Kornimate/medical-research-clean huggingface dataset:
preference methotrexate (mtx) pre-filled syringe versus pre-filled pen in rheumatoid arthritis (ra)

Conditions: Rheumatoid Arthritis

Summary: the primary objective of this study is to assess the number of patients preferring the methotrexate pre-filled pen to the methotrexate pre-filled syringe after 6 weeks of treatment based on a questionnaire


Eligibility criteria:
inclusion criteria: * written informed consent * age between 18 and 75 years * rheumatoid arthritis according to the american college of rheumatology (acr) criteria 1987 or acr/european liga against rheumatology (eular)2010 * disease activity score (das) 28 \> 2.6 main exclusion criteria: * prior or other current subcutaneous treatment with self-injection * prior or concomitant treatment with biologics * contraindications to mtx treatment * history or diagnosis of a dermatological disease at the injection site * women with child-bearing potential who do not use a highly effective method of contraception or men who have a partner with child-bearing potential and do not use a contraception during the study and at least 6 months thereafter.
the effect of psychoeducation on hopelessness, death anxiety and caregiver burden

Conditions: Support, Family

Summary: this study was conducted to determine the effect of watson human caring model-based psychoeducation given to the relatives of patients receiving palliative care on hopelessness, death anxiety and the burden of care.

this randomized controlled study was conducted with the relatives of patients hospitalized in the palliative care clinic of a training and research hospital in ankara,turkey. a total of 66 patient relatives, 33 of whom were in the experimental group and 33 in the control group, were included in the study. in the study, quantitative data were collected using descriptive characteristics form, beck hopelessness scale, templer death anxiety scale and caregiver strain index, while qualitative data were collected using structured interview form-1 and structured interview form-2. quantitative data collection tools were applied to the relatives of the patients in the experimental and control groups after the randomization group assignment within the scope of the pre-test. then, individual psychoeducation was given to the relatives of the patients in the experimental group for 45-60 minutes once a week for eight weeks. qualitative data were collected in these psychoeducation sessions (sessions 2,3,5,7,8) and for this purpose, structured interview form-1, structured interview form-2, and audio recording were used.

Eligibility criteria:
inclusion criteria: ability to communicate in turkish ability to write in turkish being a primary relative of the patient the patient's relative has been in the clinic for at least one week in order to adapt to the caregiver role. does not have a visual, auditory or mental disability only one relative of each patient participated in the study. provide care by the patient's relatives for at least eight hours a day exclusion criteria: * inability to speak turkish * having a hearing impairment * lack of comprehension skills * participating in another psychoeducation program within the last year * having a physical or mental problem t

Keywords: hopelessness death anxiety burden of care palliative care psychiatric nursing
effect of hypoxia exercise on erythrocyte aggregability

Conditions: Hypoxia; Training

Summary: pathological erythrocyte aggregation reduces capillary perfusion and oxygen transfer to tissue. the aggregation is determined by opposing forces, the repulsive force between cells, cell-to-cell adhesion induced by plasma fibrinogen, and the disaggregating shear force generated by blood flow. the investigators investigate how hypoxic exercise affects intrinsic/extrinsic factors of aggregation. sixty sedentary males were randomly assigned into either hypoxic (he; fio2=15%, n=20) or normoxic (ne; fio2=21%, n=20) training groups for 30 min·d-1, 5 d·wk-1 for 6 weeks at 60% of maximum work rate or to a control group (ctl; n=20). a hypoxia exercise test (het, fio2=12%) was performed before and after the intervention. the erythrocyte aggregation, binding affinity of fibrinogen and membrane biomarkers were determined by an ektacytometry and flow cytometry, respectively.

the aim of this study is to clarify the effects of exercise training with and without hypoxia on the erythrocyte aggregation, further providing a feasible strategy for developing an appropriate exercise regimen that improves cardiopulmonary fitness and minimizes the risk of hemorheological disorders. this study evaluated the distinct effects of hypoxic exercise training (he) and normaxia exercise training (ne) for 6 weeks on the following issue: (1) intrinsic/extrinsic erythrocyte aggregation, (2) binding affinity of fibrinogen to erythrocyte, (3) erythrocyte turnover rate and (4) characteristic of mature erythrocytes in blood, under hypoxic exercise test (het) (100w under air 12% o2 condition) in healthy sedentary men.

Eligibility criteria:
inclusion criteria: * having a sedentary lifestyle (without regular exercise, exercise frequency ≤ once weekly, duration \< 20 min). exclusion criteria: * exposed to high altitudes (\> 3000 m) for at least 1 year. * smoker * taking medications or vitamins * having any cardiopulmonary/hematological risk.

Keywords: erythrocyte aggregation
brain mechanism and intervention of executive-control dysfunction among substance dependents

Conditions: Substance Dependence; Executive Function Disorder; Transcranial Alternating Current Stimulation

Summary: the investigators assume that tacs could improve amphetamine and alcohol dependent patients' executive-control function by adjusting the synchronization patterns and enhancing the functional connectivity of the prefrontal-ventral striatum pathway. a random controlled trial will be used to test the effect of θ-tacs treatment. three months follow-up assessment will be conducted to test the changing of executive-control function and its mechanism.

substance abuse has become a major social and public health problem in china, especially for amphetamine abuse and alcohol abuse. executive-control dysfunction is the main symptom for substance dependents. previous studies have demonstrated the relationship between cognitive dysfunction and prefrontal-ventral striatum pathway. studies have shown that abnormal phase synchronization and phase-amplitude coupling (pac) induced the impairment of cognitive, and tacs could improve executive-control function by adjusting the abnormal synchronization. but it has not been verified among ma or alcohol patients. the investigators assume that tacs could improve ma and alcohol dependent patients' executive-control function by adjusting the synchronization patterns and enhancing the functional connectivity of the prefrontal-ventral striatum pathway. a random controlled trial will be used to test the effect of θ-tacs treatment. three months follow-up assessment will be conducted to test the changing of executive-control function and its mechanism. this study will provide a practical and theoretical basis for developing a novel treatment for substance dependents.

Eligibility criteria:
inclusion criteria: * aged 18-60, male or female, with 9 or more years of education, and able to complete questionnaire evaluation and behavioral tests * meet dsm-5 diagnostic criteria for amphetamine-type substance addiction or alcohol addiction * have used amphetamine or alcohol for at least one year (at least once a week) * normal vision and hearing, or within the normal range after correction * agree to cooperate in the follow-up evaluation * no metal implantation in the head, no history of nerve problems or head injury, and no skin sensitivity exclusion criteria: * have severe cognitive impairment, such as a history of head trauma, cerebrovascular disease, epilepsy, etc. * have used drugs promoting cognitive function in the last 6 months * have impaired intelligence (iq\<70) * abuse or dependence of other psychoactive substances (except nicotine) in the last 5 years

Keywords: substance dependence execution-control dysfunction synchronization transcranial alternating current stimulation
correction of fixed knee flexion deformity in children using eight-plate hemiepiphysiodesis

Conditions: Knee Deformity

Summary: the study aims to assess the effectiveness of hemiephysiodesis using eight plates in correction of fixed knee flexion deformities in children.

flexion contractures of the knee are quite disabling. they produce deleterious effects on knee biomechanics, quadriceps function, energy expenditure during gait and the overall ability to ambulate. these deformities occur secondary to a number of different etiologies including; congenital, traumatic, inflammatory and neuromuscular disorders with cerebral palsy (cp) being on the top of the list. the main aim of correction of sagittal plane deformities of the knee is to restore the range of motion. surgical options available for correction of knee flexion contractures include soft tissue modification, acute correction by osteotomies, gradual correction by external fixators and growth modulation by hemiephysiodesis.extensive soft tissue surgery may be needed for correction of knee deformities with potential risk of neurovascular damage and wound complications. supracondylar extension osteotomies have been widely used, however prolonged immobilization and associated neurovascular insults have always been major concerns. external fixators are cumbersome and may produce muscle tethering and pin tract infections. there are few studies in the literature reporting the use of anterior hemiepiphysiodesis for correction of knee flexion contracture. our study question can be summarized as follows; is hemiepiphysiodesis by eight plates effective for correction of fixed knee flexion deformities in children ?

Eligibility criteria:
inclusion criteria: * fixed knee flexion deformity more than 10° * unilateral or bilateral cases * 12 months or more predicted growth remaining * no response to non-operative treatment (physical therapy, bracing, casting); * recurrent cases exclusion criteria: * dynamic deformities due to spasticity * deformities responding to conservative treatment

Keywords: knee flexion deformity hemiepiphysiodesis eight plate children
szmn blocks for pain control in pediatric patients undergoing t&a

Conditions: Postoperative Pain; Opioid Use

Summary: the suprazygomatic maxillary nerve (szmn) block is a well-established, safe and effective regional technique for pain management following cleft palate procedures, however, have not been studied for patients undergoing tonsillectomy and adenoidectomy (t\&a) procedures. the goals of this study are to determine if szmn block can be utilized for pain control and decrease morbidity in pediatric patients undergoing t\&a.

patients between 6 months and 18 years undergoing t\&a surgical procedures will be reviewed for potential study enrollment. if participants agree to participate, they will be randomized into either the suprazygomatic maxillary nerve (szmn) block treatment cohort or the control cohort i.e standard of care. after anesthesia induction, patients randomized into the szmn- treatment group will receive a bilateral single injection szmn block under general anesthesia in the operating room. the injection will occur near the temples above the cheek bones. participants enrolled into the control group will receive standard of care with no changes to their anesthetic or surgical care. both groups will be asked for their verbal pain scores in the pacu and we will track their opioid consumption throughout the next few days after their procedure.

Eligibility criteria:
inclusion criteria: * ages 0-18 * give consent/parental consent to participate in study * patients undergoing tonsillectomy and adenoidectomy exclusion criteria: * participants who do not consent or have parental consent * patients who are clinically unstable or require urgent/emergent intervention * patients under age 6 months

Keywords: szmn block tonsillectomy and adenoidectomy regional anesthesia
coach2move: sustainable in daily practice

Conditions: Sedentary Lifestyle; Physical Activity; Frail Elderly Syndrome

Summary: implementation of a previously shown (cost-)effective physical therapeutic treatment strategy for community-dwelling older adults.

in a previous trial, researchers demonstrated that the coach2move approach is superior to regular physiotherapy in terms of increasing physical activity, reducing frailty, improving quality of life and reducing healthcare costs. in short, in less physiotherapeutic sessions, better outcomes were realized. despite these promising findings, the research group still has questions regarding the generalisability of these findings. the reservations towards the generalisability of the approach are caused by the following: 1. a modest (n=130), yet somewhat selective study sample was included: nearly half of the eligible individuals declined randomisation and thereby participation. an understanding is needed how this group of eligible non volunteers respond to coach2move. therefore, a study design that avoids randomisation at the patient level will be used. 2. the coach2move approach significantly increased the level of moderate physical activity among the treatment group and reduced levels of frailty significantly after 6 months, but the clinical importance of these findings is still unclear. thus, a replication of the effects in the light of physical functioning is needed in a larger more variable study population and with a longer follow-up. in addition, the results from the earlier carried out rct concerning the cost-effectiveness of coach2move have to be replicated on a larger scale. for the reasons mentioned above, it is important to further implement coach2move and study its effect, costs, and feasibility in current practice. a stepped wedge cluster randomised trial design is chosen because in the opinion of the researchers, the implementation strategy will do more good than harm (making a parallel design, in which certain practices do not receive the intervention or to withdraw the intervention as would occur in a cross-over design, is unethical) and it furthermore minimizes contamination. the objective of this study is to assess the cost-effectiveness of the implementation of a patient and context focused tailored coaching intervention (coach2move) in the daily physiotherapy practice for older adults with mobility problems compared to usual physiotherapy. the hypothesis is that coach2move leads to better physical outcomes and lower costs than usual care.

Eligibility criteria:
inclusion criteria: * aged 70 years or older * community-dwelling * mobility related problems or problems related to activities of daily living * sedentary lifestyle or are at risk of losing an active lifestyle exclusion criteria: * patients who are not ambulatory after treatment and/or are in palliative phase. * patients who are indicated to become institutionalised in the near future.

Keywords: older adults physiotherapy physical activity
evaluation of the effectiveness of a comprehensive visceral adiposity-focused anti-obesity program

Conditions: Obesity; Obesity, Morbid; Obesity, Visceral; Central Obesity; Metabolic Disease; Hypertension; Dyslipidemias; Type 2 Diabetes; Visceral Obesity

Summary: a retrospective review of body composition outcomes of participants of a comprehensive visceral-fat focused anti-obesity program. data from approximately 2000-2500 participants are expected to be included in the study.

this is a retrospective, multi-center clinical study to evaluate the efficacy of the 20lighter comprehensive anti-obesity program in reducing body composition measures including body weight, body fat, visceral adiposity, intracellular fluid, and other metrics of interest. anecdotal evidence on reductions of prescription medication, chronic health issues, and improvements in quality of life will be gauged via review of patient assessment forms and surveys.

Eligibility criteria:
inclusion criteria: * bmi \>25 * ability to stand on platform for body composition analysis exclusion criteria: * pregnant at time of enrollment * breastfeeding at time of enrollment * undergoing treatment for cancer at time of enrollment * history of major organ transplant with immunosuppressant medication * over the 70 years of age with diagnosis of three cardiovascular comorbidities at time of enrollment * adult with a vegetarian diet * diagnosis of psychiatric conditions including: schizophrenia, bipolar disorder, manic depression
impact and lived experience of parents of a child with a large or giant congenital melanocytic nevus

Conditions: Congenital Melanocytic Nevi; Congenital Melanocytic Nevus; Parent; Psychology, Social

Summary: the goal of this observational study is to describe the experiences of parents at the birth of a child with a large or giant congenital melanocytic nevus through semi-structured interviews, and to identify potential intervention strategies to improve their care and support.


Eligibility criteria:
inclusion criteria: * aged 18 years or older * willing to participate in a semi-structured interview * has received full information about the research and has not objected to participating or to the use of their data * able to understand and speak french * parent of a child under 18 years of age exclusion criteria: * under 18 years of age * not willing to participate * currently under legal protection (e.g., guardianship or curatorship) * cognitive and/or psychological impairments preventing participation in a semi-structured interview * poor understanding and/or expression of the french language * parent of a child over 18 years of age

Keywords: parents congenital melanocytic nevus congenital melanocytic nevi psychology lived experience
acetaminophen-induced hepatotoxicity in chronic alcohol abusers

Conditions: Hepatotoxicity

Summary: it is widely believed that people who abuse alcohol can sustain a liver injury after taking doses of acetaminophen just above the recommended maximum dose. this study is designed to look at the interaction between acetaminophen, liver injury and alcohol abuse. subjects will undergo baseline tests to ensure that they do not have liver damage at the time of enrollment. each subject will be randomly assigned to receive either a therapeutic dose of acetaminophen or a placebo three times a day for four days. subjects will have blood work drawn on a daily basis to monitor the status of the liver. these tests will include conventional markers of liver injury in addition to a novel biomarker of liver function, a-gst. previous work in the investigators' group has shown that a-gst is a more sensitive indicator of liver injury following acetaminophen overdose (sivilotti 1999, sivilotti 2002 x 2). however, it has never been used to study the alcoholic population. the investigators believe that a-gst may detect a subclinical acetaminophen-induced liver injury that has previously gone unrecognized in the alcoholic population.


Eligibility criteria:
inclusion criteria: * individuals who self-report consuming at least 6 drinks per day, daily, for at least 6 weeks and who are currently enrolled at the detoxification center, hotel dieu hospital. * last alcohol consumption occurring between 12 and 72 hours prior to screening for study. exclusion criteria: * individuals with a self-reported or previously documented history of hepatitis a, b, c or hiv. * individuals who have ingested any acetaminophen regardless of dose in the previous 48 hours. * individuals who have ingested \> 4 grams of acetaminophen/day in any of the previous 7 days. * individuals \< 18 years of age. * individuals with abnormal liver function at baseline (defined as ast or alt \> 120 iu/l, international normalized ratio \[inr\] \> 1.5, and a-gst \> 7.5 7 :g/l). * individuals who have an allergy or sensitivity to acetaminophen.
the turkish version of the affordances in the home environment for motor development-infant scale (ahemd-is)

Conditions: Premature; Infant Development; Environmental Exposure

Summary: the affordances in the home environment for motor development-infant scale (ahemd-is) is an instrument that assesses the quality and quantity of motor development opportunities available in the home for infants aged 3 to 18 months. since its initial publication, the ahemd-is has grown in popularity as a clinical tool and research criterion. furthermore, the ahemd-is supports the claim that environmental factors can have a positive impact on future motor skills and later cognitive behaviors of infants. also it is stated that environmental factors are associated with infant motor development and motor abilities. as of writing, it has been translated into eight languages from the original english version and has been reported as valid and reliable in countries such as china, spain, lebanon, and persia. the aim of this study was to produce the turkish version of the ahemd-is and to reveal the validity and reliability of this version.

the international classification of health, function, and disability (icf), developed by the world health organization, provides a standard framework for identifying the body functions and structures, activity restrictions, and difficulties in children's participation. one of the major innovations in the icf is that it introduces an environmental factor classification that enables the identification of environmental barriers and facilitators for both the capacity and performance of activities and tasks in daily life. the physical, social, and behavioral environments in which humans live are shaped by environmental factors. environmental factors are external to the individual and can have a positive or negative impact on an individual's participation, performance, and body function/structure. one of the tools that evaluate the environmental home environment is the affordances in the home environment for motor development-infant scale (ahemd-is). the ahemd-is is a valuable tool for assessing the home environment, one of the environmental factors affecting infant motor development, and is of considerable research and clinical importance. the importance of this questionnaire is based on evidence not just for the impact of the home environment on motor development, but also on future cognitive and social behaviors. consequently, this study aimed to translate the original english version into turkish and to test its psychometric properties for use in children aged 3-18 months. it was aimed to determine whether the translated questionnaire meets the appropriate and necessary standards for measuring the quantity and quality of motor competencies in the home environment of children aged 3-18 month.

Eligibility criteria:
inclusion criteria: * children aged 3-18 months exclusion criteria: * children younger than 3 months or older than 18 months * congenital or systemic disease