cyrilzakka/clinical-trials huggingface dataset:
Primary Care Physician's Wishes and Influencing Factors Toward Provision of Integrated Health Care

This questionnaire-based study was focused on understanding primary care physician's wish toward provision of integrated health care, associated knowledge and attitude, and analysis of influencing factors affecting their choices.

The population is aging rapidly in Taiwan. It has been estimated that 15 years from now, the elderly population will comprise over 20% of the general population. Within an aging population, the prevalence of chronic illnesses can be expected to increase, and these patients with multiple chronic illnesses will likely need a larger allocation of available resources with the national health care system. In contrast to a highly-specialized medical environment, integrated health care, with its multitude of health and medical services including diagnosis, treatment, convalescence, rehabilitation, and health promotion, can provide a more efficient synergism between the necessary aspects of delivery, supply, management and organization. Literature has shown that multi-disciplinary, well-managed chronic illness management can increase the convenience of patient medical visits and also decrease medical costs. To provide patients with multiple chronic illnesses more suitable, efficient, and higher quality medical care, and to decrease redundant or ill-advised medications or procedures, as well as to encourage medical systems to further incorporate integrated services to advance the ideal of holistic care, the Bureau of National Health Insurance issued the a decree on September 15th, 2009, named "Integrated care model and medical system-based integration plan". This questionnaire-based study was focused on understanding primary care physician's wish toward provision of integrated health care, associated knowledge and attitude, and analysis of influencing factors affecting their choices.

Eligibility Criteria:
Inclusion Criteria:

* The primary care physicians, who practicing western medicine, with the doctor licenses approved by the Department of Health in Taiwan

Exclusion Criteria:

* The subjects who are unable to complete the survey independently
Analgesic Efficacy After Umbilical Hernia Repair in Children

Umbilical hernia repair is a common painful outpatient procedure performed in children. Often analgesia for this procedure is provided by using local infiltration of the surgical site by the surgeons and perioperative opioids and NSAIDS both IV and orally. The use of opioids can cause adverse side effects which include, but are not limited to nausea, vomiting, itching, and respiratory depression, etc. The rectus sheath block can be performed in these patients to decrease their post operative pain.

Umbilical hernia repair, a common Day Surgery procedure in children, is associated with considerable postoperative discomfort. The patient has to meet certain discharge criteria such as tolerating liquids, adequate level of analgesia, etc., prior to being discharged from the day surgery unit.

Currently, both rectus sheath block and local infiltration of the surgical site are used for providing post-operative analgesia for umbilical hernia repair surgery. The local infiltration can only be done at the end of the surgical procedure as it could alter the planes of the surgical field if performed preoperatively. We believe that the analgesia provided prior to the surgical incision will decrease the amount of intraoperative and postoperative opioids used and the subsequent side effects of these medications (5,6). The rectus sheath block, a regional anesthetic technique, offers possible improved pain management following umbilical hernia repair in a recent observational study (1-3,7). We will perform a double-blinded, randomized study to compare the efficacy of rectus sheath block and surgical infiltration in providing postoperative analgesia.

Eligibility Criteria:
Inclusion Criteria:

1. Male or female subjects ages \> 5 to \< 18 years.
2. American Society of Anesthesiology (ASA)physical status 1 or 2.
3. Patients who undergo an umbilical hernia repair at CHOP.

Exclusion Criteria:

1. Parents/patients refusal to the placement of a rectus sheath nerve block.
2. Subjects with allergy to bupivacaine.
3. Patients who are developmentally delayed which precludes their participation in pain scale reporting.
4. Parents who do not comprehend English sufficiently well to read the consent and ask questions.
Motor Performance Modulation After Total Knee Replacement

Functional recovery after total knee replacement (TKR) is characterized by an incomplete muscle strength due to arthrogenic muscle inhibition (AMI) and tendency to estimate the functional level. These deficits could be related to alteration of sensory feedback, and could influence the ability to modulate patients' motor performance.

To date, there are not studies investigatin the ability to modulate the motor performance in patients with TKR compared to healthy age-matched subjects.

In this study 20 patients with TKR and 20 healthy will be included . Inclusion criteria are: age between 40 and 80 , TKR for primary knee osteoarthritis, knee flexion ≥ 90° and complete knee extension, ability to perform a sit to stand on a 46 cm high chair and to walk for at least 50 meters without aids. Exclusion criteria: patients undergoing TKR after traumas, previous tibial or femoral osteotomy, partial or complete revision surgery. subjects with psychiatric and/or cognitive impairments, or with neurological, musculoskeletal or other disorders that could influence motor or functional recovery will be also exluded.

The aim of the study is to investigate the ability in motor performance modulation in patients after TKR compared to healthy age-mtched subjects.

Primary endpoint is to investigate this ability during a leg extension performed in open kinetic chain. This ability will be also evaluated during a Sit To Stand and during walking (with 10 Meters Walking Test). Secondary endpoint is to investigate pain, rate of perceived exertion and perceived load symmetry during the three tests. In both healthy and TKR groups these outcomes will be detected two times. In particular, in TKR group, patients will be tested the day before surgery and 5 days after surgery.

This study is aimed at conducting a survey in healthy subjects and in a population of subjects undergoing TKR . Participants will undergo an acquisition similar to others already described in the literature and without adverse events. Tests will last about 60 minutes and during them, will be used the equipment of Motion Analysis Lab of "Humanitas Research Hospital".


Eligibility Criteria:
Inclusion Criteria:

* Age between 40 and 80 years
* TKR because of primary gonarthrosis
* Flexion ≥ 90° and complete knee extension
* Able to perform a Sit to Stand from a 46 cm high chair, without upper limb use
* Able to walk at least 50 meters without walking aids

Exclusion Criteria:

* TKR because of traumatic event
* Patients undergone to tibial or femoral osteotomy
* Partial or Total TKR revision
* Cognitive and psychiatric impairments
* Presence of neurological, internist or musculoskeletal system pathologies that may affect functional or motor recovery

Healthy subjects will have to comply with all the eligibility criteria just mentioned except for the inclusion criterion: Intervention of TKR following primary gonarthrosis
CPR Quality and Use of Feedback for OHCA

The purpose of this study is to investigate the quality of cardio-pulmonary resuscitation(CPR) delivered by EMS professionals and whether this quality can be improved by implementing real-time feedback during the event and an oral post-event debriefing procedure based on the actual event performance data.

The aim of this study is to investigate whether CPR quality can be improved by implementing real-time feedback and immediate oral structured post-event debriefing in out-of-hospital cardiac arrest (OHCA).

The objectives of this study is to assess the current quality of CPR delivered by emergency medical services (EMS) during OHCA events in the Capital Region of Denmark. Furthermore, to investigate if CPR quality can be improved by applying real-time feedback during OHCA resuscitation attempts and to investigate if structured oral post-event debriefing delivered immediately after a resuscitation attempt and based on data from the defibrillator can further improve CPR quality

The hypothesis of this study is that adding real-time and post event feedback can improve the compression rate, compression depth, overall CPR hands-on time (CPR fraction), and recoil with at least 15% in total for both interventions.

Using a prospective study design data is retrieved from the standard defibrillator (ZOLL X series) through ZOLL RescueNet® Case Review (software for post-event review, analysis, and debriefing) from ZOLL Medical Corporation, Massachusetts, United States of America.

The study consists of three consecutive phases. Phase one with no feedback / debriefing available for EMS. Phase two with real-time feedback during the event and phase three which adds post-event debriefing to real-time feedback. We expect to be able to include at least 500 cases in each phase.

Eligibility Criteria:
Inclusion Criteria:

OHCA

Exclusion Criteria:

No use of EMS defibrillator attached to patient during resuscitation attempt Patients \< 18 years of age OHCA without involvement of the physician manned vehicle Patients who are subject to mechanical CPR from the time of device attachment Traumatic OHCA
Safety and Efficacy of Propionyl-L-Carnitine in the Treatment of Peripheral Arterial Disease (Intermittent Claudication)

Patients with peripheral artery disease have decreased blood flow to exercising muscle causing pain. This decreased blood flow to the muscle affects the level of acylcarnitines which in turn decreases the level of carnitine. Carnitine allows muscles to function properly. This study will test the safety and efficacy of Propionyl-L-Carnitine taken in combination with a monitored exercise training program.

To test the hypothesis that Propionyl-L-Carnitine taken in combination with monitored exercise training may improve exercise performance the study will randomize male or female adults with peripheral artery disease and claudication to receive either Proprionyl-L-Carnitine or Placebo.

Eligibility Criteria:
Inclusion Criteria:

* Ambulatory outpatient who are able to exercise
* Intermittent claudication due to peripheral artery disease
* Willingness to participate in a monitored exercise training program

Exclusion Criteria:

* Pain at rest, ischemic ulcerations, gangrene of the lower extremity
* Peripheral Artery Disease of a non-atherosclerotic nature
* Any disease process other than PAD, that may interfere with performance during the treadmill test or prevent the subject from reaching their claudication-limited PWT
* Current participation in an exercise training program or previous participtation in a monitored exercise training program within 6 months of the screening visit.
French Observatory of ElectroConvulsive Therapy (ECT)

Since the 30s, ECT has been a psychiatric treatment mainly used for drug-resistant depressive illnesses. Clinical studies have shown its therapeutic efficiency compared to standard treatments also in other psychiatric illnesses. Although efficient, ECTs also induce side effects. In France, there is currently no consensus on providing the suitest medical care. It is therefore important to review our nowadays health care models in order to maintain and improve the recommendations of the French National Agency for Accreditation and Evaluation in Health, the last of which date from 1997! Within this context, this project has the dual objective of (1) identifying ECT medical procedure in France and (2) developing research to evaluate and to improve the effectiveness of this treatment.


Eligibility Criteria:
Inclusion Criteria:

* Patients consecutively referred for ECT.

Exclusion Criteria:

* Not specified
ASP8825 - A Study to Investigate the Food Effect on the Pharmacokinetics of ASP8825

The objective of this study is to evaluate the effect of food on the pharmacokinetics and safety after administration of ASP8825 in healthy non-elderly adult male subjects.


Eligibility Criteria:
Inclusion Criteria:

* Body weight: ≥50.0 kg and \<80.0 kg
* Body mass index BMI: ≥17.6 and \<26.4 \[BMI= Body weight (kg)/(Height (m))2\]

Exclusion Criteria:

* Subjects who received any study drugs in other clinical trials or post-marketing studies within 120 days before screening
* Subjects who received or are scheduled to receive medications (including over-the-counter \[OTC\] drugs) within seven days before the hospital admission day of period 1.
* Subjects who deviate from the normal range of blood pressure, pulse rate, body temperature and standard 12-lead ECG at screening or the hospital admission day of period 1
* Subjects who meet any of the criteria for laboratory tests at screening or the hospital admission day of period 1. Normal ranges of each test specified at the study site or the test/assay organization will be used as the normal ranges in this study.
* Subjects with a complication of drug allergies
* Subjects who developed upper gastrointestinal symptoms (e.g., nausea, vomiting, and stomachache) within seven days before the hospital admission day of period 1
* Subjects with a complication or history of hepatic disease (hepatitis viral and drug-induced liver injury, etc.)
* Subjects with a complication or history of heart disease (cardiac failure congestive, angina pectoris and arrhythmia requiring treatments, etc.)
* Subjects with a complication or history of respiratory disease (severe asthma bronchial and bronchitis chronic, etc.) (except for a history of non-severe infantile asthma)
* Subjects with a complication or history of alimentary disease (severe peptic ulcer, reflux esophagitis, etc.) (except for a history of appendicitis)
* Subjects with a complication or history of renal disease (acute kidney injury, glomerulonephritis, nephritis interstitial, etc.) (except for a history of calculus)
* Subjects with a complication or history of cerebrovascular disorder (cerebral infarction, etc.)
* Subjects with a complication or history of malignant tumor
* Subjects who have a habit of excessive alcohol drinking or smoking
* Subjects who previously received administration of ASP8825
The Effect of Ebastine/Pseudoephedrine on Subacute Cough

To determine whether ebastine/pseudoephedrine is effective on subacute cough.

1. Visit 0 week

   * Patients with subacute cough,area randomized to either ebastine/pseudoephedrine or placebo for 1 week.
   * The cough severity and quality of life were measure with VAS score and cough-specific quality-of-life questionnaire(CQLQ)
2. Visit 1 week check VAS score and CQLQ
3. Visit 4 weeks check VAS score and CQLQ

Eligibility Criteria:
Inclusion Criteria:

* patients with subacute cough(3-8 weeks)
* age: 20-70 years

Exclusion Criteria:

* Chest X-ray abnormality(+) as a probable cause of cough
* other explainable confirmed diagnosis(+) such as acute infectious disease
* Severe cough or cough complication which needs other anti-tussive agents.
* on ACEI
* with more than three hypertensive agents
* change of hypertension medication 3 months ago
* immunocompromized host
* relative or absolute contraindication for ebastine/pseudoephedrine

  1. hypersensitivity to ebastine/pseudoephedrine
  2. glaucoma
  3. moderate to severe hypertensive disease
  4. coronary heart disease
  5. hyperthyroidism
  6. moderate to severe liver disease
  7. benign prostate hyperplasia
  8. psychological problem
  9. Parkinson's disease
  10. on linezolid or supposed to use it.
Exploring Cerebellar Inhibition of the Motor Cortex in Stroke Patients

The past 10 years of research in post stroke patients have shown certain types of rehabilitation can help neuronal plasticity of the brain. Transcranial magnetic stimulation (TMS) can be used to monitor this plasticity by mapping the brain's function (measuring brain activity). Recent research suggests that TMS can be used for both prognosis (determining future function) and to determine what type of rehabilitation therapy will work best after stroke. The purposes of this research study are to: 1) determine changes in cerebellar activity after motor cortical stroke 2) compare changes in recovery of motor function with changes in cerebellar - motor cortex connections; 3) determine the ability of TMS to "predict" functional outcome after stroke. The primary hypotheses are: 1) functional recovery will be correlated with TMS changes (as measure of motor threshold (MT), intracortical inhibition, cerebellar cerebral inhibition (CBI), motor evoked potentials (MEPs) and recruitment curves; 2) baseline TMS will predict future functional outcomes.

Transcranial magnetic stimulation (TMS) can be used to monitor this plasticity by mapping the brain's function (measuring brain activity). Recent research suggests that TMS can be used for both prognosis (determining future function) and to determine what type of rehabilitation therapy will work best after stroke. The purposes of this research study are to: 1) determine changes in cerebellar activity after motor cortical stroke 2) compare changes in recovery of motor function with changes in cerebellar - motor cortex connections; 3) determine the ability of TMS to "predict" functional outcome after stroke. The primary hypotheses are: 1) functional recovery will be correlated with TMS changes (as measure of motor threshold (MT), intracortical inhibition, cerebellar cerebral inhibition (CBI), motor evoked potentials (MEPs) and recruitment curves; 2) baseline TMS will predict future functional outcomes.

Eligibility Criteria:
Inclusion Criteria:

* one sided ischemic stroke confirmed by radiology
* adults

Exclusion Criteria:

* brainstem stroke
* cerebellar stroke
* seizure with the recent stroke
* any history of uncontrolled seizure
* pregnancy or planning on getting pregnant during the next year
* recent history (past year) of alcohol and drug abuse (due to lack of follow up) Other criteria include TMS exclusions: aneurysm clips, previous surgery over motor cortex, open craniotomy.
Impact of Rehabilitation Program on PAH Patients Treated With Macitentan.

48 patients, over the age of 18, with pulmonary arterial hypertension (PAH) classified as WHO III-IV, that are all stable under Macitentan therapy ( medication for treating PAH patients), will be recruited to the study through the pulmonary hypertension (PH) clinic at Soroka Medical Center. The patients will be randomly divided into an intervention group, which will exercise twice a week for 12 weeks, supervised by physiotherapists, and a control group, which will only receive the medication. Tests will be performed before the beginning of the intervention program, 6 weeks after it has begun, at the end of the 12 week program, and 3 months after finishing the program.

48 patients, over the age of 18, with PAH classified as WHO III-IV, that are all stable under Macitentan therapy, will be recruited to the study through the PH clinic at Soroka Medical Center. The patients will be randomly divided into intervention and control groups.

The intervention group will exercise in a pulmonary rehabilitation program twice a week, for 12 weeks. The exercise protocol will include circuit training, with 2-3 minutes exercise intervals, including aerobic and strength training, and will be supervised by physiotherapists. The control group will continue to receive their usual Macitentan treatment.

All study participants will undergo tests before the beginning of the intervention program, 6 weeks after it has begun, at the end of the 12 week program, and 3 months after finishing the program. The tests will include a cardio-pulmonary exercise test, 6 minute walk distance measurement, WHO functional class evaluation, levels of Brain natriuretic peptide (BNP), EMPHASIS10 questionnaire (emPHasis-10 questionnaire is a short questionnaire for assessing Health Related Quality of Life in pulmonary arterial hypertension), Short Form-36 (SF-36) quality of life questionnaire and echocardiography.

Once data collection is completed, two way ANOVA repeated measures will be used to assess the changes in outcome measures.

Eligibility Criteria:
Inclusion Criteria:

1. PAH patients group 1
2. Patients Age \> 18 years,
3. Patients with WHO III
4. Patients on Macitentan treatment who are stable on disease-targeted medication for at least 2 months prior to inclusion.

Exclusion Criteria:

1. Patients with other significant comorbidity such as Pulmonary veno-occlusive disease (PVOD) or pulmonary capillary haemangiomatosis, Malignancy, Recent myocardial infarction in the last 2 weeks.
2. Patients on other PAH specific medications treatment.
Assessment of Bmi-1 on Protein and Molecular Levels in Oral Dysplasia and Squamous Cell Carcinoma: A Diagnostic Study

The aim of the current study is to assess the validation of Bmi-1 detection at both protein and molecular levels in oral epithelial dysplasia and oral squamous cell carcinoma as a biomarker for early cancer detection versus biopsy embedded in paraffin blocks.

Head and neck squamous cell carcinoma (HNSCC) including oral squamous cell carcinoma (OSCC) has been reported as the sixth most common cause of cancer mortality in the world and the fifth most commonly occurring cancer. Thus a compelling need for investigation of the underlying molecular events associated with OSCC tumorigenesis has emerged for better understanding of such lesion. Moreover, identification of biomarkers for early detection and prediction of prognosis became of extreme importance, as it was reported that early diagnosis has been vital for effective treatment of OSCC and improved the survival rate of OSCC patients.

OSCC may originate from malignant transformation of the normal oral mucosa, as well as from oral potentially malignant lesions (OPMLs) with different degrees of oral epithelial dysplasia (OED). The approach of a step-wise transition from OPMLs to OSCC was well-established, but it could be difficult to predict if and when an OPML would undergo full transformation and resulted in a tumor. Thus, using specific molecular biomarkers able to identify OED lesions with higher potential for malignant transformation would be very beneficial. Unfortunately, up to date there has been no tools available to monitor OED lesions or HNSCC patients for early stages of local recurrences or distant metastases .

Among the recently introduced biomarkers, B-lymphoma Moloney murine leukemia virus insertion region-1 (BMI1), a member of the polycomb group (PcG) genes, was considered to be pivotal in regulating stemness-related genes involved in maintaining the self-renewal ability of stem cells by promoting chromatin modifications. BMI1 was also known to be deregulated in various human types of cancer. Previous studies have revealed the capability of BMI1 to be used as a prognostic marker in gastric, esophageal, nasopharyngeal cancer, prostate, breast, cervical and ovarian cancer, However, the role of BMI1 in maintaining self-renewal and tumorigenicity in HNSCC or HNSCC-derived cancer stem cells (CSCs) remained to be clarified.

Eligibility Criteria:
Inclusion Criteria:

1. In vitro studies.
2. Samples used are oral dysplasia and squamous cell carcinoma.
3. Diagnostic accuracy of Bmi-1 marker on oral dysplasia and SCC.
4. English language published articles only.

Exclusion Criteria:

1. In vivo studies.
2. Studies using any techniques other than immunohistochemistry or PCR.
3. Samples using any carcinoma rather than squamous cell carcinoma.
4. Samples using benign tumors.
5. Samples using sarcomas.