cyrilzakka/clinical-trials huggingface dataset:
LOC387715/HTRA1 and the Combined Photodynamic Therapy With Intravitreal Bevacizumab in Polypoidal Choroidal Vasculopathy

This study is to investigate whether there is an association of the LOC387715/HTRA1 variants with response to treatment with combined photodynamic therapy and intravitreal bevacizumab for patients with polypoidal choroidal vasculopathy.

This is a retrospective cohort study comprised of 70 eyes being treated for polypoidal choroidal vasculopathy with combined photodynamic therapy and intravitreal bevacizumab injections. Patients were genotyped for the LOC387715 (rs10490924) and the HTRA1 gene polymorphism (rs11200638).

Eligibility Criteria:
Inclusion Criteria:

* patients older than 60 years of age at onset
* polyp-like terminal aneurysmal dilations with or without branching vascular networks in indocyanine green angiography (ICGA) and subretinal reddish-orange protrusions corresponding to polyp-like lesions
* patients who had combined photodynamic therapy and intravitreal bevacizumab injections, and followed up for more than 12 months after the first treatment

Exclusion Criteria:

* patients with retinal or choroidal diseases including pathologic myopia, angioid streaks, idiopathic choroidal neovascularization (CNV), presumed ocular histoplasmosis, and other secondary CNV
* patients who refused genotypic analyses
Predicting Myocardial Infarction After Abdominal Surgery: Clinical Scores & Biomarkers

All patients undergoing non-cardiac surgery who met the inclusion criteria underwent a preoperative evaluation using specific assessment tools.

Following surgery, patients were closely monitored in the intermediate care unit for the first 24 hours for the development of acute myocardial infarction (AMI). AMI was diagnosed based on the presence of chest pain, elevated cardiac biomarkers, and specific electrocardiogram (ECG) and echocardiogram findings.


Eligibility Criteria:
Inclusion Criteria:

* Patients older than 45,
* Patients of ASA-PS grade II-IV,
* Patients who prepared for non-cardiac surgeries of SSS of II-IV,
* Patients free of exclusion criteria,
* Patients signed the written consent for the study precipitation.

Exclusion Criteria:

* Patients of ASA-PS grade I or V,
* Patients younger than 60 years,
* Patients planned to undergo surgeries of SSS \>IV,
* Patients were severely frail with CFS\>6,
* Patients had abnormal preoperative electrocardiography (ECG),
* Patients had a history of previous major cardiac or cerebrovascular events,
* Patient had disturbed cognitive function, coagulopathy, severe anemia with hemoglobin concentration (HBC) \< 7 gm/dl.
Amantadine as Adjunctive Therapy to Antipsychotics in Schizophrenia

Amantadine as add-on therapy to antipsychotics may improve schizophrenia positive, negative and cognitive symptoms.


Eligibility Criteria:
Inclusion Criteria:

* Under antipsychotics with residual symptoms

Exclusion Criteria:

* Pregnancy
* Lactation
Analyzing IBS to Identify Biomarkers and Microbiome Signatures

Microbiota from fecal samples from IBS-D patients, in combination with vitamin D supplementation added to our 3-D immunocompetent intestinal models will establish a high fidelity disease model to achieve our long-term goal to understand the relationship between gut microbiome, vitamin D levels, host gene expression and IBS-D symptoms that could ultimately be used as a testing platform for treatment and prevention.

The pathophysiology of IBS is not well understood. Preliminary studies support IBS-D patients with varied microbiome fingerprints, vitamin D levels, and blood serotonin levels compared to non-IBS patients. The investigators have novel 3-D immunocompetent intestinal models to establish a new model of high fidelity disease to examine the relationship of IBS-D patients gut microbiome, with supplemental vitamin D levels, and the relationship of blood serotonin and vitamin D levels. IBS-D patients and healthy controls will be asked to provide a fecal sample, a biopsy sample of colonic tissue obtained during a clinically appropriate flexible sigmoidoscopy or colonoscopy, and a blood sample. There will be 1-2 office visits. One visit will last 30 minutes, the second visit no longer than 3 hours. This study is funded by a combined MAYO-Arizona State University seed grant. The samples will be analyzed at ASU. Our long-term goal is to understand the relationship between gut microbiome, vitamin D levels, host gene expression, serotonin levels, and IBS-D symptoms that could ultimately be used as a testing platform for treatment and prevention of this highly prevalent disorder.

Eligibility Criteria:
Inclusion criteria:

IBS-D subjects:

* Patients who fulfill IBS-D criteria, without causes of active inflammation.
* active symptoms for at least 2 months
* diagnosed at least 6 months prior to enrollment

Healthy Control:

- Healthy control patients should have no active infection or inflammation.

Exclusion criteria:

* does not meet inclusion criteria
* will not participate in blood draw, stool sample donation, or endoscopy
* history of acute illness within 3 months of testing
* any fecal transplant history
Local vs Systemic Methotrexate in Management of Uterine Ectopic Pregnancy

This study aims to compare local and systemic methotrexate in the management of uterine ectopic pregnancy regarding the duration of beta human chorionic gonadotropin (hCG) clearance and need for further management options.

Ectopic pregnancy is considered a life-threatening condition which requires immediate intervention. Owing to the advancements in medical technology, ectopic pregnancy can now be diagnosed in the early stages.

Methotrexate (MTX) is an antimetabolite drug showing a competitive reversible binding concerning natural dihydrofolates and acting as an inhibitor of the dihydrofolate-reductase (DHFR), a key enzyme synthesizing the tetrahydrofolates needed for the synthesis of purine and pyrimidine rings.

Eligibility Criteria:
Inclusion Criteria:

* Age from 20 to 40 years.
* Women with uterine ectopic pregnancy (interstitial pregnancy, cervical pregnancy, or cesarean scar pregnancy).
* Gestational age is less than 9 weeks, the embryo size is smaller than 10 mm, and the serum beta-human chorionic gonadotropin (β-hCG) levels are less than 10,000 mIU/mL.

Exclusion Criteria:

* Patients with basal beta hCG levels less than 1500 mIU/Ml.
* Any contraindications to MTX as a hepatic disorder, renal disorder and thrombocytopenia
* Diabetes mellitus.
* Severe vaginal bleeding or hemodynamic changes or hemoperitoneum.
* History of cancer.
* Ascites.
* Pleural effusion.
Morphological Characteristics of Inferior Pole Patellar Fractures and a Finite Element Analysis Combined with a Retrospective Clinical Study of Anchor Suture and Titanium Cable Cerclage Treatment

The goal of this study is to compare the biomechanical stability and clinical outcomes of two treatment methods for inferior pole patellar fractures (IPPF): anchor suture with patellar cerclage and Kirschner-wire tension band combined with patellar cerclage. The study involves patients with IPPF, focusing on fracture patterns and treatment outcomes.

1. Undergo retrospective analysis of fracture patterns using fracture mapping.
2. Participate in biomechanical analysis via finite element modeling of both treatment methods.
3. Be part of a clinical comparison between two surgical treatments based on operative time, postoperative complications, and functional outcomes.


Eligibility Criteria:
Inclusion Criteria:

(1) diagnosis of IPPF confirmed by X-ray or CT, and (2) patients aged between 18 and 70 years.

Exclusion Criteria:

(1) concomitant fractures of other parts of the knee, (2) open fractures, and (3) pathological fractures.
Effectiveness of Lidocaine Injection on Stellate Ganglion in Pediatric Patients With Autism Spectrum Disorder

The goal of this clinical trial is to explore efficacy of stellate ganglion block Children with Autistic Disorder. The main question it aims to answer is:

Can stellate ganglion block improve the Autistic Disorder in children? Children with Autistic Disorder will be divided into the control group and experimental group evenly. All the patients were provided with routine therapy, while the patients in the experimental group were given stellate ganglion block. The Childhood Autism Rating Scale of the two groups of patients before and after treatment are evaluated.

Autistic Disorder in children is becoming increasingly more. The goal of this clinical trial is to explore efficacy of stellate ganglion block Children with Autistic Disorder. The main question it aims to answer is:

Can stellate ganglion block improve the Autistic Disorder in children? Children with Autistic Disorder will be divided into the control group and experimental group evenly. All the patients were provided with routine therapy, while the patients in the experimental group were given stellate ganglion block. The Childhood Autism Rating Scale of the two groups of patients before and after treatment are evaluated.

Eligibility Criteria:
Inclusion Criteria:

* Diagnosed as Autistic Disorder.
* Aged between 3 years old and 6 years old.
* No contraindications to stellate ganglion block.

Exclusion Criteria:

* Other significant physical or neurodevelopmental disorders.
* Other significant medical conditions
Heat Stress and Volume Administration

Heat stress reduces the central blood volume and causes orthostatic intolerance. The hypothesis is that infusion of volume may reduce effects of orthostatic stress during heat stress.


Eligibility Criteria:
Inclusion Criteria:

* Age \> 18 \< 40

Exclusion Criteria:

* Abnormal medical history
Evaluation of the Microbiome in Multiple Sclerosis

To access the small intestinal microbiome and find abnormal microbiome/metabolome signature in luminal fluid samples from small bowel in MS compared to HC that could be used as biomarkers for MS.

Participants will be swallowing the SIMBA capsule which allows for minimally-invasive sampling of the microbiome and metabolome deep in the small intestine. Researchers will use the capsule samples to access the small intestinal microbiome and find abnormal metabolomic signatures in luminal fluid samples from the small bowel in Multiple Sclerosis (MS) patients compared to healthy control.

Eligibility Criteria:
Inclusion Criteria:

1. Age between 18 and 60 years inclusive.
2. Have diagnosis of Multiple Sclerosis (relapsing remitting or secondary progressive for the MS cohort) or be a healthy individual living in the same household (non-MS for the healthy control cohort)
3. No antibiotics, or colon cleanses/bowel preparation in the previous 2 weeks.
4. Written informed consent

Exclusion Criteria:

1. Known to have swallowing disorders
2. Known disease which, in the investigator's opinion, would lead to intestinal stricture or obstruction with a risk of capsule non-excretion (particular diseases which would be assessed on a case-by-case basis would include, achalasia, eosinophilic esophagitis, diverticulitis, Crohn's disease, Ulcerative colitis, cancer diagnosis or treatment within the past year, or previous oesophageal, gastric, small intestinal, or colonic surgery. 3) Appendectomy or cholecystectomy more than 3 months prior to enrolment are acceptable). The main deciding factor would be history of obstructive symptoms in the previous 3 months prior to entry.
3. Use of any medications in the previous week that could substantially alter gastrointestinal motor function (e.g., opioids, prokinetics, anticholinergics, laxatives), or acidity (PPI, H2RA); for both groups.
4. \< 2 bowel movements per week (for both groups).
5. Risk or suspect of being pregnant
Prospective Multicenter Randomized and Controlled Study Evaluating the Benefit of Early Pulmonary Vein Isolation Compared to Usual Treatment in Patients Aged Over 75 Years and Presenting With Atrial Fibrillation

Therapeutic management of Atrial Fibrillation (AF) is based either on heart rate control or on rhythm control, a strategy which aims to maintain a normal heart rhythm. The benefit in terms of morbidity and mortality of a normal heart rhythm would, however, be largely offset by the frequent side effects of antiarrhythmic drugs which could even lead to an increase in mortality compared to rate control. This increase has particularly been suggested in people aged over 75.

Since the emergence of catheter Pulmonary Vein Isolation (PVI), an effective alternative to antiarrhythmic drugs has become available. This technique makes it possible to isolate the foci triggering AF under local or general anesthesia with greater effectiveness than medications and very low risks. Records in the elderly do not seem to show a reduction in effectiveness or an increase in complications. However, in the absence of a dedicated randomized study, its use is strongly limited in the elderly where rate control (52% of people over 65 years old) and the use of antiarrhythmic drugs are largely favored due to the simplicity of implementation and the low cost of medications.

However, an early rhythm control strategy seems to reduce cardiovascular events in relatively old individuals (average age 70 years). The use of PVI in first line could make it possible to further improve these results.

The objective of the investigator is therefore to carry out the first randomized comparative study proposing to evaluate the impact of early PVI compared to usual treatment in patients aged 75 and over with AF.


Eligibility Criteria:
Inclusion Criteria:

* Man or woman aged 75 and over.
* Paroxysmal AF or early recurrent or persistent paroxysmal AF first diagnosed less than 12 months ago.
* Patient who consented to participate in the study.
* Patient affiliated to a social security system.

Exclusion Criteria:

* Indication of cardiac pacing or defibrillation at baseline.
* History of valve replacement, atrial occlusion or exclusion.
* History of AF ablation.
* Contraindication to anticoagulation or an invasive procedure.
* Significant heart disease (structural with alteration of LVEF \<35%, congenital heart disease, hypertrophic heart disease with wall of more than 15 mm, revascularized coronary syndrome less than 3 months old).
* Stroke less than 6 months old.
* Uncontrolled dysthyroidism.
* Chronic renal failure (CKD - eGFR \<30 µMol/L).
* Patient under curatorship, guardianship, safeguard of justice.
* Life expectancy less than 24 months.
* Participation in another therapeutic trial likely to impact the study evaluation criteria.
* Severe cognitive impairment noted in history.
* Lack of understanding of the study.
Digital Health Intervention Based on Artificial Intelligence to Support the Personalized Recovery of Long COVID Patients Affected by Fatigue (AIDA)

The AIDA feasibility study builds upon mental health and technology acceptance theoretical frameworks. It examines the feasibility of a mobile-based digital program to support patients with long covid affected by fatigue. The program Adhera ® Fatigue Self-management is adapted for long covid patients.

The study will explore the usability and engagement of a digital program designed for long covid patients affected by fatigue. The digital program relies on the Adhera® personalized digital health solution that includes personalized patient education and support, monitoring using psychometrics and wearables, and mental wellbeing exercises. The patients access the mobile solution via a mobile app. A total of 15 patients will be recruited and use the mobile solution for one month.

Eligibility Criteria:
Inclusion Criteria:

* Legal adults (older than 18)
* Long COVID diagnosis within the last year
* In possession of a compatible smartphone (Android OS v4.4 or higher)
* Reporting any of these symptoms:

  * Fatigue
  * Dyspnea
  * Anxiety
  * Stress
  * Depression
  * Sleep disorder

Exclusion Criteria:

* Hospital admission during follow-up due to pathology not related to COVID-19
* Patients without digital literacy or who cannot use the mobile application.
* Known severe psychiatric illness or cognitive impairment
* Being pregnant (or suspected to be pregnant)
Distance Education for Nursing Students on Critical Thinking

Critical thinking forms the basis of nursing knowledge. Critical thinking skills constitute a vital part of the nurse's work performance, adaptation, problem solving, awareness of the responsibilities of the profession, and the conceptual understanding of nursing. Due to the increasing number of dependent patients, complex care needs and increasing research in the field of health, intensive care nurses have to think critically in order to learn throughout life, develop professionally, work effectively with teammates, reach care and treatment goals, and contribute to the change of society.

The sample size of the study was calculated using the G\*Power Software (ver. 3.1.9.2) program. For the smallest sample size of the study, 85% power and medium effect size (f:0.25) at the 95% confidence interval, 110 individuals were found, with at least 55 individuals in each group. The intervention group consisted of students enrolled in the intensive care nursing course, which is one of the third year elective courses, and the control group consisted of the students enrolled in the perinatology course from the third year elective courses. The study was completed on a voluntary basis. After the losses, a sample of 64 from the intervention group and 54 from the control group was created, and the data of a total of 118 students were evaluated. The students in the intervention group were given theoretical training for the first 4 weeks, followed by theoretical and case presentations in the following weeks. It is aimed to increase the critical thinking disposition of the students by using critical thinking techniques during the trainings. A total of 8 weeks of training was given. For the first 5 weeks, training was given with a two-week break for the next three weeks. The control group was given a booklet for critical thinking. Pre-test and post-test were applied simultaneously to both groups. Critical thinking disposition scale was applied in the pre-test and post-test.

Eligibility Criteria:
Inclusion Criteria:

* Willingness to participate in the research,
* Willingness to participate in the research,
* Not having taken a critical thinking course before,
* Being able to speak Turkish,

Exclusion Criteria:

* Not being willing to participate in the research,
* Not willing to participate in the research,
* To fill in the research forms incompletely,
* Working as a nurse in an institution
* To be a graduate of the nursing department from a health vocational high school.
D2 Dopamine Receptor on Human Aldosterone-Producing Adenoma and Its Role in Aldosterone Secretion and Cell Proliferation

Dopamine (DA) is one of the main catecholamines in mammals. Its major role as a brain neurotransmitter is well known as well as its contribution to the development of pathologies, mainly arterial hypertension. Traditionally, dopamine receptors are divided into two families according to the stimulation or inhibition they may produce at the adenyl cyclase level. Five dopamine receptors have been identified: D1 (D1a) and D5 (D1b) exist in the D1 family. D2s, D2l, D3 and D4 belong to the D2 family. Formerly, less than 1% of patients with hypertension were believed to have primary hyperaldosteronism; however, recent studies have suggested that primary aldosteronism affects 5-13% of patients with hypertension and aldosteronomas are a more common cause of hypertension than previously thought. At least 2% of patients with hypertension may have an aldosteronoma. The investigators' previous clinical observation found two subtypes of aldosterone-producing adenoma (APA), which were defined according to their responses to metoclopramide during salt manipulation. On a high-salt diet (HS), the nonsuppressible subjects, with less dopaminergic inhibition of aldosterone secretion, had less urinary DA excretion and greater blood pressure (BP) elevation \[Wu KD et al. 2002\]. The investigators' recent study of six patients with an APA found that the expression of the D2 receptor in APA was not universal. The amounts of D2 receptor messenger ribonucleic acid (mRNA) were more variant in either APA or their remnant adrenal glands. Only two cases of APA expressed the D2 receptors with much weaker signals compared with those in their respective remnant adrenals \[Wu KD et al. 2001\]. The investigators' current work demonstrates that the D2 receptor negatively regulates AII-stimulated aldosterone secretion and aldosterone synthase mRNA expression in NCI-H295R cells. On the other hand, the D4 receptor counteracts with the effect of the D2 receptor. In a future study, the investigators wish to quantify D2 and D4 receptor mRNA and protein expression in APA and their remnant adrenal glands and correlate them to their clinical metoclopramide test results. The investigators also wish to know whether the difference between the D2 and D4 receptor expression reflect the different effects of dopamine inhibition on AII-stimulated aldosterone secretion and aldosterone synthase transcription. Finally, the investigators will explore the role of D2 and D4 receptors on AII-stimulated adrenal cell proliferation.


Eligibility Criteria:
Inclusion Criteria:

* Adrenal aldosterone-producing adenoma
Emergency Preservation and Resuscitation (EPR) for Cardiac Arrest From Trauma

The goal of this study is to rapidly cool trauma victims who have suffered cardiac arrest from bleeding with a flush of ice-cold sodium chloride to preserve the patient to enable surgical control of bleeding, followed by delayed resuscitation with cardiopulmonary bypass.

The intent of the technique to be studied is to induce a state of hypothermic preservation in trauma victims who have exsanguinated to the point of cardiac arrest. In appropriately selected subjects, after an initial emergency attempt at resuscitation with standard techniques, an arterial catheter will be inserted into the descending thoracic aorta. Using appropriate tubing, pump, and heat exchanger,a large quantity of ice-cold saline (0.9% Sodium Chloride for Injection USP) will be pumped as rapidly as possible into the aorta with the goal of cooling the brain (tympanic membrane temperature, Tty) to \<10 C. If possible, a large venous catheter will be placed and recirculation of fluid established.

Once the subject has been sufficiently cooled, bleeding will be controlled surgically. The subject will then be resuscitated and rewarmed with full cardiopulmonary bypass.

The goal is to improve neurologically-intact survival in these patients.

Eligibility Criteria:
Inclusion Criteria:

* Penetrating trauma with clinical suspicion of exsanguinating hemorrhage
* At least 1 sign of life at the scene (pulse, respiratory efforts, spontaneous movements, reactive pupils)
* Loss of pulse \<5 min prior to Emergency Department (ED) arrival or in ED or operating room
* ED thoracotomy performed without immediate return of a palpable pulse in the carotid arteries after clamping the descending thoracic aorta

Exclusion Criteria:

* No signs of life for \>5 min prior to the decision to initiate EPR
* Obvious non-survivable injury
* Suggestion of traumatic brain injury, such as significant facial or cranial distortion
* Electrical asystole
* Rapid external assessment of the injuries suggests massive tissue trauma or blunt trauma involving multiple body regions
* Pregnancy
* Prisoners