Kornimate/medical-research-clean huggingface dataset:
the virtual reality therapy as a pulmonary rehabilitation supporting method

Conditions: Pulmonary Disease; COPD; Anxiety State; Stress; Depressive Symptoms; Mood Disorders

Summary: this study evaluates the effectiveness of virtual reality (vr) therapy in the treatment of depression and anxiety symptoms in patients undergoing the pulmonary rehabilitation. the first study group will receive vr therapy (vr group) as an addition to the traditional pulmonary rehabilitation. the second group (active control group) will receive schultz autogenic training as a standard supplement to the pulmonary treatment. the third group (control group) will undergo only the traditional pulmonary rehabilitation.

pulmonary rehabilitation leads to the improvement to the physical capacity and overall fitness of the patients with copd allowing restoration of independence in daily functioning. psychological support is required in order to reduce the negative psychological symptoms related to both the pulmonary disease itself and the comorbidities. in this study the investigators want to assess the effectiveness of the virtual reality (vr) therapy compared to standard psychological support (schultz autogenic training). thanks to using head mounted display (vr goggles 2018) and the phenomenon of total immersion vr therapy allows to completely separate the patient from the hospital environment, provides an intense visual, auditory and kinesthetic stimulation. depending on the stage of therapy it can have a calming and mood-improving effect or, in another part of the therapy, it can motivate the patient to the rehabilitation process. the additional aim of the vr therapy is to help the patients regain their emotional balance, let them recognize their psychological resources and trigger the natural recovery mechanisms. the goals of the project: 1. the evaluation of the influence of vr therapy on the depressive symptoms, the anxiety level and the stress level of the patients undergoing the pulmonary rehabilitation. 2. the comparison of the influence of the vr therapy and schultz autogenic training on the pulmonary rehabilitation process. 3. the evaluation of the pulmonary therapy improvements in patients with and without depressive, anxiety or stress symptoms.

Eligibility criteria:
inclusion criteria: * copd; * pulmonary rehabilitation conducted in ward settings; * anxiety symptoms scored 8 and more in hads-a or depressive symptoms scored 8 and more in hads-d. exclusion criteria: * inability to self-complete the research questionnaires; * presence of the following issues at the time of the examination or in the medical data: disturbances of consciousness, psychotic symptoms or other serious psychiatric disorders; * initiation of psychiatric treatment during the research project; * contraindications for virtual therapy (epilepsy, vertigo, eyesight impairment); * the patient's refusal at any stage of the research project.

Keywords: virtual reality pulmonary rehabilitation psychotherapy depression anxiety stress copd
neonatal pain- and distress experiences and later pain behavior of former preterm and critically ill newborn infants

Conditions: Pain

Summary: preterm and critically ill neonates experience many painful manipulations. the aim of the study is to evaluate the influence of these experiences and maternal deprivation on later pain behavior. using scoring systems, prechtl general movements, skin conductance, testing flexor reflex levels with von frey filaments and measuring salivary cortisol levels the investigators compare pain behavior of preterm (birth weight (bw) \ 48 hours) with healthy neonates at the time of their first vaccination at the age of 3-4 months. the investigators are also testing flexor reflexes and skin conductance and general movements in regular intervals during the initial hospital stay. the investigators hypothesize that pain behavior is different at the age of 3-4 months in children with many early painful experiences.


Eligibility criteria:
inclusion criteria: * preterm \ 48 hours exclusion criteria: * asphyxia * ich grade 3 and higher

Keywords: pain behavior
open pilot of cognitive behavioural therapy for insomnia in pregnancy

Conditions: Insomnia

Summary: despite the literature showing cognitive behavioural therapy for insomnia (cbt-i) to be effective in a variety of populations including postpartum women, as well as the demonstrated harmful consequences of sleep disturbances in late pregnancy, no trials have investigated its efficacy during pregnancy. this project will investigate the efficacy and acceptability of cognitive behavioral therapy for insomnia (cbt-i) in pregnancy.

study details are included in the publication listed here: https://www.ncbi.nlm.nih.gov/pubmed/27124405

Eligibility criteria:
inclusion criteria: * english speaking women * over the age of 18 * between twelve and twenty-eight weeks of gestation * identify as experiencing sleep disturbances will be recruited. exclusion criteria: * women who identify as experiencing symptoms of sleep disorders other than insomnia (i.e. restless legs syndrome, obstructive sleep apnea) * women who are experiencing a current major depressive episode, or have been diagnosed with bipolar disorder or other disorders that have a psychotic, dissociative, hallucinatory, or delusional component * currently taking prescribed medications for sleep problems * inability to attend at least 4 out of the 5 weekly therapy sessions, participate in the assessments * smoking, drinking alcohol or drug use during pregnancy.
bronchoprotection of salbutamol in asthma and chronic obstructive pulmonary disease

Conditions: Asthma; COPD

Summary: this study will investigate potential differences in how two puffs of salbutamol protects airway smooth muscle from contracting in people with asthma and chronic obstructive pulmonary disease (copd).

in asthma, the administration (inhalation) of a selective β2 receptor agonist (e.g. salbutamol), prior to methacholine challenge has been shown to shift the dose response curve to the right and "bronchoprotect" the airway against airway smooth muscle contraction. the extent of β2 receptor agonist bronchoprotection in copd is unknown. airway hyperresponsiveness (ahr) to direct acting agents such as histamine and methacholine is a feature of both asthma and copd. in asthma, the abnormality leading to ahr is believed to be due to changes in airway smooth muscle (e.g. hypertrophy, hyperplasia, contractile apparatus) whereas in copd the ahr is likely due to structural or geometric changes. the investigators hypothesize that the bronchoprotection afforded by salbutamol against methacholine challenge will be greater in asthma than in copd due to differences in underlying airway abnormalities.

Eligibility criteria:
inclusion criteria: * asthma or copd exclusion criteria: * asthma and copd
thulium fiber laser (tfl) versus holmium moses laser for ureteroscopic management of kidney stones

Conditions: Kidney Stone

Summary: this study aims to compare the efficacy and safety of both types of lasers, holmium moses and tfl, in management of kidney stones requiring treatment.

the prevalence of kidney stones has been increasing over the last two decades with lifetime recurrence risk reported to be as high as 50%. holmium lasers are nowadays considered the "gold standard" for treatment of urinary tract stones. recently, the holmium laser urology platform from lumenis has been updated to include a new technology called moses, which provides improved energy delivery of the laser to treat the stones, reduces migration of the stone during the procedure, and limits potential collateral tissue damage. a new generation of lasers has evolved due to the advances in laser fiber technology, leading to the development of the thulium fiber laser (tfl). tfl can operate within a large range of energy, frequency and pulse duration settings. the small fiber size is one of the main advantages of tfl, as it allows better endoscope performance through easier deflection and bigger working channel space. furthermore, it produces small stone fragments and better dusting capabilities compared to the standard holmium laser when adjusted on the same power settings. this study will compare the efficacy and safety of holmium moses and tfl in management of kidney stones requiring treatment.

Eligibility criteria:
inclusion criteria: 1. 18 years of age and over at the time of enrollment. 2. patients referred with single kidney stones of 10-20 mm in its largest diameter, or multiple stones involving a single calyx. 3. written informed consent to participate in the study 4. ability to comply with the requirements of the study procedures exclusion criteria: 1. patients with ipsilateral distal ureteral stones or stricture. 2. stone size \> 20 mm or multiple kidney stones in different calyces. 3. previous shock wave lithotripsy (swl) treatment for the same stone. 4. participants with active urinary tract infection until appropriately treated 5. uncorrected coagulopathy (anticoagulants or blood thinners which cannot be withheld before surgery). 6. pregnancy. 7. participants with preexisting conditions, which, in the opinion of the investigator, interfere with the conduct of the study. 8. participants who are uncooperative or cannot follow instructions. 9. participants who lack the capacity, or cannot speak english, in order to provide free and informed written consent. 10. patients with solitary kidney.
instant message-delivered cognitive behavioural therapy for insomnia (cbt-i)stroke caregivers

Conditions: Stroke; Insomnia; Depressive Symptoms; Caregiver Burnout; Psychological Distress; Mobile Phone Use

Summary: the proposed trial aims to assess the effectiveness of cognitive-behavioural therapy for insomnia (cbt-i) based ecological momentary intervention (emi) for reducing insomnia symptoms among stroke caregivers.

existing studies reported that 40-95% of family caregivers had clinically significant insomnia symptoms including reduced total sleep duration, prolonged sleep onset latency, frequent night awakenings, and poor sleep efficiency and quality. cognitive-behavioural therapy for insomnia (cbt-i) has shown a large effect in reducing insomnia among adults. innovative and interactive technologies, such as internet-delivered cbt-i (icbt-t), have therefore been incorporated into cbt-i, which was identified to have similar effects to that of traditional cbt-i. in the proposed trial, screened stroke caregivers will be recruited from community centres, rehabilitation centres, and tertiary hospitals in hk. the intervention group will receive cbti-based emi through instant messaging applications as personalised and real-time psychological support led by nurses for 3 months. the control group will only receive stroke and brief sleep hygiene education with chat-based support on the topics.the primary outcomes are sleep condition indicator (sci) and insomnia severity index (isi) scores. secondary outcomes will include sleep quality, depressive symptoms, anxiety symptoms, caregiver's burden, quality of life, and et al. a post-trial qualitative study will be conducted to understand the participants' experience of and compliance with the emi.

Eligibility criteria:
inclusion criteria: * primary family caregiver (aged ≥18) of stroke survivor * able to read and communicate in chinese * engaged caregiving roles for \> 4 hours per day; * able to use a smartphone messaging app (e.g., whatsapp and wechat) * sci ≤ 21 scores (i.e., clinically significant insomnia) exclusion criteria: * has provided care for \<1 month prior to recruitment * has a diagnosis of psychiatric disease or is currently taking psychotropic drugs * currently taking medication to help with sleep * currently participating in any type of psychological intervention
observational study of fat loss in hiv infected adults taking nucleoside reverse transcriptase inhibitors (nrtis)

Conditions: HIV Infections; Lipodystrophy; Metabolic Diseases; Nutrition Disorders

Summary: nucleoside reverse transcriptase inhibitors (nrtis) are a class of anti-hiv (human immunodeficiency virus) drug that can be an important part of an hiv treatment regimen. because anti-hiv therapy may have negative side effects, there is a great need to carefully study hiv infected patients on such regimens. one negative side effect observed in many hiv infected patients is lipoatrophy, a condition that results in fat loss in the body. it is unclear if nrtis also have a role in the development of mitochondrial toxicity, a condition that affects the body's ability to produce energy. the purpose of this study is to observe the effects of an nrti-based, protease inhibitor (pi)-sparing drug regimen on fat loss in hiv infected, treatment-naive adults. study hypothesis: the initiation of nrti-containing, pi-sparing therapy will inhibit mitochondrial dna (mtdna) synthesis and lead to a decrease in mtdna content in adipose tissue, skeletal muscle and peripheral blood mononuclear cells (pbmcs), will cause deterioration in mitochondrial function, will increase fat apoptosis and oxidative damage biomarkers, and will lead to progressive decrease in body fat content.

nrtis are a mainstay of hiv treatment regimens, often part of initial treatment regimens for newly diagnosed patients. recent data suggest that nrtis are responsible for lipoatrophy, a condition marked by progressive fat loss. another negative side effect to antiretroviral (arv) regimens is mitochondrial toxicity, which can damage the heart, nerves, muscles, kidneys, pancreas and liver, as well as affecting the body's ability to produce energy for important life processes. it has been hypothesized that lipoatrophy may be related to mitochondrial toxicity, but a causal relationship between the two has yet to be established. this study will examine hiv infected treatment-naive patients who are initiating their first arv regimens. the regimens will contain 2 nrti, one of which being zidovudine and a non-nucleoside reverse transcriptase inhibitor (nnrti). the regimens will not contain any pis. patients will participate in this study for 96 weeks. there will be 4 study visits at weeks 12, 24, 48, and 96. dual-energy x-ray absorptiometry (dexa) scans and fat biopsies will occur at all visits. additionally, blood collection for metabolic testing will occur at week 12. arvs will not be provided by this study.

Eligibility criteria:
inclusion criteria: * hiv-1 infected * treatment-naive * plan to initiate first arv regimen with 2 nrtis and an nnrti * plan to include zidovudine as part of first arv regimen exclusion criteria: * current use of steroids or growth hormone * coagulopathies or other bleeding disorders * pregnancy or breastfeeding

Keywords: lipoatrophy mitochondria treatment naive
depression and driving

Conditions: Depression; Drive

Summary: this project will assess how depression, preclinical ad, and antidepressants affect driving behavior in cognitively normal older adults (65 years).

the long-term goal is to accurately identify who is at risk of decline in driving, to forecast when decline will occur, and to intervene before decline, thereby reducing the numbers of crashes, injuries, and death in older adults. the findings indicate that the long preclinical stage of alzheimer disease (ad), as reflected in amyloid imaging and cerebrospinal fluid (csf) biomarkers among cognitively normal participants, is associated with poorer driving performance on a standardized road test. this project will assess how depression, preclinical ad, and antidepressants affect driving behavior in cognitively normal older adults (65 years).

Eligibility criteria:
inclusion criteria: * drive on average at least once per week * has a valid driver's license * willing to complete blood draw * willing to complete either lumbar puncture or pet imaging * 65 years or older * speaks english exclusion criteria: * not willing to complete blood draw and/or one other biomarker * less than 65 years of age * does not drive a vehicle/ is no longer actively driving
perioperative blood pressure and in-hospital morbidity after coronary artery bypass surgery

Conditions: Ischemic Cardiopathy

Summary: the prevalence of hypertension is high, estimated at 80% in patients with cardiovascular (cv) disease. the optimal blood pressure (bp) level for cv prevention remains controversial. data from the literature highlight that the relationship between bp level and mortality is not linear, but rather j-shaped. in particular, in treated hypertensive patients with stable coronary artery disease, a systolic bp below 120 mm hg is associated with the risk of recurrent coronary events and cv mortality. an inverse relationship was recently demonstrated between bp level before revascularization procedure and mortality at 3 months and 1 year after the procedure in patients managed for critical ischemia. these data underline the need for a personalized approach to the management of hypertension, especially in elderly hypertensive patients with comorbidities. the question of the optimal mean bp value also arises in cardiac surgery, especially during extracorporeal circulation in patients undergoing coronary artery bypass grafting. hypotension during cardiac surgery appears to be associated with renal failure and perioperative mortality in some patients. conversely, high blood pressure levels (above the cerebral autoregulatory threshold) may be associated with postoperative cognitive impairment and bleeding risk. in hypertensive patients, the autoregulatory capacity of cerebral and renal perfusion is partly impaired, with a greater susceptibility to ischemia in case of hypotension. personalized blood pressure targets could be beneficial perioperatively with a lower risk of postoperative complications. the objective of this protocol is to determine a correlation between perioperative mean arterial pressure level and in-hospital morbidity in a population of patients with ischemic heart disease managed for coronary artery bypass grafting (cabg). the results of this descriptive work would make it possible to introduce the problem of the optimal blood pressure target during extracorporeal circulation according to the existence of peripheral arterial damage and preoperative blood pressure values.


Eligibility criteria:
inclusion criteria: * patient whose age ≥ 18 years * patient with ischemic heart disease managed for coronary artery bypass grafting (cabg) between 01/01/2016 and 12/31/2020 * french-speaking patient exclusion criteria: * patient under guardianship or curatorship * patient deprived of liberty * patient under court protection * patient objecting to the use of his data for this research
topical centella asiatica and the cosmetic appearance of stretch marks

Conditions: Stretch Marks; Striae Distensae; Cosmetic Appearance of Stretch Marks

Summary: the purpose of this study is to clinically evaluate the efficacy, safety as well as patient satisfaction in the use of topical centella asiatica (ca) on the cosmetic appearance of stretch marks.

subjects with abdominal stretch marks will be enrolled in to this study. the presence of abdominal stretch marks will be confirmed by a board certified dermatologist. the right and the left side of the abdomen will be randomized by binary randomization to treatment with ca cream or the vehicle cream. therefore each patient will serve as their own control. each half of the abdomen will be subjected to topical treatment with ca 1% cream formulated in pcca lipoderm® base or pcca lipoderm® base as the placebo vehicle treatment based on prior randomization. the creams will be given to the patient in blinded fashion: cream a (containing ca) and cream b (vehicle/placebo) with instructions apply both formulations daily at night. patients will be asked to return to clinic at 6 weeks and 12 weeks for follow up assessment for a total of 3 sessions (baseline, 6 weeks, 12 weeks). high-resolution digital photographs of the stretch marks will be taken at baseline and at each follow-up visit to document clinical response. two physician graders blinded to the photographs and the treatments will assess cosmetic outcome on a six-point analog scale the width of the treated stretch marks in each subject will also be measured at the baseline and 8 weeks after the final treatment. the difference of the width will be converted into the percentage of reduction from the baseline. subjects will also be asked to complete two surveys at each visit. the two surveys include patient satisfaction with cosmetic and clinical outcome based on a five-point scale.

Eligibility criteria:
inclusion criteria: 1. english-speaking subjects over the age of 18 2. subjects clinically diagnosed with stretch marks exclusion criteria: 1. history of keloid scarring 2. isotretinoin use within the last 6 months 3. oral prednisone use within the last 3 months 4. non-ablative laser procedures to the abdomen within 1 year of study initiation 5. ablative resurfacing procedures to the abdomen within 3 years of the study initiation 6. pregnancy 7. use of immunosuppressive drugs 8. known hypersensitivity to centella asiatica

Keywords: gotu kola centella asiatica
the age of orthoinfo: a randomized controlled trial evaluating patient comprehension of informed consent

Conditions: Knee Osteoarthritis

Summary: this study is a non-funded, single center, multi-arm, parallel group randomize control trial. in this study, the investigators aim to evaluate the impact of a visual aid on patient comprehension an orthopedic informed consent discussion in low socioeconomic populations. the primary outcome is patient comprehension measured by a validated knowledge-based multiple choice questionnaire. the secondary outcomes include: patient satisfaction and time efficiency. the investigators hypothesize that using an anatomic model visual aid during an orthopedic informed consent discussion will improve patient comprehension, satisfaction and time-efficiency of orthopedic care.


Eligibility criteria:
inclusion criteria: * patients newly diagnosed with knee osteoarthritis managed with steroid injections * patients who express lack of knowledge regarding knee osteoarthritis (causes, diagnosis, treatment, anatomy) * english speaking * patients that meet the federal poverty guideline for healthcare (i.e. medicaid) exclusion criteria: * patients under the age of 18 * college graduates * non-english speaking * patient without the capacity to give consent * patients with a tactile, mental, visual or auditory disability