Kornimate/medical-research-clean huggingface dataset:
shared decision making in the emergency department: chest pain choice trial

Conditions: Chest Pain; Acute Coronary Syndrome

Summary: our long-term goal is to promote evidence-based patient-centered evaluation in the acute setting to more closely tailor testing to disease risk. to compare the use of risk stratification tools with usual clinical approaches to treatment selection or administration, we propose the following: 1. test if chest pain choice safely improves validated patient-centered outcome measures in a pragmatic parallel patient randomized trial. hypothesis: the intervention will significantly increase patient knowledge, engagement, and satisfaction with no increase in adverse events. 2. test if the decision aid has an effect on healthcare utilization within 30 days after enrollment. hypothesis: the intervention will significantly reduce the rate of hospital admission, rate of cardiac testing, and total healthcare utilization.


Eligibility criteria:
inclusion criteria: 1. 18+ years of age (at least 18). 2. admitted to emergency department for chest pain. 3. being considered by the treating clinician for admission for cardiac testing. exclusion criteria: 1. ischemic changes on the electrocardiogram not known to be old as determined by the treating clinician in real time. 2. elevated cardiac troponin (ctn) above the 99th percentile reference limit. 3. known coronary artery disease as defined by consensus guidelines on risk stratification studies for emergency department patients with potential acute coronary syndrome (≥ 50% stenosis on cardiac catheterization; prior electrocardiographic changes indicative of ischemia, e.g., st-segment depression, t-wave inversion, or left bundle branch block; perfusion defects or wall motion abnormalities on previous exercise, pharmacological, or rest imaging studies; previous documentation of acute myocardial infarction; or, if no records are available, patient self-report of coronary artery disease). 4. cocaine use within the previous 72 hours by clinician history. 5. pregnancy. 6. referral to the emergency department by a personal physician for admission. 7. patients who indicate that a hospital different than the site hospital is his or her "hospital of choice" in the event of a return emergency department visit. 8. patients undergoing medical clearance for a detox center or any involuntary court or magistrate order. 9. homelessness, out-of-town residence or other condition known to preclude follow-up. 10. patients in police custody or currently incarcerated individuals. 11. patients who have, in their clinician's best judgment, major communication barriers such as visual or hearing impairment or dementia that would compromise their ability to give written informed consent (or use the decision aid).

Keywords: chest pain decision aid acute coronary syndrome cardiac emergency department cardiac testing healthcare utilization patient centered outcomes shared decision making unnecessary hospital admissions
exercise training in patients with pulmonary arterial hypertension

Conditions: Pulmonary Arterial Hypertension

Summary: in this study, the effects of kettlebell exercise training on functional capacity, dyspnea and activities of daily living in patients diagnosed with pulmonary arterial hypertension (pah) will be investigated.


Eligibility criteria:
inclusion criteria: * patients diagnosed with pulmonary arterial hypertension (pah) by a specialist physician in accordance with the 2015 guideline for the treatment and diagnosis of pulmonary hypertension of the european heart and respiratory societies (ers/esc), * patients with stable pharmacological treatment, * patients clinically stable at least last three months. exclusion criteria: * presence of orthopedic or neurological problems that will affect functional tests and muscle strength measurement, * recent surgical procedures, * recent syncope, * pregnancy, * presence of severe left heart failure, * presence of severe ischemic heart disease, * hypertensive patients, * patients who have problems in communicating.
tislelizumab in participants with relapsed or refractory classical hodgkin lymphoma

Conditions: Classical Hodgkin Lymphoma

Summary: the primary objective of the study is to evaluate the efficacy of tislelizumab in participants with relapsed/refractory classical hodgkin lymphoma, as measured by the overall response rate per the lugano classification, and as determined by the investigator.


Eligibility criteria:
key inclusion criteria: 1. histologically confirmed diagnosis of relapsed or refractory chl 2. relapsed chl (disease progression after pr or cr to the most recent therapy) or refractory chl (failure to achieve pr or cr to most recent therapy). participants will be allocated to one of two cohorts based on the following criteria: cohort 1: relapsed or refractory to prior autologous hematopoietic stem cell transplant (hsct) 1. has failed to achieve a response or progressed after autologous hsct 2. is not a candidate for additional autologous or allogeneic hsct cohort 2: relapsed or refractory to salvage chemotherapy, and has not received prior autologous or allogeneic hsct 1. is not a candidate for autologous or allogeneic hsct 2. has received at least 1 prior systemic regimen for chl 3. measurable disease defined as ≥ 1 2-\[18f\] fluoro-2-deoxy-d-glucose (fdg)-avid nodal lesion that is \> 1.5 cm in the longest diameter, or ≥ 1 fdg-avid extra-nodal lesion (eg, hepatic nodules) that is \> 1 cm in the longest diameter 4. eastern cancer oncology group (ecog) performance status of 0 or 1 key exclusion criteria: 1. nodular lymphocyte-predominant hodgkin lymphoma or gray zone lymphoma 2. prior allogeneic hematopoietic stem cell transplantation 3. prior therapy targeting pd-1 , pd-l1,pd-l2, or ctla-4 (cytotoxic t-lymphocyte-associated protein 4) pathways 4. active autoimmune disease or history of autoimmune disease that may relapse note: other protocol defined inclusion/exclusion criteria may apply.
mri risk maps for prostate cancer diagnosis using targeted biopsy

Conditions: Prostate Cancer; Prostate Adenocarcinoma; Prostate Neoplasm

Summary: doctors leading this study hope to learn about a software that researchers at the university of chicago have developed to help analyze radiographic images (different techniques for taking images that allow doctors to visualize the body's internal structures) of the prostate. participation in this research will last about 12 months. there is a one-time mri and 1-2 biopsies and then the investigator would like to follow the participant's progress.


Eligibility criteria:
inclusion criteria: * patients with known or suspected prostate cancer who have been referred for a diagnostic magnetic resonance imaging (mri) exam of the prostate, to be followed by an mri-guided fusion biopsy of the prostate. * voluntary written informed consent before the mri examination. exclusion criteria: * subjects incapable of giving informed written consent. * subjects who cannot adhere to the experimental protocols for any reason, or have an inability to communicate with the researcher; * subjects with psychiatric disorders that affect their ability to consent for themselves will be excluded and not the entire population of patients with psychiatric disorders. * prisoners. * minor children (under the age of 18 years old). * patients with previous treatments (surgery, radiation, focal ablation, hormone or other chemotherapy) for prostate cancer.

Keywords: prostate cancer
clinical benefit of the treatment with trastuzumab in combination with lapatinib in metastatic breast cancer her2 positive patients who has been previously treated with trastuzumab and/or lapatinib

Conditions: Breast Neoplasm

Summary: a retrospective, observational, not epa, multicenter study to evaluate the clinical benefit of trastuzumab in combination with lapatinib in metastatic breast cancer her2 positive patients who has been previously treated with trastuzumab and/or lapatinib between january 2005 and december 2011


Eligibility criteria:
inclusion criteria: * confirmed diagnosis of metastatic breast cancer her2-positive phenotype (confirmed by ihc 3 + or fish positive) * older than 18 years * progressed to at least one prior treatment line for mbc with trastuzumab and / or lapatinib, either as monotherapy or in combination with chemotherapy or hormonal therapy schemes * having the patient's complete medical history that contains all lines antiher2 therapy treatment * being a patient who initiated the combination of trastuzumab and lapatinib between january 2005 and december 2011 * inform the patient and get the signature of the informed consent exclusion criteria: * not having phenotypic classification of the tumor by ihc or fish test for her2 * being a patient with her2-negative phenotype(fish negative or ihc in range \[0-2 +\] without fish) * being a patient who received the trastuzumab and/or lapatinib treatment (tl) in combination with chemotherapy * being a patient who, since january 2012, began tl therapy for metastatic disease.

Keywords: breast neoplasm receptor,her2 antineoplastic agent antibodies, monoclonal trastuzumab, lapatinib protein kinase inhibitors quinazolines
influence of treatment for patent ductus arteriosus on cerebral oxygenation in preterm infants

Conditions: Prematurity of Fetus; Patent Ductus Arteriosus

Summary: the purpose of this study is to examine the influence medical or surgical treatment for patent ductus arteriosus in preterm infants on cerebral and renal tissue oxygenation and on cardiac output.

in this observational trial the investigators want to examine whether clinical or echocardiographic parameters of patent ductus arteriosus are related to * cerebral tissue oxygen saturation, total hemoglobin, fractional tissue oxygen extraction and hbd * renal tissue oxygen saturation, total hemoglobin, fractional tissue oxygen extraction and hbd as measured by near infrared spectroscopy and to * stroke volume * cardiac output as measured by electrical cardiometry. the investigators want to examine the impact of surgical and medical treatment for patent ductus on these parameters. the investigators want to compare the change of these parameters between responders to medical treatment and nonresponders.

Eligibility criteria:
inclusion criteria: * newborn infant below 34 weeks postmenstrual age at the time of birth * patent ductus arteriosus with signs of hemodynamic relevance (as judged by the attending neonatologist) * parental informed consent exclusion criteria: * patent ductus arteriosus as part of malformation syndrome * additional major cardiovascular malformations

Keywords: preterm neonates hemodynamically relevant patent ductus arteriosus
the effect of laughter yoga on the stress levels of infertility women

Conditions: Laughter Yoga

Summary: this research is a randomized controlled study to evaluate the effect of laughter yoga on the stress levels of infertility women. randomization was provided in the sample included in the study, and it was divided into experimental and control groups. at the beginning of the study, the infertility stress scale was applied to women in both groups to determine their stress levels. afterwards, 8 sessions of laughter yoga were applied to the experimental group for 4 weeks. no application was made to the control group. after 4 weeks, the infertility stress scale was administered to the women in both groups to re-determine their stress levels.

this research is a randomized controlled study to evaluate the effect of laughter yoga on the stress levels of infertility women. at the beginning of the study, necessary ethics committee permission and institutional permissions were obtained. both of the researchers have a certificate of leadership in laughter yoga. as a result of the power analysis, it was determined that 80 women should be included in the study. considering that there may be losses, it was decided to include 90 women in the study. by providing randomization, 90 women who met the sampling criteria and volunteered to participate in the study were divided into two groups as 45 experimental and 45 control. at the beginning of the study, the infertility stress scale was applied to women in both groups to determine their stress levels. afterwards, 8 sessions of laughter yoga were applied to the experimental group for 4 weeks, two sessions a week. no application was made to the control group. after 4 weeks, the infertility stress scale was administered to the women in both groups to re-determine their stress levels.

Eligibility criteria:
inclusion criteria: * be between the ages of 19-45 * have been diagnosed with infertility * at least primary school graduate * not having a diagnosed psychiatric disease * will not have an ovulation pick up process, intrauterine insemination and embryo transfer procedure in the next 1 month exclusion criteria: * have ovulation pick up process in the last 1 month * undergoing intrauterine insemination in the last 1 month * undergoing an embryo transfer in the last 1 month * not regularly attending laughter yoga sessions (for the experimental group) * applying another alternative method to reduce stress during the research process

Keywords: laughter yoga infertility stress nurse
effect of cerebral oxygen saturation monitoring on pocd of elderly patients undergoing shoulder arthroscopy

Conditions: Cerebral Oxygen Saturation; Postoperative Cognitive Function

Summary: to observe whether adjusting the level of intraoperative controlled hypotension through cerebral oxygen saturation monitoring can improve postoperative cognitive function(pocd) and reduce postoperative neurological complications, a prospective randomized controlled study method will be used in this study. 400 elderly patients undergoing shoulder arthroscopic surgery under general anesthesia combined with brachial plexus block will be selected. they will be randomly divided into control group and experimental group according to whether cerebral oxygen saturation monitoring was used during the operation. the control group maintain the target blood pressure only according to the controlled hypotension guideline, and the experimental group adjust the controlled hypotension level under the guidance of cerebral oxygen saturation monitoring. the general condition, operation, anesthesia and hospitalization related data of the patients will be recorded.

cognitive function will be evaluated within 3 days before operation and 3 days, 14 days and 3 months after operation. delirium and vas pain score will be evaluated 24 hours after operation. venous blood will be taken before operation and 24 hours after operation to detect cognitive related markers and inflammatory factors. in addition, 10 blood samples of patients in each group were selected for rna omics test. one month, six months and 12 months after operation, cognitive function was evaluated by cognitive function telephone questionnaire (tics-m), and the ability of daily living was evaluated by idal. in addition, 20 non-surgical patients were selected for cognitive function evaluation at the same time point as the exercise effect of pocd detection.

Eligibility criteria:
inclusion criteria: * patients undergoing elective shoulder arthroscopic surgery under general anesthesia combined with brachial plexus block; * asa grade ≤ grade iii; * patients can communicate normally, can cooperate and complete cognitive function test; * patients volunteered and signed informed consent. exclusion criteria: * bmi \ 27 kg / m2; * previous history of dementia, psychosis or other central nervous system diseases or mental diseases, such as cerebral infarction, stroke, parkinson's disease, etc; * patients taking sedatives or antidepressants; * alcoholics or drug addicts; * illiteracy, severe hearing or visual impairment; * patients with cognitive impairment before operation (mmse score \< 23); * patients with peripheral vascular diseases and contraindication of arterial puncture and catheterization; * patients unable to carry out long-term follow-up or poor compliance.

Keywords: controlled hypotension
the effects of early enteral nutrition on endoscopic therapy of esophagogastric varices in liver cirrhosis

Conditions: Liver Cirrhosis; Esophageal and Gastric Varices

Summary: the purpose of this study was to evaluate the safety of early enteral nutrition on endoscopic therapy of esophagogastric varices in liver cirrhosis ,and to assess the impact of different eating times on patients, so as to determine the best time for patients to obtain nutrition after surgery.

for patients with gastroesophageal varices in liver cirrhosis,, there is no clear guideline and consensus on when to start eating after endoscopic treatment. in 2015, a randomized controlled study in taiwan of china confirmed that compared with liquid diet given 48 h after endoscopic treatment, liquid diet given 4 h and started enteral nutrition would not increase the risk of rebleeding, and could improve the nutritional status of patients. however, some patients after endoscopic treatment would suffer from post-sternal pain, abdominal pain, nausea, vomiting and other discomforts, affecting appetite and delay the diet time. based on the above research background, we observed and evaluated the safety and effectiveness of early enteral nutrition in patients with cirrhotic esophageal and gastric varices after endoscopic treatment, and analyzed the influencing factors of enteral nutrition in patients with cirrhotic esophageal and gastric varices after endoscopic treatment, so as to further clarify the optimal time for patients to eat after endoscopic treatment.

Eligibility criteria:
inclusion criteria: * patients with cirrhosis of gastroesophageal varices undergoing endoscopic therapy exclusion criteria: * endoscopic treatment of uncontrollable bleeding * accompanied with other endoscopic treatments that need to be fasting * with obvious hepatic encephalopathy and liver failure * did not sign the informed consent form and refused to participate

Keywords: early enteral nutrition esophageal and gastric varices rebleeding
a transgenerational e-intervention for gestational diabetics and their offspring

Conditions: Gestational Diabetes Mellitus; Pregnancy

Summary: this study includes a behavioral educational intervention that focuses on healthy eating, physical activity and glucose management during pregnancy and post partum among women newly diagnosed with gestational diabetes mellitus (gdm).

this is a pilot trial in which 50 women newly diagnosed with gestational diabetes are randomized to either one of two groups: 1) active internet intervention or 2)usual care (self-directed) educational intervention. the primary pregnancy outcome is change in a1c. the primary postpartum outcome is weight.

Eligibility criteria:
inclusion criteria: * diagnosed with gestational diabetes confirmed singleton pregnancy 24-32 weeks gestation age planning to deliver within the study area exclusion criteria: * pre-existing diabetes (type 1 or 2) non-english speaking not planning to deliver in the study area

Keywords: gestational diabetes
swallowing disorders after prolonged mechanical ventilation

Conditions: Larynx Disease

Summary: epidemiology study for evaluation of incidence of swallowing disorders (sd) after prolonged invasive ventilation (more than seven days), using a clinical statement. all consecutive patients are screened, and clinical evaluation is performed during 48h after patient's extubation. if a sd exist, a new evaluation is realized 48h after. three groups will be created (1.no sd, 2.transitory sd and 3.persistent sd (eg persistent after 48h)). data complementary are notified at day 28 (pneumonia? nutritional status?)


Eligibility criteria:
inclusion criteria: * more than 7 days of invasive mechanical ventilation exclusion criteria: * age \< 18 years old * preexistent swallowing disorders, stroke, tracheostomy * failure of patient's agreement
micra accelerometer sensor study 2

Conditions: Bradyarrhythmia

Summary: the purpose of the mass2 is to characterize accelerometer signals of micra implantable device during different postures and activities and to understand the source of the sensed motion, in order to test feasibility for future enhancements in device functionalities.


Eligibility criteria:
inclusion criteria: * subject is ≥ 18 years old * subject is implanted with a micra device * subject or witness (if applicable as per local regulation) is able and willing to provide informed consent exclusion criteria: * subject is in atrial fibrillation * subject is not able to perform study requirements
chromoendoscopy in inflammatory bowel disease

Conditions: Colonoscopy

Summary: patients with longstanding ulcerative colitis (inflammatory bowel disease, ibd) have increased risk of developing colorectal cancer (crc) when compared with that of the general population. therefore patients with longstanding colitis undergo regular screening colonoscopy at varied time intervals depending on their individual risk. this is thought to detect early mucosal (interior bowel lining) abnormalities, known as dysplasia, which can progress to crc. until recently, ibd surveillance has relied upon colonoscopy with multiple (at least 33) random biopsies of the bowel lining to detect dysplasia, but now international guidelines recommended a technique called chromoendoscopy. chromoendoscopy involves applying a dye, called indigo-carmine, to the bowel lining whilst performing colonoscopy which highlights more subtle abnormalities, therefore increasing dysplasia detection rate. there is no standard international concentration of the dye spray used during chromoendoscopy. studies have used different concentrations of indigo-carmine dye ranging from 0.1 to 0.4%. we have recently shown that 0.2% dye improves detection rates compared to high definition white light. the recent international scenic guidelines suggest using 0.03% indigo-carmine via a foot pump. however there are no trials comparing the two methods and no previous trials have used the 0.03%. we therefore aim to perform a randomised control trial, comparing 0.03% indigo-carmine dye versus 0.2% in detecting dysplasia in patients undergoing surveillance colonoscopy in ibd. any lesions seen will assessed using standard endoscopic appearance but also using optical biopsy forceps to further characterise the lesion, then manage the lesion as standard guidelines. we will also take two additional rectal biopsies, which will be snap frozen in liquid nitrogen and then studied using raman spectroscopy, infra red spectroscopy and electrochemical impedance to develop optical markers to identify patients at higher risk of dysplasia.


Eligibility criteria:
inclusion criteria: * 1) patients with longstanding (more than 8 years of disease), extensive (extending proximal to splenic flexure) colitis attending for surveillance colonoscopy. 2) patients aged over 18 years of age 3) patients with primary sclerosing cholangitis and inflammatory bowel disease colitis. exclusion criteria: * 1) pregnant 2) unwilling or unable to give informed consent 3) severe active colitis 4) poor bowel preparation 5) unable to reach the caecum