cyrilzakka/clinical-trials huggingface dataset:
Postoperative Thrombosis Prevention in Patients With CD

Patients with Cushing disease was randomized to 2 groups. After surgery, the patients were managed with mechanical prevention or mechanical prevention plus anticoagulant drugs(LMWH followed by rivaroxaban), VTE was observed 24h, 5day, 4weeks and 12weeks after surgery.Bleeding events were also recorded.

Cushing disease, caused by ACTH-secreting pituitary adenomas, can lead to serious complications with increased mortality. Minimally invasive surgery is currently the preferred treatment for the disease, allowing more than 80% of tumors to be completely removed. However, postoperative venous thrombosis (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) pose great threats to patients' safety. According to the literatures and the data from our center, up to 27% of the patients with Cushing's disease developed VTE after surgery. Due to the lacking of a randomized prospective study, there is no consensus or guideline on preventative anticoagulation protocols for postoperative management in patients with Cushing's disease. This is a prospective randomized control study on preventative anticoagulation in patients with Cushing's disease after transsphenoidal resection.

Eligibility Criteria:
Inclusion Criteria:

* Cushing\&#39;s disease diagnosed and treated with transsphenoid surgery at study centers

Exclusion Criteria:

1. History of VTE before surgery or within 24 hours post-surgery
2. Acute bacterial endocarditis
3. Major bleeding events
4. Thrombocytopenia
5. Active gastrointestinal ulcers
6. History of stroke
7. High risk of bleeding due to clotting abnormalities
8. Participation in other clinical trials within the last three months
9. Contraindications to rivaroxaban (e.g., renal dysfunction with eGFR \&lt; 50 mL/min)
10. Presence of other malignant diseases
11. Severe mental or neurological disorders
12. Presence of intracranial vascular abnormalities
13. Contraindications to mechanical prophylactic anticoagulation
14. Pregnancy
15. Any other condition that researchers deem inappropriate for study participation.
The Effect of Low-frequency rTMS on Motor Function in PD Patients With Freezing of Gait

This study is a double blind comparative study examining the effectiveness of the rTMS treatment on Freezing of Gait (FOG) phenomenon in patients with Parkinson's disease. We hypothesize that treatment using rTMS stimulation on frontal lobe areas will improve gait quality and decrease the frequency of FOG in patients with Parkinson's disease.

A course of low-frequency repetitive transcranial magnetic stimulation (rTMS) delivered over the supplementary motor area (SMA) improves motor symptoms in patients with Parkinson's disease (PD).

The present study is a comparative study that examines the effectiveness of rTMS treatment technique Freezing of Gait (FOG) phenomenon in Parkinson's disease patients. We hypothesize that treatment using rTMS stimulation on frontal areas will decreasing frequency of FOGs in patients with Parkinson's disease and improve gait quality and quality of life.

Eligibility Criteria:
Inclusion Criteria:

1. Idiopathic Parkinson's disease (PD), as diagnosed by a neurologist.
2. The mini-mental state examination questionnaire score above 24 points.
3. Suffer from a disabling phenomenon called Freezing of Gait (FoG) (Freezing Of Gait questionnaire score\> = 10)
4. Negative responses to the Preliminary Safety Magnetic Stimulation Treatment questionnaire.

Exclusion Criteria:

1. Other neurological or psychiatric disorders.
2. Severe personality disorder.
3. High Blood Pressure.
4. History of epilepsy, seizures or convulsions.
5. History of epilepsy or convulsions in first-degree relatives.
6. History of head injury or stroke.
7. Metal remains of the skull or inside the brain (outside the oral cavity).
8. Surgeries including metallic implants or known history of metal particles in the eye, pacemakers, hearing devices transplantation, or medical pumps.
9. Current history of migraines for the last six months.
10. A history of drug or alcohol abuse
11. Other medical research in the time to experiment or three months ahead. -
Tobacco Cessation Training Program in Spanish-speaking Countries

This project is responsive to the identified gap of lack of tobacco cessation training programs in Latin American \& Caribbean countries. Currently, smoking rates in the Latin American and Caribbean region are high, and previous surveys show that health professionals do not have enough skills to help smokers to quit. In consequence, in absence of trained health professionals, many smokers who visit health care services are under-treated. The Fruitful Project aims to adapt an original on-line course developed in Spain to the reality of the three Latin American countries (Bolivia, Guatemala and Paraguay) and disseminate evidence-based tobacco cessation interventions among health care professionals.

Tobacco cessation training programs to treat tobacco dependence have measureable effects on patients' smoking. Tobacco consumption in low and middle income countries is increasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs addressed to their health professionals and organizations.

Based on a previous online training program for hospital workers in Spain, the Fruitful Study aims are twofold:

1. to adapt the course to the reality of 3 Spanish-speaking low and middle income countries (Bolivia, Guatemala, and Paraguay) and;
2. to evaluate the effectiveness of the program among the participant hospitals and workers.

Investigators use a mixed methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be:

1. participants' attitudes, knowledge and behaviors before and after the training and
2. the level of implementation of tobacco control policies within the hospitals before and after the training.

The theoretical framework for this project includes Card's adapting model and Roger's diffusion of innovations model.

This study will show whether it is possible to adapt an online course to the reality of developing countries. In addition, investigator will measure whether an online program will produce changes in tobacco control policies at the organizational level and increase the level of knowledge, attitudes and perception in tobacco cessation at participants' level.

Eligibility Criteria:
Inclusion Criteria:

* Health professionals of the participating centers

Exclusion Criteria:

* No exclusion criteria
Impact of Measures Taken to Contain COVID-19 on Hospital Surgical Care Services and Clinical Outcomes

Swift and decisive actions on the part of healthcare and hospital authorities are required to effectively contain the current COVID-19 pandemic. These measures firstly allow personnel and facilities leeway to provide surge capabilities to meet anticipated increased demands on the healthcare service. In addition, by deferring none urgent hospital visits, admissions and investigations, such measures support social distancing and aid attempts to control disease transmission. Deferring perceived non-urgent patient services may however lead to unintended delayed diagnoses and exacerbation of current patient conditions and lead to increased emergency admissions and surgeries.

A policy decision was made that essential surgical services pertaining to cancer and urgent cardiovascular surgery were allowed but that surgeons had the option to postpone what is assessed to be less urgent cases. Increasingly patients also postpone their surgeries or visits because of anxieties over the developing situation. Elective surgical services at the Outram Campus were thus significantly reduced from January 2020 as part of the measures to contain the COVID-19 outbreak.

The surgical philosophy during this period was that a judicious policy that allowed surgeons to proceed with surgery deemed critical but to postpone those deemed less so will at the system level, avoid poor outcomes for patients who required surgery and yet successfully re-allocate resources required to address the unfolding pandemic.

Cohort of patients who were treated will be analysed via retrospective medical records review. These patients are classified according to the institution, type of surgical procedures, the medical condition and the dates of surgical treatment. The study will be compared across four time periods as listed:

-1Jan-31Dec2020 -1Jan-31Dec2019 -1Jan-31Dec2018 -1Jan-31Dec2017

The study focus on surgical indices for selected high-volume cancer and non-cancer diagnoses over the period 1st January 2020 to 31 December 2020 and compare them with similar indices across the same period of time in the preceding 3 years in particular, for the following surgical procedures:

1. Surgeries for the following cancer diagnoses:

   1. breast cancer, \[XIV- N60, no malignancy\], \[Malignant, II Neoplasms- C50\], colorectal cancer, \[C18, 19, 20\],
   2. hepatocellular carcinoma, \[C22\]
2. Selected non-cancer surgeries: a. Cholecystectomy b. Abdominal hernia repair

Eligibility Criteria:
Inclusion Criteria:

* Patients who had the following surgeries during the period 01 Jan 2017 to 31 December 2020.

From the identified surgical procedure type as shown Surgeries for the following cancer-related procedures.

1. Breast Cancer
2. Colon Cancer
3. Liver
4. Rectum

Selected non-cancer surgeries.

1. Abdominal Wall
2. Gall bladder

Patients from SGH and its releated institute NCC Only local Singapore citizens

Exclusion Criteria:

No exclusion criteria

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The Glucagonotropic Effects of Glucose-dependent Insulinotropic Polypeptide and Alanine in Healthy Individuals

The study is a randomised, double-blinded, placebo-controlled, crossover study enrolling 10 healthy male participants. Each participant will undergo four separate study days in randomised order. Each study day encompasses a continous 90-minute i.v. infusion with either placebo, glucose-dependent insulinotropic polypeptide (GIP), alanine or GIP + alanine.

The primary objective of the study is to find out whether intravenous administration of the naturally occuring gut hormone GIP and the amino acid alanine, separately and combined, results in additive or synergistic glucagonotropic effects during euglycaemic conditions in healthy participants. Secondary objectives are to disclose the effect of the abovementioned interventions on insulin secretion and circulating levels of total and individual amino acids.


Eligibility Criteria:
Inclusion Criteria:

* Caucasian ethnicity
* Body mass index (BMI) 20-27 kg/m\^2
* Glycated haemoglobin (HbA1c) ≤ 42 mmol/mol
* Informed and written consent

Exclusion Criteria:

* Late microvascular complications except mild nonproliferative retinopathy
* Liver disease (alanine aminotransferase (ALAT) and/or aspartate aminotransferase (ASAT) \> 2 times normal values) or history of hepatobiliary disorder
* Treatment with any glucose-lowering drugs
* Active or recent (within 5 years) malignant disease
* Active tobacco smoking/use
* Any condition considered incompatible with participation by the investigators.
A Study of LY3478006 in Healthy Participants

The purpose of this study is to learn more about how safe and how well tolerated LY3478006 is when given by injection into a vein or just under the skin to healthy participants. Blood tests will be done to check how much LY3478006 is in the bloodstream and how long the body takes to get rid of it. For each participant, the study will last up to about 16 weeks, including screening.


Eligibility Criteria:
Inclusion Criteria:

* Are overtly healthy male or female Japanese or non-Japanese participants, as determined by medical history and physical examination
* Women not of childbearing potential
* Are aged 18 to 55 years (20 to 55 years for Japanese participants), inclusive, at screening

Exclusion Criteria:

* Have clinically significant abnormal electrocardiogram (ECG) results
* Have persistent abnormal blood pressure or pulse rate, as determined by the investigator
* Have evidence of orthostatic hypotension, defined as a decrease in systolic or diastolic blood pressure greater than or equal to (≥)20 millimeters of mercury (mmHg) or ≥10 mmHg, respectively
* Have significant history or presence of cardiovascular, respiratory, hepatic, ophthalmological, renal, gastrointestinal, endocrine, hematological, neurological, or psychiatric disorders
* Have a history or presence of mononeuropathy, polyneuropathy, or autonomic neuropathy
* Have significant allergies to humanized monoclonal antibodies
Open-label, Single Center, Non-randomized, Fixed Sequence Phase 1 Drug-drug Interaction Study With LEO 32731 and Midazolam

This is a single center, non-randomized, open-label, fixed sequence study to investigate the effect of multiple oral dosing of LEO 32731 (up-titrated), on CYP3A activity in healthy male subjects using midazolam as a probe CYP3A substrate.

The study will be conducted in two seamless parts:

Part I - Maximal Tolerated Dose (MTD) Part II - Drug-Drug Interaction with midazolam


Eligibility Criteria:
Inclusion Criteria:

1. Subjects will, prior to any study related activities, have given their written informed consent to participate in the study and to abide by the study restrictions.
2. Subjects will be males between 18 and 55 years of age, inclusive.
3. Subjects will have a body mass index (BMI) between 18.0 and 30.0 kg/m2 inclusive.
4. Subjects must be in good health, as determined by medical history, physical examination, vital signs assessment, 12-lead ECG, and clinical laboratory evaluations.
5. Subjects (including those who have had a vasectomy) must agree to use condoms with spermicide during each sexual intercourse or must agree to be abstinent starting at first drug administration until 3 month after the final dosing.

   Also subjects must agree not to donate sperm in the same time period.
6. Subjects' female partner of childbearing potential must use an additional acceptable method of contraception. Eligible methods are: hormonal contraceptives (oral, injected, implanted, transdermal), intrauterine devices or systems (e.g. hormonal and non-hormonal IUD), barrier methods (condom and diaphragm, condom and cervical cap, etc.) in combination with a spermicide.

Exclusion Criteria:

1. Subjects who have received any prescribed systemic or topical medication within 14 days of the first dose administration unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise safety.
2. Subjects who have used any non-prescribed systemic or topical medication (including herbal remedies) within 7 days of the first dose administration (excluding occasional use of paracetamol or ibuprofen, e.g. in case of pain).
3. Subjects who have received any medications, including St John's Wort known to alter drug absorption or elimination processes (change the enzyme levels) within 30 days of the first dose administration of study drug.
4. Subjects who are still participating in a clinical study (e.g. attending follow-up visits) or who have participated in a clinical study involving administration of an investigational drug with new chemical entity within the past 60 days, or a marketed drug compound within the past 30 days prior to the first dosing.
5. Subjects who have donated any blood, plasma or platelets in 3 months prior to first dosing or who have made donations on more than 3 occasions within the 12 months preceding the first dose administration.
Esketamine Combined With Remimazolam on Postoperative Sleep Disturbance and Anxiety in Patients

To explore the effects of esketamine combined with remimazolam on postoperative sleep disturbance and anxiety in surgical patients undergoing gastroenteroscopies

Postoperative sleep disturbance (PSD) occur in the form of sleep deprivation, circadian rhythm disturbance, and structural abnormalities, and have a high incidence in patients undergoing surgery. Postoperative sleep disorders can lead to postoperative delirium and cognitive dysfunction, aggravate postoperative acute pain, and delay postoperative recovery.

Benzodiazepines have a certain sedative hypnotic anti-anxiety effect, and remimazolam as a new benzodiazepine, its sedative hypnotic anti-anxiety effect is worthy of further exploration.Esketamine is an NMDA receptor antagonist with analgesic and sedative effects, and is widely used in clinical treatment of refractory depression. For patients undergoing surgery, in addition to sedation and analgesia, whether the intraoperative use of esketamine has positive effects on postoperative sleep disturbance and anxiety is worth exploring.

Eligibility Criteria:
Inclusion Criteria:

1. Age 20-65 years old;
2. ASA classification is grade I-III;
3. Elective surgery is proposed
4. BMI of 19-30 kg/m2;
5. Patients who agreed to enroll in this study voluntarily

Exclusion Criteria:

1. Those who are known to be allergic to the drug ingredients in this study and their allergic constitution;
2. Allergic history of general anesthesia drugs, opioid drugs, non-steroidal drugs;
3. History of neurological diseases; History of chronic pain; Drug and alcohol addiction; A long history of opioid use; Opiates were given 48 hours before surgery;
4. ASA rating of IV or V;
5. Coronary heart disease, bronchial asthma, severe hypertension, severe blood system dysfunction, liver and kidney function, electrolyte abnormalities;
6. History of gastrointestinal disease (peptic ulcer, Crohn's disease, ulcerative colitis);
7. Respiratory insufficiency, respiratory failure;
8. Patients who refused to use intravenous PCA for analgesia;
9. Pregnant or lactating women;
10. BMI\<18 kg/m2 or BMI\>30kg/m2;
11. Poor compliance, unable to complete the experiment according to the study plan;
12. Participants who have participated in clinical trials of other drugs within the last 4 weeks;
13. Any circumstances deemed unsuitable for inclusion by the researcher for any reason.
Physician Use of Non-English Language Skills in Cancer Care

The purpose of this study is to test a method for analyzing interactions between patients and doctors, the Roter Interaction Analysis System (RIAS). The RIAS measures the quality of communication between patients and their cancer doctors.


Eligibility Criteria:
Inclusion Criteria:

* is a English or Spanish-speaking patient
* between the ages of 21-80 years old
* has a new diagnosis of any type of cancer (diagnosed within the past 4 months), or has a recurrence of either breast, colon or lung cancer (recurrence diagnosed within the past 4 months)
* scheduled to have surgery or begin chemotherapy and/or radiation therapy within the next 2 months

Oncology clinician Inclusion:

* provides care to LEP patients
* has MD, DO, RN, NP or PA degree
* is between the ages of 21-80

Exclusion Criteria:

* is unable to provide informed consent in either English or Spanish
Robotic Assisted vs Custom Made Total Knee Arthroplasty

The goal of this clinical trial is to compare Robotic Assisted, functionally aligned vs Custom Made Total Knee Arthroplasty in patients with knee osteoarthritis. The main questions it aims to answer are:

* Which implant/philosophy yields better clinical outcomes?
* Which implant/philosophy yields better satisfaction?
* Which system is more OR efficient? Participants will be followed for 2 years postoperatively.


Eligibility Criteria:
Inclusion Criteria:

* - The patient is a male or non-pregnant female between the ages of 40 and 90 years
* The patient requires a primary total knee replacement
* Patient is deemed appropriate for a cruciate retaining knee replacement
* The patient has a primary diagnosis of osteoarthritis (OA)
* The patient has intact collateral ligaments
* The patient is able to undergo CT scanning of the affected limb
* The patient has signed the study specific, ethics-approved, informed consent document
* The patient is willing and able to comply with the specified pre-operative and post-operative clinical and radiographic evaluations

Exclusion Criteria:

* - The patient has a history of total, unicompartmental reconstruction or fusion of the affected joint
* Patient has had a previous osteotomy around the knee
* The patient is morbidly obese (BMI \> 41)
* The patient has a deformity which will require the use of stems, wedges or augments
* The patient has a varus deformity ≥ 15°
* The patient has a valgus deformity \>3°
* The patient has a neuromuscular or neurosensory deficiency, which would limit the ability to assess the performance of the device
* The patient is unable to speak German
* The patient is pregnant
Randomized Control Trial of Second Stage of Labor

The hypothesis of this study is that extending the second stage of labor beyond current American College of Obstetricians and Gynecologists suggestions can reduce the cesarean delivery rate. The cesarean delivery rate in the United States is around 30 percent. This is a number that continues to be increasing over the last few decades and will continue to climb. Each subsequent cesarean section puts the mother and baby at increased risk for postpartum hemorrhage, bowel and bladder injury, abnormal placentation, febrile morbidity and death. The most common reason for a cesarean delivery is a repeat cesarean delivery. One way to reduce this number is to prevent the first cesarean delivery. The aim of this study is evaluate if extending the second stage of labor affects the cesarean delivery rate and subsequent perinatal morbidity.

1. Consent at the time of admission or in the office
2. 2nd stage starts at full dilation
3. Randomization occurs at 2 hours without epidural or 3 hours with epidural, stratified by epidural status
4. Randomization scheme is according to a predetermined computer-generated block randomization scheme with block sizes of 6,8 and12 (random blocks).
5. Sequentially numbered and sealed opaque envelopes prepared according to the randomization scheme and delivered to a secure container in labor and delivery suite to maintain concealed treatment allocation.
6. At the 3 hour mark, the next number envelope is pulled and opened by the physician/nurse to reveal the designated group. At this point the patient is considered randomized.
7. Provider preference for cesarean delivery, operative vaginal delivery, continued pushing, with intention-to-treat analysis
8. Those that require cesarean delivery - usual perioperative management
9. Early termination criteria: emergency cesarean delivery, category 3 fetal heart tracing

Eligibility Criteria:
Inclusion Criteria:

* Nulliparous women
* singleton pregnancies
* cephalic presentation
* 36.0-41.6 weeks
* age 18 and older

Exclusion Criteria:

* Category 3 fetal heart tracing
* major congenital anomalies
* multiples
* planned cesarean delivery
* intrauterine fetal demise
* Trial of labor after cesarean