Kornimate/medical-research-clean huggingface dataset:
personalized experiences to inform improved communication for minorities with life limiting illness

Conditions: COPD; Heart Failure; Cancer

Summary: the purpose of this research is to develop patient-centered palliative care interventions to improve patient-provider communication and quality of life (qol) of ethnic and racial minority patients living with life-limiting illnesses. eliciting personal experiences is an effective way for patients to communicate their cultural values and beliefs. this study will assess how to integrate the patients' personal experience narratives into the electronic health record (ehr). the primary hypothesis is that the implementation of a patient-centered intervention to elicit personal experiences that are included in the ehr will improve patient-provider communication and patients' qol.

racial and ethnic minority patients with a life limiting illnes (lli) in the united states are underserved in many ways, including quality of palliative care. specific disparities have been reported in palliative care for minority patients, including sub-optimal patient-provider communication and resulting lower qol. a potential approach to improve communication is to elicit patients' personal narratives that address their cultural or spiritual values and beliefs, and include them in the ehr. the objective of this observational study is to assess the feasibility and efficacy of a palliative care nursing intervention designed to 1) identify barriers and facilitators for eliciting and recording relevant narratives from the perspectives of the key stakeholders: minority patients with lli; 2) to conduct usability testing, applying a user-system-environment evaluation process to determine essential requirements for integration of the patient-centered narratives into the ehr; and 3) identify barriers and facilitators of integration of the patient's narrative into daily workflow from the perspectives of key stakeholders: acute care bedside nurse.

Eligibility criteria:
inclusion criteria: patients * 18 years of age or older * able to read english * capable of giving informed consent * self-identifying as part of a racial or ethnic minority * diagnosed with at least one lli. the operational definition of lli eligible for this study includes the following diagnoses: 1. metastatic solid cancer or inoperable lung cancer; 2. copd with fev1 values \< 35% predicted or oxygen dependence; 3. new york heart association class iii or iv heart failure (chf). inclusion criteria: nurse * 18 years of age or older * confirm verbally that they were involved in the care of a patient who is participating in the storytelling intervention

Keywords: psychosocial underserved palliative electronic health record narrative
augmenting treatment effects of voice therapy in parkinson disease

Conditions: Parkinson Disease

Summary: the purpose of this study is to evaluate the impact of a non-invasive brain stimulation technique called transcranial magnetic stimulation (tms) on voice/speech treatment in people with parkinson's disease (pd), through the use of speech and voice analysis, examination of voice box, and brain imaging methods.

effective treatment of the speech disorder in ipd is as important as the optimal control of limb motor symptoms. presently, the lee silverman voice treatment (lsvtò loud) - is a time intensive behavioral treatment for parkinson's hypophonia. facilitatory tms is a safe and a complimentary stimulation technique. brain imaging has also identified suitable target brain regions that are readily accessible to tms. this combined treatment modality approach should be more effective and efficient the lsvt alone. the study will enroll patients with parkinson's disease with moderate to severe hypophonia. a total of 36 patients will be recruited over 3 years and divided into 3 groups (n=12 each). the three cohorts are: 1. lsvt +sham tms; 2. lsvt +left rtms and 3. lsvt + right rtms. this is a longitudinal double blind randomized controlled clinical trial. all investigators and study personnel will be blind to the study except for the pi responsible for tms (dr. narayana). the entire protocol occurs over 19 weeks. during the first week, the participants will be screened, consented. during the second week, baseline behavioral and imaging data will be collected. next, the patients will be randomized to one of the three treatment groups. then the patients will enter a 4-week treatment phase, where they will receive tms/sham tms and lsvt 4 days a week for 4 weeks. during the seventh week, patients will undergo post treatment behavioral and imaging assessments. then the patients will return in week 19 to complete the follow up behavioral measures and imaging session.

Eligibility criteria:
inclusion criteria: * individuals with idiopathic parkinson's disease (ipd) between the ages of 45 and 80 years with moderate to severe hypophonia * none or mild cognitive impairment or depression * stable medication therapy for at least 3 months. must be "optimally medicated" at the start of the study. this means that there should be no change in mediction type or dosage in 3 months prior to enrolling in the study. the medications should not be causing significant or serious advese effects exclusion criteria: * history of drug abuse or neurological condition other than or in addition to ipd (for example stroke) * individuals with advanced ipd (stage v) or who had lsvt within 3 years * pregnant females * history of seizures, history of major head trauma, metal objects implanted in the head, ferrous metal filings in the eye, brain damage, inflammation of the brain, cardiac pacemaker, implanted medication pump, cardiac lines, heart disease, currently taking certain types of medication for depression or seizures (tricyclic antidepressants or neuroleptics which lower seizure threshold
life-steps counseling to enhance adherence and engagement in prep care

Conditions: Adherence, Medication

Summary: the purpose of this study is to test how different types of interventions may affect how someone takes their pre-exposure prophylaxis (prep) medication.


Eligibility criteria:
inclusion criteria: 1. age: 18 years or older 2. male sex at birth or trans man (current gender identity is male) assigned female sex at birth 3. self-reports as a person who has sex with men 4. prep naïve or is currently prescribed prep and reports uncertainty about future adherence 5. medical providers at each site will determine that the participant is indicated for prep per centers for disease control (cdc) guidelines 6. screens in for currently having one or more of the following psychosocial syndemic problems: depression; heavy alcohol use; problematic substance use or polydrug use; history of trauma or abuse; and/or current interpersonal violence 7. owns a cell phone that has texting and internet / data capacity exclusion criteria: 1. unable to provide informed consent due to severe mental or physical illness, cognitive impairment, or substance intoxication at the time of interview 2. discovery of active suicidal ideation or major mental illness (e.g. untreated psychosis or mania) at the time of enrollment (these patients will be referred immediately for treatment, but may join the study when this is resolved) 3. laboratory or clinical findings that would preclude prep initiation (e.g. decreased creatinine clearance)

Keywords: life-steps hiv prevention
laparoscopic prostatectomy for chronic prostatitis

Conditions: Prostatitis; Chronic Prostatitis With Chronic Pelvic Pain Syndrome

Summary: prostatitis is an inflammation of the prostate, an pelvic organ of men. prostatitis can cause great discomfort which varies but can include pelvic pain, pelvic pressure, a vague sense of discomfort, a feeling of malaise and fatigue, fever, burning on urination, pain on reaching orgasm, and bleeding. in many men the symptoms of prostatitis can be chronic. it is estimated that in the united states chronic prostatitis is responsible for as many as two million doctor visits a year. the disease can be ruinous, interfering with work, intimacy, and other things. the causes of chronic prostatitis are not understood. the treatments commonly used, including antibiotics and prostate massage, work poorly. we now have evidence that laparoscopic prostatectomy can eliminate the misery of chronic prostatitis. this trial aims to quantify and better characterize the effect of laparoscopic prostatectomy on the symptoms of chronic prostatitis.


Eligibility criteria:
inclusion criteria: * age 30 and greater * nih-cpsi score of 25 and higher * symptom duration of at least one year * failed treatment with antibiotics and/or other medications exclusion criteria: * inability to tolerate anesthesia * inability to speak any english

Keywords: chronic prostatitis prostate pain pelvic pelvis inflamation
proof-of-concept, open-label study in patients with early alzheimer's disease

Conditions: Early Alzheimer's Disease

Summary: a phase 2a study in men and women with early alzheimer's disease to evaluate the pharmacodynamics, pharmacokinetics and safety of obicetrapib therapy.

this study will be a proof of concept, phase 2a study in patients with early alzheimer's disease (clinical diagnosis of alzheimer's disease stage 3 or 4 based on the national institute on aging alzheimer's association research framework criteria) to evaluate the pharmacodynamic, cognitive effects, pharmacokinetic, and safety and tolerability of obicetrapib therapy.

Eligibility criteria:
inclusion criteria: * men \& women 50-75 years * post-menopausal or women not of child-bearing potential * diagnosis of alzheimer's disease based on national institute for aging: * biomarker classification a+t+n+ or a+t+n- * clinical stage 3 or 4 with clinical dementia rating score \>/= 0.5 \& \ /=20 * have an apoe genotype of e4/e4 or e3/e4 * not on or on stabilized ad medication * patient \& study partner willing to sign consent exclusion criteria: * other than ad, disorder that may impair cognition * contra-indication for mri * history of neurological, psychiatric or mental conditions; * history stroke * mi * type 1 diabetes \& type 2 with hba1c\>8% * bp \> 150/90 mmhg * renal or hepatic impaired * hyperaldosteronism * cancer * depression * laboratory abnormalities * not able to undergo lumbar puncture * taking certain medications including lipid altering
psychosocial and clinical characteristics predicting women's acceptance of office hysteroscopy

Conditions: Pelvic Girdle Pain

Summary: study type: observational, prospective. objectives: primary: identify psychosocial and clinical factors that predispose to the occurrence of pain following office hysteroscopy secondary: stratify risk factors for pain previous cesarean section and pain score repeat c section and pain score post-menopausal and pain score type of delivery and pain score body mass index and pain score history of dysmenorrhea and pain score, abnormal uterine bleeding and pain score previous surgery upon uterine cervix and pain score characterize women's psychosocial profile and pain score establish anxiety as a factor influencing pain perception using (state-trait anxiety inventory for adults). determine if there is a specified population who would benefit from procedure under anaesthesia

authors tend to compare pain in hysteroscopy in groups by scope size and variation in technique (e.g. 3mm versus 5mm scopes; vaginoscopic versus traditional speculum insertion approach), so score results reflect relative improvement in tolerability between groups, and they do not have as control an examination expected to be free of suffering. to the investigators' knowledge there has to date never been an adequate judgement of the proportion of women in the group where pain is felt and should therefore be expected. focus has always been put on the group of patients who are pain free (or where it is deemed acceptable). stating office hysteroscopy is painless because vas score is halved by miniaturization seems an arbitrary statement for a small, but never the less important group of women. it should be interesting to investigate factors which might contribute to pain in office hysteroscopy despite the fact the majority of the group will bear mild or no pain. the investigator believes that although reduction of scope size has brought about significant reduction in distress, it remains a painful procedure for some patients and therefore subjecting them to this ordeal may be regarded as an aggression; pain control interventions to reduce suffering might be considered (anxiolytic drugs, local, para-cervical or even general anaesthesia could be of interest in selected cases).

Eligibility criteria:
inclusion criteria: * women scheduled for office hysteroscopy written informed consent; diagnosis of uterine abnormal bleeding, sonographic evidence of thickened endometrium, sterility workup, endometrial polyps or sub mucous myoma, foreign body extraction or insertion (i.e. sterilization) or other condition with indication for procedure and who meet study eligibility criteria; ability to fill in the study questionnaires. exclusion criteria: * refusal to participate in study innability to fill in the study questionnaires

Keywords: following hysteroscopy
endometrial and myometrial changes, with and without fibroids

Conditions: Fibroids

Summary: fibroids are common among women in fertile age. the relation between fibroids and infertility is controversial. our goal is to claculate a ratio between uterine cavity - endometrium \& myometrium in normal uterine s and study the interference of the cavity in uterine s with fibroids.

phase 1- 1. retrospective measurments of uterine dimensions of 100 women with normal uterin 2. measurment of the above during different sycle days in the same woman. 30 women. phase 2- retrospective measurments of 500 uterine dimensions of women with fibroids phase 3- the same for 400 uterine malformations

Eligibility criteria:
inclusion criteria: * women at ivf unit exclusion criteria: * inabilty to measure propperly the uterine dimensions

Keywords: endometrium myometrium fibroids uterine malformations
screening of colorectal cancer in the public healthcare sector in argentina

Conditions: Colorectal Neoplasms

Summary: introduction: early detection of certain types of cancer significantly increases the likelihood of successful treatment and reduces mortality from these causes. however, the use of screening and the early detection of selected tumors such as colorectal cancer (crc) are lower than those expected in our country. the objective of this project is to evaluate the effectiveness of a multicomponent strategy that improves the screening and early detection of crc in the population at risk of primary health care clinics (pccs) of the public health system. population: people leaving in the catchment area of 10 selected primary care clinics from the public health system in the province of mendoza, argentina. design and methods: a randomized clinical study by clusters. 10 pccs will be included: 5 will be randomly assigned to receive an intervention to increase the crc screening rates (improvement cycles) and 5 to the control arm (usual care). 150 participants will be included in each pccs, in total, 1500 participants. intervention: an innovative vision is proposed, which combines a participatory and dynamic methodology based on improvement cycles. this approach includes the implementation of participatory learning sessions for health providers, involving the effectors of the design of the intervention. in the intervention branch at least 3 workshops (sessions) will be held with the members of the care system, in order to identify opportunities for improvement oriented to the design and application of an innovative intervention based on best practices. each one of the sessions will constitute an analysis of the improvement cycle, following the following steps: 1) selection of participants of the initial workshop; 2) development of work model based on bibliographic review and initial qualitative phase; 3) initial workshop with effectors for training in continuous improvement, objectives, interventions and data collection; 4) learning workshops to discuss results, applicability of interventions and modifications to the work plan; 5) closing session to evaluate preliminary results and discuss continuity of interventions beyond the project. outcomes: 1) percentage of the population at risk that completes the screening; 2) percentage of the population classified as at habitual risk or increased by risk factors.


Eligibility criteria:
inclusion criteria: * subjects who have public health coverage * age between 50 and 75 years old * residence in the catchment area of the pccs * with an indication to perform screening for crc with fobt * people who consent to participate exclusion criteria: * people who are bedridden. * people who plan to move in the next 3 months.

Keywords: screening fecal occult blood test (fobt) prevention quality improvement cycles health promotion
assessment of whole body cryotherapy in treatment of active axial spondylarthritis

Conditions: Spondylarthritis

Summary: whole body cryotherpy (wbc) is a well-tolerated procedure that implies patients' exposition at a temperature of approximately -110 degrees. a considerable increase in the popularity of wbc has occurred in rheumatologic patients, despite a lack of evidences of its efficiency. because of its interesting anti-inflammatory properties, the investigators think that wbc could be an alternative treatment to classical nsaids (non steroidal anti inflammatory drugs) and corticosteroids, in patients suffering from axial spondyloarthritis. this is a proof of concept study.


Eligibility criteria:
inclusion criteria: * patients suffering from axial spondyloarthritis diagnosed according to asas criteria, with sacroiliitis on x-rays or mri, with active disease (basdai \> 4/10) despite a stable treatment will be included. exclusion criteria: * contra indication to cooling, * previous wbc treatment, * no social security cover
assessment of glucose concentrations in people without diabetes mellitus after standardized meals and in daily life

Conditions: Subjects Without Diabetes Mellitus; Assessment of Glucose Concentrations

Summary: participants will perform blood glucose monitoring (bgm) over the course of 14 days and, in parallel, wear continuous glucose monitoring (cgm) systems. because current cgm systems typically achieve a lower level of analytical accuracy than bgm systems, participants will perform at least 5 blood glucose (bg) measurements per day. in addition, cgm systems are used to obtain minimally-invasive high-frequency glucose measurements to fill the gaps between bg measurements.


Eligibility criteria:
inclusion criteria: * at least 18 years of age * written informed consent * subject is legally competent and has the capacity to understand character, meaning and consequences of the study * subject is willing to refrain from intake of salicylic acid and ascorbic acid and medication and/or compounds containing these substances exclusion criteria: * anamnestically known diabetes mellitus * severe acute or chronic disease with potential risk of being adversely affected by the study procedures (at the study physician's discretion) * current constitution that compromises the subject's capability to participate in the study (at the study physician's discretion) * pregnancy or lactation period * known severe skin reactions to adhesives * blood donation within the previous two months (according to the subject's statement) * language or other barriers potentially compromising an adequate compliance with study procedures
comparison of tapered- vs. cylindrical-shaped tube cuffs pressure alteration with nitrous oxide

Conditions: Adverse Effect of Other General Anesthetics; Anesthesia Intubation Complication; Inhalation of Nitrous Oxide; Trachea

Summary: when using nitrous oxide for general anesthesia, nitrous oxide diffusion induces intracuff hyperinflation of the endotracheal tube. furthermore the difference among various types of cuffed endotracheal tubes in cuff pressure behavior during nitrous oxide exposure. taperguard(tm) tube has been newly introduced and has tapered-shape cuff. in vitro study, the intracuff pressure of taperguard(tm) tube was lower than that of conventional tube with cylindrical-shaped cuff of the conventional tube(hi-lo(tm) tube). therefore, this clinical study is needed to evaluate the intracuff pressure during general anesthesia with nitrous oxide exposure.

during 60 minutes after routine anesthetic induction and intubation of the endotracheal tubes, intracuff pressures will be measured every 10 minutes with a manometer (vbm, sulz, germany). 60% nitrous oxide will be added at time 0. for 60 minutes from the beginning of general anesthesia, intracuff pressures will be measured every 10 minutes. after 60 minutes, intracuff pressures will be maintained around 20 cm h2o during the remaining period of the surgery. the questionnaire for a sore throat, hoarseness, and dysphagia will be questioned at about 1, 6, and 24 hours after the surgery and the general anesthesia.

Eligibility criteria:
inclusion criteria: * patients who will undergo general anesthesia in a supine position with a neutral position of the head (hand and forearm sugery) * 18\~70 years old * american society of anesthesiologists physical status 1-2 * body mass index \< 30 kg/m2 exclusion criteria: * contraindication for nitrous oxide * difficult intubation * cormack-lehane grade \> 3 * airway-related or pulmonary diseases * short or long operation time (\ 3 hours)

Keywords: cuff pressure cylindrical cuff endotracheal tube nitrous oxide tapered cuff
bridging the evidence-to-practice gap

Conditions: Hypertension

Summary: the proposed project will address this evidence-to-practice gap by evaluating the effect of practice facilitation (pf) of the intervention implementation fidelity (primary outcome) and clinical measures at 12 months (secondary outcomes).

advancing medication adherence for latinx with hypertension through a team-based care approach (alta) evaluates the effectiveness of using a quality improvement method called practice facilitation (pf) to implement our evidence-based systems-level intervention for improving medication adherence and blood pressure control. the alta intervention focuses on identifying latinx patients with uncontrolled hypertension who are non-adherent to their antihypertensive medication, referring them to health coaches, coaching patients on medication adherence and self-management, care planning, and monitoring patients to improve patient outcomes.

Eligibility criteria:
inclusion criteria: * self-identify as latino * be fluent in english or spanish * be age 18 years or older * receiving care in a safety-net primary care practice * have uncontrolled htn documented in the electronic health record (ehr) on at least two visits in the past year (defined as an average bp ≥ 140/90 mmhg) * have been prescribed at least one anti-hypertensive medication and be non- adherent to their medications, defined as adherence \<80% in the preceding 12 months, as determined by prescription orders obtained from the clinic ehr. clinic and nonclinical staff inclusion criteria: • primary care provider (md/do, np), nurse, medical assistant, or administrative staff employed at the participating practices and (b) interacts with at least five patients with a diagnosis of hypertension. exclusion criteria: * being deemed unable to comply with the study protocol (either self-selected or by indicating during screening that s/he could not complete all requested tasks) * participation in other hypertension-related clinical trials * have significant psychiatric comorbidity or reports of substance abuse (as documented in the ehr) * plan to discontinue care at their practice within the next 12 months clinic and nonclinical staff exclusion criteria: • refuse to participate