cyrilzakka/clinical-trials huggingface dataset:
Therapeutically Alternatives In Ventilator-Induced Diaphragm Dysfunction Critically Ill Patients

The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).

The study is a prospective experimental study on adult patients admitted to the Critical Care Department in Qasr Al-Ainy. This study is conducted prospectively to assess the efficiency of trigger sensitivity adjustment on patients with ventilator-induced diaphragmatic dysfunction (VIDD).1. Flow Trigger: This type of trigger responds to the gas flow during inspiration. A flow trigger measures the rate of change of flow as the patient begins to inhale. When the flow reaches a certain threshold, the ventilator is triggered to deliver a breath.

1. Laboratory investigations: Arterial blood gases (ABG):- (PH, PCO2, HCO3, and PO2) after the session.
2. Ventilator Parameters:( a) Minute Ventilation, b) Tidal Volume, c) Rapid Shallow breathing index, d) Negative Inspiratory Force (NIF) will be measured pre and post-treatment

Eligibility Criteria:
Age (years)

Weight (kg)

Height (cm)

BMI (kg/m²)

Inclusion Criteria:

* Patients who had undergone MV for 48 hours or more in a controlled mode.
* Patients could not generate maximum inspiratory pressure of more than 15 mbar
* Patients had diaphragmatic excursion less than 3 cm. (normal level from 3 to 5 cm.)(It can increase in a condition person to 7-8 cm).
* Patients had a diaphragmatic thickness fraction of less than 30%

Exclusion Criteria:

* Patients with comorbidities interfering and compromising weaning like cardiac arrhythmia, pericardial effusion, congestive heart failure, or unstable acute coronary syndrome.
* Patients who had inadequate training performance of the inspiratory muscle such as those having myopathy or neuropathy.
* Patients hemodynamically unstable.
* Patients who had a major neurological deficit.
* Sedated Patients.
Work of Breathing Under Extreme Hypercapnia Induced by Ventilation Insufficiency

The aim of the study is to investigate Work of Breathing of a person in simulated avalanche snow and consequent use of the measured data for judging which one of three simulated scenarios are alike while increasing hypercapnia in the simulated avalanche snow.

The study is a part of a university diploma thesis aimed at studying physiological conditions and development of breathing parameters of a person breathing in the simulated avalanche snow. The Investigator is measuring Work of Breathing in three scenarios: a) 2L air pocket, b) 2L air pocket with resistance compensation and c) no air pocket. The investigator hypothesize that the Work of Breathing during compensation of air pocket will be alike with no air pocket scenario, thus proving significance of the resistance reduction for survival. The aim of the study is to investigate the effect of Work of Breathing on gas exchange in subjects breathing into the simulated avalanche snow scenarios.

Eligibility Criteria:
Inclusion Criteria:

* healthy and fit volunteers, classified as The American Society of Anesthesiologists class I
* without a smoking history

Exclusion Criteria:

* Tiffeneau Index less than 0.70
* any cardiovascular or respiratory condition
A Comparative Study of the Baska Mask Vs Proseal Laryngeal Mask Regarding Airway Sealing Pressure

Baska mask air way(BM) in comparative study with Proseal laryngeal mask airway (PLMA) regarding performance of Baska mask improves the safety and efficacy of airway management for in patients undergoing general anesthesia by mechanical ventilation confirmation of position by fiber optic view of glottis opening and success of gastric tube insertion , Airway sealing pressure, Leak fraction, insertion time and "overall insertion" success rates, and post-operative complications (airway trauma, hoarseness, sore throat and Dysphagia ).

Maintenance of a patent airway is a major responsibility for the anesthesiologists, interruption of gas exchange, even for a few minutes, can result in catastrophic outcomes such as brain damage or death.

Supraglottic airway devices are devices that ventilate patients by delivering anaesthetic gases/oxygen above the level of the vocal cord. Since the development of the laryngeal mask airway, many other supraglottic devices have been introduced in the clinical practice of airway management, trying to offer a simple and effective alternative to endotracheal tube.

However, following experience with such simple cases, clinicians soon become comfortable with more complex cases, such as cases of longer duration, cases with sicker patient reported favorable outcomes in safety profile, risk, ease of insertion, recovery of patients and cost analyses. However, there is an under reporting of complications aris¬ing during ventilation with this device and the risk factors associated with such complications in adult patients. These include Hypoxia, laryngospasm, and difficulty with insertion, suboptimal ventilation, bronchospasm, aspiration, desaturation, hy¬potension and conversion to intubation with ETT. These can be significantly serious and life threatening

Eligibility Criteria:
Inclusion Criteria:

1. Healthy adult ASA I-II patients,
2. Both genders, aged 18-45 years,
3. Body weight between 50 and 90 kg who BMI \> 30 kg/m2
4. Non-urgent surgery of planned duration up to 2 hrs

Exclusion Criteria:

1. Patient refusal
2. Patients having known tendency to nausea/vomiting or pharyngeal pathology
3. Morbid obese patients with body mass index \>30 kg/m2
4. Patients known to have gastro-esophageal reflux disease (GERD), hiatus hernia or previous upper gastrointestinal tract surgery
5. History of difficult intubation, measured the common predictive indices for difficult intubation (BMI, thyromental distance,Mallampati grade, inter-incisor distance, dentition and neck movement ).
Efficacy and Safety Study of LAS41007 in the Treatment of Actinic Keratosis

The aim of this study is to determine the efficacy, safety and tolerability of either a once or twice daily topical application of LAS41007 compared to a twice daily application of LAS106521 in the treatment of actinic keratosis.


Eligibility Criteria:
Inclusion Criteria:

* At least 4-10 clinically assessed actinic keratosis grade I to II (according to Olsen et al, 1991) in the face/forehead and/or on the bald scalp
* The diameter of each AK target lesion is not less than 0.5 cm and not greater than 1.5 cm
* The target lesions must be located in overall 2 treatment areas with a size of 25 cm2 per treatment area

Exclusion Criteria:

* Have evidence of clinically significant or unstable medical conditions such as:

  * metastatic tumor or tumor with high probability of metastatic spread
  * heart failure (NYHA class III or higher)
  * immunosuppressive disorder (e.g. HIV)
  * hematologic, hepatic, renal, neurologic or endocrine disorder.
  * collagen-vascular disorder (e.g. cerebrovascular disorder or other bleedings).
  * gastrointestinal disorder (e.g. active ulcera or history of recurrent peptic ulcera or hemorrhage)
* Suffer from paresthesia in the treatment areas
* Show Cornu cutaneum of the skin and/or hypertrophic AK lesions in the treatment areas
High Versus Low Pneumoperitoneum PressUre for Parenchymal Transection in Minimally Invasive Major Liver Surgery

Minimally invasive techniques in liver surgery gain popularity as they facilitate postoperative recovery while achieving comparable oncologic outcomes to the open approach. No consensus on the application of pneumoperitoneum pressure in minimal invasive liver resections (MILR) has been reached yet, as prospective clinical studies are scarce. The positive pressure of the CO2 pneumoperitoneum reduces intraoperative blood loss during MILR alongside the development of new transection devices and advancements in inflow control. Low-pressure pneumoperitoneum on the other hand has been shown to decrease postoperative pain scores and analgesic consumption in comparison to standard pneumoperitoneum, and international guidelines recommend the application of "the lowest intra-abdominal pressure allowing adequate exposure of the operative field rather than a routine pressure". Nevertheless, evidence for the application of low-pressure pneumoperitoneum is only moderate to low, requiring additional studies to better define its safety. To address this oxymoron, the investigators conduct a randomized non-inferiority trial to investigate the effect of low in comparison to high-pressure pneumoperitoneum during the transection phase of major MILR on intraoperative blood loss while also evaluating the risk of embolic complications.


Eligibility Criteria:
Inclusion Criteria:

* age equal or older than 18 years and
* capacity of consent and
* planned elective conventional laparoscopic or da Vinci-assisted major liver resection or resections near the liver hilum or the hepatic venous vasculature. Major liver resections are defined as the resection of 3 liver segments or more (right and left partial hepatectomies, extended right and left hepatectomies, liver resections of 3 or more segments). Right posterior sectionectomies and mesohepatectomies of ≥2 liver segments are considered resections in proximity to the liver hilum or hepatic venous vasculature.

Exclusion Criteria:

* the participation in another trial with interference of intervention and outcome of this study,
* being a woman who is pregnant or breast-feeding or planning to become pregnant,
* American Society of Anesthesiologists (AS) score \>3,
* language barrier,
* any contraindication to a minimal invasive surgical approach or intolerance to pneumoperitoneum
* a patent foramen ovale (PFO) or any other structural cardiac defect that facilitates paradoxical gas embolisms,
* diagnosis of neuromuscular disease, heart failure NYHA \> class II or chronic obstructive pulmonary disease (COPD)
* being on oral anticoagulation therapy other than Aspirin 100mg daily or any other condition known to increase the risk of bleeding.
Motivate: A Web-based Intervention

The aim of this study is to test whether MotivATE can increase attendance at assessment. This will be done using a single-consent Zelen randomised control trial, with all non-emergency adult clients referred to the Kimmeridge Courte Eating Disorder Service over a one year period being randomised to either treatment as usual (TAU) or TAU plus access to the MotivATE intervention prior to their assessment appointment.

MotivATE is a web-based intervention intended to be delivered at the point of referral to an Eating Disorder (ED) service. The intervention focuses on managing expectations of assessment, addressing ambivalence and increasing users' motivation and confidence to attend their initial appointment. This is achieved through the use of information, motivational tools, interactive activities and stories from other individuals with EDs spread across four 15-20 minute modules. These modules have been evaluated by service-users who have an ED.

The aim of this study is to test whether MotivATE can increase attendance at assessment. This will be done using a single-consent Zelen randomised control trial, with all non-emergency adult clients referred to the Kimmeridge Courte Eating Disorder Service over a one year period being randomised to either treatment as usual (TAU) or TAU plus access to the MotivATE intervention prior to their assessment appointment.

Routine audit data will be collected to compare the number of people who attend their assessment appointment in the MotivATE group verses the control group. Usage data generated by the intervention will also be assessed. Twenty participants from the MotivATE group will be invited to give qualitative feedback about their experience of the intervention.

Eligibility Criteria:
Inclusion criteria

1) Referrals to the eating disorders service during the study period.

Exclusion criteria

1. Inpatients or emergency and urgent cases.
2. Patients who have already been randomised into the study.
3. Non English speakers
An Evaluation of the Energy Expenditure From Wii Fit Games

The purpose of this study is to provide energy expenditure data on Wii Fit / Wii Fit Plus games as compared with resting and treadmill walking/running.

Increasing physical activity and, consequently, increasing energy expenditure and reducing obesity are among the highest public health priorities in the U.S. because physical inactivity negatively affects a wide variety of medical conditions (e.g., metabolic syndromes, cardiovascular disease). Research has shown that a major contributor to physical inactivity is the sedentary behavior induced by increased use of computer and video games. However, some of the newer generations of game consoles such as the Nintendo Wii market their product for its physical activity promoting features. Nintendo's recent release of Wii Fit / Wii Fit Plus uses a balance board and is the first game in which whole-body movements closely mirror that of the actual activity. As the use of these gaming systems may be more enjoyable modes of promoting physical activity than the traditional treadmill exercise, respondents may in turn exercise more regularly and for longer periods of time. To the best of the investigators' knowledge, no studies exist that demonstrate the energy expenditure of the Wii Fit / Wii Fit Plus among adults, or the Wii Fit / Wii Fit Plus compared to other forms of aerobic exercise such as walking and running. This study will provide preliminary data for future external grant applications comparing the energy expenditure of different physical activity conditions employing cutting-edge interactive physical activity promoting technology among adults. The potential contributions of the Wii Fit / Wii Fit Plus to promote healthy behaviors by being an alternative form of physical activity may be particularly informative for people who are unable to meet the national public health recommendations due to personal, health, safety or environmental concerns.

Eligibility Criteria:
Inclusion Criteria:

* No chronic disease by self-report (e.g. cardiovascular, renal, hepatic, neurodegenerative, neoplastic, metabolic {diabetes}, hypertension).
* Between the ages of 20-35.
* Normal BMI (BMI between 18.5 and 24.9).
* Not a current nicotine user.
* Demonstrates capacity for giving informed consent. Willing to participate by providing informed consent and committing to complete the study.

Exclusion Criteria:

* NA
Cardio-Pulmonary Exercise Testing in Healthy Population

Introduction: Cardiopulmonary exercise test (CPET) is a helpful tool for evaluation of aerobic exercise capacity and tolerance for variety of population. The test progression include an incremental stepwise or ramp control protocol to exhaustion There are different methods used in various clinical setting. CPET involves the measurement of respiratory gas exchange i.e. oxygen uptake, carbon dioxide, minute ventilation, other variables while monitoring ECG, blood pressure, pulse oximetry and exertion perceived (Borg Scale) during an incremental test on a cycle-ergo meter or treadmill. This test allow to assess an integrative exercise responses to submaximal and maximal effort.

Aim: To compere exercise responses and achieved criteria for maximal exercise testing with different exercise protocol Methods: Healthy volunteers (normal and overweight ) will be recruited to participants in the study. Demographics (age, sex), anthropometric (height, weight, abdominal circumference), will be measured. By using questionnaire, physical activity behavior and motivation toward engage in physical activity will be filled by the participants. Each participants will conducted an exercise test on treadmill (using Modified Bruce Protocol) and cycle ergometer. Quark CPET metabolic cart (Cosmed, Rome, Italy) will be used to collect and analysis gas exchange. 10 minute after the graded exercise test Supra maximal exercise test (SMT) will be done for 2 minutes one stage (treadmill protocol) or 10% at cycle protocol higher than highest load achieved in the incremental test.

All exercise parameter done on the different ergometer will be compared


Eligibility Criteria:
Inclusion Criteria:

* Healthy 18-55

Exclusion Criteria:

* Physical activity limitation due to orthopedic , neurological and cognition deficit Pregnancy children
Laser Versus Vitrectomy Versus Intravitreal Triamcinolone Injection for Diabetic Macular Edema

Macular edema is the main cause of vision loss in diabetic patients. Its treatment is mainly based on laser photocoagulation, but has limited results. Alternative treatment are under investigation, such as vitrectomy and intravitreal injections of triamcinolone .The aim of VITRILASE is to compare the efficacy of these two treatments to laser photocoagulation for diabetic macular edema.

It is a randomized study with three arms

* vitrectomy
* repeat intravitreal triamcinolone injections
* laser photocoagulation

Eligibility Criteria:
Inclusion Criteria:

1. Patient with type 1 or type 2 diabetes
2. Visual acuity (VA) : 0.1≤ VA \< 0.5 (35 ≤ ETDRS score \< 70)
3. Patient with diffuse diabetic macular edema , as defined by :§ Retinal thickening involving the center of the macular on biomicroscopy§ AND diffuse leakage on fluorescein angiography .
4. Macular thickness in the central area 1000 µm in diameter ³ 300 µm.
5. Patient with :· Either diffuse diabetic macular edema · Or combined diffuse and focal diabetic macular edema with persistent diffuse macular edema 6 months after laser treatment of the focal edema .
6. Systolic blood pressure ≤ 160 mmHg and diastolic blood pressure ≤ 90 mmHg.,
7. HbA1c \< 10%.

Exclusion Criteria:

1. Patient with tractional diabetic macular edema, as defined by· A taut, thickened posterior hyaloid on biomicroscopy AND/OR· a thickened , highly reflective posterior hyaloid on OCT , partially detached from the posterior pole, and exerting a traction on the macula
2. Active proliferative diabetic retinopathy (ETDRS stage 61 or more severe)
3. Structural damage to the center of the macula in the study eye likely to preclude improvement in visual acuity following the resolution of macular edema, including atrophy of the retinal pigment epithelium, subretinal fibrosis, laser scar(s), or organized central hard exudate plaque³ 1 disk area
4. Hypertensive retinopathy
5. Epiretinal membrane.
6. Rubeosis irides .
7. Patient requiring immediate panretinal photocoagulation or panretinal photocoagulation performed within the past 6 months .
8. History of chronic glaucoma in the study eye
9. History of elevated intraocular pressure ≥30 mm Hg and/or alteration of visual field
10. Concomitant therapy with systemic or topical ocular corticosteroids within the last 15 days .
11. Cataract surgery in the study eye within the past 6 months, Yttrium-Aluminum-Garnet (YAG) laser capsulotomy within the past 6 months,
12. Aphakia
13. Patient with pseudophakic macula edema
14. Unstable medical status including glycemic control and blood pressure. Patients in poor glycemic control who, within the last 4 months, initiated intensive insulin treatment (a pump or multiple daily injections) should not be enrolled.
15. Chronic renal failure
16. Pregnant or nursing (lactating) women
A Controlled-Feeding Study to Assess the Effect of Cashews on Fasting Lipoprotein Levels

This study will assess the nutritional effect of cashews on LDL-C concentrations and secondarily on other aspects of the fasting lipoprotein lipid profile in healthy men and women with moderately elevated cholesterol.

This trial will utilize a randomized, two-period crossover design to examine the effects of cashew consumption on LDL-C and other aspects of the fasting lipoprotein lipid profile in healthy, moderately hyper-cholesterolemic individuals consuming a typical "American diet." Two arms consisting of two 28-day controlled-feeding treatment periods will allow for an isocaloric comparison of a diet with or without cashews.

Eligibility Criteria:
Inclusion Criteria:

* BMI of ≥18.00 and ≤32.00 kg/m\^2
* Fasting LDL-C level ≥130 mg/dL and \<200 mg/dL
* Fasting TG ≤350 mg/dL

Exclusion Criteria:

* CHD or CHD risk equivalent
* Pregnancy
* Use of lipid altering medications which cannot be stopped
* Certain liver, kidney, lung, or gastrointestinal conditions
* Poorly controlled hypertension
* Certain medications
* Allergy or sensitivity to nuts or other food/beverage or food/beverage component
* Active cancers treated within prior 2 years (except non-melanoma skin cancer)
* Significant weight loss or gain within prior 3 months
Comparing Shoulder Stretching and Percussive Massage on Shoulder Rotation and Attack Speed in Female Volleyball Players

This study aims to investigate the acute effects of PNF modified sleeper stretches and percussive massage treatment on shoulder rotation movements and attack speed in female volleyball players and compare these applications.

56 female volleyball players will randomized into 2 groups of 28 people each. In the evaluations conducted on the participants, rotational normal joint movements of the athletes will be measured using a digital inclinometer. The spike velocities of the athletes will be determined using a sports radar (Sports Radar 3300, Sports Electronics Inc, Washington, D.C. USA.). Participants will be randomly divided into two different groups consisting of 28 individuals each. The Proprioceptive Neuromuscular Facilitation Stretching Group (PNFG) participants will undergo one session of PNF posterior shoulder stretching exercise in the modified sleeper position. The Percussive Massage Treatment Group (PMTG) participants will receive a 5-minute massage on the posterior deltoid area. Evaluations will be repeated three times before the applications, immediately after, and 30 minutes post-application and the effects of different applications will be compared through analysis.

Eligibility Criteria:
Inclusion Criteria:

* Being a volleyball player
* Age between 14 and 40 years

Exclusion Criteria:

* Presence of shoulder pain
* History of fracture and surgery in the shoulder girdle
* Presence of systemic musculoskeletal disease
* Presence of glenohumeral instability (Positive apprehension, relocation, or subluxation test)
* Pain in the cervical region with upper extremity movements
* Experiencing shoulder problems requiring medical treatment within the last year
Effects of Pneumococcal Vaccine on Nasopharyngeal Carriage

The purpose of this study is to assess the direct effects of the ten-valent pneumococcal conjugate vaccine administered to infants on nasopharyngeal carriage at 3 to 5 years of age.

These children have been vaccinated in infancy in the cluster-randomized Finnish Invasive pneumococcal Disease (FinIP) Trial (a separate protocol reported at ClinicalTrials.gov Identifier:NCT00861380) during 2009 to 2011.

Also the indirect effect on nasopharyngeal carriage will be assessed on vaccinees' elder non-vaccinated siblings aged 5 to 9 years.

This study includes a cross-sectional sampling of nasopharyngeal and oropharyngeal swabs in 2013 from vaccinated and unvaccinated children.

Eligibility Criteria:
Inclusion Criteria for FinIP-vaccinated children:

1. age 3 to 5 years
2. enrolled in the FinIP trial and has received at least one dose of study vaccine in the infant vaccine schedule (3+1 or 2+1)
3. at least one parent with fluent Finnish
4. informed consent from one parent

Exclusion criteria for FinIP-vaccinated children

1. PCV vaccination administered, other than the randomized study vaccine
2. history of antimicrobial treatment within 4 weeks (the child can be enrolled later)

Inclusion criteria for unvaccinated siblings

1. age 5 to 9 years
2. younger sibling living in the same household having participated in the FinIP trial (regardless of the vaccination schedule)
3. at least one parent with fluent Finnish
4. informed consent from one parent

Exclusion criteria for unvaccinated siblings

1. PCV vaccination administered
2. history of antimicrobial treatment within 4 weeks (the child can be enrolled later)