Kornimate/medical-research-clean huggingface dataset:
hospital implementation of a stroke protocol for emergency evaluation and disposition

Conditions: Stroke, Acute; Ischemic Stroke, Acute; Hemorrhagic Stroke

Summary: most stroke patients are initially evaluated at the closest hospital but some need to be transferred to a hospital that can provide more advanced care. the "door-in-door-out" (dido) process at the first hospital can take time making transferred patients no longer able to get the advanced treatments. this study will help hospitals across the us "stand up" new ways to evaluate stroke patients, decide who needs to be transferred, and transfer them quickly for advanced treatment.

nearly 800,000 people in the united states (us) each year experience acute stroke, which remains the leading cause of adult disability and 5th leading cause of death. despite the proliferation of stroke centers nationwide, almost half of the us population lives beyond a 60-minute drive of a comprehensive stroke center (csc) and many patients require inter-hospital transfer (iht) from a non-csc to a csc. building upon prior work to reduce door-in-door-out (dido) time at referring hospitals, this proposal entitled "hospital implementation of a stroke protocol for emergency evaluation and disposition (hi-speed)" study seeks to (1) implement a novel, evidence-based, multi-component dido intervention in eight diverse stroke systems of care across multiple regions of the us and (2) conduct a dual evaluation of its effectiveness in reducing median dido time (primary outcome) and disability (secondary outcome) and of the fidelity and quality of implementation. the hi-speed study will definitively establish the effectiveness and generalizability of a multi-component evidence-based dido intervention and provide information about contextual adaptations for high-quality implementation and widespread dissemination. this study benefits from our well-established interdisciplinary expertise in stroke, emergency and prehospital medicine, systems and quality engineering, health services research, and strong multicenter research collaborations. findings from hi-speed will have substantial implications for a wide range of hospitals and stroke systems of care worldwide.

Eligibility criteria:
inclusion criteria: * age \>=18 years * final diagnosis: ais, ich, or sah exclusion criteria: * final diagnosis: tia or stroke nos * age \<18 years * comfort care measures on day 0 or 1 * left hospital against medical advice * enrolled in clinical trial related to stroke that is competing with this study

Keywords: interhospital transfer quality improvement implementation science stroke systems of care
predictors of early hematoma expansion in patients with acute intracerebral hemorrhage (clinical and laboratory study)

Conditions: ICH - Intracerebral Hemorrhage

Summary: this study aim to develop inflammatory score based on proper integration of several inflammatory markers and investigate whether it was associated with hematoma expansion and poor outcomes in patients with ich .

intracerebral hemorrhage(ich) accounts for approximately a quarter of all stroke subtypes with high mortality and the survi- vors always have varying degrees of residual disability. however, few medical and surgical treatments are clearly beneficial comparing with ischemic stroke. hematoma expansion, which is a determinant of poor outcomes, occurs in about 30% of ich patients especially at the early stage. attenuating hema- toma expansion is a compelling target for ich treatment, while the outcomes have not been accordingly improved after curbing the growth of hematoma in several clinical trials. it will be more helpful if a predictor can identify the risk of hematoma expansion and poor outcome rapidly and accurately. thus the antiexpansion treatment to the patients with positive of such predictor is likely to provide clinical benefits.

Eligibility criteria:
inclusion criteria: * patients having spontaneous ich aged 18 years or older admitted to a stroke unit within 24 hours after symptom onset . exclusion criteria: 1- patient have secondary ich (cerebral aneurysm, moyamoya syndrome, arteriovenous malformation, tumor, trauma or hemorrhagic transformation from brain infarction); (2)patient have primary intraventricular hemorrhage (ivh); (3)patients with historical modified rankin scale (mrs) score greater than 1 (4) patient refused to be enrolled.
neoadjuvant androgen deprivation therapy plus abiraterone with or without apalutamide for high-risk prostate cancer

Conditions: Prostate Cancer

Summary: this is a randomized study to evaluate the efficacy and safety neoadjuvant androgen deprivation therapy with goserelin and abiraterone with or without apalutamide prior to radical prostatectomy for patients diagnosed with localized high-risk prostate cancer.

in the prostate specific antigen (psa) era, about 15% to 20% of patients are diagnosed with high-risk localized disease and radical prostatectomy is a standard therapy for this subgroup of patients. however, despite best local therapy, about 30-60% of high-risk patients will eventually develop biochemical relapse and a significant proportion of these patients may progress with metastatic disease and die from prostate cancer. currently, there is no data supporting the use of neoadjuvant therapy for patients with high-risk disease since studies failed to demonstrate clinically significant benefit with standard androgen deprivation therapy (adt). following improved outcomes in other malignancies with the use of neoadjuvant therapy with active drugs in the metastatic setting, there is a growing interest in evaluating new-generation androgen receptor (ar)-targeted therapy in earlier stages of prostate cancer. therefore, the goal of this study is to evaluate the efficacy and safety of neoadjuvant therapy with adt and abiraterone versus maximal androgen blockade using adt, abiraterone and apalutamide for patients with high-risk localized prostate cancer.

Eligibility criteria:
inclusion criteria: * histologic confirmed prostatic adenocarcinoma * non-castrate levels of testosterone (\> 150 ng/dl) * high-risk localized prostate cancer, defined by either: * tumor stage t3 by digital rectal examination, or * primary tumor gleason score ≥ 8, or * psa ≥ 20 ng/ml * willing to undergo prostatectomy as primary treatment for localized prostate cancer * adequate hematologic, renal and hepatic function: * wbc \> 3000/ul * platelets \> 150,000/ul * creatinine \< 2 mg/dl * bilirubin \< 1.5 x upper limit of normal (uln) * ast/alt \< 2 x uln * karnofsky performance status (kps) ≥ 80% * able to swallow the study drugs whole as tablets exclusion criteria: * pathological finding consistent with small cell, ductal or neuroendocrine carcinoma of the prostate * current or prior hormonal therapy, radiation therapy or chemotherapy for prostate cancer * evidence of metastatic disease (m1) on imaging studies * other prior malignancy less than or equal to 5 years prior to randomization with the exception of squamous or basal cell skin carcinoma * abnormal cardiac function as manifested by nyha (new york heart association) class iii or iv heart failure * history of prior cardiac arrhythmia. * evidence of serious and/or unstable pre-existing medical, psychiatric or other condition (including laboratory abnormalities) that could interfere with patient safety or provision of informed consent to participate in this study.

Keywords: neoadjuvant therapy high-risk prostate cancer
digital patient education platform in head and neck cancer

Conditions: Head and Neck Cancer

Summary: head and neck cancer is a disease that has a particular propensity for treatment-related morbidity. it is hypothesized that patients who are more involved in their care in hospital and who are actively provided with more treatment-related education may report increased satisfaction and have improved overall outcomes. the investigators aim to determine whether delivery of patient-centred education in a multimedia format via a digital platform has an impact on overall satisfaction and perceived quality of medical care.


Eligibility criteria:
inclusion criteria: * patients aged 19 years old or above * patients seen in outpatient clinic who are scheduled to undergo reconstructive head and neck surgeries for a confirmed oral or oropharyngeal cancer diagnosis. exclusion criteria: * patients who are unable to use a digital tablet * patients who do not speak or read english * individuals unable to understand the purpose, methods and conduct of this study * patients unwilling to provide informed consent

Keywords: education patient satisfaction multimedia free flap head and neck cancer
use of epidurals intraoperatively for patients undergoing pancreas resection

Conditions: Pancreatic Cancer

Summary: the purpose of this study is to see if there is a difference in complications in patients who have an epidural started earlier (during their surgery) and used as part of the anesthetic in addition to using it for post operative pain compared with patients who receive an epidural later in the surgery to be used only for post operative pain.


Eligibility criteria:
inclusion criteria: * adult patients ≥ 18 years of age who can provide informed consent * scheduled for pancreaticoduodenectomy exclusion criteria: * pregnancy * history of documented anaphylaxis or contraindication to any of the study medications * significant cognitive impairment or documented psychologic impairment * contraindication to epidural per pain service guidelines * use of a sustained release opioid medication such as long-acting morphine, fentanyl patches, methadone, and buprenorphine within the last 3 months * post randomization exclusion will occur if the patient is found to have unresectable disease at laparotomy and therefore will not have the potential for the same postoperative complications.

Keywords: general anesthesia epidural pancreaticoduodenectomy 18-056
evaluating how the treatments in the action to control cardiovascular risk in diabetes (accord) study affect diabetic retinopathy (the accord eye study)

Conditions: Diabetic Retinopathy

Summary: diabetic retinopathy (dr) is an eye disease that can occur in people with diabetes and can cause poor vision or blindness. the action to control cardiovascular risk in diabetes (accord) study is examining the effect of various treatments on cardiovascular disease in people with diabetes. this current study will examine the effects of the accord treatments on the progression of dr in people participating in the accord study.

dr is the most common diabetic eye disease and is the leading cause of blindness in adults in the united states. it is caused by damage to the blood vessels of the retina, which is the light-sensitive outer layer of the eye. retinal blood vessels are often affected by the high blood sugar levels associated with diabetes. older people have an increased risk of developing dr; however, dr is likely to occur earlier and be more severe in anyone who has poorly controlled diabetes. almost everyone who has had diabetes for more than 30 years will eventually show signs of dr. symptoms of dr include poor night vision, seeing spots in front of the eyes, blurred vision, and blindness. the accord study is a study that is examining the effects of different treatments on cardiovascular disease in people with diabetes. participants in the accord study will receive one of eight different combinations of treatment, including blood sugar control, blood pressure control, and cholesterol-controlling medication. this study will enroll participants in the accord study and will examine the effects of the study treatments on dr. the results from this study may be used to develop new treatments to help prevent diabetes-related blindness. study visits will occur at baseline and year 4. at each study visit, participants will have an eye exam and specialized fundus photographs taken of the back of the eye and retina.

Eligibility criteria:
inclusion criteria: * participating in the accord study exclusion criteria: * has had laser photocoagulation for dr * has had vitrectomy surgery for dr

Keywords: type 2 diabetes mellitus cardiovascular diseases
impact of schemas, cognitive emotion regulation on quality of life of hiv patients: assessing outcomes of cbt

Conditions: Quality of Life

Summary: the present study has investigated the impact of schemas, cognitive emotion regulation and social connectedness on the quality of life of hiv patients in south punjab region, pakistan.

the present study has investigated the impact of schemas, cognitive emotion regulation and social connectedness on the quality of life of hiv patients in south punjab region, pakistan. the main study was conducted in four steps as follows: step 1: pre-testing, n=150 baseline assessment random assignment of willing participants to control and experimental step 2: cbt intervention, n=40, 20 each group step 3: post-test step 4: follow up assessmen

Eligibility criteria:
inclusion criteria: - registered at art clinics south punjab region hiv patients stage 1 or stage 2 understands urdu age above 20 exclusion criteria: aids converted no other terminal illness no other diagnosis below 20 age
bilateral upper limb amputation observatory

Conditions: Bilateral Upper Limb Amputation; Transverse Short Amputation of the Hand; Arm Amputation

Summary: in france, there is currently no data to directly estimate the number of bilateral upper limb amputations, their characteristics and therapeutic care. by extrapolation from the regional institute of physical medicine and rehabilitation (pmr) nancy in 2005, the number of new cases of amputated patients with prosthetic fitting of the upper limb was estimated at 355. epidemiological data from the 2009-2010 annual report of the limbless statistics database (collection of quantitative clinical data and demographic of amputees patients referred by orthopaedic centres in the united kingdom , whose population's characteristics are similar to france) identified 395 incident cases of upper limb amputation with, 6 bilateral amputations observed. the causes are varied: traumatic, infectious or related to diabetes. the population was relatively young, aged between 15 and 54 year old. on this basis, the estimated number of new cases of bilateral upper limb amputations throughout france should therefore be about 40 incident cases over a 5-year period. this observational study is aimed at collecting comprehensive and high quality data to describe the french population of bilateral upper limb amputees.


Eligibility criteria:
inclusion criteria: all french patients : * presenting bilateral upper limb amputation, from short transverse amputation of the hand (hand not fully functional) to arm amputation; * affiliated with a social security scheme or assimilated; * who have given their non-opposition to participate in the study. exclusion criteria: * patients with finger amputation only; * patients already having prosthesis of one upper limb (first amputation) and willing to receive prosthesis fitting after a contralateral amputation

Keywords: bilateral upper limb amputation prosthetic fitting epidemiology clinical practices totally non-functional hand
safety and immunogenicity of covid-19 vaccination in patients with cancer

Conditions: Patients With Cancers; COVID-19; Vaccine

Summary: severe acute respiratory syndrome coronavirus 2 (sars-cov-2) has caused pandemic since outbreak in 2020. patients with cancers may be at higher risk than those without cancer for coronavirus disease 2019 (covid-19). at present, limited data are available on the safety and immunogenicity of covid-19 vaccination for patients with cancer.

this study is a prospective, single-arm, open-label clinical trial. a total of 300 patients with different cancers including hepatocellular carcinoma, breast cancer, lung cancer, esophageal cancer, gastric cancer and colorectal cancer were included in this vaccination study. all of the patients will further accept 12 months follow-up study after vaccination. safety and immunogenicity will be carefully recorded and detected.

Eligibility criteria:
inclusion criteria: 1. age above 18 years 2. patients with diagnosed cancers including hepatocellular carcinoma, breast cancer, lung cancer, esophageal cancer, gastric cancer and colorectal cancer were included . 3. patients who have received local or systemic anti-cancer therapies according to the treatment guidelines previously or currently, and have a stable condition with the ecog score below 2. 4. the functions of multi-organs were normal or basically normal, and there are no contraindications for vaccination. exclusion criteria: 1. patients with acute attack of chronic diseases. 2. patients have history of convulsion, epilepsy, encephalopathy and psychosis. 3. patients who are allergic to any component of the vaccine, or have a serious history of vaccine allergy. 4. pregnant or lactating women. 5. sufferring serious cardiovascular diseases, such as arrhythmia, conduction block, myocardial infarction, and severe hypertension can not be well controlled by drugs. 6. patients have severe chronic diseases or diseases can not be controlled well during the progress, such as asthma, diabetes, thyroid disease, etc. congenital or acquired angioedema / neuroedema. 7. systemic cytotoxic drugs, cell therapies including nk cells, cytokine induced killer cells, dendritic cells, ctl and stem cells infusion are required during vaccination.
non-invasive brain stimulation for people with stroke

Conditions: Stroke

Summary: every five minutes someone in the uk has a stroke. it is the main cause of long-term disability among adults in the uk despite a fall in age-specific stroke incidence, with a growing number of survivors remaining dependent for activities of daily living. while most people with stroke regain walking ability, upper limb problems with no voluntary arm and hand activity, affecting a third of people after stroke, has a poor prognosis. transcranial direct current stimulation (tdcs) is a non-invasive procedure used to polarise brain regions through the application of weak direct currents and has the potential to develop into a useful aid to treatment strategies in neurorehabilitation. recent literature into the application of tdcs in people with arm and hand impairments after stroke has shown promising results on upper limb function measures like the jebsen-taylor hand function test. furthermore, a recent pilot study evaluated a six-week training programme combining tdcs with robot-assisted hand training and reported significant improvements in upper limb function. however, the robot in the latter study focused on single-plane distal movements only and long-term effects of the tdcs were not assessed. recent robotic developments included robots with three rotational degrees-of-freedom for the upper limb, but the effectiveness of this type of robot combined with tdcs in early stroke settings is unknown. ethical approval was sought from nhs nres committee south central- southampton b (ref: 11/sc/0345) to conduct this study.


Eligibility criteria:
inclusion criteria: 1. have a confirmed clinical diagnosis of a haemorrhagic or an ischaemic stroke confirmed clinically or by ct, pet or mri scan 2. experienced a single (first) stroke or multiple strokes 3. in the acute, sub-acute or chronic phase of their recovery (the first three to seven days are referred to as the acute phase. the first two weeks to six months are defined as the sub-acute phase, and the chronic phase begins after three or six months (teismann et al. 2011, duncan et al. 2003a) 4. have had a subcortical or cortical stroke 5. be over the age of 18 years 6. have any level of upper limb impairment exclusion criteria: 1. a history of epilepsy (tms studies) due to the fact that tms could cause an epileptic fit 2. impaired gross cognitive function; score of less than 24 of the mini-mental state examination (folstein et al. 1975) 3. any metal implants in the head including cochlear implants 4. any another neurological condition apart from stroke 5. are currently participants in another intervention study using tms/tdcs
the effect of probiotic and prebiotic use on fibromyalgia syndrome

Conditions: Fibromyalgia

Summary: the aim of the present study is to determine the effectiveness of probiotic and prebiotic treatments in patients with fibromyalgia syndrome.

fifty-three, fibromyalgia syndrome participants were randomized to receive either: 1) probiotic 4×1010 cfus per day 2) 10 g dose prebiotic (inulin) per day or 3) placebo for 8 wk. fibromyalgia impact questionnaire (fiq), visual analogical pain scale (vas), beck depression inventory (bdi), beck anxiety inventory (bai), pittsburg sleep quality index (psqi) and quality of life (sf-36) were measured during the baseline, 4 weeks and 8 weeks intervention phases. finally, the adverse effects will be evaluated.

Eligibility criteria:
inclusion criteria: 1. women aged 20-65 years. 2. signature of informed consent by the patient. 3. patients diagnosed according to the 2010 american college of rheumatology (acr) diagnostic criteria for fibromyalgia. 4. participants should be diagnosed with fibromyalgia at least 1 year ago. exclusion criteria: 1. using of antibiotic and nutritional supplements 2. being pregnant or breastfeeding 3. the presence of any allergies 4. being involved in any medical or psychological research 5. the presence of severe gastrointestinal diseases 6. psychiatric illness other than depression and anxiety.

Keywords: probiotics prebiotics fibromyalgia
readiness to disclose mother's hiv diagnosis to their children in beijing, china

Conditions: HIV

Summary: specific aims of the 1-year project are to pilot test the disclosure support intervention by (a) evaluating acceptability and feasibility with a preliminary randomized trial among 10 hiv+ mothers (5 in the intervention group and 5 in the treatment as usual (tau) group) and (b) assessing outcomes in mothers (quality of life and mental health indicators, adherence, social support, and disclosure stress, efficacy, readiness, and completion). the intervention will be compared to treatment as usual, with baseline (0 weeks), immediate post-intervention (4 weeks), and 12-week follow-up (16 weeks) assessments.

hiv disclosure to children has been shown to strengthen family relations and increase assistance with medical care, reinforcing the parent's willingness to live. some chinese children aware of their parents hiv diagnosis do exhibit emotional and social dysfunction; however, adequate support from caregivers (e.g., grandparents or even their hiv+ parents) can improve the children's quality of life and academic performance. there is a clear need for practical interventions to address parental distress around hiv disclosure in china, where cultural norms often emphasize family identity and cohesion and underscore the need for family-based programs, which have been shown to be feasible and efficacious for hiv-affected families.

Eligibility criteria:
inclusion criteria: * hiv+ mother ≥18 years of age, * not psychotic or demented; * receiving clinical care at the ditan hospital, * a mother of an hiv-negative child of age 13-25 years who does not know about the mother's infection; * well enough to attend study sessions as the clinic. exclusion criteria: * no psychotic or demented

Keywords: disclosure