Kornimate/medical-research-clean huggingface dataset:
haart adherence among hiv-infected persons and the factors affecting treatment adherence

Conditions: Acute HIV Infection; Acquired Immunodeficiency Syndrome; Medication Adherence

Summary: the general objective of this study is to evaluate haart adherence in estonia and the factors affecting adherence; and the impact of an individual adherence enhancement counselling and treatment monitoring model (advanced adherence, advadh), compared to the regular counselling received by haart patients.

specific hiv treatment - haart (highly active antiretroviral therapy) can suppress hiv replication and consequently preserve the functioning of immune system. haart therapy is a lifelong treatment with several different concomitantly administered oral medications. according to studies, low adherence to treatment is directly related to patient's knowledge and beliefs about haart. studies have shown the success of different interventions increasing adherence to haart, but additional studies need to be carried out in order to determine the most effective components of the interventions and the methods most suitable considering the local context, that could be used in everyday work and with limited resources. the first places to implement the activities directed at improving treatment adherence are medical institutions, i.e. the departments of infectious diseases where hiv-positive individuals receive haart treatment. the aims of the study are: * to determine the rate of adherence to haart and its associated factors; * to conduct a small-scale intervention (randomised controlled) study implementing a brief adherence counseling targeting persons receiving haart.

Eligibility criteria:
inclusion criteria: * hiv infected; * ≥18 years of age; * speak and read either estonian or russian; * receiving or starting a haart regimen exclusion criteria: - triple class antiretroviral drug resistance, as determined from a prior resistance test performed in clinical practice, defined according to international antiviral society - usa (ias-usa) interpretive guidelines for genotypic resistance mutations

Keywords: antiretroviral therapy, highly active treatment adherence
prenatal screening, diagnosis and intrauterine intervention of fetal abnormal chromosome and structure in twins pregnancy

Conditions: Chromosome Abnormality; Twin Pregnancy With Antenatal Problem

Summary: the risk of abnormal chromosome and structure is much higher in twins than in singletons, and traditional early pregnancy screening strategy for single pregnancy is not suitable for twins. based on our management experience of fetal medicine at twin pregnancy, and multi-center cooperation, the study will carry out the following clinical studies: 1. to explore a suitable, early, noninvasive and accurate prenatal screening strategy for twin pregnancy. 2. fetal chromosomal abnormalities


Eligibility criteria:
inclusion criteria: * ultrasound diagnosis as twin pregnancy * at 11-14 gestational weeks exclusion criteria: * multiple pregnancies (three or more) * maternal history of chromosome aneuploidy abnormality or tumor
thumb vs great toe recovery

Conditions: Residual Neuromuscular Blockade

Summary: researches are comparing the accuracy of measuring muscle relaxation in the thumb versus the great toe.


Eligibility criteria:
inclusion criteria: * age \> or = 18 years old * patients willing to participate and provide an informed consent * patients undergoing an elective surgical procedure that requires use of non-depolarizing nmba agents administered intraoperatively. * patients with planned administration of sugammadex as a neuromuscular blocking reversal agent. exclusion criteria: * patients with disorders, such as stroke, carpal tunnel syndrome, broken wrist with nerve damage, dupuytren contracture, or any similar wrist injury. * patients with systemic neuromuscular diseases such as myasthenia gravis * patients with significant organ dysfunction that can significantly affect pharmacokinetics of neuromuscular blocking and reversal agents, i.e., severe renal impairment or end-stage liver disease. * patients having surgery that would involve prepping the arm or leg into the sterile field

Keywords: neuromuscular blockade tetragraph amg emg
an open label study of l059 (levetiracetam) in japanese epilepsy subjects with generalized tonic-clonic seizures

Conditions: Epilepsy; Generalized Tonic-clonic Seizures

Summary: the investigators will provide levetiracetam treatment to epilepsy subjects in japan who are judged to benefit from continued treatment with levetiracetam by the investigators and who are willing to continuously receive this drug.


Eligibility criteria:
inclusion criteria: * the subject in japan has completed either of the studies n01159 or n01363 or has discontinued the n01159 study due to lack of efficacy. * the subject who is judged to benefit from continued treatment with levetiracetam by the investigators exclusion criteria: * subjects with multiple protocol deviations during n01159 or n01363, such as missing laboratory data, and low or noncompliance with the study medication, and who the investigator considers not to have the potential to have deviations stopped are ineligible

Keywords: levetiracetam epilepsy generalized tonic-clonic seizures
safety and efficacy of folatescan (technetium tc 99m ec20) in women with suspected ovarian or endometrial cancer

Conditions: Ovarian Cancer; Endometrial Cancer

Summary: a multi-center clinical study to evaluate the safety and efficacy of folatescan (technetium tc 99m ec20) in women with suspected ovarian or endometrial cancer. phase i - the proposed indication for folatescan is disease or pathological assessment of ovarian or endometrial masses.

the study is designed to verify product safety, determine optimal imaging time, gather efficacy data for the radioactive drug product (technetium tc 99m ec20), and assay masses for presence of folate receptors, in women with suspected ovarian or endometrial cancer. twelve subjects will be enrolled, with a minimum of five malignant cases, as determined by histopathological evaluation. women with a suspected ovarian or endometrial mass who either 1) have fixed, paraffin embedded tissue sample(s) available for immunohistochemical staining obtained from a previous pathological evaluation or 2) are scheduled for a procedure to obtain tissue for pathological evaluation that can be fixed and paraffin embedded for immunohistochemical staining are eligible for this study. the ovarian mass may be either an initial finding, e.g., found at a routine pelvic examination or to investigate symptoms, or the ovarian or endometrial mass may be a finding suspicious of recurrent or residual tumor at follow-up examination after surgical resection of confirmed ovarian or endometrial cancer. patients may not be pregnant or breastfeeding at enrollment.

Eligibility criteria:
inclusion criteria: * subjects must meet the following eligibility requirements to be enrolled in the study. 1. subjects must be female, 18 years of age or older. 2. subjects must have suspected ovarian cancer or metastatic or recurrent ovarian or endometrial cancer with a known pelvic mass as diagnosed by ultrasound, mri, or ct. 3. subjects either are scheduled to undergo a procedure to obtain tissue for pathological evaluation that can be fixed and paraffin embedded for immunohistochemical staining or have sufficient amounts of fixed, paraffin embedded tissue sample(s) available for immunohistochemical staining obtained from a previous pathological evaluation. 4. subjects must provide written informed consent prior to enrollment. 5. subjects must have kidney function with a creatinine value \<2.0 mg/dl (within the previous 30 days). exclusion criteria: * subjects must be excluded if any of the following conditions are present: 1. subject is pregnant or breast-feeding. 2. subject is simultaneously participating in another investigative drug study. 3. subject has completed the follow-up phase of any previous study less than 30 days prior to enrollment in this study. 4. subject is unable to tolerate conditions for radionuclide imaging. 5. subject has been administered another radiopharmaceutical that would interfere with the assessment of technetium tc 99m ec20.

Keywords: ovarian cancer endometrial cancer
far infrared radiation treatment for diabetes

Conditions: Diabetes Mellitus

Summary: a study to determine the use of far infrared (fir) radiation for treatment of diabetes.

diabetes mellitus is a disease in which glucose is not sufficiently metabolized. this results in high glucose levels in blood and glucose in the urine. cells can starve because glucose is not being metabolized. both types of diabetes can cause dangerous complications, including blindness, heart and blood vessel disease, and kidney failure. a decrease in circulation may eventually require the amputation of limbs. we are postulating that energy specific electromagnetic radiation of the central nervous system, the viscera and the endocrine system has the potential to enhance the immune system; thereby improving the health of the patients.

Eligibility criteria:
inclusion criteria: * persons with type 1 or type 2 diabetes exclusion criteria: * none

Keywords: thye 1 diabetes type 2 diabetes
natural killer cells in immunologic thrombocytopenic purpura of adults

Conditions: Immunologic Thrombcytopenic Purpura (ITP) Adults

Summary: immunologic thrombcytopenic purpura (itp) affects both children and adults. the incidence is estimated in adults about 1,6/100 000/per year. chronic and relapsing forms of the disease that represent 70% of adult cases are associated with impairment of quality of life related to treatments side effects and bleeding. itp is secondary to the destruction of circulating platelets through an auto-immune process and to a decrease of platelet production in bone marrow. auto antibodies are usually directed against epitopes of the gpiib/iiia, expressed by platelets. the destruction of the platelets seems to occur mainly in the spleen through antibody dependent cytotoxicity. both macrophages and cytotoxic t lymphocytes subsets participate to the platelet destruction through the cd16, the low affinity receptor for the fc of igg. thus the cd16 "pathway" is a target for treatments in itp as for example intravenous immunoglobulins and more recently inhibitors of the syk kinase.

natural killer cells (nk) cells, who are now implicated in the pathophysiology of several autoimmune diseases, express cd16 and display antibody dependent cytotoxicty. moreover nk cells are present in human spleen. however their role in itp has not been studied so far. nk could represent a new target for treatments in itp. we propose thus to conduct a study to characterizes nk cells changes in patients with itp.

Eligibility criteria:
inclusion criteria: * itp patients,platelets less than 50000 g/l exclusion criteria: * secondary itp (vih, vhc...) * treatment with immunosuppressive agents except corticoids (10 mg/day) * treatment with ig iv less than 3 weeks * treatment with rifuximab less than 6 months
acupoint selection based on meridian theory in primary insomnia of liver depression and spleen deficiency type

Conditions: Primary Insomnia

Summary: the classical literature combined with modern medicine to select acupoints, in order to intervene in the autonomic nerve function of the superior cervical sympathetic ganglion as an opportunity, put forward the meridian acupoints mainly to reconcile the head orifices ying wei, acupuncture treatment of primary insomnia clinical research. heart rate variability ( hrv ), pittsburgh sleep quality index ( psqi ), polysomnography ( psg ) and the mos item short from health survey ( sf-36 ) were observed. insomnia severity index ( isi ), dysfunctional beliefs and attitudes about sleep scale 16 ( dbas-16 ), gaba, glx and other secondary indicators were used to clarify the clinical short-term and long-term efficacy of different acupoints in the treatment of patients with primary insomnia and the intervention effect on hrv.

in this randomized controlled trial, 96 patients with insomnia of liver depression and spleen deficiency type were selected from the third affiliated hospital of zhejiang university of traditional chinese medicine. all patients will be randomly assigned to the control group or the acupuncture group. main outcome measures : pittsburgh sleep quality index ( psqi ) was used to measure sleep quality, and 36-item short form health survey ( sf-36 ) was used to measure quality of life. secondary outcomes included the insomnia severity index ( isi ), sleep dysfunction beliefs and attitudes scale 16, dbas-16, gaba and glx.

Eligibility criteria:
inclusion criteria: * in line with the diagnostic criteria of insomnia of liver depression and spleen deficiency type in traditional chinese medicine : * in line with the western diagnostic criteria for insomnia ; * 18 ≤ age ≤ 40 years old, male or female ; * patients with a course of more than two weeks ; note: the above criteria must be met for inclusion in this study. exclusion criteria: * insomnia caused by a variety of organic diseases, neurological or psychiatric disorders * pregnancy, lactation or drug allergy * there are more serious primary diseases such as cardiovascular and cerebrovascular diseases, gastrointestinal diseases, endocrine system diseases, or psychiatric patients. * patients with coagulation dysfunction and bleeding tendency.

Keywords: liver stagnation and spleen deficiency type insomnia acupuncture randomized controlled trial
priorities aligned deprescribing for persons living with dementia and their caregiver

Conditions: Dementia

Summary: the purpose of this study is to compare patient priorities care (ppc) and usual care (uc) patients to identify differences in post-encounter medication changes, treatment burden (tbq), and shared decision making in older patient assessment of chronic illness care (opacic), to understand ppc participant's sense-making and communication approaches related to deprescribing decisions in relation to the identified health priorities and to identify and categorize adverse drug withdrawal events (adwes)


Eligibility criteria:
inclusion criteria: * dementia listed as an active problem in the medical record, including alzheimer's disease, vascular dementia, frontotemporal dementia, parkinson's dementia, lewy body disease. * the functional assessment staging tool (fast) score of 5 or lower (this will be established by the patient's clinician). * 2 or more additional chronic conditions * takes 5 or more regular medications and * a caregiver present during visits. caregivers may include family members or unrelated caregivers and will be identified through chart review and confirmed by clinician, patient, and surrogate decision maker if necessary. identified caregivers must be involved in decisions and care of people living with dementia (plwd) and routinely attend clinic visits with patient exclusion criteria: * fast score of 6 or more (this will be established by the patient's clinician). * significant hearing, vision, or advanced cognitive impairment that limits ability to participate in ppc encounters, * caregiver is unwilling or able to participate in visits, or * deemed ineligible by their primary care physician (pcp)
effects of neuromuscular blocking agents (nmba) on the alteration of transpulmonary pressures at the early phase of acute respiratory distress syndrome (ards)

Conditions: Acute Respiratory Distress Syndrome

Summary: mortality in acute respiratory distress syndrome is high (40 to 60 %). protective mechanical ventilation, until 2010, was the cornerstone of the ards therapeutic strategies. recently, a prospective multicenter study demonstrates that a 48h continuous infusion of neuromuscular blocking agents (nmba) have a positive impact on mortality of ards patients. (papazian et al. acurasys study. nejm 2010; 363:1107-16). the mechanisms through which nmbas could improve survival remain speculative. they are as follows: * reduction of the consumption of oxygen linked to ventilatory workload; * increase of chest wall compliance improving mechanical ventilation during ards and better adaptation to the protective ventilation strategy; * anti-inﬂammatory effect contributing to a reduction in pulmonary inﬂammation and improvement in oxygenation, * reduction of the variations of transpulmonary pressure (tpp) by the way of better synchronisation between patient and the ventilator. the use of nmba could also reduce the ventilator induced lung injury by a better control of tpp.


Eligibility criteria:
inclusion criteria: * early (\ = 5 cmh20 exclusion criteria: age \< 18 ans patient already under continuous infusion nmba. known nmba allergy or intolerance contra-indication to introduction of nasogastric tube
non-inferiority of peer comparison interventions

Conditions: Respiratory Tract Infections

Summary: the objective of this study is to test the hypothesis that the peer comparison intervention in the use of behavioral economics to improve treatment of acute respiratory infections (beari) trial (meeker et al. 2016) promoting antibiotic stewardship did not adversely impact physician job satisfaction as measured in the study exit survey at trial completion. detrimental impacts on job satisfaction is a phenomenon that was observed in a randomized controlled trial using a peer comparison intervention with different characteristics from the beari trial. (reiff et al. 2022) the beari trial sample size, intraclass correlation, and measurement of job satisfaction are comparable to reiff et al. 2022.

this secondary analysis includes all providers from the use of behavioral economics to improve treatment of acute respiratory infections (beari) trial who completed the exit survey following 18 month trial completion. the objective of this study is to test the hypothesis that the peer comparison intervention in the beari trial (meeker et al. 2016) promoting antibiotic stewardship did not adversely impact physician job satisfaction. detrimental impacts on job satisfaction is a phenomenon that was observed in a randomized controlled trial using a peer comparison intervention with different characteristics from the beari trial. (reiff et al. 2022) the beari trial sample size, intraclass correlation, and measurement of job satisfaction are comparable to reiff et al. 2022. the differences in peer comparison interventions between beari and reiff et al. include the following: 1. differences in physicians' control and agency over patient adherence to screening recommendations vs. their own antibiotic prescribing 2. relatedly, in the antibiotic stewardship study, there were achievable benchmarks for improvement, including a feedback and ranking framework allowing all physicians to attain the highest status and thus obtain positive feedback. 3. differences in framing and presentation of messages the investigators define a clinically significant detrimental effect on job satisfaction as 27% of individuals reducing job satisfaction ratings by one point on a 5-point likert scale. this shift is equivalent to a mean difference of 0.32 and a cohen's d of 0.36. this difference corresponds to approximately a ⅓ reduction in job satisfaction on a 5-point likert scale. h0: the beari peer comparison intervention had a clinically and statistically significant detrimental effect on physician job satisfaction. control-peercomparison\>=0.32 ha: the peer comparison intervention had no clinically significant negative impact on physician job satisfaction. control-peercomparison\<0.32 the investigators will conduct a traditional hypothesis test control-peercomparison= 0.0 as a secondary analysis.

Eligibility criteria:
inclusion criteria: * all providers included in the beari trial exclusion criteria: * n/a

Keywords: antibiotics inappropriate prescribing behavioral research
application of trans cranial direct current stimulation for executive dysfunction after traumatic brain injury

Conditions: Traumatic Brain Injury

Summary: traumatic brain injury (tbi) particularly affects the frontal lobes and patients often suffer from executive dysfunction and behavioral disturbances. these types of injuries often involve axonal damage to pre frontal brain areas, which mediate various cognitive and behavioral functions. dorsolateral prefrontal circuit lesions cause executive dysfunction, orbitofrontal circuit lesions lead to personality changes characterized by disinhibition and anterior cingulate circuit lesions present with apathy. patients who suffered traumatic frontal lobe damage often demonstrate a lasting, profound disturbance of emotional regulation and social cognition. weak transcranial direct current stimulation (tdcs) induces persisting excitability changes in the human motor cortex. this effect depends on the stimulation polarity and is specific to the site of stimulation. interacting with cortical activity, by means of cortical stimulation, can positively affect the short-term cognitive performance and improve the rehabilitation potential of neurologic patients. in this respect, preliminary evidence suggests that cortical stimulation may play a role in treating aphasia, unilateral neglect, and other cognitive disorders. several possible mechanisms can account for the effects of tdcs and other methods on cognitive performance. they all reflect the potential of these methods to improve the subject's ability to relearn or to acquire new strategies for carrying out behavioral tasks. it was also found that activation of prefrontal cortex by tdcs reduces appetite for risk during ambiguous decision making. in this tdcs study the investigator uses one anode and one cathode electrode placed over the scalp to modulate a particular area of the central nervous system (cns). the stimulation is administered via the neuroconn dc.stimulator serial number 0096. the dc-stimulator is a micro-processor-controlled constant current source. the dc-stimulator is a ce-certified medical device for conducting non-invasive transcranial direct current stimulation (tdcs) on people.electrode positioning is determined according to the international eeg 10-20 system.


Eligibility criteria:
inclusion criteria * ages 18-70 years. * traumatic brain injured patients who were diagnosed with executive function difficulties. * patients who are able to cooperate and comprehend simple instructions. * patients who can provide informed consent after both oral and written information was given and discussed. exclusion criteria: * pregnancy. * patients who sufferred a penetrating head trauma. * patients who underwent a frontal craniotomy * patients with a history of psychiatric problems * in cases of severe porencephaly at stimulation site * active epilepsy or a history of seizure.

Keywords: traumatic brain injury executive function difficulties transcranial direct current stimulation