Kornimate/medical-research-clean huggingface dataset:
cardinality matching study of early v.s. delayed vv ecmo in severe respiratory failure

Conditions: Acute Respiratory Failure; ECMO

Summary: clinical reasoning and recent data suggest that early use of venovenous extracorporeal membrane oxygenation in refractory respiratory failure may confer a survival advantage. this retrospective matched study will assess whether patients who received vv ecmo at less severe hypoxaemia had differing outcomes to those who received ecmo with very severe hypoxaemia.

vv ecmo is increasingly used in refractory respiratory failure. despite advances in lung protective ventilation strategies, patients who have severe respiratory failure often develop complications from mechanical ventilation, including volutrauma and barotrauma. ecmo allows gas exchange to occur extracorporeally and may reduce the potential burden of iatrogenic lung injury by allowing a reduction of volume and pressure support - a 'lung rest' strategy. it is theorised that earlier intitiation of ecmo may allow for better outcomes, as there will have been less time for iatrogenic lung injury to occur. the uk ecmo registry has been collected of patients treated under the nhs england commissioned respiratory ecmo service since 2011. this study has been previously registered and publication is intended shortly. patients will be extracted from this registry if they received vv ecmo. propensity matching scores will be created and patients will be stratified into groups of 'early' vs 'delayed' ecmo, based on their probability of being in either group. patients will be divided into cohorts based on the median pao2/fio2 ratio at decision to cannulate ('less severe hypoxaemia') and ('very severe hypoxaemia'). matched cohorts will be created correcting for key confounding factors (age, primary diagnosis, duration of pre-ecmo ventilation and paco2), using cardinality matching (a novel technique described by zubizaretta et al. in 2014) and traditional propensity-score-based methods. the technique with greater balance and statistical power (as defined by sample size) will be selected for the primary analysis. further analyses will assess the relationship between hypoxaemia at decision-to-cannulate and confounding factors as above.

Eligibility criteria:
inclusion criteria: * patients included in the uk ecmo registry (see previous registration; nct number awaited; protocol ecmo-001) * patients with vv ecmo exclusion criteria: * patients with inadequate or missing data for creation of propensity score models.
digital dysmorphology project

Conditions: Down Syndrome

Summary: in this study, the investigators propose a novel method to detect down syndrome using photography for facial dysmorphology, a tool called computer-aided diagnosis (cad). after validating the method, this technology will be expanded to perform similar functions to assist in the detection of other dysmorphic syndromes. by using photography and image analysis this automated assessment tool would have the potential to improve the diagnosis rate and allow for remote, non-invasive diagnostic evaluation for dysmorphologists in a timely manner.

in this study, investigators propose a novel method to detect down syndrome using photography for facial dysmorphology, a tool called computer-aided diagnosis (cad) . local texture features based on contourlet transform and local binary pattern are investigated to represent the facial characteristics. a support vector machine classifier is then used to discriminate between normal and abnormal cases. accuracy, precision and recall are used to evaluate the method. after validating the method, this technology will then be expanded to perform similar functions to assist in the detection of other dysmorphic syndromes. by using photography and image analysis this automated assessment tool would have the potential to improve the diagnosis rate and allow for remote, non-invasive diagnostic evaluation for dysmorphologists in a timely manner.

Eligibility criteria:
inclusion criteria: * pediatric subject with down syndrome. * healthy pediatric siblings of a subject with down syndrome and/or other individuals with another genetic referral to serve as a control group. * subject must be less than 18 years old. exclusion criteria: * subjects 18 years or older.
inhibitory receptors in eosinophils of atopic subjects

Conditions: Atopy; Atopic Dermatitis; Asthma; Allergic Rhinitis; Food Allergy

Summary: the purpose of this study is to analyze the expression and activity of inhibitory molecules on eosinophils obtained from allergic subjects.


Eligibility criteria:
inclusion criteria: * age 20-60 years * a physician-diagnosed atopic disease exclusion criteria: * atopic disease not active * steroid treatment * active non-atopic inflammatory disease, including infections * pregnancy
effect of nitrous oxide on eeg

Conditions: Nitrous Oxide; Electroencephalography; Anesthetic, Inhalation

Summary: our recent preclinical observations suggest that monitoring of slow electroencephalogram (eeg) oscillations may be used to predict the efficacy of rapid-acting antidepressants such as ketamine or nitrous oxide. in this project we will carry out critical clinical research on healthy volunteers and study the effects of nitrous oxide on eeg. results will be used for the design of clinical trials on depressed individuals. the project will be done in collaboration between neuroscientists at the university of helsinki and clinicians at the tampere university hospital.


Eligibility criteria:
inclusion criteria: 1. informed consent obtained 2. age between 18 - 40 3. male 4. body mass index 18 - 27 exclusion criteria: 1. age \ 40 2. alcohol use disorders identification test (audit) \>6 points 3. drug abuse screening test 20 (dast-20) \> 0 points 4. beck depression inventory (bdi) \> 11 points 5. symptom check list 90 (scl-90) over mean values of finnish population in any dimensions of the scl-90 or the global severity index 6. any respiratory disorder including sleep apnea 7. any heart illness 8. epilepsy 9. known vitamin b12 deficiency

Keywords: eeg slow wave activity nitrous oxide n-methyl-d-aspartate-receptor blockade delta wave self-reported psychiatric symptoms
the effect of robotics-assisted tilt table and functional electrical stimulation in stroke patients

Conditions: Stroke

Summary: among subacute stroke patients (within 4 weeks after the onset), patients who are unable to walk are divided into experimental groups and control groups, and conventional rehabilitation treatment including physical therapy and occupational therapy is performed for 4 weeks or more in all groups. robot assisted inclined bed treatment and fes were performed, and the control group performed conventional inclined bed treatment. the purpose of this study is to investigate the effect of robot-assisted inclined bed treatment by tracking observation and comparative analysis of the lower limb function, gait ability, bone density and muscle mass of each group. patients appropriate for the selection criteria are divided into experimental group and control group in random permuted blocks to conduct the study. in the experimental group, fes was performed at the same time as the robot-assisted inclined bed treatment once a day for 30 minutes, 5 days a week for 4 weeks, and the control group performed conventional inclined bed treatment for 30 minutes once a day for 4 weeks, 5 days a week. separately from this in all groups, functional electrical stimulation treatment is performed once a day in the area except the lower extremities. in addition, all patients receive palliative physical therapy for 4 weeks for 1 hour a day. all subjects undergo a physical examination and whole body composition assessment before and after 4 weeks of treatment, and f/u after 4 weeks of treatment.


Eligibility criteria:
inclusion criteria: 1. patients within 4 weeks of onset of first stroke 2. patients with an fac score of 1 or less and at least one lower limb fma of 15 or less 3. adult male or female over 50 years of age 4. those who have consented in writing to this clinical trial 5. a person who understands the purpose of the clinical trial and can adapt well to the treatment process exclusion criteria: 1. those with lower motor neuron lesions 2. a person who has an artificial implant due to a fracture of the lower extremity and spine, or a metal implant that generates an electrical signal such as an artificial pacemaker. 3. those with a history of bone metabolism related diseases such as thyroid or parathyroid disease (excluding osteopenia and osteoporosis) or bone tumor 4. a person who has a history of fracture at the site of bone mineral density (ex. l1-l5, femoral head) 5. those who have skin ulcers or skin diseases such as open wounds that make it difficult to apply robotic therapy 6. those with the construction of the lower extremities 7. those with deep vein thrombosis or arterial vascular disease of the lower extremities 8. pregnant women 9. not appropriate according to the judgment of other researchers
blood pressure reduction in patients with asymptomatic aortic valve stenosis

Conditions: Aortic Valve Stenosis; Hypertension,Essential; Heart Failure

Summary: the aim of this study is to investigate the effect of strict blood pressure control versus conventional care in patients with asymptomatic moderate to severe aortic valve stenosis. the study is a randomized (1:1), open label, controlled intervention trial. hypothesis: 1. strict bp control for 12 months reduces the progression of lv remodelling compared to conventional treatment. 2. strict bp control for 2 years reduces the increase in aortic valve calcification and lv remodelling compared to conventional treatment. 3. strict bp reduction for up to 10 years reduces the need for aortic valve replacement and cardiovascular events compared to conventional care.


Eligibility criteria:
inclusion criteria: * aortic valve peak velocity (vmax) of 3.0-5.0 m/s and/or aortic valve area (ava) ≤ 1.2 cm2 * blood pressure: sbp \>= 127 mmhg measured by bp-tru * lvef ≥ 50% * age \> 18 years * safe birth control management (intrauterine devices or hormonal contraceptives (contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release)) for women of childbearing potential. * negative urine-hcg for women of childbearing potential * ability to understand the written patient information and to give informed consent. exclusion criteria: * symptoms due to as * symptomatic orthostatic hypotension and/or one minute standing sbp \< 110 mmhg (16). * suspicion of secondary hypertension * participation in other randomized drug study (device studies accepted) * moderat to severe aortic valve regurgitation e.g. vena contracta \> 5 mm, assessed by echocardiography) * known or suspected ischemic heart disease (coronary angiography with \>70% stenosis in a major epicardial vessel, symptoms or signs of myocardial ischemia, e.g. angina pectoris, wall motion abnormalities). patients who have previously undergone complete revascularization of major coronary arteries due to angina pectoris are eligible for inclusion. * significant coronary obstructive lesions detected by baseline cardiac ct that requires a revascularisation procedure. * egfr \< 30 ml/min or end-stage renal disease * other disease, comorbidity or treatment making the subject unsuitable for study participation as judged by the investigator

Keywords: aortic valve stenosis hypertension heart failure
chronicling the copd patient journey and change in copd symptoms, quality of life and exacerbations following initiation of budenoside/glycopyrronium/formoterol [bgf]

Conditions: Chronic Obstructive Pulmonary Disease (COPD)

Summary: the chronicles study will investigate the change in clinical and patient reported outcomes after six-months of treatment with budenoside/glycopyrronium/formoterol \[bgf\] in a real-world setting.

this is a prospective, open label, non-interventional, single network of clinical practice centers study that will be conducted in routine clinical care in the pulmonary/ primary care practitioner (pcp) care setting in ontario, canada. eligible patients will be enrolled into the study only following the treating physician's decision and patient agreement to initiate treatment with bgf. patients will be observed for up to 6 months post-treatment initiation with bgf.

Eligibility criteria:
inclusion criteria: * physician diagnosis of copd * copd patients in the best care network who have a cat score \>=10 * age \>=35 at time of enrolment * minimum 12-month recorded prior medical history for patients * physician decision and patient agreement to initiate treatment with breztri based on routine care (and in accordance with label and reimbursement criteria) * ability to read english and to provide consent to inclusion in the study exclusion criteria: * diagnosis of asthma * dementia or other health issues related to memory * inability to use inhalers * copd due to documented α-1 antitrypsin deficiency * previous treatment with triple fixed-dose combination therapy in 12 months prior to screening visit * hospitalisation due to copd exacerbation within the last 30 days prior to enrolment * pregnancy or lactation period * participation in an ongoing clinical interventional or observational trial for another copd medication (or completed another trial within last 30 days of initiating bgf) * patient self-reporting or a physician record with an active covid-19 infection at time of enrolment or hospitalized due to covid-19 infection in the last 60 days * previous enrolment in this study

Keywords: copd; readmissions; maintenance therapy; triple therapy; real-world evidence; mortality; cardiopulmonary events, exacerbations
trauma patients and hypothermia in the emergency room: readyheat® versus cotton wool blanket

Conditions: Hypothermia; Trauma

Summary: hypothermia is a common problem in traumatized patients leading to severe complications such as impaired coagulation, increased rate of wound infections and overall patient discomfort among others. therefore, the investigators test out the new self warming readyheat® blanket device against the currently used cotton wool blanket in terms of effects on the prevention and treatment of hypothermia.

hypothermia is a common problem in traumatized patients leading to severe complications such as impaired coagulation, increased rate of wound infections and overall patient discomfort among others. therefore, the investigators test out the new self warming (via an exothermic reaction) readyheat® blanket device against the currently used cotton wool blanket in terms of effects on the prevention and treatment of hypothermia. near body core temperature is measured by a sublingual sensor as the "gold standard" of body core temperature measurement - the pulmonary artery catheter - is too invasive and not suited for this collective of patients in the emergency room setting. blanket use will be randomized. temperature will be taken at emergency room admission, after 15, 30 and 45 minutes of treatment as well as right before handing the patient over to the next caring unit (icu, imc, operating theatre etc.). if treatment time is shorter than expected measurement will stop at the latest possible point. blankets will be applied to the patient once admission in the emergency room is complete and will only be lifted for interventions.

Eligibility criteria:
inclusion criteria: - trauma patients ≥ 18 years of all severity stages including poly traumatized patients admissioned through the emergency room exclusion criteria: * patients \< 18 years * patients after pre-hospital cardiac arrest or ongoing cpr at time of admission

Keywords: hypothermia (poly) trauma emergency room warming blanket
using online tools to increase weight loss in primary care

Conditions: Obesity

Summary: the goal of the proposed project is to test the effectiveness of an intervention (connect4health engage) focused on motivating and guiding patients to use empirically supported, freely available online tools for weight loss. a randomized trial will be conducted in primary care clinics. fifteen to twenty pcps will be recruited, followed by 453 patients. patients will complete either the 52-week connect4health engage intervention or connect4health discover, an educational control.


Eligibility criteria:
inclusion criteria: * age 18 or older * bmi ≥ 30 kg/m2 based on self-report body weight and height, or bmi 27-29.9 kg/m2 with a weight related comorbidity of hypertension, type 2 diabetes, pre-diabetes, dyslipidemia, or obstructive sleep apnea, gastroesophageal reflux disease, or coronary artery disease. * self-report weight ≤ 375 lbs (the maximum weight that bodytrace scales can accurately detect is 397 lbs, thus 375 lbs provides a buffer to allow detection of at least 20 lbs weight gain). * has valid email address in ehr * has an appointment scheduled with enrolled pcp about 30-45 days after idr query * speaks and reads english * has either wifi internet access at home or a phone or tablet with a data plan. exclusion criteria: * bmi≥ 45 kg/m2. * currently enrolled in structured weight loss treatment * in past month, has been actively participating in a weight loss focused online community (i.e., posting or reading content). * currently tracking food intake 3 days per week * pregnant or planning to become pregnant in the next 6 months * currently breastfeeding (or pumping breastmilk) 3 times per day or more. * currently undergoing treatment for cancer or has active cancer * had cardiovascular event in the past 60 days * inpatient psychiatric treatment in the past 6 months * eating disorder in past 5 years * congestive heart failure resulting in recent (past 6 months) hospitalization or contributing to difficulty breathing or difficulty doing daily activities. * dementia diagnosis * bariatric surgery in the past year or currently undergoing evaluation for bariatric surgery * type 1 diabetes * currently taking prescription medication for weight loss * inability to stand on body weight scale independently * impaired hearing * unable to read content on websites without assistance * planning to move out of the region in the next 12 months.

Keywords: obesity
tranexamic acid as an intervention in abruptio placenta

Conditions: Vaginal Bleeding; Prolonged Pregnancy

Summary: abruptio placenta is one of the common causes of antepartum haemorrhage which is more common in the second half of pregnancy and causes a high maternal and neonatal morbidity and mortality

abruption has been estimated to occur in 6.5 pregnancies per 1000 births, with an associated perinatal mortality rate of 119 per 1000 in the united states. a cochrane database study revealed that there is no evidence from trials to show the best way to help pregnant women and their fetuses when there is a placental abruption. the baby may need to be delivered immediately, by cesarean section if alive, and often vaginally if the baby has died. treatments include pain relief, blood transfusion, and monitoring. bleeding during pregnancy is characterized by activation of the fibrinolytic system. tranexamic acid is a potent pharmaceutical agent that suppresses fibrinolysis and thus can be used for managing hemorrhage in pregnancy. the fda's pregnancy category for tranexamic acid is category b.

Eligibility criteria:
inclusion criteria: * 24 weeks gestation and more * stable hemodynamically * accepted to participate exclusion criteria: * hypersensitivity to tranexamic acid * defective color vision * history of venous thromboembolism * pre-existing medical conditions that could affect pregnancy outcomes (diabetes mellitus, hypertension, renal disease) * smoker * refused to participate in the trial

Keywords: abruptio placenta interventional study perinatal mortality vaginal bleeding
the effect of obesity on recovery profile in children

Conditions: Obesity, Childhood

Summary: it is planned to investigate whether obesity affects the recovery profile after anesthesia in pediatric patients. to evaluate recovery profile, time to spontaneous ventilation (the time between anesthetic discontinuation and beginning of spontaneous ventilation), lma removal time (the time between anesthetic discontinuation and lma removal), open eyes (the time between anesthetic discontinuation and eye opening in response to verbal stimulus or painful pinching), and pacu discharge will be also noted.


Eligibility criteria:
inclusion criteria: * asa physical status i and ii * routine surgery under general anesthesia exclusion criteria: * any known cerebrovascular disease * long- or short-term (within the previous 24 hours) intake of any drug acting in the central nervous system * the patients bypassing the recovery room
effectiveness of the transitional care model in total knee arthroplasty patients

Conditions: Knee Osteoarthritis; Pain; Self Efficacy; Health Care Utilization

Summary: the aim of this study was to determine the effectiveness of transitional care in patients with total knee arthroplasty on patients' functional status, perceived self-efficacy, and health care use. based on the sampling inclusion criteria, we assigned the patients who would undergo knee arthroplasty to the control (n=35) and intervention (n=35) groups, via the block randomization method. the intervention group received transitional care, while the control group received usual care. data were collected on post-intervention functional status, level of self-efficacy, and hospital visits outside of routine control.

this randomised control study was conducted 70 eligible partients with total knee arthroplasty in a public hospital orthopedic and traumatology service. participants were randomly assigned to receive either the 6-week 'transitional care model' program or usual care. assessments of self-efficacy and functional status of patients were conducted at baseline, 2nd and 9th weeks after discharge. time-dependent changes in patient outcomes were assessed by using western ontario and mcmaster universities osteoarthritis index (womac) and arthritis self-efficacy scale (ases) measurements tools. assessments of hospital visits outside of routine control were conducted 2nd week, 6th week, 9th week, and 12th weeks after discharge. the functional status of the intervention group patients improved more than the control group according to womac mean scores. intervention group patients receiving transitional care had higher mean scores at the 2nd-week and 9th-week postoperatively in perceived self-efficacy . besides, the rate of admission to the hospital in the intervention group was lower compared to the control group, and a significant difference was observed in the 6th-week follow-up.

Eligibility criteria:
inclusion criteria: * having decided to undergo total knee arthroplasty for the first time due to osteoarthritis * volunteering to participate in the research, not having a psychological, physical, and mental disability that may prevent communication, not having any major chronic problems such as end-stage organ failure, kidney, neurological, cancer * being discharged to the home from a hospital * being able to speak turkish * being available by phone * being aged 50 and over exclusion criteria: * unwillingness to continue the study * rehospitalization * exposure to a disease or trauma that would affect functional independence during the study