Kornimate/medical-research-clean huggingface dataset:
adaptive interventions for emergency department patients with opioid use disorder

Conditions: Opioid Use Disorder

Summary: the adapt-ed study is a two-stage, sequential multiple assignment randomized trial (smart) to inform the development of an adaptive intervention that is optimally effective in increasing long-term buprenorphine use for adults presenting to the ed with probable opioid use disorder (oud).

the adapt-ed study is a two-stage, sequential multiple assignment randomized trial (smart) to inform the development of an adaptive intervention that is optimally effective in increasing long-term buprenorphine use for adults presenting to the ed with probable oud. the trial includes (1) two first stage components: the ca bridge model with substance use navigator assisted treatment initiation and linkage to care (sun) or ca bridge plus immediate telehealth connection to an outpatient provider (sun+telebridge); (2) a dynamic tailoring variable describing (non) response to the first stage: whether the patient has not filled an outpatient buprenorphine prescription at 30 days or whether the patient returns to the ed with an oud-related event or self-reports non-adherence to buprenorphine within the first 90 days; (3) two second-stage components for non-responders; either ongoing buprenorphine treatment by an ed-based interim treatment team (ed-itt) or ed-itt augmented with behavioral health support (ed-itt+bhs). first-stage responders will receive no further active intervention unless the participant returns to the ed or notifies the sun about no longer taking buprenorphine within 90 days of study enrollment. hypothesis 1: the investigators hypothesize that the most intensive adaptive treatment strategy (ats) will lead to (a) more days of buprenorphine use and (b) a longer time to overdose, self-harm, or death compared to the least intensive ats. hypothesis 2: the investigators hypothesize that (a) sun+telebridge in the first stage of the ats and (b) ed-itt+bhs in the second stage of the ats will each lead to more days of buprenorphine use and a longer time to overdose, self-harm, or death within the first 12 months compared to sun and ed-itt, respectively, and (c) there is a synergistic positive effect of receiving both sun+telebridge and ed-itt+bhs on days of buprenorphine use. hypothesis 3: the investigators hypothesize that the effect of sun+telebridge versus sun and the effect of ed-itt+bhs versus ed-itt among first stage non-responders will be larger among those with (a) a history of overdose at baseline and (b) co-occurring depression or ptsd at baseline relative to those who do not have either or those conditions.

Eligibility criteria:
inclusion criteria: * presented for ed care at armc * age 18 or older * probable oud diagnosis * speak and understand english or spanish * have capacity to give informed consent * provide a signed and dated informed consent form
effects of home-based pulmonary rehabilitation in patients with severe or very severe chronic obstructive pulmonary disease (copd)

Conditions: Chronic Obstructive Pulmonary Disease

Summary: this study will investigate if adding a domiciliary respiratory physiotherapy treatment to standard care in patients with chronic obstructive pulmonary disease (copd) can improve physical function (walking test) and quality of life.


Eligibility criteria:
inclusion criteria: * severe copd (fev1/fvc \< 70% and fev1 \< 50% pred.) associated to hypoxaemic chronic respiratory insufficiency (pao2 \< 60mmhg) or * very severe copd (fev1/fvc \< 70% and fev1 \< 30% pred.) with the following characteristics: * no signs of lung restriction (tlc≥80%) * clinically stable for at least the last four weeks * mrc ≥ 2 * no participation to pr programmes in the last year fev1= forced expiratory volume in the 1st second fvc= forced vital capacity tlc= total lung capacity pao2= partial pressure of arterial oxygen exclusion criteria: * - muscular-skeletal impairment that could limit the patient's participation to the exercise programme; * cognitive impairment that could limit the patient's participation to the activities of education and exercise, as assessed by the mini mental state (mms) test \<26; * malignancies

Keywords: copd respiratory physiotherapy
measurement of fibroid volume and 2d, 3d us

Conditions: Gynecology

Summary: objective: to compare 2-dimensional and 3-dimensional ultrasound measurements with the actual myomas volume after surgical removal, to clinically test the validity and usability of 3d ultrasound technology as opposed to conventional 2d real-time ultrasound and to assess the reliability of different ultrasound methods to measure volume of uterine fibroids.


Eligibility criteria:
inclusion criteria: * surgical intervention exclusion criteria: * unfit for surgery
the impact of covid-19 pandemic on hip and knee replacement

Conditions: Covid19; Hip Arthropathy; Knee Arthropathy

Summary: during the covid-19 pandemic, the care of patients undergoing hip or knee replacement for osteoarthritis remains a clinical priority. to date, there is limited empirical knowledge about the impact of pandemic on the care of patients surgically treated for orthopaedic diseases, affected or not by covid-19. the aim of the present study is to describe and investigate the effects of the covid-19 pandemic on the nursing-sensitive and rehabilitation outcomes of patients undergoing hip and knee replacement.

from hospital electronic registry of patients will be possible to screen the patients eligible for the study. from each electronic patients record, health professional researchers will be responsable to collect data. variables about nursing and physiotherapy care, the staffing activities and the outcome achieved by the patients will be collected. to investigate the impact of covid-19 pandemic, data of the pandemic period (june-december 2020), will be compared with the data of the same year pre-pandemic (january-march 2020). during the period from april to may 2020, only orthopaedic surgery for emergency trauma or disease was allowed.

Eligibility criteria:
inclusion criteria: patients undergone hip or knee replacement for osteoarthritis exclusion criteria: patients undergone hip or knee replacement for fracture, trauma or oncological diseases

Keywords: covid19 pandemic hip arthropathy knee arthropathy nursing sensitive outcome rehabilitation
muscle stretching - the potential role of endogenous pain inhibitory modulation on stretch tolerance

Conditions: Muscle Stretching Exercises; Pain Threshold

Summary: this study investigates the influence of a remote, painful stimulus on stretch tolerance. half of the participants will receive a conditioning painful stimulus following static stretching while the other half will rest quietly.

the effect of stretching on joint range of motion is primarily related to changes in the tolerance to stretch, but the mechanisms underlying this change are still largely unknown. the nervous system has an inbuilt ability to modulate the perceived magnitude of afferent noxious stimuli via supraspinally mediated endogenous pain inhibition or facilitation and by engaging endogenous mechanisms pain tolerance in healthy individuals is known to increase. thus increasing the tolerance to pain could potentially increase range of motion following stretching.

Eligibility criteria:
inclusion criteria: * eligibility for participation included the absence of any pain or other conditions that might affect the somatosensory system. exclusion criteria: * substance abuse, * history of neurological or mental disabilities * lack of ability to comply with instructions * delayed onset of muscle soreness.

Keywords: stretch tolerance range of motion
efficacy of ciprofloxacin therapy in avoidance of sepsis in patient undergoing percutanous nephrolithotomy

Conditions: Nephrolithiasis

Summary: efficacy of ciprofloxacin therapy in avoidance of sepsis in patient undergoing percutanous nephrolithotomy. a randomized controlled trial.

to figure out the value of oral ciprofloxacin medication in ameliorate the outcome of renal nephrolithiasis extraction via the endoscope as regard the sepsis.

Eligibility criteria:
inclusion criteria: * 1. patient 18 years or older * stones ≥ 2 cm and/or mild to moderate hydronephrosis * sterile mid urine stream exclusion criteria: * patients with a stent, nephrostomy tube or indwelling catheter * renal failure * fever before surgery * previous manipulation/procedure * concomitant bladder stone or tumour * patients with active uti * contralateral renal/ureteric stone
comparison between two methods in the acceleration of the retraction of upper canines

Conditions: Malocclusion, Angle Class II, Division 1

Summary: patients at the orthodontic department of university of damascus dental school will be examined and subjects who meet the inclusion criteria will be included. then, initial diagnostic records (diagnostic gypsum models, internal and external oral photographs, as well as radiographic images) will be studied to ensure that the selection criteria are accurately matched. the aim of this study is to compare flapless bone cutting by mechanical drills to evaluate the acceleration of the retraction of upper canines versus traditional bone cutting by piezo-surgery in comparison with a control group without bone cutting after extraction of upper first premolars in class ii type i patients.


Eligibility criteria:
inclusion criteria: * age between 18-27 years * patients who have malocclusion class ii type i and who require first-premolar extraction with: * dentoalveolar class ii type i with anb between 5 and 9 degrees. * protrusion between (5-10 mm) * overbite between (0-4) * vertical dimension is normal or over the normal range * mild to moderate crowding * all patients should have complete permanent occlusion on the maxilla * all patients should have normal periodontal tissue and good oral health, which will be assessed by: 1. depth of the gingival pocket does not exceed 4 mm 2. plaque index does not exceed 1 3. gingival index does not exceed 1 exclusion criteria: * patients in which oral surgery under local anesthesia is contraindicated due to medical, psychological, or social reasons. * patients who have a general health problem that affects dental movement * patients who have undergone previous orthodontic treatment * patients with mixed occlusion * patients who have lost one or more of their teeth since birth or who have one of the permanent teeth extracted (except the third molar) * patients who have bad oral health or active periodontal disease
long-term safety of nipple sparing mastectomy in women with gpv in breast cancer

Conditions: Breast Cancer Surgery

Summary: patients with a germline pathogenic variant (gpv) in high-penetrance breast cancer susceptibility genes who are considering risk reducing mastectomy (rrm) often strongly desire to keep their nipple areola complex but inquire as to whether it is safe to do so. relative to traditional or skin sparing mastectomy (ssm) techniques, nipple sparing mastectomy (nsm) is associated with improved psychosocial and sexual well-being and is significantly better for body image and reducing feelings of disfigurement. despite this, guidelines have yet to endorse the use of nsm over other rrm techniques, stating that more data and longer follow-up are needed to confirm it as a safe and effective strategy in gpv carriers. as nsm was not routinely adopted in high-risk patient populations undergoing rrm before 2010, there has been little data to inform the long-term oncologic safety of nsm. well-designed studies have reported low to negligible rates of subsequent breast cancer in brca1/2 carriers following nsm, but have been limited by short median follow-up of less than 3 years. the current study is designed to confirm, with longer follow-up, prior findings on the oncologic safety of nsm in unaffected brca1/2 carriers. the investigators will also expand data to other high-penetrance gpv carriers, including palb2, cdh1, pten, and tp53, for whom there is little-to-no data on outcomes following rrm.


Eligibility criteria:
inclusion criteria: * assigned female sex at birth * age 18 years or older * confirmed gpv in brca1, brca2, palb2, tp53, cdh1 or pten identified on pre-symptomatic genetic testing exclusion criteria: * history of breast cancer prior to genetic testing * history of ovarian cancer prior to genetic testing * history of bilateral mastectomy performed prior to genetic testing * presence of a variant of uncertain significance (vus) in the absence of another gpv in brca1, brca2, palb2, tp53, cdh1 or pten.

Keywords: breast cancer surgery nipple sparing mastectomy oncologic safety cancer prevention breast cancer prevention brca germline pathogenic variant gpv li fraumeni hereditary lobular breast cancer cowden syndrome palb2
peptide vaccine targeting to cancer specific antigen combined with anti-angiogenic peptide antigen in treating patients with non-small cell lung cancer

Conditions: Non Small Cell Lung Cancer

Summary: the purpose of this study is to evaluate the safety, tolerability, immune response and clinical response of different doses of hla-a\*2402 restricted epitope peptides urlc10, cdca1, vegfr1 and vegfr2 emulsified with montanide isa 51.

urlc10 and cdca1 have been identified as cancer specific molecules especially in non small cell lung cancer using genome-wide expression profile analysis by cdna microarray technique. we have determined the hla-a\*2402 restricted epitope peptides derived from these molecules. we also tend to use the peptides targeting to tumor angiogenesis. vegf receptor 1 and 2 are essential targets to tumor angiogenesis, and we identified that peptides derived from these receptors significantly induce the effective tumor specific ctl response in vitro and vivo. according to these findings, in this trial, we evaluate the safety, immunological and clinical response of those peptides.

Eligibility criteria:
inclusion criteria: disease characteristics 1. advanced or recurrent non small cell lung cancer 2. second line or later therapeutic status patient characteristics 1. ecog performance status 0-2 2. life expectancy \> 3 months 3. hla-a\*2402 4. laboratory values as follows 1500/mm3\ 75000/mm3 bilirubin \< 3.0mg/dl asparate transaminase \< 99iu/l alanine transaminase \< 126iu/l creatinine \< 2.2mg/dl 5. able and willing to give valid written informed consent exclusion criteria: 1. active and uncontrolled cardiac disease (includes patients with myocardial infarction within 6 months before entry) 2. pregnancy (woman of child bearing potential) 3. active and uncontrolled infectious disease 4. adrenal cortical steroid hormone dependent status 5. decision of unsuitableness by principal investigator
longitudinal assessment of transient elastography in cystic fibrosis

Conditions: Cystic Fibrosis Liver Disease

Summary: to determine if transient elastography (te), when combined with ultrasound (us) pattern characterization can improve the prediction of progression to a nodular pattern on us. to confirm the feasibility of obtaining te measurements in children with cystic fibrosis (cf) to prospectively assess whether te data are associated with conventional laboratory markers of hepatic fibrosis to determine the variability of te measurements taken at different sites in the same patient

a noninvasive assessment of hepatic fibrosis is desperately needed to advance the care of children with cf significant liver disease and to provide for measurements during clinical trials. that global assessment might serve as both a predictor/descriptor of disease course but also as a critical biomarker for clinical research. fibroscan® measurement of liver stiffness has great potential to fill this void. the underlying hypothesis of this proposal is that elastography in addition to us can improved the prediction of the development of a nodular liver on us and development of portal hypertension over time in children and young adults with cf.

Eligibility criteria:
inclusion criteria: * participants enrolled in cfld net push study in longitudinal follow up at centers with fibroscan available (currently 8/11 centers) * entry criteria for that study were: * cf as determined by sweat chloride \>60 meq/l * pancreatic insufficiency * age 3-12 years old at entry * for entry into the longitudinal follow up subjects were in one of two groups * a screening us pattern of nodular liver (cir), heterogeneous increased echogenicity (htg) or homogeneous increased echogenicity (hmg) * a screening us pattern of normal (nl) matched to a htg subject (2 nl:1htg) by age, center and pseudomonas status exclusion criteria: * exited from the push study * unable / unwilling to sign consent

Keywords: cystic fibrosis liver disease pancreatic insufficiency cystic fibrosis transient elastography
low intensity shock wave therapy in the management of erectile dysfunction

Conditions: Erectile Dysfunction

Summary: researchers are evaluating the efficacy of low intensity shockwave therapy (liswt) via morenova in the treatment of erectile dysfunction (ed).

ed is broadly defined as the inability to achieve or maintain an erection sufficient for sexual intercourse or activity. current treatment for ed consists of oral medications, intracavernosal injections and surgically placed penile prosthetics. in the literature this has been described as a stepwise approach, offering therapy beginning with the least invasive treatment option. the goal of liswt is to restore natural erections and / or improve responses to oral medications (first line therapy). liswt for ed is under evaluation in the usa. the european association of urology guidelines on ed were recently updated to include liswt for men with mild to moderate ed. the energy/pulse used in this application is approximately 10% of the energy used for disintegrating kidney stones; no serious side effects have been reported. shock wave therapy for diabetic ulcers has recently been approved by the fda.

Eligibility criteria:
inclusion criteria: * the patient must have given his informed and signed written consent * the patient is a male * between 40 to and including 55 years of age * the patient has ed for longer than 1 year but less than 5 years. * the patient is pde5i responsive, meaning he is able to achieve and maintain an erection under the effect of the maximal dosage of pde5i * iief-ef domain score of 17-20 * evidence based criteria: doppler clinical exam exclusion criteria: * the patient is participating in another study that may interfere with the results or conclusions of this study * history of radical prostatectomy or extensive pelvic surgery * past radiation therapy of the pelvic region within 12 months prior to enrollment * recovering from cancer within 12 months prior to enrollment * neurological disease which effects erectile function * psychiatric disease which effects erectile function * the patient is taking blood thinners * history of diabetes mellitus * history of coronary artery disease * evidence based criteria: doppler clinical exam * severe erectile dysfunction with iief-ef domain score \< 16
validation of the o3 regional somatic tissue oxygenation monitor

Conditions: Oxygen Deficiency

Summary: testing the absolute accuracy of the masimo o3 regional oximeter in reading somatic tissue oxygenation in healthy volunteers under controlled hypoxia.


Eligibility criteria:
inclusion criteria: * age between 18 and 45 years, inclusive * willing and able to provide written informed consent * healthy subjects exclusion criteria: * pregnant women * presence of any cardiovascular or pulmonary disease * exposure to high altitude(s) (\>2000 m) within 30 days prior to the study * known allergy to intravenous contrast medium or heparin * subject has skin abnormalities affecting the digits such as psoriasis, eczema, angioma, scar tissue, burn, fungal infection, substantial skin breakdown, nail polish or acrylic nails that would prevent monitoring of spo2 levels during the study * patients deemed not suitable for the study at the discretion of the investigator
dc vaccine in pancreatic cancer

Conditions: Pancreatic Ductal Adenocarcinoma

Summary: this research study is designed to evaluate the effects of a dendritic cell (kind of white blood cell) vaccine for pancreatic cancer.

this is a single arm open label trial that will assess the safety and tolerability of mature dendritic cell (mdc3/8) vaccine (primer and booster) in subjects with resected pancreatic adenocarcinoma. eligible patients that provide written informed consent will undergo apheresis to collect blood mononuclear cells for vaccine production approximately 1 week prior to vaccine infusion. each study subject will receive cyclophosphamide 300mg/m\^2 intravenously 3 to 4 days prior to the vaccine dose to deplete regulatory t cells. for each vaccine dose, all subjects will receive autologous dendritic cells pulsed with mutant kras peptides corresponding to the subject's specific tumor mutation and human leukocyte antigen type. on day 1, the subject will receive the primer vaccine dose; this will be followed by one booster vaccine dose approximately 8 weeks later. peripheral blood will be taken weekly, and a second apheresis procedure will be performed at the end of study to monitor the immune response to the vaccine. information will be gathered from usual clinic visits for approximately 1 year following the end of treatment study visit to evaluate for disease recurrence.

Eligibility criteria:
inclusion criteria: * pathologically-confirmed kras(g12d-), kras(g12v-), kras(g12r-) or kras(g12c-mutated) pancreatic ductal adenocarcinoma who are at high risk of relapse and have no evidence of disease. * expression of one or more of the following hla class i alleles: hla-a02, hla-a03, hla-a11, hla-b07 and hla-c08. * male or female, age 18+ * ecog performance status 0-1 * certain required laboratory values, performed within 14 days prior to consent * subjects of reproductive potential must agree to use a medically accepted birth control method during the trial and for at least two months following the trial. * provide written informed consent exclusion criteria: * prior treatment with more than two lines of cytotoxic chemotherapy. radiotherapy is not considered a line of therapy. * prior malignancy (except non-melanoma skin cancer) within 3 years. * pregnant or nursing women. * concurrent treatment with systemic immunosuppressants, including corticosteroids (e.g prednisone), calcineurin inhibitors (e.g tacrolimus, cyclosporine), antiproliferative agents (e.g mycophenolate mofetil, azathioprine) within 2 weeks of eligibility confirmation. local (inhaled or topical) steroids or replacement dose prednisone (≤ 10 mg daily) are permitted. * known chronic viral infections including hepatitis b, hepatitis c, and hiv. * known allergy to eggs. * prior history of uveitis or autoimmune inflammatory eye disease. * uncontrolled intercurrent illness. * any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or interpretation of subject safety or study results.

Keywords: pancreatic adenocarcinoma cancer vaccine dendritic cell vaccine mutant kras