Kornimate/medical-research-clean huggingface dataset:
impact of video presentations on medical students' attitudes toward mental illness

Conditions: Stigmatization; Depression; Psychosis

Summary: this is a randomized controlled trial examining the impact of videos on medical students' implicit and explicit attitudes and knowledge related to mental illness in nepal. medical students are randomized to one of three conditions: (a) no video, (b) a didactic video based on the mental health gap action programme (mhgap) modules for depression and psychosis; and (c) videos with personal testimonials from mental health service users with depression and psychosis.

stigma towards mental health patients exists within health systems worldwide, affecting high- and low-income countries alike. stigmatizing beliefs held by health professionals toward mental illness can have detrimental health impacts on the patients. these stigmatizing beliefs against mental health patients within the health system have been noted across south asia, including nepal. two sources of stigmatizing beliefs towards mental illness are explicit (conscious) and implicit (unconscious) attitudes held by health professionals. there is a dearth of research that investigates both explicit and implicit attitudes of health professionals towards mental health in south asia though. one method to reduce stigma is through contact with people who suffer from mental illness. however, there is a gap in the literature on low- and middle-income countries integrating contact with mental health service users in health provider trainings. forthcoming research in nepal is exploring the causal impact of service user involved mental health trainings of health professionals on explicit and implicit attitudes as well as clinical care, but this research has yet to investigate the effects of service user training on health professional students (in progress). research efforts on mental health trainings should be expanded to student populations to reduce negative attitudes before providers enter the workforce. the purpose of this study is to evaluate whether information-based training with or without service user testimony is more effective at reducing implicit and explicit biases toward mental health patients and increasing clinical care in nepali health professional students. the findings from this study will fill the gap in research that evaluates intervention efficacy of reducing stigma towards mental health patients in nepali student health education. by implementing mental health trainings, the long-term goals of this intervention are to reduce stigma held by health professionals against mental health patients and improve clinical care in nepal by reducing negative implicit and explicit attitudes.

Eligibility criteria:
inclusion criteria: * medical students in universities in nepal exclusion criteria: * medical students are excluded if they have already completed their psychiatric clinical rotation
efficacy and safety of unfractionated heparin on severe sepsis with suspected disseminated intravascular coagulation

Conditions: Sepsis; Disseminated Intravascular Coagulation

Summary: the primary objective of this study is to estimate the efficacy of unfractionated heparin(ufh) on icu mortality in severe sepsis with suspected dic.the second objective is to estimate the effect of ufh on 28-day mortality,and the change of the japanese association for acute medicine(jaam) score and sofa score. the third one is to evaluate the safety of ufh in severe sepsis patients with suspected dic.

during the study, the whole process of data validation and registry procedures will be implemented by the principal investigator of the study, and monitored by the ethics committee of the first affiliated hospital of china medical university.there are 2 research supervisors(2 icu doctors) to assess the accuracy, completeness and representativeness of registry data, and to report the study process and research results to principal investigator.investigators have also edited a data dictionary including each variable used by the registry and normal ranges of all detection indexes. the standard operating procedures have been formulated to address the registry and data analysis. the feasibility and significance have been assessed carefully and funded by the health and family planning commission of liaoning province(no.lncc-b01-2014).the sample size is 600 participants through statistic calculation. the plan for missing data and statistical analysis will be implemented by specialized statisticians of china medical university.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of severe sepsis or/and septic shock * suspected dic:the score of platelets plus international normalized ratio in the jaam criteria is equal or more than 3 scores exclusion criteria: * consent declined * pregnant or breastfeeding * the length during icu is less than 24 hours * with other types of shock * have bleeding or high risk for bleeding * have an indication for therapeutic anticoagulation * have a known or suspected adverse reaction to ufh including hit * are currently enrolled in another trial * known or suspected cirrhosis or other severe hepatic diseases * terminal illness with a life expectancy of less than 28 days

Keywords: severe sepsis disseminated intravascular coagulation unfractionated heparin
clinical study of efficacy and safety of chung a won in women's patients with osteoporosis

Conditions: Osteoporosis

Summary: a randomized, single center, double blind, parallel, placebo-controlled, clinical study of efficacy and safety of chung a won and placebo for 24 weeks three times a day on the improvement of osteoporosis and symptoms in women's older than 50 patients with osteoporosis.


Eligibility criteria:
inclusion criteria: 1)female more than 50 years old in osteoporosis exclusion criteria: 1. wash out peroid: using agents more than 3 months against osteoporosis 2. subject who takes drugs that may affect the clinical trials (corticosteroids, anticonvulsants, tranquilizers, antidepressants, hypnotic, diuretic) 3. subject who has a chronic liver disease, thyroid disease and chronic renal disease 4. subject who is chronic alcoholics and undernourished 5. other conditions were not suitable in study : severe physical defects mental defects 6. pregnant woman 7. subject who is not calibrated hypercalcemia/hypocalcemia 8. secondary osteoporosis : subject who takes drugs(glucocorticoid, diabetes medications) 9. subject who has 60% more fracture risk in frax(who fracture risk assessment tool)
prediction of delirium in medical icu patients

Conditions: Delirium; Intensive Care Unit Delirium

Summary: in intensive care unit (icu) patients, the ability to predict delirium may help reduce its incidence, duration, and severity. the prediction of delirium in icu (pre-deliric) model was recently developed for this purpose. our aim was to test the pre-deliric model in the medical icu.

delirium, a disturbance of consciousness with an acute onset and a variable course of impaired cognitive functioning, is common in patients admitted to the icu. several tools are available for assessing delirium in icu patients, of which the confusion assessment method-intensive care unit (cam-icu) has the highest sensitivity and specificity. although several predictive models for non-intensive care patients exist, as well as one for older medical intensive care patients, no evidence based prediction model for general intensive care patients is available. also the tools are not involved the metabolic parameters which cause delirium. because of that the tool need to have biochemical parameters. in the light of these information our aim is to validate the pre-deliric model in medical icu in turkish people.

Eligibility criteria:
inclusion criteria: * be at the medical icu * 18 and older years of age * predict to stay in the icu over 24 hours * not to be pregnant * not to be breastfeeding * not to have dementia, alcoholism * have not previously received a diagnosis of delirium * have not communication problem * agree to participate to the study by patient's relatives exclusion criteria: * younger than 18 years old * stay in the icu less than 24 hours * be pregnant * breastfeeding * have dementia, alcoholism * previously received a diagnosis of delirium * have communication problem * not agree to participate to the study by patient's relatives
guidelines for drug therapy of hypertension: multi-site implementation

Conditions: Hypertension

Summary: clinical trial of implementation of clinical practice guidelines for managing hypertension in primary care clinics.

background: hypertension, the most commonly reported medical problem in veterans, is a major risk factor for heart disease and stroke. lowering blood pressure decreases the risk of these adverse clinical outcomes. widely promoted evidence-based clinical practice guidelines set target blood pressures for adequate control, yet most hypertensives, including va patients, do not meet the targets. guidelines also call for use of specific drugs depending on the patient's pattern of comorbid characteristics; yet, clinicians often prescribe drugs that are not guideline-concordant. objectives: the long term objective of this work is to contribute to the va's ability to respond flexibly to rapidly evolving medical knowledge by establishing a system guidelines that can be used throughout the va nationally for implementing multiple different clinical practice. in collaboration with stanford medical informatics we developed an automated decision support system for hypertension management, known as athena dss built with eon technology for guideline-based decision support. athena dss incorporates hundreds of knowledge rules to operationalize guidelines for hypertension. methods: athena dss combines patient information from vista with an automated knowledge base of hypertension to generate patient-specific recommendations for management of hypertension that are displayed to primary care clinicians in pop-up windows in the va�s computerized patient record system (cprs) when the record for appropriate patients is opened on the day of scheduled primary care clinic visits. the athena dss pop-up provides advice on adequacy of control of blood pressure and specific recommendations for drug therapy of hypertension, a visual display of the patient�s medication history and concurrent blood pressures, evidence supporting the main recommendations, and other information. we deployed the system at three va medical centers--durham, san francisco, and palo alto�and conducted a clinician-randomized trial. we logged data on use of the system, monitored comments entered by clinicians, and conducted a questionnaire survey of clinicians. we planned analyses of impact on clinician prescribing and patient blood pressures. we planned preparation for dissemination of the system to additional va medical centers. status: project work is ongoing at time of preparing this report. we recently received notice of funding for a visn collaborative that will use the athena dss in five medical centers in visn 1 (new england).

Eligibility criteria:
inclusion criteria: primary care clinicians at participating study sites. that is physicians, nurse practitioners and physician assistants who have their own panel of patients to whom they provide direct patient care. exclusion criteria:

Keywords: drug therapy practice guidelines reminder systems ambulatory care hypertension clinical protocols quality assurance, health care
study to gather information on the safety and how radium-223 dichloride, an alpha particle-emitting radioactive agent, works under routine clinical practice in taiwan in patients with castration-resistant prostate cancer (crpc) which has spread to the bone

Conditions: Castration-resistant Prostate Cancer

Summary: in this observational study researchers want to gather more information about safety and survival in patients suffering from castration-resistant prostate cancer (crpc) which has spread to the bone and were treated with radium-223 in routine clinical practice in taiwan. radium-223 (ra-223) is an alpha particle-emitting radioactive agent approved for the treatment of men with metastatic castration-resistant prostate cancer (mcrpc).

the primary objective of the study is to describe the safety profile of radium-223 dichloride in patients having castration-resistent prostate cancer with symptomatic bone metastases and who are treated in routine clinical practice in taiwan. the secondary objective is to assess the effectiveness of radium-223 dichloride in these patients.

Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed castration-resistant adenocarcinoma of the prostate with bone metastases * treatment decision for radium-223 according to local label needs to be made independent from and before patient enrollment in the study by the investigator * no contra-indications according to the local marketing authorization exclusion criteria: * previously treated with radium-223 for any reason * currently treated in clinical trials including other radium-223 studies or planned participation in an investigational program with interventions outside of routine clinical practice during the study period

Keywords: bone metastases radium-223 dichloride
the feasibility and safety of the toetva for benign thyroid nodules

Conditions: Thyroid Diseases

Summary: thyroid surgery has been developed as a new technique for zero scar in surgery by applying transoral endoscopic thyroidectomy with sublingual approach. the new technique is locating the surgery which pierced through floor of mouth, cause severe tissue damage, high complication, and conversion rates to open surgery and surgical difficulties due to limitation of movement. nevertheless, each report is still including small number of patients. recently, the transoral endoscopic thyroidectomy vestibular approach (toetva) has been proven feasible and safe in several overseas centers. moreover, a successful toetva case was reported in local media in the late last year. hence, this study is for evaluating the feasibility and safety of the toetva prospectively at a tertiary referral center in hong kong. the following are the procedure of the study: 1. recruit patients from the clinic. 2. patients will receive treatment within 3 months 3. patients will have different assessments like ultrasonography assessment, fine needle biopsy, direct laryngoscopy, and cosmectic scoring in pre-operation, post-operation 2 week, post 1 month, post 3 month, post 6 month and post 12 month. 4. patients will be monitoring by the same team after the study.


Eligibility criteria:
inclusion criteria: * have a cyst, nodule or a goiter which has been shown to be benign on fine needle aspiration cytology, * need to undergo a unilateral thyroid resection, * have a nodule size no larger than 4cm in largest diameter, * willing to undergo this new approach rather than the traditional open approach. exclusion criteria: * unfit for surgery, * has had previous surgery or radiation at the neck, * unable to tolerate a general anesthesia, * wearing dental braces, * absence of vocal cord mobility at laryngoscopy.

Keywords: thyroid thyroidectomy transoral endoscopic surgery
which ventilatory strategy is better for lung in upper abdominal surgeries?

Conditions: Anesthesia Induced Atelectasis

Summary: ventilated patients especially those undergoing upper abdominal surgeries are prone to lung atelectasis. they are at risk of adverse effects secondary to inadequate lung ventilation. applied peep and recruitment maneuver are thought to enhance lung aeration under general anesthesia which could be assessed by ultrasound.

the aim of our study is to assess the effect of using peep with and without recruitment maneuver on atelectasis and lung aeration during open upper abdominal surgeries by ultrasonography. application of peep improves intraoperative oxygenation and thus could minimize the incidence of postoperative atelectasis and respiratory complications during abdominal surgeries. a recent study found that peep and rm prevented intraoperative aeration loss, which didn't persist after extubation when comparing effects of positive end-expiratory pressure/recruitment maneuvers with zero end-expiratory pressure on atelectasis during open gynecological surgery by ultrasonography

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists' physical status grades i, ii, and iii. exclusion criteria: * patient refusal. * psychiatric diseases. * body mass index \> 35 kg/m2. * previous intrathoracic procedures. * history of severe obstructive pulmonary disease. * history of severe restrictive lung disease. * pulmonary arterial hypertension ( systolic pulmonary arterial pressure \>40 mmhg). * pregnancy.
effect of goserelin (zoladex®) in spinal and bulbar muscular atrophy

Conditions: Spinobulbar Muscular Atrophy; Kennedy's Disease

Summary: this is a therapeutic trial study to demonstrate whether goserelin, a lhrh agonist has benefit in sbma objective: 1. to study effects of goserelin to clinical course of patients with spinal and bulbar muscular atrophy in thailand 2. to demonstrate physiological and pathological changes in treated patients with goserelin. 3. to assess tolerability and adverse effect of goserelin therapy


Eligibility criteria:
inclusion criteria: 1. provision of informed consent 2. males, age over 20 years, undesired fertility 3. have positive family history of muscle weakness with these clinical signs: * bulbar involvement (difficulty in breathing, swallowing, talking) * muscle atrophy with or without fasciculation * decrease or normal deep tendon reflex * normal babinski response * no sensory impairment * mild tremor (either postural or intention) * gynecomastia * decrease libido and infertility 4. subjects have a confirmed diagnosis to sbma by both ncv test and dna study demonstrated the number of cag repeated more than 35. exclusion criteria: 1. have weakness caused by other etiologies and have liver or kidney disease. 2. have currently prostatic cancer 3. want to have a child 4. participation in a clinical study during the last 30 days. 5. females and children age \< 20 years old

Keywords: spinobulbar muscular atrophy kennedy's disease goserelin electrophysiologic study inclusion body
18f-fdopa pet/ct imaging in patients undergoing metabolic surgery

Conditions: Diabetes Mellitus, Type 2; PreDiabetes; Obesity

Summary: the aim of the study is to compare the endocrine function of pancreas between pre and post metabolic surgery in patients with type 2 diabetes or prediabetes. the study will examine the endocrine function of pancreas using 18f-fdopa pet/ct imaging and various biochemical laboratory tests


Eligibility criteria:
inclusion criteria: * type 2 diabetes or prediabetes * body mass index \>25.0 kg/m2 * written informed consent exclusion criteria: * diabetes induced by chronic pancreatitis or pancreas cancer * chronic glucocorticoid usage * significant coronary artery disease or cerebrovascular disease within the previous 3 months * uncompensated congestive heart failure * severe pulmonary disease defined as fev1 \< 50% of predicted value * end stage renal disease on dialysis * acute infectious disease within the previous 3 months * pulmonary thromboembolism or thrombophlebitis within the previous 3 months * history of cancer (except for basal cell skin cancer or cancer in situ) * prior gastrointestinal surgery (except for appendectomy or hemorrhoidectomy) * gastrointestinal disorders, malabsorptive disorders, or inflammatory bowel disease * history of chronic liver disease (except for nafld/nash) * psychiatric disorders including dementia, active psychosis, severe depression requiring \> 2 medications, history of suicide attempts, alcohol or drug abuse within the previous 5 years

Keywords: diabetes mellitus, type 2 prediabetes obesity
ozurdex endophtamitis cohort, prognostic assessment at 12 months

Conditions: Endophthalmitis

Summary: ozurdex endophthalmitis is a rare and potentially very serious pathology. different treatments can be carried out early and change the functional prognosis of the patient.


Eligibility criteria:
inclusion criteria: * patient who had endophtalmitis following an ozurdex implant injection within 2 months exclusion criteria: * intra oculaire procedure in the interval between the injection of ozurdex and endophtalmitis

Keywords: ozurdex visual acuity endophtalmitis
the skills, confidence & preparedness index (scpi)

Conditions: Diabetes Mellitus

Summary: the lmc skills, confidence and preparedness index (scpi) is a tool that was developed by diabetes specialists to individualize the education/support that a healthcare provider delivers to patients with diabetes. it has been shown to have high reliability, validity and generalizability. this study assessed the validity and reliability of a revised, final version of the scpi in a large sample of patients with type 1 and type 2 diabetes, as well as the clinical responsiveness of the scpi to a diabetes self-management education intervention in a smaller cohort of patients with poor glycemic control.

canadian experts in diabetes care developed the skills, confidence \& preparedness index (scpi) to assess diabetes self-management in patients. the scpi is web-based, gives immediate feedback to the healthcare provider, and is associated with glycemia. the scpi was designed to allow a healthcare provider to individualize the education/support by assessing the three critical dimensions of self-management: knowledge of a skill; confidence in ability to change a behavior; and preparedness to begin implementing the behavior change. two previous validation studies showed that the scpi has high internal consistency, reliability, generalizability, and external validity. following further focus groups with healthcare providers and patients, the scpi questions and response scale were edited to further optimize clarity. this study assessed the validity and reliability of a revised, final version of the lmc scpi in a large sample of diabetes patients, as well as clinical responsiveness of the scpi to a diabetes self-management education (dsme) program intervention. this study recruited type 1 and type 2 patients from the waiting rooms of seven lmc diabetes \& endocrinology specialist clinics in ontario, canada. patients completed the scpi electronically and their demographic and health information was retrieved from their electronic medical records. a smaller cohort of patients with uncontrolled glycemia were enrolled into a dsme program. participants completed the scpi at their baseline visit and their individual results were incorporated into the care paths that were then customized for that participant. the dsme program provided five to seven visits with a diabetes educator over three to four months. patients completed the scpi again at their final visit.

Eligibility criteria:
inclusion criteria: * diagnosis of type 1 or type 2 diabetes * age ≥ 18 years * ability to read english * duration of diabetes ≥ 6 months (dsme cohort only) * a1c ≥ 8.0% (dsme cohort only) exclusion criteria: -

Keywords: self-management questionnaire diabetes education