Kornimate/medical-research-clean huggingface dataset:
pathway to detection & differentiation of delirium & dementia in the emergency department

Conditions: Cognitive Impairment; Emergency Care; Dementia; Delirium

Summary: this is an observational study of the pragmatic implementation of an ed screening, outpatient referral, and care coordination process for older ed patients who may have ucid.

embedded pragmatic, implementation pilot that incorporates training, ed assessment for delirium and dementia risk, referral of ed patients with undiagnosed cognitive impairment and dementia for primary care feedback and care recommendations. this pilot would gather observational data evaluating the feasibility of incorporating cognitive impairment screens into routine ed delirium assessments, and developing optimal work flow for identifying and referring ed patients with suspected (undiagnosed) dementia for confirmatory evaluation and care coordination.

Eligibility criteria:
inclusion criteria: * adults age 65 or older * discharged from the adult ed at ynhh or the ed at nmh exclusion criteria: * documented or known history of dementia * alcohol/substance intoxication while in the ed * non-english or non-spanish speaking

Keywords: delirium
total intravenous anesthesia with propofol vs. general anesthesia in outpatient shoulder arthroscopic surgeries

Conditions: Rotator Cuff Tears; Rotator Cuff Injuries; Orthopedic Disorder; Sports Injury; Anesthesia

Summary: this study is comparing total intravenous anesthesia with propofol with a regional nerve block against general anesthesia with a regional nerve block on the primary endpoint of time to meet discharge criteria.

the primary objective of this study is to determine if using total intravenous anesthesia with propofol (tiva-p sedation) with a regional nerve block will decrease the time to meet discharge criteria. this will be done with patients undergoing shoulder arthroscopic procedures at the roanoke ambulatory surgical center. currently, inhaled general anesthesia (ga) with a regional nerve block is utilized for these outpatient arthroscopic procedures. this involves the patient receiving propofol through an iv to put a patient to sleep, followed by intubation (breathing tube in throat) and the administration of inhaled anesthesia for the duration of the procedure. another approach for anesthesia in these procedures is tiva-p sedation. in this protocol the patient receives the same initial amount of propofol through the iv as they would if they were getting general anesthesia. once they are asleep, it is maintained with a continuous intravenous administration of propofol. with this approach, the patient is not intubated and exposed to the same anesthetic agents as general anesthesia. as a result, the patient may not experience the potential side effects associated with general anesthesia. we believe that this will lead to a faster time to meet discharge criteria and also fewer of anesthetic side effects.

Eligibility criteria:
inclusion criteria: * 18-75 years of age * candidate for a shoulder arthroscopic procedure in the beach chair position exclusion criteria: * american society of anesthesiologists (asa) level 4 or above * history of brachial plexus injury * chronic obstructive pulmonary disorder * unstable asthma * bmi greater than 40 * allergy to local anesthesic (bupivacaine) * contralateral phrenic nerve impairment * history of difficult airway * poorly controlled gastroesophageal reflux disease * known aspiration risk * surgery not performed at the roanoke ambulatory surgical center * pregnant patients or patients who have a positive pre-operative human chorionic gonadotropin (beta-hcg) pregnancy test * coagulopathies * allergy to propofol * patient request for specific anesthesia method
safety and efficacy of raav-hrs1 in patients with x-linked retinoschisis (xlrs)

Conditions: X-linked Retinoschisis

Summary: this study will evaluate the safety and efficacy of a recombinant adeno-associated virus vector expressing retinoschisin (raav2tyf-cb-hrs1) in patients with x-linked retinoschisis. up to 27 participants will be enrolled and 3 dose levels will be evaluated in a dose escalation format.

this will be a non-randomized, open label, phase 1/2 dose escalation study. up to 27 participants will be enrolled. each participant will receive the study agent by intravitreal injection in one eye on a single occasion. enrollment will begin with the lowest dose and will proceed to higher doses only after review of safety data by a data and safety monitoring committee (dsmc). participants in the dose escalation phase will be ≥ 18 years of age. after the maximum tolerated dose is identified individuals ≥ 6 years of age will be enrolled. safety will be measured by the number and proportion of participants experiencing adverse events and immune response to rs1. efficacy will be measured by evaluation of changes in visual function and schisis cavity size.

Eligibility criteria:
inclusion criteria include: 1. retinal disease consistent with a diagnosis of xlrs and documented mutations in the rs1 gene 2. male individual at least 18 years of age (dose escalation phase) or at least 6 years of age (maximum tolerated dose phase), 3. able to perform tests of visual and retinal function, 4. visual acuity specified for each group 5. not treated with cais currently or within 3 months prior to study enrollment, 6. have acceptable laboratory parameters. exclusion criteria include: 1. prior receipt of any aav gene therapy product, 2. pre-existing eye conditions that would preclude the planned intravitreal injection or interfere with interpretation of study endpoints or complications of vector administration.

Keywords: xlrs maculoschisis retinal degeneration rs1 adeno-associated virus gene therapy aav
safety, pk and efficacy study of sjp-0132 in subjects with dry eye disease

Conditions: Dry Eye Disease; Dry Eye Syndrome

Summary: this is the first study in humans to evaluate the effectiveness of sjp-0132 in the treatment of dry eye disease. this study will evaluate the safety, tolerability, efficacy, and pharmacokinetics of single- and multiple-dose regimens of sjp-0132 in subjects with dry eye disease


Eligibility criteria:
inclusion criteria: * body mass index (bmi) within 18.5 to 30.0 kg/m2 (inclusive) and body weight between 45 kg and 100 kg * generally healthy as determined by medical history, physical examinations, clinical laboratory examination, and ophthalmologic examinations performed at screening * have a subject reported history of dry eye disease in both eyes for at least 6 months prior to screening * non-smoker or ex-smoker for \>12 months exclusion criteria: * have clinically significant systemic or ophthalmic disease * has a positive serum pregnancy test at screening or urine pregnancy test * have had significant blood loss or have donated or received one or more units (450 ml) of blood or plasma within 30 days before randomization * have used or anticipates use of any prescription or over-the-counter medication, including topical medications such as ophthalmic solutions, nasal drops or spray, vitamins, alternative and complementary medicines (including herbal formulations) within 14 days or 5 half-lives (whichever is longer) before randomization or at any time during the study * use or anticipates use of prescribed dry eye medications within 28 days prior to randomization or at any time during the study * have used or anticipates use cyp3a4 inducers, such as st. john's wort, within 14 days before randomization or at any time during the study. * have consumed red wine, grapefruit or grapefruit juice, seville oranges, star fruit, or any products containing these items, or any foods that may inhibit cyp3a4, within 48 hours before randomization and throughout the duration of the study * have a positive urine alcohol or urine drug test at screening or day -1 * contact lens wearers who cannot discontinue the wear over the trial period * have undergone eye surgery (including laser surgery) within the last 12 months or whom the investigator considers unsuitable * have a best corrected visual acuity (bcva) worse than 20/100 in either eye * history of permanent punctal occlusion (cautery or laser) or current use of punctal plugs * any corneal abnormality or disease which might impact normal tear film spreading * active or history of significant corneal disease * known allergy or sensitivity to fluorescein, lissamine green or any of the study medications other protocol-defined inclusion/exclusion criteria may apply
evaluating a personalized trans-diagnostic group therapy for anxiety

Conditions: Anxiety Disorders

Summary: this study is examining the impact of a therapy group for all anxiety disorders provided by the stanford department of psychiatry and behavioral sciences's psychosocial treatment clinic on anxiety symptoms, impairment, and access to quality mental health care.

anxiety disorders are prevalent, impairing, and often precede other psychiatric and medical comorbidity (kessler et al, 2005). cognitive behavior therapy (cbt) and acceptance and commitment therapy (act) are effective, evidence-based treatments for anxiety disorders that can be delivered in either a group or individual format (deacon \& abramowitz, 2004; arch et al 2012). traditionally, group therapy has been delivered a single diagnosis at a time. this presents challenges to care delivery, however, because a sufficient number of patients with the same diagnosis and the same availability in their schedule must be assembled in order to start a group. fortunately, cbt and act can be used to target key trans-diagnostic constructs such as excessive worry, avoidance, and fear of negative evaluation that may occur in many anxiety diagnoses. indeed, emerging research suggests these constructs may be closer to the etiological dysfunction in anxiety disorders than the diagnoses themselves and may therefore be the best treatment targets (craske, 2012). because of this, there is now movement towards trans-diagnostic approaches that flexibly apply core principles of cbt and act to any anxiety disorder. group therapy is a cost-efficient and effective care delivery model that is also generally acceptable to patients with anxiety disorders. however, individual therapy is often preferred (sharp et al, 2004), perhaps due to greater personalization of care relative to standard group therapy. to address this concern the investigators aim to use a pre-treatment assessment to develop a personalized plan for each patient entering a trans-diagnostic anxiety group. in order to evaluate the effectiveness of this approach, patients enrolled in the group who consent to participate in research will complete assessments of anxiety and related symptoms, quality of life, and cognitive function before and after therapy.

Eligibility criteria:
inclusion criteria: * age 18+ * enrolled in a trans-diagnostic group therapy for anxiety disorders in the stanford psychiatry \& behavioral sciences' psychosocial treatment clinic. * english fluency exclusion criteria: * unable to provide informed consent * acute safety concerns (e.g., suicidality requiring a higher level of care)
origin to insertion kinesio tapping vs non-directional kinesio tapping on quadriceps peak torque

Conditions: Quadriceps Muscle Atrophy

Summary: this study was conducted to investigate the effect of kinesio tapping on electrical activity and peak torque of quadriceps during concentric and eccentric muscle contraction were carried out in the motion analysis laboratory.

a pretest posttest control group design was used to. two hundred normal subjects of both sexes were recruited. subjects were randomly assigned into two groups of equal number. * cura kensio-tapping group: consisted of 100 subjects (females and males) will receive kinesio taping from origin to insertion on the superficial muscles of quadriceps femoris (vastus medialis (vm), vastus lateralis (vl), rectus femoris (rf). * placebo-group: consisted of 100 subjects (females and males) will receive placebo kinesio taping across quadriceps.

Eligibility criteria:
inclusion criteria: * age must be ranged from 22-30 years. * body mass index must be ranged from 20-24.9 kg/m². exclusion criteria: * knee or quadriceps disorders preventing physical stress. * cardiovascular or neurological problems. * athletic subjects. * smokers. * heavy caffeine intake subjects.
treatment program for anemia in aids patients

Conditions: HIV Infections; Cytopenias

Summary: the objective of the eprex (erythropoietin) treatment program is to provide erythropoietin for the treatment of anemia in aids patients.


Eligibility criteria:
exclusion criteria co-existing condition: patients with the following are excluded: * life expectancy \< 3 months. * = or \< grade 4 performance score. * aids-related dementia. * uncontrolled hypertension. * acute symptomatic opportunistic infection or other aids-defining illness. patients with the following are excluded: * life expectancy \< 3 months. * = or \< grade 4 performance score. * aids-related dementia. * uncontrolled hypertension. * acute symptomatic opportunistic infection or other aids-defining illness. patients must have: * a clinical diagnosis of aids. * hematocrit \< 30 percent. * endogenous serum erythropoietin level = or \< 500 u/ml. * a life expectancy = or \> 3 months. * \> grade 4 performance score.

Keywords: recombinant proteins drugs, investigational erythropoietin acquired immunodeficiency syndrome anemia zidovudine
ct myocardial perfusion to guide the diagnosis and treatment of patients with stable coronary artery disease (potential)

Conditions: Treatment Decision, Coronary Artery Disease

Summary: the overall goal of this project is to compare the non-revascularization rate of coronary angiography in patients with stable coronary artery disease (cad) within 90 days after ct myocardial perfusion imaging (ct-mpi) or single-photon emission computed tomography myocardial perfusion imaging (spect-mpi), and 1-year major adverse cardiovascular events (mace).

participants will be patients with proven coronary artery disease (cad) who are scheduled randomized to undergo ct myocardial perfusion imaging (ct-mpi) or single-photon emission computed tomography myocardial perfusion imaging (spect-mpi) to evaluate myocardium ischemia. those patients with positive myocardial ischemia will scheduled to undergo invasive coronary angiography (ica), and those without myocardial ischemia will have optical medical therapy. the purpose of the study is to verify that ct-mpi guided clinical pathways are not inferior to spect-mpi pathways in downstream treatment decision making and safety assessment. in order to achieve this aim, the study team will compare the non-revascularization rate of ica within 90 days after ct-mpi and spect-mpi. 1-year major adverse cardiovascular events (mace) will be also compared.

Eligibility criteria:
inclusion criteria: * age ≥18 years * patients with stable chest pain who have undergone coronary ct angiography and have 50-90% stenosis in at least one vessel \> 2mm in diameter * able to provide signed informed consent exclusion criteria: * suspected or confirmed acute coronary syndrome * evidence of clinical instability or need for an emergent procedure * history of percutaneous coronary stent implantation, history of coronary artery bypass grafting, or history of myocardial infarction * left main artery stenosis ≥ 50% * severe heart failure (new york heart association (nyha) ≥iii) * estimated glomerular filtration rate \< 60 ml/min/1.73 m2 * contraindicated to use contrast agents, beta-blockers, nitrates or adenosine drugs * acute episodes of bronchial asthma or chronic obstructive pulmonary disease * ii or iii degree atrioventricular block * history of pacemaker or implantable cardioverter defibrillator implantation * combined with other cardiovascular diseases including cardiomyopathy, congenital heart disease, valvular heart disease, pulmonary vascular disease, pericardial disease, etc * pregnant or trying to be pregnant * combined with any other serious disease, life expectancy \<1 year * any condition leading to possible inability to comply with the protocol procedures and follow-up * currently participating in any other clinical trials

Keywords: ct myocardial perfusion imaging coronary artery disease clinical pathway spect myocardial perfusion imaging
a study to determine the effectiveness of endoscopic full-thickness plication for the treatment of gerd

Conditions: Gastroesophageal Reflux Disease (GERD)

Summary: the aim of this study was to determine the effectiveness of endoscopic full-thickness plication (plicator; ndo surgical, inc., mansfield, ma) for the treatment of gerd in comparison to a sham procedure. patients with symptomatic gerd requiring maintenance proton pump inhibitor therapy were entered into a randomized, single-blind, prospective, multicenter trial. seventy-eight patients were randomly assigned to undergo endoscopic full-thickness restructuring of the gastric cardia with transmural suture. eighty-one patients underwent a sham procedure. group assignments were revealed following the 3-month evaluation. the primary endpoint was ≥ 50% improvement in gerd-hrql score. secondary endpoints included medication use and esophageal acid exposure. patients achieving ≥ 50% improvement in gerd-hrql score at 3-months versus baseline off-meds were considered responsive to their assigned procedure. patients who failed to reach this level of improvement at 3-months were considered non-responders. analysis of these dichotomized variables (responder/non-responder) was done using fisher's exact test comparing the proportion of responders between the active and sham groups. intent-to-treat analysis was also performed. the null hypothesis was that the proportion of responders was the same in both the active and sham groups. testing was done at the 5% level of significance (alpha=0.05).


Eligibility criteria:
patients 18 years or older with a history of heartburn or regurgitation symptoms requiring daily ppi therapy were recruited. inclusion criteria: * gerd-hrql score ≥ 15 while off ppi therapy, and at least 6 points higher than on-ppi score * pathologic esophageal acid exposure, defined as ph\ 14.7 * lower esophageal resting pressure of at least 5mmhg; and * suitability for surgery (american society of anesthesiologists physical status classification i or ii). exclusion criteria: * significant esophageal dysmotility as determined by manometry * esophagitis grade iii or iv (savary-miller) * barrett's epithelium * hiatus hernia \> 2cm * persistent dysphagia, weight loss, esophageal bleeding, vomiting, gas or bloating * esophageal or gastric varices * previous endoscopic or surgical anti-reflux procedure * other esophageal or gastric surgery * chronic use of anticoagulant or platelet anti-aggregation therapy (other than for cardiac prophylaxis); and * pregnancy.

Keywords: gerd sham randomized controlled study endoscopic full-thickness plication plicator
efficacy and safety of ojeok-san on korean patients with cold hypersensitivity in the hands and feet

Conditions: Cold Hypersensitivity

Summary: the purpose of this trial is to investigate the efficacy and safety of ojeok-san(ojs) on korean patients with cold hypersensitivity in the hands


Eligibility criteria:
inclusion criteria: 1. female subjects aged 19 to 59 years have a complaint of chh. 2. patients must include at least one or more of the following symptoms: * those who have the symptoms of chh in normal temperature which most individuals feel no cold; * those who have the symptoms of extremely cold hands in cold temperature exposure; * those who are on the return to a warmer environment, the symptoms of cold hands is not completely rewarmed; 3. those who have 4 cm or greater of vas chh score; 4. a thermal differences between the palm (pc8) and the upper arm (lu4) may be higher than 0.3℃; 5. those who can comply with all study-related procedures, medications, and evaluations; 6. given a written informed consent form. exclusion criteria: 1. patients with calcium antagonists or beta-blockers with the purpose of treating chh; 2. those who have one or more finger gangrene or ulceration; 3. those who are diagnosed by hypothyroidism or currently medicated to thyroid drugs; 4. those who are diagnosed by autoimmune disease or have a positive ana test result; 5. those who are diagnosed by carpal tunnel syndrome or have a positive tinel and phalen's tests; 6. those who are diagnosed with cervical disc herniation or (malignant) tumor disease; 7. those who are diagnosed with diabetes; 8. those who are currently medicated to drugs that may affect to chh symptoms, such as anticoagulants etc; 9. those who have moderate level of liver dysfunction (each of ast, alt greater than 100 iu/l) or kidney dysfunction (cr 2.0mg/dl); 10. those who do not (cannot) abide by treatment and follow up due to the mental illness such as behavior disorder, depression, anxiety neurosis, schizophrenia, or serious mental illness; 11. those who are diagnosed with moderate anemia and hematologic disorders (adult non-pregnant women hemoglobin (hgb) level less than 7g/dl, hematocrit (hct) level less than 26%, white blood cell (wbc) level greater than 11,000/mm3); 12. those whose systolic blood pressure (sbp) 180mmhg or diastolic blood pressure (dbp) is greater than 100 mmhg based on average value of at least 2 measurements; 13. those who are suspected arrhythmia that showing up on ecg, or diagnosed by heart diseases, such as, ischemic heart disease and so on; 14. those who are addicted to alcohol or drugs; 15. those who are pregnant (positive urine-hcg) or lactating or have the chances of pregnancy; 16. those who are diagnosed with malignant tumor 17. those who are currently participated in other clinical trials; 18. those who are unable to understand and speak korean; 19. those who are judged to be inappropriate for the clinical study by the researchers.

Keywords: cold hypersensitivity korean medicine ojeok-san cold intolerance
novel senhance robotic system in urologic surgery: its clinical application and implication

Conditions: Urologic Diseases; Surgery

Summary: an observational study to collect data from the participants who received urologic surgeries using the senhance robotic system.

this is an observational study and investigators will collect peri-operative demographic data, and short-term outcomes (3-6 months) from the participants who received minimal invasive surgeries using senhance robotic system in the national taiwan university hospital yunlin branch, urology department. the investigators want to demonstrate if the robotic system is safe and feasible in urologic laparoscopic surgeries. the operation included tep, radical prostatectomy, radical nephrectomy (nephroureterectomy) , adrenalectomy, radical cystectomy, and ureter surgery et al. up to 2022/12, we had recruited 127 tep, 83 radical prostatectomies, 17 adrenalectomies, 40 nephrectomies, 29 partial nephrectomies, 13 radical cystectomies and 18 other surgeries, such as ureter surgery

Eligibility criteria:
patients undergo laparoscopic urologic surgeries

Keywords: urology senhance robotic surgical system laparoscopic surgery