cyrilzakka/clinical-trials huggingface dataset:
Prediction of Platinum Resistance and Prognosis of High-grade Serous Ovarian Cancer

High-grade serous ovarian carcinoma (HGSOC) is the most common subtype of ovarian carcinoma. Platinum-based drugs are the first-line chemotherapeutic agents for HGSOC, but platinum resistance and prognosis are difficult to predict. Domestic and foreign studies have found that multi-functional MRI could reflect the macroscopic heterogeneity of tumors from different perspectives; habitat imaging contributed to reflecting the spatial heterogeneity of tumors; the attention mechanism could integrate features of different scales; and multi-omics were capable to improve predictive performance. Previously, our team has demonstrated the importance of MRI and its functional imaging in the diagnosis and histological evaluation of gynecological tumors. And conventional MRI habitat imaging, multi-instance learning based on whole slide image (WSI), and multi-omics model could effectively predict platinum resistance in HGSOC patients. Therefore, this study aims to perform habitat imaging on multi-functional MRI such as multi b-value DWI and DCE-MRI and to train WSI-based multi-instance learning to construct pathological signature. Then, combined with clinical indicators, radiomics based on MRI habitat, and pathomics, a multi-omics fusion model trained by attention mechanism was constructed. Finally, to explore the value of MRI habitat, WSI, and multi-omics in predicting platinum resistance and prognosis in HGSOC patients. This study combines macroscopic functional imaging and microscopic pathological information to construct a multi-omics complementary model, which can predict platinum resistance and prognosis of HGSOC patients more comprehensively and accurately, and further guide the formulation of clinical treatment.


Eligibility Criteria:
Inclusion Criteria:

* Patients diagnosed as HGSOC based on surgery and pathology.
* The standard treatment including surgical cytoreduction followed by at least three cycles of regular platinum-based chemotherapy after surgery.
* Follow-up records available for more than six months after postoperative chemotherapy.
* For MRI analysis, pelvic MRI examination including axial T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI), and diffusion-weighted imaging (DWI) was performed within two weeks prior to treatment, and patients had no any treatments other than neoadjuvant chemotherapy (NACT) performed between MRI and surgery.

Exclusion Criteria:

* Patients with a history of platinum-based chemotherapy for other malignancies.
* Absence of essential clinical data.
* For MRI analysis, patients with poor MRI imaging quality and registration, or a tumor maximum diameter \< 1 cm on MRI needed to be excluded.
* For pathology analysis, patients without H\&E-stained WSIs or with poor WSI imaging quality should be excluded.
Study of Sodium Bicarbonate in Restoring Blocked Catheters

This is a study looking at the use of sodium bicarbonate to restore the flow of blocked central line devices in patients with blood cancers.

Central line devices uses thin tubes that are placed into a vein in the body to give medicines, fluids, nutrients, blood products, etc.

Sometimes, the lines become blocked. The standard procedure to get the line working again is to use alteplase, a protein that dissolves blood clots. While blood clotting is one cause of a blocked line, other reasons included the formation of calcium deposits. Sodium bicarbonate is routinely used in the treatment of patients receiving chemotherapy. Sodium bicarbonate is a liquid drug which is capable of dissolving protein and calcium deposits.

This study will compare whether sodium bicarbonate works just as well as alteplase to recover the function of a blocked line.


Eligibility Criteria:
Inclusion Criteria:

* Hematology patients with indwelling CVC/PICC line.
* Patients continuing to receive chemotherapy treatment for consolidation, intensification and maintenance regimens in hematological malignancies such as in acute leukemia, lymphoma, myelodysplastic syndrome, supportive care measures using blood products, ongoing anti-infective treatments, and nutrition.
* Patients whose CVC/PICC line becomes obstructed during routine care are being identified and presented to attending physician and pharmacist.
* Mechanical obstruction having been ruled out by visual inspection and manipulation of the patient's posture or extremities or both.

Exclusion Criteria:

* Patients with hemodialysis line occlusions
* Anyone with documentation of prior history of alteplase allergy or hypersensitivity reactions
Nasal Versus Venous Lorazepam for Control of Acute Seizures in Children

Status epilepticus (SE) is a common pediatric emergency which is potentially life-threatening and requires rapid termination. Early and effective treatment is essential to prevent the morbidity and mortality associated with prolonged convulsive SE. Lorazepam is the standard of care for control of SE when administered by intra-venous (IV) route. The investigators intend to compare efficacy and adverse effect profile of intra-nasal vs. intravenous routes of administration of lorazepam. In resource poor settings, sometimes trained personnel or appropriate equipment for intra-venous cannulation is not available. Alternate routes of administration, if shown equivalent to conventional IV route, will be very useful in such settings or for out of hospital management of seizures in children.


Eligibility Criteria:
Inclusion Criteria:

* Children presenting convulsing to the pediatric emergency or developing seizure while in casualty
* Age 6-14 years

Exclusion Criteria:

* Known hypersensitivity to any benzodiazepine
* Child has received any parenteral anti-convulsant within 1 hr prior to enrollment
* Presence of severe cardio-respiratory compromise or cardiac arrhythmias
* Presence of upper respiratory tract infection
* Presence of basal skull fracture causing cerebro-spinal fluid (CSF) rhinorrhea
BC Healthy Connections Project

Nurse-Family Partnership (NFP) is a primary prevention program that was developed by Dr. David Olds in the United States (US) with the goal of helping vulnerable young first-time mothers and their children. The program involves public health nurses (PHNs) visiting mothers in their homes, providing intensive supports starting in pregnancy and continuing until children reach their second birthday. Studies in the US have shown that NFP significantly reduces child maltreatment and child behaviour problems, while also improving children's early learning and mother's economic self-sufficiency. Economic studies have also shown that the program pays for itself over the long-term. However, NFP has never been tested in Canada. Due to major differences in our populations and in our public services, we do not know whether NFP will show the same benefits here. We therefore plan to conduct a scientific evaluation of NFP's effectiveness in British Columbia (BC), in close collaboration with the BC government and BC's Health Authorities. Using randomized-controlled trial methods, NFP's effectiveness will be specifically evaluated in comparison with existing perinatal services in BC regarding outcomes across three fundamental domains: 1) pregnancy and birth; 2) child health and development; and 3) maternal health and life course. Findings from this evaluation will be used to improve the NFP program - to better meet the needs of vulnerable young mothers and their children in BC.


Eligibility Criteria:
Inclusion Criteria:

1. Aged 24 years or under
2. First Birth
3. Less than 27 weeks gestation
4. Competent to provide informed consent, including conversational competence in English
5. Experiencing socioeconomic disadvantage (must meet 5a or 5b):

5a. Aged 19 years or younger (eligible) 5b. Aged 20-24 (eligible if has TWO of the following):

* 5.1. Lone parent (is not married or living common-law, i.e., not living with the same person for more than one year)
* 5.2. Less than grade 12 (does not have BC's Dogwood certificate, General Education Development \[GED\] Credential or other diploma equivalent to grade 12; note that the Evergreen Certificate is not equivalent to grade 12)
* 5.3. Low income (based on answering "yes" to any ONE of the following)
* 5.3a. Do you receive income assistance (e.g., disability, social assistance, employment insurance, or BC Medical Services Plan Premium Assistance)?
* 5.3b. Do you find it very difficult to live on your total household income, particularly regarding food and rent?
* 5.3c. Do you live in a group home, shelter, or institutional facility (e.g., treatment center)?

Exclusion Criteria:

1. Planning to have the child adopted
2. Planning to leave the NFP catchment area (for three months or longer)
Breathing Exercises With And Without Aerobic Training In Patients With Postural Orthostatic Tachycardia Syndrome

Postural orthostatic tachycardia syndrome (POTS) is a chronic, multifactorial syndrome with complex symptoms of orthostatic intolerance. Of the major complaints are breathlessness and exercise intolerance. The aim is to explore the potential impact of a physiotherapy intervention involving education and breathing control on dysfunctional breathing and improving exercise intolerance in POTS. The study would be a randomised controlled trial. Duration would be 4 week. Patients will be randomly divided into two groups by lottery method. Data will be collected through questionnaire from enrolled subjects in physical therapy department of Liaqat Hospital, Lahore. Experimental group will be treated by Progressive Breathing Retraining Exercise Program-2 times a day for 15 minutes, initially Controlled Nasal Breathing with progressively increasing the Controlled Pause, 4 times a day for 15 minutes, then both techniques will be performed together. In addition to this Aerobic training will be assigned to both the groups. Aerobic training will include cycling and treadmill- for 30 minutes\\day for 5 days\\week for 1 month. Total 20 sessions. While the controlled group will receive only aerobic training which will include cycling and treadmill for 30 minutes\\day for 5 days\\week for 1 month. Total 20 sessions. The dysfunctional breathing and exercise intolerance will be assessed through Nijmegen Questionnaire and Veterans Questionnaire respectively at 0 week, after 2 week and after 4 week. The data will be analyzed by spss version 25.


Eligibility Criteria:
Inclusion Criteria:

* Only Females
* Age: (15-45years)
* +ve tilt table test
* +ve 10 minutes standing test
* Nijmegen score \>22,
* increase in HR\>30bpm; with no orthostatic fall in blood pressure.symptoms occuring in \>3 months

Exclusion Criteria:

* pregnancy
* No cardiac or respiratory pathology
* Surgical history
* Participants in another research protocol
* Any other medical condition that confers greater morbidly than POTs (e.g.,active Cancer)
A Six-Month Follow-Up Study of Participants With Coronavirus Disease 2019 (COVID-19) Previously Enrolled in a RO7496998 (AT-527) Study

This study will evaluate the long-term sequelae of COVID-19 in patients diagnosed with COVID-19 who previously enrolled in a RO7496998 (AT-527) study (i.e. parent study NCT04889040 \[CV43043\]), for approximately 6 months after the end of the parent study.


Eligibility Criteria:
Inclusion Criteria:

* Participant was diagnosed with COVID-19 and enrolled in a Phase III RO7496998 (AT-527) COVID-19 study

Exclusion Criteria:

* Participation in an interventional study at the time of enrollment or plans to enroll in an interventional study during this study.
* Any serious medical condition or abnormality of clinical laboratory tests that, in the investigator's judgment, precludes the patient's safe participation in and completion of the study
Registry-based Stroke in Tunisia

Study the prevalence of strokes in the emergency department (ED) and their possible eligibility for thrombolysis.

The diagnosis and management of strokes represent a great emergency that requires multidisciplinary teams and an organization of the care chain from the collection of patients at the site of the stroke to follow-up care.

That is why it is necessary to identify the prevalence of stroke in the ED in Tunisia and to evaluate their eligibility for thrombolysis.

Eligibility Criteria:
Inclusion Criteria:

* All patients with stroke symptoms.

Exclusion Criteria:

* Refusal of inclusion
Retrospective Data Analysis on the Application of Swan-Ganz Catheter in Cardiac Surgery

The investigators aimed to investigate postoperative complications associated with Swan-Ganz Catheter based on the clinical data of Wuhan Union Hospital and Wuhan Asian heart hospital for 10 years, including major cardiovascular, respiratory adverse events, ICU time, mechanical ventilation time, length of hospital stay, in-hospital mortality, and 30-day postoperative mortality events.


Eligibility Criteria:
Inclusion Criteria:

* Over 18 years old;
* Patients undergoing major cardiac surgery under general anesthesia;
* Patients with complete sex, age, use of floating catheter and prognosis data

Exclusion Criteria:

* ASA grade V and above;
* End stage renal disease requiring (or undergoing) renal replacement therapy;
* Pregnant or lactating women
Case Series With Saneso 360° Gastroscope

To confirm the procedural performance of the Saneso 360° gastroscope in Esophago-gastro-duodenoscopy (EGD) procedures.

This study is a prospective, multicenter case series per standard of care EGD procedures using a nonsignificant risk Saneso 360° gastroscope. 20 cases will be included at up to five (5) clinical sites. Patients who meet all eligibility criteria will be included and will have a clinically indicated EGD procedure performed using the study device. Immediately thereafter, patients will have an EGD procedure using a standard Gastroscope (Olympus GIF180) by a second endoscopist. Enrolled subjects will be followed for 7 days after their procedure. If the procedure is not successful with the study device, the endoscopist will complete the procedure with a traditional gastroscope used at each facility.

Eligibility Criteria:
Inclusion Criteria:

* 18 -74 years of age
* Willing and able to comply with the study procedures and provide written informed consent to participate in the study.
* Scheduled for a clinically indicated routine EGD procedure
* ASA class 1-3.

Exclusion Criteria:

* Altered esophageal, gastric, or duodenal anatomy
* Pregnant women, children under 18 years of age, and adults over 75 years of age.
* Subjects for whom routine endoscopic procedures are contraindicated due to comorbid medical conditions.
* Patients who are currently enrolled in another investigational study that would directly interfere with the current study, without prior written approval from the sponsor
* ASA class 4-5.
Fludarabine or Chlorambucil as First-Line Therapy in Treating Older Patients With Previously Untreated Chronic Lymphocytic Leukemia

RATIONALE: Drugs used in chemotherapy, such as fludarabine and chlorambucil, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It is not yet known whether fludarabine is more effective than chlorambucil in treating chronic lymphocytic leukemia.

PURPOSE: This randomized phase III trial is studying fludarabine to see how well it works as first-line therapy compared to chlorambucil in treating older patients with previously untreated chronic lymphocytic leukemia.

OBJECTIVES:

Primary

* Compare the overall and progression-free survival of older patients with previously untreated chronic lymphocytic leukemia treated with fludarabine vs chlorambucil.
* Compare the duration of remission in patients treated with these regimens.

Secondary

* Compare the incidence of toxicity, especially infections, in patients treated with these regimens.
* Compare the quality of life in patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive fludarabine IV on days 1-5. Treatment repeats every 28 days for up to 6 courses.
* Arm II: Patients receive oral chlorambucil on day 1. Treatment repeats every 15 days for up to 12 months.

PROJECTED ACCRUAL: A total of 205 patients will be accrued for this study.

Eligibility Criteria:
DISEASE CHARACTERISTICS:

* Confirmed diagnosis of chronic lymphocytic leukemia, meeting any of the following staging criteria:

  * Binet stage A with B symptoms
  * Binet stage B or C, meeting 1 of the following criteria:

    * Rapid disease progression
    * Enlarged lymph nodes and organs
    * Severe B symptoms
* Previously untreated disease

PATIENT CHARACTERISTICS:

Performance status

* ECOG 0-2

Life expectancy

* More than 6 months

Hematopoietic

* No thrombocytopenia
* No autoimmune hemolytic anemia

Hepatic

* Not specified

Renal

* Not specified

Other

* No severe organ dysfunction
* No other prior or concurrent neoplasm

PRIOR CONCURRENT THERAPY:

Chemotherapy

* No prior chemotherapy
* No other concurrent chemotherapy
Detection in Tandem Endocuff Cap Trial

A randomised back to back study comparing cap and Endocuff to detect adenomas during colonoscopy


Eligibility Criteria:
Inclusion Criteria:

1. Age 18 years and over
2. Referral for surveillance, or diagnostic colonoscopy
3. Ability to give informed consent

Exclusion Criteria:

1. Absolute contraindications to colonoscopy
2. Established or suspicion of large bowel obstruction or pseudo-obstruction
3. Known colon cancer or polyposis syndromes
4. Known colonic strictures
5. Known severe diverticular segment (that is likely to impede colonoscope passage)
6. Patients with active colitis (ulcerative colitis, Crohn's colitis, diverticulitis, infective colitis)
7. Patients lacking capacity to give informed consent
8. Pregnancy
9. Patients who are on clopidogrel, warfarin, or other new generation anticoagulants who have not stopped this for the procedure
Myocardial Injury and Dysfunction Associated With COVID-19 Vaccination

The overall goal of the study is to investigate the characteristics and potential mechanisms responsible for myocardial injury and dysfunction in patients after COVID-19 vaccination. Cardiac damage will be assessed with cardiac MRI and endomyocardial biopsy (EmBx) histopathology. Myocardial gene expression will be measured in RNA extracted from EmBxs mRNA abundance compared to nonfailing and failing control hearts.

To determine whether there is microvascular thrombosis-associated myocardial damage and dysfunction vs. inflammation or other changes in patients who, following administration of SARS-CoV-2 mRNA vaccine, develop evidence of myocardial injury typically diagnosed as "myocarditis" based on cardiac MRI findings.

Further, the degree of inflammatory reaction vs. microthrombotic injury to cardiac myocytes from biopsied myocardial tissue will be compared with biopsied myocardial tissue from control hearts. mRNA expression of the ACE2 and ITGA5 binding targets of SARS-Cov-2 Spike protein encoded by mRNA vaccines, as well as expression of other genes that may contribute to post-vaccine pro-thrombotic and pro-inflammatory states including Coagulation Factor 3 (F3, also known as tissue factor), ACE, AGTR1 and AGT) or a dysfunctional cardiac state (NPPB as a marker of pathologic remodeling) will be examined as candidate genes. Additional, global gene expression is being measured by RNA-Seq and microarray.

Eligibility Criteria:
Inclusion Criteria:

1. age ≥18 years;
2. clear evidence of myocardial involvement including:

   1. High Sensitivity Troponin I value of (≥0.05 ng/ml (the 99% upper bound)) OR
   2. an LVEF \< 50% OR
   3. ST-T change suggesting STEMI, NSTEMI or myopericarditis in the absence of coronary artery disease, OR
   4. new onset sustained VT or VF
3. Late gadolinium enhancement or edema on cMRI consistent with myocardial injury or inflammation.
4. Documentation of vaccination with mRNA-based COVID-19 vaccine.
5. No history of COVID-19, or a negative SARS-CoV-2 PCR or other FDA approved laboratory test within 1 week of enrollment.
6. Patient and/or legally authorized representative must be competent to understand and agree with informed consent form.

Exclusion Criteria:

1. Hemodynamic instability as evidenced by escalating doses of inotropic agents or vasopressors within the prior 24 hours
2. Respiratory instability as evidenced by increasing oxygen requirements over the 24 hours prior to consent or FiO2 requirement ≥ 60 %.
3. evidence that respiratory failure is the primary reason for myocardial dysfunction;
4. Moderate to severe pulmonary hypertension (mean PAP ≥35 mmHg);
5. INR \>1.8 on no anticoagulation or contraindication to withdrawing anticoagulation;
6. platelets \<100,000/mm3.
7. History of laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain reaction (PCR) testing or other commercial or public health assay.
8. Acute or chronic kidney disease with glomerular filtration rate \< 30 ml/min.1.72m2
Short-term Effect of Intensive Insulin Therapy on Incretin Secretion

In type 2 diabetic patients, abnormality in secretion or action of incretin(GLP-1, GIP) is observed. Although controversy still exists, the secretion of GLP-1 is thought to be reduced by 20-30% while GIP secretion is normal or slightly elevated, in type 2 diabetic patients. Various parameters such as the duration of diabetes, the amount of meal and their constitution, gastric bypass surgery, and some antidiabetic drugs affect the secretion of incretin. However, the secretion of GLP-1 and GIP in glucotoxic condition and whether they recover after improvement of glycemic status is not known. The investigators aim to study the effect of intensive insulin treatment in uncontrolled diabetic patients.


Eligibility Criteria:
Inclusion Criteria:

* type 2 diabetic patients with disease duration of less than 15years
* age of 20-70 years
* BMI 22-27
* HbA1c 9-13%
* patients willing to receive intensive glucose control
* patients who are able to monitor their glucose level at home

  * for normal glucose tolerance group : NGT subjects with same range of age and BMI
  * for early diabetes group : patients with diabetic duration of less than 5 years and HbA1c level less than 7.5% for at least last 6 months

Exclusion Criteria:

* previous history of insulin treatment
* patients taking alpha-glucosidase inhibitor or thiazolidinedione
* serum creatinine \>= 1.5 mg/dL
* hemoglobin \< 10 g/dL
* AST/ALT greater than 3 times normal range
* ischemic heart disease, congestive heart failure (NYHA grade \>=2)
* chronic renal failure, proliferative diabetic retinopathy, CVA
* patients with gastroparesis or taking medications altering gastric motility
* usage of steroid or other agents affecting glucose metabolism
* pregnant or breast-feeding women