Kornimate/medical-research-clean huggingface dataset:
impact of peripheral nerve blockade on outcomes after total knee replacement

Conditions: Pain; Osteoarthritis

Summary: pain is common after knee replacement surgery and can impact a variety of patient outcomes. peripheral nerve blocks provide improved pain control and may improve function. however, their impact on other outcomes is poorly described. therefore, this comparative effectiveness study will estimate the independent association between nerve blocks and health outcomes after knee replacement surgery.

this retrospective, population-based cohort study will evaluate the comparative effectiveness of peripheral nerve blocks on patient and health system outcomes after elective total knee replacement surgery. the investigators will develop a non-parsimonious propensity score to control for potential indication bias and confounding in this observational study. using the propensity score the investigators will match patients who receive a peripheral nerve block to a patient who did not to estimate the independent association of peripheral nerve blocks with our study outcomes.

Eligibility criteria:
inclusion criteria: * first primary total knee replacement during the study period exclusion criteria: * revision arthroplasty

Keywords: orthopedics anesthesiology nerve block length of stay patient readmission
nutrition in disguise: development and palatability testing of novel food products

Conditions: Malnutrition

Summary: nutrition in disguise is focused on developing and testing the acceptability of nutrient dense food products appropriate for older adults and specifically those living in long term care.

project description: the overall goal of this research is to develop food recipes that are rich in vitamins, minerals and other food components known to support the physical and mental health of older adults. a variety of enhanced food recipes will be initially designed for older adults living in residences with applicability to pre-frail and frail older adults living in the community. it is hypothesized that the nutrient (protein and vitamins and minerals) density and anti-oxidant (i.e. phytochemical) potential of menus used in residential environments can be improved in a cost-effective manner with the inclusion of several enhanced food recipes designed for this population. this will be achieved by identifying high nutrient ingredients that can be incorporated into recipes of foods that are highly consumed by this segment. initial work will summarize what is known from existing literature about micronutrient deficiencies and interventions with vitamins, minerals and antioxidants to improve the health of older adults. foods commonly consumed that can be enhanced to promote their nutritional density (e.g. more nutrients in less calories) will be identified and recipes developed and tested with older adults living in the community and in residences. products that pass this testing will then be introduced into a residence menu rotation to determine if they are well accepted by residents. a cost benefit of introducing these new products into a residence menu will be demonstrated by showing the gains in nutritional quality of the menu for the cost of producing these products in the home. relevance to the field of food innovation: currently, older adults, especially those who are frail or live in residences, do not consume adequate nutrition to optimize their health. micronutrient inadequacies are a potential problem. research to date suggests that diet can also be supportive for delaying frailty and slowing the progression of dementia. yet, food choices and offerings can be low in nutrition. cost effective, innovative recipes that used common ingredients to reach nutrition goals for older adults are needed. anticipated outcomes: up to 10 enhanced recipes that have been developed for residences will be developed and tested for palatability. knowledge tools will be created for home chefs on how to incorporate nutrient dense ingredients into recipes and how to use the information gained in this project for menu planning.

Eligibility criteria:
inclusion criteria: * older adults living in the community with no food allergies * older adults living in long term care with and without dementia with no food allergies exclusion criteria: -
navigated repetitive transcranial magnetic stimulation in improving motor rehabilitation in participants with brain tumors

Conditions: Brain Neoplasm

Summary: this trial studies how well navigated repetitive transcranial magnetic stimulation works in improving motor rehabilitation in participants with brain tumors. navigated repetitive transcranial magnetic stimulation may help improve patients' lost motor function after surgery.

primary objectives: i. determine feasibility of conducting 10 sessions of navigated repetitive transcranial magnetic stimulation (nrtms) during the post-surgical rehabilitation time period. exploratory objectives: i. explore the effects of the nrtms training program on motor recovery. ii. explore changes in cortical activity: electroencephalographic (eeg) activity including event-related potentials (erps) and motor evoked potentials (meps) will be assessed from baseline to end of treatment (eot). outline: between 1-7 days after standard of care surgery, participants undergo 10 nrtms sessions over 30 minutes each over 3 weeks. after completion of study, participants are followed up at 3 months.

Eligibility criteria:
inclusion criteria: * patients with brain tumors associated with the motor cortex * understand and read english, sign a written informed consent, and be willing to follow protocol requirements * eastern cooperative oncology group (ecog) performance status of 0-2 * motor impairment must be related to the surgical procedure or the tumor itself (in the opinion of the treating physician) * patients who are within 7 days of brain tumor resection associated with the motor cortex * eligibility for the nrtms treatment will be based on motor ability and will be determined postoperatively by the surgeon exclusion criteria: * patients who are taking any antipsychotic medications * patients who have ever been diagnosed with bipolar disorder or schizophrenia * patients with a history of stroke
exploration of the synovial fluid inflammation mediators under diacerhein in knee osteoarthritis

Conditions: Osteoarthritis

Summary: some inflammation mediators, notably il-1, are implied in the joint degeneration phenomena of osteoarthritis. the aim of this study is to confirm in vivo the favourable effect of diacerhein on il-1 and also to appreciate its effect on other synovial inflammation mediators.


Eligibility criteria:
inclusion criteria: * painful osteoarthritis * hydarthrosis (synovial effusion) exclusion criteria: * large effusion * severe pathologies * anti-osteoarthritic treatments

Keywords: osteoarthritis, il-1
a project to study probiotic beauty products on skin improvement

Conditions: Skin Diseases

Summary: the aim of the study was to use probiotic beauty products for 4 weeks and evaluate the impact of products on healthy skin.

twenty subjects were recruited and informed to apply the lotion gel twice per day (3\~5 mg/cm2 once) for 4 weeks. two kinds of facial lotiongels, "a" gel and "b" gel, were provided to every subject. the "a" gel (tac/collagen lotiongel) was applied on subjects' right face and the "b" gel (placebo lotion) on their left face (formula showed as table s2). ordinary cosmetics usage was permitted but any change of usage was not allowed during the intervention. outdoor activities (sun exposure) and the usage of sunscreen lotion were not limited in this study. every subject was required to inspect his/her skin condition on week 0 and 4. before inspection, the face was washed with water and waited for 30 min in an air-conditioned room (25°c, humility 55 ± 5%). among these 20 subjects, eight of them had severe acne with at least two acne lesions on each side of face when participating this trial. they were instructed for more visits to evaluate the symptom of acne on week 1 and 2. skin hydration (corneometer cm825, courage + khazaka electroni, germany), sebum (callegari 1930, italy), and inflammation detection (chroma meter mm-500, minolta, japan) of upper cheek were measured in every subject. the improvement in inflammation was positively correlated with a decrease of a\* value or an increase of l\* value. visia® complexion analysis (visia® complexion analysis, u.s.a.) was also employed to measure the skin inflammation, porphyrins numbers and brown spot numbers of whole face. the result was presented as the mean value and the relative percentage (%) to the baseline.

Eligibility criteria:
inclusion criteria: healthy volunteers aged above 20 years old exclusion criteria: 1. subject with diseases of the skin, heart, liver, kidney, endocrine and other organs and patients with mental illness (according to medical history). 2. subjects who have known cosmetic, drug or food allergies, difficulty in digestive tract absorption or disorder. 3. female who is pregnant or nursing or planning to become pregnant during the course of the study. 4. received facial laser therapy, chemical peeling or uv overexposure in the past 4 weeks. 5. involuntary subject 6. people who is taking chronic disease medication
implementation strategies for monitoring adherence in real time

Conditions: Lung Cancer; Medication Adherence; Symptoms and Signs

Summary: the objective of this project is to identify effective strategies to help patients with lung cancer manage side effects and achieve optimal adherence to oral targeted therapies. to achieve this objective, we will evaluate the effect of a novel, bidirectional conversational agent, compared to usual care, on adherence to oral targeted therapies using a two-arm randomized controlled trial, and explore how multilevel factors impact the acceptability and effectiveness of this strategy by collecting qualitative and quantitative data from clinicians and patients.

drawing from insights in behavioral economics and implementation science, the goal of our project is to identify effective strategies for improving lung cancer outcomes by helping patients to better manage symptoms and adhere to oral therapies. given the rapid increase in fda-approved targeted therapies, the need for such strategies will continue to grow. our central hypothesis is that conversational agent will improve adherence to oral therapies by targeting patient-level determinants of behavior change. the specific aims are to: 1) test the effects of a patient-directed intervention (conversational agent) to improve adherence to oral targeted therapies in patients with non-small cell lung cancer.; and 2) use mixed-methods approaches with clinicians and patients to explore multilevel factors shaping the acceptability, effectiveness, and future implementation of intervention into routine cancer care. primary trial outcomes (adherence and persistence) will be measured using microelectronic monitoring system (mems) caps. secondary outcomes will be assessed using longitudinal surveys and medical record data.

Eligibility criteria:
inclusion criteria: * adult patient (age \> 18 years) with nsclc at uphs who is receiving one of the following nine oral therapies: afatinib, erlotinib, dacomitinib, gefitinib, osimertinib, alectinib, brigatinib, crizotinib, or lorlatinib. * patient possession of a mobile device that can send/receive sms texts * ability to respond to questions and engage with "penny" in english * ability to provide informed consent to participate in the study * approval from the patient's medical oncologist to be approached exclusion criteria: * inability to respond to questions and engage with "penny" in english * inability or unwillingness to provide informed consent to participate in the study * inability to engage with sms text-messaging platform * concurrent enrollment in a therapeutic clinical trial * taking more than one oral targeted therapy or concurrent chemotherapy during the study window * lack of approval from the patient's oncologist

Keywords: medication adherence symptom management non-small cell lung cancer implementation science digital health behavioral science
potlako: a programmatic intervention to improve access to timely oncology care

Conditions: Neoplasms; HIV; Healthcare Disparity

Summary: diagnostic and treatment delays contribute substantially to disparities in cancer morbidity and mortality between low- and middle- income countries (lmics) and high-income countries. individuals present with advanced stage disease resulting in minimal chance for cure or long-term survival. the potlako project will implement and evaluate a multifaceted intervention to test the hypothesis that a package of enhanced coordination of care including an electronic messaging, transportation support, and training targeted at generalist clinicians at primary and secondary level facilities, can reduce time to diagnosis and stage at diagnosis for hiv-infected individuals with cancer.


Eligibility criteria:
inclusion criteria: * citizen of botswana * suspected or diagnosed cancer exclusion criteria: * involuntary incarceration
health care analysis on myocardial revascularization in patients with chronic coronary heart disease (chd)

Conditions: Coronary Heart Disease

Summary: myocardial infarction and chronic coronary heart disease (cchd) are the most frequent causes of death in germany. treatment options include widening of the narrowed / blocked coronary vessel via catheter and stent or bypass surgery in which the narrowed vessel sites are bridged. the "german national disease management guideline on cchd" helps doctors to decide which treatment is most appropriate for the severity of vascular damage and possible concomitant diseases of the patient. nevertheless, there are other factors determining treatment decision. for example, the equipment or preferences of the hospital or department in which patients are admitted, play a role in the decision. the aim of the revask project is to investigate whether and to what extent the collaboration of cardiology and heart surgery specialists in so-called "heart teams" influences the decision on therapy. for this purpose, doctors and patients will be interviewed about how the treatment decision was made and how satisfied both sides are with the outcome of the treatment and the decision. in addition, claims data from several german health insurance companies (techniker, barmer, betriebs- und innungskrankenkassen) will be analyzed. treatment data, which is documented as usual by the treating medical staff and passed on to the health insurance companies for accounting purposes, is used. furthermore, treatment data recorded in the registers of the professional societies is analyzed.


Eligibility criteria:
inclusion criteria: * with chronic coronary heart disease * and 2- or 3-vessel or main-vessel disease * who are being treated at one of the recruitment sites * with a promptly planned intervention for myocardial revascularization * who are insured with pre-specified german health insurance companies (barmer or tk) exclusion criteria: -

Keywords: chronic coronary heart disease myocardial revascularization heart team decision making cardiology heart surgery
nationwide long-term outcome surveillance of physiomesh® vs. other meshes in laparoscopic incisional hernia repair

Conditions: Hernia, Abdominal; Recurrence; Postoperative Complications

Summary: the primary aim of the present study was to show how a national clinical register combined with other nationwide administrative registers may serve as a tool for pre- and post-marketing evaluation of new mesh and mesh fixation products for hernia surgery, using physiomesh® versus other meshes designed for laparoscopic hernia repair as an example.

all adult (≥18 yrs) patients registered in the danish hernia database (dhb) who underwent elective primary laparoscopic incisional hernia repair between january 1st 2010 and december 31st 2016. to obtain 100% follow-up data from dhb will be combined with administrative data from the danish national patient register. patients will be followed from initial hernia repair until reoperation for recurrence, death, emigration outside denmark or end of follow-up (november 2017). physiomesh and other mesh repairs will be propensity score matched. each patient in the physiomesh® group will be matched with two patients treated with one of the other synthetic meshes. the propensity score includes age, sex, year of surgery, diagnosis of chronic obstructive pulmonary disease, diagnosis of diabetes, diagnosis of obesity, charlson comorbidity index and size of hernia defect the primary outcome: difference in risk for a reoperation for recurrence between patients operated with physiomesh® and patients operated with another synthetic mesh designed for laparoscopic repair. the secondary outcome will be rates of 30-day readmission, 30-day reoperation for complications (excluding hernia recurrence) as well as 30- and 90-day mortality.

Eligibility criteria:
inclusion criteria: * all patients registered in the danish hernia database for a laparoscopic incisional hernia repair exclusion criteria: * if not registered for a laparoscopic incisional hernia repair in the danish hernia database
critical windows in the development of asthma endotypes and phenotypes in high-risk toddlers

Conditions: Asthma in Children; Wheezing

Summary: the purpose of this study is to learn more about how asthma develops in early childhood. this will help doctors understand how to prevent and treat asthma better.


Eligibility criteria:
inclusion criteria: * age 18 months to 36 months at first research encounter * for enrollment in emergency department (ed)/inpatient visit: presentation to the ed/inpatient with an acute wheezing episode and either evidence of at least one prior wheezing episode documented in the electronic medical record (i.e., wheezing, pneumonitis, bronchiolitis, reactive airways disease, or asthma) that occurred ≥ 14 days from current episode, or caregiver report of one of the following: * child has had wheezing or whistling in the chest at any time in the past lasting at least 24 hours and occurring at least 14 days prior to the current ed visit * child has been treated with albuterol or used an inhaler or a nebulizer at least 14 days prior to the current ed visit * caregiver has been told that their child has bronchiolitis, asthma, or reactive airways disease at least 14 days prior to the current ed visit * for enrollment in visit 1: at least three separate wheezing episodes, separated by at least 14 consecutive days without a wheezing episode (wheezing lasting ≥ 24 hours), as reported by parent/caregiver or patient's care provider and/or documented in the patient's medical record * third episode may be at time of presentation to ed or admission as inpatient (ip) to hospital when recruitment would occur (visit ed/ip) * bronchiolitis and wheezing/asthma exacerbations are considered wheezing episodes * the wheezing episode does not require treatment with bronchodilators * live within a us office of management and budget-defined metropolitan statistical area (msa) and meet at least one of these criteria: 1. have publicly funded health insurance and/or 2. live in a census tract within an msa where ≥10% of families have income below the poverty level exclusion criteria: * wheeze attributed to alternative diagnoses other than bronchiolitis or asthma, including congenital anatomical abnormalities, foreign body aspiration, chronic lung disease of prematurity, other chronic lung disorders such as cystic fibrosis, and cardiac, immune, and gastrointestinal disorders. * gestational age \< 32 weeks.

Keywords: childhood asthma recurrent wheeze asthma phenotypes asthma endotypes asthma development
an efficacy study comparing zd6474 to placebo in medullary thyroid cancer

Conditions: Thyroid Cancer

Summary: the purpose of this study is to learn how hereditary or sporadic medullary thyroid cancer patients, treated with zd6474, react to the drug, what happens to zd6474 in the human body, about the side effects of zd6474, and if zd6474 can decrease or prevent the growth of tumors.


Eligibility criteria:
inclusion criteria: * confirmed diagnosis of unresectable, locally advanced or metastatic hereditary or sporadic medullary thyroid cancer. * presence of measurable tumor * able to swallow medication exclusion criteria: * major surgery within 4 weeks before randomization * last dose of prior chemotherapy received less than 4 weeks prior to randomization * radiation therapy within the last 4 weeks prior to randomization(with exception of palliative radiotherapy) * brain metastases or spinal cord compression, unless treated at least 4 weeks before first dose and stable without steroid treatment for 10 days * significant cardiac events * previous zd6474 treatment

Keywords: zd6474 mtc hereditary medullary thyroid cancer sporadic medullary thyroid cancer medullary thyroid cancer
"impact of pelvic floor prehabilitation using biofeedback on the severity of the low anterior resection syndrome in patients undergoing a total mesorectal excision for rectal cancer"

Conditions: Rectal Cancer

Summary: there is currently no specific treatment and only few measures to prevent the low anterior resection syndrome (lars). the lars often results in a severe alteration of quality of life. this study is designed to assess pelvic floor prehabilitation using biofeedback in the prevention of lars following total mesorectal excision for cancer. the pelvic floor rehabilitation with biofeedback has already been tested postoperatively in patients suffering from lars with heterogeneous results. however, this rehabilitation has never been evaluated in the prevention of lars. the prehabilitation is an innovative concept currently evaluated in the prevention of functional complications following orthopedic surgery and also prostate surgery. in high-risk abdominal surgery, cardiopulmonary prehabilitation offers satisfying results in terms of morbidity and mortality rates. this study will be the first to assess pelvic floor prehabilitation in the prevention of lars.


Eligibility criteria:
inclusion criteria: * age between 18 and 80 years old * total mesorectal excision with colorectal or coloanal anastomosis protected by an ileostomy or a colostomy for rectal cancer * absence of anastomotic leakage or stenosis * informed consent to participate in the study * social security insurance affiliation exclusion criteria: * history of anal incontinence and/or fecal urgency and/or chronic diarrhea requiring a specific treatment before rectal cancer management * absence of ileostomy or colostomy * anastomotic leakage * sensorial or cognitive disorders impeding pelvic floor rehabilitation exercise * pregnant women * minors * adults under guardianship
post-trial access program of idursulfase-it along with elaprase in children with hunter syndrome

Conditions: Hunter Syndrome

Summary: as the hgt-hit-046 (nct01506141) and shp609-302 (nct02412787) studies will be closed, this post-trial access (pta) program provides tak-609 to participants in these studies for whom the benefit:risk ratio of continued treatment with idursulfase-it remains positive.


Eligibility criteria:
inclusion criteria: 1. participants will have completed the treatment period of the hgt-hit-046 (nct01506141) or shp609-302 (nct02412787) study prior to the first dose on this program. 2. participant and/or a parent(s)/legal guardian is informed of the nature of this compassionate post-trial access program and can provide written informed consent for themselves or the child to participate (with assent from the child when appropriate prior to treatment). exclusion criteria: 1. participant has a condition that in the opinion of the treating physician may compromise their safety. 2. participant has a known hypersensitivity to idursulfase-it or its components.