Kornimate/medical-research-clean huggingface dataset:
effects of phlebotomy on insulin sensitivity in insulin resistance-associated hepatic iron overload patients

Conditions: Insulin Resistance; Iron Overload

Summary: the purpose of this study is to evaluate efficacy of phlebotomy on insulin sensitivity as evaluated by euglycemic-hyperinsulinic clamp in insulin resistance-associated hepatic iron overload patients.

the main objective of this study is to evaluate in patients with hsd effects of treatment with phlebotomy rules with lifestyle and dietary rules versus lifestyle modifications alone on peripheral insulin resistance (assessed by hyperinsulinemic clamp). secondary objectives are: * to study in all patients with hsd the relationship between the amount of iron intrahepatic and degree of peripheral insulin resistance and liver before therapeutic intervention. * to study and compare the effects of phlebotomy treatment versus no treatment on: * plasma levels of adipocytokines, * plasma concentrations of inflammatory markers and markers of insulin resistance, * the serum ferritin, * the post-hepatic clearance of insulin, * the surface of the abdominal visceral fat and subcutaneous abdominal.

Eligibility criteria:
inclusion criteria: * age between 18 and 70 years * ferritin between 450 and 1000 µg/l * hepatic iron overload proved by mri (chf \>36 µmol/g) * body mass index \> 25 kg/m² * fasting glycemia \<1,26 g/l * hba1c \< 6,5% * signed written and informed consent exclusion criteria: * other causes of hyperferritinemia: * inflammatory syndrome (crp \>10 mg/l) or inflammatory, immune or malignant diseases * hyperferritinemia-cataract syndrome (familial cataract or personal history of cataract before 50 years old) * low ceruloplasmin level * porphyria (cutaneous signs) * haemochromatosis established by the genotype (c282y homozygous or c282y/h63d coumpound heterozygous genotypes) * contraindication of phlebotomy * haemoglobin \<13,5 g/dl (threshold established by the etablissement français du sang) * heart failure or coronary heart diseases * hepatic failure, renal (gfr \<50ml/min) or respiratory insufficiency (chronic dyspnea) * poor venous system * viral, immune, genetic, vascular, malignant or toxic chronic hepatic disease * alcohol consumption more than 21 doses per week during 5 years or more * type 1 or type 2 diabetes * oral anti-diabetic, corticoids or immune suppressor drugs * hepatic severe disease * claustrophobia, having a pace-maker or intracerebral clips * subjects deprived of their liberty by judicial or administrative decision, subjects that are not affiliated to social security or topics exclusion period of a previous study

Keywords: phlebotomy insulin resistance iron overload
improving sleep in a psychiatric hospital

Conditions: Sleep Disorder; Mental Health Issue

Summary: the purpose of this study is to examine effects of sleep promotion versus treatment as usual (tau) on subjective, self-reported sleep while in inpatient psychiatric treatment, to examine effects of sleep promotion vs. tau/sleep disruption on self-reported depression, anxiety, suicide risk across inpatient length of stay, readmission at 72 hours, objective sleep and to compare implementation outcomes of acceptability and feasibility of sleep promotion relative to tau/sleep disruption as reported by patients, clinicians, and clinic leaders using mixed methods.


Eligibility criteria:
inclusion criteria: * admitted voluntarily to inpatient psychiatric hospital for suicidal ideation or behavior. * continue to express suicide risk on the suicide behaviors questionnaire-revised (sbq-r) of ≥8 at admission. * cognitive ability as tested by the montreal cognitive assessment (moca) of \> 23. * have sufficient communication and comprehension ability to consent to the study * english speaking exclusion criteria: * intellectual disability/unable to give informed consent. * patients with one-to-one supervision or 15-minute (q15) safety checks for suicidality or aggression will be unable to enroll in the study until these restrictions are discontinued. * patients with roommates that are on one-to-one supervision or q15 safety checks for suicidality or aggression. * patients enrolled in the study with a patient admitted as their roommate who requires one-to-one supervision or q15 checks-patient will be unenrolled if a room change is not possible.

Keywords: suicidal ideation
training therapists to administer contingency management-patient phase - 3

Conditions: Substance Abuse

Summary: the purpose of this study is to train therapists to administer contingency management (cm). this project will train up to 42 community-based treatment providers about the rationale for and the specifics of administering cm. initial training will occur in 2-day workshops, followed by weekly supervision in delivery of cm with test cases. we expect that the majority of therapists will achieve high levels of competence and adherence in administering cm treatment within 3-5 test cases, as measured by ratings of audiotapes. to examine the efficacy of cm, each therapist who achieves adherence and competence in delivering cm will administer standard treatment alone or standard treatment plus cm to substance-abusing outpatients. in the cm condition, patients will have the opportunity to win prizes for submission of negative samples, and the treatment will be in effect for 12 weeks. in total, up to 200 patients will be randomly assigned to one of the two conditions. a research evaluator will conduct follow-up assessments, scheduled for 3, 6 and 9 months after treatment initiation.


Eligibility criteria:
inclusion criteria: * age 18 years or older * meets dsm-iv criteria for cocaine abuse or dependence * english speaking (est. \>90% of patients) for those in drug-free programs, they must have initiated treatment within the past week. for methadone patients, they must be stabilized on a dose of methadone, defined as being on the same dose for at least 30 days and not currently requesting or being considered for a dose modification. methadone patients must also have submitted at least 30% cocaine positive urine samples in the past 3 months. exclusion criteria: * acute uncontrolled psychiatric disorder (psychosis, suicidality) as determined by the scid * dementia (\<23 on the mini mental state exam; folstein \& folstein, 1975) * in recovery for pathological gambling

Keywords: contingency management substance abuse treatment
construct and evaluate the effectiveness of a theory-based mhealth for overweight and obese women during pregnancy

Conditions: Gestational Weight Gain; Physical Activity

Summary: this study was to construct and develop an application (app) based on social-cognitive theory for overweight and obese women during pregnancy.

our program used and evaluated the mhealth program, which has pregnant women using app and wearable devices to help prevent excessive gestational weight gain, and it continued to promote physical activity for overweight and obese pregnant women.

Eligibility criteria:
inclusion criteria: pregnant women--who have had, for 8-12 weeks, a pre-pregnancy body mass index of more than 25 kg/m2 exclusion criteria: high risk pregnancy, such as pre-clampsia, pregnancy induced hypertension, preterm contraction

Keywords: overweight obese pregnant women
engaging staff to improve covid-19 vaccination response at long-term care facilities

Conditions: COVID-19

Summary: the enspire study is a cluster-randomized comparative effectiveness trial being conducted within long-term care and residential facilities that will test a communication and engagement strategy for increasing covid-19 booster vaccination rates against an enhanced usual care comparator (centers for disease control and prevention or other national organization vaccine education and communication materials) among facility staff. the communication and engagement strategy being tested includes (1) the development of materials co-designed with and tailored to facility staff whose primary language is a language other than english or who are from certain cultural affinity groups and (2) the distribution of the developed materials by members of the language/cultural affinity groups with peer advocacy activities (full intervention). the study is being conducted in washington state and georgia. long-term care/residential facilities will be asked to furnish their staff booster rate at 4 timepoints: pre-intervention, and one month (timepoint 1), 3 months (timepoint 2), and 6 months (timepoint 3) post-intervention. staff at participating long-term care facilities will be invited to complete three online surveys at 3 timepoints: pre-intervention, 3 months post-intervention and 6 months post-intervention. long-term care facilities will be randomized to a trial arm following the pre-intervention data collection.


Eligibility criteria:
inclusion criteria: * works at a participating long-term care facility that has more than 50 staff members, has a staff covid-19 booster vaccination rate of ≤60% as of december 1, 2021, and is located in washington state or georgia. * 18 years or older exclusion criteria: * does not work at an enrolled long-term care facility * 17 years or younger

Keywords: vaccine confidence
oral health and nutrition integrated care model

Conditions: Deglutition Disorders

Summary: the purpose of this project is to propose an "oral health and nutrition integrated service model" for the long-term care system based on the establishment of the assessment tools for oral hygiene and health, swallowing ability, nutritional status and food texture. this service model will be as the reference for long-term care policy making. this project includes four aspects such as evaluation tools, professional training, community promotion and policy development which will be completed in 5 stages. in the first stage, we will search and review the domestic and international materials which are related with the tools for evaluating oral hygiene and health (oral health assessment tool, ohat), swallowing ability (eat-10, eating assessment tool; functional oral intake scale, fois), nutritional status (taiwan version of mini nutritional assessment, mna) and food texture (taiwan food texture grading system). we will also inventory the resources of oral health and nutrition before importing to community. in the second stage, an expert meeting will be held to determine the evaluation tool and the teaching materials of the training courses. in the third stage, an institution (en chu kong nursing home) will be the filed area to establish the "oral health and nutrition integrated service model". at the same time, assistants and instructors will be trained for conducting the assessment of oral health and nutrition status in the institution. then, the status of oral health, chewing ability and nutrition will be investigated in the institution. in the fourth stage, we will modified the materials of training programs based on the data from resources inventory for the community (zhong-he district, for example: li-xing village, de-xing village or zheng-xing village). furthermore, the training programs for assistants and instructors will be also held in the community during the fourth stage. in the fifth stage, based on the evaluation tools and the integrated service models, the practical suggestions will be provided for the long-term care service policy making and implementation.


Eligibility criteria:
inclusion criteria: * hospitalized people in en chu kong nursing home (taiwan) * consciousness with expressing ability exclusion criteria: * unconscious * without expressing ability
the effect of active breathing exercises in stroke patients with respiratory rhythm disorder

Conditions: Respiratory Rhythm Disorder

Summary: the goal of this clinical trial is to explore the effect of active breathing exercises in stroke patients with respiratory rhythm disorder. patients will be randomly divided into an observation group and a control group, all receiving routine rehabilitation treatment. on this basis, the observation group will be given active breathing exercises. researchers will compare dysphagia of two groups.

a growing body of literature indicates the existence of a highly stable, coordinative relation between respiration and oropharyngeal swallowing in healthy adults. the goal of this clinical trial is to explore the effect of active breathing exercises in stroke patients with respiratory rhythm disorder. patients will be randomly divided into an observation group and a control group, all receiving routine rehabilitation treatment. on this basis, the observation group will be given active breathing exercises. researchers will compare dysphagia of two groups.

Eligibility criteria:
inclusion criteria: * diagnosed with respiratory rhythm disorder * age ≥ 18 years; * meeting the diagnostic criteria of stroke; * any degree of dysphagia at admission; * steady vital signs, without severe cognitive impairment or sensory aphasia, able to cooperate with the assessment. * transferred out within three weeks of hospitalization in the neurology department. exclusion criteria: * complicated with other neurological diseases; * tracheostomy tube plugged; * unfeasible to the support of parenteral nutrition; * simultaneously suffering from liver, kidney failure, tumors, or hematological diseases.
a partnership to translate an evidence-based intervention (take heart) for vulnerable older adults with heart disease

Conditions: Heart Diseases

Summary: to evaluate the effectiveness of take heart, a behavioral/educational program for adults age 50+ with heart disease, or with at least two risk factors for heart disease, that helps them to better manage their health condition(s). take heart is a new version of an evidence-based program that has recently been adapted to be suitable for the needs of adults residing in detroit.

in this study, a heart disease self-management program will be tested in a low-income, predominantly african-american community via a partnership with the detroit area agency on aging (daaa), the detroit medical center (dmc), and university of michigan school of public health's center for managing chronic disease (cmcd). the specific aims of the research are to: (1) adapt existing program materials to be appropriate for the new target population, getting feedback from various sources including focus group interviews; (2) conduct a pilot study of the adapted "take heart" program; (3) refine the intervention and conduct a randomized trial with 376 participants age 50 years and over, to assess health outcomes; (4) assess the translation and implementation of the intervention in the target setting and identify factors that help and hinder the process; (5) assess cost savings associated with the intervention; and (6) develop guidelines for "scaling up", that is, for replicating the program in other low-income areas through the national network of area agencies on aging.

Eligibility criteria:
inclusion criteria: 50 years or older 1 or more diagnosed cardiovascular conditions, including: * atrial fibrillation * angina * myocardial infarction * congestive heart failure * valvular disease (aortic stenosis or mitral regurgitation) * peripheral vascular disease * pulmonary hypertension * or \>2 major risk factors for cardiovascular disease (cvd; high cholesterol, high blood pressure, smoking, diabetes, chronic kidney disease-stage 3 or 4) * must have access to a mobile or landline telephone * must be able to travel to group sessions, with or without transportation assistance exclusion criteria • limited fluency in english posing significant barrier to deriving program benefit

Keywords: self-care health education chronic disease heart diseases risk factors for heart disease
hypogonadism in young men with type 2 diabetes

Conditions: Hypogonadotropic Hypogonadism; Type 2 Diabetes

Summary: low testosterone production, known clinically as hypogonadism, appears to be common complication of type 2 diabetes, affecting one in three diabetic men. hypogonadism is known to be associated with decreased muscle mass, increased fat mass, increased inflammation and decreased fertility. in this grant, the investigators propose to study the effects of having low testosterone on 1) insulin sensitivity, the ability of the body to handle glucose 2) fat and muscle mass at specific areas of the body 3) expression of mediators of inflammation in the blood 4) semen quality. this study will compare diabetic men (with or without hypogonadism). this study will also evaluate the effect of treatment with clomiphene (a drug that increases testosterone and sperm production) or testosterone in men with diabetes and hypogonadism. the investigators hope that this project will help us understand the state of hypogonadism in young type 2 diabetic men who are in their peak fertility years and give us insights into treatment of this condition. with the rising prevalence of type 2 diabetes in the young, this project may have implications for public health.

this project will study young men with type 2 diabetes. we have shown that half of these men have low testosterone levels. this can lead to 1) low muscle mass; 2) more fat mass; 3) insulin resistance; 4) low sperm count and 5) increased inflammation (that increases the risk of heart disease). this project will study these consequences in detail and also the possibility of reversing them with treatment. information from this project will be useful in planning of future studies that will evaluate the effect of treatment of low testosterone on mortality, heart disease and stroke.

Eligibility criteria:
inclusion criteria: * t2d males with age 18-40 years exclusion criteria: 1. planning to have children in the next one year 2. use of androgens, cc, hcg, aromatase inhibitors or over the counter health supplements which contain androgens currently or in the past 6 months; 3. psa \> 4ng/ml, symptoms of severe bph, prostate nodule or severe enlargement on digital rectal examination or h/o prostatic carcinoma 4. hemoglobin a1c \> 8% 5. hematocrit \> 50% 6. history of obstructive sleep apnea 7. congestive heart failure 8. use of thiazolidinediones or exenatide 9. currently suffering from depression, with or without treatment 10. history of severe depression in the past which needed hospitalization 11. currently suffering from foot ulcer, significant periodontal disease or any other chronic infectious condition 12. coronary event or procedure in the previous 6 months 13. hepatic disease (transaminase \> 3 times normal) or cirrhosis 14. renal impairment (serum creatinine \> 1.5) 15. hiv or hepatitis c positive status 16. participation in any other concurrent clinical trial

Keywords: hypogonadism diabetes spermatogenesis insulin resistance
endoscopist and endoscope motions during colonoscopy

Conditions: Intestinal Disease; Colonic Diseases

Summary: the aim of the study is to record and analyze endoscopist and endoscope motions to identify key movements during colonoscopy.

the increasing development of interventional digestive endoscopy raises the challenge to teach and learn complex endoscopic procedures. nowadays experts are facing the challenge of explaining precisely an elaborate choreography of movements performed during the procedure, while novices are confronted with a broad range of hand, wrist and shoulder movements each resulting in different endoscope responses. the teaching strategy of endoscopy could benefit from a dedicated motion library that would associate the endoscopist's motion and the consequent endoscope response. a simplified endoscopic language made of individual motions could greatly shorten the learning curve. the aim of the study is to record and analyze endoscopist and endoscope motions to identify key movements during colonoscopy.

Eligibility criteria:
inclusion criteria: * patient male or female * patient over 18 years old * patient who are scheduled for a colonoscopy procedure under sedation * patient able to understand the study and provide written informed consent * patient affiliated to the french social security system. exclusion criteria: * patient unable to provide a written informed consent * patient with an altered colonic anatomy due to previous surgery * patient with a known anomaly of the colon * patient carrying an implantable medical device (pacemaker...) * patient with a condition preventing its participation to study procedures, according to investigator's judgment * pregnancy or breastfeeding * patient in custody * patient under guardianship

Keywords: colonoscopy tracking motion
the influences of caffeine on heart rate variability of preterm infants

Conditions: Autonomic Nervous System

Summary: caffeine has a stimulatory effect on the ans. this has not yet been investigated in preterm infant who get caffeine before stopping ventilation. the investigators hypothesis is that this stimulatory effect may be characterized by hrv analysis methods.


Eligibility criteria:
inclusion criteria: * infants born before 34 weeks gestation exclusion criteria: * sepsis * congenital malformations

Keywords: autonomic nervous system
new stent retriever, versi system for ais

Conditions: Acute Ischemic Stroke

Summary: to confirm efficacy and safety of versi system for acute ischemic stroke

efficacy; tici 2a or more recanalization upto 3 pass of study device safety; symptomatic intracranial hemorrhage within 24 hours of procedure

Eligibility criteria:
inclusion criteria: * onset to treat within 8 hours * nihss 8 or more * aspects 5 or more * target vessel is ica, mca, va, ba, pca * non-eligible or failed iv rt-pa exclusion criteria: * known hemorrhagic tendency * arterial dissection, vasculitis * allergy for contrast media * other inappropriate condition