Kornimate/medical-research-clean huggingface dataset:
enhancing indoor, community, and advanced wheelchair skills in spinal cord injury (sci)

Conditions: Spinal Cord Injury

Summary: we propose to test an evidence-based wheelchair skills training program to optimize wheelchair safety and performance in veterans with sci. the proposed training program incorporates emerging evidence on wheelchair biomechanics and motor-skills learning, and addresses recommendations in a new clinical practice guideline. given the difficulty in translating wheelchair skills learned in a therapy clinic with "real world" problems in the home and community post-discharge, we are proposing to conduct the wheelchair skills training in and around the veteran's home. the immediate goal is to enhance ability, performance time, safety, community participation, and quality of life, while minimizing physical strain. the ultimate goal is to reduce morbidity/mortality associated with wheelchair use and promote successful aging with a disability.

the purpose of this 3-year randomized controlled clinical trial is to evaluate use of a community-based wheelchair skills training program (wstp). objectives include: 1. determine the immediate and sustained effects of a wstp on ability, performance time, and physical strain. 2. examine the effects of mediating and moderating variables on ability, performance time, and physical strain. 3. examine the effects of a wstp on safety, community participation, and quality of life. 4. promote dissemination of wstp in va sci centers through two key activities: (a) design innovative marketing plans to increase participation and promote patient-centeredness based on patient-perceived benefits. (b) estimate health care resources needed to add home-based

Eligibility criteria:
inclusion criteria: * sci for at least 1 year (neurologically stable) * level of injury: c6 and below who use manual wheelchair as a primary means of mobility * able to self-propel wheelchair * between the ages of 18-75 * able to follow simple instructions exclusion criteria: * progressive disease (e.g. spinal tumor) * extended bedrest for more than 30 days * ventilator-dependent * any cardiac or respiratory condition that would limit subject's physical performance * unstable medical conditions * use power wheelchair or scooter as primary means of mobility * pregnancy

Keywords: wheelchairs safety
effects of low fodmap diet on colonic epithelial physiology in diarrhea-predominant irritable bowel syndrome

Conditions: Irritable Bowel Syndrome

Summary: this research is studying whether changing an individual's diet may have an impact as a treatment or outcome for irritable bowel syndrome (ibs). this research will show if diet might play a role in triggering changes that may cause ibs. this study is being done to learn if a low fodmap (fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols) diet causes changes in the colon lining which mediates improvement in ibs symptoms.


Eligibility criteria:
inclusion criteria: * normal serum studies including serum tissue-transglutaminase antibodies, thyroid stimulating hormone levels, c-reactive protein or fecal calprotectin, complete blood count since the onset of symptoms. * normal stool studies including, ova and parasites since the onset of symptoms * ibs-sss score of ≥175 at the end of the 7-day screening period in case of presence of any alarm features and/or elevated inflammatory markers (c-reactive protein or fecal calprotectin), patients will be eligible if they have been excluded for inflammatory bowel disease with colonoscopy in the last one year. exclusion criteria * individuals already on a lfd or other dietary restriction such as gluten free diet within the past 6 months * individuals with any known food allergy or insulin-dependent diabetes * known history of celiac disease, inflammatory bowel disease or microscopic colitis * prior small bowel or colonic surgery or cholecystectomy * pregnant patients * antibiotics in the past 3 months * those who regularly use mast cell stabilizers or anti-histaminic or non-steroidal anti-inflammatory agents (nsaids) excluding daily baby aspirin or steroids or bile-acid binder.
nsaids versus paracetamol versus paracetamol + nsaids in traumatic pain management

Conditions: Acute Pain Due to Trauma

Summary: the purpose of this study is to: compare the effect of paracetamol alone against nsaids alone against the association of paracetamol + nsaids in the treatment of traumatic pain.

paracetamol, nsaids, or a combination of the two molecules are usually prescribed. patients even use these medications without a prescription. it is not known, however, whether or not nsaids have an additional value relative to paracetamol for the treatment of pain. all patients were assigned in a 1:1:1 ratio. randomization of subjects was performed centrally according to a computer-generated random code provided by one of investigators who was not involved in any other part of the trial. the patients included were divided into 3 groups: paracetamol group who received paracetamol 1000 mg orally every 8th hour for 7 days; nsaid group who received piroxicam 20 mg orally twice a day for 7 days, and paracetamol-nsaid combination who received both treatments at the same doses for 7 days. all protocol treatments were administered in opaque packets with code number according to the randomization list by an independent nurse who was not involved in monitoring or follow-up of the individuals. data were collected for each patient, including demographics, medical history, and findings of the clinical examination. injury severity score (iss) whose values range from 0 to 75 was also assessed. each patient was re-evaluated on the 3rd and 7th day post-trauma (d7) using a telephone contact by a clinical research associates who was blinded to the details of the study to note the following clinical data: pain vns, ed readmissions for residual pain, need for other analgesics other than those of the protocol, other treatment modalities the patient might have used (adherence to the treatment prescribed), and side effects. in addition patients were asked about their satisfaction with pain control following ed using five point likert scale: very dissatisfied, not satisfied, neutral, satisfied and very satisfied and about the degree to which they adhered to medication schedule. the principal investigator who was aware of the allocation was not involved in monitoring or recording of the outcomes until the data collection was completed.

Eligibility criteria:
inclusion criteria: * age 18 years or older * acute (\ 3 on a visual numeric scale exclusion criteria: * open fracture * head, abdominal, thoracic or polytrauma. * need for hospitalization, regular use of paracetamol and nsaids during the two weeks before admission to ed * history of allergy or hypersensitivity to either paracetamol or nsaids, * contraindication to paracetamol or nsaids, * acute /history of gi hemorrhage and renal insufficiency, * an inability to assess pain intensity according to the vns. * pregnancy * heart failure * known hepatic cirrhosis * known severe renal impairment (creatinine clearance \<30 ml/min) * swallowing disorders * refusal, incapacity or difficulties to consent or to communicate

Keywords: acute pain, trauma, paracetamol, nsaid
optimized health-related social needs screening and community linkages

Conditions: Emergencies

Summary: the objective of this study is to to understand the most effective method for health-related social need (hrsn) screening in the challenging environment of an emergency department by randomizing patients to oral or written hrsn screening in the ed.

bilingual research assistants (ra) will screen patients for eligibility based on the predetermined criteria and approach eligible patients with a brief description of the study and opportunity for participation. interested participants will complete a verbal consent process to reduce the barriers to participation, a brief demographic questionnaire, and an assessment of health literacy (newest vital sign) followed by the partners healthcare hrsn screener randomized to an oral v. ipad screening strategy. after completion of the screening tool, participants will complete a secondary questionnaire asking about satisfaction with the process, the presence of additional hrsn not recorded by the partners healthcare screener, and their perspectives on screening. at the conclusion, all participants will be provided with standardized, bilingual list of community resources to address each of the screening domains.

Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years patients and either a parent/guardian of a pediatric/cognitively disabled patient in the mgh ed, 2. triaged to the acute, cdu, fast track, urgent, and pediatrics areas, 3. english- or spanish-speaking, and 4. capable of informed consent. exclusion criteria: 1. patients unwilling to have the interview audio-recorded, 2. medically unstable patients, and 3. section 12, lack of capacity medical hold, sexual assault, child abuse, and emotionally distressed patients.

Keywords: social needs
oral cromolyn sodium for the treatment of eosinophilic esophagitis

Conditions: Eosinophilic Esophagitis

Summary: this is a randomized, double-blind, placebo-controlled study of oral cromolyn sodium when made into a viscous preparation for the treatment of eosinophilic esophagitis.

eosinophilic esophagitis is an antigen-mediated allergic disease of the esophagus characterized by symptoms of gastrointestinal complaints and eosinophilic inflammation limited to the esophagus. currently, first line therapeutic recommendations include swallowed, topical steroids or dietary therapy. while both work for the majority of patients, they both have limitations. the investigators are examining the use of oral cromolyn sodium as a treatment for this condition. this medication is a non-steroid that is already approved for other conditions. when taken orally, it is essentially not absorbed systemically, so side effects are minimal. there is only 1 brief, retrospective report of its use in this condition suggesting it does not work. however, from studying swallowed, topical steroids, it may require formulating the medication into a viscous preparation for it to work.

Eligibility criteria:
inclusion criteria: * diagnosis of eosinophilic esophagitis exclusion criteria: * concomitant treatment with swallowed corticosteroids. any prior use of swallowed corticosteroids will require a 4 week washout period. * pregnancy (all females of child bearing potential will have urine pregnancy test done at baseline). * evidence of pathologic eosinophilia in other locations in the gi tract. * participation in another research protocol * reduced renal or hepatic function (all subjects will have a baseline creatinine and liver function panel drawn)
construction of early warning model for the new psychoactive substances using in adolescents

Conditions: Drug Addiction

Summary: based on the biological-psychology-sociological medicine pattern, this study aims to construction an early warning model of the new psychoactive substances (nps) using for adolescents aged 14-35 years old. this study intends to obtain the data related to the behavioral expression of addiction susceptibility genes, adverse childhood experience, cognition, resistance and the use of nps in adolescents by questionnaire survey (sample size: 200), and then use logistic regression and machine learning to construct an early warning model.

based on the biological-psychology-sociological medicine pattern, this study aims to construction an early warning model on the use of the new psychoactive substances using for adolescents aged 14-35 years old. this study intends to conduct a questionnaire survey (sample size 200) to obtain data related to the behavioral expression of addiction susceptibility genes, childhood adversity experience, cognition, resistance and the use of nps in adolescents from different regions and different populations. through data analysis, this study aims to get the weight of different risk factors on nps use, and then use logistic regression and machine learning to construct an early warning model, so as to screen out high-risk groups. at the same time, the expert group was consulted to establish a risk early warning system to provide a basis for intervention.

Eligibility criteria:
inclusion criteria: * adolescents aged 14-35 (including 14,35 years old) * agree to participate in the studies exclusion criteria: * be diagnosed with psychological or mental illness * people that are unconscious, emotionally unstable, or unable to communicate normally * patients with severe diseases

Keywords: risk prediction model nps addiction susceptibility genes adverse childhood experience adolescents
conventional versus point-of-care based coagulation management

Conditions: Cardiac Surgery; Coagulation Management

Summary: the purpose of the study is to determine the efficacy of two different algorithms for coagulation management in patients undergoing cardiac surgery suffering from increased bleeding tendency. algorithm 1 is based on conventional coagulation analyses (inr, aptt, platelet count, fibrinogen concentration,...) and algorithm 2 is based on thrombelastometry using the rotem-device and impedance aggregometry using the multiplate device.


Eligibility criteria:
inclusion criteria: * age \> 18 years, combined surgical procedures (acb \& valve surgery), double valve surgery, aortic surgery, re-dos exclusion criteria: * none

Keywords: poc rotem multiplate bleeding tendency coagulation management amount of transfused red blood cell concentrates, ffp platelet concentrates rate of rethoracotomy ventilation time
is a low thyreotropin level predictive of recurrent arrhythmia after catheter ablative surgery?

Conditions: Atrial Fibrillation; Subclinical Hyperthyroidism

Summary: overt hyperthyroidism (so-called "goiter" in lay language) is a hormonal disturbance that is known to increase the risk of atrial fibrillation (a common heart arrhythmia with potentially severe consequences) in some patients. previous research has indicated that even slight elevations in thyroid hormone levels - so called subclinical hyperthyroidism - may increase this risk. when atrial fibrillation and overt hyperthyroidism are found simultaneously in a patient, the hormonal imbalance must be treated first in order to later resolve the arrhythmia. it is unclear whether this strategy holds true for subclinical hyperthyroidism. our two hypotheses are: 1) subclinical hyperthyroidism is more prevalent in patients admitted for atrial fibrillation ablation than in the population as a whole, and 2) patients with subclinical hyperthyroidism and atrial fibrillation benefit less from ablation than others. as a control group, we have chosen patients admitted for ablation of av-nodal reentry tachycardia at the same clinics as the cases. no correlation has ever been shown between av-nodal reentry tachycardia and hyperthyroidism.


Eligibility criteria:
inclusion criteria: * atrial fibrillation or av-nodal reentry tachycardia * fulfills criteria for ablation (severe arrhythmia symptoms; for atrial fibrillation patients, having tried at least one antiarrhythmic agent with poor effect) * admitted for ablation for the first time * has left blood samples for thyroid status (tsh, free t4, free t3) exclusion criteria: * atrial flutter * overt hyperthyroidism
enhancing cognitive training through exercise following a first schizophrenia episode

Conditions: Schizophrenia; Schizophreniform Disorder; Schizoaffective Disorder

Summary: this is a confirmatory randomized controlled trial of the efficacy of a novel intervention combining neuroplasticity-based cognitive training with aerobic exercise, compared to the same systematic cognitive training alone. treatment occurs for 6 months after randomization, with a followup assessment at 12 months. the investigators hypothesize that combining neuroplasticity-based computerized cognitive training and neurotrophin-enhancing physical exercise will produce neurotrophin increases and cognitive and functional improvements, even relative to cognitive training alone. the investigators target the period shortly after a first episode of schizophrenia to maximize the generalization of cognitive improvement to functional outcome, before chronic disability is established.

the cognitive training and exercise intervention consists of 24 weeks of systematic computerized cognitive training, 4 hours per week, plus aerobic exercise, 150 minutes per week. the cognitive training intervention includes the same systematic cognitive training. the first 12 weeks involve neurocognitive training, using training exercises from posit science brain hq. the second 12 weeks involves social cognitive training, using the posit science socialville modules. aerobic exercise occurs as two 45-minute sessions at the clinic and two 30-minute sessions at home weekly. intensity of aerobic exercise is tailored to maintain an individualized target heart rate zone and is monitored by a heart rate recorder. a weekly one-hour bridging skills group with other members of the treatment condition is designed to aid generalization of training to everyday life situations. the immediate target is brain-derived neurotrophic factor. the primary treatment outcomes are overall cognitive deficit level and global functioning level.

Eligibility criteria:
inclusion criteria: 1. a first episode of a psychotic illness that began within the past two years; 2. a diagnosis by dsm-5 of schizophrenia, schizoaffective disorder, mainly depressed type, or schizophreniform disorder; 3. sufficient acculturation and fluency in the english language to avoid invalidating research measures; and 4. residence likely to be within commuting distance of the ucla aftercare research program. exclusion criteria: 1. inability to participate in aerobic exercise; 2. evidence of a known neurological disorder (e.g., epilepsy) or significant head injury; 3. evidence of moderate or severe alcohol or substance use disorder within the six months prior to the first episode or evidence that substance abuse triggered the psychotic episode or makes the schizophrenia diagnosis ambiguous; or 4. mental retardation, i.e. estimated premorbid iq less than 70.

Keywords: cognitive training aerobic exercise neurotrophic factors randomized controlled trial functional outcome
the efficacy and safety of dapagliflozin in improving heart failure in dialysis patients

Conditions: The Efficacy and Safety of Dapagliflozin in Improving Heart Failure in Dialysis Patients

Summary: dialysis patients have a higher incidence of cardiovascular events and require more effective measures to delay the progression of heart failure. many studies have shown that dapagliflozin has cardioprotective effect, but most studies focus on non-dialysis patients with egfr more than 20ml/min/1.73m2. however, the data on patients with egfr less than 20ml/min/1.73m2 or dialysis patients, especially peritoneal dialysis patients, is less. exploring the efficacy and safety of dapagliflozin in improving heart failure in dialysis patients is of great clinical significance.


Eligibility criteria:
inclusion criteria: * 1.age between 20 and 70 years old; 2.maintenance dialysis for longer than 3 months; 3.diagnosis with chronic heart failure, left ventricular ejection fraction (lvef)≤40% or nt-probnp\>12000pg/ml; 4.the patient signs an informed consent form. exclusion criteria: * 1.patients with liver function impairment; 2.patients with severe hypoglycemia/hypotension/ketoacidosis; 3.patients with active pyelonephritis or symptomatic urinary tract infection; 4.dapagliflozin allergies or severe adverse reactions; 5.patients suffering from other severe diseases; 6.patients participating in other clinical trials; 7.pregnant or lactating women; 8.failure to sign a written informed consent form; 9.unable or unwilling to comply with the experimental protocol approved by the researcher
drug therapy for alcohol detoxification

Conditions: Alcoholism

Summary: this project will provide relevant clinical information for primary care practitioners treating alcohol withdrawal syndrome in outpatient settings. this double-blind, placebo- controlled clinical trial will compare the effectiveness of lorazepam (ativan) and carbamazepine (tegretol) in alcoholics who meet the criteria for a diagnosis of uncomplicated alcohol withdrawal syndrome. participants are randomized to five days of treatment with a 1-week posttreatment followup.


Eligibility criteria:
inclusion criteria: * meets criteria for alcohol dependence and uncomplicated alcohol withdrawal syndrome. * ability to provide informed consent, complete self-rating questionnaires, and respond to structured clinician-rated instruments. * must live within 50 miles or one hour of the study site and have reliable transportation to the site. * must have a significant other who will provide a collateral report, attend outpatient visits, and be available by telephone. * subjects must be medically stable. * must have a clinical withdrawal assessment prior to study. exclusion criteria: * meets criteria for any other substance dependence syndrome other than alcohol dependence or marijuana abuse. * use of other illicit psychoactive substances (except marijuana) in the last 7 days. * use of pharmaceutical agents within the last 14 days that are known to lower the seizure threshold, augment or decrease the alcohol withdrawal syndrome. * history of status epilepticus or two or more seizures occurring within 24- hour period during a previous alcohol withdrawal or other forms of epilepsy. * current major depressive illness, dementia, suicidal or homicidal ideation, or past or present schizophrenia. * acute medical instability as characterized by hepatic encephalopathy, past or present severe liver failure. * diabetes requiring insulin, or severe renal disease. * pregnant females. * high blood pressure. * individuals with vomiting who cannot take oral medications at beginning of study or whose vomiting can be controlled only with antiemetic medication. * high white blood count, or liver function test that is 3 times higher than normal. * known hypersensitivity or previous adverse reaction to carbamazepine, lorazepam, or other benzodiazepines. * any relevant ecg abnormality which might require hospitalization or greatly interfere with safety during outpatient withdrawal. * history of severe gastrointestinal (gi) disease which might render absorption of the medication difficult or produce medical instability of the patient during detoxification which would include active peptic ulcer disease, ulcerative colitis, regional ileitis, or evidence by history or physical examination of gi bleeding. * familial tremor or other neurological condition, determined by history, known to produce tremor. * unable to provide a written informed consent.