cyrilzakka/clinical-trials huggingface dataset:
Effects and Mechanism of Prolonged Continuous Theta Burst Stimulation on Neuropathic Pain

Neuropathic pain (NP) is one type of refractory chronic pain condition,medical treatments for NP is limited because of its poorly response. A noninvasive brain-stimulation method called transcranial magnetic stimulation (TMS) has garnered interest as an alternative treatment for intractable NP potentially through inducing therapeutic brain plasticity.Indeed, high-frequency (≥ 5 Hz) Repetitive TMS (rTMS) over the primary motor cortex (M1) is suggested to be able to reduce neuropathic pain in randomized controlled studies.Overall, the clinical application of rTMS in chronic pain is still limited by the response rate,the investigation of rTMS protocols is important for improving rTMS analgesia. Theta burst stimulation (TBS) mimics the bursts of neuronal firing which results in robust long-term potentiation. Continuous TBS (cTBS) is designed to decrease excitability, whereby prolonged cTBS (pcTBS, i.e. multiple cTBS being delivered continuously) has recently been demonstrated to increase excitability. More importantly, pcTBS was found to have comparable or even better analgesic effects than standard 10 Hz rTMS. These findings together call for more studies to validate the analgesic efficacy of pcTBS.

In this study, the investigators aim to assess and compare the efficacy of prolonged continuous theta burst stimulation (pcTBS) with 10HZ rTMS in NP patients.

The investigators designed a randomized, double-blind, sham-controlled study at 1 center. fifty NP patients were randomly assigned to 3 groups. A series of 5 daily pcTBS(1200 pulses/session) or 10-Hz rTMS (1500 pulses/session) of primary motor cortex (M1) or sham stimulation was applied to each patients.

Eligibility Criteria:
Inclusion Criteria:

* (1)woman or man over 18 and under 70 years old; （2）pain fulfilling the criteria for probable or definite peripheral neuropathic pain ; (3) pain for at least 3 months, continuous pain (at least four days per week), at least moderate intensity (≥ 4/10 assessed by VAS) ; (4) stable pharmacological treatment for pain at least 2 weeks before inclusion; (5) able to cooperate in completing questionnaire.

Exclusion Criteria:

* (1) Any clinically significant or unstable ongoing medical or psychiatric disorder including major depression; (2) History of substance abuse (alcohol, drugs); (3) Past treatment with repetitive transcranial magnetic stimulation (rTMS); (4) Contraindications to rTMS (previous severe head trauma or neurosurgical intervention, past or current epilepsy, active brain tumor, intracranial hypertension, implanted ferromagnetic devices, e.g., cardiac pacemaker, neurostimulator, or cochlear implants); (5) other type of pain more severe than neuropathic pain; (6) Any difficulty to fill out questionnaires (due to language or cognitive problems); (7) impossibility to be followed during the time course of the study;
Current Scope of Practice of Today's Hepatopancreatobiliary Surgeons: A Survey of AHPBA Members

The development of multiple training pathways to foster competent hepatopancreatobiliary (HPB) surgeons has led to a diverse group of surgical subspecialists. The objective of our study was to determine the current scope of practice of today's HPB surgeons. An online survey was sent to all the Americas Hepato-Pancreato-Biliary Association's members to assess the current scope of practice of today's HPB surgeons. We found very few surgeons run a solo HPB practice, so changes may be needed in HPB training to provide uniformity and enhance the scope of practice for future HPB surgeons.


Eligibility Criteria:
Inclusion Criteria:

* Member of Americas Hepato-Pancreato-Biliary Association

Exclusion Criteria:

* No or non-functioning email address
A Study Using Tacrolimus, Sirolimus and Bortezomib as Acute Graft Versus Host Disease (GVHD) Prophylaxis in Allogeneic Peripheral Blood Stem Cell (PBSC) Transplantation

The purpose of this study is determine the highest dose of bortezomib, a new drug for graft-versus host disease prevention, that can be given in combination with sirolimus and Tacrolimus, without causing severe side effects. This research is being done because there is no treatment that is 100% effective in preventing graft versus host disease.

The goals of this study are to:

1. Collect peripheral blood stem cells (PBSCs) from donors for transplant.
2. Determine the largest possible dose of bortezomib that can be given to recipients with various blood cancers in a safe manner.
3. Monitor the recipient for risk of infection or side affects associated with the transplant.
4. Monitor the recipient for increased immunity following transplantation.


Eligibility Criteria:
Inclusion Criteria:

* Undergoing myeloablative peripheral blood stem cell transplantation
* Have an HLA matched-related or matched-unrelated donor (9/10 antigen or allelic mismatch or 10/10 HLA match permitted).
* Hematological malignancy including patients with: AML, ALL, NHL, Hodgkin's Disease, CLL, CML, MDS and Multiple Myeloma
* Meeting institutional standard criteria for allogeneic PBSC transplantation

Exclusion Criteria:

* Patient has \>Grade 2 peripheral neuropathy within 14 days before enrollment.
* History of autologous or allogeneic transplantation
* Evidence of HIV seropositivity
* Evidence of active infection
* Patients with cardiac dysfunction as described in the protocol
* Patients with hypersensitivity to bortezomib, boron or mannitol
Medication Review in Patients on Anti-parkinson Therapy

To identify patients within the community taking anti-parkinson medications in whom the diagnosis of Parkinson's disease is incorrect and to supervise and clinically monitor the withdrawal of anti-parkinson medications in this patient group

Step 1 - Practice based pharmacist and medical review using database search for the following:

* Anti-parkinson drug therapy (excluding anticholinergic monotherapy).
* Disease codes to identify Parkinson's disease and parkinsonism, and exclude other diagnoses where anti-parkinson therapy may be used, although both are expected to be very small numbers (pituitary tumour, restless leg syndrome)
* To identify the duration of parkinsonism from the date of entry of the disease code.
* Pharmacy re-fill data to identify intermittent usage of treatment as an indicator of it being unlikely that the patient has idiopathic or dopa responsive parkinsonism.
* To identify patients on monotherapy with anti-parkinson therapy e.g. Selegiline for a prolonged duration as this is likely to suggest an alternative diagnosis.
* To record drug dosage over time, e.g. on an annual basis, again to identify whether patients fit in with the expected rates of change for degenerative parkinsonism where increasing combinations of drugs at higher doses are used over time.

Step 2 - Review of case records:

· Parkinson's disease nurse specialist and medical review of case records to identify additional clinical features of the condition and assist in identifying cases where it appears likely that anti-parkinson drug treatment is not helping the patient's condition.

Step 3 - Specialist out-patient review and follow-up:

· Invitation to the patient to attend the combined neurology/medicine for the elderly movement disorder clinic service where scoring against diagnostic clinical criteria would be undertaken, and where appropriate tapering of anti-parkinson therapy gradually under continued specialist observation.

Eligibility Criteria:
Inclusion Criteria:

Patients on anti-parkinson medication who:

* Have been on monotherapy for a prolonged period, or
* Use anti-parkinson medications intermittently, or
* Do not have the expected change in medication over time in keeping with degenerative Parkinson's disease.

Exclusion Criteria:

* Patients on anti-parkinson medication for reasons other than Parkinson's disease.
* Patients with significant co-morbidity (end stage liver, cardiac or renal disease).
Assessment of Pain in People With Thalassemia

Thalassemia is an inherited blood disorder that can result in mild to severe anemia. People with thalassemia often experience pain, but the exact sources and prevalence of pain remain unknown. This study will examine the prevalence and severity of pain in people with thalassemia who are treated with regular blood transfusions and people with thalassemia who are not treated with regular blood transfusions.

Thalassemia is an inherited blood disorder in which the body makes an abnormal form of hemoglobin-the protein in red blood cells that carries oxygen. People with thalassemia often experience fatigue, shortness of breath, and pain. Recent medical advances in treating people with thalassemia who receive regular blood transfusions-a standard procedure that refreshes the healthy red blood supply-have resulted in increased life spans for these people. However, with the extended life spans have come additional issues, including pain. There have been no previous research studies that have examined pain levels in people with thalassemia, and as a result, the sources and prevalence of pain remain unknown. The purpose of this study is to assess the prevalence and severity of pain, common pain sites, and the impact of pain on functioning and well-being in people with thalassemia who receive regular blood transfusions and people with thalassemia who do not receive regular blood transfusions.

This study will enroll people with transfusion-dependant thalassemia and people with non-transfusion-dependant thalassemia. At a baseline study visit, participants will complete a demographic questionnaire and a pain assessment questionnaire. At Months 3, 6, and 9, study researchers will telephone participants to go over the same pain assessment questionnaire again.

Eligibility Criteria:
Inclusion Criteria:

* Thalassemia, as documented by clinical diagnosis, including the following:

  1. B-thalassemia (intermedia or major)
  2. Hgb H disease
  3. Hgb H with non-deletional mutations (e.g., Hgb H Constant Spring)
  4. E-B-thalassemia
  5. Homozygous alpha thalassemia
  6. Other thalassemic conditions not explicitly excluded
  7. Thalassemia intermedia due to heterozygous B mutation with an alpha excess
* Participants can be of any race, ethnicity, and either gender.

Exclusion Criteria:

* Thalassemia trait (i.e., single recessive B gene mutation, 2 gene alpha mutation) and thalassemia Hgb S, C, or D compound heterozygotes
* Unwillingness or inability to complete the Brief Pain Inventory (BPI) on a quarterly basis
* Has had a successful bone marrow transplant
Comparing Angiomax to Heparin With Protamine Reversal in Patients OPCAB

The purpose of this study is to examine the safety and efficacy of Angiomax as an alternative anticoagulant to heparin with protamine reversal in patients undergoing off-pump coronary artery bypass graft surgery.


Eligibility Criteria:
Inclusion:

* Provide written informed consent before initiation of any study related procedures.
* Be at least 18 years of age.
* Be accepted for elective off-pump coronary artery bypass graft (CABG) surgery without concomitant cardiac surgical procedures.
* \< 4 planned Coronary Artery Bypass Grafts

Exclusion:

* Any prior Cardio-Thoracic Surgical procedures requiring median sternotomy
* Confirmed pregnancy - baseline urine or serum pregnancy test (if woman of childbearing potential).
* Cerebrovascular accident within 6 months before randomization, or any cerebrovascular accident with residual neurological deficit.
* Intracranial neoplasm, arteriovenous malformation, or aneurysm.
* Dependency on renal dialysis or creatinine clearance \<30mL/min.
* Ongoing treatment with warfarin (or other oral anticoagulants) at the time of randomization. Patients previously treated with warfarin may be enrolled if warfarin therapy can be safely discontinued and baseline INR is \<1.3 times control in the absence of heparin therapy.
* Known allergy to Angiomax or hirudin derived drugs, or known sensitivity to any component of these products.
* Patients receiving clopidogrel within the previous 5 days of randomization.
* Patients receiving a glycoprotein IIb/IIIa inhibitor within 48 hours if abciximab (ReoPro) or within 24 hours if eptifibatide (Integrilin) and tirofiban (Aggrastat) of randomization
* Patients receiving lepirudin or argatroban within the previous 24 hours of randomization.
* Patients receiving low molecular weight heparin (LMWH) or thrombolytics within the previous 12 hours or unfractionated heparin within 30 minutes of randomization.
* Patients with active or prior history of heparin-induced thrombocytopenia (HIT)/heparin-induced thrombocytopenia and thrombosis syndrome (HITTS)\*.
* Participation in other clinical research studies involving the evaluation of other investigational drugs or devices within 30 days of randomization.
* Refusal to undergo blood transfusion should it become necessary.
* Any other disease or condition, which, in the judgment of the investigator would place a patient at undue risk by being enrolled in the trial or inability to comply with study requirements.
Monitored Saturation Post-ICU

The overall aim with this project is to describe the correlation between measured and charted saturation after intensive care and also describe the saturation-pattern in these patients. The investigators will also correlate post-ICU desaturations measured as oxygen denaturation index and complications to pre-ICU obstructive sleep apnea and the STOP BANG screening questionnaire.


Eligibility Criteria:
Inclusion Criteria:

* \>18 years of age.
* Admitted to the Central Intensive Care Unit (CIVA)
* Signed informed conscent by the patient or a relative

Exclusion Criteria:

-
Connective Tissue Massage With Fibromyalgia

The aim of the study was to examine the effectiveness of clinical pilates exercises and connective tissue massage in individuals with Fibromyalgia (FM). 32 women were randomly divided into two groups as intervention (n=15, mean age=48.80±7.48) and control (n=17, mean age=55.64±7.87). While connective tissue massage and clinical pilates exercises were applied to the intervention group, control group were applied only clinical pilates exercises.According to our results, connective tissue massage increased the effectiveness of clinical pilates exercises in individuals with FM.


Eligibility Criteria:
Inclusion Criteria:(a) having FM diagnosis according to American College of Rheumatology 2016 criteria, (b) being a women, (c) aged 20-65. (d) being stable in drug use for at least 6 months or more. (e) being volunteer to participate in this study.

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Exclusion Criteria:(a) have been exercising regularly for the past three months, (b) the presence of uncontrolled cardiopulmonary disease, (c) the presence of orthopedic, neurological or mental problems that may prevent exercise, (d) having undergone any surgery in the last six months for both groups, (e) pregnancy, (f) presence of malignancy, (g) not being able to participate in at least 75% of the training.

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Hatha Yoga for Smoking Cessation

The purpose of this study is to determine whether Hatha Yoga can improve the chances of a successful smoking quit attempt.

While many smoking cessation interventions have been studied, even the most successful interventions result in less than 40% abstinence from smoking at 6 months. Most people attempt to quit multiple times before maintaining long-term abstinence from tobacco. Research into interventions to improve quit rates and decrease smoking prevalence is a high priority for multiple organizations. Yoga is an attractive non-pharmacological option because it can be used safely during pregnancy and lactation, can be combined with other pharmacologic and non-pharmacologic treatments, and can be continued well past the smoking cessation date to combat withdrawal symptoms and cravings. There is a critical need for innovative and effective methods for tobacco control that focus on both prevention and cessation.

This project will be broken into two stages. The first stage will aim to pilot test yoga techniques for feasibility and acceptability. Recruitment and retention strategies will be tested and participant satisfaction will be evaluated. Preliminary measures of smoking abstinence and withdrawal symptoms will be conducted.

The second stage of this study will be a randomized trial to compare smoking abstinence with cognitive behavioral therapy (CBT), CBT + yoga, or yoga alone.

Eligibility Criteria:
Inclusion Criteria:

* Age 19 years or older
* Smoker of 5 or more cigarettes per day
* Willing and physically able to participate in yoga
* Not currently practicing Hatha yoga.

Exclusion Criteria:

* Use of smokeless tobacco
Determining Depression Treatment Preferences of Low-Income Latinos in Primary Care Settings

This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos.

Depression is a serious illness that is difficult to diagnose and treat, especially in populations that underutilize mental health services. The Latino population is one such group. Accommodating patient preferences for care, provider capacities, and administrator priorities is essential to the development of effective depression care interventions that are sustainable in public sector systems. However, little is understood regarding the depression treatment preferences of low-income Latinos who have not received quality depression care and who may not feel that they can voice their opinions about their health care. In addition, little is known about the preferences, capabilities, and priorities of providers and administrators in primary care clinics. This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos. The study will also evaluate the effectiveness of various treatments in reducing depression.

Following baseline assessments of depression treatment preferences and resources, participants in this open label study will be randomly assigned to receive collaborative care either immediately or after a waiting period. Individuals assigned to receive immediate care will undergo treatment for 12 weeks. Other participants will receive treatment at a later time. All participants will have the option to receive one of the following treatments: (1) medication management from the Depression Care Specialist (DCS) and antidepressant medication from their primary care provider (PCP); (2) cognitive-behavioral therapy from the DCS; or (3) a combination of both treatments. Depression treatment outcomes and preferences will be measured post-intervention. Provider and administrator preferences will also be measured post-intervention and potential strategies for implementing patient-centered depression care programs will be identified.

Eligibility Criteria:
Inclusion Criteria:

For Participating Patients:

* Attending one of the study clinics for primary care
* English or Spanish-speaking
* Screens positive for major depressive disorder or dysthymia

For Providers:

* All primary care providers providing at least one day of services at one of the study clinics

For Administrators:

* Administrative, medical, and nursing directors from each study site and directors of affiliated local mental health clinics

Exclusion Criteria:

For Participating Patients:

* Acutely suicidal
* Screens positive for bipolar disorder, psychotic disorder, or cognitive impairment
The Sleep and Teamwork in EMS Study

More than half of Emergency Medical Services (EMS) workers report work-related mental and physical fatigue. Odds of injury among fatigued EMS workers are nearly double that of non-fatigued workers. There is a compelling need to reduce fatigue among EMS workers, yet few EMS organizations have a formal fatigue management program and many may not be cost-effective or evidence-based. This trial addresses national goals of the National Occupational Research Agenda (NORA) and tests a novel approach to fatigue risk management that is easily scalable to large workforces and low-cost for employers of shift workers.

The investigators will test an enhanced version of our SleepTrackTXT pilot intervention - Sleep and Fatigue Treatment in EMS (SaFTiE) - in a two-arm parallel cluster-randomized design of EMS agencies. Our unit of randomization will be the EMS agency, with the intervention deployed as a Fatigue Risk Management Program that can be integrated into an agency's existing program. During the active intervention phase, the investigators will use SaFTiE and an attention placebo control (APC) group to test the specific effect of our multi-component intervention on EMS worker fatigue and sleep health.

Eligibility Criteria:
Inclusion Criteria:

* 18 years or older
* Live in United States (including Hawaii and Alaska)
* Licensed / certified EMS clinician
* Currently work in shifts
* Do at least one clinical shift per week
* Own a smartphone
* Willing to answer monthly surveys and daily text-messages,

Exclusion Criteria:

* Exclude EMS personnel who are primarily administrative with non-clinical duties
* Are restricted from using personal smartphone during periods of work
* Do not own a smartphone capable of running the study mobile app
Analysis of the Impact of the Undernutrition on the Cerebral Infarct in Thrombolized Patients

Many clinical trials show that 30 to 50 % of the hospitalized patients are undernourished in various degrees. This prevalence didn't change since 15-20 years The fact is that the present undernutrition in the admission deteriorates during the hospitalization.

Besides, the cerebral vascular accident (AVC) complicates the first days, in at least 50 % of the cases, the disorders of the gulp, which are a risk factor of acquired undernutrition. The nutrition holds an important place in the therapeutic coverage of the AVC. Nevertheless, the link between the undernutrition the entrance and the evolution of the AVC is at the moment only little known. The purpose is to study the impact of the undernutrition in the entrance to the hospital (undernutrition previous to the AVC), on the gravity and the evolution


Eligibility Criteria:
Inclusion Criteria:

* patient admitted in hospital for vascular cerebral accident in 2015
* thrombolytic treatment

Exclusion Criteria:

* no thrombolytic treatment
* transcient ischaemic attack
Single-cell Landscape of BALF in Patients With Severe ARDS and CARDS

The goal of this observational study is to learn about the effect of steroid therapy in patients with COVID-19 ARDS. The main questions it aims to answer are:

* Differences between patients with COVID-19 ARDS before and after steroid treatment in BALF single cell landscape, as well as patients with different prognosis.
* Differences between COVID-19 and non COVID-19 ARDS patients in BALF single cell landscape.

Participants will Choose whether to use or not to utilize steroid treatment based on conditions.

Collect BALF from COVID-19 and non-COVID-19 ARDS patients both before and during remission, then perform single-cell sequencing.

Eligibility Criteria:
Inclusion Criteria:

* Severe ARDS patients

Exclusion Criteria:

* None