Kornimate/medical-research-clean huggingface dataset:
eus-guided celiac plexus block vs. sham in chronic pancreatitis

Conditions: Chronic Pancreatitis

Summary: the aim of this randomized trial is to assess the efficacy of eus-cpb in the alleviation of abdominal pain in patients with chronic pancreatitis.

chronic pancreatitis is a complex fibroinflammatory disease arising from numerous etiological factors and a variety of clinical manifestations. abdominal pain is the most debilitating complication and can result in significant morbidity and impact on quality of life. endoscopic ultrasonography (eus) has been increasingly utilized for celiac plexus block (eus-cpb), whereby a steroid in combination with a local anesthetic agent are injected into the celiac plexus within the abdominal cavity. the aim of this randomized trial is to assess the efficacy of eus-cpb in the alleviation of abdominal pain in patients with chronic pancreatitis.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * abdominal pain of at least 3 months duration and a vas score ≥ 3, with or without the use of narcotic analgesics. * diagnosis of chronic pancreatitis on eus examination, with ≥ 5 features on eus. * no other cause of abdominal pain exclusion criteria: * age \< 18 years. * history of prior eus-cpb. * use of anticoagulants that cannot be discontinued for the procedure. * clinically significant allergy to bupivacaine or triamcinolone. * unable to obtain consent for the procedure from either the patient or lar. * intrauterine pregnancy.
congitive behavioral therapy workshop for content moderators

Conditions: Work-Related Condition; Work-Related Stress Disorder

Summary: professional content moderators play a critical role in preventing internet users from being exposed to more sensitive content. however, recent literature has shown that this work places content moderators at increased risk for several psychological outcomes, including intrusive thoughts and vicarious stress trauma. this pilot study will assess the acceptability and feasibility of a brief (4-session) cognitive-behavioral workshop to reduce these risks.

the growing amount of user-generated content is forcing companies to hire more and more content moderators (cms). there is ample empirical evidence that exposure to the trauma of others at work affects well-being and mental health , and research focused on cms suggests that they experience similar effects as other professionals. this includes an increased risk of developing syndromes such as secondary posttraumatic stress, vicarious trauma, and burnout. recent literature, although limited, indicates that cms are already using coping strategies such as creating boundaries between work and personal life, although they expressed a preference for individual therapy with specialized professionals. however, this initial work points to the need for technology companies to develop prevention programs based on preventing exposure to traumatic content (. therefore, a cbt workshop consisting of four 90-minute group sessions was designed specifically to prevent work-related consequences in a small sample of content moderators. the workshop will have a cognitive-behavioral orientation, which has been shown to be more effective for posttraumatic symptoms. psychological distress, ptsd symptoms, job satisfaction, and coping strategies will be measured before and after the intervention to assess the feasibility of the workshop.

Eligibility criteria:
inclusion criteria: * actively work as a professional content moderator, for at least 6 months. exclusion criteria: * presence of a psychotic or personality disorder as defined by dsm-5 criteria. * receive another psychological treatment during the time of the study.
quantifying the impact of the peanut ball on the duration of the active stage of labor

Conditions: Labor Onset and Length Abnormalities; Prolonged Labor; Labor Long; Labor; Poor

Summary: prolonged labor is associated with adverse maternal and fetal outcomes including infection, postpartum hemorrhage and increased nicu admission. one of the most common indications for cesarean section in the us is prolonged labor. maternal positioning through labor facilitated by birthing balls is believed to help facilitate labor. current data is inconclusive on whether or not the use of birthing balls is advantageous in a statistically significant manner. in this prospective randomized controlled trial, participants will be randomly selected to receive either the experimental intervention (repositioning peanut ball during labor) or the control intervention (the standard therapy of traditional repositioning during labor). primary outcome: time of active labor to delivery with and without use of the peanut ball. secondary outcome: cesarean section frequency.


Eligibility criteria:
inclusion criteria: * fetus must be vertex in position at the time of admission to l\&d * pregnant patients age 16 years old and above * singleton pregnancy (ie. one fetus) * patients who receive induction and augmentation of labor may be included * include both nulliparous and multiparous women * patients with htn, diabetes, and obesity at any point in their pregnancy may be included * patients may be included in the study regardless of whether or not they received an epidural * patients who have been randomly assigned to receive a peanut ball must be placed on the peanut ball at 6cm dilation, not earlier. * patients who present to l\&d dilated to 4cm may be included exclusion criteria: * tolacs and vbacs will be excluded * multiple gestation will be excluded * category 3 fetal tracing will be excluded * chorioamnionitis will be excluded * patients who present to l\&d at 6cm cervical dilation will be excluded * patients placed on the peanut ball before 6cm cervical dilation will be excluded * patients with fetal malpresentation will be excluded

Keywords: peanut ball labor cesarean section
the effect of routine and random pacifier use methods in preterm infants

Conditions: Feeding; Neonatal

Summary: the aim of this study is to determine the effect of the routine 5-min pacifier use before feeding and the random 30-min pacifier use independent from feeding during the day on the transition to bottle feeding process in preterm infants.

preterm infants, may most frequently experience feeding difficulties as a result of lower oral-motor tone, poor coordination during sucking-swallowing-respiration, sleepy behavior, gastrointestinal dysmotility and immature sucking pressure and being unable to sustain their physiological values at a normal level during feeding. in the literature, it is reported that approximately 82% of preterm infants have an oral feeding difficulty. as a consequence, it is a very complex process to acquire a safe and effective feeding skill and preterm infants need support in the weeks after birth until participants develop skills that are necessary for oral feeding and complete a successful transition to total oral feeding independent from orogastric catheter. although studies have stressed positive effects of the non-nutritive sucking (nns) intervention on feeding performance, it is reported that there is a need for more comprehensive randomized controlled studies revealing the use frequency, duration or effect of time. in the neonatal intensive care unit (nicu) where the study will be conducted, an appropriate method is chosen for preterm infants based on their general condition and the feeding transition stages are determined incrementally with repetitive follow-ups during feeding. the routine 5-min pacifier use method before feeding and the random 30-min pacifier use method during the day will be applied to newborns who have enteral feeding. newborns who already use pacifier independent from feeding during the day in the clinic and to whom these methods are applied, will comprise the control group. in order to ensure a homogeneous application in the control group, the pacifier use duration will be limited to 30 minutes. pacifier use durations have been determined in line with the literature examining the contribution of pacifier use to the feeding of preterm infants. newborns, to whom the routine 5-min pacifier use method is applied before each feeding, will comprise the experimental group. all newborns included in the study will be followed until participants are discharged.

Eligibility criteria:
inclusion criteria: preterm infants; * whose legal representatives agree to take part in the study and sign the informed consent form, * who have a stable clinical picture, * who are on the first day of enteral feeding will be included in the study. exclusion criteria: preterm infants; * who have a comorbidity, * who are intubated, * who have an inherent anomaly, * who have parenteral feeding will not be included in the study.

Keywords: preterm non-nutritive sucking feeding
the role of neutrophils in the age-driven decline in anti-pneumococcal vaccine responses

Conditions: Aging

Summary: this study focuses on the role of neutrophils in shaping the adaptive immune response to the anti-pneumococcal vaccine prevnar-13 in young and elderly adults.

this study focuses on the role of neutrophils in shaping the adaptive immune response to the anti-pneumococcal vaccine prevnar in young and elderly adults. this study involves direct vaccination of human volunteers. the endpoints will be determining how vaccination affects neutrophil responses and linking those neutrophil responses to antibody responses following vaccination. the main results will be: 1. elucidating how neutrophils kill bacteria before and after vaccination 2. elucidate the phenotype of neutrophils before and after vaccination 3. elucidate how neutrophils interact with b and t cell in vitro before and after vaccination 4. measure antibody levels and function before and after vaccination 5. correlate neutrophil responses to antibody levels and function

Eligibility criteria:
inclusion criteria: * both sexes * have not been vaccinated with any licensed or experimental pneumococcal vaccine * ages 21-40; and ≥65. individuals \>60 years old will also be recruited in case we find no unvaccinated people ≥65 years old * free of acute infections within the last 2 weeks * did not take any anti-inflammatory medicine in the last week * did not ingest alcohol in the last 24 hours * ability and willingness to provide consent exclusion criteria: * previous vaccination with any licensed or experimental pneumococcal vaccine * known hypersensitivity to vaccination and vaccine components * immune deficiency * use of immune-modulating or suppressive drugs * malignancies within the last 2 years * known hematological, rheumatic and inflammatory diseases * known chronic infections * poorly controlled chronic cardiovascular and metabolic conditions * pregnancy * dementia

Keywords: aging neutrophils streptococcus pneumoniae pneumococcal conjugate vaccine
effect of sleep apnea on blood pressure control and outcome early after subarachnoid hemorrhage

Conditions: Subarachnoid Hemorrhage; Sleep Apnea

Summary: in this observational study patients with subarachnoid hemorrhage (sah) will be screened for sleep apnea (sa) to investigate if sa is associated with impaired blood pressure control and worse clinical outcome early after sah.

patients admitted with non-traumatic sah will be consented and screened for sleep apnea within 48 hours after hospital admission. blood pressure and clinical outcome will be monitored throughout icu treatment and hospital stay, respectively. diagnosis of sleep apnea will be confirmed on follow-up 3-6 month after sah by sleep apnea screening (portable cardiorespiratory monitoring and out-of-center polysomnography, respectively).

Eligibility criteria:
inclusion criteria: * subarachnoid hemorrhage (hunt \& hess 1 to 4) * \> 18 years of age * ability to consent for study of healthcare proxy able to confirm patient will to participate exclusion criteria: * stoke within 3 month prior to admission * intubation prior or within 24 hours after admission * no healthcare proxy

Keywords: subarachnoid hemorrhage sleep apnea
bipap in pediatric moderate to severe asthma randomized control trial

Conditions: Asthma in Children

Summary: the goal of this clinical trial is to study if starting bi-level positive airway pressure (bipap), a mask that gives pressure to the lungs, works well for children in the emergency department with moderate to severe asthma attacks. the main questions it aims to answer are: 1. whether initiation of bipap at the same time as continuous beta-agonist therapy (e.g., nebulized albuterol) will decrease how long children with moderate to severe asthma attacks need to receive continuous beta-agonist therapy. 2. whether early bipap changes how the lungs function in children with asthma attacks. 3. whether children receiving early bipap experience more issues or side effects than those children who do not. all children will receive the usual treatment for asthma attacks; if they are still experiencing moderate to severe symptoms after the initial treatment, they will be asked to participate in the study. participants will then wear a mask while they are receiving the continuous beta-agonist therapy. some patients will receive bipap where pressure is given to the lungs and others will have a sham bipap mask where no pressure is given to the lungs. study participants will wear the mask for 4 hours or until their treatment team feels they are ready to come off of the continuous beta-agonist therapy. participants will receive more medications and decisions on going home or being admitted to the hospital will be decided as usual by their treatment team. researchers will compare bipap versus control (sham bipap) groups to see if there is a difference in how long continuous beta-agonist therapy is needed, how the lungs are functioning, and number or type of side effects.


Eligibility criteria:
inclusion criteria: * 5 to 17 years of age (inclusive) presenting to the ed with an asthma exacerbation * prior diagnosis of asthma by a physician who prescribed asthma medications (beta-agonist and/or inhaled or oral steroids) * pram score of 4 or greater after administration of first-line therapy (albuterol/ipratropium back to backs, corticosteroids, +/- oxygen) and need for continuous beta-agonist therapy after first-line therapy exclusion criteria: * prior participation in the study * hypercapnic (paco2 \> 60 mmhg) respiratory failure or need for invasive mechanical ventilation as determined by the treating physician * hypoxemic respiratory failure (sao2 \ 0.35) * presence of a tracheostomy or baseline noninvasive ventilation requirement * non-asthma causes of wheezing: foreign body, tracheomalacia, vocal cord dysfunction, pulmonary edema, uncorrected congenital heart disease, cystic fibrosis, anaphylaxis * absolute or relative contraindication to bipap: facial trauma, uncontrollable vomiting, hypotension for age, glasgow coma score of 8 or less, drowsiness or confusion, known or clinical suspicion for pneumothorax, pneumomediastinum, or subcutaneous emphysema, pregnancy

Keywords: pediatric asthma asthma bi-level positive airway pressure bipap beta-agonist
standard versus intensive monitoring after myocardial infarction looking for atrial fibrillation

Conditions: Atrial Fibrillation New Onset; Myocardial Infarction

Summary: after a myocardial infarction (mi), patients discharged home in sinus rhythm may develop af that is asymptomatic, undetected, and undertreated. previous studies (carisma and arrest) have demonstrate high rates of new-onset af recorded on implantable loop recorder (ilr), although the routine implantation of ilrs post-mi remains costly and invasive. the external loop recorder may effectively identify patients with new-onset af through a validated diagnostic algorithm and targeted monitoring during a high-risk period (immediately after hospital discharge). we will prospectively randomize patients to receive an external loop recorder or standard care, evaluating rates of new-onset af developing within 30 days after mi.

the simpl-af trial will evaluate the role of intensive monitoring after myocardial infarction, assessing for new-onset af after hospital discharge. patients will be randomized to receive intensive monitoring or standard care in a 2:1 distribution. patients randomized to intensive monitoring will receive a spiderflash® monitor, worn for 30-days after discharge and returned for analysis. the primary objective of this study is to evaluate at the incidence of new-onset af at 30-days post-mi using an intensive monitoring strategy, compared to standard of care. secondary objectives include the impact of intensive monitoring on oral anticoagulation rates at 90-days and 1-year after monitoring, and the risk factors for developing new-onset af, and the variables associated with initiating or withholding anticoagulation.

Eligibility criteria:
inclusion criteria: * patients with st-elevation myocardial infarction (stemi) or non-st-elevation myocardial infarction (nstemi; third universal definition of mi) with or without pci. all patients must have troponin elevation. * no history of af during hospitalization, at discharge, or pre-existing af documented on history (i.e. hospital records, previous hospitalization, ecg records). * no anticoagulation for af or other indications (i.e. lv thrombus, heart valves, venous thromboembolism/deep venous thrombosis). * no concomitant disease expected to reduce expected lifespan to \<2 yrs. exclusion criteria: * patients receiving cabg surgery during this hospitalization or planned cardiac surgery within the next 3 months. * patients with spontaneous coronary artery dissection (scad), non-atherosclerotic coronary disease (nacad), and takotsubo cardiomyopathy are excluded from this study. * patients with contraindications to anticoagulation. * patients with a chronic skin disorder on the upper torso, or an allergy to medical tape or glue.

Keywords: atrial fibrillation myocardial infarction intensive monitoring oral anticoagulation hospitalization
bevacizumab plus egfr-tkis in chinese patients with egfr-mutant nsclc: a real-world study

Conditions: NSCLC

Summary: this study is a prospective, multicenter, real-world study to investigate the efficacy and safety of bevacizumab plus epidermal growth factor (egfr) tyrosine kinase inhibitors in chinese patients with stage iiib/iv egfr-mutant non-small cell lung cancer.


Eligibility criteria:
inclusion criteria: * patients must meet the following criteria for study entry: 1. signed informed consent form. 2. age≥18 years. 3. histologically or cytologically documented inoperable, locally advanced (stage iiib, iiic), metastatic (stage iv) or recurrent non-squamous nsclc. 4. an exon 19 deletion mutation or exon 21 l858r mutation in egfr has been found clinically, with or without egfr t790m mutation 5. eastern cooperative oncology group performance status 0-2 or kps ≥60 6. previous egfr-tkis or anti-angiogenic agents or systemic cytotoxic chemotherapy for locally advanced, metastatic or recurrent disease has not been performed. exclusion criteria: * patients who meet any of the following criteria will be excluded from study entry: 1. squamous carcinoma or mixed non-small cell lung cancer with squamous component. 2. potential hazard for receiving egfr-tkis or bevacizumab by clinical evaluations 3. previous history of receiving egfr-tkis or bevacizumab treatment prior to study enrollment 4. suspected or diagnosed leptomeningeal metastases 5. chest radiotherapy within 3 months prior to study enrollment 6. open surgery within 4 weeks prior to study enrollment
neoadjuvant nivolumab for operable esophageal carcinoma

Conditions: Esophageal Squamous Cell Carcinoma

Summary: this is a single arm phase ii study, in which maximum 3 cycles of nivolumab (240 mg fixed dose every 2 weeks) is administered for t2- or t3-node negative esophageal squamous cell carcinoma, before curative operation.


Eligibility criteria:
inclusion criteria: 1. histologically confirmed esophageal squamous cell carcinoma 2. clinical stage t2n0 (invasion to muscularis propria) or t3n0 (invasion to adventitia) 3. ecog performance 0 or 1 4. age 19 years or older exclusion criteria: 1. prior therapy (operation, radiotherapy, immunotherapy, or chemotherapy) for esophageal cancer 2. ineligibility or contraindication for esophagectomy 3. has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug. 4. has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). 5. has severe hypersensitivity and adverse events (≥grade 3) to nivolumab and/or any pd-1/pd-l1 inhibitors.
effect of morning versus evening perindopril on blood pressure control in people with type 2 diabetes

Conditions: Diabetes Mellitus, Type 2; Hypertension

Summary: we assessed the influence of time of administration of ace inhibitors on circadian blood pressure control in sub saharan type 2 diabetes patients with stage 1 hypertension over 56 days as first line treatment.

background: renin-angiotensin system antagonists represent the mainstay of blood pressure (bp) lowering treatment options in people with diabetes. ace inhibitors have a long half-life and offer the advantage of a single daily dose, usually empirically taken in the morning. objective: we assessed the influence of time of administration of ace inhibitors on circadian bp control in type 2 diabetes (t2d) patients with stage 1 hypertension. methods: twenty t2d patients (9 being women) with a mean age of 58.7 years, diagnosed with stage 1 of hypertension and naive to bp lowering medications, were included. they were randomly allocated to receive perindopril 10 mg/day as a monotherapy either in the morning or in the evening for 28 days, with crossover without washout period on day 29th and additional 28 days follow-up. a 24-hour ambulatory bp monitoring (abpm) was performed at baseline, days 28 and 56.

Eligibility criteria:
inclusion criteria: * type 2 diabetes * grade 1 hypertension * informed consent exclusion criteria: * estimated creatinine clearance≤ 60ml/min * white coat hypertension after initial 24 hour abpm * previous antihypertensive treatment * pregnant women * individuals working during the night * hyperkalemia

Keywords: diabetes hypertension perindopril chronobiology africa
pyruvate kinase deficiency global longitudinal registry substudy of protocol ag348-c-008

Conditions: Pyruvate Kinase Deficiency

Summary: this is a substudy of study ag348-c-008, an observational, longitudinal, multicenter, global registry that aims to better understand the longitudinal clinical implications of pyruvate kinase deficiency (pk deficiency). the primary purpose of this study is to describe the cognition of participants with pk deficiency, as objectively measured by the cogstate brief battery (cbb).


Eligibility criteria:
inclusion criteria: * participant must be ≥18 years of age; * participant must be enrolled in study ag348-c-008.

Keywords: glycolytic enzymopathy congenital nonspherocytic hemolytic anemia (cnsa) pkd