cyrilzakka/clinical-trials huggingface dataset:
MRI Repository for Acute Stroke Clinical and Research Applications

Stroke is one of the leading causes of death and long-term disability. A major unresolved problem in MRI-based stroke assessment is to relate image features to brain function in a way that can properly guide stratification for treatment and rehabilitation. This requires extracting meaningful and reproducible models of brain function from stroke images, a daunting task severely hindered by the great variability of lesion frequency and pattern. Large datasets are imperative to uncover possible lesion-function relationships.

In this project the investigators will create a large database of acute strokes MRIs. The investigators will retrospectively archive an estimated 3,000 MRIs of patients with acute stroke, acquired at the Johns Hopkins Hospital, 2009-2019. This dataset will include 1.5 and 3 Tesla scans, diverse protocols and sequences (e.g., diffusion and perfusion weighted images (DWI/b0, PWI), T1, T2, FLAIR, susceptibility weighted images), with typical clinical low voxel resolution (4-7 mm3). Lesions will be initially delineated on DWI/b0, the most informative MRI sequence for acute stroke. After anonymization and defacing, two trained evaluators will perform the manual lesion segmentation. Two expert neuroradiologists will create consensual structured radiological reports with information about stroke type and location according to different criteria (e.g., 34 brain structures and 11 vascular territories). The investigators will also archive structured information from discharge (demographics, laboratory, and neurological evaluation of patients, including NIH stroke scale and modified Rankin scale, mRS), as well as the 90-days follow-up mRS.


Eligibility Criteria:
Inclusion Criteria:

* patients admitted at Hopkins Stroke center with the diagnosis of acute brain stroke

Exclusion Criteria:

* Not performed MRI
Comparison Between Effect of Systemic Fentanyl Infusion and Fentanyl Added as An Adjuvant to Lidocaine in Bier Block For Controlling Pain in Patients Undergoing Hand Surgeries

Injury and deformity of the upper extremity can result in dysfunction to nerves, tendons and bones which can lead to disability and pain.

Various techniques of regional anesthesia are frequently used for upper extremity surgery. Specifically, intravenous regional anesthesia, the Bier block, is an effective anesthetic technique. This technique, developed by Dr August Bier in 1908, provides complete anesthesia, a bloodless field, and eliminates the need for general anesthesia. However, it was not until the 1960s that this technique was reintroduced and used in upper extremity surgery due to several disadvantages and reports of major complications. Because of the dose of lidocaine and tourniquet time, there is potential for cardiac and neurological complications such as arrhythmias, seizures, and compartment syndrome the aim of this study To evaluate the effect of Systemic Fentanyl Infusion compared to addition of Fentanyl as An Adjuvant to Lidocaine in Bier Block for Controlling Pain in Patients Undergoing Hand Surgeries

Injury and deformity of the upper extremity can result in dysfunction to nerves, tendons and bones which can lead to disability and pain.

Various techniques of regional anesthesia are frequently used for upper extremity surgery. Specifically, intravenous regional anesthesia, the Bier block, is an effective anesthetic technique. This technique, developed by Dr August Bier in 1908, provides complete anesthesia, a bloodless field, and eliminates the need for general anesthesia. However, it was not until the 1960s that this technique was reintroduced and used in upper extremity surgery due to several disadvantages and reports of major complications. Because of the dose of lidocaine and tourniquet time, there is potential for cardiac and neurological complications such as arrhythmias, seizures, and compartment syndrome

Eligibility Criteria:
Inclusion Criteria:

* Patients age from 18 years to 40 years

  * Both sex
  * Patients of the American Society of Anesthesiologists (ASA) physical Status class I and II
  * BMI less than 40

Exclusion Criteria:

* • Patients who refuse to participate in study.

  * Uncooperative patients.
  * Patient with crush injury
  * Peripheral vascular, neurological or muscle diseases.
  * Coagulation disorders that affect the blood's clotting activities e.g.: Hemophilia.
  * History of hypersensitivity to the drugs being evaluated
A Randomized Controlled Trial on the Effect of Needle Gauge on the Pain and Anxiety Experienced During Arterial Puncture

Arterial blood-gas (ABG) measurements are the gold standard to evaluate pulmonary gas exchange. However, arterial punctures are more painful than venous punctures and, in ICU patients, cause greater anxiety than tracheal aspiration. The only technique that has been shown to effectively reduce pain during arterial punctures is the subcutaneous injection of lidocaine. However, this technique is more time consuming and is poorly used.

Topical anesthesia is widely used during arterial punctures despite the lack of proof of efficacy.

While performing arterial punctures with small gauge needles is feasible, to the best of the investigators knowledge no studies have assessed the effect of needle gauge on arterial puncture related pain.

The aim of the present study was to compare the pain experienced during arterial punctures performed with a 25 G or 23 G needle. The secondary endpoints were the characterization of the pain and the anxiety associated with the arterial punctures.


Eligibility Criteria:
Inclusion Criteria:

* patients who had a planned assessment of arterial blood gas in our Respiratory Department

Exclusion Criteria:

* under the age of 18
* inability to provide consent
* the presence of a contraindication to arterial punctures based on the American Association of Respiratory Care Guidelines
RAMPS VS SRPS for Pancreatic Body and Tail Adenocarcinoma

Two arms RCT is design, patients with pancreatic body or tail adenocarcinoma will be randomly assigned to the Radical Antegrade Modular Pancreaticosplenectomy (RAMPS) group or Standard Retrograde Pancreatosplenectomy (SRPS) group. The primary objective is to evaluate the effect of RAMPS on the overall survival of patients with resectable body and tail pancreatic ductal adenocarcinoma. And the secondary objective is to evaluate the disease-free survival, R0 resection rate, number of retrieved lymph nodes and perioperative outcomes like postoperative complication rate, severe complications, mortality and functional recovery time between the experimental group and control group.


Eligibility Criteria:
Inclusion Criteria:

* Age 18-80 years old;
* Resectable pancreatic body and tail ductal adenocarcinoma with both preoperative and intraoperative evaluation(refer to NCCN guideline 2018 of Pancreatic Cancer);
* ECOG Performance Status 0-1;
* Adenocarcinoma of pancreatic body and tail duct, without distant metastasis and ascites;
* The estimated survival time is ≥ 3 months;
* Follow-up in time and obey the research requirements;
* Be voluntary to this clinical trial and can sign the informed consent;
* Normal hematological index (Leukocyte, platelet, liver function, renal function, DIC, electrolyte index, Hb \>10g/dL).

Exclusion Criteria:

* The patients with distant metastasis according to preoperative tumor staging;
* Patients with recurrent pancreatic ductal adenocarcinoma;
* The artery or vein is involved and could not be resected or reconstructed(according to preoperative evaluation or intraoperative evaluation after exploration);
* Patients with cardiopulmonary disfunction and cannot tolerate operation;
* The patients accepted neoadjuvant chemotherapy and radiotherapy before operation;
* Patients with other malignancies or hematopathy
* Before the operation, the total bilirubin was more than 250 μmol/L without preoperative biliary drainage or after biliary drainage, the total bilirubin was still more than 250 μmol/L;
* Pregnancy diagnosed, planned pregnancy and lactating female patients
* Refusal to sign consent.
* Intraoperative exclusion include:Tumor metastasis; not pancreatic primary disease; unresectable pancreatic body/tail adenocarcinoma
* Postoperative exclusion include: not pancreatic ductal adenocarcinoma according to pathological examination.
* Withdrawal of informed consent;
* Willingness to withdraw from the study.
Effect of Schistosomiasis Mansoni on HIV Susceptibility and Female Genital Immunology

The aim of this study is to assess the impact of Schistosoma mansoni infection and its treatment on genital immunology and HIV susceptibility in Ugandan women.

Schistosomiasis mansoni is a water-borne disease caused by helminth Schistosoma mansoni (S. mansoni), in which adult worms deposit eggs in mesenteric blood vessels. Schistomiasis prevalence in the fishing communities in East Africa, and particularly in the Lake Victoria region, exceeds 60% and there is overlap in this region with a high prevalence of HIV (29%).

A recent epidemiological study found an association between S. mansoni and HIV infection in adult women residing near Lake Victoria in Tanzania. Furthermore, in primate studies S. mansoni infection was shown to increase susceptibility to SIV infection after rectal (but not intravenous) challenge, implying that S. mansoni might increase HIV susceptibility by altering local mucosal (gut) immunology.

While S. mansoni does not directly infect the genital tract, we hypothesize that the inflammation it causes in the gut may be associated with mucosal inflammation at other sites through activation of common mucosal homing integrins such as a4b7. Therefore in this study we propose to explore whether S. mansoni increases inflammation and/or HIV susceptibility in the endocervix of adult women.

HIV-uninfected adult women from Entebbe, Uganda will be screened for schistosomiasis using a commercial CCA rapid test kit, and infected women who fulfill the study eligibility criteria will be recruited into the study. Kato-Katz microscopy analysis will be performed to assess egg shedding at baseline. Additionally, urine microscopy will be done to screen for Schistosoma hematobium (which can directly involve the genital mucosa). Schistosomiasis treatment will be provided to all participants according to Ugandan clinical guidelines.

Endocervical cytobrush, vaginal SoftCup and blood samples will be collected at three time points; at baseline and 4 and 8 weeks after schistosomiasis treatment, at the same stage of the menstrual cycle. Using an ex vivo HIV entry assay and mucosal cytokine and microbiome analyses we will quantify the effect of S. mansoni and its treatment on cervical HIV susceptibility and genital inflammation.

Eligibility Criteria:
Inclusion Criteria:

* Positive (score above "trace") on a urine CCA rapid test
* Willing to be treated with praziquantel
* Willing to give informed consent, and answer short questionnaires on economic status, and sexual risk behavior.
* Willing to comply with the requirements of the protocol
* HIV and classical STI (see below) negative

Exclusion Criteria:

* HIV infected
* Malaria infected
* Pregnant.
* Irregular menstrual cycle, or actively menstruating at the time of genital sampling.
* Tested positive for classical STIs (syphilis, gonorrhea, chlamydia, Trichomonas vaginalis) or having genital ulcers
* Prior hysterectomy
* Deemed by physician to be unlikely to complete study protocol.
Inhibition Effects of Probiotics on Pathogens Associated With VAP

This study evaluates that P. aeruginosa, A. baumannii, K. pneumonia and Staph aureus which are obtained from patients' tracheal aspiration culture who treated with mechanical ventilation will be compared with Lactobacillus (LAB) members and nisin bactriocin in the laboratory. The aim is to investigate the probiotics' antimicrobial properties and effects on these bacteria's growth rate.

Ventilator associated pneumonia (VAP) is one of the most commonly seen hospital-acquired infections that occurs in patients who receive mechanical ventilation. VAP usually occurs 48-72 hours after mechanical ventilation and is related increased incidence of multidrug-resistant infections, increased antibiotic use, extended mechanical ventilation time, increased patient stay in the intensive care unit (ICU), and increased patient stay in the hospital. One recent intervention is the probiotic therapy which is a nonantibiotic strategy for maintenance of the host's aerodigestive microbial balance and VAP prevention.Common causative pathogens of VAP include Gram negative bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter species, and Gram-positive bacteria such as Staphylococcus aureus. In this study, these Gram negative pathogens obtained from mechanical ventilated patients' tracheal aspiration culture and reference bacteria strains will be compared with Lactobacillus (LAB) members and nisin in the laboratory. Probiotics' antimicrobial properties and effects on these bacteria's (obtained from patients and reference strains) growth rate will be investigated.

Eligibility Criteria:
Inclusion Criteria:

* Patients who mechanically ventilated at least 48 hours in the intensive care unit

Exclusion Criteria:

* Patients who mechanically ventilated less than 48 hours
A Observational Study to Compare Effectiveness and Safety of the Surgeries in Patients With Esophageal Cancer

The study was designed to compare effectiveness and safety of the surgeries of Ivor-Lewis and Mckeown in patients with esophageal cancer

The trial is a multi-centre real-world non-interventional observational study. The study was designed to compare effectiveness and safety of the minimally invasive surgeries of Ivor-Lewis and Mckeown in the Chinese patients with IA-IIIB esophageal cancer via a retrospectively review method based on the study data on patient demographic/tumor biological characteristics and clinical treatments.

Eligibility Criteria:
Inclusion Criteria:

* Pathologically diagnosed middle and lower thoracic IA-IIIB esophageal cancer after surgeries;
* Patients who received minimally invasive radical dissections of Ivor-Lewis and Mckeown;
* Patients who received tubular gastroesophageal reconstruction;

Exclusion Criteria:

* Patients complicated with arrhythmia, or serious disfunctions of heart, lung, liver, and kidney before surgeries;
* Patients with second primary tumors;
* Patients who received abdominal or thoracic surgeries;
* Patients who received gastrostomy or nesteostomy before surgeries;
* Patients with suspected cervical lymph metastases (in the subgroup of the patients who received the surgery of Mckeown)
Accuracy of Teledentistry Versus Direct Oral Examination for Elderly in Aged-Care Homes: A Pilot Cross-Sectional Study

The residents will receive oral health education, then three examiners ( licensed dentists ) will perform the direct oral examination of the participants. During the same visit, a dental student will take the intraoral photographs in the aged care home.

Later, three different blinded examiners (licensed dentists) will assess the intraoral photographs of the same group of participants. The participant's dentition will be examined using the scores developed by the World Health Organization (WHO) for oral health surveys. Also, the examiners will perform a visual inspection of the oral mucosa for any signs of oral potentially malignant disorders (OPMD), as the mortality of high-risk populations is proven to be reduced by visual oral cancer screening.

Finally, the residents who require treatment will be referred to Kasr EL Ainy dental hospital to receive dental treatments.

The residents will receive oral health education, by three examiners ( licensed dentists ) with a t least 5 years experience. Then the same examiner will perform the direct oral examination of the participants. They will fill the dentition status, denture status, oral lesions and intervention urgency section of the World Health Organization (WHO) form 2013 version.

During the same visit, a dental student will take the intraoral photographs in the aged care home. The photographs will include 5 views (upper occlusal, lower occlusal , frontal, right lateral and left lateral).

The photographs will be uploaded on one drive and later, three different blinded examiners (licensed dentists) will assess the intraoral photographs of the same group of participants. The participant's dentition will be examined using the scores developed by the World Health Organization (WHO) for oral health surveys. Also, the examiners will perform a visual inspection of the oral mucosa for any signs of oral potentially malignant disorders (OPMD), as the mortality of high-risk populations is proven to be reduced by visual oral cancer screening.

Finally, the residents who require treatment will be referred to Kasr EL Ainy dental hospital to receive dental treatments.

Eligibility Criteria:
Inclusion Criteria:

* Elderly living in aged care homes in Egypt
* Have the ability to communicate with the examiner
* Have the ability to give consent to participate in the study.
Assessment Of Educational Strategies In Heart Failure Patients Presenting To The Emergency Department For Care

This study evaluates the impact of a new education-based intervention on outcomes in un- and under-insured Heart Failure (HF) patients presenting to the Emergency Department (ED) for care. Intervention patients will receive personalized education regarding their condition, pre- and post-testing of their HF knowledge base, and ED standard of care during the enrollment (index) visit. Patients will then be contacted via telephone 30 days post-index visit for re-testing and reinforcement of previously learned material. Patients in the control group will receive ED standard of care.

In 2015, 12.8% of adults ages 19-64 in the United States lacked any form of health insurance. An even greater number fell under the umbrella of under-insured. Studies indicate that the un- and under-insured receive less preventive care, are diagnosed at more advanced disease stages, and have higher mortality rates than their insured counterparts, due to the lack of accessible primary care services. These issues are most readily evident in patients with chronic conditions. When a preventable, chronic condition worsens, these patients have no choice but to visit the ED to address their most immediate health concerns, leaving the underlying chronic problem untreated. HF is a particularly burdensome chronic problem for patients of all socioeconomic statuses and one of the leading causes of ED and hospital readmissions.

Numerous educational efforts have been tested in an attempt to reduce HF readmissions but have met with mixed results. Consequently, HF patients are generally seen as refractory to educational and management strategies. The investigators propose here a new, targeted educational intervention designed to improve patient outcomes and readmission rates in un- and underinsured HF patients.

Eligibility Criteria:
Inclusion Criteria:

* Patients with a pre-existing documented diagnosis of HF presenting to the ED

Exclusion Criteria:

* 1) Patients in unstable condition requiring immediate medical attention, 2) hemodynamically unstable, 3) age \< 18 years, and/or 4) incarcerated.
Comparison of Oxygenation Methods in Sedation

Abstract

Backgrounds and objectives:

Dental treatments, especially in children who can not be cooperated, may require deep sedation due to intense anxiety and fear. During sedation oxygen is usually given to the patients by nasal cannula. Investigators want to use nasal mask for non-invasive mechanical ventilation for oxygenation of the patient during sedation for dental treatment and described it with nasal cannula.

Methods:

Seventy three children classified as ASA 1 or 2, aged between 3 to 17 will be included for this study. During deep sedation procedure group M will be applied nasal mask in order to noninvazive mechanical ventilation, group C will be applied nasal cannula connected to the oxygen flowmeter.

Majority of dental treatments can be performed under local anesthesia. However, this is not always possible for pediatric non-cooperative patients with severe anxiety. In these cases, unpleasant dental experiences may lead to dental phobia when they become adults. For such patients requiring short-term dental procedures, sedation can best choice.

In sedative procedures of patients it is necessary to delivery oxygen to the patient's respiratory system. This can achieved by means of nasal cannulas or interface masks like nasal mask which are connected to the oxygen flowmeter of the anesthesia machine. Investigators hypotezed that oxygen delivery via non-invazive machanic ventilation with nasal mask which is connected to the anesthesia-breathing circuit unit could be better than nasal cannula connected to the oxygen flowmeter of the anesthesia machine during deep sedation for dental treatment.

Eligibility Criteria:
Inclusion Criteria:

* patients aged betweeen 3-17
* patients with wn ASA( American Society of Anesthesiologists) score 1-2

Exclusion Criteria:

* patients under 3 years old
* patients above of ASA score 2
Effect of Functional Training on Motor Performance

The functional strength training is mainly dealt with anti-gravity muscles and aiming at maximal carry over in day to day activities. The functional strength training can be given using resistance and it may be gravity, body weight, resistance bands and free weights. The exercises are specific to the muscle or muscle groups recruited during the functional activities


Eligibility Criteria:
Inclusion Criteria:

1. Age ranged from 7 to 10 years old.
2. The degree of spasticity ranged from grade 1 to 2 hypertonia according to Modified Ashwarth Scale (MAS)
3. Level II and III on GMFCS-ER
4. They were able to understand and follow verbal instructions

Exclusion Criteria:

* 1- visual or auditory problems. 2- Orthopedic surgery in the lower limb in the last 12 months before the study. 3- Fixed deformities in joints and bones of lower limbs. 4- Botox injection in the last six months before the study. 5- Children with any special medications affecting muscle functions (anti-spastic drugs).