cyrilzakka/clinical-trials huggingface dataset:
Study of One Protein Implicated in Wegener Disease

The investigators recently showed an abnormal expansion of NK-like CD4+ T cells in Wegener's granulomatosis (WG), mainly in the diffuse vasculitis presentation. These cells expressed an assortment of activating NK cell receptors and their signaling partners, in particular DAP12. The investigators hypothesize that DAP12, or a downstream signaling target of DAP12, is the missing link between the different cell components involved in WG (neutrophils, macrophages, CD4 T cells).

The investigators will test our hypothesis of "DAP-12 gain-of-function" by quantitative (mRNA and protein) and qualitative (DNA, signaling and cellular activation) analysis of the DAP12 signaling pathway in WG patients with localized (group 1; n=30) or diffuse WG (group 2; n=30) by comparison with patients with micro polyangitis (group 3; n=30), or with sarcoidosis ( group 4; n=30), and healthy blood donors (group 5; n=30). Blood samples will be collected during a routine medical visit. These results may help to design future therapeutic strategies based on modulation of specific intra-cellular pathways involved in the disease.

Eligibility Criteria:
Inclusion Criteria:

* Group 1: WG, with granulomatous lesions limited to upper airway or lungs and no evidence of generalized vasculitis ,± biopsy, ± anti-PR3 ANCA
* Group 2: WG with granulomatous lesions plus vasculitis expression (renal, neurological, skin, gut or heart involvement), ± biopsy, ± anti-PR3 ANCA
* Group 3: Necrotizing vasculitis with no granulomatous lesions, ± PAUCI immune glomerulonephritis, ± anti-MPO ANCA
* Group 4: clinical presentation compatible with sarcoidosis, ± biopsy, ± ECA elevated ± tuberculin anergy

Exclusion Criteria:

* \<18 years
* Pregnancy or breastfeeding
* Absence of signed informed consent
* No affiliation to insurance
Effect of Metadoxine on Oxidative Stress in Non-alcoholic Hepatic Steatosis

Oxidative stress is produced by imbalance between reactive oxygen species and antioxidant systems. This state is frequently associated with chronic diseases like obesity, insulin resistance, metabolic syndrome and hepatic steatosis. In the liver, the oxidative stress may trigger the progression of fatty liver disease, from triglyceride accumulation to inflammation, cirrhosis and hepatocellular carcinoma. Thus, the attenuation of oxidative stress, could be an important therapeutic target to lessen the severity of the disease. Until now, there is not a medical treatment to cure non-alcoholic fatty liver disease, but therapies aimed at reducing oxidative stress have been proposed. Metadoxine, an ionic complex of pyridoxine-pyrrolidone molecule, acts as a synthetic antioxidant, forming traps that can reduce free radicals; likewise, metadoxine has a proven capacity to reduce fat liver in alcoholic hepatitis. Finally, in fact that alcoholic and non-alcoholic liver diseases share molecular mechanisms in the generation of oxidative stress, the investigators propose metadoxine as a posssible modifier of the oxidative stress in non-alcoholic liver disease, prediabetic patients.


Eligibility Criteria:
Inclusion Criteria:

* Male and female
* 18 to 65 years old
* Ultrasonographic diagnosis of NAFLD
* Prediabetes diagnosis

Exclusion Criteria:

* Alcoholism
* Hepatitis C or B Virus Infection
* Pregnancy
* Autoimmune hepatitis
* Metformin or metadoxine allergy
* Parenteral nutrition in the last month
* Weigh loss greater than 10% in the last month
* Taking vitamin supplements in the last month
Effect of a Single Ultra-Processed Meal on Myocardial Endothelial Function Assessed With Positron Emission Tomography

The objective of this study is to evaluate the effect of an ultra-processed meal on myocardial endothelial function using positron emission tomography (PET).

The proposed study is an open-label, randomized crossover clinical trial. Participants will be divided into 2 groups: half of the participants will consume a Mediterranean meal during the first experimental visit and an ultra-processed meal during the second, and vice versa for the other half. The order in which the meals will be consumed will be determined randomly.

This project will contribute to clarify the role of diet in the development and progression of coronary artery disease. The results obtained from this study may potentially demonstrate the harmful effect of ultra-processed foods, even in the short term, on coronary arteries.

The proposed study is an open-label, randomized crossover trial. This design will allow participants to serve as their own controls. This is critical as there is some variability in response to vasodilators in the population, and by using this research design, we increase our ability to detect small changes. The study consists of 3 visits: a preliminary visit and two imaging visits. During the preliminary visit, the study will be explained to participants, and consent will be obtained. During the imaging visits, participants will consume a meal, and PET imaging will be completed 4 hours later. Half of the participants will consume the Mediterranean meal during the first visit and the ultra-processed meal during the second visit, and vice versa for the other participants. Randomization will determine the order in which the meals are consumed.

Eligibility Criteria:
Inclusion Criteria:

1. Men aged between 18 and 50 years.
2. Absence of cardiovascular symptoms.
3. Ability to provide free and informed consent.

Exclusion Criteria:

1. Presence of cardiovascular disease.
2. Active smoking or within the past 12 months.
3. Hypertension (BP \> 140/90 mmHg).
4. Renal failure (Creatinine clearance \< 90 mL/min).
5. Type I or II diabetes.
6. Dyslipidemia (LDL ≥ 3.5 mmol/L or total cholesterol/HDL ratio ≥ 5.0).
7. Heart failure (Left ventricular ejection fraction \< 50%).
8. Congenital heart disease.
9. Obesity (BMI \> 35 kg/m2).
10. Uncontrolled asthma or chronic obstructive pulmonary disease (COPD).
11. History of severe allergy or reaction to adenosine or dipyridamole.
12. Second-degree type II or third-degree atrioventricular block.
13. Bradycardia with resting heart rate \< 40 bpm.
14. Chronic alcoholism.
15. Substance abuse.
16. Claustrophobia.
17. Vegetarianism.
18. Use of statins or beta-blockers.
19. Food allergy preventing consumption of study meals.
20. Participation in this project would result in cumulative research study radiation dose \> 50 mSv in the past 12 months.
21. Neurocognitive disorders or medication use affecting cognition.
22. Any condition that, in the opinion of the investigators, could compromise the subject's participation in the study.
Post-Pandemic Perception of Public Space in Singapore

In this study it is aimed to investigate the difference between the brain response to different urban environments in Singapore before and after the COVID-19 pandemic. The datasets acquired from 34 healthy individuals as part of ongoing study "Effects of Landscape on the Brain" (IRB Ref #: S-18-352) will be used. These datasets consist of neurophysiological data recordings and behavioral self-reported measures and were collected before 20 of January 2020. The same experimental protocol would be followed, given that the data collection in the lab-setting would start after 7 th May 2020/whenever research activities are allowed to resume, and the outdoor sessions after the "circuit-breaker" period in Singapore is over.

The aim is to explore the difference between pre and post COVID-19-related isolation on their perception of green and public spaces, as well as mood, neuroelectrical (EEG) and haemodynamic (fNIRS) response.

The hypothesi is that crowded, busy public spaces, such as experimental site near Chinatown MRT, may induce more patterns of brain activity related to stress, anxiety and aversive attitudes after COVID-19 as compared to before. Similarily, it is expected that green urban spaces, such as experimental site at Hortpark, perceived after COVID-19 can elicit more salutogenic effect of relaxation, positive emotions and attention restoration than before the pandemic.

This study will allow better understanding of the mental health consequences of unprecedented period of isolation at home and social distancing. The relationship between city residents and their living environment may change due to COVID-19 and it's very important to uncover the mental health implications of social distancing to prepare for potential future outbreaks through developing tools and solutions addressing specific issues. Finally, for the urban planning and design the study may highlight important trends in changing human perception of space and redefine the concept of a "healthy city".

Eligibility Criteria:
Inclusion Criteria:

* Age of 21 to 75
* Right-handed only

Exclusion Criteria:

* left-handed
* serious visual or auditory impairment

  * Major neurological disorders e.g. epilepsy, stroke
  * Any form of cancer
  * Major heart diseases: e.g. ischemic heart disease
  * Major lung diseases: e.g. chronic obstructive pulmonary disorder.
  * Major liver disease e.g. liver failure
  * Major kidney disease e.g. kidney failure
A Study to Examine the Safety and Toleration of PEP005 Topical Gel in Patients With Actinic Keratoses on the Top of the Hand

The purpose of this study is to examine the safety and toleration of PEP005 Topical Gel, administered on an actinic keratosis (AK) treatment area on the top of a hand.

Actinic keratoses (AK) is a common skin condition characterized by rough, scaly patches or sores on the top layer of the skin which if left untreated can progress to skin cancer. Current treatments can cause scarring and hypopigmentation, be inconvenient, or require long treatment duration. Non-invasive alternative therapy for treatment of AK lesions is thus being researched.

Eligibility Criteria:
Inclusion Criteria:

* Male patients at least 18 years of age.
* Post-menopausal female patients
* 4 to 8 clinically typical, visible and discrete AK lesions within an area on the dorsum of one hand.
* Written informed consent has been obtained.
* Agreement from the patient to allow photographs of the selected AK treatment area to be taken and used as part of the study data package.
Effects of Feet Mechanical Stimulation on Cardiovascular Autonomic Profile and Inflammation in Parkinson's Disease

In the present study, investigators test the hypothesis that a controlled mechanical pressure applied on specific sites of both fore-feet (ES) can reduce the inflammatory state and arterial blood pressure in patients with Parkinson's Disease by increasing the overall parasympathetic activity and reducing vascular sympathetic modulation.

Neuroinflammation may contribute to the cascade of events leading to neuronal loss in Parkinson's disease (PD) thus facilitating motor and autonomic impairment. A link between autonomic function and chronic and acute inflammation has been previously described. Specifically, active inflammatory state was associated with an overall increased sympathetic tone, whereas the parasympathetic cholinergic activation seemed to promote a decrease of inflammatory compounds in inflamed tissues. In addition, a functional link between peripheral sensory afferents and autonomic control has been reported. In a recent study it was observed that in PD patients a somatosensory activation by mechanical stimulation of specific sites of the fore-foot (effective stimulus, ES), improved gait, increased cardiac vagal modulation and decreased vascular sympathetic activity at rest. This latter effect was associated with a decline in arterial blood pressure values.

The present study is aimed at:

* Addressing the magnitude of the inflammatory state in PD patients.
* Testing the hypothesis that a change in the autonomic profile of PD patients induced by ES, consistent with cardiovascular increased parasympathetic and decreased sympathetic activities, may promote an overall reduction of the PD inflammatory state.

Eligibility Criteria:
Inclusion Criteria:

* Idiopathic PD characterized by a moderate/important motor impairment (Hoehn\&Yhar scale 2-4)
* PD will be diagnosed according to the United Kingdom (UK) Parkinson's Disease Society Brain Bank criteria, (or on the basis of clinical criteria, Dopamine Transporter (DAT)- scan and/or MRI).

Exclusion Criteria:

* Dysautonomias and other neurodegenerative diseases
* History/familiarity with seizures
* Atrial fibrillation and other relevant cardiac rhythm disturbances
* Chronic inflammatory diseases and chronic use on anti-inflammatory drugs
* Diabetes
* Other neurological or psychiatric diseases
* Pacemakers or other electronic implants inserted into the body
* Coronary disorders, elevated intracranial blood pressure
* Assumption of drugs facilitating seizures, psychiatric drugs, alcohol abuse
Cervical Cord to Canal Diameter Ratio

Cervical epidural block could cause spinal cord injury if the epidural needle is over-inserted and punctures the spinal cord. Investigators retrospectively evaluated the imaging data of 100 patients (50 men and 50 women) who underwent both cervical computed tomography (CT) and cervical magnetic resonance imaging (MRI) at our hospital. Investigators measured the diameters of the spinal canal and spinal cord from the 3rd cervical vertebra to the 1st thoracic vertebra (T1) at each level by using the patients' cervical CT and MR images. The spinal cord and spinal canal diameters were measured in the transverse plane of cervical MR and CT images, respectively.

The spinal canal diameter, i.e., the epidural transverse diameter, was measured as the distance between the innermost border of the left and right pedicles at each upper pedicular level from C3 to T1 on transverse CT images by using a picture archiving and communication system (PACS; INFINITT PACS G3, INFINITT Healthcare, Korea) The spinal cord diameter was measured between the left and right outermost distances of the cord at each upper pedicular level, which were almost the same locations used for measuring the spinal canal diameter, from C3 to T1 on transverse MR images by using the PACS.

Eligibility Criteria:
Inclusion Criteria:

* 100 patients (50 men and 50 women aged 20 to 70 years old) who visited our hospital and underwent both cervical CT and MRI simultaneously

Exclusion Criteria:

* patients who had a history of cervical spine surgery or cervical cord edema, whose CT or MR images did not include all the cervical vertebrae from C3 to T1,
* patients who had at least one missing medical detail such as diagnosis, age, height, or weight.
FloPatch for Prevention of Hypotension After Induction of General Anesthesia

This study is being conducted to find out if a special device called FloPatch™, which sticks to a persons skin and uses ultrasound to check the blood flow in their neck, can tell if someone going to have low blood pressure after they get put to sleep for surgery. The investigators will be testing this in adults who are having elective non-heart surgery. Basically, the goal is to see if this device can help predict who might have low blood pressure during surgery.

Hypotension is a common side-effect of general anesthesia induction, and is related to adverse outcomes, including significantly increasing risk of one-year mortality. Even short durations of intraoperative hypotension have been associated with acute kidney injury (AKI) and myocardial injury. Myocardial injury after non-cardiac surgery (MINS) is a common postoperative complication associated with adverse cardiovascular outcomes, and intraoperative hypotension is believed to be involved in its development.

In the preoperative setting, a systematic review of 50 studies (2,260 patients) evaluating techniques to assess adult patients with refractory hypotension or signs of organ hypoperfusion found that half of all patients were fluid-responsive, pointing to volume status as a significant risk factor, while also presenting a challenge in distinguishing fluid-responders from non-responders. For surgical patients, preoperative fasting, hypertonic bowel preparations, anesthetic agents, and positive pressure ventilation all contribute to reduced effective circulating blood volume. Optimized fluid therapy remains the cornerstone of treatment of hypovolemia, with excellent effectiveness. Since the liberal use of fluids may result in fluid overload, which is associated with the development of pulmonary edema, wound infection, postoperative ileus, and anastomotic leakage, it is imperative to identify those patients who may benefit from it.

The hypothesis is that the corrected Flow Time (cFT) measured by the FloPatch will help predict hypotension after the induction of general anesthesia.


Eligibility Criteria:
Inclusion Criteria:

* Adult patients ≥ 18 years
* Undergoing elective noncardiac under general anesthesia

Exclusion Criteria:

* Hypotension, defined as Mean Arterial Pressure (MAP) below 65 mmHg preoperatively on the day of surgery.
* Treated with angiotensin converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) on the day of surgery.
* Patients with heart failure with ejection fraction (EF) \< 40%.
* A history of any previous neck surgery or trauma.
* Cardiac rhythm other than sinus at the time of common carotid artery corrected Flow Time (cFT) assessment.
* Patients who will receive neuraxial blockade (epidural or spinal) performed before induction of general anesthesia.
* Planned placement of a jugular central venous catheter or surgery to be performed in the area of the FloPatch.
* Patient is pregnant or is undergoing obstetrical surgery.
Effect of Early Extracorporeal Diaphragm Pacing Combined With Tilt Table in Ventilated Patients.

The aim of this study is to test the effect of 1week of extracorporeal diaphragm pacing (EDP) combined either with or without tilt table verticalization (TTV) on diaphragm function in patients with mechanical ventilation compared to conventional physiotherapy (CPT).

In order to explore whether extracorporeal diaphragm pacing (EDP) combined with tilt table verticalization (TTV) improves diaphragm function in mechanically ventilated patients, the investigators conducted a three-arms randomized controlled trial of 90 ventilated patients in the ICU of a general hospital in the southern China state of Guangzhou. After assessment of inclusion and exclusion criteria, patients were randomly assigned to one of the following three groups: (1) EDP with TTV and with conventional physiotherapy (CPT) (n = 30), (2) EDP without TTV and with CPT (n = 30), and (3) conventional physiotherapy (CPT; n = 30).

Eligibility Criteria:
Inclusion Criteria:

* Duration of mechanical ventilation prior to enrollment≤ 72 hours.
* Expected duration of mechanical ventilation≥72 hours.
* Participants (or their legal representatives) have signed informed consent.

Exclusion Criteria:

* Pregnancy or breast-feeding.
* Prone ventilation or current extracorporeal membrane oxygenation.
* Hemodynamic instability: mean arterial pressure is less than 65 millimeters of mercury (mmHg) or higher than 85 millimeters of mercury (mmHg), heart rate \> 150 beats / minute, intravenous use of larger doses of vasopressors (such as dopamine \> 10 mg/ (kg· min) or norepinephrine/epinephrine \>0.1 mg/ (kg· min)) or aortic balloon counter pulsation; respiratory rate\< 5 breaths per minute; Oxygen saturation\< 88%.
* New-onset myocardial ischemia.
* Unstable cervical spine fracture and spinal cord injury.
* Deterioration of neurological function, requiring intracranial pressure monitoring and ventricular drainage, or active control of intracranial hypertension.
* Current neuromuscular block treatment or pre-existing neuromuscular disease or neuromuscular junction disease affecting respiratory muscle (such as myasthenia gravis, Guillain-Barré syndrome, etc.).
* There are contraindications to diaphragmatic pacing (local skin, tissue incompleteness or infection, chest X-ray examination shows pneumothorax or pleural effusion accounting for 1/3 of bilateral chest cavity).
* Body mass index (BMI) ⩾40 kg/m2.
* Known / suspected phrenic nerve palsy.
* Patients who refuse active treatment or are in the terminal stage of malignant tumors, have an expected life expectancy of \< 6 months, etc.
* Participated in other clinical studies related to mechanical ventilation within 2 months prior to the start of the study.
Factors Influencing of Pulse Pressure Variation (PPV)

The investigators studied the predictive value of PPV in the patients with different influencing factors;and the method to improve the predictive value,which can improve the application of PPV in ICU.

PPV can be used to predict fluid responsiveness in patients with circulatory shock.However, it is affected by many factors, which leads to the decrease of the applicability of PPV in ICU.Therefore, the investigators studied the predictive value of PPV in the patients with different influencing factors;and the method to improve the predictive value,which can improve the application of PPV in ICU.

Eligibility Criteria:
Inclusion Criteria:

* Patients requiring invasive mechanical ventilation
* Acute circulatory failure,defined as:systolic blood pressure \<90 mmHg or blood pressure in patients with previous hypertension lower than the baseline value\> 40 mmHg; vasoactive drugs are required to maintain blood pressure (mean arterial pressure\> 65 mmHg); with or without signs of hypoperfusion (oliguria\<0.5ml.kg-1.h-1 for at least 2 hours; arterial blood lactic acid\>2.5mmol.L-1; skin mottling)

Exclusion Criteria:

* The age of the patient is less than 18 years old or more than 80 years old
* Refuse to sign the informed consent to join the group
* Atrial fibrillation and other arrhythmias that seriously affect the output per beat;
* With pregnancy
* Other situations where the clinician believes that the patient is not suitable for inclusion in the study