cyrilzakka/clinical-trials huggingface dataset:
The Effects of Keeping the Patient in a Sitting Position for One Minute After Spinal Anesthesia

The aim of this study was to examine the effect of keeping the patient in a sitting position for 1 minute after spinal anaesthesia in elective caesarean operations, primarily on the formation of hypotension and secondarily on nausea-vomiting, the need for ephedrine and the block characteristics.


Eligibility Criteria:
Inclusion Criteria:

* aged 18 - 45 years,
* ASA physical status
* I - II,
* BMI of 25-30
* who were undergoing elective CS

Exclusion Criteria:

* vertebral anomaly,
* peripheral vascular disease,
* cardiovascular or psychiatric disorder,
* severe anemia,
* coagulopathy
* infection in the intervention region
Effect of Caudal Nalbuphine on Postoperative Emergence Agitation in Pediatrics Undergoing Infra-umbilical Surgeries

Effect of caudal nalbuphine on postoperative emergence agitation in pediatrics undergoing infra-umbilical surgeries and pain assessment


Eligibility Criteria:
Inclusion Criteria:

* Age 2_12 years
* Both genders
* ASA I_II
* Children undergoing infra-umbilical surgeries

Exclusion Criteria:

* Guardians refusal
* congenital anomalies at the lower spine or meringues
* Increased intracranial pressure
* Skin infection at site of injection
* Bleeding diathesis
* Known allergy to any drugs used
Efficacy of Coffee Versus Peppermint Oil Intake in Promoting GIT Motility After Cesarean Section

It is a comparison between coffee effect versus peppermint oil in promoting GIT motility after cesarean section

This study includes 600 patients who underwent cesarean delivery under spinal anaethesia subdivided into two groups each contain 300 patients Group 1 will have 100 ml of coffee after 2,4 and 6 hours Group 2 will have 100 me of pepper mint oil After 2,4 and 6 hours

Then outcomes will be assessed as per time frame

Eligibility Criteria:
Inclusion Criteria:

* willingness to participate.
* uncomplicated pregnancy.
* uncomplicated cesarean section.
* under regional anesthesia
* BMI\<30kg/m.
* level of hemoglobin is 10g/dl or more

Exclusion Criteria:

* medical disorders in the form of HTN,DM and hepatic disorders and bleeding disorders
* intra operative bowel or bladder injury during the cesarean section
* intra operative severe bleeding
* chronic gastrointestinal problems like chronic constipation ,peptic ulcer ,esophagitis ,hiatus hernia and IBS
* sever intestinal adhesions
* Respiratory problems and infection that require medication intervention
* operation more than 90 minutes
The Erector Spinae Plane Block and Its Effect on Respiratory Status and Pain Management in Rib Fracture Patients

The purpose of this research study is to identify the benefits of a type of nerve block, called an erector spinae plane block (ESP), in the treatment of patients with multiple rib fractures and uncontrolled pain despite receiving current institutional standards of care.

Rib fractures are one of the most common injuries secondary to blunt chest trauma, and carry significant risk in terms of patient morbidity and mortality. Pulmonary complications resulting from these injuries include severe atelectasis with hypoxemia, pneumonia, pleural effusions, respiratory distress syndrome, need for mechanical ventilation and ICU admission, and prolonged hospital stay. Many institutions have tried to develop protocols to risk stratify and appropriately treat these patients, with the goal of predicting those with higher likelihood of pulmonary complications in order to minimize additional morbidity. Studies have demonstrated critical spirometry values which correlate to worse patient outcomes; specifically, vital capacity less than 50% predicted, or less than 2L. Subsequently, there have been numerous attempts to identify the best treatment interventions for these high risk patients. In addition to multi-modal pain management, the most commonly used procedures include thoracic epidurals, continuous or single shot paravertebral blocks, and intercostal blocks. However, all of the above interventions carry significant risk, and the frequent use lovenox thromboprophylaxis drastically limit their use. Recently, a novel peripheral nerve block technique has been developed, an erector spinae plane block (ESP), which may provide similar or greater efficacy to the above, with significantly less risk to the patient.

Eligibility Criteria:
Inclusion Criteria:

* Blunt chest trauma
* Sustaining at least 3 unliateral rib fractures
* Resultant vital capacity less than 30% predicted
* Pain score reaches threshold despite using the current institutional standard of care for pain control

Exclusion Criteria:

* Patients whose weight less than 60kg.
* Patients with bilateral rib fractures.
* Patients that are intubated and mechanically ventilated.
* Pregnant Individuals.
* Any individual with a documented allergy to ropivacaine.
* Patients with limited English proficiency (LEP)
* Patients whose body habitus prevents the practitioner's ability to adequately perform the procedure.
Vouchers vs. Prizes for Cocaine-Dependent Methadone Patients - 2

The purpose of this study is to compare voucher-based contingency management (CM) procedures to a lower-cost CM system that provides opportunities to win prizes. Cocaine-dependent outpatients are randomly assigned to (a) standard treatment, (b) standard treatment plus usual magnitude prize CM, (c) standard treatment plus higher magnitude prize CM, or (d) standard treatment plus voucher CM. Urine and breath samples are collected 2-3x/week for 14 weeks. Follow-up interviews are conducted at 1,3,6 and 9 months following intake during which substance use and psychosocial functioning are assessed.


Eligibility Criteria:
Inclusion criteria:

* age \> 18 years
* current DSM-IV diagnosis of cocaine dependence
* received methadone treatment at the clinic for at least 3 months
* on a stable dose of methadone (no changes in dosing) for at least one month and not presently requesting a dose alteration
* submitted one or more clinic-collected cocaine positive urine samples in the previous 3 months
* English speaking
* pass a brief quiz related to understanding of the informed consent form

Exclusion criteria:

* have a serious, uncontrolled psychiatric illness (e.g., acute schizophrenia, bipolar disorder, severe or psychotic major depression, or suicide risk)
* have dementia (\<23 on the Mini Mental State Exam; Folstein et al. 1975)
* are in recovery from pathological gambling
Efficacy and Safety of Single-port Surgical Robot System in Thoraic Surgery

Robotic surgical systems have become a promising surgical assistance system, with unique advantages such as 3D high-definition visual system, highly flexible wrist-jointed instruments, and automatic fitering of hand tremors. Robotic surgical systems is applied in various fields including urology, general surgery, cardiothoracic surgery, head and neck surgery, and gynecology. Currently, the Da Vinci surgical robot system is the most widely used robot system globally. However, the Da Vinci robot system for single-port laparoscopic surgery has not yet been launched in China. Therefore, the investigators conduct a prespective, single-center study to evaluate the efficacy and safety of single-port surgical robot system in thoracic surgery.


Eligibility Criteria:
Inclusion Criteria:

* Age between 18 and 75 years, regardless of gender.
* Patients who require endoscopic surgical treatment and have indications for lung segment/lobe resection; for pre-trial subjects, there is no restriction on the type of procedure, and inclusion is based on the investigator's judgment of having indications for thoracic surgery.
* Preoperative ASA classification of I-III.
* Voluntary participation in the clinical trial and willingness to provide informed.

consent, either by the subject or their guardian.

* Willingness to cooperate and complete trial follow-up and related examinations.

Exclusion Criteria:

* Patients with a history of thoracic surgery or previous history of other malignant tumors deemed unsuitable for inclusion by the investigator.
* Patients with severe comorbidities (cardiac, pulmonary, hepatic, cerebral, renal diseases) or physical weakness who cannot tolerate general anesthesia or surgery.
* Patients with severe bleeding tendencies or coagulation disorders.
* Patients in the active phase of infectious diseases or with other severe non-communicable infections.
* Patients positive for Human Immunodeficiency Virus (HIV) antibodies or syphilis seropositive patients.
* Patients with a suspected or confirmed alcohol, drug, or substance addiction.
* Patients with a history of epilepsy, mental illness, or cognitive impairment.
* Women who are pregnant, breastfeeding, or planning to become pregnant during the trial period.
* Participation in other interventional clinical trials within 3 months prior to signing the informed consent form.
* Other situations in which the investigator deems inappropriate for participation in this clinical trial.
Moderated Hypofractionated Online Adaptive Radiotherapy in Cervical Cancer

The most common external beam radiotherapy fractionation scheme for cervical cancer is 45-50.4 Gy delivered in 25-28 fractions. However, prolonged treatment duration can lead to insufficient availability of medical resources. We hope to assess the safety and efficacy of moderated hypofractionated online adaptive radiotherapy in combination with brachytherapy in patients with cervical cancer in a multicenter study.

This is a multicenter, non-inferiority, phase 3, randomized controlled study. This study investigates the role of moderated hypofractionated online adaptive radiotherapy by randomizing patients to this experimental regimen versus the standard of treatment.The purpose of this study is to access safety and efficacy of moderated hypofractionated online adaptive radiotherapy in combination with high-dose-rate brachytherapy in patients with cervical cancer, which based on the previous research (NCT05994300).

Eligibility Criteria:
Inclusion Criteria:

1. The patient is fully voluntary and has the capacity for autonomy, signing the informed consent form 30 days prior to enrollment
2. Age ≥18 and ≤75 years
3. FIGO stage IB-IIIB cervical cancer; IIIC1 (lymph node metastasis ≤2 cm, without common iliac lymph node metastasis)
4. Pathologically diagnosed as squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma
5. Concurrent weekly cisplatin therapy ± immunotherapy
6. Able to undergo brachytherapy
7. ECOG performance status of 0-1, with an expected ability to tolerate lying flat for half an hour.

Exclusion Criteria:

1. Patients who have undergone cervical cancer surgery, excluding pelvic lymphadenectomy or pelvic lymph node dissection, or cervical conization
2. FIGO stages IA, IIIC2, IVA, or IVB
3. FIGO stage IIIC1 with lymph nodes \>2 cm, or with common iliac lymph node metastasis
4. History of prior abdominal or pelvic radiotherapy
5. Pregnant or breastfeeding women
6. Patients with active infections or fever
7. Other severe diseases that may significantly affect clinical trial compliance, such as unstable heart disease, kidney disease, chronic hepatitis requiring treatment, poorly controlled diabetes, or mental disorders.
A COMPARISON OF LEFT VENTRICULAR FUNCTION IN THE APICAL 4 CHAMBER AND SUBCOSTAL 4 CHAMBER TTE VIEWS IN THE PERIOPERATIVE SETTING

This study aims to examine the correlation and agreement of regional and global measurements of ventricular function in the apical 4 chamber and subcostal 4 chamber view. Additionally, we will explore limitations of the technology and explore the effect of left lateral positioning.

In transthoracic echocardiography, a number of measures are endorsed by current guidelines for quantifying ventricular function. These include conventional (mitral annular plane velocities, ejection fraction) and novel, speckle-tracking (STE) technologies. However, these measurements are standardized to be measured in the left lateral decubitus position in the apical (4-chamber) view of awake spontaneously breathing patients.

In the perioperative period, however, attaining these measurements in the endorsed circumstances may be challenging for a number of reasons. First, obtaining usable AP4C images may be difficult in ventilated or post-surgical patients. While the SC4C is generally obtainable visualized structures are not identical to those of the AP4C and measurement technologies such as Doppler are misaligned Secondly, patient conditions (e.g. in distress, or during surgery) may preclude positioning the patient in the left lateral decubitus position. Finally, patients may be ventilated and under anesthesia.

Newer technologies - such as speckle-tracking- may partially overcome these difficulties as these technologies are considered to be relatively angle independent. For quantification, it would be important to know whether or not speckle-tracking based measurements in the SC4C are sufficiently close to those measured under the endorsed conditions.

Eligibility Criteria:
Inclusion Criteria:

* Consenting adult patients undergoing elective non-cardiac surgery

Exclusion Criteria:

* Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant,
* Previous enrolment into the current study,
* Emergency procedures mandating expeditive patient care,
* Nonregular heart rhythm
* Valvular heart disease in the LV at least midgrade
Contrast-free Magnetic Resonance Angiography (MRA) at 3.0 T for Intracranial Aneurysm Detection

The Chinese Cerebral Aneurysms Survey is a continuing prospective study to evaluate the effectiveness of unenhanced, three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) with volume rendering (VR) at 3-T in the detection of intracranial aneurysms.

Recent years,three-dimensional time-of-flight MRA (3D-TOF-MRA) has become a useful, contrast-free method for observing intracranial vessels and is widely utilized as a screening examination for intracranial aneurysms. The studies available in Medline show mixed results.Some of these studies just included MRI/MRA in the analysis, which have a high rate of false-positives and are unreliable, and some were lack of control (ruptured aneurysm), precise numbers of false-positive results, standard images process and review, or corroborative IADSA in some patients. Furthermore, most previous studies included small sample size with aneurysm detection at 0.5-T or 1.5-T MR. Thus, these results have been inconclusive because of certain pitfalls in these studies.

Since 2007, we have conducted a clinical study to objective detection of intracranial aneurysms in our routine diagnostic work-up of intracranial aneurysms by our neuroradiologists using a standard procedure with 3D-TOF-MRA with VR at 3T. The investigators want to establish the quality data to prospectively compare 3D-TOF-MRA with VR at 3T vs 3D-RDSA in the diagnosis of intracranial aneurysms in a largest cohort of patients and test it accuracy in screening for suspected patients

Eligibility Criteria:
Inclusion Criteria:

* Suspected or known intracranial aneurysms

Exclusion Criteria:

* Patient's inability to cooperate
* Chronic renal failure patients
* Any patients with a contraindication to MRA examination, such as pacemaker, orbital metallic foreign body, coronary stent, etc.
* Any patients with a contraindication to DSA examination, such as allergic to contrast medium, etc.
Behavioral Economic Approaches to Increase Physical Activity Among Patients With Elevated Risk for Cardiovascular Disease

The objective of this study is to use a randomized, controlled trial to test the effectiveness of using gamification, financial incentives, or both to increase physical activity among patients with elevated risk for atherosclerotic cardiovascular disease (ASCVD). ASCVD is the leading cause of morbidity and mortality in the United States. Regular physical activity has been shown to reduce the risk of ASCVD, but less than 50% of US adults achieve enough physical activity to obtain these benefits.

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in the United States (US). Regular physical activity has been demonstrated to reduce the risk of ASCVD and is associated with a number of other health benefits. Yet, less than 50% of adults in the US achieve enough physical activity to actually obtain these benefits. Insights from behavioral economics have been shown to both better reflect the 'predictable irrationality' of humans and to be effective in designing interventions that achieve sustained improvements in health behavior. Our prior work has demonstrated that interventions using financial incentives and gamification can leverage principles from behavioral economics to increase physical activity during 3-month interventions and sustain effects in 3-month follow-up periods. These findings warrant further investigation of longer-term effects. In this study, we conduct a four-arm randomized, controlled trial to evaluate the effectiveness of using behavioral economic approaches including gamification, financial incentives, or both to increase physical activity among patients with elevated risk for atherosclerotic cardiovascular disease during a 12-month intervention with a 6-month follow-up.

Eligibility Criteria:
Inclusion Criteria:

* Age 18 years or older
* Have a 10-year ASCVD risk score of 7.5% or greater (including those with existing ASCVD)
* Are able to provide informed consent

Exclusion Criteria:

* Are already participating in another physical activity study
* An 18-month physical activity program is infeasible (e.g. metastatic cancer; unable to ambulate or provide informed consent) or unsafe (currently pregnant or told by a physician not to exercise)
* They do not have a device (e.g. smartphone, tablet, or computer) to transmit data from the wearable activity tracker
* Baseline step count is 7,500 or greater
* They do not have a primary care physician in the University of Pennsylvania Health System.
Evaluating the Impact of Improvements in Urban Green Space on Older Adults' Physical Activity and Wellbeing: a Natural Experimental Study

Background: Creating or improving urban green space has the potential to be an effective and sustainable way to increase physical activity and improve other aspects of wellbeing in older adults. However, the size and quality of the existing evidence base is weak. There is particularly a lack of studies on older adults and in the United Kingdom. This study aims to evaluate the effect of four small local street greening intervention projects on older adults' physical activity and wellbeing over a one-year period. The street greening includes tree and flower planting, and artificial tree decorations. These projects are based in a deprived urban neighbourhood in Greater Manchester, United Kingdom.

Methods: Eight unimproved comparison sites were selected to compare with the intervention sites. The researchers will measure physical activity and two other behavioural indicators of wellbeing (Connect: connecting with other people; and Take Notice: taking notice of the environment) using a newly developed observation tool. It is thought that the largest effect of the interventions will be on Take Notice behaviour due to improvements in the aesthetic quality of green space at the intervention sites. Baseline data collection occurred in September 2017 before the interventions were installed in November 2017. Follow-up data collection will be repeated in February/ March 2018 (6 months) and September 2018 (12 months).

Discussion: The present study offers a rare opportunity to evaluate the before-and-after effects of small-scale changes in urban green space, in an understudied population (older adults) and setting (United Kingdom). Although the interventions are expected to have small effects on peoples' behaviour, this study will address key weaknesses in previous studies.


Eligibility Criteria:
Inclusion Criteria:

° All individuals (infants, children, teens, adults, older adults) entering the target area during observation periods

Exclusion Criteria:

° Any individuals that request their data to be removed from the study
S. Aureus Colonization in Atopic Dermatitis

The purpose of this study is to characterize the bacterial strains that colonize children with atopic dermatitis.

The investigators hypothesize that rectal cultures will be more sensitive than anterior nares cultures for detecting S. aureus colonization, and that strains of S. aureus colonizing patients with atopic dermatitis will be resistant to commonly used topical antibiotic ointments.

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritis and eczematous lesions with a worldwide prevalence of 15-20%. The burden of disease is highest in the most developed nations and predominantly affects children, with 50% of cases arising in the first year of life, and most others arising in the first 5 years. There is a well-known increased susceptibility to skin infection with S. aureus in patients with AD, and such infections are associated with clinical deterioration. While it is routine to evaluate for S. aureus colonization in the anterior nares, there is recent evidence suggesting that rectal colonization may be more significant. The significance of colonization site has not been evaluated in the AD population.

Additionally, while topical antibiotics are a mainstay of treatment in AD, there is no routine data on the resistance to these agents.

Our aim is to characterize the S. aureus colonization patterns in children with AD, including site of colonization and antibiotic resistance. We will analyze routinely-collected skin culture specimens from children with AD seen at our center and determine antibiotic susceptibility profiles. The significance of colonization site will be analyzed.

Eligibility Criteria:
Inclusion Criteria:

* subjects with a diagnosis of atopic dermatitis seen by the Columbia University Medical Center department of dermatology
* subjects ages 0 to 18 years

Exclusion Criteria:

* those patients in which a definitive diagnosis of AD cannot be made
* subjects over the age of 18 years old
* subjects with evidence of acute systemic illness
* subjects currently taking systemic antibiotics
* subjects with viral or fungal skin infection
* any individual who declines participation
Computerised Testing of Cognitive Response to Cerebrospinal Fluid Shunting in Idiopathic Normal Pressure Hydrocephalus

A novel computerised neuropsychological test battery for normal pressure hydrocephalus (NPH) has been developed. The aim is to provide the clinician with a free of charge, standardized tool, assessing the cognitive decline or improvements in the cognitive domains specific for NPH. Results from the battery indicate good reliability and validity for the computerized tests

Results from the computerised battery seems promising. However, ability for the battery to detect cognitive improvements after a shunt operation remains to be tested.

Study objectives

1. Improvement after shunt. The aim of this study is to evaluate the effects of shunting on neuropsychological performance in NPH patients, using a computerized battery.
2. Feasibility. The ability to complete the test battery by the intended patient group will be tested.
3. Baseline profile. Baseline scores for NPH-patients will be compared to scores of healthy individuals (from previous study).


Eligibility Criteria:
Inclusion Criteria:

* Older than 60 years of age

"Probable INPH" according to the NIH guidelines

Planned shunt surgery based on a diagnosis of INPH.

Exclusion Criteria:

* Known cause for hydrocephalus (i.e., secondary NPH). Medical condition preventing cognitive testing (e.g. deafness, blindness).

Patients not considered for shunt operation.