cyrilzakka/clinical-trials huggingface dataset:
Continuous Glucose Monitoring, Contingency Management, and Motivational Interviewing for Patients With Type 2 Diabetes in Kansas City

This study is evaluating a behavioral treatment program that uses diabetes coaching and financial rewards in addition to continuous glucose monitoring to improve diabetes management in adult patients with type 2 diabetes. This study will evaluate if this behavioral treatment program increases individual adherence to a diabetes treatment plan and improves blood sugar management.

A randomized parallel-group pilot study of a combination intervention using Motivational Interviewing (MI) and Contingency Management (CM) for patients with T2DM. Individuals will be randomized in a 1:1 ratio to the intervention group or the control group. Randomization will be blocked and stratified by long-acting insulin and GLP1 medication use. All participants will be given a Continuous Glucose Monitor (CGM) to assess real-time blood sugar levels and establish CM rewards for those assigned to the treatment group.

Eligibility Criteria:
Inclusion Criteria:

1. Diagnosed with type 2 diabetes
2. Age 18 to 65
3. Hemoglobin A1c (blood draw or point-of-care) test available within the last 3 months
4. Most recent hemoglobin A1c result between 8.0 and 11.0
5. Currently receiving treatment for diabetes by a licensed healthcare provider.
6. Reliable access to a personal smart phone that is compatible with CGM
7. English speaking

Exclusion Criteria:

1. Type 1 diabetes
2. Secondary type 2 diabetes (diagnosis secondary to other medical conditions such as pancreatitis, Cystic Fibrosis, or Cushing disease)
3. Prescribed short-acting (mealtime) insulin as part of diabetes treatment plan
4. Known or acknowledged active substance use disorder or that would interfere or negatively impact participation in the study
5. Diagnosis of a medical/psychiatric condition that would prevent participation in the study (e.g., Intellectual Disability, Alzheimer's disease, Traumatic Brain Injury, Schizophrenia)
Influence of Fampridine on Working Memory in Healthy Young Subjects

Proof of concept study on the acute effects on working memory of 10 mg fampridine SR as well as the effects after repeated administration of 10 mg twice daily (3.5 days).

The hypothesis ist that fampridine improves working memory performance.


Eligibility Criteria:
Inclusion Criteria:

* male or female
* generally healthy
* normotensive (BP between 90/60mmHg and 140/90mmHg)
* BMI between 19 and 29,9 kg/m2
* aged between 18 and 30 years
* fluent German-speaking
* IC as documented by signature
* at least double vaccination against Covid-19

Exclusion criteria:

* contraindications to the class of drugs under study, e.g. known hypersensitivity or allergy to 4-aminopyridine
* use of potassium channel blockers within the last 3 months
* concomitant treatment with OCT 2 inhibitors and substrates (e.g. cimetidine, propranolol)
* acute or chronic psychiatric disorder (e.g. major depression, psychoses, somatoform disorder, suicidal tendency)
* acute cerebrovascular condition
* history of seizures
* risk of lowered seizure threshold (due to e.g. sleep deprivation, withdrawal of alcohol after alcohol abuse)
* renal impairment
* history of malignant cancers
* walking problems (e.g. due to dizziness)
* bradycardia \> 50/min during clinical examination
* clinically significant concomitant disease states (e.g. hepatic dysfunction, cardiovascular disease, diabetes, asthma)
* clinically significant laboratory or ECG abnormality that could be a safety issue in the study
* known or suspected non-compliance
* drug or alcohol abuse
* inability to follow the procedures of the study, e.g. due to language or psychological problems of the participant
* participation in another study with an investigational drug within the 30 days preceding and during the present study
* prior participation (less than two years ago) in a study investigating working memory (notably the n-back task)
* enrolment of the investigator, his/her family members, employees and other dependent persons
* smoking (\>3 cigarettes per day)
* intake of psychoactive drugs (e.g. benzodiazepines, antidepressants, neuroleptics)
* pregnancy or breast feeding
* experiencing a syncope during basal rMT measuring
* metal in the brain, skull or elsewhere in the body (e.g., splinters, fragments, clips, etc.)
* implanted neurostimulator (e.g., DBS, epidural/subdural, VNS)
* cardiac pacemaker or intracardiac lines
* medication infusion device
* piercings, pivot teeth (retainers are no exclusion criterion)
* tattoos (head area) less than 3 months old or older than 20 years
* condition after neurosurgery
* hearing problems or tinnitus
* not able to sit still due to tremor, tics, itching
* history of repeated syncope
* head trauma diagnosed as concussion or associated with loss of consciousness
* diagnosis of epilepsy, or a convulsion or a seizure in the past of the participant or his family
* TMS in the past showing problems
* MRI in the past showing problems
* surgical procedures to spinal cord
* spinal or ventricular derivations
Evaluating Strategies to Improve Guideline Directed Medical Therapy: The GDMT Research, Education & Assist Trial for Heart Failure Care

Heart failure with reduced ejection fraction (HFrEF) is associated with high mortality and adverse events (hospitalization or urgent outpatient visits for HF), along with diminished quality of life. Despite convincing data that evidenced-based, guideline-directed medical therapies (GDMT) improve mortality and heart failure-related events, there remains insufficient utilization of these life-saving drugs (evidence-based beta-blockers (EBBB), angiotensin-neprilysin inhibitors (ARNI)/ angiotensin converting enzyme inhibitors (ACEi)/ angiotensin receptor blockers (ARB), mineralocorticoid receptor antagonists (MRA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with HFrEF. The primary objective of this study is to implement and evaluate a multifaceted, interdisciplinary intervention to improve GDMT use, reduce mortality, and reduce future heart failure events in patients with HFrEF.

This is a cluster randomized study designed to evaluate the effectiveness of interventions aimed at improving GDMT in patients with HFrEF. Clinicians stratified based on practice specialty, location, and pharmacist referral habits will be permuted block randomized to achieve 45%/45%/10% proportional distribution across the following arms respectively: (1) usual care, (2) multi-pronged clinical decision support (CDS) inclusive of a patient portal message about GDMT, an interruptive advisory upon chart entry as a notification to clinicians on GDMT consideration and a Best Practice Advisory (BPA) that includes a GDMT order set, and (3) multi-pronged CDS as in #2 but replacement of GDMT order set with referral to integrated clinical pharmacist co-management. Secondarily, each of the 5 clinical practice sites of roughly equal HFrEF patient loads were assigned to receive either an early or delayed education rollout. Exploratory analyses will look to determine the independent and incremental benefits of education with other interventional approaches.

Eligibility Criteria:
Inclusion Criteria:

* Patients aged 18 years or older AND
* Completed visit at included Geisinger cardiology outpatient clinics (office visit or telemedicine) AND
* Clinicians are on a list of currently active Geisinger clinicians in outpatient cardiology clinics who can prescribe heart failure medications AND
* Active problem list diagnosis of HFrEF at time of Cardiology clinic encounter OR Left Ventricular Ejection Fraction (LVEF) \< 40: most recent to the cardiology clinic encounter within 2 years of the visit.

Exclusion Criteria:

* Currently in hospice or palliative care (ICD 10 code: Z51.5)
* Patient is allergic to each category of GDMT
* Patient is prescribed medications from all four categories of GDMT, including ARNI specifically
Assessment of Trace Elements, Systemic Inflammation and Electrolytes

COPD is one of the most common causes of health problems worldwide. It is a disease that is associated with several systemic features that affect its morbidity and mortality.

The most prominent features of COPD are systemic inflammation and oxidative stress. There is growing interest in establishing the significance of systemic inflammatory biomarkers in COPD patients, as they could be useful in evaluating exacerbations, monitoring disease progression, and evaluating treatment outcomes.

C-reactive protein (CRP) is a biomarker for systemic inflammation, produced mostly by hepatocytes in response to tissue injury or inflammation.

Tumor necrosis factor - alpha (TNF-α) is a key modulator of the immune system's response to infection. At the sites of inflammation, this cytokine regulates the function of poly-morphs and lymphocytes, with essentially protective benefits for the host. Increased TNF-α production may enhance an injury process locally and also elevated circulating levels may have negative systemic consequences.

Trace elements are hypothesized to play a role in the pathogenesis of many diseases, either directly or indirectly. Trace elements play an important function in the inhibition and activation of enzyme processes .

Zinc, for example, is a co-factor for various enzymes and is important for cell membrane stability, protein synthesis, proper tissue growth, and nucleic acid metabolism.

Severity of COPD exacerbation is associated with increased levels of copper (Cu) and zinc (Zn).

Patients with COPD are liable for various electrolyte derangements, especially during exacerbations. Hyponatremia is typically observed in the final stages of COPD. Hypokalemia may also occur independently or concomitantly with hyponatremia, and because magnesium plays a role in muscle tone, a drop in magnesium levels in COPD is a component that reduces respiratory muscle function and causes muscle fatigue.

Eligibility Criteria:
Inclusion Criteria:

* COPD patients

Exclusion Criteria:

* Patients with Cardiovascular diseases,
* diabetes mellitus,
* chronic kidney disease,
* chronic liver disease,
* collagen vascular diseases,
* cancer,
* currently smoking,
* current pneumonia or inflammation, or refused to participate in the study
Effect of Renal Denervation in End Staged Renal Disease With Resistant Hypertension

A. Hypertension is a major cardiovascular risk factor and numerous treatment strategies have been developed to treat hypertension properly and reduce cardiovascular risk.

B. However, there is a subgroup of hypertension which are resistant to treatment.

1. Resistant hypertension is associated to sympathetic hyperactivity
2. Renal sympathetic nerve is known to be associated with systemic sympathetic activity
3. According to research of recent years, catheter based renal sympathetic denervation is a safe and effective treatment modality to treat resistant hypertension C. Resistant hypertension is observed in end stage renal disease (ESRD) frequently.

D. Sympathetic hyperactivity is observed in ESRD patients E. Catheter based renal sympathetic denervation is expected to improve resistant hypertension in ESRD patients

F. The aim the present study is to evaluate the effects and safety of catheter based renal sympathetic denervation on resistant hypertension in ESRD


Eligibility Criteria:
Inclusion Criteria:

* Patients who are under hemodialysis due to end stage renal disease
* Patients who have resistant hypertension with office SBP \>160 mmHg)
* Patients who are or over 18 years old.
* Patients who submit informed consent

Exclusion Criteria:

* Known secondary hypertension patients
* Patients who have renal artery which is not adequate for renal denervation

  1. The main renal artery diameter \< 4 mm, or renal artery length \< 20 mm
  2. The renal arteries into which stable catheter insertion is difficulty and which have hemodynamically or anatomically significant stenosis
  3. The renal arteries who have undergone renal angioplasty
* Patients who have history of myocardial infarction, unstable angina, syncope cerebrovascular insufficiency or extensive atherosclerotic disease with intravascular thrombosis, or unstable plaque
* Type 1 Diabetes
* Patients who have scheduled percutaneous coronary intervention (PCI) or operation within 6 months
* Hemodynamically significant valvular heart disease in which blood pressure reduction may cause significant deterioration of patient's health.
* Primary pulmonary hypertension
* Patients who have the intracardiac defibrillator(ICD) or pacemaker which do not allow delivery of radiofrequency energy.
* Patients who require continuous oxygen supply or mechanical ventilation for treatment of obstructive sleep apnea
* Patients who have serious medical condition which can compromise the safety of the patients and the safety and integrity of the study.
* Patients who have unresolved drug issue, alcoholism
* Patients who lack ability to understand and follow the instruction the researcher
* Patient who cannot follow up
* Patients who are registered in other trial
* Patients who are pregnant, nursing or planning to be pregnant
Validity of Information Employed to Generate Standardized Mortality Ratios Using Hospital Administrative Databases (RNMH)

In a retrospective cross-sectional study, investigators aimed to valid the variables employed to generate standardized mortality ratio from hospital administrative databases. For this purpose, investigators have compared those variables collected in administrative databases with the information available in patient medical record.


Eligibility Criteria:
Inclusion Criteria:

* All inpatients stays in acute care from high mortality diagnosis related groups (DRGs) registered in administrative databases of participating hospitals from January to December 2010.

Exclusion Criteria:

* Hospital participation refusal
Impact of Respiratory Allergy on Response to Initiation of Biotherapy in Severe Asthma in Adult Severe Asthmatic Patients Followed at Poitiers University Hospital on Biotherapy

The aim of this study is to take stock of the situation of adult patients with severe asthma on biotherapy, followed up at Poitiers University Hospital, and in particular to increase our knowledge of factors predictive of response to biotherapy. The main aim is to improve the management of adult severe asthma patients treated with biotherapy, according to their allergic status.


Eligibility Criteria:
Inclusion Criteria:

* Severe asthma patient on biotherapy
* Age \> or = 18 years
* Follow-up at Poitiers University Hospital

Exclusion Criteria:

* Absence of allergological assessment
* Patient's refusal to participate in study
A Prospective Observational Cohort Study of Awake Prone Position Ventilation Strategy in Patients With Acute Respiratory Failure

Awake prone positioning has been used widely for patients with COVID-19.Many research results are not uniform on the key issue of whether the prognosis of patients can be improved，and most of the subjects were patients with SARS-CoV-2 infected who are not intubated.The investigators will conduct a prospective observational study on patients with acute respiratory failure induced by various causes to determine whether awake prone position can reduce the need to upgrade to invasive mechanical ventilation and improve the prognosis of patients compared with standard treatment.


Eligibility Criteria:
Inclusion Criteria:

* 1.Older than 17 years, admitted to the ICU;2.Patients with acute respiratory failure meet the following conditions：①Under the condition of breathing air at rest, PaO2 of subjects is lower than 60mmHg and/or PaCO2 is higher than 50mmHg; ②Under the support of COT and HFNC, PaO2/FiO2 of the subject is less than 250; ③ Under the support of NIV ;

Exclusion Criteria:

* 1.Refusing to cooperate with active treatment; 2.Immediate need for intubation as determined by the treating team.3Patients with hemodynamic instability and moderate to high dose of vasopressors (norepinephrine dose ≥ 0.15 mcg/kg/min)；4.Contraindication to PP (e.g. vomiting, abdominal wound, unstable pelvic/spinal lesions, pregnancy \>20/40 gestation, severe brain injury)；
Blood-aqueous Barrier Integrity in Eyes Undergoing Intravitreal Bevacizumab Therapy to Treat Neovascular AMD

The aim of this study is to evaluate the effect of repeated intravitreal bevacizumab injections on blood-aqueous barrier permeability in eyes with neovascular age-related macular degeneration (AMD).


Eligibility Criteria:
Inclusion Criteria:

* active AMD-associated choroidal neovascularization (CNV) confirmed with fluorescein angiography (FA) and optical coherence tomography (OCT)

Exclusion Criteria:

* history of uveitis, vitreous hemorrhage, neovascular glaucoma, corneal opacities, recent ocular surgery (within 3 months), or prior anti- vascular endothelial growth factor (VEGF) injections
Quantification of Tenofovir Alafenamide Adherence (QUANTI-TAF)

This study is being done to evaluate the relationship between adherence to antiretroviral therapy (ART) and HIV drug concentrations in persons living with HIV (PLWH) that are taking tenofovir alafenamide (TAF). Adherence will be measured with an ingestible biosensor (digital pill). Antiretroviral drug concentrations will be measured in different types of blood cells.

PLWH taking or initiating/re-initiating TAF will be recruited for a 16-week study. Upon entering the study, participants will be trained on the use the digital pill to objectively quantify adherence. Study participants already taking TAF will return every 4 weeks for a study visit where blood for drug concentrations will be obtained. Participants initiating/re-initiating TAF will return weekly for the first 4 weeks, at weeks 6 and 8, and every 4 weeks thereafter for a study visit where drug concentrations will be obtained.

Eligibility Criteria:
Inclusion Criteria:

1. Females or males with HIV, able to give informed consent and comply with study procedures.
2. Currently on (\> 6 months), or planning to initiate/re-initiate TAF.

Exclusion Criteria:

1. For females of childbearing age, active pregnancy or any intent to become pregnant
2. Hepatitis C (HCV) infection for which treatment is anticipated within the next 16 weeks after enrollment. Treated HCV with sustained virologic response is allowable if last dose of HCV antivirals was \>12 months prior to enrollment
3. Advanced renal (eGFR \<30 mL/min/1.73m\*\*2) or liver (Child-Pugh B or C) disease
4. History of extensive bowel surgery, gastric bypass, or gastroparesis
5. Concomitant use of any prescription or non-prescription drug known (or with the potential) to significantly influence the PK of TAF (e.g. rifamycins, carbamazepine, phenytoin, St. John's Wort, tipranavir)
Increased Risk of Non-alcoholic Fatty Liver Disease in Low Birth Weight Individuals

The investigators recently demonstrated a increase in liver fat in early middle-aged LBW compared to normal birth weight (NBW) men, and 20% of the LBW - but none of the normal birth weight (NBW) - men had previously unknown non-alcoholic fatty liver disease (NAFLD). Here the investigators will further examine the Increased risk of non-alcoholic fatty liver disease in low birth weight individuals by performing a validation study.

An adverse fetal environment characterized by low birth weight (LBW) plays a key role in the development of type 2 diabetes (T2D). The investigators recently demonstrated a 3-fold increase in liver fat in 26 early middle-aged LBW compared to 22 normal birth weight (NBW) men, and 20% of the LBW - but none of the normal birth weight (NBW) - men had previously unknown non-alcoholic fatty liver disease (NAFLD). The investigators hypothesize that ectopic fat deposition and NAFLD is among the earliest disease manifestations and on the critical path to the development of more severe cardiometabolic disease in LBW. Here we aim to perform an extended nested case-control screening study to evaluate hepatic steatosis (NAFLD) and fibrosis in early middle-aged, non-obese LBW men and women and NBW controls. In total, 250 LBW men and women (birth weight (BW) \<10% of the population) and 50 NBW controls (BW between 50-90% of the population) born at term (weeks 39-41), 35-40 years-of-age will be recruited from the National Danish Birth Registry for the nested case-control NAFLD screening study. The nested case-control NAFLD screening study will serve as a recruitment platform for a subsequent intervention study.

Eligibility Criteria:
Inclusion Criteria:

* 250 healthy, men and women born with a low birth weight (birth weight (BW) \<10% of the population) and 50 born with a normal birth weight controls (BW between 50-90% of the population)
* born at term (weeks 39-41)

Exclusion Criteria:

* BMI\>35 kg/m2
* Disease/medication known to affect primary outcome
* Self-reported high physical activity level
* Alcohol intake above general recommendations.
* Metabolic/liver disease
* Weight gain/loss of \>3 kg within the past 6 months
Thyroid Dysfunction in Patients With Nephrotic Syndrome

This study is to evaluate Thyroid Hormone profile in patients with Nephrotic syndrome to identify clinical predictor of Thyroid dysfunction in patients with Nephrotic syndrome

Nephrotic syndrome (NS) is one of the most popular glomerular diseases all over the world It result in loss of various macromolecules which exist in the plasma and bound to plasma proteins. They are carried away and lost in the urine due to increase glomerular membrane permeability.The abnormalities arising as a result of persistence of generalized edema , substantial heavy proteinuria \>3,5 gm/24 h 3, hypoalbuminemia\<30 g/L and hyperlipidemia Also, nephrotic syndrome may associated with thromboembolism and increase risk of infection, vitamin D deficiency, Iron deficiency and endocrine abnormalities such as primary Hypothyroidism.The interaction between kidney and Thyroid hormone is an important factor in the normal functioning of both the vital organs, thyroid hormone play a major role in early development of kidney structurally and regulation of major glomerular and tubular function and water and electrolytes balance .Kidneys on other hand are important in the metabolism and elimination of Thyroid Hormone.The effect of nephrotic syndrome on thyroid function can be explained by presence of proteinuria and loss of Thyroid binding globulins (TBG) in urine

which lead to decrease in Total T3,Total T4,free T3 and free T4 and consequently increase in TSH from the pituitary gland with over function of thyroid gland in order to maintain Thyroid hormone levels. Another theory explain association between nephrotic syndrome and thyroid dysfunction is Autoimmunity which can attack both organs and may also cause abnormal function of both organs. Thus, subclinical Hypothyroidism and overt Hypothyroidism may happen in NS patients and CKD patients

Eligibility Criteria:
Inclusion Criteria:

* Nephrotic syndrome defined by the following:

  1. Generalized edema
  2. Urine protein excretion \> 3,5 g/24 hours
  3. Urine protein to creatinine ratio \> 3,500mg/g
  4. Serum albumin level less than 30 g/L

Exclusion Criteria:

- 1) Patients \< 18 years old 2) Patients who have Thyroid diseases, current or past history of thyroid hormone or antithyroid drug intake.

3) Patients who have diabetes mellitus or autoimmune diseases as systemic lupus erythematosus and RA 4) Medications known to affect thyroid function. 5) Patients with liver cirrhosis and chronic liver disease as augmentin