cyrilzakka/clinical-trials huggingface dataset:
Wrist Extensor MEP Up-conditioning for Individuals With Incomplete Spinal Cord Injury

The purpose of this study is to examine the relationship between common clinical assessments and measurements of the function of brain-spinal cord-muscle connections, and to examine the effects of training a brain-spinal cord-muscle response in individuals with incomplete spinal cord injury. A transcranial magnetic stimulator (TMS) is used for examining brain-to-muscle pathways. This stimulator produces a magnetic field for a very short period of time and indirectly stimulates brain cells with little or no discomfort. The target muscle is the wrist extensor (extensor carpi radialis) muscle that bends the wrist back. It is hypothesized that training the wrist extensor muscle response to transcranial magnetic stimulation will increase the strength of the brain-to-muscle pathway, which will improve the ability to move the arm.

It is hoped that the results of this training study will help in developing therapy strategies for individuals, promoting better understanding of clinical assessments, and understanding treatments that aim to improve function recovery in people with spinal cord injury (SCI).

This study requires 30 visits, and each visit will last approximately 1.5 hours.


Eligibility Criteria:
Inclusion Criteria:

1. a history of injury to spinal cord at or above C6
2. neurologically stable (\>6 mo post SCI)
3. medical clearance to participate
4. weak wrist extension at least unilaterally
5. expectation that current medication will be maintained without change for at least 3 months. Stable use of anti-spasticity medication (e.g., baclofen, diazepam, tizanidine) is accepted. In participants with bilateral wrist extension weakness, the more severely impaired arm is studied.

Exclusion Criteria:

1. motoneuron injury
2. medically unstable condition
3. cognitive impairment
4. a history of epileptic seizures
5. metal implants in the cranium
6. implanted biomedical device in or above the chest (e.g., a cardiac pacemaker, cochlear implant)
7. no measurable MEP elicited in the ECR
8. unable to produce any voluntary ECR EMG activity
9. extensive use of functional electrical stimulation to the arm on a daily basis
10. pregnancy (due to changes in posture and potential medical instability).
Ondansetron Versus Domperidone for Treating Vomiting in Acute Gastroenteritis in Children

Most of the trials conducted comparing ondansetron and domperidone have been conducted among children aged below 5 or 6 years of age while no study from Pakistan has compared efficacy of these antiemetic agents among children up to 12 years of age. The findings of present study will give valuable evidence about the effectiveness of these antiemetic agents to prevent vomiting among children suffering with acute gastroenteritis at a resource limited setting of South Punjab, Pakistan.

to compare the efficacy of ondansetron versus domperidone for treating vomiting in acute gastroenteritis in children at a resource limited emergency setting of South Punjab, Pakistan.

Eligibility Criteria:
Inclusion Criteria:

* Children of both genders aged below 12 years of age having 3 or more non-bilious, non-bloody vomiting episodes within 24 hours and with suggestive signs and symptoms of Acte Gastroenteritis.

Exclusion Criteria:

* Children who took any kinds of antiemetic in the last 6 hours of presentation of emergency department.
* Children having chronic liver disease, chronic kidney disease or congenital heart disease, neurological disorders, any kinds of malignancy, severe dehydration (requiring intravenous fluid replacement), severe acute malnutrition (weight-for-height below -3 standard deviation (SD) adopting WHO child growth protocols) or history known to allergy to antiemetics.
FOcal RECurrent Assessment and Salvage Treatment

Radiotherapy is the commonest form of prostate cancer treatment in the UK. In one in four men, radiotherapy will fail to control the cancer. These men are offered hormonal treatment which has significant side effects. Few men are offered a further treatment such as surgery, HIFU or cryotherapy. Only half of these men are cancer free at 5 years. The investigators believe this is due to poor imaging tests such as CT and Bone scan that cannot accurately detect whether cancer has come back inside or outside of the prostate or both. Also radiotherapy damages tissue surrounding the prostate which affects tissue healing for example after surgery. Treating just the cancer in the prostate only (focal treatment) rather than the whole prostate may limit this damage and cause fewer side-effects. The investigators want to see if new imaging tests can better identify cancer that has spread outside of the prostate and areas of cancer inside the prostate. Our new tests are whole-body MRI (for distant disease) and MRI guided biopsies (MRI-TB) (for local disease). First, the investigators will compare the results of whole-body MRI to existing imaging tests (bone-scan, and choline PET/CT) that try to find distant spread. Second, the investigators will compare the results of MRI-TB to a very detailed and accurate biopsy of the prostate called template prostate mapping which will show us where and how aggressive the cancer is. Third, if the cancer is confined to the prostate, the investigators will treat men using focal salvage therapies HIFU and cryotherapy. The investigators believe that these new imaging tests could better identify those who will benefit from early hormone treatment and those who will benefit from local salvage treatment. Our study may help justify carrying out a larger trial looking at how good the treatment is in controlling cancer in the medium and long-term.


Eligibility Criteria:
Inclusion Criteria:

1. Previous external beam radiotherapy with or without neo-adjuvant/adjuvant hormone therapy
2. Biochemical failure as defined by the Phoenix criteria (PSA nadir + 2ng/ml)
3. Men considering local salvage treatment for radio-recurrent disease
4. Life expectancy of 5 years or more

Exclusion Criteria:

1. Have taken any form of hormones (except 5-alpha reductase inhibitors) within the previous 6 months
2. Unable to have MRI scan as defined by standard care practice
3. Metallic implant likely to cause artefact and reduce scan quality
4. PSA doubling time of 3 months or less
5. PSA value 20ng/ml or greater
6. Prior prostate biopsies following biochemical failure
7. Any prior local intervention to the prostate (e.g., laser/electrical resection or incision, cryotherapy, HIFU, any other ablative modality, any other radiotherapy, any other prostate injection therapy for symptoms or cancer control)
8. Unable to have general or regional anaesthesia
9. Unable to give informed consent
Nutritional Intervention in Malnourished Patients With Chronic Heart Failure

Malnutrition is common in patients with heart failure (HF) and is associated with a worse prognosis.

However, there is little information on the impact of nutritional intervention in malnourished patients with heart failure. Therefore, the aim of our study is to evaluate whether a specific nutritional intervention has an impact on mortality and hospitalizations, quality of life, nutritional status, and functional capacity in patient with heart failure and malnutrition.

A high prevalence of malnutrition has been reported in hospitalized patients with acute heart failure and some studies suggest that personalized treatments or interventions on nutritional status could improve prognosis in these patients. Previous studies have shown that malnutrition is an independent factor associated with worse prognosis not only in hospitalized patients with decompensated HF but also in patients with chronic stable HF. In this sense, it has been postulated that nutritional intervention in malnourished patients with HF could have some prognostic benefit. However, there are very few data published in the literature that have assessed the nutritional status and the benefit of a nutritional intervention in stable ambulatory patients with chronic HF.

Therefore, the aim of this study was to evaluate whether the application of an educational and nutritional intervention in malnourished patients with heart failure improves prognosis, nutritional status, functional capacity and quality of life.

Eligibility Criteria:
Inclusion Criteria:

* Patients older than 18 years with a confirmed diagnosis of HF according to current criteria established by clinical practice guidelines and who present left ventricular dysfunction documented by echocardiography (LVEF less than 40%).
* Patients with clinical stability in the last 6 months defined as no admissions or decompensations in the last 6 months.
* Patients with malnutrition or at risk of malnutrition according to criteria established by the Mini Nutritional Assessment score (see attached).
* Patients who agree to participate in the study by signing the written informed consent after receiving verbal and written information about the study.

Exclusion Criteria:

* \*Dementia or severe cognitive impairment.

  * Dialysis.
  * Already receiving nutritional supplements.
  * Known concomitant oncologic process or other concomitant disease with life expectancy of less than 1 year.
  * Pregnant women.
  * Participation in another clinical trial concurrently.
Efficacy and Feasibility of Combining FOLFIRINOX and Stereotactic Radiotherapy for Patients With Irresectable Locally Advanced Pancreatic Cancer.

The purpose of this study is to investigate whether combining FOLFIRINOX chemotherapy and stereotactic radiotherapy in patients with locally advanced pancreatic cancer leads to an increase in survival.


Eligibility Criteria:
Inclusion Criteria:

* Cytological or histologically confirmation of pancreatic cancer.
* WHO performance status of 0 or 1
* ASA classification I or II
* Tumor considered locally advanced after diagnostic work-up including CT-imaging and diagnostic laparoscopy.
* No evidence of metastatic disease
* Largest tumor diameter \< 7 cm x 7 cm x 7 cm
* Normal renal function (Creatinine ≥ 30 ml/min).
* Normal liver tests (bilirubin \< 1.5 times normal; ALAT/ASAT \< 5 times normal)
* Normal bone marrow function (WBC \> 3.0 x 10e9/L, platelets \> 100 x 10e9/L and hemoglobin \> 5.6 mmol/l)
* Age \> 18 years and \< 75 years
* Written informed consent

Exclusion Criteria:

* Prior radiotherapy, chemotherapy or resection (bypass surgery allowed).
* Lymph node metastases from primary tumor outside the field of radiation.
* Second primary malignancy except in situ carcinoma of the cervix, adequately treated non-melanoma skin cancer, or other malignancy treated at least 3 years previously without evidence of recurrence.
* Pregnancy, breast feeding.
* Serious concomitant systemic disorders that would compromise the safety of the patient or his/her ability to complete the study, at the discretion of the investigator.
Striving to Quit: First Breath

This study is designed to test the hypotheses that incentives can increase both participation in smoking cessation treatment and resulting cessation rates, when they are offered to Medicaid BadgerCare Plus pregnant smokers.

Aim 1: To determine the extent to which contingent financial "treatment incentives" (i.e., incentives for biochemical verification visits, treatment engagement, and abstinence) versus "attendance incentives" (i.e., incentives for only attending the biochemical verification visits), increase rates of prenatal and postnatal smoking abstinence. Participants will be BadgerCare Plus members who are recruited into the First Breath program while pregnant.

Aim 2: To determine the extent to which treatment incentives, versus attendance incentives, increase rates of engagement in First Breath smoking cessation intervention when offered to pregnant and postpartum BadgerCare Plus members.

Aim 3: To determine the cost-effectiveness and reach of the First Breath intervention delivered to pregnant and postpartum smokers when it is paired with treatment incentives and when paired with only attendance incentives.

Aim 4: To determine if the First Breath intervention with treatment incentives, in comparison to that intervention with only attendance incentives, produces significantly greater benefits in pregnant and postpartum women with regards to nonsmoking health outcomes: i.e., reduced depression, increased levels of breast feeding, and greater perceived support.

Aim 5: To identify moderating and mediating effects of treatment incentives when offered in the context of the First Breath intervention delivered to pregnant and postpartum women.

Eligibility Criteria:
Inclusion Criteria:

* pregnant women
* enrollment in Wisconsin Medicaid (BadgerCare Plus or Medicaid SSI)
* resides in study area
* member of participating Medicaid HMOs
* not involved in any other stop smoking research studies
* 18 or older
* English speaking
* smoked daily (at least one cigarette each day for at least one week) at some time within the last 6 months
* willingness to quit smoking, cut down, or stay quit
* willing to complete study visits and phone calls
* willing to provide updates in contact information

Exclusion Criteria:

* not enrolled in Wisconsin Medicaid (BadgerCare Plus or Medicaid SSI)
* not enrolled in study area
* not a member of participating Medicaid HMOs
* not pregnant or enrolled in First Breath
* less than 18 years of age
* non-English speaking
* does not smoke daily (at least one cigarette each day for at least one week) at least some time within the last 6 months
* not willing to complete study procedures and assessments or provide updated contact information
ADL and CONUT for Predicting 1-year Mortality Risk in Older Adults After Hip Fracture

Hip fracture has a serious impact on the quality of life and even the survival of older adults. The multidisciplinary management of hip fracture has been shown to be effective in improving patient outcome and cost-effective in international studies. As geriatricians and members of a multi-disciplinary team（MDT）, we are aware of various scores in predicting the 1-year mortality risk in hospitalized older adults with multimorbidity. However, given the need for a deeper understanding of the preoperative status of elderly patients who were suffering from pain, tension, anxiety, delirium,etc., we hope to explore a simple, quick, objective, and accurate method for assessing the status of elderly patients with hip fractures to predict their survival risk.

This was a single-center retrospective cohort study which were approved by the Clinical Research Ethics Committee of Beijing Tongren Hospital, Capital Medical University (TREC2023-KY026). Demographic characteristics and medical parameters, such as age, gender, body mass index (BMI), comorbidities, hemoglobin , lymphocytes, C-reactive protein (CRP), fasting blood glucose, creatinine, total protein, albumin, triglycerides, total cholesterol and American Association of Anesthesiologists (ASA) were collected from the electronic medical record system. Controlling nutritional status (CONUT) was calculated from 3 variables: serum albumin concentration, total cholesterol concentration, and lymphocyte count, as previously reported. All enrolled patients were followed-up in an outpatients setting. Survival data were obtained via direct contact with patients or patients' caregiver by their physicians at the hospital , or via telephone interview of their family by dedicated coordinators and investigators. The follow-up lasted for one year and the last follow-up was ended on December 31, 2022. All analyses were performed using SPSS version 19.0 (SPSS, Chicago, IL, USA).

Eligibility Criteria:
Inclusion Criteria:

1. patients aged ≧65 years old;
2. patients diagnosed with hip fracture, including femoral neck fracture, femoral intertrochanteric fracture, and femoral subtrochanteric fracture;
3. patients whose injury was within 21 days of presentation.

Exclusion Criteria:

1. patients aged \<65 years old;
2. patients with pathological fractures due to tumor metastasis or infection or inherited bone disorder;
3. patients with avascular necrosis of femoral head;
4. patients with periprosthetic fractures;
5. old fracture patients treated more than 21 days from injury;
6. patients with severe trauma or fracture in other parts;
7. patients and their families who could not bear the surgical risk and are unwilling to receive surgical treatment;
8. patients died in hospital.
Identification of Risk Factors for Acute Coronary Events by OCT After STEMI and NSTEMI in Patients With Residual Non-flow Limiting Lesions

The objective of this study is to compare the clinical outcome of Non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) patients with non-obstructive, non-culprit coronary lesions and either presence or absence of vulnerable plaque characteristics as assessed by optical coherence tomography (OCT).

Despite major advances in the treatment of acute coronary syndromes a large proportion of patients is still at risk for new coronary events after experiencing an acute coronary syndrome (ACS). Detection of residual vulnerable plaques after ACS using OCT potentially identifies patients at high risk for new coronary events. However, no prospectively collected data on the prognostic power of OCT for plaque rupture are available at this moment. To design trials aimed to reduce events in patients with vulnerable plaques it is required to collect such prospective data on the relation between OCT derived characteristics of vulnerability and clinical outcome.

Eligibility Criteria:
Inclusion Criteria:

* Informed consent must be obtained.
* Patients with STEMI or NSTEMI and residual, non-culprit CAD, with the possibility of plaque vulnerability.
* Residual plaque(s) is(are) non-obstructive (FFR≥0.80).

Exclusion Criteria:

* Refusal or inability to provide informed consent.
* \< 18 years of age
* Hemodynamic instability, respiratory failure, Kilip class ≥ 3.
* Previous Coronary Artery Bypass Grafting (CABG).
* Indication for revascularization by CABG.
* Anatomy or lesions unsuitable for OCT catheter crossing or imaging (aorta-ostial lesions, small diameter segment, severe calcifications, lesion is too distal for OCT catheter)
* Pregnancy.
* Estimated life expectancy \< 3 year
Improving Dental Health Among Toddlers in the Dominican Republic

Caries prevalence in the Dominican Republic (DR) seems high, although recent information is lacking. In DR there is a growth and development program for all children from the age of 0 to 5.Even though there is a mandatory educational health program for children and parents in this program, where periodically pediatricians examine them, this program does not include oral health education/prevention. Thus, it is proposed A) to devise materials to be used by pediatricians to share relevant information about caries control to parents of toddlers, and B) to evaluate the impact of such material on caries prevention for groups of toddlers over a 1.5-year period. Educational material will be developed for parents, and the pediatricians will deliver this material to 10-months-old children randomly selected at Plaza de la Salud Hospital. The PI will train the pediatricians in caries prevention and how to deliver the information to the parents in a clear manner. A total of 306 will be allocated into two groups. The experimental group (128 children) will receive the devised educational materials at 10 months, follow-up information will be provided at growth and development visits when the child is 18-, and 24 months old. The second group will be considered as the control group and will not receive any educational materials (178 children). All the enrolled children will receive fluoride containing toothpaste and tooth brushes. After 18 months when the children will be about 3 years old they will be examined to assess dental caries status. A sample mortality rate of 40% is expected during the two-year follow-up. Differences in caries status between the two groups will be examined using Welch's independent t-tests for unequal variances.


Eligibility Criteria:
Inclusion Criteria:

* Healthy children
* Parents agreed to participate in the program

Exclusion Criteria:

-
The Effect of Patient Position on Postdural Puncture Headache

We aimed to investigate the association between the position in which spinal anesthesia was performed and postdural puncture headache occurrence.

Records of patients who underwent caesarean section between January, 2013 and November, 2013 with spinal anesthesia will be retrospectively examined. Demographic data of patients, comorbid diseases, position of patient while performing spinal anesthesia, the number of spinal puncture attempts will be recorded.

Eligibility Criteria:
Inclusion Criteria:

* Patients older than 18 years were included

Exclusion Criteria:

* Conversion to general anesthesia was the exclusion criteria.
Glutathione and Function in HIV Patients

We have recently reported that older patients with HIV are deficient in glutathione (GSH) due to decreased availability of cysteine and glycine, and that oral supplementation with cysteine (as n-acetylcysteine) and glycine for 2-weeks corrects their own levels, and improves (but does not fully normalize) concentrations of red-cell GSH. We also found that when GSH deficient, subjects had impaired mitochondrial fuel oxidation and this improved with an increase in intracellular GSH concentrations. These older HIV patients also had significant increases in muscle strength with improvement of GSH levels.The current proposal in older HIV patients will investigate study if cysteine and glycine supplementation for a duration of 12 weeks will result in changes in : (a) GSH levels; (b) body composition/anthropometry; (c) strength and function; (d) quality of life; (e) mitochondrial energetics; (f) biochemistry (including dyslipidemia and oxidative stress); (g) protein and glucose metabolism; (h) cognition and memory. After completing supplementation for 3 months, GSH concentrations, strength, function, mitochondrial energetics and neurocognitive tests will be measured for a further 2 months to determine the effects of washout.

Detailed data are not as yet available

Eligibility Criteria:
Inclusion Criteria:

HIV patients:

* age 45-65 years

Non-HIV subjects:

* age 45-65 years

Exclusion Criteria:

1. Hospitalization in the past 3 months
2. Untreated hypothyroidism or hyperthyroidism
3. Known diabetes mellitus, hypercortisolemia, coronary artery disease.
4. Known liver impairment (ALT and AST \>2ULN)
5. Renal impairment (Creatinine\>1.4)
6. Inability to walk
7. Patients on anticoagulation or antiplatelet therapy.
8. Patient with triglyceride concentrations \>500 mg/dl.
Behavioral and Cognitive Therapies for Auditory Hallucination Management

The present study wants to evaluate the efficacy of a short psychoeducational type group intervention and Cognitive behavioral therapy (CBT) 3rd wave on the severity of hallucinatory Acoustico-Verbal (HAV) symptomatology in patients with schizophrenia.


Eligibility Criteria:
Inclusion Criteria:

* Schizophrenic disorders, schizo-affective disorders
* Suffering from persistent HAV
* No change in symptomatology for 3 months.
* No anticipated change in antipsychotic treatment (anti-hallucinatory): olanzapine, risperidone, amisulpride, quetiapine, aripiprazole, loxapine, haloperidol, clopixol, modecate, nozinan, cyamemazine, piportil, clozapine
* Major patient, or major incompetent.

Exclusion Criteria:

* Mental retardation
* Subject participating in another search including an exclusion period still in progress at pre-inclusion