Kornimate/medical-research-clean huggingface dataset:
ed physical therapy for acute low back pain

Conditions: Low Back Pain

Summary: emergency department (ed)-initiated physical therapy is a rapidly growing resource and represents a promising treatment approach to low back pain. this clinical trial will evaluate an innovative model of an emergency department "embedded" physical therapist to treat patients with acute low back pain, with a focus on improving patient functioning and reducing opioid use.

low back pain represents a significant health care burden in the united states and accounts for nearly four million emergency department (ed) visits per year. in nearly two thirds of these visits, an opioid medication is administered or prescribed, making low back pain the most common reason for which opioids are prescribed. despite this aggressive medication-based approach, patient outcomes after an ed visit for back pain remain poor: after three months, nearly half of all patients report persistent functional impairment, and one in five patients report continued opioid use. ed-initiated physical therapy (ed-pt) is a promising new resource to improve patient care for low back pain. a growing number of eds now have dedicated physical therapists that evaluate and treat patients through a combination of education, prognostic guidance, and early mobilization and exercise. preliminary data indicate that patients receiving ed-pt, compared to usual care, report more rapid functional improvement and use fewer opioids. however, these observational data are limited by biases in treatment selection due to physician discretion in which patients receive ed-pt, as well as other measured and unmeasured confounders. to more rigorously evaluate the efficacy of ed-pt for acute low back pain, the investigators will conduct a single-center physician-randomized trial of an embedded physical therapy intervention (need-pt) versus usual care in ed patients with acute low back pain, comparing a primary outcome of pain-related functioning and a secondary outcome of opioid use at the primary endpoint of three months.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * low back pain (originating between 12th rib and buttocks) * symptom duration ≤ 30 days (current episode) * evaluated by a physician randomized to either study arm * evaluated when ed physical therapy is available (e.g., mon-fri, 8am-4pm) * likely to be discharged home (based on physician assessment) * ability to complete follow-up data collection electronically or by telephone * english-speaking exclusion criteria: * chronic low back pain or prior lumbar surgery * serious red-flag signs/symptoms (bladder/bowel incontinence, saddle anesthesia, debilitating motor weakness) * obvious non-musculoskeletal etiology for low back pain (e.g., shingles, kidney stone) * other concomitant injuries or pain (e.g., closed head injury, shoulder pain) * unable to ambulate at baseline * known pregnancy, under police custody, unable to consent

Keywords: low back pain physical therapy emergency department functioning disability opioid
the effect of immediate versus delayed debriefing on basic life support competence in undergraduate nursing students.

Conditions: BLS Competence; Debriefing

Summary: the goal of this clinical trial is to find out if immediate (hot) or delayed (cold) debriefing is better for undergraduate nursing students during basic life support (bls) training. the study aims to: * identify the effect of hot versus cold debriefing in bls training for nursing students. * identify which debriefing method students prefer. researchers will compare the two debriefing methods. participants will: * be randomly assigned (by flipping a coin) to either hot or cold debriefing. * take part in a simulation about basic life support.

this rct aimed to identify the efficacy of cold versus hot debriefing in bls training for undergraduate nursing students\&#39; bls competence and to assess the impact of hot and cold debriefing nursing students\&#39; debriefing experience. specific aims/hypothesis specific aim 1: identify the efficacy of cold versus hot debriefing in bls training for undergraduate nursing students\&#39; bls competence. hypothesis 1a: in both cold and hot debriefing groups, there is a significant difference in the bls competence of undergraduate nursing students between pre-intervention and post-intervention. hypothesis 1b: undergraduate nursing students who receive cold debriefing will show greater bls competence than those who receive hot debriefing. our approach to testing the aim is to conduct an experimental design study. specific aim 2: assess the impact of hot and cold debriefing on undergraduate nursing students\&#39; debriefing experience. hypothesis 2: undergraduate nursing students who receive cold debriefing will show greater debriefing experience scores than those who receive hot debriefing.

Eligibility criteria:
inclusion criteria: * junior or senior nursing students (i.e., in their third or fourth year of the bsn degree). exclusion criteria: * nursing students who are not junior or senior.

Keywords: debriefing simulation basic life support undergraduate nursing students
effect of a topical ketamine on acute and chronic pain, dose finding

Conditions: Breast Cancer

Summary: the aim of this study is to investigate the effect of addition of different doses of ketamine locally in acute and chronic post-mastectomy pain after breast cancer surgery and on the probability of developing chronic post-mastectomy pain.


Eligibility criteria:
inclusion criteria: - american society of heart association class i-ii female patients * aged 18-60 years * scheduled for modified radical mastectomy with axillary dissection for breast carcinoma exclusion criteria: * known allergy to the study drugs * significant cardiac- * respiratory- * renal or hepatic disease
a study of ker-050 to treat anemia due to very low, low, or intermediate risk myelodysplastic syndromes

Conditions: Myelodysplastic Syndromes; Cytopenia

Summary: the purpose of this study is to evaluate the effects of ker-050 on anemia in patients with very low, low or intermediate risk mds.

ker-050 is a therapeutic protein designed to increase red blood cell and platelet production by inhibiting the signaling of a subset of the transforming growth factor beta (tgf-ß) family of proteins to promote hematopoiesis. it is being developed for the treatment of low blood cell counts, or cytopenias including anemia and thrombocytopenia in patients with myelodysplastic syndrome (mds) and myelofibrosis (mf).

Eligibility criteria:
key inclusion criteria: 1. diagnosis of mds according to world health organization (who)/french american british (fab) classification that meets revised international prognostic scoring system (ipss-r) classification of very low, low, or intermediate risk disease. 2. \< 5% blasts in bone marrow. 3. peripheral blood white blood cell count \<13,000/µl. 4. anemia defined as: 1. in non-transfused participants, having received no red blood cell (rbc) transfusions within 8 weeks hgb concentration ≤ 10.0 g/dl or 2. in ltb participants, having received 1 to 3 units rbcs for hgb ≤ 9.0 g/dl within 8 weeks or 3. in htb participants, having received ≥ 4 units of rbcs for hgb ≤ 9.0 g/dl within 8 weeks 5. eastern cooperative oncology group (ecog) performance status of 0, 1, or 2 (if related to anemia. 6. females of child-bearing potential and sexually active males must agree to use effective methods of contraception. key exclusion criteria: 1. any active infection requiring parenteral antibiotic therapy within 28 days prior to cycle 1 day 1 or oral antibiotics within 14 days of cycle 1 day 1. 2. diagnosis of secondary mds (i.e., mds known to have arisen as the result of chemical injury or treatment with chemotherapy and/or radiation for other diseases). 3. vitamin b12 deficiency. 4. prior treatment with azacitidine, decitabine, lenalidomide, luspatercept, or sotatercept. 5. treatment within 28 days prior to cycle 1 day 1 with: 1. erythropoiesis stimulating agent (esa) or 2. granulocyte colony-stimulating factor (g-csf) or 3. granulocyte-macrophage colony-stimulating factor (gm-csf) 6. iron chelation therapy if initiated within 8 weeks prior to cycle 1 day 1. 7. vitamin b12 therapy within 8 weeks prior to cycle 1 day 1. 8. treatment with another investigational drug or device or approved therapy for investigational use \< or = 28 days prior to cycle 1 day 1, or if the half-life of the previous product is known, within 5 times the half-life prior to cycle 1 day 1, whichever is longer. 9. platelet count \> 450 x 10\*9/l or \< 30 x 10\*9/l. 10. transferrin saturation \< 15%. 11. ferritin \< 50 µg/l. 12. folate \< 4.5 nmol/l (\< 2.0 ng/ml). 13. vitamin b12 \< 148 pmol/l (\< 200 pg/ml). 14. estimated glomerular filtration rate (gfr) \< 40 ml/min/1.73 m2 (as determined by the chronic kidney disease epidemiology collaboration \[ckd-epi\]. 15. pregnant or lactating females

Keywords: transfusion
quadruple therapy for triple therapy resistant helicobacter pylori infection

Conditions: Treatment of Helicobacter Pylori

Summary: triple therapy, a combination of proton pump inhibitor with two antibiotics, is the gold standard for anti-helicobacter pylori treatment. usual antibiotics are clarithromycin, and either amoxicillin or one of the nitroimidazoles (metronidazole). however, there is an increasing evidence of h. pylori resistance to classical triple therapy. another reason for this failure being low patient compliance with treatment. a regimen useful in one geographical area may not be effective or practical in another area. the aim of this study was to eradicate h. pylori infection resistant to triple therapy, establish the efficacy and safety of a 14-day therapeutic regimen to eradicate of h. pylori in patients who have failed with the classical triple therapy (omeprazole, clarithromycin and amoxicillin) given for 14 days.


Eligibility criteria:
inclusion criteria: * informed consent given by the patient * patients known to have h. pylori infection diagnosed by histopathology, rapid urease test and urea breath test * failure to respond to classical triple regime of amoxicillin 1gram, clarithromycin 500mg and omeprazole 20mg twice a day for 10-14 days as documented by repeat urea breath test done one month after eradication therapy exclusion criteria: * evidence of any malignancy, gastric outlet syndrome, history of gastric surgery, chronic liver disease, severe chronic renal failure, or any major co-morbidity. * known or suspected hypersensitivity to the medication used in the study

Keywords: h.pylori triple therapy failure quadruple therapy
efficacy of esomeprazole for non-allergic rhinitis: a double-blind, placebo controlled trial

Conditions: Vasomotor Rhinitis

Summary: the purpose of this study was to see if high dose esomeprazole (40mg bid) was effective in treating non-allergic rhinitis


Eligibility criteria:
inclusion criteria: * age between 18-80, symptoms of perennial rhinitis, negative epicutaneous skin testing to a panel of common aeroallergens, and ability to speak english exclusion criteria: * pregnancy or breast-feeding, evidence of positive skin tests to a common aeroallergen, treatment with a proton pump inhibitor within the month prior to enrollment, treatment with any other anti-reflux therapy within the last month on a daily basis or within the last two weeks on an as needed basis, and other gastrointestinal disorders leading to reflux symptoms

Keywords: non-allergic rhinitis, laryngopharyngeal reflux
a multilevel intervention to improve timely cancer detection and treatment initiation

Conditions: Neoplasms; Hiv; Cervical Cancer; Breast Cancer; HNSCC; Vulvar Cancer; Anal Cancer; Cancer Suspect

Summary: this study evaluates whether the potlako+ intervention of community education, clinical provider support, and patient navigation can improve access to cancer case for patients presenting with symptoms of cancer. half of communities will receive the potlako+ intervention, while the other communities will continue to receive standard programs.

the potlako+ trial is a pair-matched, community-randomized study involving 20 rural and peri-urban communities in botswana (population \~190,100 with \~100,000 30 years or older). communities will be randomized 1:1 to the potlako+ intervention versus standard care. the goal of the intervention is to identify individuals with symptoms/signs suggestive of cancer and expedite diagnosis (and treatment). the trial includes a community education component focused on cancer awareness and importance of early diagnosis and a patient navigation component that aims to expedite the diagnostic evaluation. community education will be directed at approximately 50,000 community residents (30 years and older). we anticipate approximately 1500 cancer suspects will be identified by their clinic providers.

Eligibility criteria:
1. community members 1. inclusion criteria: * botswana citizen * age 30 years or older * engaged in longitudinal care for chronic health problem * resident of study community 2. exclusion criteria: * involuntary incarceration * educational messaging could interfere with clinical management or increase distress in the opinion or clinic or research staff 2. cancer suspects 1. inclusion criteria: * botswana citizen * age 30 years or older * resident of study community * recorded as a cancer suspect by clinic staff 2. exclusion criteria * involuntary incarceration * unable or unwilling to provide confirmation of informed consent * already engaged in oncology care
implications of self-weighing during weight loss treatment

Conditions: Overweight and Obesity; Signs and Symptoms; Behavior, Eating

Summary: this study aims to analyze the effectiveness of introducing behavioral elements in a weight loss program, in this case, comparing the difference between self-weighing versus not doing so.


Eligibility criteria:
inclusion criteria: * having a imc \>25, * being sedentary and * have not been submitted to a restrictive diet in the 6 months preceding this study exclusion criteria: * suffered from type 2 diabetes or renal conditions * being pregnancy or attempt at pregnancy, * undergoing antidepressant pharmacological treatment

Keywords: obesity self-weighing weight loss mobile health
targeted high-definition transcranial direct current stimulation (hd-tdcs) for reducing post-stroke movement impairments

Conditions: Stroke

Summary: stroke is the leading cause of serious, long-term disability. the emergence of abnormal muscle synergies following a stroke presents a major limitation to the recovery of independent function. despite the development of many interventions for movement recovery post-stroke, rehabilitation treatments are minimally effective to the muscle synergy impairment. previous studies have found that muscle synergy impairment is associated with the damage to the corticospinal tract and the maladaptive recruitment of the contralesional cortico-reticulospinal tract. the investigators hypothesize that facilitating the damaged cortico-spinal tract (via primary motor cortex) and/or inhibiting the contralesional cortico-reticulospinal tract (via dorsal premotor cortex) will reduce muscle synergy impairment. in this pilot project, the investigators propose to run a proof-of-concept pilot trial to evaluate the effect of the targeted high-definition transcranial direct current stimulation (hd-tdcs) on mitigating muscle synergy impairment.

this randomized, double-blinded, sham-controlled cross-over study will include three stimulation conditions: 1) anodal stimulation over the ipsilesional primary motor cortex, 2) cathodal one over the contralesional premotor cortex, 3) sham stimulation in chronic hemiparetic stroke patients. stroke participants (\> 3 months after stroke) with moderate to severe motor impairments (fugl-meyer motor assessment - upper extremity score between 10-40, in absence of clinically defined sensory deficits) and an ischemic unilateral subcortical lesion will receive each type of stimulation for 20 minutes. their brain activity and behavior data will be collected for the outcome measures. the patient time commitment in this study is approximately 7 weeks where subjects have 3 x 1-day intervention and measurements, with 2 weeks washout period in between. the total number of potential enrolled subjects in this pilot study is 12.

Eligibility criteria:
inclusion criteria: * ischemic unilateral stroke lesion (confirmed by the most recent clinical or radiological reports) at least 3 months prior to participation in this project. * paresis confined to one side, with moderate to severe motor impairment of the upper limb (fugl-meyer upper extremity scores of 10-40) * capacity to provide informed consent exclusion criteria: * muscle tone abnormalities and motor or sensory impairment in the unimpaired limb * severe wasting or contracture or significant sensory deficits in the paretic upper limb * severe cognitive or affective dysfunction that prevents normal communication and understanding of consent or instruction * severe concurrent medical problems (e.g. cardiorespiratory impairment) * using a pacemaker * metal implants in the head * known adverse reaction to tms and tdcs * pregnant

Keywords: stroke upper limb impairment hd-tdcs
evaluation of the remineralizing effect of aloe vera versus diode laser for management of deep carious lesions.

Conditions: Deep Caries

Summary: the present study will be performed to evaluate: the remineralizing effect of aloe vera versus diode laser on deep carious dentin after selective caries removal.

this study was conducted on 45 teeth selected from patients according to inclusion and exclusion criteria. they were selected from the dental clinic in faculty of oral and dental medicine for girls, al-azhar university. the procedure was explained and written informed consent was obtained from each patient. the possible discomforts, risks, and benefits were fully explained to the patients. ethical committee approval was obtained. protocol of caries removal was applied subsequently, the central cariogenic biomasses and superficial part of the necrotic and demineralized dentin was excavated, leaving the leathery dentin layer. sample grouping: the patients were randomly assigned into three main groups according to the material used (15 for each) which were assessed at different time intervals (b1) after three months,(b2) after six months. a1: cavities will be sealed directly by temporary restorative material (conventional glass ionomer) without any treatment. a2: cavities will be treated by diode laser then sealed directly by temporary conventional glass ionomer. a3: cavities will be treated with aloe vera then sealed directly by temporary conventional glass ionomer. evaluation of the remineralization effect of each group will be assessed radiographically immediately at base line (b0), after three months (b1) and six months (b2) to evaluate the dentin remineralization.

Eligibility criteria:
inclusion criteria: * subject must have active deep carious lesion. * clinical and radiographic examinations of carious lesions. exclusion criteria: * teeth with pulpal involvement * teeth with abscess * teeth with pain or swelling * teeth with developmental disorders * teeth with adjacent soft tissue lesions * patients with systemic illness will be excluded
autogenous ramus bone block harvesting with piezosurgery

Conditions: Alveolar Bone Resorption

Summary: the aim of this randomized prospective clinical trial was to evaluate the outcome of bone block harvesting from the retromolar region using the conventional and piezosurgery method. the study was planned on 19 patients (13f,6m) on 31 donor sites. in patients with bilateral bone harvesting, the donor site and the surgical method to be used were determined by the randomization protocol, while in patients with bone harvesting from a single site, the donor site was determined by considering parameters such as proximity to the operation site and distance to the inferior alveolar nerve. clinical parameters such as operation time, pain, swelling, trismus, nerve damage were evaluated.


Eligibility criteria:
inclusion criteria: * asa i-ii * the main inclusion criteria were severe alveolar ridge atrophy in the horizontal plane (≤4 mm) and no accompanying vertical defect, according to preoperative cbct scans. exclusion criteria: * individuals who had systemic disease affecting bone or soft tissue metabolism * smokers (more than 10 cigarettes a day * alcohol dependent * systemic disease affecting bone or soft tissue metabolism * donor field in the mouth of another region (simfiz, tuber etc.) or any extra-oral field is planned to be used * patients with cleft lip-palate or defect exceeding the alveolar crest * grafts applied to defects caused by tumors, osteoradionecrosis, or congenital malformations * patients with an unstable systemic condition such as metabolic bone disease, uncontrolled diabetes, or untreated hypothyroidism, as well as smokers, patients undergoing radiation therapy or chemotherapy
home exercise for individuals with neurodegenerative disease

Conditions: Neurodegenerative Diseases; Leukodystrophy; Ataxia; LBSL; Leukoencephalopathy with Brain Stem and Spinal Cord Involvement and High Lactate Syndrome (Disorder); Leukoencephalopathy with Brainstem and Spinal Cord Involvement and Lactate Elevation; Cerebellar Ataxia; Adrenomyeloneuropathy

Summary: the primary goal of this study is to address the need for targeted therapeutic interventions for impairments that impact walking in related neurodegenerative diseases.

this study will inform clinicians in quantitatively assessing baseline disease severity, selectively applying the appropriate exercise to the disease pathology, and measuring efficacy of the exercise intervention. as part of this overall goal, the aims are to: a. determine feasibility of remotely supervised exercise programs. b. optimize remote outcome measures for clinical monitoring and towards future clinical trials. c. measure changes in balance and walking post intervention.

Eligibility criteria:
inclusion criteria: * the eligibility criteria for males is x-linked adrenoleukodystrophy as determined by biochemical determination or genetic testing. * the eligibility criteria for females is x-linked adrenoleukodystrophy as determined by biochemical determination, genetic testing, or pedigree analysis. * the leukoenceophalopathy with brainstem and spinal cord involvement and lactate elevation inclusion criterion is a confirmed dars2 mutation through genetic analysis. * for people with cerebellar ataxia, people with diagnoses of cerebellar damage from stroke, tumor or degeneration will be included. those with a genetically confirmed cerebellar disorder will be asked to provide their genetic testing to note their particular type of ataxia. * we will also include patients with other neurodegenerative diseases similar to these disorders as determined by chart review and clinical exam. healthy volunteers * able to stand for 30 seconds without upper extremity support * ambulatory (including use of a cane or a walker) * able to walk for 2 minutes exclusion criteria: * other medical or psychological conditions which in the clinical judgement of the investigator would interfere with acquiring the study information or performing the exercises safely including but not limited to: uncontrolled hypertension, orthopedic conditions, diabetes, seizure disorder, peripheral vestibular loss, severe aphasia, dementia, pregnancy