to healthcare workers and minimize the use of personal protective equipment (ppe) have renewed interest in telemedical solutions as a method to triage and manage individuals with covid-19. this investigation deploys a legged robotic platform to facilitate agile, highly mobile telemedicine to manage covid-19 patients in the emergency department. the primary objective is to measure the patient response to interacting with these systems.


Eligibility criteria:
inclusion criteria: * presenting to the emergency department for evaluation * \> 18 years old exclusion criteria: * brought to emergency department via ambulance * \<18 years old * non-english speaking * in extremis, or unable to participate due to underlying acute medical condition
efficacy of surgical preparations in lumbar spine surgery

Conditions: Infection

Summary: the purpose of this study is to 1) identify the common bacterial flora found on the skin overlying the lumbar spine, and 2) evaluate the efficacy of readily available skin-preparation solutions in the elimination of bacterial pathogens from the surgical site following skin preparation (duraprep versus chloraprep).


Eligibility criteria:
inclusion criteria: * all patients undergoing lumbar spine surgery (discectomy, laminectomy, fusion, etc). exclusion criteria: * open wound at the incision site, * abrasion in the vicinity of the incision site, * an active infection at or near the surgical site, or * an active infection elsewhere in the body.

Keywords: duraprep chloraprep lumbar spine
alt-ramec expansion and protraction by edo in cleft lip and palate patient

Conditions: Cleft Lip and Palate

Summary: evaluate the treatment outcome of alternate rapid maxillary expansion and constriction alt-ramec protocol on patients with cleft lip and palate, using a differential opening expander and face mask which will be measured and recorded by cone beam computed tomography (cbct).

cleft lip and palate are among the most common deformities in children.clefts patient are usually having orofacial problems as missing or unerupted permanent teeth, alveolar bone defect, speech difficulty . patients with cleft lip and palate (clp) commonly have maxillary arch constriction (maxillary hypoplasia) and class iii malocclusions due to deficient of maxillary growth the upper jaw of patients with cleft palate will be expanded by maxillary expander with differential opening (edo) with alternate rapid maxillary expansion and constriction (alt-ramec) , which is opened by opening the expansion device by 1 mm per day for a week, then closing the device at a rate of 1 mm per day in the second week and so on alternately for 7 consecutive weeks after the completion of the expansion, the facemask device will be used to protraction of maxilla the measurement and difference before and after treatment will be assessment by cone beam computed tomography (cbct). .

Eligibility criteria:
inclusion criteria: * patients of both sexes. * cleft lip and palate patients. * all patient age ranges from 8 to 12 years. * all the cases showed maxillary arch constriction and deficiently * all patients had maxillary permanent first molars. * primary lip adhesion and palatal closure. exclusion criteria: * patients had received any surgical assisted expansion or maxillary protraction or fixed orthodontics before. 2. maxillary dentition unsuitable to bond the expander (less than two dental unit bedside first permanent molar) . 3. absent maxillary permanent first molars. 4. uncooperative patients/parents

Keywords: alt-ramec expansion cleft lip and palate patient cone beam computed tomography (cbct) protraction facemask maxillary expander with differential opening (edo)
efficacy of zolmitriptan (zomig) in the treatment of migraines in adolescents

Conditions: Migraine

Summary: the purpose of this study is to evaluate the effectiveness and safety of zolmitriptan (zomig) nasal spray, 5.0 mg, compared with placebo (inactive drug) for 2 migraine headaches over a 3-month period in adolescent patients (aged 12 to 17 years) with migraine headaches


Eligibility criteria:
inclusion criteria: * adolescents aged 12-17 years at the time of screening. patients must not be enrolled if they will turn 18 years of age within 12 weeks after randomization. * an established diagnosis of migraine for at least 1 year; a minimum of 2 migraines, considered to be moderately/severely disabling, per month on average during the school year * a history of usual migraine duration of \>2-hours untreated for the 3 month prior to screening exclusion criteria: * a history of basilar, ophthalmoplegic or hemiplegic migraine headache or any potentially serious neurological condition that is associated with headache or clinically significant abnormalities indicated from the medical history, physical exam etc * has used monoamine oxidase inhibitor-a (mao-a), methysergide, methylergonovine or cimetidine in the 2 weeks before randomization. * evidence of ischemic heart disease, arrhythmia, accessory conduction pathway disorder as determined by central cardiologist using predetermined and agreed upon pediatric standards; has uncontrolled hypertension

Keywords: zolmitriptan zomig migraine headache response headache headache pain
a safety, tolerability and efficacy study of v158866 in central neuropathic pain following spinal cord injury

Conditions: Neuropathic Pain Due to Spinal Cord Injury

Summary: the purpose of this study is to investigate whether v158866 is safe and effective for the treatment of neuropathic pain due to spinal cord injury.


Eligibility criteria:
inclusion criteria: * aged 18 - 65 years * documented spinal cord injury at or below t5 * moderate pain at or below the level of the spinal cord injury for at least 3 months * compliant with daily diary * stable pain scores on the nrs * mean pain intensity of at least 4 and not more than 9 on the nrs (or if the mean nrs score is \>9, the mean gracely score must be ≤19) exclusion criteria: * women of child-bearing potential * men who intend to father a child * a history of multiple drug allergies, hypersensitivity to any cannabinoid * an increased risk of seizure * evidence of depression and/or a score of \>19 on the bdi-ii * suicidal ideation or suicidal behavior in the past 10 years * a history of substance abuse or dependence within the past year, excluding nicotine and caffeine * a positive urine test for cannabis at screening * taking excluded medications that cannot be stopped * a positive pregnancy test

Keywords: neuropathic pain spinal cord injury
dried plums for bone health in older postmenopausal women

Conditions: Bone Diseases, Metabolic

Summary: the objective of the investigators current study was to examine whether 50 g dried plum would be as effective as 100 g dried plum in reversing bone loss in osteopenic older postmenopausal women.

forty-five randomly assigned into one of three treatment groups: 1) 50g dried plum; 2) 100g dried plum; and 3) control (0g dried plum). all groups received 500mg calcium and 400 iu vitamin d as a daily supplement. blood samples were collected at baseline, 3 and 6 months to assess biomarkers of bone turnover. physical activity recall and 3-day food records were obtained at baseline, 3 and 6 months to examine physical activity and dietary confounders as potential covariates

Eligibility criteria:
inclusion criteria: * bmd t-score of l1-l4 between -1 to -2.5 standard deviation of the mean * age 65 to 79 exclusion criteria: * bmd t-score at any site fell below 2.5 standard deviation of the mean * subjects treated with calcitonin, bisphosphonates, raloxifene and/or anabolic agents such as parathyroid hormone and growth hormone, or steroids within three months before the start of the study * metabolic bone disease, renal disease, cancer, cvd, diabetes mellitus, respiratory disease, gastrointestinal disease, liver disease or other chronic diseases, heavy smoking (more than twenty cigarettes/day) and current use of any prescription medications known to alter bone and calcium metabolism * regularly consumed dried plum or prune juice were not included in the study.

Keywords: osteoporosis dried plum functional food
curio digital therapy for the treatment of post-partum depression

Conditions: PostPartum Depression

Summary: primary objective: evaluate the clinical effectiveness of the mamalift plus app compared to control (digital sham plus treatment as usual) for the management of ppd in the observed population for a period of 9 calendar weeks. it is hypothesized that women who use the mamalift plus app will experience less severe symptoms of depression in post-partum period than comparable women who do not and receive their usual care from health providers.

women between 18 and 50 years of age who have had a live birth within 3 months prior to study start date and have a diagnosis of mild to moderate ppd. a total of 200 women will be recruited to volunteer in the study with 166 assigned to the intervention arm and 37 assigned to the control group.

Eligibility criteria:
inclusion criteria: * participants must be able to read, write and speak english; 3. participants must provide written informed consent prior to enrollment; 4. participants must be 18 to 50 years of age at the time of enrollment; 5. participants must have had a live childbirth \<=3 months prior to their enrollment into the study; 6. participants who have a score of greater than or equal to 13 but not exceeding 19 on the edinburgh postnatal depression scale (epds) during initial screening visit/call; 7. depression diagnosis needs to be confirmed by licensed behavioral health therapist or medical professional; 8. participants must answer "0/never" or "1/hardly ever" to the self-harm question on epds (question #10); 9. participants must be willing to use a mobile app and own an ios or android enabled mobile phone or device; 10. participants must have wireless internet connectivity in their home (or have access to internet connectivity) and be willing to connect devices via a wi-fi network exclusion criteria: -

Keywords: postpartum depression (ppd), symptoms of ppd, anxiety, peri-natal depression, mild-to-moderate depression
flextoba for people with multiple sclerosis

Conditions: Multiple Sclerosis

Summary: the purpose of this study is to test the effectiveness of a dvd-delivered, home-based six-month physical activity intervention for people with multiple sclerosis.

persons with ms are less likely to be active than their healthy counterparts, a statistic that is compounded by the symptom manifestations of ms. however, there is increasing evidence to support the importance of physical activity in ms. unfortunately, structured, safe, and efficacious physical activity programs that are often conducted in medical or university settings are often not accessible to many older adults with or without ms. we propose to conduct a randomized controlled pilot trial testing the efficacy of a dvd-delivered physical activity intervention which targets factors that have the potential to reduce disability in older adults with ms. this dvd-based intervention has been previously approved by the irb at the university of illinois for a similar study with low-active, community-dwelling older adults (irb protocol number: 09765). this novel intervention provides systematic, programmatic activities with alternative versions of each exercise that allow individuals of all capabilities to complete the program successfully. it focuses on improving flexibility, strength, and balance and has been demonstrated to be feasible, well-accepted, and efficacious in a large sample of older adults without ms. importantly, intervention resulted in clinically significant improvements in the short physical performance battery, reliable determinant of disability, institutionalization, morbidity, and mortality. if such an intervention was equally successful in older persons with ms, this could have considerable public health impact.

Eligibility criteria:
inclusion criteria: * being non-active, defined as reporting not engaging in regular activity (30 minutes accumulated per day) on more than two days of the week in the prior six months; * aged 50 years and older; * fluent in english; * relapse-free in the last 30 days; * ambulatory with minimal assistance(i.e., walk independently or with a single-point assistive walking device such as a cane); * the provision of medical clearance for participation in a physical activity program by participants' physicians, along with a physician-confirmed diagnosis of ms (communication with physicians will be facilitated by research staff). exclusion criteria: * self-reported physical activity on a regular basis within the last six months (2 times or more per week); * younger than 50 years of age; * relapse in the last 30 days; * no regular access to a television; * no physician-confirmed diagnosis of multiple sclerosis; * unable to successfully score above 21 (out of 39)on the telephone interview of cognitive status questionnaire (tics-m).

Keywords: multiple sclerosis quality of life functional fitness