cyrilzakka/clinical-trials huggingface dataset:
Evaluation of Transcranial Doppler Vasoconstrictor Vasoreactivity During General Anesthesia in Hypertensive Patients

During a general anesthesia, people over 65 years old and hypertensive, have a modification of the vasoreactivity and their cerebral blood flow under vasoconstrictor such as norepinephrine or phenylephrine. We study the variation of the average velocity of the average cerebral artery under vasoconstrictor and during a modification of End Tidal CO2 (EtCO2) by transcranial Doppler.

General anesthesia induces a sympathetic block frequently leading to hypotension, especially in elderly and hypertensive patients. Currently, Phenylephrine (PE) and Norepinephrine (NE) are commonly used in clinical practice to address this arterial pressure drop. Their cardiovascular effects are not exactly the same, even though they both increase mean blood pressure.

Maintenance of mean arterial pressure is not the only hemodynamic goal during general anesthesia in the elderly. Cognitive disorders have been demonstrated during post-anesthetic awakening.

Cerebral hemodynamics is assessed by analyzing the speed of blood flow in the middle cerebral artery using transcranial Doppler (DTC). It measures the systolic and diastolic speed as well as the pulsatility index, which are predictive factors for lowering cerebral blood flow.

Eligibility Criteria:
Inclusion Criteria:

* older over 65 years
* high blood pressure disease
* need general anesthesia
* need vasopressors : norepinephrine or phenylephrine
* temporal window of transcranial doppler is viable

Exclusion Criteria:

* Acute, valvular, rhythmic or ischemic cardiovascular pathology
* severe arthritis (stage 3)
* Intra-cranial pathology
* Significant carotid stenosis (\> 40%) or carotid endarterectomy
* Cervical surgery
* Taking a premedication that can modify cerebral vasoreactivity
* Insulin-dependent diabetes for more than 10 years
* Person under judicial protection
* Opposition to data processing
Prucalopride for Postoperative Ileus in Patients Undergoing Gastrointestinal Surgery

The purpose of this study is to evaluate the effect and safety of prucalopride on recovery of gastrointestinal function in patient undergoing major gastrointestinal surgery. The investigators hypothesize that patients who take prucalopride after major gastrointestinal surgery will have shorter duration of postoperative ileus.

Postoperative ileus (POI), an interruption of bowel motility function, virtually occurs in all patients undergoing major gastrointestinal(GI) surgery. This functional impairment persists for a variable duration, usually resolving within 1 day in the small intestine, 1 to 3 days in the stomach and 3 to 5 days in the colon. Therefore, time of return of colonic function is the the major determinant of duration of POI. Attempts to reduce the duration of POI have prompted the implementation of fast track surgery including early removal of the nasogastric tube, early feeding, alvimopan, gum chewing, and prompt ambulation. However, it is still reported to be more than 4-5 days in most of the randomized trial. Therefore, methods specifically aiming at promoting postoperative colon motility may further enhance the GI function recovery, and prucalopride may be one of the options.

Prucalopride, a substituted benzamide with selective 5-HT4 agonist activity, has been shown previously to significant improve colon motility and transit, but it only has mild effect on gastric or small bowel transit. The drug is well tolerated with no significant adverse effects. Recently, prucalopride has been approved in Europe and America for the symptomatic treatment of chronic constipation in women in whom laxatives fail to provide adequate relief. However, its usage in the postoperative period has not been tested. This study will test the ability and safety of prucalopride given 24hrs after GI surgery to hasten the recovery of GI function.

Eligibility Criteria:
Inclusion Criteria:

1. Consecutive patients undergoing elective gastric, small bowel, or partial colonic resection via laparotomy or laparoscopy.
2. Patients with American Society of Anaesthesiologists grading I-III
3. Informed consent available.

Exclusion Criteria:

1. Patients with stoma creation, extensive adhesiolysis, total or subtotal colectomy , or patients who had a history of total or subtotal colectomy.
2. Patients who developed intraoperative problems or complications, or had peritoneal carcinomatosis.
3. Patients who developed serious complications within 24 hours after surgery.
4. Those who received epidural anesthesia or analgesia.
5. Patients who received other prokinetic drugs.
6. Patients who were allergic to prucalopride.
7. Patients with severe comorbidity and/or organ(kidney, liver, and heart) dysfunction
8. Patients had complete bowel obstruction
9. Patients who have participated other clinical trials.
10. Patients who have short bowel(\<200cm small bowel) or history of constipation.
Development and Evaluation of Magnetic Resonance Imaging Acquisition and Analysis Methods

Magnetic resonance imaging (MRI) is a diagnostic imaging method with constant progress and improvement in the way the MRI images are obtained. Many of these advances involve changes to MRI software and hardware. The goal of this study is to find out the possible benefits of new MRI techniques. This will allow us to use the new MRI methods in research and patient care.


Eligibility Criteria:
Inclusion Criteria:

* Men and women age 18 or older

Exclusion Criteria:

* Anyone who would be normally excluded from undergoing an MRI examination as per Memorial Hospital for Cancer and Allied Diseases Screening Questionnaire for MRI
* Patients/volunteers with a pacemaker, aneurysm clip or any other condition that would warrant avoidance of a strong magnetic field
* Female patients/ volunteers who are pregnant or nursing
* Patients/ volunteers who are unable to comply or complete the MRI exam due to claustrophobia or high levels of anxiety
* Patients/ volunteers from the vulnerable population, as defined by 45 CFR 46.
* Patients at higher risk due to age, frailty, or the emergent nature of their condition
Knowledge Evaluation and Assessment of the Effectiveness of an Education Intervention on Acne

Acne vulgaris is a chronic inflammatory disorder of the skin in the pilosebaceous unit of the hair follicle, associated with oil production. It is found across skin types and is present in 85% of adolescents, representing a large affected population. Because of the universal nature of the disease, 36.3% of acne patients come from backgrounds other than Caucasian.

The purpose of this study is to examine patient knowledge about acne in different populations and to assess the effectiveness of a teaching intervention on acne knowledge. The investigators aim is to better understand and subsequently reduce any potential health disparities within the minority populations.

This project will evaluate differences in acne knowledge between different ethnic groups, and the efficacy of an educational intervention. Subjects will first complete a survey evaluating their knowledge of acne and how acne affects them psychosocially before an educational intervention. Immediately following the intervention, the patient's knowledge of acne will be evaluated again. Finally, two months after the intervention, a phone call will be made evaluating their retention of the education materials and their quality of life related to psychosocial effects of acne. Investigating this educational intervention and any current disparities in acne education and understanding will better allow us to educate and treat acne patients in the future.


Eligibility Criteria:
Inclusion criteria:

* Subjects ages 18 years of age and older and able to give consent
* Subjects with a diagnosis of acne vulgaris

Exclusion criteria:

* Subjects who are not proficient in English
* Subjects who were unable to give informed consent
* Subjects who do not have a diagnosis of acne vulgaris
The Role of TextRAd on Detection of Liver Metastasis in Rectal Cancer

This is a retrospective analysis of all patients diagnosed with LARC who received NCRT and had MRI scans between 2003-2014 at East Suffolk and North Essex NHS Foundation Trust. Region of interest was drawn around the tumor or its location on T2 MRI images. Six texture parameters were systematically extracted from Textural histograms of post-treatment scans. These parameters were examined to determine their ability to predict local recurrence and distant metastases through Kaplan-Meier survival curves and log-rank tests.


Eligibility Criteria:
Inclusion Criteria:

* All subjects must have MRI post-Chemotherapy treatment to detect the response to Neoadjuvant treatment and compare it to pre-treatment scans to easily determine if there were a posttreatment liver metastasis.
* Locally advanced rectal cancer (LARC) = MRI stage: T3/T4 and/or N1/N0.

Exclusion Criteria:

* Distant metastases.
* Synchronous tumour.
Trial Using Motivational Interviewing Positive Affect and Self-Affirmation in Hypertension (TRIUMPH)

The primary aim of this study is to evaluate whether an intervention that combines positive affect and self-affirmation with motivational interviewing (TRIUMPH) improves blood pressure control compared to an educational/behavioral contract intervention at 12 months. We hypothesize that a greater proportion of participants in the experimental arm of TRIUMPH will have adequate blood pressure control as defined by Seventh Joint National Committee on Detection, Evaluation and Treatment of Hypertension (JNC-7.)

TRIUMPH is designed to build on the findings of our previous studies by combining positive affect and self affirmation with motivational interviewing in order to increase blood pressure control in community based practices that care for large numbers of hypertensive black patients. Patients in both the educational and behavioral contract control group and would receive a workbook, would make a behavioral contract, and a home blood pressure monitor. The positive affect/self-affirmation group would receive the same components as the control group. In addition the experimental group would receive a positive affect/self-affirmation induction and motivational interviewing.

Both the control group and the experimental group would be followed at 2 month intervals. The outcome blood pressure control in this group will be contrasted to the knowledge/behavioral contract group. We hypothesize that we can increase the percent of patients who have blood pressure control to 75%.

Eligibility Criteria:
Inclusion Criteria:

* 18 years or older.
* Must be receiving care within the Renaissance Health Network for at least one year.
* Must have uncontrolled HTN defined as an average SBP\>140 mmHg or DBP\>90 mmHg on at least two previous visits in the past year and be taking at least one antihypertensive medication.
* Must self-identify as Black, or African American.
* Must have patient's physician to participate in the study.

Exclusion Criteria:

* Being deemed unable to comply with the study protocol (either self-selected or by indicating during screening that he/she could not complete all requested tasks).
* Participation in other clinical trials.
* Diagnosis of cognitive dysfunction or significant psychiatric comorbidity.
Development of a Multipurpose Dashboard to Monitor the Situation of Emergency Departments

An emergency department (ED) is a healthcare service that provides the first clinical assessment and treatment to patients with various acute conditions. These departments, however, are often overwhelmed by the large volume of patients. As a consequence, ED crowding has become a global concern and has been correlated to reduced timeliness and effectiveness of care and increased patient mortality. Concerning input, 20% to 30% of patients are brought to the ED by ambulance; the remaining are self-presenting for the vast majority. Notably, non-urgent conditions characterize a high proportion of all ED visits worldwide, and almost all of these visits involve self-presenting patients. Increasing the awareness of these patients about the mandate of EDs and the real-time situation of the neighboring emergency departments has the potential to reduce the self-presentation of patients with minor, non-urgent conditions. Such patient empowerment can be achieved through a dashboard. Concerning throughput, working in the ED requires emergency physicians and nurses to treat many patients at once while maintaining situational awareness of the surroundings. This is especially true for the head of the department, but it also holds for all physicians. It can be crucial, for example, for physicians to know if there is a bottleneck in the flow of the entire patient care process, such as a particularly high average waiting time for radiology reporting or cardiologic consultation. The availability of this information allows countermeasures to be put in place to regain efficiency. All this can be achieved through dedicated dashboards automatically fed from various information system. In addition, appropriate dashboards also enable health policymakers to monitor specific epidemiological phenomena, such as the emergence of certain infectious diseases, in a timely manner.


Eligibility Criteria:
Inclusion Criteria:

* Adult
* Arrived at emergency department between 1 January 2025 and 31 December 2025

Exclusion Criteria:

- None
A Study of RG1662 in Adults and Adolescents With Down Syndrome (CLEMATIS)

This multi-center, randomized, double-blind, 3-arm, parallel-group, placebo-controlled study will evaluate the efficacy and safety of RG1662 in adults and adolescents with Down syndrome. Subjects will be randomized to receive RG1662 either at low or high dose or placebo orally twice daily for 26 weeks.


Eligibility Criteria:
Inclusion Criteria:

* Individuals aged 12-30 years of age inclusive
* Clinical diagnosis of Down syndrome (trisomy 21) confirmed by chromosomal analysis (karyotyping)
* Males, or non-pregnant, non-lactating females. For females of childbearing potential, strict contraceptive prevention is required.
* Body-mass Index (BMI) 18-42 and 15-30 kg/m2 inclusive for adults and adolescents respectively
* Ability to complete the Clinical Evaluation of Language Fundamentals (CELF)-preschool 2 word classes task
* Subjects must have a parent, or other reliable caregiver who agrees to accompany the subject to all clinic visits, provide information about the subject as required by the protocol, and ensure compliance with the medication schedule
* Study participants must have sufficient language, vision and hearing to participate in study evaluations, as judged clinically by investigator

Exclusion Criteria:

* Subjects with a current DSM 5 diagnosis of any primary psychiatric diagnosis (including ASD or MDD)
* Subjects with a history of infantile spasms, of West syndrome, Lennox-Gastaut syndrome, Early Infantile Epileptic Encephalopathy or any treatment-refractory epilepsy associated with cognitive or developmental regression, of severe head trauma or CNS infections (e.g. meningitis)
* Subjects with a known or suspected clinical seizure event of any type within 24 months prior to screening
* Clinically relevant ECG abnormalities at screening or baseline; QTcF above 450 ms; personal or family history (first degree relatives) of congenital long QT syndrome
* Inadequate renal or hepatic function
VR Mindfulness Study

This is an exploratory study investigating the use of virtual reality-based guided mindfulness meditation in improving pain, stress, and mood within various clinical populations. The feasibility of utilizing VR applications within the populations of patients with various specific disease types and clinical settings is a burgeoning area of research. The goal is to establish an association between the use of VR-based mindfulness meditation, and pain, stress, and mood scores.

This is a two-center, multi-site exploratory study conducted within the University of California, Los Angeles Health and Greater Los Angeles VA systems. A total of 60 subjects will be recruited. Screening data will be reviewed to determine subject eligibility. Subjects who meet all inclusion criteria and none of the exclusion criteria will be entered into the study.

Subjects will undergo assessments of stress, depression, anxiety, and pain at baseline, pre- and post-VR guided mediation, and monthly for three months. Each subject can undergo VR-guided meditation session no more than one time per day. In subjects who are hospitalized, an attempt will be made to have the subjects undergo the VR meditation and complete the pre- and post- meditation assessments daily until hospital discharge.

Duration of the study is expected to be 1 year. Each session is expected to last approximately 15 minutes.

Subjects will be given instructions on proper use of the VR devices and how to start the guided meditation software. Once familiar with the device, participants will undergo a guided VR meditation using a commercial VR application. The meditation will last approximately 15 minutes. Prior to starting and on upon completion of each VR meditation session, participants' state pain, anxiety, depression, and stress will be assessed. For each participant enrolled, baseline and monthly assessments using the DASS-21 and PPI-SFI3a will be performed for three consecutive months

Eligibility Criteria:
Inclusion Criteria:

* Adults at least 18 years old
* Able to read and understand English (Guided meditation software has not yet been translated to languages other than English)

Exclusion Criteria:

* Age \<18 years old
* Unable to speak, read or understand English language
* Blindness or severe hearing impairment
* Any disability or neurological deficit that would impair subject from using the virtual reality console
* Significant movement disorder
* Vertigo and/or motion sickness
Machine-Generated Mortality Estimates and Nudges to Promote Advance Care Planning Discussion Among Cancer Patients

This study will use a stepped-wedge cluster randomized trial to evaluate the effect of a health system initiative using machine learning algorithms and behavioral nudges to prompt oncologists to have serious illness conversations with patients at high-risk of short-term mortality.

Patients with cancer often undergo costly therapy and acute care utilization that is discordant with their wishes, particularly at the end of life. Early serious illness conversations (SIC) improve goal-concordant care, and accurate prognostication is critical to inform the timing and content of these discussions. This study will use a stepped-wedge, cluster randomized trial to evaluate the effect of a health system initiative using machine learning algorithms and behavioral nudges to prompt oncologists to have serious illness conversations with patients at high-risk of short-term mortality. Oncology practices will be randomly assigned in sequential four-week blocks to receive the intervention.

Eligibility Criteria:
Inclusion Criteria:

* Care for adults with cancer at the following clinics at Perelman Center for Advanced Medicine

  * Breast Oncology
  * Gastrointestinal Oncology
  * Genitourinary Oncology
  * Lymphoma
  * Melanoma and Central Nervous System Oncology
  * Myeloma
  * Thoracic / Head and Neck Oncology
* Care for adults with cancer at the Pennsylvania Hospital Oncology clinic

Exclusion Criteria:

* Providers who care for only patients with benign hematologic disorders
* Providers who see only genetic consults
* Providers who see less than 12 high-risk patients in either the pre- or post- intervention periods
* Visits for patients with lung cancer who are enrolled in an ongoing palliative care clinical trial that may lead to more SICs
* Patient visits that are for oncology genetics consults (such patients may still be included if they see their primary oncologist during the trial)
* Providers who have not undergone serious illness conversation program training (SIC)
Efficacy and Safety of Dietary Supplementation of Diamine Oxidase to Improve Symptoms in Patients With IBS

This project is a single center, randomized, controlled clinical trial evaluating the effects of DAO enzyme dietary supplement on symptoms of irritable bowel syndrome.

These participants are randomized to either a 4-week group with DAO enzyme dietary supplement or placebo. The participants are required to fill out IBS-SSS and IBS-QOL questionnaires and record their IBS symptom improvement, IBS treatment drug use, compliance and adverse reactions every evening. At the same time, the patients' diet is continuously recorded for 3 days by 24-hour diet review method in Visit 0, Visit 1 and Visit 2, respectively, to inform the patients to avoid large fluctuations in diet structure. On days 0, 14 and 28, the subjects are asked to visit the hospital offline. The staff check with the subjects in detail according to the scale and questionnaire contents, and review the general situation and questionnaire in the previous 2 weeks. On the 7th and 21st day, the staff contact the subjects online to provide guidance and remind the subjects to fill in the scale and questionnaire. In addition, oral mucosal samples, urine and feces will be collected for identifying mutations in the genetic DAO enzyme coding gene, histamine detection and 16sRNA sequencing, respectively.


Eligibility Criteria:
Inclusion Criteria:

1. Age 18-65 years old;
2. Diagnosed with IBS according to Rome IV diagnostic criteria; Recurrent abdominal pain occurred on an average of at least 1 day per week in the past 3 months and was associated with two or more of the following criteria: i. Related to defecation; ii. Associated with changes in bowel frequency; iii. Correlated with fecal morphological changes. The symptoms appeared at least 6 months before diagnosis, and the above diagnostic criteria were met in the last 3 months.
3. Voluntarily participate in the experiment and sign the informed consent.

Exclusion Criteria:

1. Patients with endoscopy examinations which suggest chronic intestinal diseases other than IBS, such as inflammatory bowel disease, celiac disease, gastric and duodenal ulcers, parasitic or bacterial intestinal infections;
2. Pregnant and lactating women;
3. Patients suffering from serious concomitant diseases, such as liver disease, cardiovascular disease, lung disease, kidney disease, tumor;
4. Alcoholism.
Effect of Phototherapy Incorporated Into an Exercise Program on Osteoarthritis of the Knee

The aim of the proposed study is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program on pain, functional capacity, range of motion, muscle strength in individuals with osteoarthritis of the knees. The participants will be allocated to different groups through a randomization process using opaque envelopes containing cards stipulating one of the three following groups: Group A (exercise protocol); Group B (exercise protocol + phototherapy protocol); and Group C (exercise protocol + placebo phototherapy protocol). Phototherapy will be performed on the knees diagnosed with osteoarthritis.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of osteoarthritis of the knee (unilateral) according to criteria of the American College of Rheumatology
* age between 40 and 80 years
* either gender
* knee pain and functional disability for at least six months confirmed by historical medical.

Exclusion Criteria:

* Dementia
* neurological disorder (sensory or motor)
* cancer
* diabetes
* acute adverse health condition
* symptoms of osteoarthritis of the hip
* cardiopulmonary disease that impedes walking
* need for wheelchair or gait-assistance device
* and having received steroids through intra-articular injection or orally in the previous six months