cyrilzakka/clinical-trials huggingface dataset:
Optimizing Pulsatility During Cardiopulmonary Bypass

Cardiopulmonary bypass during cardiac surgery provides blood flow to the body during surgery but has adverse effects on different organs. Blood flow during cardiopulmonary bypass may be pulsatile or non-pulsatile, which may impact normal organ function after surgery. The study will collect data on the type of cardiopulmonary bypass used during surgery and organ function to determine if there is an association between the type of bypass and organ function.

Cardiac surgery is a high-risk elective surgical procedure frequently requiring CPB in which a machine pumps blood while the surgeon operates on the heart. CPB contributes to surgical risk by causing endothelial dysfunction and acute kidney injury (AKI). Endothelial dysfunction and AKI happen because heart lung machines typically generate non-pulsatile blood flow, which is abnormal and results in impaired tissue oxygen delivery. Normal blood flow is pulsatile due intermittent contraction and relaxation of the heart during the cardiac cycle, which produces a mechanical signal that induces endothelial cells to produce nitric oxide. Without nitric oxide, blood flow does not penetrate as deeply into organs such as the kidneys which leads to acute kidney injury. AKI increases mortality 10-fold after cardiac surgery placing many people at risk since over 400,000 people have surgery with CPB each year in the United States. Thus, pulsatile CPB may influence endothelial function and renal blood flow after cardiac surgery. This study will observe patients undergoing cardiac surgery with CPB and compare patients who receive pulsatile or non-pulsatile CPB.

Eligibility Criteria:
Inclusion Criteria:

* Age 50 to 70
* Able to provide informed consent
* Scheduled for elective cardiac surgery with cardiopulmonary bypass

Exclusion Criteria:

* Patients undergoing emergency procedures
* Diagnosed with sepsis
* Experiencing delirium
* Experiencing hemodynamic instability (heart rate \> 100 and systolic blood pressure \< 90)
* Patients with a mechanical circulatory support device
* Requiring vasoactive medications before surgery
* Patients with a reduced left ventricular ejection fraction (less than 50%)
* Patients with a contraindication to transesophageal echocardiography
The Application of Large Language Model in Emergency Chest Pain Triage

This study will evaluate the accuracy and efficiency of large language model in emergency triage.

The study is to evaluate the value of large language model in emergency triage, their accuracy and efficiency were evaluated and compared with traditional triage. To explore whether the model can effectively reduce the workload of medical staff, while improving the speed and quality of triage. In addition, the ability of the model to predict serious medical events such as acute heart events and strokes was evaluated. It also included surveys of patients; acceptance and satisfaction with the use of the artificial intelligence-assisted triage system. Analyze the economic benefits of adopting this technology, including cost saving and optimal allocation of resources.

Eligibility Criteria:
Inclusion Criteria:

1. All patients with chest pain entered the emergency triage procedure.
2. patients aged 18 and above.

Exclusion Criteria:

1. Patients with severe cognitive impairment or inability to communicate.
2. There are patients who have been explicitly referred to specific departments (for example, some of the 120 transfer patients, who may go directly to the green channel) .
3. Patients with unstable vital signs .
4. Patients with potential medical problems.
5. Is participating in other clinical trials.
6. Failure to follow test procedures.
7. Those who refuse to sign the informed consent form.
Recovery After Dialysis-Requiring Acute Kidney Injury

The Recovery After Dialysis-Requiring Acute Kidney Injury (RAD-AKI) Pilot Study is a 2-arm randomized clinical trial of hospitalized patients with dialysis-requiring acute kidney injury (RAD-AKI), comparing conventional thrice-weekly intermittent hemodialysis dialysis (control) to a "conservative dialysis strategy" in which hemodialysis is not continued unless specific metabolic or clinical indications for RRT are present. The overall hypothesis is that the current practice of thrice-weekly acute intermittent hemodialysis for AKI-D masks evidence of renal recovery and may actually delay or preclude recovery. The primary objective of this pilot study is to assess the safety and feasibility of the proposed intervention and study design.

The recent landmark Artificial Kidney Initiation in Kidney Injury (AKIKI) trial showed that a delayed strategy for RRT initiation among patients with incident stage 3 AKI - in which RRT was delayed unless specific metabolic or clinical indications for RRT were present - was safe and averted the need for RRT in nearly half of the critically ill participants, in comparison to an early RRT initiation strategy. The hypothesis for this study is: for prevalent patients with established AKI-D, a conservative dialysis strategy - in which hemodialysis is not continued unless specific metabolic or clinical indications for RRT are present - will shorten time to RRT-independence and improve the likelihood of renal recovery.

The RAD-AKI Pilot Study is a 2-arm randomized clinical trial of hospitalized patients with dialysis-requiring acute kidney injury (RAD-AKI) that will compare conventional thrice-weekly intermittent hemodialysis dialysis (control) to a "conservative dialysis strategy." The primary objective of this pilot study is to assess the safety and feasibility of the proposed intervention and study design.

Eligibility Criteria:
Inclusion Criteria:

* Adult inpatients with AKI-D due to acute tubular necrosis who have already initiated renal replacement therapy
* If initiated on CRRT, patients will be eligible only if they have already tolerated 1 intermittent hemodialysis (IHD) session at the research site.
* If transferred from an outside hospital, eligible patients must have tolerated 1 IHD session at the research site prior to enrollment.
* Not requiring vasopressor support
* Not intubated and not having a supplemental oxygen requirement of \>5 L/min via nasal cannula
* Treating MDs (nephrology and primary team attendings) and patient (or legally authorized representative) consent to enrollment

Exclusion Criteria:

* Diagnosis of end-stage renal disease (ESRD) or chronic dialysis prior to hospitalization
* Baseline estimated glomerular filtration rate (eGFR) \<15 mL/min/1.73m2
* Liver transplant unit patients
* Patients who underwent kidney transplantation during index hospitalization
* Cause of AKI-D is complete nephrectomy
* Current pregnancy
Effect of Paracervical Block Volume on Pain Control for Dilation and Curettage.o

The investigators are conducting a study on pain control for dilation and curettage (D\&C). Participants are eligible to enroll if they are a planning to have a D\&C in a participating clinic. The investigators are studying how different ratios of medication to liquid affect pain when injected around the cervix. Both potential methods use the same dose of medication, though researchers would like to know which one works better. To be in this study, participants must be over the age of 18 with an early pregnancy loss or undesired pregnancy measuring less than 12 weeks gestation undergoing D\&C while awake in clinic.

Dilation and Curettage (D\&C) is often performed in the first trimester for surgical abortion and management of miscarriage and can be painful for patients before and after the procedure. Most procedures are performed while the patient is awake or with minimal sedation in the clinic setting, and a key component of pain control is the paracervical block, or injecting lidocaine into the tissue around the cervix. A paracervical block with 20cc of 1% buffered lidocaine has been proven to provide superior pain control than a sham paracervical block. However, many providers often use similar doses of lidocaine in a higher volume to improve pain control. At University of California, San Diego (UCSD) and University of California, Los Angeles (UCLA), some providers routinely use a 20cc of 1% buffered lidocaine block and some routinely use a 40cc of 0.5% buffered lidocaine block. This practice has not been studied in a randomized controlled trial. The purpose of this study is to compare pain control during D\&C with a 20cc 1% buffered lidocaine with vasopressin paracervical block compared to a 40cc 0.5% buffered lidocaine with vasopressin paracervical block.

An inclusion criterion for this study is that patients must specifically be referred to family planning clinics at UCSD and UCLA for an in-clinic D\&C. Therefore, the D\&C is a required procedure for both study groups. The only difference in care between the study groups will be which paracervical block they receive.

Eligibility Criteria:
Inclusion Criteria:

1. Women over the age of 18 presenting to UC San Diego and UC Los Angeles
2. Undesired pregnancy or missed abortion \< 11 weeks 6 days gestation
3. Must speak English or Spanish
4. Desire surgical termination of pregnancy or management of miscarriage in clinic

Exclusion Criteria:

1. Women with a diagnosis of inevitable or incomplete abortion
2. Desire for general anesthesia or IV sedation
3. Chronic pain conditions
4. Any medical comorbidities that are a contraindication to performing the procedure in the clinic setting
5. Allergy to or refusal of ketorolac, oral Versed, or a paracervical block
6. If they have taken any pain medications the day of presentation to clinic
7. If they have taken Misoprostol the day of presentation to clinic
A Clinical Outcome Study of Two Multifocal Intraocular Lenses (IOL) in Cataract Patients

The purpose of this study is to compare AcrySof® IQ ReSTOR® +2.5 D Multifocal IOL in both eyes (bilateral implantation) to AcrySof® IQ ReSTOR® +2.5 D Multifocal IOL in the dominant eye with AcrySof® IQ ReSTOR® +3.0 D Multifocal IOL in the fellow eye (contralateral implantation) at Month 3 following the second eye surgery.

Each subject will complete a preoperative examination of both eyes, implantation of IOL at the operative visit for each eye, and up to 4 postoperative visits (each eye examined at Day 1-2, with binocular visits at Day 30 and Day 90 after the second implantation). The second implantation will occur between 1 and 45 days of the first. If the first eye is not implanted during surgery, the second eye is not eligible. lf both eyes are not implanted with the assigned IOL, the subject will be followed for safety evaluation.

Eligibility Criteria:
Inclusion Criteria:

* Willing and able to understand and sign informed consent, and attend postoperative examinations per protocol schedule;
* Requires cataract extraction followed by posterior intraocular lens implantation used as an on-label procedure in both eyes;
* Willing to have second eye surgery within 45 days of first eye surgery;
* Expected postoperative astigmatism \< 1.0 D in both eyes, as measured by keratometry;
* Free of severe diseases(s)/condition(s) listed in the Warnings and Precautions section of the package inserts;
* Other protocol-defined inclusion criteria may apply.

Exclusion Criteria:

* Refractive lens exchange (monocular DCVA of worse than 20/20, or ≥ 0.06 logMAR). This exclusion did not apply to binocular (OU) measurement;
* Significant irregular corneal astigmatism as demonstrated by corneal topography;
* Severe degenerative visual disorders;
* Previous corneal surgery;
* Amblyopia;
* Planned multiple procedures, including LRI, LASIK, etc, during surgery or the course of the study;
* History of corneal disease;
* Severe diabetic retinopathy;
* History of retinal detachment;
* Severe conditions or acute or chronic diseases or illnesses that, per investigator's clinical judgment, would increase the operative risk or confound the results of the study;
* Pregnant or planning pregnancy during course of study;
* Other protocol-defined exclusion criteria may apply.
Study of the Ability of a New Technique to Effectively Diagnose Movement Disorders

Sante Fe is an investigation of a new technique to distinguish between different types of movement disorders, specifically organic versus functional, by observing changes in involuntary movements in two different situations.

This study involves a short, one-time visit. Subjects will be asked to undergo a brief neurological examination while being video taped in two different scenarios. The severity of the abnormal movement will be analyzed and compared among subjects with functional (FMD) versus organic movement disorders (OrgMD).

Eligibility Criteria:
Inclusion Criteria:

1. Patients with a clinical diagnosis of Functional Movement Disorder (e.g. functional tremor, functional dystonia, functional myoclonus) based on Fahn-Williams criteria or OrgMD (e.g. Parkinson disease, essential tremor, cervical dystonia) evaluated by a fellowship-trained movement disorder neurologist at Cleveland Clinic
2. Patients with mild to severe involuntary movement as a result of the movement disorder, visible for video-recording.

Exclusion Criteria:

1. Significant cognitive impairment that prevents proper informed consent
2. Patients whose movement disorders cannot be captured on video
Volrustomig Priming Regimens Exploratory Phase II Platform Study

Purpose of this study is to assess the safety, tolerability, pharmacokinetics, immunogenicity, and antitumor activity of volrustomig in combination with other anticancer drugs in participants with specified solid tumors.

This is a platform, randomized, open-label, multicenter, global study.

Enrolled participants with Stage IV non-squamous non-small cell lung cancer (NSQ NSCLC) who are treatment-naïve and have not received previous treatment for advanced or metastatic disease.

These participants will be randomized in a 1:1 ratio to one of the two treatment arms: Arm 1A and Arm 1B.

Both arms will test a volrustomig dosing in combination with chemotherapy.

Eligibility Criteria:
Key Inclusion Criteria:

* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 with no deterioration.
* Life expectancy greater than or equal to (\>=) 12 weeks.
* Adequate organ and bone marrow function.
* Body weight greater than (\>) 35 kilograms (kg) at screening and at randomization.
* Histologically or cytologically documented NSQ NSCLC.
* Absence of sensitizing epidermal growth factor receptor (EGFR) mutations.
* Absence of documented tumor genomic alteration results from tests conducted as part of standard local practice in any other actionable driver oncogenes for which there are locally approved targeted 1L therapies.
* At least one measurable lesion not previously irradiated that can be accurately measured at baseline as \>= 10 millimeter (mm) in the longest diameter.

Key Exclusion Criteria:

* Spinal cord compression.
* History of primary active immunodeficiency.
* Active or prior documented autoimmune or inflammatory disorders.
* Mixed small-cell lung cancer and NSCLC histology or sarcomatoid variant.
* Brain metastases unless asymptomatic, stable, and not requiring steroids for at least 14 days prior to start of study intervention. A minimum of 2 weeks must have elapsed between the end of radiation therapy and study enrollment.
* Prior chemotherapy or any other systemic therapy for Stage IV NSCLC. Participants who have received prior platinum-containing adjuvant, neoadjuvant, or definitive chemoradiation for advanced disease are eligible, provided that progression has occurred greater (\>) 12 months from end of last therapy.
Touchscreen-based Cognitive Tests in Healthy Volunteers

This phase Ib study aims to evaluate applicability of touchscreen-based cognitive test battery for assessment of ketamine-induced schizophrenia-like cognitive deficits in healthy volunteers. Additionally, the study aims to assess whether ketamine-induced cognitive deficits are reversed by modafinil using touchscreen-based test battery for testing of cognition.

Ketamine-induced schizophrenia-like cognitive deficits in healthy volunteers are measured by using touchscreen-based cognitive tests. In addition, the study aims to assess whether ketamine-induced cognitive deficits detected by touchscreen-based cognitive tests are reversed by modafinil.

Eligibility Criteria:
Inclusion Criteria:

* Healthy Caucasian men aged 20-40 years
* Body weight 50-100 kg
* Body mass index 19-26 kg/cm2
* Normal physical examination including heart rate (HR; 50-90/min) blood pressure (BP; diastolic 65-90 and systolic 110-140) normal haematological and clinical chemistry variables normal ECG as judged by the investigator

Exclusion Criteria:

* Visual disability or red-green color blindness
* History of mental health disorders as determined by self-reported a) physician-determined diagnoses of mental health disorders, except for nicotine and caffeine dependence, or history of suicide attempt; b) medications for mental health disorders
* History of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, or neurological disorder
* History of orthostatic syncope
* History of head injury with sequelae
* First-degree relative with a history of psychosis or epilepsy/seizure disorder or of a condition with risk of seizures
* Current regular medication
* Vaccination 2 weeks prior to study or during the study
* Known or suspected allergy/hypersensitivity to any drug
* History of regular alcohol consumption
* Current substance dependence (excluding nicotine and caffeine).
* Use of tobacco- or nicotine-containing products in excess of the equivalent of 5 cigarettes per day
* Use of any medication or alcohol 24 hours before each study visit
* Education less than high school
* Clinically relevant symptoms of depression, anxiety or sleep disturbances
* Donation of blood within 1 month prior to study
* Participation in any study with an investigational product within 2 months prior to study
* Clinical signs of suicidal or violent behaviour or psychotic symptoms
Role of Vacuum in Open Fracture Tibia Grade III Type B

- Evaluate the role of VAC in decreasing the time needed for soft tissue coverage and definitive fixation in open IIIB tibial fractures

* Open fractures are injuries in which the skin and soft-tissue integument are disrupted and the underlying bone is exposed to the external environment. This communication results in contamination by microorganisms that can cause deep or superficial infection. Impaired vascularity, devitalized tissue, and loss of skeletal stability are all factors leading to increased susceptibility to infection after open fracture \[1, 2\].
* Current protocols for treating open fractures include early administration of antibiotics, timely surgical debridement, skeletal stabilization, sterile dressing, systemic support, and establishment of soft-tissue coverage in a wound environment that is clean \[3, 4-8\].
* VAC is being used to obviate the need for, or enhance the success of, free-flap coverage in open fractures that are significant enough to preclude primary closure, delayed primary closure, or healing by secondary intention. VAC device and its components, which in a closed system expose the open wound bed to negative pressure. This pressure removes edema or hemorrhage, mechanically pulls on the wound edges, decreases in wound surface area, improves circulation, and enhances proliferation of granulation tissue that filled the soft tissue defect, enhance debridement of wound debris, reducing the need for costly free-flap transfers. VAC devices have been used in many surgical disciplines but only recently have become popular in orthopedics \[7, 9,\].

Eligibility Criteria:
Inclusion Criteria:

* - Gustilo Type III B open fractures of the tibia \[10\].
* Skeletal mature patients.

Exclusion Criteria:

* - Bone defect more than 5 cm Gustilo Type III B open fractures of the tibia.
* Medical commodities that make the patient unfit for surgery. (e.g. Liver Cell Failure, liver cirrhosis, renal failure )
Assessment of Ridge Preservation Using Moldable Beta-tricalcium Phosphate Bone Grafting System

Randomized Controlled study to compare the effectiveness of two different treatment approaches using a new moldable beta-tricalcium phosphate(TCP) bone graft material in ridge preservation of an atraumatic extraction socket site compared to allograft with collagen plug.


Eligibility Criteria:
Inclusion Criteria:

* Provision of informed consent
* At least 18 years old
* In need of one posterior tooth, excluding third molar molars, planned for extraction and replacement with a dental implant (If the subject requires two adjacent socket preservation, they can still be enrolled in the study but only one site will be used for the study)
* Intact ridge as verified with cone-beam CT scan
* At least one natural tooth adjacent to the study site present.

Exclusion Criteria:

* Insufficient interocclusal space to allow for implant supported prosthesis
* Dehiscence or fenestration identified at the time of reviewing CBCT.
* Non-treated caries or uncontrolled periodontal disease present affecting the teeth in adjacent to study teeth.
* Any of natural teeth adjacent to the study site presents active periapical endodontic lesion ("active periapical endodontic lesion" will be determined per consultation by endodontics specialist).
* Adjacent tooth (mesial and distal) to study site was extracted within last 6 months
* Adjacent teeth (or tooth) to study site with significant soft tissue loss
* Smoker using more than 10 cigarettes or equivalent per day
* Smokeless tobacco use or e-cigarette use
* Current alcohol or drug abuser
* Systemic or local disease or condition that would compromise post-operative healing and/or osseointegration e.g. uncontrolled diabetes
* Need for systemic corticosteroids or any other medication that would influence post-operative healing and/or osseointegration
* Pregnancy, as indicated by positive serum human chorionic gonadotropin (HCG) test result.
* Unable or unwilling to return for follow-up visits for a period of 5 months
* Unlikely to be able to comply with study procedures according to Investigators judgement
* Subject in other clinical trials