Kornimate/medical-research-clean huggingface dataset:
ppa tele-savvy: a pilot study of an online intervention for caregivers of persons living with ppa

Conditions: Primary Progressive Aphasia; Caregiver Burnout

Summary: the primary goal of this pilot project is to adapt an evidence-informed on-line psychoeducation program (tele-savvy) to address the unique challenges facing informal caregivers of those living with ppa and geared toward achieving caregiver mastery in this population.

the primary goal of this pilot project is to develop an evidence-informed on-line psychoeducation program (tele-savvy) based on the well-established savvy caregiver program to address the unique challenges facing informal caregivers of those living with primary progressive aphasia (ppa) and to help these caregivers achieve mastery. key elements of the adaptation process are to identify and adapt mechanistic elements of the tele-savvy intervention (increasing self-efficacy, mastery of new skills, increased knowledge of disease-specific symptoms and trajectories, problem-solving skills). we will engage ppa caregivers in the process of adapting the existing tele-savvy program to fit their needs and then pilot test the adapted ppa tele-savvy program.

Eligibility criteria:
inclusion criteria: aim 1: informal (family or friends) caregivers of persons living with or deceased from ppa. age 18 or over providing or have provided at least 2 hours per day of unpaid assistance, on average, for a person in the early-middle stage of ppa. must have access to a computer with adequate internet connection. able to use a videoconferencing platform and receive email. participants must be able to read, speak and understand english and have no uncorrectable vision or hearing deficits that might impede participation. aim 2: informal (family or friends) caregivers of persons living with ppa. age 18 or over providing at least 2 hours per day of unpaid assistance, on average, for a person in the early-middle stage of ppa. must have access to a computer with adequate internet connection. able to use a videoconferencing platform and receive email. must be able to read, speak and understand english and have no uncorrectable vision or hearing deficits that might impede participation. exclusion criteria: -
the analgesic efficacy of ultrasound guided transversus abdominal plane block after abdominal cancer surgeries

Conditions: Abdominal Cancer

Summary: effective postoperative pain control results in decreased cardiac and pulmonary complications, patient satisfaction and early mobilization. a prospective, randomized comparative study was done of analgesic efficacy, opioid requirement and side effects in patients undergoing lower abdominal cancer surgeries. in study group ultrasound guided transversus abdominis plane (tap) block was given and control group no tap block was given. patient controlled analgesia (pca) with intravenous morphine was given to both group patients, and total good pca demands in both the groups was studied.

adult patients of both sexes undergoing major lower abdominal cancer surgeries were enrolled in the study. after obtaining written informed consent from all the patients, they were randomly allotted to either study (tap) group or control group. standard general anesthesia with endotracheal intubation was performed in all the patients. preoperatively all patients received information about visual analogue scale (vas) for pain score from 1 to 10 depending on intensity of pain and about the use of patient controlled analgesia (pca) pump. after the end of surgery and before extubation bilateral ultrasound guided transversus abdominis plane (tap) block was performed with 16 g tuohy needle and 18 g braun perifix epidural catheter was placed about 6-8 cms in situ. bupivacaine 0.25 % 20 ml was given bilaterally and repeated 8 hourly in the postoperative anaesthesia care unit (pacu) for first 24 hours. the pca pump was set to deliver bolus intravenous morphine 1 milligram ( mg ) with lock out interval 10 minutes. in the pacu heart rate, non invasive blood pressure, visual analogue score at rest and on knee flexion, sedation score, nausea and vomiting, any side effects as itching was noted by care provider at 0, 2, 4, 6, 12, 18 and 24 hours. total and good pca demands upto 24 hours was recorded.

Eligibility criteria:
inclusion criteria: * adult patients belonging to american society of anesthesiologist (asa) physical status i to iii, for open lower abdominal major onco surgeries more than 2 hours duration. exclusion criteria: * patient refusal to participate in the study, allergy to local anesthetics, coagulopathy, local skin infection at the site of tap block.

Keywords: transverse abdominis plane (tap) block patient control analgesia (pca)
postoperative radiation of patients with breast cancer in extreme hypofractionation.

Conditions: Breast Cancer

Summary: evaluation of treatment toxicity of extreme hypofractionation of the whole breast in five fractions of 5.2 gy in five consecutive workdays.

the focus of this phase 2-trial is set on feasibility as well as early and late toxicity rates. one possible disadvantage of extreme hypofractionation could be an increased rate of fibrosis within the irradiated region. therefore, a closer look will be taken with this prospective trial. in addition, we are planning an accompanying translational research program since hypofractionated schedules are suggested to be more immunogenic in breast cancer. secondary objectives therefore are: cosmetic outcome, local tumor control, quality of life, dynamic immune status, importance of tumor infiltrating immune cells, overall survival, disease-free survival, feasibility of breath-hold radiation technique.

Eligibility criteria:
inclusion criteria: * histologically confirmed invasive breast cancer or ductal carcinoma in situ (dcis) * pt-category pt0-3 * complete resection (r0) * absence of distant metastasis (m0) * absence of contralateral breast cancer/ dcis * karnofsky performance score ≥ 60% * age ≥ 18 years at time of study entry * written informed consent exclusion criteria: * all patients not fulfilling inclusion criteria * morbus paget or pathological skin infiltration * earlier or synchronous breast cancer * pregnant or breast-feeding women * increased radiosensitivity or any genetic disposition for increased radiosensitivity, e.g. ataxia telangiectatica * judgement by the investigator that the patient is unlikely to comply with study procedures and requirements
n-acetylcysteine plus naltrexone for the treatment of alcohol dependence

Conditions: Alcoholism

Summary: the purpose of this study is to determine whether: (1) the combination of n-acetylcysteine + high-dose naltrexone (150 mg) works better than high-dose naltrexone (150 mg) alone in reducing alcohol drinking; and (2) high-dose naltrexone (150 mg) alone works better than low-dose naltrexone (50 mg) alone in reducing alcohol drinking.

the 3 groups (n-acetylcysteine plus naltrexone 150 mg, naltrexone 150 mg, and naltrexone 50 mg) will be compared in a 12-week randomized, double-blind clinical trial.

Eligibility criteria:
inclusion criteria: * age 18-65 years * alcohol dependence by dsm-iv criteria * heavy drinking at least 6 times within the past month ('heavy drinking' defined as 5 or more standard drinks per day for men and 4 or more standard drinks for women) * able to provide informed consent * a score of 6 or more on the penn alcohol craving scale (pacs) * subject agrees not to take over-the-counter analgesics during the study exclusion criteria: * current drug abuse or dependence by dsm-iv criteria (except nicotine and marijuana) * current psychotic disorders or bipolar disorders * current suicidal or homicidal ideation * positive illicit drug screen test (except marijuana) * ongoing narcotic use or risks for narcotic use during the study * increased risk for severe alcohol withdrawal by a score of 10 or more on the clinical institute withdrawal assessment for alcohol, revised (ciwa-ar) * clinically significant cardiac, hepatic, renal, neurologic, or pulmonary disease * baseline aspartate aminotransferase (ast) or alanine aminotransferase (alt) greater than 3 times normal * current use of disulfiram, acamprosate or topiramate * pregnant or nursing, or inadequate birth control methods in women of childbearing potential * alcohol breathalyzer level 0.08 or more at the screening visit * severe alcohol withdrawal (delirium tremens or withdrawal seizures) within the past year * currently requiring inpatient treatment for treating alcohol dependence

Keywords: n-acetylcysteine naltrexone
effects of tupler's technique on postpartum diastasis recti and strength recovery of abdominal muscles

Conditions: Diastasis Recti

Summary: diastasis rectus is the separation of the muscles along the midline of the abdomen, typically as seen in women after pregnancy. separation is mostly larger than 2cm width at above, below or level of umbilicus. with this muscular pathology women do not feel any pain symptom just perceiving symptoms of physical discomfort, abdomen muscle weakness and its bulging. excess weight of mother or baby and multiple birth pregnancy is the common risk factor for the dra. various tools will be used for the diagnosis of dra such as vernier caliper by using centimeter ruler, diagnostic ultrasonography that give the exact measurement, pressure biofeedback unit which is used to assess the strength of weak muscles, and patient specific functional scale that used to determine the functional limitation and its improvement. to treat the dra conservatively, tupler's technique and conventional physical therapy will be directed. electrical muscular stimulations will also be given as a baseline before applying both treatments. in tupler's technique, diastasis rehab splint and tupler's exercises will be used whereas in conservative physical therapy, scarf tie around abdomen while performing exercises, respiratory rehabilitation manoeuvre and abdominal muscle exercises will be used. the aim of the study is to find the the effects of tupler's technique and conventional physical therapy treatment for abdominal muscle strength regaining and in reducing the diastasis recti among females with diastasis recti after their postpartum period. it is a randomized clinical trial and convenient random sampling is to be used with an inclusion criterion of patients having age between 20-40 years, both primiparous and multiparous women and diastasis recti more than 2.5cm within 6 weeks or more postpartum. patients will be randomly allocated into two groups, group a will receive tupler's technique and group b will receive conventional physical therapy intervention. total duration of study will be six months. assessment will be done before and after the treatment. pressure biofeedback unit, vernier caliper, ultrasound and patient specific functional scale are to be used to measure the outcomes. data will be assessed by using parametric/non parametric test after completion of study.


Eligibility criteria:
inclusion criteria: * aged between 20-40 years * both primiparous and multiparous women * diastasis recti more than 2.5cm within 6 weeks or more postpartum exclusion criteria: * neurological signs, specific spinal pathology (e.g. disc lesions, malignancy, or inflammatory disease) or any other major medical pathology. * any complication during pregnancy
wild 5 wellness: a 30-day intervention for residents

Conditions: Resident Wellness; Burnout, Professional; Medical Residents; Mental Health Wellness 1; Mental Health Disorder; Resident Physician

Summary: the purpose of this study is to explore the efficacy and feasibility of an integrated, prescriptive, and trackable wellness intervention amongst resident physicians combining five wellness elements including exercise, mindfulness, sleep, social connectedness, and nutrition.

data from the initial pilot of wild 5 wellness data reported at the annual us psychiatric congress meeting demonstrated positive results with their 30-day intervention: this study uses compelling proof that even a non-medication, self-directed, low cost 30-day intervention, focusing on mental wellness offers clinically significant help with mood, anxiety, mindfulness, sleep, social connectivity, and emotional eating (jain et al., 2015) the purpose of this study is to explore the efficacy and feasibility of an integrated, prescriptive, and trackable wellness intervention amongst residents at orange park medical center (opmc) by combining five wellness elements including: exercise, mindfulness, sleep, social connectedness, and nutrition. data will be collected to evaluate participants' adherence and response to a 5-pronged 30-day wellness intervention. it is expected that this 30-day integrated, prescriptive, and trackable program will be found to be an efficacious wellness intervention among residents at opmc. to the best of our knowledge, even though there is abundant research supporting each of the wild 5 wellness elements (exercise, mindfulness, sleep, social connectedness, and nutrition) individually, there is no research exploring the effectiveness of an integrated, prescriptive, and trackable wellness intervention combining these five elements. therefore, this work will be unique in that it will collect both objective and subjective data to assess the feasibility and effectiveness of this type of wellness intervention. it will lend support to the growing body of research on the efficacy of wellness interventions for a variety of different health conditions, as well as a residency-based population. finally, it is hoped that positive results will yield increased access to and utilization of this type of intervention, thereby improving resident wellness.

Eligibility criteria:
inclusion criteria: * participants must be enrolled residents at orange park medical center (opmc). exclusion criteria: * refusal to participate.
the long-term and short-term efficacy and safety of transplantation autologous bone marrow cells (bmcs) in patients with the first stemi (st segment elevation myocardial infarction)

Conditions: Vascular Diseases; Cardiovascular Diseases; Acute Myocardial Infarction

Summary: the purpose of this study is to test the hypothesis that the intracoronary transplantation of autologous mononuclear and cd 133 + bone marrow cells will improve left ventricular contractile function and will reduce the combined end points after the primary stemi (mortality, recurrent myocardial infarction, angina, heart failure, stroke).

the study was randomized, opened, controlled. 85 patients with the first stemi were enrolled. patients were divided to three groups. on admission all patients were received thrombolytic therapy by 1,5 million u streptokinase. transplantation of autologous mononuclear bone marrow cells (bmmcs) and аutologous cd133 + cells by balloon catheter placed into infarct-related artery (ira) was performed at once after stent implantation in 28 patients patients (1st group) and in 10 patients (2nd group) on the 7-21 days of stemi. another 47 patients (3nd group) undergo only stent implantation into ira the same day of stemi. autologous bmmcs were obtained from bone marrow aspirate by gradient centrifugation. echocardiography, holter monitoring were performed. plasma concentration of the pro-inflammatory and anti-inflammatory cytokines (il1, 6,8,10), of the growth factors (stem cell factor - scf, vascular endothelial growth factor - vegf, hepatocyte growth factor - hgf, fibroblast growth factor - fgf, insulin-like growth factor - igf), the number of circulating cd34 +38-, cd133 +, сd117 +, cd90 +34- stem cells were determined in these patients in the acute and sub-acute myocardial infarction period. it is going 7 years after the beginning of planned to evaluate left ventricular function of these patients, incidence of cardiovascular end points (death, recurrent myocardial infarction, angina, heart failure, stroke) and their combinations, to evaluate the safety of transplantation of autologous bmcs (formation of intra-myocardial tumor or neoplastic processes of other sites) after 7 years from the beginning of study.

Eligibility criteria:
inclusion criteria: * 18 years and to 75 years * informed consent * first stemi * term admission to an intensive care unit in the first 24 hours of onset * time reperfusion of the ira is not earlier than 4 hours after the initial onset of acute transmural myocardial infarction exclusion criteria: * atrial fibrillation, a permanent form valvular heart disease * severe comorbidity

Keywords: bone marrow cells acute myocardial infarction transplantation of autologous mononuclear transplantation of autologous cd133 + cells
hearts r34 feasibility study, autistic participants

Conditions: Autism Spectrum Disorder

Summary: the goal of this randomized clinical trial is to test whether the 6 sessions hearts healthy relationships classes increases the satisfaction that autistic adults feel about their friendships and dating relationships compared to a 6 weeks online discussion group. the 6 hearts sessions cover: healthy and unhealthy relationships, launching new relationships, neurohealth, meeting and reconnecting, boundaries, and healthy endings. participants who take part in this research study will be in this research study for three months. during this time, participants will be asked to complete two 30-minute and six 10-minute online surveys, and participate in two 20-minute interviews over zoom.


Eligibility criteria:
inclusion criteria: * diagnosed with autism by a healthcare provider or other professional * willing to be randomized to either hearts or the active control condition (acc) * have not already participated in the study, nor in the hearts class previously * english speaking exclusion criteria: * unwilling or unable to provide informed consent by themselves * have participated at any time previously in hearts research or the hearts class * are unable to understand english

Keywords: friendships dating relationships zoom sessions satisfaction
evaluate breast masses using a new method of ultrasound contrast to detect abnormal blood flow in breasts

Conditions: Breast Cancer; Breast Abnormalities

Summary: the purpose of this study is to determine if breast imaging with ultrasound can be improved by using 1) a ultrasound attachment with two transducers and 2) a contrast agent. these changes might allow smaller blood vessels to be seen than under the way breast ultrasound is usually performed.

the purpose of this study is to determine if performing ultrasound with an attachment made up of two transducers (rather than just a single transducer) will provide more information about the blood vessels in the breast than the current attachment. the study will also examine the question of whether use of an ultrasound contrast agent will the scanner to see smaller blood vessels than are detected without the agent.

Eligibility criteria:
inclusion criteria: * female subjects who have breast masses and scheduled for core biopsy. exclusion criteria: * pregnant or lactating females. * females who have heart problems or sensitivity to contrast agents. * females who have had previous surgery for breast cancer.
dmd- interactive virtual reality study

Conditions: Duchenne Muscular Dystrophy

Summary: this study will help determine if an interactive virtual reality system can improve the physiotherapy of young patients with duchenne muscular dystrophy (dmd).

duchenne muscular dystrophy (dmd) is a genetic disease causing muscle weakness and wasting affecting 2,500 people in the uk. international standards of care recommend that children with dmd undertake a daily stretching programme to maintain maximum muscle extensibility and optimise function. a lot of children are not motivated to perform these exercises, leading to earlier complications, reduced function and a poorer long-term prognosis. our collaborative research group has previously developed an interactive immersive virtual reality (ivr) system to improve the delivery, engagement and success of physiotherapy for adult amputees, burns' patients and children with upper limb injuries. vr headsets have become more accessible in terms of price, usability and portability. in a recent ppi survey, 78% of paediatric dmd patients stated that a vr system could improve physiotherapy engagement and performance. this study will investigate the feasibility and acceptability of an ivr device on paediatric dmd rehabilitation. in phase 1 of this study, clinicians, physiotherapists, parents, carers and patients will participate in a co-design workshop to explore core vr rehabilitation scenarios. an ivr platform will be developed that will emulate current dmd physiotherapy. in phase 2, investigators will ask therapists and children to take part in testing the ivr platform. vr scenarios will be further developed and then tested in a trial with 16 dmd patients aged 5-10 years. pre and post-trial assessments will be performed to determine the effect of the ivr system on improving physiotherapy adherence, muscle strength testing, quality of life and anxiety. qualitative interviews and questionnaires will be conducted with patients and clinical staff to obtain feedback on patient acceptability as well as practicality and acceptability of using ivr in a clinical setting. this study will help determine if an ivr system can improve the physiotherapy of young patients with dmd.

Eligibility criteria:
inclusion criteria: * aged 5-10 years * diagnosed with duchenne muscular dystrophy (dmd) and receiving lower limb physiotherapy care * ambulant patients * able to speak/understand english exclusion criteria: * physical or cognitive difficulties indicating the child would struggle to use the device or complete study activities. * outside age range. * non-ambulant patients. * facial injuries precluding the use of hmd. * issues relating to balance that could be affected by vr. * severe visual impairment.
fosmidomycin with clindamycin or with clindamycin plus artesunate

Conditions: Malaria

Summary: the aim of this study is to evaluate the role of clindamycin and artesunate as possible combination partners for fosmidomycin to protect it from its susceptibility to recrudescent infections when used as monotherapy for acute plasmodium falciparum malaria while retaining its excellent safety profile

the scientific rationale for the use of this combination is to inhibit the ability of the parasite to synthesise isoprenoids, as precursors of many essential compounds including sterols, carotenoids and ubiquinones. this is effected through blockade of the non-mevalonate pathway by fosmidomycin as a potent inhibitor of 1-deoxy-d-xylulose 5-phosphate reductoisomerase coupled with targeting of protein biosynthesis by azithromycin through binding to the 50s ribosomal subunit. this mode of action contrasts with the ability of the human host to utilise the mevalonate pathway for isoprenoid synthesis and accounts for the safety profiles of both drugs through the mechanism of selective toxicity. moreover it affords protection against cross resistance with existing chemotherapeutic agents.

Eligibility criteria:
inclusion criteria: * male and female subjects aged 15 to 55 years * body mass index ≥ 18.5kg/m2 * uncomplicated p falciparum malaria with acute manifestations * asexual parasitaemia between 500ul and 100,000ul * ability to tolerate oral therapy * able to give informed signed consent exclusion criteria: * signs of severe malaria, according to who criteria * body mass index ≤ 18.5kg/m2 * pregnancy by history or by positive urine test * lactation * mixed plasmodial infection * concomitant disease masking assessment of response, including diabetes, * uncontrolled hypertension, heart failure, hepatic dysfunction (alanine-amino transferase \>150 u/l), renal impairment (creatinine \>125umol/l or 3mg/dl) * haemoglobin \< 8g/dl * white cell count \> 12000/ul * anti-malarial treatment within previous 28 days * symptomatic aids

Keywords: malaria plasmodium falciparum acute uncomplicated