cyrilzakka/clinical-trials huggingface dataset:
Significant Pathology Associated With Crossed Leg Sign

By determining the correlation of a Crossed Leg Sign with signifcant pathology, a clinician would then be able to use this correlation to risk stratify his/her patients for significant pathology.

By determining the correlation of a Crossed Leg Sign with signifcant pathology, a clinician would then be able to use this correlation to risk stratify his/her patients for significant pathology. Therefore, by determining the sensitivity and specificity of this physical exam finding, the clinician would have a better idea of the patients clinical management, including diagnostic testing and ultimate treatment of the patient. Crossed Leg Sign will be defined in this study as: any patient observed in the Emergency Department with sustained crossed legs. To my knowledge, crossed legs have never been evaluated in regards to it's correlation with significant pathology. This could potentially add another physical exam finding to be used by the clinician.

Eligibility Criteria:
Inclusion Criteria:

* Any patient observed in the Emergency Department with sustained crossed legs.

Exclusion Criteria:

* Any patient not observed to have sustained crossed legs and is not being used as a control.
Active Versus Expectant Management of the Third Stage of Labor

The purpose of this study is to determine if giving oxytocin immediately after delivery causes less bleeding, transfusion needs and hastens delivery of placenta.

Postpartum hemorrhage is the leading cause of maternal mortality worldwide. During the third stage of labor, the period following the delivery of the baby until the delivery of the placenta, the patient is at increased risk for blood loss. Controversy remains as to the optimal method of delivering the placenta. Two predominant, yet very different, strategies have emerged. Expectant management is most commonly used in the United States. This includes waiting for signs of placental separation, followed by maternal pushing to expel the placenta. Then uterotonic agents are administered,usually oxytocin. This is in contrast to active management, which consists of uterotonic administration immediately following delivery of the fetus, in association with gentle umbilical cord traction and fundal massage. This is the predominant practice in the United Kingdom, where the uterotonic agents of choice are either oxytocin alone, or a combination of oxytocin and ergometrine.

Comparison: Active management with oxytocin to expectant management of the third stage of labor on the effect of postpartum hemorrhage.

Eligibility Criteria:
Inclusion Criteria:

* Singleton gestation
* Cephalic presentation
* \>37 weeks gestation
* \>16 years of age

Exclusion Criteria:

* Multiple gestation
* Breech presentation
* Blood dyscrasias
* Multiparous females Para \>5
* Placenta previa
* Patients on anticoagulants
* Previous history of postpartum hemorrhage
* IUFD
* Non-reassuring fetal heart rate pattern
Exercise and Steroid in Knee Osteoarthritis

Osteoarthritis (OA) of the knee is a very common chronic joint disorder associated pain and disability. As no cure exists, management aims to reduce pain, improve function, and enhance quality of life. The recommended hierarchy of management should consist of exercise in first line, then the add-on of drugs if necessary, and ultimately, if necessary, surgery.

The effect size of exercise therapy is of the same magnitude as most pharmacological treatments but is often without adverse effects. Local pharmacological treatment of the afflicted knee joint is recommended by means of intra-articular injections of corticosteroids, which is considered as a standard medical treatment of knee OA and are included in established guidelines for management of knee OA. While the two treatment approaches have been investigated separately in numerous clinical trials, the efficacy of a combined pharmacological and non-pharmacological approach is not known, despite the high rank of such combined treatment approach on the recommended hierarchy of management.

The purpose of this study is to assess the effects of exercise therapy in combination with intra-articular corticosteroid injections on patient reported pain and function in patients with knee OA.

The hypothesis is that the combined treatment approach (exercise therapy preceded by intra-articular injection of corticosteroid) enhances the clinical outcome compared to exercise therapy preceded by a placebo injection.


Eligibility Criteria:
Inclusion Criteria:

* age 40 years or above
* clinical knee osteoarthritis verified by radiography
* pain during level walking of at least 40 mm on a 0-100 mm visual analog scale
* clinical signs of local inflammation
* body mass index between 20 and 35

Exclusion Criteria:

* Exercise therapy within 3 months
* Intraarticular corticosteroid within 3 months
* Counter indications to exercise
* Counter indications to corticosteroid
* pregnant or breast feeding
* Auto immune disease
* Planned surgery in the study period
* significant cardiovascular disease
* significant neuroloigal disease
* significant psychiatric disease
* regional pain syndromes (e.g. fibromyalgia)
* spinal nerve root compression syndromes
Conservative Surgery for Placenta Accreta

A stepwise surgical approach for conservative management of placenta previa accreta.

a stepwise surgical approach for conservative management of placenta previa accreta to preserve women's uterus and to evaluate the efficacy and safety of this approach in controlling postpartum hemorrhage including intrapartum hemorrhage associated with conservative management.

Eligibility Criteria:
Inclusion Criteria:

* Any age.
* Any parity.
* Previous one or more cesarean delivery.
* Placenta previa accreta diagnosis confirmed by gray scale \& color flow Doppler ultrasound in 3rd trimester. All participants had undergone abdominal ultrasound showing placenta previa anterior completely covering the internal os, with criteria suggestive of invasion by U/S

Exclusion Criteria:

* women with medical disorder
* women with bleeding tendency
Neurofunctional Correlates of the Behavioral Modifications Associated With Tachidino in Children With Developmental Dyslexia

Developmental dyslexia (DD) is the most common learning disorder. Multiple cognitive and sensory domains contribute to the etiology of DD and develop before reading acquisition. Atypical brain functional responses and structural features have been found in the reading developing circuitry. Treatments addressing visual-spatial attention and motion perception (Visual Attention Training; VAT) are among the most effective interventions in Italian children with DD. The VAT seems to improve the efficiency of the visual attention system and the magnocellular (M) pathway which is crucial for learning to read. Evidence for impaired M function in subjects with DD in the visual striate and extra-striate cortex have been reported. How these treatments affect the brain functionality is still not clear. Since DD has a neurobiological basis, it is important to deeply investigate atypical functional responses and structural features in reading-related areas, and to understand how treatments operate at the neuronal level. A growing number of studies investigates structural and functional measures in neurodevelopmental disorders by using high-resolution MRI at high field (3T and 7T). Similarly, several studies examine the effects of different types of reading training upon brain activity. Better understanding of the relationship between structural/functional abnormalities and DD could disentangle the causes of reading difficulties and helps in developing effective treatments.

The significance of this study is twofold: 1) NEURAL CORRELATES OF TREATMENT: The investigators expect TACHIDINO to specifically affect the underlying neurophysiological functioning which influences reading skills in children with DD; 2) BRAIN SIGNATURES: As integrated multi-domain data (behavioral and brain imaging) are complementary to each other, they could enhance the possibility to find unique treatment/brain functioning combinations to evaluate the effectiveness of intervention and to predict the treatment response.


Eligibility Criteria:
Inclusion Criteria:

* Reading skills (both accuracy and speed) below -2.00 standard deviation

Exclusion Criteria:

* No ADHD
* No contraindications to magnetic resonance
A Study of Neoadjuvant/Adjuvant Durvalumab for the Treatment of Patients With Resectable Non-small Cell Lung Cancer

This is a Phase III, randomized, double-blind, placebo-controlled, multi-center international study assessing the activity of durvalumab and chemotherapy administered prior to surgery compared with placebo and chemotherapy administered prior to surgery in terms of pathological complete response.


Eligibility Criteria:
Inclusion Criteria:

* Age ≥18 years
* Newly diagnosed and previously untreated patients with histologically or cytologically documented NSCLC with resectable (Stage IIA to select \[ie, N2\] Stage IIIB) disease
* World Health Organization (WHO)/ECOG PS of 0 or 1 at enrollment
* At least 1 lesion, not previously irradiated, that qualifies as a RECIST 1.1 Target Lesion (TL) at baseline
* No prior exposure to immune-mediated therapy including, but not limited to, other anti-CTLA-4, anti-PD-1, anti-PD-L1, and anti-PD-L2 antibodies, excluding therapeutic anticancer vaccines
* Adequate organ and marrow function
* Confirmation of a patient's tumour PD-L1 status
* Provision of sufficient tumour biopsy sample for evaluation and confirmation of EGFR and ALK status
* Planned surgery must comprise lobectomy, sleeve resection, or bilobectomy

Exclusion Criteria:

* History of allogeneic organ transplantation
* Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease, diverticulitis, systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome)
* History of another primary malignancy
* History of active primary immunodeficiency
* Active infection including tuberculosis hepatitis B and C, or human immunodeficiency virus
* Deemed unresectable NSCLC by multidisciplinary evaluation
* Patients who have pre-operative radiotherapy treatment as part of their care plan
* Patients who have brain metastases or spinal cord compression
* Stage IIIB N3 and Stages IIIC, IVA, and IVB NSCLC
* Known allergy or hypersensitivity to any of the study drugs or excipients
* Existence of more than one primary tumour such as mixed small cell and NSCLC histology
* Patients whose planned surgery at enrollment includes any of the following procedures: pneumonectomy, segmentectomies, or wedge resections
* Patients with a documented test result confirming the presence of EGFRm or ALK translocation
Prediction of Hypotension Using Perfusion Index and Pleth Variability Index After Spinal Anesthesia for C/S

Spinal anesthesia for caesarean section is associated with a decrease in systemic vascular resistance and cardiac output and may cause hypotension in a significant portion of the parturients. Hypotension during delivery may cause maternal and fetal complications. If parturients who are likely to develop hypotension after spinal anesthesia can be identified before surgery, anesthesiologists would have opportunity to take measures such as prophylactic vasopressor administration.

Perfusion index (PI) measured by pulse oximetry reflects vasomotor tone which affects the degree of hypotension after spinal anesthesia. This is a non-invasive method of assessing the relative vascular tone with the use of pulse oximeter which calculates the ratio of pulsatile versus the non-pulsatile component of the blood flow. A lower PI indicates greater peripheral vasomotor tone.

Pleth variability index (PVI) is calculated using maximum and minimum values of perfusion index during respiratory cycles. PVI is one of the dynamic indices that can predict fluid responsiveness.

The aim of this study is to investigate whether the PI and PVI values at different patient positions can predict hypotension during caesarean section.


Eligibility Criteria:
Inclusion Criteria:

* singleton parturient
* planned for elective LSCS under spinal anesthesia

Exclusion Criteria:

* gestational age \< 36 weeks
* emergency cases
* placenta previa, pre-eclampsia
* BMI\>40
* Reynauld disease
* patient refusal
* cardiovascular disease
A Study of BIND-014 in Patients With Urothelial Carcinoma, Cholangiocarcinoma, Cervical Cancer and Squamous Cell Carcinoma of the Head and Neck

BIND-014 (docetaxel nanoparticles for injectable suspension) is being studied in patients with advanced urothelial carcinoma, cervical cancer, cholangiocarcinoma or carcinomas of the biliary tree and squamous cell carcinoma of the head and neck.

Ferumoxytol imaging will also be investigated at US sites as an exploratory endpoint.


Eligibility Criteria:
Inclusion Criteria:

1. Diagnosis of advanced urothelial carcinoma, cervical cancer, cholangiocarcinoma or carcinomas of the biliary tree or squamous cell carcinoma of the head and neck.
2. Progressive disease after ≥ 1 prior chemotherapy regimen.
3. Patients with brain metastases are eligible if asymptomatic and neurologically stable for at least 4 weeks and are not taking any medications contraindicated
4. Chemotherapy must have been completed at least 4 weeks prior to initiation of study medication
5. ECOG performance status 0-1
6. Tumors must have measurable disease as per RECIST (version 1.1);
7. Female or male, 18 years of age or older
8. Adequate organ function
9. Life expectancy of \> 3 months

Exclusion Criteria:

1. Current treatment on another therapeutic clinical trial
2. Prior treatment with docetaxel within 6 months of enrollment
3. Stage II, III or IV cardiac failure
4. Carcinomatous meningitis
5. Ongoing cardiac dysrhythmias
6. Peripheral neuropathy
7. Serious concomitant conditions
8. Pregnant or breast feeding
9. Known sensitivity to ferumoxytol
10. Hypersensitivity to polysorbate 80
The Application of Smart Health Management System on Home-Care for Elderly Patients

Aims: The purposes of this study are

1. to create a smart living environment with home care system using GPS and cloud-based services for elderly people.
2. to improve the home care system from user feedback and recommendations.

Methods: Participants (n = 50) will be recruited from geriatric clinics in National Taiwan University Hospital (NTUH) main hospital and its Beihu branch. Enrollment criteria include: aged 60 or older, living alone or with one companion (not children), taking at least one chronic medications, having the capability to understand the study and complete the study, willing to participate into the study with telephone follow ups.

Background: At present, with the changing of the society structure, the ratio of nuclear family and older people who live alone is arising. Therefore, making care system fit for aging population to create a appropriate healthcare is cricial. Thus, the investigators have established a smart home health care system, SilverLink to improve resident quality for older adults living alone.

Aims: The purposes of this study are

1. to create a smart living environment with home care system using GPS and cloud-based services for elderly people.
2. to improve the home care system from user feedback and recommendations.

Methods: Participants (n = 50) will be recruited from geriatric clinics in NTUH main hospital and its Beihu branch. Enrollment criteria include: aged 60 or older, living alone or with a companion (not children), taking at least one chronic medications, having the capability to understand the study and complete the study, willing to participate into the study with telephone follow ups.

This study includes two sessions:

1. set up the healthcare system, with home GPS and sensors. The investigators will stick small sensors on fridge door, pillbox, pendant...for automatic detection of the frequency of food intake, take medicine and get out of home....Also, the investigators will use accelerometer to track the body movement for older adults.
2. use APP for blood pressure (BP) or other measurements data tracking. The investigators develop an APP system to help older adults to log in and track their dairy physiological measurements. (optional)

Anticipated results:

Provide feasibility data for system to allow future modifications of the system.

Improve older adults' life quality and satisfaction. Under the integration of this healthcare technology and the central communication medical services may create a smart healthcare network, which is not only the effectiveness on reducing medical costs, but also will provide a convenient connection between living alone older adults and their family.

Eligibility Criteria:
Inclusion Criteria:

* aged 60 or older,
* living alone or with a companion (not children),
* taking at least one chronic medications,
* having the capability to understand the study and complete the study,
* willing to participate into the study with telephone follow ups.

Exclusion Criteria:

* If patients were unable to meet at least the inclusion criteria above.
Clinical Evaluation of the AmniSure ROM Test

To show that having less qualified personnel (non-Laboratory trained professionals) perform the test yields the same result as if a Laboratory trained professional performed the test.

The main goal of this study is to show that when performed by less qualified personnel, the AmniSure® ROM Test is so simple and accurate that the likelihood of erroneous results by the Intended-User is negligible and that the test poses no unreasonable risk of harm to the patient if performed incorrectly.

Eligibility Criteria:
Inclusion Criteria:

* Subjects must be pregnant.
* Subjects must be between 18 and 50 years of age and have a gestational age of 11.0-42.0 weeks.
* Subjects reporting suspicion, signs, or symptoms suggestive of ROM, PROM, PPROM.
* Subjects providing informed consent.

Exclusion Criteria:

* Subjects who have placenta previa.
* Subjects who have heavy vaginal bleeding.
* Subjects who have had digital vaginal examination immediately prior to evaluation for ROM.
An Innovative Taping Technique for Improved Intravenous (IV) Catheter Securement

This is a prospective, single-blinded, randomized study to assess the ability of taping methods used to secure intravenous (IV) catheters to resist the IV from being pulled away from the skin. Participants will have IV catheters taped on top of the skin (without insertion into the skin) using three taping methods, BCH Emergency Department (BCH ED), Chevron, and our novel method. Six measurements will be obtained per subject (3 random taping methods measuring their resistance to force in two directions, retrograde direction or towards the wrist and 90-degree angle to the arm).

Accidental removal of IV catheters delay patient care and can cause additional medical anxiety and pain that is heightened in the pediatric population. Moreover, such failed catheters create an increased burden economically and emotionally to patients, hospitals, and clinicians. To facilitate the most accurate, consistent results, a calibrated hand wheel test stand with a force gauge will be used to obtain force measurements. We will obtain the amount of force is required to remove the IV catheter form the skin of the subjects to compare the three taping measurements in two different directions. The retrograde direction will be pulling the IV distally from the IV site, towards the participant's wrist. The 90-degree angle will be pulling the IV medially away from the IV site.

Eligibility Criteria:
Inclusion Criteria:

* Employees of Boston Children's Hospital

Exclusion Criteria:

* Individuals under the direct supervision of any study investigators
* Individuals with excessive hair in/near the antecubital fossa region on either arm
* Individuals with fragile and/or non-intact skin in/near the antecubital fossa region
* Individuals who have adhesive allergies
* Individuals who have already participated
A Study to Compare the Safety and Imaging Pattern of Cyclotron-produced Technetium (CTC) vs. Generator-produced Technetium (G-PERT) in People With Thyroid Disorders Who Need Surgery

A 99mTc Pertechnetate (G-PERT) scan is a nuclear medicine test that can create an image of the thyroid gland and other organs. G-PERT is approved by Health Canada for the direct imaging and measurement of thyroid uptake.

Doctors and researchers at the University of Alberta have developed a new method of producing 99mTc Pertechnetate (called CTC). It is made in a cyclotron at the Medical Isotope and Cyclotron Facility (MICF) at the University of Alberta, Edmonton, Alberta. This new production method will provide another source of 99mTc Pertechnetate. The aim of this study is to confirm that CTC is safe and can be used interchangeably with G-PERT.

The clinical trial will be a Phase III, prospective, crossover, image interpretation blinded, single site study. All subjects will receive Tc-99m pertechnetate (one CTC and one G-PERT administration separated by at least 48 hours) and subsequently be imaged for thyroid uptake and whole body biodistribution. The order of the scans will be randomized. The thyroid image will be interpreted for uptake / no uptake in the thyroid, and the whole body biodistribution image will be interpreted for uptake / no uptake in selected anatomical sites. Interpretation of thyroid imaging results will be compared with other clinical findings (such as pre-surgical ultrasound, fine needle aspirate, and post-surgical pathology results, when available). All imaging assessments will be conducted by 1 blinded Nuclear Medicine physician. A safety evaluation will be conducted on all subjects receiving CTC, consisting of vital signs, haematology and SMA-12 serum biochemistry profile (pre-injection and post-imaging), and, for both CTC and G-PERT, an adverse event assessment (until the subject leaves the Nuclear Medicine department) after each administration.

Eligibility Criteria:
Inclusion Criteria:

1. Male or female ≥ 18 years of age and \< 80 years of age.
2. Have a proven or suspected thyroid pathology that requires surgery by standard clinical criteria.
3. Able and willing to follow instructions and comply with the protocol.
4. Provide written informed consent prior to participation in the study.

Exclusion Criteria:

1. Nursing or pregnant females.
Aquatic Therapy for Children With Neuromotor Deficits

The purpose of this study is to explore the feasibility, fidelity and acceptability of an aquatic therapy assessment and intervention for children ages 3-9 with neuromotor deficits such as cerebral palsy. The intervention takes place in a warm water therapy pool, twice a week for ten weeks and targets swim safety skills, upper extremity function and self care participation and performance.

The purpose of this study is to explore the feasibility, fidelity and acceptability of an aquatic therapy assessment and intervention. The intervention will target swim safety skills, upper extremity function and self care participation and performance in children with neuromotor conditions such as cerebral palsy. The study includes an intake evaluation session, twenty sessions of aquatic therapy (twice a week for 10 weeks) and a post evaluation session. This takes place in Columbus, Ohio.

Each session will be a combination of land-based self care training and water-based upper extremity exercise and swim skill training. The intervention structure will include the following:

1. Self Care Session: Doffing clothing, preparing for swimming
2. Motor learning aquatic activities guided by individualized goals
3. Self Care session: Towel dry, rinse off, dressing

Individualized activities will be planned according to the individualized goals written for each child participant.

Eligibility Criteria:
Inclusion Criteria:

* 3-9 years for the children, 18+ for the parents/guardians.
* child with neuro-motor diagnosis (CP, hypoxia, etc.)
* child impairments in upper extremity function
* child deficits in performance of self care activities

Exclusion Criteria:

* compromised airway
* uncontrolled seizures