Kornimate/medical-research-clean huggingface dataset:
better asthma outcomes: lowering tobacco smoke exposure

Conditions: Lung Diseases; Asthma

Summary: to improve disease outcomes through reduction in secondhand tobacco smoke exposure of children with asthma

background: secondhand tobacco smoke (shs) exposure increases asthma morbidity in children. efforts to reduce exposure have had mixed results. this study is a randomized controlled trial of an exposure reduction intervention, with objective feedback to parents on the child's exposure based on urine cotinine measurement, and counseling tailored to the child's specific exposure sources/locations and parental readiness to take specific actions to reduce exposure from each source/location. this trial involves 350 shs-exposed children with persistent asthma, 3-12 years of age, receiving care from the kaiser health care program in northern california. primary outcomes over the 18 months of follow-up will be asthma acute care utilization and urine cotinine/creatine ratio. changes in controller medication adherence will be evaluated using a pharmacy-based dispensing index. design narrative: primary objective: to evaluate the efficacy of a behaviorally-based, cotinine-feedback-and-monitoring program designed to reduce shs exposure in an 18-month randomized controlled trial (rct) with 350 children with persistent asthma, 3-12 years of age, in comparison with usual medical care. secondary objectives: 1) to investigate the behavioral mechanisms that mediate between the intervention and associated improvements in asthma outcomes, and 2) to determine the influence of initial caregiver stage of change with regard to smoking practices on response to the intervention. hypotheses: 1. disease outcomes: a behaviorally-based, individually-tailored intervention that emphasizes shs exposure reduction, provides sequential feedback to the parent on the child's urine cotinine level, and is tailored to the parent's stage of change with regard to smoking practices will be associated with decreased asthma crisis care utilization and improvements in secondary disease outcomes over an 18-month follow-up period when compared with usual medical care. 2. ets exposure: the shs reduction intervention will be associated with lower shs exposure at follow-up (assessed by urine cotinine/creatinine ratio), compared with usual medical care. 3. mechanism: decreases in urine cotinine/creatinine ratio will be instrumental in intervention-associated improvements in asthma crisis care utilization.

Eligibility criteria:
* age 3-12 years * kaiser member for \>= 1 year * \>= 1 asthma care visit in prior year * persistent asthma likely based on prior year: physician diagnosis code of persistent asthma or \>= 4 beta agonist (ba) dispensing events or \>= 4 anti-inflammatory (ai) dispensing events * secondhand smoke exposure by parent report. * parent agrees to participate in a clinical trial of a smoke exposure reduction interventio
fecal microbiota transplantation as the first-line treatment in active pediatric crohn's disease

Conditions: Crohn Disease

Summary: to explore the safety and effectiveness of repeated and multiple fecal microbiota transplantations (fmts) plus partial enteral nutrition (pen) as a first-line treatment for active crohn's disease (cd) in children.

recent studies have suggested that gut imbalance and deregulation of immunological responses plays a pivotal role in the disease development of crohn's disease (cd), and that fmt could be a useful treatment. our study is aims to repeated and multiple fmts plus pen as a first-line treatment for active crohn's disease (cd) in children. the patients were divided into 2 groups voluntarily. patients treated with fmt coupled with pen were defined as the fmt group, and those treated with pen combined with immunosuppressants (hormones, azathioprine, thalidomide) served as the immunosuppressive group. the therapeutic effect of the two groups was compared. in the induction stage of cd, fmt group received fmt and pen intervention, and fmt was given 1-3 courses, 3-6 times per course. the transplantation routes include oral capsule, enema and/or colonoscopy. all the patients received pen (80% of total calories as a polymeric diet, peptamen, nestle, vevey, and switzerland) intervention to help induce and maintain clinical remission.

Eligibility criteria:
inclusion criteria: age of older than 2 years and younger than 16 years with no genetic diseases; newly diagnosed with mild-to-moderate cd ( defined by the pcdai of \>10 and ≤40, and ses-cd of \>3); subjects with no change in medication or dose at least 1 week prior to transplantation; agree to received regularly colonoscopy exclusion criteria: patients who were treated with corticosteroids, methotrexate, thiopurines, and anti-tnf agents as their first-line treatment

Keywords: crohn disease;fecal microbiota transplantation
abbreviated mgso4 therapy in post-partum preeclampsia

Conditions: Pregnancy; Preeclampsia

Summary: magnesium sulfate is used for seizure prophylaxis in pregnancies complicated by preeclampsia. there is debate as to how long to continue this therapy after delivery of the pregnancy. different schemes have been offered to shorten the exposure to magnesium sulfate after delivery, with little data. we seek to investigate the effect of shortened magnesium sulfate therapy on the post-partum recovery phase of mild preeclampsia. our hypothesis was that shortened therapy (12 hours versus the traditional 24 hours post-partum) has no effect on disease course, and will result in significantly shorter exposure to magnesium sulfate.

the study has been completed at this time. consenting women with suspected mild preeclampsia (new onset/exacerbated hypertension with proteinuria) were randomly assigned 12 (12-hour) or 24-hours (24-hour) of postpartum mgso4. treatment was continued beyond the initially assigned time period for new findings of severe preeclampsia. clinical and laboratory data were collected. analysis was by intent to treat, utilizing fisher's exact, chi-square, and student's t-tests where appropriate

Eligibility criteria:
inclusion criteria: * women with suspected mild preeclampsia diagnosed antepartum, intrapartum, or post-partum were eligible for inclusion after delivery at term (≥ 34 weeks' gestational age). exclusion criteria: * inability to give informed consent, preterm delivery, severe preeclampsia

Keywords: pregnancy preeclampsia treatment
sinema model of care to improve the health of stroke patients in rural china

Conditions: Stroke

Summary: despite the significant burden of stroke in rural china, secondary prevention of stroke is scarce. the aim of the study is to develop a system-integrated technology-enabled intervention (sinema) model for the secondary prevention of stroke in rural china and evaluate the effectiveness of the model compared with usual care. the hypothesis is that trained village doctors, equipped with digital health technology, can provide essential evidence-based care to stroke survivors in rural china.

the sinema trial is a cluster-randomized controlled trial to evaluate the effectiveness of implementation of a system-integrated and technology-enabled model of care to improve the secondary prevention of stroke in nanhe county, a rural area of hebei province, china. fifty villages from five townships are stratified randomized in a 1:1 ratio to either the intervention arm (implementing sinema model) or the control arm (usual care). after a baseline survey, intervention will be implemented in 25 intervention villages, lasting for 12 months. follow-up survey will be conducted in the same way in all villages at 12-month after the initial of the study. process evaluation will be conducted every three month, and economic evaluation will also be conducted.

Eligibility criteria:
inclusion criteria: those who * are aged more than 18 years old; * have a history of stroke (including ischemic and hemorrhagic stroke) diagnosed at county hospital or higher-level facilities, and currently in a clinically stable condition and not receiving acute stroke treatment; * will live in this village for at least nine months during the next 12 months; * have a basic communication ability (i.e. can understand simple instructions); * give participant informed consent and are willing to participate in the study. exclusion criteria: those who * are unable to get out of bed without maximum assistance; * have serious life-threatening disease such as cancers; * who have an expected life span of less than 6 months.

Keywords: secondary prevention primary healthcare village doctors rural china medication adherence physical activity
cognitive behavioral social skills training for youth at risk of psychosis

Conditions: At Risk of Psychosis

Summary: schizophrenia and other psychotic disorders are serious and debilitating mental illnesses that incur substantial suffering for patients and major challenges to the investigators health care and legal systems. the prodrome is the period prior to onset of psychosis when functional decline and clinical symptoms gradually emerge. the presence of a clinical high-risk (chr) syndrome in young adults is associated with heightened risk (25-35%) for the later development of psychosis, and for those who do not necessarily go on to develop a psychotic illness, research has suggested that the majority continue to have fluctuating subthreshold symptoms and poor social and role functioning. there are no specific treatments to help with these functional difficulties. however, recent findings suggest that in people with schizophrenia, cognitive behavioral and social skills training (cbsst) leads to significantly greater increase in the frequency of social functioning activities compared to treatment as usual or goal-focused supportive therapy, and preliminary data suggest cbsst is a feasible treatment for chr. this proposal is a competitive application for a three-site, longitudinal study aimed at testing the effectiveness and feasibility as well as mediators and mechanisms of action of a manualized cbsst intervention that will target functional difficulties associated with clinical risk states for psychosis. the goals are 1) to examine whether cbsst compared to a placebo intervention (psychoeducation) matched for group involvement and therapist time improves functioning in youth at chr and 2) to determine whether reduction in defeatist beliefs and improvement in social competence mediate change in psychosocial functioning in chr youth in the cbsst. in this single-blind randomized 2-arm trial participants will be randomized to one of two treatments: cbsst, an 18-week group comprised of three modules; 1) cognitive skills; 2) social skills; and 3) problem solving, or a psychoeducation support group that does not teach active cognitive behavioral therapy or social skills training. over a five-year period, the multi-site collaboration will follow large chr sample that will undergo comprehensive assessments of psychosocial and behavioral changes, to examine changes in social and role functioning, as well as symptom changes from baseline to the end of treatment, and to 6 month follow-up. this approach will demonstrate the feasibility of a treatment for which it is easy to train therapists and which can readily be disseminated to regular clinical community practice. in addition, it will provide insights into likely approaches to halting or mitigating the pathological process and advance the investigators understanding of risk prediction; both critical steps in prevention.


Eligibility criteria:
inclusion criteria: * have prodromal criteria in the past 4 years * one attenuated psychotic symptom rated 3 or more * rating on social functioning \<6 exclusion criteria: * meet criteria for a psychotic disorder neurological disorder iq\<70
clinical effects of moxibustion combined with tailored baduanjin exercise programs on early postoperative rehabilitation in lumbar disc herniation patients undergoing minimally invasive surgery

Conditions: Lumbar Disc Herniations

Summary: this study is a single-center randomized controlled trial, aiming to explore the effect of moxibustion combined with the modified baduanjin exercise regimen on the early rehabilitation of patients with lumbar disc herniation (ldh) after minimally invasive surgery. a total of 120 patients were included in the study and randomly divided into the control group (conventional treatment and rehabilitation care), the baduanjin group (conventional treatment + modified baduanjin), and the combined intervention group (conventional treatment + baduanjin + moxibustion). by comparing the visual pain scores (vas), lumbar function scores (joa), lumbar range of motion, and anxiety scale (hama) changes at 1 day, 1 month, and 3 months after surgery, the study evaluated the improvement effect of the integrated traditional chinese medicine and western medicine rehabilitation plan on postoperative pain relief, functional recovery, and psychological state. the study innovatively integrates the advantages of traditional chinese medicine moxibustion for warming and promoting meridians and the low-intensity exercise of the modified baduanjin, optimizes the difficulty of traditional rehabilitation training, and provides evidence-based basis for improving patient compliance and standardizing postoperative rehabilitation programs.


Eligibility criteria:
inclusion criteria: * ① refer to the diagnostic criteria for ldh in the "diagnosis and treatment guidelines for lumbar intervertebral disc protrusion (2020 edition)"; * age \> 18 years old; ③ patients who have not responded to conservative treatment and have undergone minimally invasive surgery for lumbar intervertebral disc protrusion in our hospital, including percutaneous puncture interventional procedures (percutaneous intervertebral disc aspiration, percutaneous intervertebral disc laser ablation, percutaneous intervertebral disc ozone ablation, and radiofrequency nucleus removal and formation), micro-lumbar intervertebral disc resection, micro-endoscopic lumbar intervertebral disc resection, and percutaneous endoscopic lumbar intervertebral disc resection; ④ participants who voluntarily participate in this study. exclusion criteria: * ① previous history of lumbar surgery; * those with severe spinal canal stenosis or other severe deformities; * patients with bleeding tendencies or hematological diseases; ④ patients with mental disorders and cognitive impairments; ⑤ patients allergic to the drugs used in the study; ⑥ patients with severe primary diseases (such as tuberculosis, tumors and mental disorders), or those with postoperative lumbar infections.
allopregnanolone (zuranolone) in post-stroke depression

Conditions: Post Stroke Depression

Summary: the goal of this phase ii clinical trial is to learn if the oral synthetic allopreganolone analog (zuranolone) is safe to take and is well tolerated by stroke survivors experiencing moderate to severe post-stroke depression and if it will help with the symptoms of depression. the main questions it will aim to answer are: * is zuranolone safe to take by participants who have moderate to severe post-stroke depression? * is zuranolone well-tolerated by participants who have moderate to severe post-stroke depression? * does zuranolone treat moderate to severe post-stroke depression? the study will enroll six participants. all participants will be given 50 mg of zuranolone for 14 days. participants will be asked to provide blood samples, complete some questionnaires including those related to mood and a cognitive assessment.


Eligibility criteria:
inclusion criteria: * 21-65 years old of any sex and race/ethnicity * clinical ischemic or hemorrhagic acute stroke (confirmed by ct or mri) occurring within 1 year of date of enrollment * moderate to severe psd (post-stroke depression) defined as having depressive symptoms lasting for at least 2 weeks and scoring 17 or more on the ham-d (hamilton depression rating scale) exclusion criteria: * have abused or been dependent on narcotics, recreational drug use, or alcohol * advanced liver or kidney problems * pregnant or plan to become pregnant * post-partum period or breastfeeding * history of attempted suicide * active psychosis or suicidal ideation necessitating clinical intervention * antidepressant medications titration or initiation within 12 weeks of recruitment * history of bipolar disorder, schizophrenia or treatment resistant depression preceding the stroke

Keywords: zuranolone post stroke depression allopregnanolone stroke
magnesium supplementation to prevent bone loss

Conditions: Osteoporosis

Summary: extreme magnesium deficiency is known to have an impact on the synthesis, secretion and/or action of calcium regulating hormones. many older adults are at risk for less severe magnesium deficiency, since the majority of adults receive less than the recommended daily allowance of magnesium. we hypothesize that magnesium supplementation will have a beneficial effect on calcium regulating hormones and markers of bone turnover.

this is a 12 month randomized, double-blind, placebo-controlled study of magnesium supplementation. our hypothesis was that magnesium supplementation would decrease bone turnover markers and alter calcium-regulating hormones: parathyroid hormone and 1, 25 dihydroxyvitamin d. male and female adults over 55 without with a t-score at the hip above -2 are randomized to magnesium 250 mg bid or identical placebo bid. at baseline, all participants had a bone mineral density (bmd) by dxa scan at the hip and spine, blood biomarkers of bone resorption and formation, and calcium regulating hormones. participants were followed for 12 months, with repeat measurement of calcium regulating hormones and bone turnover markers.

Eligibility criteria:
inclusion criteria: 1. healthy ambulatory men and women between the ages of 55-75 years 2. women at least 5 years after menopause exclusion criteria: 1. inability to give informed consent in accordance with institutional guidelines 2. creatinine greater than or equal to 2 mg/dl, since magnesium is excreted by the kidneys 3. diarrhea or loose frequent stools (\> 2 a day) at least 3 days/ week in last 3 months 4. use within 12 months of estrogen, bisphosphonates, calcitonin, or raloxifene 5. current use of loop diuretics 6. use within 12 months of corticosteroids 7. history of hyperparathyroidism, hyperthyroidism, or osteomalacia within past 12 month 8. vitamin d deficient as measured by 25-hydroxyvitamin d outside of the normal range 9. magnesium supplementation of greater than 250 mg/day 10. calcium supplementation of greater than 1500 mg/day 11. conditions which, in the opinion of the investigator, would interfere with the evaluation of bmd at the spine including severe scoliosis, osteophytosis and lumbar fusion 12. bilateral hip replacement 13. bmd at the lumbar spine l2-l4 of less than 0.859g/cm2 for women or 0.895 g/cm2 in men; or total hip less than 0.698 g/cm2 for women or 0.731 g/cm2 for men; or femoral neck less than 0.627 g/cm2 for women or 0.658 g/cm2 for men this represents a t-score of less than -2 at each site 14. high serum calcium on screening blood test

Keywords: osteoporosis bone density magnesium vitamin d
effects of virtual reality training for stroke patients

Conditions: Stroke Patients

Summary: to examine the effects of using a virtual reality (vr) system to improve upper limb motor function among subacute hemiparetic stroke patients. under this aim, the investigators have two objectives: (1) to develop and test a procedure for the quantitative assessment of stroke patients in a virtual environment; and (2) to compare the outcome measures of the two groups of stroke patients (vr-intervention vs. conventional-control) on these two modes of training.

after being informed about the study and potential risks, all participants who gave written consent will undergo the study. a randomized controlled trial with pre-/post-study, of 42 stroke patients with upper limb weakness (21 patients in the control group and 21 patients in the intervention group), 18-65 years old, all are newly admitted stroke patients in the rehabilitation clinic from one hospital. participants in the intervention group will receive 60 minutes of vr training to improve upper limb function and daily living activities. participants in the control group will receive 60 minutes of conventional training to improve upper limb function and daily living activities. the training includes grasp, grip, pinch, gross, and finger-hand coordination movement. the training will perform 5 times/week for 4 weeks. two outcome measures: (a) the barthel index and (b) the fugl-meyer assessment, time spent to complete a task were used to compare two groups.

Eligibility criteria:
inclusion criteria: 1. new in-patients clinically diagnosed hemiparetic stroke patients; 2. patients with a history of the first incidence of stroke with upper limb weakness with a motor impairment upper limbs as a primary deficit; 3. muscle strength \> 2/5 on the medical research council (mrc) scale; 4. good cognitive ability as indicated by a score \> 15 on the mini-mental state examination (mmse); motricity index sore \> 26; and 5. ability to communicate and sign the consent. exclusion criteria: 1. in-patient with ataxia or any other cerebellar symptoms; 2. orthopedic alterations or pain syndrome of the upper limb; 3. peripheral nerve damage affecting the upper extremities; 4. visual or hearing impairment (does not allow the possibility of interaction with the vr system); 5. severe hemispatial neglect; 6. severe shoulder or hand pain (unable to volitionally position the hand in the workspace without pain); 7. insensate forearm and /or hand, edema of the affected forearm and /or hand; 8. uncontrolled seizures disorder; 9. severe depression (\>13 on beck depression inventory fast screen); and 10. severely impaired cognition or comprehension.

Keywords: hemiparetic stroke patients virtual reality impairment upper limbs
pulse oximetry with automated verbal prompts

Conditions: Hypoxemia

Summary: this study will evaluate the effectiveness of an automated voice prompting system on post operative hypoxia within the postoperative anesthesia care unit (pacu). this will be done to detect an improvement of the patient experience and provider care through a decrease in the number of peripheral capillary oxygen saturation (spo2) monitor alarms via the patients own ability to follow the instruction and improve their spo2 levels.

the investigators will examine and observe the patient's stay in the pacu and utilize the pulse oximetry software and data to analyze the ability to evaluate the difference in patient oxygenation levels and supplemental oxygen use with automated verbal prompted monitoring versus a standard care control group. as well as determine if automated verbal prompted monitoring leads to less monitor alarms and subsequent improvement of subjective alarm fatigue and patient satisfaction with their care versus standard care. the pulse oximeter will have a finger probe that will be attached to the patient's middle finger to read the patient's spo2 levels. each time the participant's pulse oximetry value declines to 93% or less, an automated verbal prompt, created via the software, will generate as a soft prompt. this will be followed up by a hard prompt if no improvement is seen in their oxygenation level after a period of time. a positive feedback elicitation will be given if the participant's saturation levels increase above 93%. this automated verbal prompt guidance will take place during the entirety of the investigational group's pacu stay.

Eligibility criteria:
inclusion criteria: * planned general anesthetic * ability to provide informed consent exclusion criteria: * use of regional anesthesia * altered mental status * hearing impairment requiring assistive devices * inability to hear normal conversational voice during the consent process * inability preoperatively to squeeze probe finger against thumb for any reason * baseline spo2 less than or equal to 93% (on room air or baseline home oxygen requirement) * history of methemoglobinemia * suspected or confirmed carbon monoxide (co) poisoning * planned admission to an intensive care unit