Kornimate/medical-research-clean huggingface dataset:
improving quality & equity of emergency care decisions (iqed)

Conditions: Emergency Department

Summary: recent work in emergency medicine has shown errors were more likely to occur at the end of shifts, as pressure exists to make a number of decisions simultaneously, and after what may be an already long series of cognitive challenges. decision fatigue may also contribute to disparities by surfacing subconscious bias. the objective of the r21 pilot phase of improving quality \& equity of emergency care decisions (iqed) is to identify addressable gaps in quality and equity and use performance feedback as an intervention to improve performance on chest pain, ct imaging, and antibiotic prescribing. performance feedback intervention will include feedback offline via email or text.

the objective of the r21 pilot phase of improving quality \& equity of emergency care decisions (iqed) is to identify addressable gaps in quality and equity and use performance feedback as an intervention to improve performance on chest pain, ct imaging, and antibiotic prescribing. performance feedback intervention will include feedback offline via email or text. each clinician will be randomized at the provider or clinic level to either the intervention or control group. once clinicians are randomized, the aforementioned intervention will be turned on for a 3-6 month time period. for providers in the intervention group, the goal is to evaluate the effect of social norms on overuse and underuse behavior related to prescriptions or testing. near real-time social norms will be delivered to providers which benchmark their own performance on various metrics to that of their peers. the investigators performance feedback reports for each provider randomized to receive the audit and feedback intervention will have three key characteristics: (1) each target provider will receive his or her individual performance, (2) benchmarks will prominently feature the performance of providers who would be considered credible peers of the target provider, and (3) benchmarks will reflect only performance that is desirable (e.g., showing only the performance of the best-performing credible peers). providers randomized to the control group will follow standard practice.

Eligibility criteria:
inclusion criteria: * attendings and residents that see patients in the emergency department. exclusion criteria: * none

Keywords: emergency medicine behavioral research
the relationship between motor cortex oxygenation and motor function recovery in stroke patients

Conditions: Stroke

Summary: stroke is the most common cause of motor function impairment. however, the functional impairment is not totally irreversible. several mechanisms may involved in both the cortical and motor function recovery after onset of stroke, and most of them are related to changes of cortical perfusion and metabolism. motor function recovery after stroke (especially middle cerebral artery territory lesion) frequently follow stereotypic pattern (brunnström stage). this study is designed to investigate the relationship between motor cortex oxygenation/metabolism and motor function recovery after stroke. to seek if there is similar stereotypic pattern of motor cortex oxygenation/metabolism change during the recover stage after stroke.

participants receive evaluations (1/week for 3 months period) of * motor function (include: mmse, brunnström stage, fugl-meyer assessment of physical performance, box and block test of manual dexterity, functional independence measure) * cortical perfusion detection during performing limb movements (using nirs) then use path analysis to investigate the relationship between motor cortex oxygenation/metabolism and motor function recovery after stroke.

Eligibility criteria:
inclusion criteria: * ischemic stroke(unilateral, onset within 7 days, without previous stroke history) * vital sign stable * upper extremity motor function impairment(brunnström stage i\~iii) exclusion criteria: * with pacemakers * seizure history * serious dysrhythmias * poor cognition function(mmse\<13)

Keywords: cortical activation motor function activity of daily living
innovative patient-partner-guided virtual group speech pathology intervention model in head and neck cancer

Conditions: Dysphagia

Summary: this project aims to study an innovative intervention, the eg2 intervention, developed by speech-language pathologists at the centre hospitalier de l'université de montréal to improve therapeutic adherence and prevent dysphagia in patients treated with chemoradiotherapy for head and neck cancer. the innovation consists in offering a speech therapy intervention that is 1) virtual, 2) group-based (whereas it is usually individual) and 3) involves a patient partner. this intervention has the potential to improve quality of care, accessibility to services and optimize health care resources.


Eligibility criteria:
inclusion criteria: * adults ≥ 18 years of age with a diagnosis of head or neck cancer * chemoradiotherapy treatments planned for curative purposes * planned external radiation therapy dose of at least ≥60 grays * sufficient proficiency in french to complete self-reported questionnaires exclusion criteria: * remote metastases * previous or planned total laryngectomy * previous moderate/severe dysphagia known and/or evaluated by speech therapy * diagnosis of a second synchronous cancer at the time of study enrollment * history of prior radiation therapy to the head and neck area * have a cognitive impairment (diagnosed or suspected) that may significantly interfere with participation in the intervention and various measurement procedures.
guided application of ventricular catheters

Conditions: Hydrocephalus

Summary: failure of ventricular catheters remains a significant problem in patients with hydrocephalus. the purpose of this study is to determine whether the use of a simple instrument assisted by a smart phone application software can achieve a more precise placement of ventricular catheters than the standard free-hand placement technique.

free-hand placement of ventricular catheters (vc) is reported to be inaccurate in 10-40%. furthermore, there is evidence that the quality of vc positioning is correlating with the risk for proximal shunt obstruction. ultrasound or neuronavigation are used in order to improve to placement. however, they are associated with significant technical efforts and increased time. in this study a simple instrument assisted by a smart phone application software is used in order to achieve precise placement of ventricular catheters. the results are compared with the standard free-hand procedure. patients requiring a ventricular catheter are randomized to one of the two treatments. the primary outcome parameter is a qualitative and quantitative assessment of the position of the ventricular catheter on a post-operative image. the evaluation of the primary criteria is performed by a radiologist blinded to the randomization arm.

Eligibility criteria:
inclusion criteria: * patients requiring a permanent ventricular catheter for the treatment of csf (cerebrospinal fluid) - circulation disorder or another disease (ventricular shunt oder ommaya/rickham-reservoir) * frontal occipital horn ratio (fohr) \< 0.5 * use of a new puncture channel * frontal access to the ventricles * patient´s informed consent exclusion criteria: * known unevenness of the skull at the entry point * slit ventricles; frontal and occipital horn width ratio (fohwr) \< 0.05 * participation in another clinical trial with interfering endpoints

Keywords: ventricular catheter, hydrocephalus, shunt, brain disease
fish oil supplement in rectal cancer

Conditions: Rectal Neoplasms

Summary: neoadjuvant treatment with radiotherapy (rdt) and chemotherapy (ct) are the treatment of choice for rectal adenocarcinomas in stages ii and iii. this results currently in pathologic complete response in 10% to 30% of cases. the immune and inflammatory response is altered in these individuals and is directly related to response to therapy. both the disease and the treatment of colorectal cancer have an impact on quality of life and nutritional status. in studies with cells and animal models the incorporation of fatty acids eicosapentaenoic acid (epa) and docosahexaenoic (dha) - derived from fish oil - has been shown to interfere in the process of inflammation, cell signaling and gene transcription enhancing the response to treatment. are reported ability to restore the apoptosis of tumor cells, sensitization of tumor cells to chemotherapy, production of less pro-inflammatory cytokines and the preservation of normal energy and protein metabolism. the aim of this study is to verify if the daily consumption of 2.4 g epa + dha for adults in neoadjuvant therapy can promote changes on inflammatory and immunological markers of host response to tumor and if this response is altered by nutritional status. it is expected that supplementation can reflect in control of inflammatory and immune response in favor of tumor cell death contributes to pathological complete response and that it happens with preservation of nutritional status. subjects will be randomized as to supplementation. all will be assessed in four moments during neoadjuvant therapy and immediate postoperative. results will be presented by comparing the intervention group and control group at each moment.


Eligibility criteria:
inclusion criteria: * candidate to neoadjuvant therapy according ac camargo cancer center protocol; * accept consume fish oil capsules and participate in clinical, pathological and nutritional assessments by signing the consent form. exclusion criteria: * be allergic to fish and fish products, * it has previously undergone treatment for colorectal cancer or in presence of other concomitant cancer treatment.

Keywords: rectal cancer inflammation omega-3 fish oil nutritional status
absorb extend clinical investigation

Conditions: Myocardial Ischemia; Coronary Artery Stenosis; Coronary Disease; Coronary Artery Disease; Coronary Restenosis; Cardiovascular Disease

Summary: the absorb extend trial is to continue the assessment of the safety and performance of the absorb bioresorbable vascular scaffold (bvs) system absorb bvs is currently in development at abbott vascular.


Eligibility criteria:
inclusion criteria: * up to two de novo lesions can be treated, each located in a separate native epicardial vessel. * target lesion(s) must be located in a native coronary artery where target vessel(s) diameter is ≥ 2.0 mm and ≤ 3.3 mm and target lesion length is ≤ 28 mm, both assessed by on-line quantitative coronary analysis (qca). * target lesion(s) must be in a major artery or branch with a visually estimated stenosis of ≥ 50% and \< 100% with a timi flow of ≥ 1. * if two treatable lesions meet the inclusion criteria they must be in separate major epicardial vessels (lad with septal and diagonal branches, left circumflex artery (lcx) with obtuse marginal and/or ramus intermedius branches and right coronary artery (rca) and any of its branches). * percutaneous interventions for lesions in a non-target vessel are allowed if done ≥ 30 days prior to or if planned to be done 6 months after the index procedure. * percutaneous intervention for lesions in the target vessel are allowed if done \> 6 months prior to or if planned to be done 6 months after the index procedure. exclusion criteria: * lesion(s) located within an arterial or saphenous vein graft or distal to a diseased (defined as vessel irregularity per angiogram and \> 20% stenosed lesion by visual estimation) arterial or saphenous vein graft. * lesion(s) involving a bifurcation with side branch vessel ≥ 2 mm in diameter and/or ostial lesion \> 40% stenosed by visual estimation or side branch requiring predilatation. * total occlusion (timi flow 0), prior to wire passing. * target vessel(s) contains visible thrombus. * another clinically significant lesion is located in the same epicardial vessel (including side branch) as the target lesion(s). * subject has received brachytherapy in any epicardial vessel (including side branches).

Keywords: drug eluting stent stents angioplasty bioabsorbable bioresorbable scaffold
anti-fatigue effect of korean red ginseng in patients with non-alcoholic hepatitis

Conditions: Fatigue

Summary: background: korea red ginseng (krg) has anti-carcinogenic activity, anti-oxidant activity, and cancer related anti-fatigue. methods: seventy five patients with non-alcoholic hepatitis were prospectively randomized to receive 3 weeks of krg or placebo. liver function test, pro-inflammatory cytokines, adiponectin, fatigue severity scale, and antioxidant activity were check and compared.

fatigue severity scale we used to be krupp's fatigue severity scale. the survey has nine questions as following: (1) my motivation is lower, when i am fatigued (2) exercise brings on my fatigue (3) i am easily fatigued (4) fatigue interferes with my physical functioning (5) fatigue causes frequent problems for me (6) my fatigue prevents sustained physical functioning (7) fatigue interferes with carrying out certain duties and responsibilities (8) fatigue is among my 3 most disabling symptoms (9) fatigue interferes with my work, family, or social life. all subjects scored each question on a 7-point scale (1 = strongly disagree to 4 = neither disagree nor agree to 7 = strongly agree). all fatigue severity scale calculated and collected by one research nurse (c.w.k) in the department of internal medicine.

Eligibility criteria:
inclusion criteria: * aspartate aminotransferase (ast) ≥ 50 u/l or alanine aminotransferase (alt) ≥ 50 u/l, and fatty liver or hepatitis exclusion criteria: * viral hepatitis, alcoholic hepatitis, autoimmune hepatitis, pancreatitis, hemochromatosis, wilson's disease, drug induced liver injury, or cancer

Keywords: fatigue panax ginseng chronic hepatitis non-alcoholic fatty liver disease adiponectin
the effect of allergen inhalation on sputum myeloid and plasmacytoid dendritic cells in mild atopic asthmatics

Conditions: Asthma

Summary: summary: a picture is emerging of dendritic cells migrating through the blood to the airways following allergen inhalation in atopic asthmatics. although the koh and mccarthy articles present novel findings, both do not provide a comprehensive view of sputum dcs following allergen challenge. therefore, the proposed study will examine the kinetics of mdcs and pdcs in the induced sputum of atopic asthmatics following inhalation of allergen. hypothesis: following allergen challenge, sputum myeloid and plasmacytoid dcs will migrate into the airway lumen in atopic asthmatics during the timeframe of the late asthmatic response. objective: the objective of this study is to examine the kinetics of dendritic cells in induced sputum following allergen challenge in atopic asthmatic subjects.

subjects will be put through two study periods. each study period will consist of four visits and will be separated by 2-4 weeks. on the first visit, subjects will undergo screening procedures, including complete history and physical examination. in addition, methacholine inhalation challenge and skin-prick testing will be preformed to assess airway hyper-responsiveness and determine atopic status respectively. lastly, sputum will be induced before challenge (0 hrs) and peripheral blood will be collected. on the second visit, subjects will inhale diluent or allergen and sputum will be collected 7 hours following inhalation challenge. next, on the third visit, subjects will return 24 hours following inhalation challenge and sputum will be induced. on the final visit, subjects will return 72 hours following inhalation challenge and sputum will be collected, along with peripheral blood. before the next study period begins, there will be a washout period of 2-4 weeks. on the first visit of the second study period, a methacholine challenge will be performed to ensure the return of pc20 to within one doubling dose of baseline values. also, sputum will be induced before challenge (0hrs) and peripheral blood will be collected. on the second visit, subjects will inhale diluent or allergen and sputum will be collected 7hrs following inhalation challenge. next, on the third visit, subjects will return 24 hours following inhalation challenge and sputum will be induced. on the final visit, subjects will return 72 hours following inhalation challenge and sputum will be collected, along with peripheral blood.

Eligibility criteria:
inclusion criteria: * mild atopic asthmatics, presently well controlled on ß2-agonists. * non-smokers. * baseline fev1 more than 70% of predicted normal. exclusion criteria: * airway infection during the last 4 weeks. * exacerbation during the last 4 weeks. * inhaled or oral steroids during the last 4 weeks. * antihistamines during the last 48 hours. * asthma medication other than inhaled and/or oral ß2-agonists during the last 4 weeks. * pregnant women.

Keywords: asthma atopy allergen challenge sputum myeloid and plasmacytoid dendritic cells
impact on quality of life of osteopathic visceral mobilizations after endometriosis surgery

Conditions: Endometriosis; Osteopathy in Diseases Classified Elsewhere

Summary: one of the most common post-operative complications of gynaecological surgery, and in particular endometriosis surgery, is the formation of peritoneal adhesions. after laparotomy, it affects up to 90% of patients. minimally invasive techniques (such as laparoscopy) reduce the risk of adhesion formation, but cannot totally prevent it. adhesions can lead to chronic pelvic pain, dyspareunia, digestive disorders and infertility. various strategies and devices have been developed to try and limit adhesion formation, but their effectiveness has not been fully proven in the literature. the only real treatment for adhesions is adhesiolysis, although adhesions often reform. the quality of surgery remains the best means of preventing adhesion formation. to reduce the morbidity associated with pelvic adhesions, it is essential to develop alternative, non-invasive, anti-adhesive methods such as manual osteopathic visceral mobilization.


Eligibility criteria:
inclusion criteria: * woman of legal age * indication for surgery for infiltrating endometriosis * able to give informed consent to participate in research * patient included in no endo (national endometriosis observatory promoted by clermont-ferrand university hospital) exclusion criteria: * indication for surgery for superficial endometriosis * patient of legal age, under guardianship or trusteeship * pregnant or breast-feeding patient * patients not affiliated to the social security system * patients who do not speak french * patients under court protection * simultaneous participation in another study * refusal to participate.
social robot support for healthcare professionals

Conditions: Frailty at Older Adults

Summary: this study evaluates the effectiveness of integrated care pathway steps supported by social robots. half of the participants will receive regular care, while for the other half a social robot dialogue will be included as part of the pathway step.

there is a worldwide increasing shortage of adequately trained healthcare personnel, leading to the challenge for society to prevent a future "lack of care". at the same time the number of people requiring healthcare is expanding rapidly, amongst others due to the growing percentage of older adults in the population. new means of supporting the available healthcare professionals are therefore urgently required. modern healthcare is often implemented through "integrated care pathways". certain steps in these pathways involve dialogues with patients. speaking social robots are increasingly being advertised as supportive for healthcare professionals and may handle certain structured dialogue types, such as questionnaires. based on previous positive preclinical experiences with social robots interviewing community-dwelling older subjects, the researchers want to investigate the implementation of a social robot in an integrated care pathway in the outpatient clinic.

Eligibility criteria:
inclusion criteria: * suspicion of need for quality of life support exclusion criteria: * psychiatric disorders
effects of code sepsis implementation on emergency department (ed) sepsis care

Conditions: Sepsis

Summary: sepsis is a life-threatening complication of infection that can be difficult to recognize and treat promptly. timely administration of antibiotics for emergency department (ed) patients with sepsis is challenging. the goal of this study is to determine the potential effectiveness and unintended consequences of reorganizing ed care for patients with suspected sepsis.


Eligibility criteria:
inclusion criteria (overall): 1. adult (age ≥18 years) 2. ed patient at intermountain medical center, utah valley hospital, dixie regional medical center 3. arrival to study emergency department (ed) during study period of 11/13/2018 to 2/12/2021. exclusion criteria (overall): (1) trauma patient

Keywords: sepsis clinical protocols emergency medicine
bia-guided dry weight assessment on sleep quality in chronic hemodialysis patients

Conditions: Renal Failure Chronic Requiring Hemodialysis; Poor Quality Sleep

Summary: based on many previous data proving hypervolemia in chronic hemodialysis patients could lead to sleep apnea and poor sleep quality. the investigators conduct this trial to evaluate whether more accurate dry weight assessment with bia in these patients can lead to better sleep quality (measured by sleep actigraphy and questionnaires). the investigators will enroll 30 chronic hemodialysis patients in hemodialysis unit of ramathibodi hospital whose age \> 18 years with subclinical hypervolemic status and baseline pittsburgh sleep quality index (psqi) score \> 5 into study. patients with bed-ridden status, alteration of consciousness and unstable hemodynamics will be excluded. then eligible patients will be randomized into 2 groups, bia-guided and standard clinical guided dry weight assessment. the investigators will assess participants' dry weight at beginning of study, 3rd month and 6th month. sleep actigraphy parameters (eg. total sleep time, sleep efficiency), sleep questionnaires score, left ventricular mass index by echocardiography, ambulatory blood pressure monitoring and blood chemistry results were collected at beginning of study, the end of 1st, 3rd and 6th month. the primary outcome is change of sleep actigraphy parameters between the groups. the secondary outcomes are change of sleep questionnaires scores, change of left ventricular mass index, change of ambulatory bp monitoring and also cardiovascular complications between groups.

this randomized control trial aim to detect the better volume control guided by bioimpedance may improve ambulatory blood pressure control, sleep quality and left ventricular hypertrophy.

Eligibility criteria:
inclusion criteria: * regular hemodialysis 3 times/week * psqi score \>5 * subclinical hypervolemia exclusion criteria: * bed ridden status * alteration of consciousness * unstable hemodynamics

Keywords: bia chronic hemodialysis sleep quality