cyrilzakka/clinical-trials huggingface dataset:
Arm and Leg Cycling Exercise After Stroke

It has been found that arm and leg cycling is similar to walking in terms of the muscle activation patterns and joint ranges of motion. In addition, arm and leg cycling and walking activate similar neural pathways. Another advantage of arm and leg cycling is that it involves coordination of all four limbs in a rhythmic movement. This may be particularly beneficial given previous findings that arm movement contributes to the activation of leg muscles during walking in humans. This is achieved with interconnected neural pathways that link the arms to the legs. These neural interlimb connections remain intact in stroke victims, such that maximizing the contribution of the arms to the legs may increase coordination for walking. Thus, the objectives of this research are to determine if arm and leg cycling can be used to increase the strength of interlimb connections and if this helps to improve walking ability in a post-stroke population. It is hypothesized that arm and leg cycling will transfer to improvements in walking in a post stroke population.

For those who have suffered a stroke, damage to the brain can result in a decreased ability to walk, thus decreasing quality of life in a significant way. Traditionally, body weight supported treadmill training has been used for walking rehabilitation; however, this therapy requires specialized technicians, equipment, and facilities. Arm and leg cycle ergometers, a device commonly found in a gym, could provide an inexpensive and readily accessible means for walking rehabilitation.

Eligibility Criteria:
Inclusion Criteria:

* stroke
* lives within the Victoria, Vancouver Island, and Vancouver mainland communities

Exclusion Criteria:

* inability to stand for 5 minutes unassisted
Clomifene Citrate as First Line Treatment in in Vitro Fertilization Cycles for Patients With Lower Ovarian Reserve

Women with compromised ovarian reserve requiring in vitro fertilization (IVF) still represent a demanding challenge for clinicians. It has classically been claimed that using higher dosages of gonadotropins may overcome the scarce ovarian responsiveness to hyper-simulation and increase the chances of success. However, scientific evidence supporting this view is scanty and costs are inevitably much higher. In this study, the investigators hypothesized that similar chances of pregnancy may be achieved with a mild stimulation using exclusively Clomiphene citrate (CC).


Eligibility Criteria:
Inclusion Criteria:

* age 18-42 years
* infertility status
* Day 3 serum FSH \> 12 IU/ml in at least two occasions or previous poor response (≤3 oocytes retrieved) to hyper-stimulation

Exclusion Criteria:

* contraindications to infertility treatments or pregnancy
Incretin Action in Physiology and Diabetes

This project is designed to advance understanding of the incretin effect in health and disease. This system of gut-islet linkage is essential for normal glucose tolerance, impaired in T2DM, and amenable to therapeutic intervention. However, there are important gaps in understanding incretin function that limit application of this system; this project will address several of these. A secondary, but critical aspect of this research is focus on inter-individual variation in the physiology of the incretin system. This is a novel direction for research in this field and is critical to advancing the concept of individualized medical care in diabetes by establishing whether there is a physiologic basis for predicting the existence of responders and non-responders to incretin therapies.

Currently, we have described only Aim 1 from this grant in this protocol registration. While Aim 2 and 3 are described in the grant, Aim 1 will be conducted first and the results from this Aim and / or the publication of other results in the field may affect the approach to Aims 2 and 3.


Eligibility Criteria:
Inclusion Criteria:

* healthy adult volunteers
* fasting plasma glucose value ≤ 95 mg/dL, measured at screening visit
* HbA1c ≤ 5.9%, measured at screening visit

Exclusion Criteria:

* history of diabetes diagnosis, including gestational diabetes
* presence of Type II diabetes mellitus among any first degree family members
* rheumatoid arthritis
* inflammatory bowel disease
* unstable angina or uncompensated heart failure
* pulmonary disorders including COPD and asthma
* malabsorptive GI disease, such as celiac disease, or gastric bypass
* significant hepatic disease
* renal insufficiency (eGFR \< 60 mL/kg/min)
* anemia (hematocrit \< 34%) as measured at screening visit
* pregnancy
* uncontrolled hypertension
* consumption of daily medications that alter glucose metabolism or GI function (glucocorticoids, psychotropics, narcotics, metoclopramide)
Perioperative Factors and Early Postoperative Kidney Graft Function Recovery

Divided into two groups based on acute kidney injury: non-acute kidney injury group vs. non-acute kidney injury group. Acute kidney injury group, Acute Kidney Injury Network (AKIN), Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE), or Kidney Disease: Improving Global Outcomes (KDIGO) I would like to divide it according to the definition. After testing the normal distribution of patients, donors, grafts, types of immunosuppressants, surgery/anesthesia factors, and blood test findings between the two groups through the Shapiro-Wilk test, continuous data was tested using the student t-test or Mann-Whitney U test. Sizes are compared using , and categorical data is compared with proportions using the χ2 test or Fisher's exact test. Analysis of factors related to acute kidney injury will be performed through univariate and multivariate logistic regression analysis.


Eligibility Criteria:
Inclusion Criteria:

* Adult patients aged 19 years or older who underwent kidney transplant surgery in the operating room

Exclusion Criteria:

* Pediatric patients under 19 years of age
* Patients with multiple organ transplants, including kidney transplants
* Patients undergoing re-kidney transplant surgery
* Patient examination findings missing from electronic medical record
Patient and Physician Knowledge of Key Safety Messages

This cross-sectional epidemiologic study measured physician and patient awareness and understanding of the key messages in the Xarelto prescriber guide and Xarelto patient alert card.


Eligibility Criteria:
- Inclusion criteria:

Physician eligibility:

* Prescription of rivaroxaban in the past 6 months for adult patients for the Prevention of stroke and systemic embolism with non-valvular atrial fibrillation (SPAF) or Treatment of deep venous thrombosis (DVT) and prevention of recurrent DVT and pulmonary embolism (PE) following an acute DVT.

Patient eligibility:

* Use of rivaroxaban for SPAF or DVT within the previous 3 months; aged 18 years and above; able to understand and complete the consent form and patient questionnaire.
Oral Pathology Asynchronous Telementoring Pilot Study

The purpose of the proposed research project is to evaluate and enhance the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the 6 dental clinics of Family Health Centers at NYU Langone (FHC), a Federally Qualified Health Center (FQHC) in Brooklyn, NY.

The tele-mentoring intervention involves training dental faculty members and residents to use intraoral cameras to take photographs of oral lesions and place them in the Dentrix electronic health record (EHR), along with descriptions of the lesions. Using a mixed-methods approach, the study will evaluate and enhance the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the 6 FHC dental clinics.

Eligibility Criteria:
Inclusion Criteria:

Dental patients will be eligible for study participation if they meet the following criteria:

1. Greater than or equal to 18 years of age.
2. Live in any of the 5 boroughs of New York, NY and visit a participating FHC dental clinic for routine dental care.
3. Able and willing to provide informed consent, have their oral lesion(s) photograph(s) and accompanying data entered into the Dentrix EHR, and participate in an exit interview.

Dental providers will be eligible for study participation if they meet the following criteria:

1. Greater than or equal to 18 years of age.
2. Be employed as a dentist or placed as a dental resident at a participating FHC dental clinic.
3. Able and willing to provide informed consent and participate in feasibility testing (provider survey or semi-structured interview).

Exclusion Criteria:

Dental patients will be excluded from study participation if they meet the following criteria:

1. Have an acute or terminal illness or a serious mental illness or any other severe health condition(s) that might preclude visiting an oral health care provider.
2. Are currently participating in another oral health study.

Dental providers will be excluded from study participation if they meet the following criteria:

1. Have an acute or terminal illness or a serious mental illness or any other severe health condition(s) that might preclude them from completing the feasibility testing.
Second-line Therapy

This study will help identify which ARV candidates should be prioritized for pediatric use in resource-limited settings

Children in resource-limited settings are increasing experiencing treatment failure, as defined by virologic, immunologic, and/or clinical criteria. There are few studies of HIV resistance mutations in children failing first line NNRTI therapy in resource limited settings. The emergence of treatment failure and drug resistance in children on ART emphasizes the urgency for developing evidence-based second-line and salvage treatment strategies. Pediatric treatment is complicated by a number of factors, including having fewer numbers of ARVs approved by drug safety agencies and the lack of pediatric formulations. This further shortens the list of available second-line ARVs as compared to adults.

Despite the growing number of children on second-line therapy worldwide, there are limited data on efficacy of second-line PI therapy in children after NRTI-NNRTI failure. There are currently no options for third-line/salvage regimens for children in resource-limited settings. New drugs and drug classes are approved for use in children by the US FDA but are not routinely available outside of high-income settings.

Also, there are no data on the resistance patterns of children failing second-line therapy in resource-limited settings to guide clinical management and ARV procurement. Clinicians need evidence-based guidelines for how to manage children with treatment failure, and access to the drugs necessary to construct potent and durable third-line regimens.

TASER-P is a longitudinal observational cohort study to monitor for treatment failure to second-line ART in Asian children.

Eligibility Criteria:
Inclusion Criteria:

* Age \< 18 years old
* Have confirmed HIV infection
* Are being switched to or treated with second-line ART. Second-line ART is defined as the second regimen with a major antiretroviral class switch. For example, a switch from an NNRTI-based to a PI-based regimen or vice versa
* Caregivers give informed consent. Children will be asked to give assent if they know their HIV status and have reached the minimum age to give assent according to each site's institutional review board regulations

Exclusion Criteria:

* Started mono- or dual- therapy as the first ART therapy
* Failing first-line triple nucleoside reverse transcriptase inhibitor regimen
* Are being switched to or treated with second-line ART without failure of first-line therapy (i.e., for toxicity)
* Caregiver +/- child (if asked to give assent) refuses to participate in this study
* Have not been enrolled in TApHOD
Sevoflurane- Safety in Long-term Sedation Procedures

Patients needing intensive care often require sedative drugs to reduce anxiety and agitation during ventilator care and invasive therapeutic and diagnostic procedures. At present there is no optimal sedative agent for these patients. The most commonly used sedative agents in intensive care units are midazolam and propofol. Both drugs have side effects of clinical importance.

At present, a viable alternative to intravenous sedation is inhalatory sedation. Sevoflurane, as other inhaled anesthetic agents, is sedative in low doses. A new simplified method of administration of isoflurane or sevoflurane has been developed. The Anesthetic Conserving Device is a modified heat-moisture exchanger (HME) that permits direct infusion of sevoflurane to the airway, where it is vaporized in an evaporator rod in the device.

However, the use of sevoflurane is limited to anesthesia and sedation lasting no more than 12 hours, since the possible renal problems posed by inorganic fluoride in prolonged operations remain the subject of controversy.

The primary aim (and primary hypothesis) of the current trial is to determine whether sevoflurane can be administered as a sedative drug for more than 48 hours without clinically relevant physiopathological effects on kidney and liver function.

Other end-points of the trial are to evaluate the quality of sedation of sevoflurane, in terms of sedation control, the rapidity and predictability of awakening, and the incidence of delirium in critical care patients.


Eligibility Criteria:
Inclusion Criteria:

* Signing of the informed consent document (patient or relatives).
* Patient age 18 years or older.
* Expected minimum duration of sedation: 48 hours.

Exclusion Criteria:

* Chronic renal failure treated with replacement therapy (hemodialysis or peritoneal dialysis).
* Acute kidney injury in Stage 3 of AKIN classification
* Grade C hepatic Child-Pugh classification
* Established Acute Respiratory Distress Syndrome (ARDS).
* Central nervous system pathology with cognitive disorders that not allow performing the test of the study: severe dementia, Alzheimer's disease, depression, schizophrenia, acute stroke.
* Head trauma with Glasgow \<12.
* Patient treated with antiepileptic drugs that must be maintained during the study period
* Patients requiring the use of neuromuscular blocking agents during the infusion of study drug, except for the insertion of the endotracheal tube.
* Epidural or spinal analgesia
* Allergy or known hypersensitivity to any of the study drugs
* Patients with known or suspected genetic susceptibility to malignant hyperthermia
* Previous participation in this trial
* Participation in another clinical trial within 4 weeks prior to selection.
* Pregnant women
White Spot Lesions Development in Mixed Dentition Patients

36 patient will be divided into two equal groups. one for removable inclined plane while the other will be treated using clear aligner appliances. evaluation of the white spot lesion will be accumplished for all patients clinically before anr after completion of treatment.

The sample size was calculated using G\*Power (Version 3.1.9.4; Germany) and designed to have a power of 82% assuming type I statistical error of 5% and one-tailed statistical test based on Azeem and Hamid.13 The calculated sample was 15 patients in each group. The sample will be increased to include 36 patients: 18 patients per group for a 20% expected loss.

Patients with the age range of 9 to 12 years will be selected for the study. All patients and their parents will be informed of the procedures and will sign the informed consent. Patients who had periodontal diseases, bone resorption cleft lip and palate deformities, orofacial syndrome, hypoplastic enamel defects, and multiple restorations on the facial surfaces or unable to maintain good oral hygiene will be excluded from the study.

All patients will be randomly allocated into two groups according to the management protocol: inclined plane and clear aligner. The patients will be examined for any white spot lesion on the labial surface of the teeth in the upper and lower jaws clinically and using lateral and frontal intraoral photographs immediately before treatment and monthly along the treatment procedures. Each tooth will be evaluated, and the total lesions count will be recorded for each patient. All patients will be instructed to maintain good oral hygiene using fluoridated toothpaste daily.

Statistical analysis:

The incidence of the WSL in each tooth and the total lesions count will be calculated for each patient. These data will be collected and subjected to the appropriate statistical tests using the SPSS version 20.0 software for Windows (IBM, USA).

Eligibility Criteria:
Inclusion Criteria:

* Patients with the age range of 9 to 12 years with anterior crossbite will be selected for the study

Exclusion Criteria:

* periodontal diseases, bone resorption cleft lip and palate deformities, orofacial syndrome, hypoplastic enamel defects, and multiple restorations on the facial surfaces or unable to maintain good oral hygiene
Using Artificial Intelligence to Predict Rectal Cancer Outcomes

Investigator retrospective collect cases during 2010-2021 diagnosed as rectal adenocarcinoma with high quality CT images. Local advanced rectal cancer cases were labeled as "disease". Nor were defined " normal".

Using artificial intelligence CNN on jupyter notebook with open phyton code to train and develop models capable to recognizing local advanced rectal cancer. Modify the phyton code for better predict rate and help physician to quickly evaluate disease severity for fresh rectal cancer cases.

From 2010.10.1\~2021.12.31, rectal cancer patients with cT3-4 lesion was included. Collect high quality CT images with DICOM files in tumor segment. cT1-2, low rectal lesions, non-CRC cases were not included. Non-contrast and artificial defect images were also excluded. CT images were labeled as" diseased " when CRM were threatened (\<2mm). All images were labeled according to judgment of 2 specialist. The data were separated into 2 parts. One for AI model training and testing, another for external validation. The training testing dataset was achieved by deep learning neural network and evaluating model accuracy performance. Then the model was applied into external validation dataset for real-world testing, evaluating coherent rate between AI and the Dr. decision. Furthermore, to see the cancer survival outcomes according to AI model prediction results.

Eligibility Criteria:
Inclusion Criteria:

* clinical staging T3-4 with high quality CT images.

Exclusion Criteria:

* 1. not primary malignancy lesion
* 2. not localizing rectum
* 3. T1-2 lesion
* 4. non contrast or poor quality images
Impact Emotional Intelligence Program on Opioid Relapse

Addiction is the repeated and increased use of a substance, the deprivation of which gives rise to symptoms of distress and an irresistible urge to use the agent again and which leads also to physical and mental deterioration. The concept of emotional intelligent (EI) "the ability to perceive accurately, appraise and express emotion; the ability to access and generate feelings when they facilitate thought; the ability to understand emotion and emotional knowledge; and the ability to regulate emotions to promote emotional and intellectual growth". Most drug addicts possess hidden defects in their social skills, and do not have good relations with their peers.

Addiction is the repeated and increased use of a substance, the deprivation of which gives rise to symptoms of distress and an irresistible urge to use the agent again and which leads also to physical and mental deterioration. Continued opioid misuse can result in syndromes of abuse and dependence and cause disturbances in mood, behavior, and cognition that can mimic other psychiatric disorders. Opioid addiction affects the young and the old, the wealthy and the poor, and the professional and the unemployed.

The concept of emotional intelligent (EI) "the ability to perceive accurately, appraise and express emotion; the ability to access and generate feelings when they facilitate thought; the ability to understand emotion and emotional knowledge; and the ability to regulate emotions to promote emotional and intellectual growth", the ability to manage and regulate emotions in an effective manner and ability to be sufficiently optimistic, positive and self- motivated in order to set and achieve goals.

Most drug addicts possess hidden defects in their social skills, and do not have good relations with their peers. The other possible causes of orienting toward drugs are defects in problem solving, stress-management, and prevention from dangerous and impulsive behaviors.

Eligibility Criteria:
Inclusion Criteria:

* in opioid groups: only opioid addiction
* in healthy groups: no history of psychiatric illness or substance use

Exclusion Criteria:

* have medical conditions
The Effect of Complex Decongestive Therapy in Patients With Lymphedema

The aim of this study is to investigate objectively the effect of lymphatic fluid which is circulated with Complex Decongestive Therapy on fluid excretion from the body in patients with lymphedema.

The lymphatic system is the accessory circulatory system that takes lymph fluid from the interstitial space and adds it to the blood circulation. It starts from the interstitial space. It consists of lymph vessels, lymph fluid and lymphatic organs. Lymph fluid passes through many lymph nodes during its transport and is filtered in these nodules. The lymphatic system takes lymphatic fluid from the tissues and brings it to the venous part of the circulatory system. The main task of the lymph system is to reabsorb substances that cannot be absorbed by the blood circulation system. Non-absorbable substances in the interstitial space are called lymphatic load. Lymphatic load; It consists of protein, water, fat and cells. The aim of lymphedema treatment is to remove the protein-rich fluid accumulated in the interstitial space into the venous system. There are many factors in the flow of lymph fluid into the veins. The most important of these is the high filtration pressure that occurs when fluid is filtered through blood capillaries. Lymph fluid flowing from the periphery to the center is generally affected by pressure changes and moves from where the pressure is high to where it is low. Contraction of the muscles adjacent to the lymph vessels, pulsation of the neighboring arteries, and the effect of the smooth muscles in the lymph vessel wall also cause pressure changes. Other factors include respiratory movements acting as a pump in the lymph flow, the actual pressure effect of abdominal pressure on the cisterna chyli, and negative intrathoracic pressure.

Complex Decongestive Physiotherapy is proven effective and considered the gold standard for the treatment of lymphedema. It increases the hydrostatic pressure that has decreased due to edema and helps the lymph fluid to re-enter the circulation.

Purpose of the study; To objectively investigate whether the lymph fluid added to the circulation through Complex Decongestive Physiotherapy in lymphedema patients has an effect on fluid excretion from the body.

Eligibility Criteria:
Inclusion Criteria:

* Female cases
* Cases diagnosed with lower extremity unilateral/bilateral lymphedema
* Having received or not received radiotherapy and/or chemotherapy

Exclusion Criteria:

* Having received treatment for lymphedema in the last year
* Having metastatic disease
* Those diagnosed with severe heart failure and/or arrhythmia
* Arterial disorders
* Kidney diseases
* Infection in affected extremities
* Psychological disorders
* Diabetes
* Nephrotic syndrome
* Diuretic use
* Patients using chemotherapy and drugs that have toxic effects on the kidneys
* Those with liver cirrhosis, liver disease
* Neurological diseases
Intervention Study to Evaluate the Importance of Information Given to Patients With Contact Allergy

The purpose of this study is to determine whether extended information given to patients with contact allergy improves knowledge, treatment efficacy and daily functioning.


Eligibility Criteria:
Inclusion Criteria:

* Patients with suspected contact allergy
* Age above 18 years
* Participants have given informed consent

Exclusion Criteria:

* Mental or language disabilities