Kornimate/medical-research-clean huggingface dataset:
stroke prevention in sickle cell anemia (stop 1)

Conditions: Anemia, Sickle Cell; Cerebral Embolism and Thrombosis; Cerebrovascular Disorders; Hematologic Diseases; Hemoglobinopathies

Summary: to reduce episodes of first time stroke by 75 percent in children with sickle cell anemia by the administration of prophylactic transfusion therapy.

background: stroke, occurring in about 10 percent of pediatric patients with sickle cell disease, is one of the most devastating complications, with a high recurrence rate after the first episode. several non-randomized studies have shown reduction in stroke recurrence when periodic blood transfusions are administered to maintain hemoglobin s under 30 percent. periodic blood transfusions are associated with significant risks of iron overload and other complications and must be accompanied by parenteral iron chelation therapy. however, this has become a standard of care for prevention of recurrent stroke in ss children. thus, a randomized trial of blood transfusion for secondary prevention would not be feasible because it would be considered unethical. based on various studies, the recurrence rate is reduced from 46 to 67 percent to approximately 7 percent on transfusion therapy. because most stroke patients are left with some neurological deficit, and face a lifetime of disability, primary prevention would have a significant impact on the management of patients. however, because of complications of blood transfusions, the hypothesis should be proven by a randomized clinical trial. a primary prevention trial had not been possible because an acceptable means of detecting those children at risk of stroke was not available. the advent of tcd to identify arterial abnormalities for the prediction of stroke has provided a means of detection. tcd abnormalities have a high specificity (100 percent) and high sensitivity (90 percent) for detecting angiographically proven narrowing of arterial diameter. thus, tcd examination of the basal cerebral arteries is predictive of who will develop a stroke. design narrative: randomized, phase iii, multicenter. approximately 3,000 children from 12 clinics were screened with transcranial doppler (tcd). a total of 130 were randomized to receive either standard supportive care or periodic blood transfusions if they were found to be at high risk of stroke on the basis of elevated cerebral blood flow as measured by tcd screening tests. primary endpoints included clinically evident symptoms of cerebral infarction with consistent findings on magnetic resonance imaging (mri), and/or symptomatic intracranial hemorrhage. secondary endpoints included asymptomatic brain lesions detected by mri in brain areas not involved in primary endpoints. hematologic characteristics of the high risk group were analyzed and serum and dna samples frozen for future analysis. recruitment ended in october 1997 with the accrual of 130 subjects. the clinical phase ended in 1999.

Eligibility criteria:
pediatric patients, ages 24 months to 16 years, with sickle cell anemia or s-beta zero thalassemia.
seated ankle robot for foot drop in aging and disabled populations: a demonstration project

Conditions: Peripheral Nervous System Diseases; Gait Disorders, Neurologic; Foot Drop; Mobility Limitation

Summary: the purpose of this research study is to test the utility of an ankle robot in people with ankle weakness and foot drop from a peripheral nervous system injury due to neuromuscular or orthopedic injury.

many individuals with central nervous system (cns) injuries (e.g., a stroke) or peripheral nervous system (pns) injuries (e.g., peroneal nerve injury, neuropathy, radiculopathy, and/or musculoskeletal injury) that affect their ankle movement have residual impairments that affect their walking and balance. these impairments include the disability "foot drop," which increases the risk for falling. this study will focus on pns injuries that cause foot drop. current therapy to address foot drop is limited primarily to the use of ankle foot orthoses (braces) that help keep the foot from hitting the ground to prevent falling. also, some individuals with foot drop use functional electrical stimulation to the leg nerve to lift the foot. regardless, none of these, or other existing, methods to address foot drop cures or even improves significantly the underlying neurological deficit behind this disability. braces improve walking safety only while they are worn, and functional electrical stimulation does not work when it is turned off, or when the nerve has been severely damaged. thus, the increased fall risk due to foot drop is generally considered life-long and incurable. the investigators have developed a shoe-interfaced ankle robot with an adaptive control system, to assist an individual with ankle movement only as needed. data from the investigators' previous studies on foot drop due to stroke show great promise for this ankle robot as a new rehabilitation tool for invididuals with foot drop. the investigators would like to utilize our findings from these stroke studies in learning how they can be used for pns-related foot drop.

Eligibility criteria:
inclusion criteria: 1. men and women, aged 18 to 88 years 2. chronic foot drop and ankle weakness in one leg from a peripheral nervous system injury due to a neuromuscular or orthopedic injury 3. ability to walk 10 meters and arise from a chair with no human assistance (but usage of usual assistive device\[s\] is permitted) exclusion criteria: 1. medical history that would preclude participation in low-intensity seated robotic-assisted rehabilitation 2. current participation in orthopedic or rehabilitation medical programs 3. active deep venous thrombosis 4. distal paretic leg skin lesions, infections, or soft tissue inflammation
evaluation of bav in different hemodynamic entities of severe as

Conditions: Aortic Valve Stenosis

Summary: the purpose of this retrospective, observational study is to compare the profit of bav and tavi in different subtypes of serve aortic stenosis.

the balloon aortic valvuloplasty (bav) is a catheter-based intervention, which can be used for dilatation of serve aortic stenosis. with this minimally invasive intervention an increase of the aortic valve area (ava) and cardiac ejection fraction (ef), decrease of transvalvular gradients and ultimately a symptom relief should be achieved. the required effect is temporary and a definitive treatment should be aspired in suitable patients. therefor transcatheter aortic valve replacement (tavr) is available. following the guidelines of the european society of cardiology for the management of valvular heart disease from 2017, the aortic stenosis can be divided into different subtypes by using haemodynamic parameters: high-gradient as (hg-as), low-flow-low-gradient as (lflg-as) and paradoxical low-flow-low-gradient (plflg-as). patients with lflg-as are suspected to have a poorer prognosis when treated curative as well as when treated palliative medicamentous, because these patients show coronary and myocardial restrictions more frequently in addition to the valvular disease. the aim of the study is to compare safety and effectiveness of balloon aortic valvuloplasty as a bridging therapy and transcatheter aortic valve replacement as a definitive treatment in hg-as, lflg-as and plflg-as patients to verify whether the subtypes of aortic stenosis profit equally from these interventions.

Eligibility criteria:
inclusion criteria: * patients with severe aortic stenosos who underwent bav exclusion criteria: * insufficient echocardiographic parameters before bav

Keywords: balloon aortic valvuloplasty severe aortic valve stenosis surgical aortic valve replacement (savr)
deep learning-based sborn diagnostic model

Conditions: Nasopharyngeal Carcinoma; Herpesvirus 4, Human

Summary: skull-base osteonecrosis (sborn) is a severe long-term complication of nasopharyngeal carcinoma (npc) post radiotherapy, which significantly diminish the quality of life, increase the risk of internal carotid artery rupture, and is frequently misdiagnosed as npc recurrence. novel diagnostic tools are therefore clinically significant. in this study, the investigators seek to ask if a deep-learning-based model shows a significantly higher sensitivity than radiologists. with a cross-sectional design, the investigators aim to recruit 312 participants in sun yat-sen memorial hospital, guangzhou, china that meet the eligibility criteria.


Eligibility criteria:
inclusion criteria: * equal to or older than 18 years old. * a history of histologically confirmed nonkeratinizing undifferentiated nasopharyngeal carcinoma. * a history of radical radiotherapy at nasopharynx. * complete remission six months post radical radiotherapy according to recist 1.1. * no evidence of distant metastasis upon recruitment. * diagnosis of sborn given by senior radiologist with 2-4 likert scores. * consent to biopsy awake or under general anesthesia. * consent to perform blood tests, ebv dna, ebv igas, and mri inspection of nasopharynx and neck. * with a written consent. exclusion criteria: * mri artifacts or other factors that interfere radiological diagnosis and region of interest contouring. * suspected lesion is not confined to nasopharynx and skull-base.

Keywords: nasopharyngeal carcinoma skull-base osteonecrosis radiotherapy epstein-barr virus
care.coach avatars for improvement of outcomes in hospitalized elders, including mitigation of falls and delirium: a multi-site clinical study

Conditions: Delirium; Fall Injury

Summary: through ninr project 1r44nr017842-01 which preceded the present study, the investigators enhanced the care.coach avatar platform to incorporate a robust suite of evidence-based protocols based on the hospital elder life program (help), and to leverage an integration with hospital-based electronic medical record (emr) systems. in the present study, the investigators seek to validate the efficacy of the new avatar platform, as measured by reduction in falls, delirium, and patient sitter utilization. also, the investigators seek to gather patient and outcomes data at a scale sufficient to begin developing machine learning algorithms for intelligent, automatic assignment of protocols to maximize patient engagement and clinical efficacy, and for intelligent, automatic screening of delirium to assist care teams in positive identification of delirium. therefore, the present study comprises a two-year randomized between-groups comparison across multiple hospitals to compare outcomes with the new generation of care.coach avatars as the intervention versus usual care only as the control. each study group will be geographically distributed across participating research sites: initially medisys health network's jamaica hospital medical center in new york, with additional hospitals to join the study over the course of two years.


Eligibility criteria:
inclusion criteria: * fall/delirium risk (may be based purely on age at the election of each site, e.g. 65+) exclusion criteria: * aggression or combativeness with intent to harm self or others * severe hearing impairment and simultaneous severe vision impairment, despite assistive devices * no comprehension of either spanish or english

Keywords: patient satisfaction hcahps loneliness delirium falls help hospitals geriatrics elder care
positron lymphography via intracervical 18f-fdg injection for pre-surgical lymphatic mapping in stage ib1 cervical cancer and high-grade endometrial cancer

Conditions: Cervical Cancer; Endometrial Cancer

Summary: the purpose of this study is to see if a radioactive substance called 18f-fluorodeoxyglucose (18f- fdg), injected into the cervix during a pet/ct scan done before surgery can show us more clearly which lymph nodes in the pelvis (the area near your uterus and cervix) contain cancer.


Eligibility criteria:
inclusion criteria: * the study population will include women with stage ib1 cervical cancer (any histologic subtype) deemed eligible for surgery, and women with a clinical stage i high-grade endometrial cancer planning to undergo surgical staging. high grade is defined by the following: * uterine serous carcinoma * clear cell endometrial carcinoma * grade 3 endometrioid carcinoma * endometrial carcinosarcoma * clinical stage i grade 1-2 endometrial cancer also eligible with deep myoinvasion ≥ 50% shown on preop mri and/or elevated preop ca-125 \> 35 u/ml. * age ≥18 years * hemoglobin ≥10 g/dl * plasma albumin ≥3 g/dl * gog performance status ≤2 * plasma glucose ≤200 mg/dl * plasma creatinine ≤1.6 * well-controlled hypertension * medical clearance for surgery and considered an appropriate surgical candidate * negative serum pregnancy test, if of child-bearing potential * if, based on surgeon's assessment, the patient is recommended to undergo surgical staging for histologically confirmed endometrial cancer or if ib1 cervical cancer is deemed eligible for surgical treatment of disease * participation in other research protocols does not exclude a patient from participation in this study exclusion criteria: * hemoglobin \<10 g/dl * plasma albumin \<3 g/dl * gog performance status \>2 * plasma glucose \>200 mg/dl * renal insufficiency with plasma creatinine \>1.6 * uncontrolled hypertension * patient does not meet medical clearance for surgery and is not considered an appropriate surgical candidate * pregnancy for stage 2: * patient who are unwilling or unable to undergo mri including patients with contraindications to mri such as the presence of cardiac pacemakers of non-compatible intracranial vascular clips, claustrophobia, inability to lie flat for the duration of the study etc. * patients with a metallic hip implant or any other metallic implant or device in the pelvis that might distort local magnetic field and compromise quality of mri

Keywords: 18f-fdg injection positron lymphography lymphatic mapping sentinel lymph nodes pet/ct 14-222
evaluation of occupational burnout and stress among dentists in covid-19 pandemic

Conditions: Burnout; COVID-19; Dentistry; Filiation; Pandemic

Summary: the aim of this study was to evaluate the factors affecting the ability and willingness of dentists to work during the covid-19 pandemic and the effect of this situation on occupational burnout. a 51-question survey, including demographic and pandemic questions and the maslach burnout inventory (mbi), was used as a data collection method and administered to dentists in turkey via the internet in two stages. a link to the survey (onlineanketler.com) was sent to the participants by e-mail or social media (whatsapp©). a total of 706 participants were included in the study. the second stage of the survey only applied to dentists who are assigned within the scope of covid-19 measures in turkey.


Eligibility criteria:
inclusion criteria: * all dentist working during the covid-19 outbreak * accepted electronically to participate in our study * completed and submitted our electronic questionnaires successfully exclusion criteria: * non-dentists * did not accept electronically to participate in our study * did not complete not submitted our electronic questionnaires successfully
lifeflow fluid study- non- critical pediatric patients having a trans abdominal ultrasound

Conditions: Dehydration in Children; Dehydration

Summary: this is an unblinded, randomized control study examining two fluid delivery modalities for non-critical female patients with a planned transabdominal pelvic ultrasound requiring intravenous fluid boluses.

subjects be identified during their clinical course in the ed and will be randomized to either the lifeflow® fluid delivery or an iv fluid bolus through the alaris® pump (standard of care). iv fluids will be provided until the subject notes the sensation of a full bladder, at which point, the standard of care clinical practice is to perform the ultrasound. the transabdominal pelvic ultrasound requires a full bladder for optimal visualization of the ovaries, adnexa, and uterus, and is the only alternative to a transvaginal pelvic ultrasound for virginal young women. all other clinical care is per standard of care. the only research component is the randomization and data collection.

Eligibility criteria:
inclusion criteria: * female patients older than 1 month and less than 18 years * patients require iv crystalloid bolus fluids before a pelvic ultrasound exclusion criteria: * known cardiac insufficiency or significant cardiac surgery * hepatic insufficiency * renal insufficiency * any known fluid overload states (ascites, pulmonary edema) * on any diuretic or antihypertensive therapy * known pregnancy
parent skills training for families of children with autism spectrum disorder

Conditions: Autism Spectrum Disorder

Summary: the study is focused on helping parents master the basic intervention skills and evaluate the effectiveness of this parental training style for children with autism spectrum disorder in china.

the investigators designed a set of parental training curriculum about early intervention. the curriculum consists of three units: (1) delivery of theoretical intervention knowledge and analysis of successful training cases; (2) commenting and making suggestion on parent-child interaction videos; (3) demonstration of intervention skills and practice .the contents of the curriculum involved setting up an environment, developing objectives (verbal communication, non-verbal communication, social interaction, imitation, fine motor skills, etc.), designing activities, dealing with challenging behavior. this study will help parents master the basic intervention skills(how to set up an environment, develop objectives, design activities, deal with challenging behavior, etc) . at last the investigators will evaluate the effectiveness of this parental training style for children with autism spectrum disorder in china.

Eligibility criteria:
inclusion criteria: * children with asd or high risk for autism; * han ethic; * parents were at least middle school educated, and agreed to do at least 20 hours per week of planned practice activities with the child in daily life. exclusion criteria: * children with syndromic asd caused by known genetic defects or inherited metabolic diseases , such as rett syndrome, fragile x syndrome, angelman syndrome, prader-willi syndrome, tuberous sclerosis; * visual, auditory and physical disabilities; * complication with other serious chronic diseases, such as liver and kidney failure, connective tissue diseases, tumors.
a trial examining cellular energetics related to various wound treatment therapies

Conditions: Diabetic Foot Ulcers

Summary: a randomized, controlled pilot study examining how cellular energetics related to various wound treatment therapies in patients with diabetic foot ulcers.


Eligibility criteria:
inclusion criteria: * type ii diabetes * subject has a diabetic foot ulcer 5cm squared or greater * subject's diabetic foot ulcer is chronic exclusion criteria: * hgba1c of 12% or greater * presence of cellulitis * presence of osteomyelitis
induction of labor in women with unfavorable cervix: dilapan versus foley bulb

Conditions: Pre-induction Dilation of Cervix

Summary: women undergoing mechanical cervical ripening for labor induction will be randomized to dilapan-s® versus foley bulb. the investigators hypothesized that osmotic cervical dilators (dilapan-s®) are as effective as foley bulb catheter in rates of vaginal delivery.

historically, mechanical methods were the first methods developed to ripen the cervix or to induce labor. dilapan-s® a synthetic osmotic cervical dilator made of a patented hydrogel (aquacryl), works by stimulating the release of endogenous prostaglandins, which degrade collagen fibers and soften the cervix. additionally, it dilates the cervix gradually and the effect is gentle as well as predictable. recently, dilapan-s® has been approved by the fda as a mechanical dilator for cervical ripening. there are no data comparing this newly approved dilapan-s® to the foley catheter, the most commonly used mechanical dilator method. therefore, the investigators propose a randomized controlled trial to determine the efficacy of dilapan-s® compared with foley catheter for cervical ripening before induction of labor in pregnant women greater than 37 weeks.

Eligibility criteria:
inclusion criteria: * pregnant woman scheduled for induction of labor. * age between 18 and 45 years. * understanding and capable to sign informed consent. * singleton pregnancy. * gestational age ≥ 37 0/7 weeks. * live fetus in cephalic presentation. * intact membranes. * pelvic exam (sterile vaginal exam) of less than or equal to 3cm and at most 60% effaced. exclusion criteria: * iodine allergy. * active labor or oxytocin has been administered. * chorioamnionitis. * prior uterine or cervical surgery. * non reassuring fetal status requiring immediate delivery. * non-cephalic fetal presentation. * active vaginal bleeding from cervical os. * placenta previa. * efw \> 5000 gm(non diabetic) or \> 4500gm (diabetic). * other contraindication to vaginal delivery.

Keywords: labor foley dilapan cervical dilators induction
evaluation of an hydrophilic acrylic intraocular lens

Conditions: Cataract Senile

Summary: evaluation of the clinical safety and effectiveness of hydrophilic acrylic intraocular lens

to show safety and the effectiveness in regard to the monocular corrected distance visual acuity (cdva) at 12-24 month postoperative.

Eligibility criteria:
inclusion criteria: * patients of any gender, aged 18 years or older at the time of the surgery * patients who had an uncomplicated (no intra-operative complication) aged-related cataract surgery * currently implanted with the study iol into the capsular bag in at least one eye * one-year post surgery follow-up (365 days -14 days/+365 days) for the study eye at the time of the postoperative visit * patient is willing and capable of providing informed consent * patient is willing and capable of complying with visits and procedures as defined by this protocol exclusion criteria: * preoperative corrected distance visual acuity (cdva) better than 0.3 logmar (0.5 decimal) or cdva not available preoperatively * preoperative documented endothelial cell count of less than 2000/mm2 (if available) * any preoperative documented ocular disorder that could potentially cause a clinically significant future visual acuity loss * any preoperative documented clinically significant anterior segment pathology (e.g. chronic uveitis, iritis, aniridia, rubeosis iridis, anterior membrane dystrophies, poor pupil dilation, etc.) * any preoperative documented clinically significant abnormal corneal finding (e.g. keratoconus, pellucid marginal degeneration, or irregular astigmatism, clinically significant corneal membrane dystrophies) * any preoperative documented clinically significant condition that could affect iol stability (e.g. zonular dialysis, evident zonular weakness or dehiscence, etc.) * any preoperative documented history of clinically significant retinal pathologies or ocular diagnosis (e.g. diabetic retinopathy, ischemic diseases, macular degeneration, retinal detachment, optic neuropathy optic nerve atrophy, amblyopia, strabismus, microphthalmos, aniridia, epiretinal membrane etc.) that could alter or limit final postoperative visual prognosis * any preoperative acute infection (acute ocular disease, external/internal infection, systemic infection) * any previous preoperative intraocular and corneal surgery * preoperative documented uncontrolled glaucoma or iop higher than 24mmhg under ocular hypertension treatment * preoperative documented or current systemic or ocular pharmacotherapy that effects patients' vision * any other preoperative documented or current pathology or condition that could be a risk for the patient according to the investigator opinion * women during pregnancy and/or lactation at time of enrollment into the study * patients unable to meet the limitations of the protocol or likely of non-cooperation during the trial * patients whose freedom is impaired by administrative or legal order * subject is enrolled in any other concurrent clinical study, with the exception of local mandatory governmental registries and observational studies/registries, that do not affect patients' vision