cyrilzakka/clinical-trials huggingface dataset:
Perioperative Rescue Transesophageal Echocardiography in Intensive and Critical Status

We initiate this study to assess the diagnostic efficiency of PReTEE, a simplified TEE scan sequence with a combination of 3 valuable views of ME 4C, ME AV LAX and TG SAX, in identifying cardiac pathologies in the phase of difficult cardiopulmonary bypass separation among patients who will undergo high-risk cardiac surgical procedures.

There are 6 TEE operators who will participate in our trial, which is of restriction.

Also, the participants we scheme to include are all junior TEE operators at our institute, who have already skilled at images obtainment and interpretation. Prior to the trial initiation, all these TEE operators will be randomly assigned into either the PReTEE group or the conventional TEE group with a 1:1 ratio (3 per group). Due to another limitation of eligible patients, TEE examinations thereby for patients are not conducted by equal numbers of operators stratified by groups. Furthermore, patients will be examined by 1-4 operators and 1 expert without removing the probe when separated from cardiopulmonary bypass. The ultimate sample size we calculate is 46 TEE examinations.

Eligibility Criteria:
Inclusion Criteria:

1. Age of 18 yr and greater;
2. High-risk cardiac surgery (one of the followings): Baseline left ventricular ejection fraction \< 50%, Coronary artery bypass graft combined with valve procedures, Multiple valve procedures (≥ 2), Aortic root or arch involved, Euroscore \> 6, Previous cardiovascular surgery

Exclusion Criteria:

1. Lack of patient consent;
2. Esophageal pathology (stricture, tumor, perforation/laceration, ulcer or fistula, diverticulum);
3. Hiatus hernia; Perforated viscus;
4. Active/recent upper gastrointestinal (GI) bleed;
5. Non-elective cardiac procedures;
6. Preoperative mechanical cardiac support (ECMO, LVAD or IABP)
Renal Denervation in Patients With Resistant Hypertension and Obstructive Sleep Apnea

The purpose of this study is to investigate the clinical utility of renal denervation for the treatment of resistant hypertension coexisting with obstructive sleep apnea.


Eligibility Criteria:
Inclusion Criteria:

* \>= 18 and =\< 70 years of age.
* systolic blood pressure \>=140mmHg (office);
* on 3 or more antihypertensive medications (including diuretic)
* mean daytime systolic ABPM \>= 135 mmHg
* obstructive sleep apnea (AHI \>=15 event/hour, indications for CPAP treatment)

Exclusion Criteria:

* renal artery abnormalities
* eGFR \< 60mL/min
* previous TIA, stroke, heart failure
* Type 1 diabetes
* ICD or pacemaker
* others
Laparoscopic Versus Vaginal Cuff Closure During LH in Benign Gynecological Lesions

To compare vaginal cuff closure via Bakay purse string with vaginal cuff closure via vaginal route with continuous locked suturing after total laparoscopic hysterectomy for benign lesions.

The objective of the present study is to compare 2 different methods for vaginal cuff closure after total laparoscopic hysterectomy for benign lesions regarding operative time, vaginal length, vaginal cuff dehiscene, hematoma formation. The first method is the Bakay purse string and the second is the closure of the vault via vaginal route with continuous locked suturing.

Eligibility Criteria:
Inclusion Criteria:

* Benign uterine lesions e.g fibroid, adenomyosis,...etc.
* Patient acceptance to undergo laparoscopic hysterectomy.

Exclusion Criteria:

* Gynecological malignancy.
* Low corporeal myoma obsecuring cervicovaginal junction.
* History of extensive abdominal surgery other than cesarean section.
The Reliability and Validity of the L-test in Patients With Multiple Sclerosis

Walking safely inside or outside is an important function in patients with Multiple Sclerosis (PwMS) that affects their daily life activity and participation. Loss of functional mobility is the major component of walking disorders in PwMS. Therefore, it is important to evaluate functional mobility.

Many functional mobility tests have been used for PwMS; however, these tests generally focus on walking speed and endurance. On the other hand, the L test, a variation of the timed up and go test (TUG), is a functional mobility measurement tool that extends the total walking distance to 20 meters and also requires the patients to turn both clockwise and counterclockwise.

Although L the test is an easy-to-use, short-term test method that evaluates higher-level components of functional mobility such as turns and transfers, to our knowledge, no study has systematically examined the reliability and validity of the L test in PwMS yet. In addition, the cut-off times that best discriminate PwMS from healthy people and fallers with non-fallers with Multiple Sclerosis (MS) have not been reported. Therefore, this study planned to investigate the reliability, validity, and discrimination of the L test in PwMS.

At baseline, the L test, Timed Up and Go test, 10 meter walk test, six minute walk test, and the timed 360 turn test will be applied to the Multiple Sclerosis group. The L test will be repeated after seven days after the first application in PwMS. Healthy controls are going to perform only the L test.

Eligibility Criteria:
Inclusion Criteria:

* Age at least 18 years,
* Neurologist-diagnosed Multiple Sclerosis,
* Expanded Disability Status Scale (EDSS) score between 0-5,
* No MS exacerbation within the last 3 months,
* Use of stable medication in the last 3 months.

Exclusion Criteria:

* Having any vision, hearing, or perception problems that may affect the research results,
* Having an orthopedic problem that will prevent walking and standing
* Having a cardiovascular, pulmonary, or hormonal disorder
Clinical Study of Caffeine for Apnea of Prematurity

The aim of the present Phase III study is to evaluate the safety, efficacy and pharmacokinetics of Caffeine Citrate for treatment of apnea of prematurity in Japan.


Eligibility Criteria:
Inclusion Criteria:

* Postconceptional age between 28 weeks and 33 weeks, and over 24 hours after birth.
* At least 6 episodes of apnea (\>20 seconds in duration) in 24 hours.
* Signed written informed consent from parent(s) or legal guardian(s).

Exclusion Criteria:

* Apnea due to: hypoxic-ischemic encephalopathy, meningitis, seizures, Grade III or IV intracranial hemorrhage, CNS depression from drugs administered to the mother during delivery, periventricular leukomalacia, pneumonia which does not improve even if it treats, hemoglobin\< 10 g/dL, sepsis, shock which does not improve even if it treats, blood pH\<7.2 on 2 consecutive determinations in spite of correction, serum calcium concentration \<7.0 mg/dL which does not improve even if it treats, serum glucose concentration \<4.0 mg/dL which does not improve even if it treats, congestive heart failure, symptomatic patent ductus arteriosus, rectal temperature\>38.5 °C on 2 consecutive readings, rectal temperature\< 35 °C on 2 consecutive readings, obstructive apnea.
* Blood urea nitrogen \>20 mg/dL, serum creatinine \>1.5 mg/dL.
* Serum AST or ALT \>3 times the upper limit of normal.
* Requirement of mechanically-assisted ventilation ( containing nasal CPAP, nasal DPAP).
* Previous treatment with methylxanthines within 7 days prior to study enrollment.
* Previous treatment with H2 antagonists (i.e., cimetidine or ranitidine) within 7 days prior to study enrollment.
* Receiving or experiencing the effects of CNS-active medication at the time of enrollment.
* Participant of other clinical trial within 6 months.
* Inappropriate to enter this clinical trial judged by the investigator in charge.
Effectiveness of Two Regimens of Misoprostol Alone for Early Pregnancy Termination and Use of SQPT for At-Home Follow-Up

This randomized trial will compare the rates of ongoing pregnancy, safety/side effects and acceptability of two medical abortion regimens that are commonly used in Latin America. The first regimen will involve three 800 mcg doses of misoprostol taken buccally in three hour intervals; the second will involve three 800 mcg doses of misoprostol taken sublingually in three hour intervals. This study will also aim to assess the feasibility and acceptability of a semi-quantitative pregnancy test (SQPT) for at-home follow-up in both settings.


Eligibility Criteria:
Inclusion Criteria:

* Presents for voluntary termination of pregnancy
* Gestational age ≤ 70 days by last menstrual period plus clinical assessment or ultrasound
* General good health including the absence of conditions which contraindicate the use of misoprostol for pregnancy termination
* Agrees to return for follow-up visit and willing to provide an address and/or telephone number for the purposes of follow-up
* Able to consent to study participation

Exclusion Criteria:

* Gestational age \> 70 days last menstrual period
* Confirmed or suspected ectopic or molar pregnancy
* Contraindications to medical abortion include having an intrauterine device in place and history of allergy to misoprostol or other prostaglandins
Self-initiated Perturbation-based Training in Older Adults

This is a single-blinded study. Participants will be randomly assigned to self-initiated perturbation-based balance training (SePBT) group or control (conventional balance training) group. Kinematic and Kinetic changes following SePBT group compared to control will be investigated.

Participants will be randomly assigned to two groups receiving SePBT or control group. All participants will give their written informed consent before baseline assessment. The study will be reported and conducted in line with the CONSORT statement. Participants will be recruited via convenient sampling in the local community. After baseline assessment, both groups will go through two 30-minute training session over two weeks. Between-group differences in behavior will be examined before and after training to identify training-induced changes in postural stability. Retention of the changes in the postural stability will be assessed four months after the training period. Incidents of falls will be followed up for 12 months after training.

Eligibility Criteria:
Inclusion Criteria:

* Community-dwelling adults aged 60 years old or older
* Able to communicate effectively in Cantonese or Mandarin
* Able to walk independently on level ground for at least 30 minutes
* Abbreviated Mental Test (Hong Kong version) scores≥6
* Have fallen in the preceding year, have concerns about falling, or feel unsteady while walking or standing.

Exclusion Criteria:

* Uncorrected vision or hearing impairment
* Osteoporosis
* Hip or knee replacement within the last year
* Have musculoskeletal, cardiovascular, mental, or neurological disorders that preclude their participation in the assessment or intervention safety
A Study To Evaluate the Safety and Efficacy of Human Neural Stem Cells for Parkinson's Disease Patient

This Pilot study will evaluate the safety and Efficacy of an investigational cell transplantation therapy, h-NSC, in patients with Parkinson's disease, through nasal drug delivery, a new delivery way. All patients will receive the therapy, which consists of human neural stem cells,

h-NSC is a cellular therapeutic consisting of human fetal neural stem cells (h-NSC). h-NSC injection will be delivered through nasal way for patients with Parkinson's disease (PD).

The study will enroll 12 moderate to severe PD patients to be treated with the cell injection therapy at the same dose. The total therapy course will be four weeks，one dose for one week. The follow up will be two times within 24 weeks after finishing the treatment. The main objective of the study is to evaluate the efficacy and safety of the cell transplantation by this new delivery way.

Eligibility Criteria:
Inclusion Criteria:

* Patient diagnosed with idiopathic PD, at least with two key symptoms (Static tremor, bradykinesia, rigidity ) , without any other evidence of Secondary Parkinson's syndrome.
* Disease course ≥7 years，modified Hoehn-Yahr is 3-5 stage
* Patient age ≥35 years
* Patients receiving a stable dose of levodopa for at least 1 months with the expectation that the treatment will remain unchanged throughout the course of the study
* The doses of levodopa ≥300mg •Signed informed consent form (ICF) by patient self or his law-in relationship before enrollment.

Exclusion Criteria:

* Hepatic dysfunction(transaminase ≥1.5 normal range), Renal dysfunction(Cr\>2.0mg/dl or 177μmol/L)，Cardiac dysfunction or other severe systematic diseases etc.
* Suffering malignancy or during anti-cancer treatment period.
* Pregancy, lactation or possible pregancy and plan to pregancy patient
* Attended other intervention clinical trial within 3 months aftre getting ICF, or during other ongoing intervention clinical trial
* Investigator think inappropriate patient for this protocol
Ecological Footprint Awareness Program in 60-72 Months Children

This study aimed to evaluate the effectiveness of an ecological footprint awareness training program for children aged 60-72 months.

This study was conducted using a cluster randomized controlled pretest-posttest experimental design. It was carried out in four kindergartens located in a city center between April and June 2023. Two of the kindergartens were assigned to the intervention group while the other two were assigned to the control group. Data was collected using the Ecological Footprint Awareness Scale for Children (EFAS-C). The training program was conducted with the children in the intervention group for four weeks, with a 40-minute session each week. The program covered one topic each week, which included waste management, water and energy use, food consumption, and transportation. The data was analyzed using descriptive statistics, paired groups t-test, and independent groups t-test, with a 95% confidence interval and p\<.05 significance level.

Eligibility Criteria:
Inclusion Criteria:

* enrolled in the schools where the study was conducted
* Approved by their family to participate in the study,
* 60-72 months old

Exclusion Criteria:

* participation in less than 2/3 of the intervention protocol
Non-invasive Diagnostics and Monitoring of MRD and Clonal Evolution in Waldenström's Macroglobulinemia and in IgM-MGUS

Multicenter retrospective and prospective observational study including patients with WM or IgM-MGUS evaluated at the time of diagnosis and during the disease course using highly sensitive techniques.

Multicenter retrospective and prospective observational study including patients with WM or IgM-MGUS evaluated at the time of diagnosis and during the disease course using highly sensitive techniques such as flow cytometry, real time quantitative PCR (RT-qPCR), digital droplet PCR (dd-PCR) and NGS, in order to: evaluate the mutational status on genomic DNA or cell-free DNA and compare the results to assess the most reliable source for mutation studies; perform and compare molecular and flow cytometry analyses on bone marrow, peripheral blood (both analyses), plasma and urine samples (only molecular analysis) to assess the best source for diagnosis and MRD monitoring.

Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of IgM monoclonal gammopathy of undetermined significance (Ig-MGUS) or Waldenström's Macroglobulinemia (WM) according to criteria established at the second International Workshop on Waldenström's Macroglobulinemia \[1\]
* Age ≥ 18 years
* Previously untreated patients (only for the prospective cohort)
* Symptomatic or asymptomatic disease
* Subject understands and voluntarily signs an informed consent form approved by an Independent Ethics Committee (IEC)/Institutional Review Board (IRB)

Exclusion Criteria:

* Active HBV, HCV or HIV infection (antiHBc+ patients with undetectable HBV-DNA are eligible to the study)
Affect Management Group for Adult Survivors of Childhood Trauma

Problems of self regulation, e.g. emotional dysfunction, represent a core symptom of adult patients with traumatic childhood experiences. The study intends to evaluate the efficiency of a 14-week group therapy for adult survivors of relational trauma in childhood. Main interventions are psychoeducation about the sequelae of childhood trauma, teaching of skills for affect regulation and techniques for activating resources. The hypothesis is that the group therapy significantly improves the participant's capacity in emotion management and self-soothing.

Problems of self regulation, e.g. emotional dysfunction, represent a core symptom of adult patients with traumatic childhood experiences. Since sufficient capacity for self soothing and emotional regulation are essential for trauma exposure, modern trauma therapy concepts are phase-oriented, beginning with working on "stabilization". The study intends to evaluate the efficiency of a 14-week group therapy for adult survivors of relational trauma in childhood. Main interventions are psychoeducation about the sequelae of childhood trauma, teaching of skills for affect regulation and techniques for activating resources. Inclusion criteria are clinical significant problems with self-regulation and the presence of childhood trauma. Outcome measures are based on self-rating questionnaires, clinical interviews and an experimental computer-task at timepoint pre-, post- and 3-month-follow-up. There is no control condition in the pilot-study phase.

Eligibility Criteria:
Inclusion Criteria:

* Adults with moderate to severe relational trauma in childhood (emotional, sexual or physical abuse, emotional or physical neglect)
* DSM-IV diagnosis of posttraumatic stress disorder

Exclusion Criteria:

* Severe dissociation
* Environmental safety problems
* Ongoing enmeshment with perpetrators
* Psychotic disorders
* Severe depression
* Acute suicidality
* Substance abuse
* Severe cognitive decline
Cognitive Behavioral Therapy for Nightmares in Children

Up to 50% of children experience nightmares annually. Nightmares interfere with sleep quality and quantity resulting in sleep deficiency, and are associated with negative mental health consequences. Previous research has shown efficacy of manualized CBT treatment for reducing trauma related nightmares in adults, and preliminary evidence has shown efficacy in children. This study is the first randomized clinical trial to evaluate the effectiveness of the treatment for idiopathic, as well as trauma related nightmares in children. The treatment in a manualized CBT protocol (5 sessions) that teaches sleep hygiene, relaxation strategies, and addresses nightmares therapeutically through exposure and rescripting.


Eligibility Criteria:
Inclusion Criteria:

* Children must have a history of nightmares occurring approximately once or more per week over a minimum of one month.
* Children must have verbal comprehension of at least age 5 (determined by PPVT), and be fluent in English.
* If taking psychotropic medications, must be stable for one month.
* Children must have a parent or legal guardian who is able to participate in treatment assignments and be able to read and speak English.

Exclusion Criteria:

* Under age 5 or over age 17.
* No nightmares (or less than averaging one per week)
* Apparent psychosis
* Pervasive developmental disorder or mental retardation
* Not able to read and speak English.
* Sleep apnea
Stereotactic Body Radiotherapy for Hepatocellular Carcinoma, and Intrahepatic Cholangiocarcinoma

This study is being done to determine if targeted radiation therapy (stereotactic) can be given to treat liver cancer, for patient who are unable to undergo surgery, over a short period of time with a small amount of side effects.


Eligibility Criteria:
Inclusion Criteria:

* Age ≥ 18
* Karnofsky Performance Status of ≥ 60
* Pathologically confirmed IHC or HCC. (Pathology not required for HCC if the lesion enhances typically on MRI and the patient is evaluated by liver transplant surgery team and thought to have HCC.)
* 4 or less separate intrahepatic lesions, with at least one lesion that is able to be followed by EASL Criteria.
* Local surgical resection is not possible due to tumor or patient factors
* Limited metastatic disease is allowed if the volume of metastatic disease does not exceed the volume of primary disease.
* Prior TACE allowed if stopped/completed at least 2 weeks prior to enrollment
* Prior chemotherapy except Sorafenib allowed if stopped/completed at least 2 weeks prior to enrollment
* Prior Sorafenib allowed if stopped/completed at least seven days prior to enrollment.
* Able to provide signed informed consent

Exclusion Criteria:

* Childs-Pugh score 9 or more
* ALT or AST ≥ 6 x upper limit of normal
* Prior history of abdominal irradiation
* Women who are pregnant or nursing
* Scheduled to undergo chemotherapy except Sorafenib at the time when radiation therapy will be given, or for up to 4 weeks after completion of radiation therapy.
* Scheduled to undergo Sorafenib within seven days of when radiation therapy will be delivered, or for up to 2 weeks after completion of radiation therapy.
* Undergone prior radiation therapy to the abdomen.
Study of Some Risk Factors for Developing RA

Introduction Rheumatoid arthritis (RA), a chronic autoimmune disease of unknown etiology, .If not managed early , RA can result in irreversible, painful, and disabling joint damage. RA is often diagnosed using predefined criteria that necessitate clinical, laboratory, and radiologic examinations.

The prevalence of RA among adults is approximately 1-2% affecting women two to four times more often than men.Although RA risk increases with age, it can manifest at any stage of life, including childhood, adolescence, and adulthood.(1-4)( Karlson EW, Mandl LA, Hankinson SE, Grodstein F, Karlson EW, Mandl LA, Hankinson SE, Grodstein F., Karlson EW, Mandl LA, Hankinson SE, Grodstein F, Karlson EW, Mandl LA, Hankinson SE, Grodstein F) To date, a limited number of RA risk or protective factors have been identified, with genetic predisposition to autoimmune response (eg, HLA-DR4 gene) and repeated environmental exposures (eg, tobacco smoke) playing a major role.(3)(Karlson EW, Mandl LA, Hankinson SE, Grodstein F) Heritability of RA is well-established because the lifetime risk of RA and related autoimmune diseases (namely, systemic lupus erythematosus, ankylosing spondylitis, scleroderma, Sjo¨gren's syndrome, and hypothyroidism) increases 1.5 to 3 times in children of women diagnosed with RA.

Patients will answer the following the questationnaire:

Name age gender

1 Socio echonomic status (average salary \\year) (Education) (Job) (residence)

1. Body mass index (height\\wt2)
2. Disease duration in months.
3. Smoking (yes) (No) Passive smoker Ex smoker
4. Reproductive history:

   * age of menarche....
   * menstrual cycle..... regular or not....... P / C
   * How many pregnancies........ living.

     * Abortion.
   * patient age at first birth (....).
   * breast feeding.....(yes).......(no)
   * use of contraceptives (yes)...pills injections IUD (N0)......
   * Does patient get pregnant during disease?...(Yes)......(no)..... Does the arthritis improved (...)or got worse (.....) -flared during the purpurium.(yes) ... (No)
   * age of menupause.... 10 Exposure to sun....(yes).....(No) 11 -Theraputic history... (Newly diagnosed)

     * (Previously diagnosed),
   * Does the patient receiving ttt? (yes) (Steroid)....... (NSAIDS)....... (2nd line drugs) (.Methotrexat(....), Leflonamide (....) Hydroquine(....) (NO)........
   * The study will include 100 patients fullfilling ACR 2010
   * Patients well subjected to

     * Through clinical examination with emphysis on joints examination
     * venous blood sampling will withdrawn and the following investigations will be done.
     * Serum VIT D level
     * Serum calcium and phosphorus
     * Anti cyclic citrullinated peptide.
     * ESR

Eligibility Criteria:
Inclusion Criteria:

* patients with rheumatoid arthritis diagnosed based on american collegue of rheumatology 2010 criteria with no history of vit D therapy

Exclusion Criteria:

* patients with rheumatoid arthritis on vit D supplements
* patient refusal
* patient not fullfill american collegue of rheumatology 2010 citeria for diagnosis pf rheumatoid arthritis