cyrilzakka/clinical-trials huggingface dataset:
ORaClES: A Trial to Improve Prognostication

This study evaluates whether an online training resource can improve the performance of medical students in recognising imminently dying palliative care patients.

Clinicians are routinely asked to provide survival estimates for palliative care patients, but recognition of imminent death (last 72 hours of life) is often inaccurate. We developed an online training resource, based on a previous study that identified the symptoms or signs that were most influential in forming expert palliative care doctors' prognostic decisions about imminent death.

This double-blind randomised controlled trial will evaluate the effectiveness of this online training resource in improving the performance of medical students in recognising imminently dying palliative care patients.

Participants are asked to visit the study website and review three series of vignettes describing patients referred to palliative care. For each vignette, participants are asked to provide an estimate (0-100%) about the probability that the patient will die in the next 72 hours. After the first series of vignettes, students randomised to the intervention arm are given access to an online training resource showing how experts weighted the relative importance of symptoms and signs. All participants are asked to complete a second series of vignettes. After two weeks, all participants are asked to return to the website and complete a third series of vignettes to assess if any effect has been maintained.

Eligibility Criteria:
Inclusion Criteria:

1. Over 18 years of age
2. Enrolled on a registered medical course within the United Kingdom
3. In the penultimate or final year of medical school
4. Sufficient English language proficiency
5. Willing and able to provide consent as indicated by taking part in the online survey

Exclusion Criteria:

None
Pain Management Following Sinus Surgery

This Study evaluates the effect of adding Non-steroidal anti-inflammatories (NSAIDs) to the post-operative pain management of sinus surgery patients and wether or not this addition reduces or eliminates the need for narcotic pain medications.

Patients will be instructed to take an NSAID regimen after surgery and will be instructed to take narcotics only for breakthrough pain.

National attention has been given to the concerning rise of opioid abuse in this country, with prescriptions for this medications more than quadrupaling in the last 17 years.

Little is known as to the appropriate use of opioid analgesics in the post-operative recovery of patients undergoing sinus surgery. Furthermore, most pain protocols include only Tylenol based opioid analgesics. No study has prospectively evaluated the volume of use of Tylenol based opioid analgesics and whether the addition of NSAIDS decreased the need for opioid analgesics.

This study will compare opioid use with and without the addition of NSAIDS following sinus surgery.

Post-operative opioid use is a great public health concern, relatively unstudied, and an area with an opportunity for potential intervention to significantly reduce risks, morbidity, and mortality to our postoperative patients by better formulating a postoperative pain management plan using evidence-based practices. Appropriate opioid prescribing practices can reduce the risk of addiction, drug overdose, death, and undertreated pain. By optimizing post-operative pain management protocols, the need for opioids following sinus surgery should be minimized.

Eligibility Criteria:
Inclusion Criteria:

• All patients age 18-65 undergoing functional endoscopic sinus surgery +/- nasal airway surgery (septoplasty and/or inferior turbinate reduction).

Exclusion Criteria:

* Not taking anti-coagulation medications including aspirin
* Clinical Diagnosis of aspirin-exacerbated respiratory disease
* Clinical Diagnosis of Cystic Fibrosis
* Clinical Diagnosis of Primary Ciliary Dyskinesia
* Inclusion of a Draf III frontal sinusotomy
* Clinical Diagnosis of Liver/Kidney Failure
* Clinical Diagnosis of Thrombocytopenia
* Clinical Diagnosis of Poorly controlled hypertension
* Clinical Diagnosis of Recent GI ulcers or gastritis
* Clinical Diagnosis of Chronic pain as defined by a narcotic prescription with 6 months or involvement in a pain management program
* Clinical Diagnosis of Primary Headache disorder
* The use of nasal decongestants in the post-operative period.
* The use of nasal packing or absorbable biomaterials.
Integrated Clinical-radiological Analysis of Hypoxia Markers in Pediatric Osteosarcomas

The aim of this pilot study is therefore to retrospectively measure the volume and percentage of necrosis on diagnostic MRI in T1 sequence and in parallel to study the expression of immunohistochemical markers of hypoxia (HIF-1α, CAIX , HIF-2α, pS6, phosphomTor, CD163 and CD68) on diagnostic biopsies of high-grade osteosarcomas from 2007 to 2018 in the Strasbourg center, focusing on the pediatric population. The investigators will systematically carry out a correlation analysis between these different parameters and with the clinical data of these same patients (response to chemotherapy, presence of metastases or not and overall and recurrence-free survival). This will eventually make it possible to highlight new prognostic markers at diagnosis.


Eligibility Criteria:
Inclusion Criteria:

* Subject ≤ 20 years at diagnosis
* Subject having been treated for osteosarcoma in the OS2006 protocol or treated according to
* Supported at Strasbourg University Hospitals between 05/01/2007 and 10/31/2018
* Availability of its diagnostic tumor material stored in paraffin
* having an MRI diagnostic evaluation comprising the injected T1 sequences necessary for the analysis of the volume / necrotic proportion.

Exclusion Criteria:

* Opposition of the patient (or his legal representatives if he is a minor) to participate in the study
* Diagnosis other than osteosarcoma
* Biological tissue from a patient who does not meet all the inclusion criteria
* Patient under legal protection
* Patient under guardianship or guardianship
Cardiogoniometry (CGM) for Early Diagnosis of Acute Coronary Syndromes (ACS)

Aims of the study:

Patients in a Chest Pain Unit (CPU) are examined to clarify if the cause of pain is cardiac or not. To identify patients with ST-elevation and other electrocardiogram (ECG) modifications a normal 12-lead ECG is used. The diagnosis non-st-elevation myocardial infarction is determined with the help of the ischemic marker Troponin. However, Troponin levels are elevated earliest 3 to 4 hours after the ischemic event, so that a negative Troponin result at the time of hospital admission is insufficient. Thus the guidelines of the German Society of Cardiology demand a second measurement after 6 to 12 hours. In rare cases false positive Troponin levels have been reported (e.g. in patients with renal insufficiency).

The aim of this study is to determine if in the early phase of diagnostic assessment cardiogoniometry can improve differentiation between patients with cardiac (ischemic) emergency and patients with non-cardiac (non-ischemic) cause of pain. Furthermore it will be evaluated if cardiogoniometry is capable to diagnose patients with non-ST-elevation myocardial infarction (NSTEMI) to the same extent as Troponin. This could avoid time loss until a possibly necessary catheter intervention ("fast track").

To clarify these questions the result of the cardiogoniometry will be compared with the leading diagnosis of the Chest Pain Unit, the diagnosis at hospital discharge as well as with the angiographic findings (as a gold standard). Therefore the performance of cardiac catheterization within 72 hours after start of symptoms is a mandatory inclusion criterion.

The cardiogoniometry vectorcardiography is a procedure that allows a stress-free and non-invasive diagnosis of myocardial ischemia: five thoracic electrodes as well as the heart flow in orthogonal summation vectors are recorded by a computer-assisted method in three dimensions.

Eligibility Criteria:
Inclusion Criteria:

* Age \> 18 years
* thoracic pain, or pain radiating to neck or arm, or acute dyspnoea
* coronary angiography within 72 hours after start of symptoms

Exclusion Criteria:

* ST elevation myocardial infarction
* hemodynamically unstable patients, provided that the application of CGM may lead to an unacceptable delay in diagnosis and therapy
* lack of blood samples for troponin determination at admission
* patients with cardiac pacemaker
* cardiogenic shock
* tachycardia (HR \> 100)
* \> 50% extra systoles
* branch block
* atrial fibrillation
* no informed consent
Development and Validation of a Clinical Risk Prediction Model for Early Acute Kidney Injury Within 48 Hours After Liver Transplantation

Acute kidney injury (AKI) is a common complication after liver transplantation, with an incidence of 12.7-95%. The occurrence of acute kidney injury after transplantation is related to the poor prognosis of patients, which significantly increases the length of hospital stay, hospitalization costs and mortality of patients. Early recognition of acute kidney injury after transplantation is of great significance. Therefore, by collecting preoperative and intraoperative variables, this study intends to establish and verify a clinical risk prediction model for early AKI after liver transplantation, in order to provide clinicians with a visual prediction tool to identify patients with high risk of early AKI after liver transplantation immediately after the operation, so as to start clinical intervention as soon as possible and improve the prognosis of patients.


Eligibility Criteria:
Inclusion Criteria:

* patients who underwent liver transplantation in Beijing Tsinghua Changgung Hospital.

Exclusion Criteria:

* (1) under 18 years of age (2) post-renal transplant (3) liver combined with other organ transplants (4) preoperative requirement for renal replacement therapy (RRT) (5) patients with second or multiple liver transplants (6) preoperative estimated glomerular filtration rate (eGFR) \<60 mL/min/1.73m2, and (7) patients with severe illness leading to termination of surgery.
Study of rBet v1 Tablets

The purpose of this study is to determine the efficacy and safety of three doses of r Bet v1 administered as sublingual tablets in birch pollen allergic subjects.


Eligibility Criteria:
Inclusion Criteria:

* Symptomatic birch pollen-related allergic rhinoconjunctivitis for at least the last 2 pollen seasons
* Sensitisation to birch pollen as demonstrated, at screening, by a positive SPT to birch pollen with wheal diameter greater than 3 mm and specific IgE levels \> 0.70 kU/L (birch pollen and rBet v 1)
* Patients asymptomatic to all other allergens during the birch pollen season
* RRTSS during the previous pollen season ≥ 12 out of a maximum possible score of 18
* Patients with an FEV1 ≥ 80% of the predicted value
* Female patients with no childbearing potential
* Female patients of childbearing potential are eligible if they are not sexually active or if they use a medically accepted contraceptive method and have a negative urine pregnancy test, and are willing and able to sign written informed consent stating that they will use appropriate contraception and not plan a pregnancy during this study
* Patients able to be compliant with respect to the completion of the daily record card and taking of the investigational products
* Patients having provided signed informed consent

Exclusion Criteria:

* Patients with symptoms of rhinoconjunctivitis during the birch pollen season due to non-birch-related allergens
* Patients with symptomatic allergic rhinitis/rhinoconjunctivitis due to house dust mites
* Patients with symptomatic allergic rhinitis/rhinoconjunctivitis due to cat or dog allergens, and living with these animals at home or at risk of frequent contacts with these animals (family, friends etc.) during the course of the study
* Patients who previously received desensitisation treatment to birch pollen and/or another Betulaceae sp. within the previous 10 years
* Patients with asthma (except birch seasonal asthma in which case the patient could be included in the study)
* Patients with any nasal or oral condition that could interfere with efficacy or safety assessments (such as nasal polyposis or oral inflammation)
* Patients with a past or current disease, which as judged by the investigator, may affect the patient's participation in or outcome of this study
* Any disease or condition which would place a patient at undue risk by being included in the study (according to the investigator's opinion)
* Usual contra-indications of immunotherapy such as concomitant local or systemic beta-blocker therapy and/or immunosuppressive drugs
* Patients with ongoing treatment by immunotherapy with another allergen
* Patients treated with inhaled/systemic steroids within 4 weeks prior to Screening, or with long acting systemic corticosteroids 12 weeks before Screening
* Patients under continuous corticotherapy or undergoing chronic treatment with H2-antihistamine drugs
* Known hypersensitivity to mannitol
* Pregnancy, breast-feeding/lactation or sexually active women of childbearing potential who are not using a medically accepted contraceptive method
* Patients with a history of drug or alcohol abuse
Study of Botulinum Toxin in Patients With Primary Hyperhidrosis

OBJECTIVES:

I. Determine the optimal dose of botulinum toxin necessary to decrease sweating in patients with primary hyperhidrosis.

PROTOCOL OUTLINE:

Patients receive injections of botulinum toxin in the clinical trial for 6 months. Patients undergo an iodine starch test and a sympathetic skin response test to assess the efficacy of the drug. Patients also complete questionnaires to evaluate the amount of sweating.

Eligibility Criteria:
* Diagnosis of hyperhidrosis
* Excessive sweating in the hands, feet, armpits, forehead, or body
The Effect of Exercise on Peripheral Blood Gene Expression in Angina

Regular exercise is known to produce significant health benefits and to reduce the risk of heart diseases, although how this benefit occurs is not well understood. White blood cells are known to be involved in triggering heart attacks, and which genes are switched on or off in white blood cells determines whether they have beneficial or harmful effects. Previous studies, and studies ongoing in our group, have demonstrated measurement of peripheral blood gene expression (which reflects white blood cell gene expression) is able to distinguish between patients with and without coronary artery disease, or patients who are able to develop good compared with poor coronary collateral arteries. Therefore, the gene expression signature in peripheral blood may provide novel diagnostic or prognostic information, and insight into the pathogenesis of heart disease.

We therefore hypothesise that exercise alters peripheral blood gene expression in patients with coronary artery disease and angina. This will identify possible ways that exercise improves angina and reduces the risk of heart disease.


Eligibility Criteria:
Inclusion Criteria:

* Class I to III angina pectoris (classified according to the Canadian Cardiovascular Society \[CCS\])with documented myocardial ischemia or coronary artery disease on angiography
* Ability to read and speak English to a level allowing satisfactory completion of written questionnaires and to understand instruction during the exercise programme.

Exclusion Criteria:

* Acute coronary syndromes or recent myocardial infarction (\<2 months)
* Left main coronary artery stenosis \>25% or high-grade proximal left anterior descending artery stenosis
* Known reduced left ventricular function (ejection fraction \<40%)
* Significant valvular heart disease
* Insulin-dependent diabetes mellitus
* Occupational, orthopedic, and other conditions that preclude regular exercise
* Patients whose ECG prevents interpretation of an exercise test (LBBB, RBBB, pacemaker implantation).
* Patients who already perform greater than 30min continuous exercise three times weekly (self-reported).
Fat-Associated Cardiovascular Organ Dysfunction

This is an observational study of cardiovascular risk factors and arterial or cardiac function in subjects with overweight or obesity. Subjects must be between 30 and 65 years of age, have a body mass index \>27.0 kg/m2 and free from known heart disease and digestive or psychiatric disorders. Study aims include identifying sex-differences in traditional cardiovascular risk factors and structural and functional abnormalities in arteries and the heart in subjects with overweight or obesity, and how this is influenced by physical fitness.

FATCOR is an observational study of women and men with overweight or obesity. In particular prevalences of conventional cardiovascular risk factors and subclinical arterial or cardiac dysfunction are explored. The study aims at identifying sex differences in presence and clustering of cardiovascular risk factors and presence of subclinical cardiovascular organ damage. The influence of physical fitness on these factors will also be assessed. All participants undergo extensive cardiovascular risk factor assessment including oral glucose tolerance test and ambulatory blood pressure recording. Subclinical cardiovascular dysfunction is assessed by carotid and femoral vascular ultrasound, echocardiography and carotid-femoral pulse wave velocity using applanation tonometry. Physical fitness is assessed from peak oxygen uptake during maximal exercise testing on a treadmill.

Eligibility Criteria:
Inclusion Criteria:

* body mass index \> 27.0 kg/m2

Exclusion Criteria:

* known heart disease
* digestive disorder
* psychiatric disorder
* unfamiliar with Norwegian language
Pilates Exercises and Soccer: A Comparative Study of Mat vs. Reformer on FMS and ROM

Pilates exercises have been used to improve core strength, trunk and shoulder strength, lower body strength, agility, dynamic balance, coordination skills, flexibility, and posture in various sports. A previous study demonstrated the beneficial impact of mat Pilates exercises on the functional performance of soccer players. However, more research is needed to understand the effects of Pilates on the FMS and ROM. Consequently, this study aimed to investigate and compare the influence of mat Pilates and reformer Pilates exercises on FMS and ROM in soccer players, addressing this critical research gap.


Eligibility Criteria:
Inclusion Criteria:

* Age: Adults 19 to 20 years old
* Gender: Male
* Volunteering players

Exclusion Criteria:

- Diagnosis: Diagnosis of a specific medical condition
Survival and nEonatal outComes of veRy Low Birth wEight Infants in Türkiye: Turkish Neonatal Society SECRETS-TR Study

The aim of this multi-center study was to evaluate the mortality rate and early neonatal outcomes of very low birth weight (VLBW) infants hospitalized in neonatal intensive care units (NICUs) in Türkiye. It was promoted by the Turkish Neonatology Society (TNS) and research was approved by the Cam and Sakura City Hospital Ethical Committee.

It was conducted between 28 April 2021 and 02 January 2023 and written informed consents from the families of included patients were obtained.

A total of 74 level III and IV NICUs participated to the study. All the centers had an oppurtunity to follow-up these high risk premature infants in terms of their medical staff, equipment and other neonatology sources.

The inclusion criteria consisted of preterm infants with birth weight (BW)≤1500 grams and with gestational age (GA) of 24 0/7 weeks to 31 6/7 weeks, all inborn and outborn infants admitted to NICU within the first 24 hours of life and approval of parental consent.The survival status, maternal, perinatal and neonatal characteristics, risk factors and early neonatal outcomes of all infants were recorded.

The study includes the selected cohort of approximately 3000 very low birth weight preterm infants born in one year period in Turkey in level III/IV neonatal intensive care units (NICUs). Detailed information on antenatal (growth, infection), natal (neonatal resuscitation, non-invasive/invasive ventilation and surfactant administration in the delivery room) and postnatal clinical course in NICUs (ventilatory support, circulation, intestinal and cranial event status,growth, exitus) were recorded. The mortality and overall spesific morbidities of the study population will be evaluated. Also, subgroup analysis for extremely low birth weight infants, micropremies, gray zone infants (22 to 24 weeks of gestational age) will also be performed for local data of Turkey and will be used for development of local guidelines and improvements in the care of preterm infants.

Eligibility Criteria:
Inclusion Criteria:

* Preterm infants with BW≤1500 grams and with gestational age (GA) of 24 0/7 weeks to 31 6/7 weeks,
* All inborn and outborn infants admitted to NICU within the first 24 hours of life
* Presence of parental consent

Exclusion Criteria:

* The larger infants than inclusion criteria,
* Infants who died in the delivery room,
* Infants admitted to NICU after first 24 hours of life,
* Infants with major congenital/chromosomal abnormalities
* Refusal of parental consent