cyrilzakka/clinical-trials huggingface dataset:
Application of Ultrasound Artificial Intelligence and Elastography in Differential Diagnosis of Thyroid Nodules

The application of computer-aided diagnosis (CAD) technology "S-DetectTM" enables qualitative and quantitative automated analysis of ultrasound images to obtain objective, repeatable and more accurate diagnostic results. The Elastic Contrast Factor (ECI) technique, unlike conventional strain-elastic imaging techniques, can evaluate the elastic distribution in the region of interest. The purpose of the study was to evaluate the differential diagnosis value of ultrasound S-DetectTM technology for benign and malignant thyroid nodules and evaluate the consistency of ultrasound S-DetectTM technology and sonographer in the differential diagnosis of thyroid nodules and explore the differential diagnosis value of Samsung ultrasound ECI technology for benign and malignant thyroid nodules.

Thyroid nodules are one of the most common nodular lesions in adults, and their incidence is increasing. Clinical studies have found that about 10%-15% of adults have thyroid nodules, most of which are benign nodules, only 7% of thyroid nodules tend to be malignant, but if not treated promptly, 5% of patients will still from benign to malignant. The incidence of thyroid cancer increases with age. According to the National Cancer Research Center, about 64,300 new cases of thyroid cancer occurred in the world in 2016, and about 1,980 died of thyroid cancer. Timely and accurate detection of thyroid nodules and differentiation of benign and malignant are important for improving clinical treatment and improving patient prognosis.

S-Detect technology is a computer-aided (CAD) system recently developed by Samsung Medical Center for thyroid ultrasound to assist in morphological analysis based on the Thyroid Imaging Reporting and Data System (TI-RADS) description and final assessment.This provides a new way to identify the benign and malignant thyroid nodules.

The ECI technique, unlike conventional strain-elastic imaging technology, performs an elastic analysis of the entire two-dimensional image. Moreover, when measuring the elastic ratio, it is only necessary to place a region of interest (ROI) at the nodule. Compared with the average elasticity of the surrounding area, it is more reflective of the elastic ratio of the mass to the surrounding tissue.

Eligibility Criteria:
Inclusion Criteria:

1. Had thyroid lesions detected by ultrasound
2. Age 18 or older
3. Upcoming FNAB or surgery
4. Signing informed consent

Exclusion Criteria:

1. Patients who had received a biopsy of thyroid lesion before the ultrasound examination
2. Can not cooperate with the test operation
3. Patients who were pregnant or lactating
4. Patients who were undergoing neoadjuvant treatment.
Efficacy of Recruitment Maneuver in Pediatric Patients Under General Anesthesia

During general anesthesia lung collapses and atelectasis occurs. Preservation of atelectasis can cause pulmonary disfunction. The goal of safe anesthesia is to protect the lungs intraoperatively. Positive end-expiratory pressure (PEEP) is distending pressure that prevents alveolar collapse during mechanical ventilation and is a part of recruitment maneuver that is often used in patients on mechanical ventilation. Overall effect of PEEP is improvement in lung function. PEEP can have adverse effects on hemodynamics. The objective of this study was to assess the effect of step up and down PEEP titration on lung function and hemodynamics in healthy preschool children during general anesthesia. One group of children was ventilated with constant PEEP. the other was submitted to PEEP titration. Changes in lung compliance, gas exchange and hemodynamic status were documented as well as any unwanted effects.

Seventy preschool children American Society of Anesthesiologists classification system (ASA) I and II scheduled for non-cardiothoracic surgery were allocated in two groups. Interventional group (n=35) received PEEP titration and Control group (n=35) didn't. They were ventilated only with PEEP 3. PEEP titration: In Intervention group, 20 minutes before the end of anesthesia PEEP was increased by 2 on every 5 breaths to 11. Ventilation with PEEP 11 was maintained for 2 minutes. Then PEEP was reduced by 2 on every 5 breaths to 5 and remain as until awakening. Total time to perform titration was 5 minutes. Blood was collected in both groups, in equal points of time that is: after induction, 20 minutes before the end of surgery and after the end of surgery (20th minute). Investigators tested differences of outcome variables between groups and within the Interventional group before and after PEEP titration. Hemodynamic monitoring and monitoring of lung function were conducted in Interventional group to observe changes during PEEP titration.

Eligibility Criteria:
Inclusion Criteria:

* age 3-7; ASA I and II
* absence of cardiovascular and respiratory comorbidity

Exclusion criteria:

* current or recent (up to 4 weeks) upper airway infection
* present of gastroesophageal reflux
* allergic reactions to anesthetics
* contraindication to chosen anesthetics
Efficacy and Safety of Aliskiren and Atenolol in Adults (>18) With Mild to Moderate Hypertension

This is a study for people diagnosed with hypertension to compare the safety and effectiveness of aliskiren alone and in combination with atenolol. Each patient will be in the study for 12 weeks.


Eligibility Criteria:
Inclusion Criteria:

1. Outpatients 18 years of age and older.
2. Patients with essential hypertension.

Exclusion Criteria:

Severe hypertension, Current diagnosis of heart failure, History or evidence of a secondary form of hypertension, Participation in any investigational drug study within one month of planned participation,

Other protocol-defined inclusion/exclusion criteria may apply
A Pilot Study to Assess the Accuracy of Blood Pressure Assessment by the Omron HeartGuide Smartwatch

The accuracy of devices like the recent FDA-clearance of the Omron HeartGuide™ Blood Pressure sensor in robust clinical settings remain in question and thus form the underpinning of this research study.

The objective of this pilot prospective study is to assess the accuracy of the Omron Blood Pressure sensor as compared to arterial line blood pressure monitoring.

The purpose of this study is to assess the accuracy of the Omron HeartGuide™ Smartwatch in measuring blood pressure and heart rate as compared to standard post-operative blood pressure and heart rate monitoring with an arterial line and heart monitor.

Hypertension affects about 75 million Americans and is the leading cause of cardiovascular disease (heart attacks and strokes), resulting in about 1,000 deaths per day. Only 50% of patients have their blood pressure adequately managed thus necessitating a better solution. Current limitations to hypertension management in non-ICU or non-surgical settings include: 1) infrequent measurements, 2) inherent data variability, 3) white coat hypertension, 4) non-compliance, or 5) poor patient-provider follow-up. A majority of patients have their blood pressure measured only during clinic visits. A wearable blood pressure sensor that takes multiple measurements per day will allow for a new level of granularity among measurements. With more continuous measurements, patients and physicians can work together to identify the onset and progression of hypertension before it causes irreversible damage to the heart, kidneys, and brain.

During testing, each subject will wear the Omron HeartGuide™ Smartwatch. Both right and left wrist circumferences will be measured prior to placing the device. All patients will be on continuous telemetry according to standard clinical practice on the ICU. Each patient will be outfitted with the Omron HeartGuide™ Smartwatch (opposite extremity of the arterial line). An Omron BP reading will be obtained at the same time as the arterial line reading. Four readings in total will be obtained for each patient. All four readings may occur on the same day or may be occur over several days.

Eligibility Criteria:
Inclusion Criteria:

* Age \> 18 years
* Post-operative cardiac surgery patients on the ICU floors at the Cleveland Clinic Main Campus
* Wrist size range ranging from 16 cm to 19 cm

Exclusion Criteria:

* Wrist size range smaller than 16 cm or larger than 19 cm
* Use of a radial artery graft for coronary artery bypass grafting
Hepatobiliary Manifestations Following Two-Stages Elective Laparoscopic Restorative Proctocolectomy for Patients With Ulcerative Colitis. A Prospective Observational Study.

Several studies using different methodological approach have revealed incomplete, old and conflicting data on the course of hepatobiliary manifestations after surgery. authors conducted a prospective observational study to evaluate the role of LRP on the course of hepatobiliary manifestations for a better knowledge of these manifestations that is necessary to improve their management.also, to evaluate the role of surgery on prevention of liver damage from progression of the disease.

Inflammatory bowel disease (IBD) prevalence is expected to reach 1% of the population in many regions over the next decade. despite the fact that the primary clinical manifestations of IBD are centred in the gastrointestinal tract, 25-40% of IBD patients develop at least one extraintestinal manifestation (EIM).

Hepatobiliary manifestations constitute one of the most common EIMs in IBD . Hepatobiliary manifestations are much more commonly associated with ulcerative colitis (UC) and include primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), fatty liver, cholelithiasis, primary biliary cholangitis, portal vein thrombosis, and hepatic abscess.

Most UC patients can be managed medically, but a minority requires proctocolectomy. Two-stage laparoscopic proctocolectomy (LPC) with ileal pouch-anal anastomosis (IPAA) is a cure for colitis, but its effect on hepatobiliary diseases is controversial.

Eligibility Criteria:
Inclusion Criteria:

* patients between 18-69 years,
* both sex diagnosed as ulcerative colitis with at least one hepatobiliary manifestation
* underwent laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis
* with or without gallstones.

Exclusion Criteria:

* age\<18 years or \> 69 years,
* alcohol abuse,
* pregnancy,
* severe heart failure or type II diabetes mellitus (defined as established diagnosis, HbA1c \> 6.4%, non-fasting glucose level \> 180 mg/dL, or on antidiabetic medication),
* development of complications or death related to the operation of LRP ,
* liver toxicity of IBD-related medications.,
* chronic viral hepatitis,
* haemochromatosis,
* Wilson's disease,
Peroneal Muscles Response to Expected and Unexpected Falls Among Young and Middle-aged Adults Before and After Neuromuscular Training

Proper functioning of the ankle musculature, specifically peroneal muscles, is crucial for maintaining balance and reducing the risk for falls. Evidence suggests that a decrease in aspects of neuromuscular control already starts at midlife (45-65 years). However, there is almost no information regarding the function of the ankle muscles at the middle-age as most experiments have compared young (\<35 years) and older subjects (\>65 years). Moreover, neuromuscular training can improve the function of ankle muscle in response to perturbation; yet, no previous study has compared the level of effectiveness between middle-aged and young adults.


Eligibility Criteria:
Inclusion Criteria:

- Healthy participants

Exclusion Criteria:

* Neurological disease accompanied by motor, sensory or cognitive impairment.
* Illness or condition that does not allow strenuous activity.
* Significant orthopedic injury to the back or lower limbs in the last six months, which limits strenuous activity or weight-bearing.
* History of orthopedic injury that includes injury to the knee or ankle ligaments.
* Taking medications that may affect stability or balance. Significant visual impairment that is not corrected using glasses/contact lenses
* Pregnancy
A Clinical Trial to Study the Safety and Efficacy of Bone Marrow Derived Autologous Cells for the Treatment of Autism

This clinical trial is a single Arm, single centre to check the safety and efficacy of bone marrow derived autologous mono nuclear cells (MNC) (100 million per dose). Trial to be conducted for 36 months.

Autism is a developmental disorder that appears in the first 3 years of life, and affects the brain's normal development of social and communication skills. Autism is a physical condition linked to abnormal biology and chemistry in the brain. The exact causes of these abnormalities remain unknown,Symptoms-Children with autism typically have difficulties in: Pretend play, Social interactions, Verbal and non-verbal communication. Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. This is called the regressive type of autism. People with autism may: Be overly sensitive in sight, hearing, touch, smell, or taste.

Eligibility Criteria:
Inclusion Criteria:

* Patient should suffer from Autism.
* willingness to undergo bone marrow derived autologous cell therapy.
* patient those provide fully Informed consent form for the study.
* Ability and willingness to regular visit to hospital and follow up during the protocol Procedures.

Exclusion Criteria:

* Patients with pre - existing or Current systemic disease such as lung , liver ( exception; History of uncomplicated Hepatitis A),gastrointestinal, Cardiac , Immunodeficiency,(including HIV) Or laboratory Investigation that could cause a neurological defect.History of Life threatening Allergic or immune- mediated reaction.
Registry for Patients with Erdheim-Chester Disease and Other Histiocytoses

The investigators want to understand more about what kinds of health problems are caused by histiocytosis, what happens as a result of different treatments, and how ECD affects people's lives, their feelings and their attitudes. The investigators also want to learn how these things change over time for people with these conditions. To try to figure this out, doctors would like to collect information about people who have histiocytosis and how they are treated for this disease.

Some participants will be asked to complete a brief interview over the telephone. Only a limited number of interviews will take place, and not everyone will be asked to participate in the interview. It is okay if the participant does not want to participate in the interview portion. If this is the case, the participant should let the study team member know when contacted.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of Erdheim-Chester Disease, Langerhans cell histiocytosis, Rosai Dorfman disease, or another histiocytic neoplasm by either 1) documented histopathologic establishing ECD or HN or 2) documented histopathologic findings compatible with Erdheim-Chester disease or HN in the context of corroborating clinical and/or radiologic findings or 3) documented radiologic findings, in the absence of a biopsy having been performed or yielding evaluable tissue, that are felt by the Principal Investigator to unequivocally represent an ECD/HN diagnosis given the clinical context or 4) self reported with supporting documentation upon medical record collection.
* Proficiency in English, in the determination of the Investigator or by self report.
* Willing to have historical and future HN-related health records sent to Registry review.

Exclusion Criteria:

* Patients unwilling to sign consent.
* Participants under the age of 18.
Left Ventricular Dyssynchrony in Multipole Pacing

Left ventricular dyssynchrony will be assessed by echocardiography using different programming of an implantable cardioverter defibrillator.

Left ventricular dyssynchrony will be assessed by echocardiography using different programming of an implantable cardioverter defibrillator using a quadripolar left ventricular lead.

Eligibility Criteria:
Inclusion Criteria:

* Indication for the implantation of a defibrillator with cardiac resynchronisation therapy

Exclusion Criteria:

* Cardiac surgery, acute coronary syndrome / myocardial infarction, percutaneous coronary intervention within the past 4 weeks
* Indication for coronary artery revascularisation
* Atrial fibrillation with insufficient rate control
* ASA (American Society of Anesthesiologists) class V or cardiogenic shock
* age \<18 years, pregnancy, tutelage
* inability to understand the patient consent for or study refusal
* anticipated insufficient echocardiographic image quality
Point of Service Diabetes Screening Evaluation

The primary objective of the trial is to collect SCOUT DS, random capillary glucose and Hemoglobin A1c measurements from subject 18 years of age or older.

The objectives of this study are to compare the accuracy of SCOUT versus random capillary glucose and several diabetes risk assessment questionnaires for detection of HbA1C-defined dysglycemia.

Eligibility Criteria:
Inclusion Criteria:

* 18 years of age or older

Exclusion Criteria:

* Known to be pregnant (self-reported)
* Receiving dialysis or known renal compromise
* Known to have photosensitivity
* Taking medications that fluoresce
* Have scars, any tattoos, rashes or other disruption/discoloration on the left volar forearm
Prevalence of Chronic Rhinosinusitis in Cystic Fibrosis

Aim of the study is to detect the prevalence of chronic rhinosinusitis and the colonisation with Pseudomonas aerug. in the upper airways in patients with cystic fibrosis.


Eligibility Criteria:
Inclusion Criteria:

* Subject has a confirmed diagnosis of cystic fibrosis

Exclusion Criteria:

* current systemic therapy against Pseudomonas aeruginosa
Influence of Resident Training on Intra-operative Workflow

Anaesthesia and surgery related time intervals of three standard operations are compared depending on whether residents or consultants are performing anaesthesia and surgery.

Hypothesis: Perioperative workflow is influenced by state of education, time intervals reflecting anaesthesia as well as surgical performance increase due to resident training. Therefore, costs of perioperative care increase as well.


Eligibility Criteria:
Inclusion Criteria:

* Healthy subjects scheduled for one of the three defined procedures (defined by German Diagnose Related Groups ID) under general or regional anesthesia

Exclusion Criteria:

* Patient's refusal of data collection, emergency procedures, change of physician in charge (resident to consultant or the other way around) of anesthesia or surgical team
A Study of First or Second Line Treatment With Tarceva (Erlotinib) in Patients With Advanced Non-Small Cell Lung Cancer

This single arm study will assess the safety and efficacy of Tarceva monotherapy in patients with advanced non-small cell lung cancer. Patients will receive Tarceva 150mg p.o. daily. The anticipated time on study treatment is until disease progression, and the target sample size is 100-500 individuals.


Eligibility Criteria:
Inclusion Criteria:

* adult patients \>= 18 years of age;
* inoperable, locally advanced, recurrent or metastatic (Stage IIIB/IV) non-small cell lung cancer;
* ECOG performance status of 0-3;
* previously untreated, or failed on one prior course of standard systemic chemotherapy and/or radiotherapy.

Exclusion Criteria:

* prior systemic anti-tumor therapy with HER1/EGFR inhibitors;
* unstable systemic disease;
* any other malignancies within 5 years (except for adequately treated cancer in situ of the cervix, or basal or squamous cell skin cancer;
* any significant ophthalmologic abnormality.
IBD Strong Peer2Peer for Self-Management of Psychological Distress

Psychological distress (PD) as a result of inflammatory bowel disease (IBD) is prevalent and associated with worse disease-related outcomes. IBD-associated psychological distress (IBD-PD) is particularly common at initial diagnosis, during disease flares, before surgery, and during transitions of care. Access to evidence-based, gold-standard psychological interventions and emotional support for IBD-PD has been identified as a major care gap by persons living with IBD. The COVID-19 pandemic has further exacerbated the burden of PD for persons living with chronic diseases like IBD, predisposing at-risk individuals to even greater mental struggles. Studies have shown a minority of patients are asked about IBD-PD in routine clinical care and that even if asked, access to mental health care is extremely limited. iPeer2Peer is an evidence-based, peer-led, virtually administered intervention for IBD-PD in the pediatric population that has demonstrated feasibility, acceptability and early effectiveness. Using qualitative data derived from an extensive stakeholder engagement process, iPeer2Peer has been adapted to meet the needs of adults living with IBD-PD. This program, IBD Strong Peer, will be studied through a randomized, wait list-controlled hybrid implementation-effectiveness trial in Nova Scotia. This study will provide implementation data needed to improve and adapt the intervention and implementation strategy to meet local needs, as well as provide early effectiveness data. This data will inform the design and statistical power needed for future larger, multicenter randomized control trials. IBD Strong Peer has significant potential to improve access to evidence-informed interventions for IBD-PD.


Eligibility Criteria:
Inclusion Criteria:

* Adult IBD patient (18 years or older)
* In a period of transition (newly diagnosed, transitioning from pediatric to adult care, flaring or changing medications, recently admitted to hospital, or facing the need for surgery)

Exclusion Criteria:

* Screening positive for severe psychological pathology
* Do not speak English
* Diagnosis of a major comorbid psychiatric condition such as bipolar disorder or schizophrenia,
* No access to the internet
COVID-19 Burnout Study

The aims of this study are to assess whether the use of a MBI therapy delivered remotely is associated with a reduction of perceived stress among HCPs in the Radiation Medicine Program (RMP) and with a decrease risk of burnout during and post COVID-19.


Eligibility Criteria:
Inclusion Criteria:

* -Employee in the radiation medicine program in UHN
* Health Care Professional (Therapist, Nurse, Physician, Resident, Physician assistant, Physician admin assistant)
* Over 18

Exclusion Criteria:

* Not working at the radiation medicine program at UHN
Indomethacin Prophylaxis for Heterotopic Ossification After Surgical Treatment of Elbow Trauma

Patients who present to our institution with a traumatic injury to their elbow who need operative management will be randomized to one of two groups; a treatment arm and a control arm. The treatment arm will receive a three-week postoperative course of indomethacin while the control group will not. We will follow both groups to assess whether or not indomethacin prophylaxis affects the rate of heterotopic ossification.


Eligibility Criteria:
Inclusion Criteria:

* Terrible Triad
* Radial head fracture surgical treatment
* Monteggia and Trans-olecranon Fracture Dislocations
* Distal Biceps Tendon Injuries
* Distal Humerus Fractures
* Coronoid Fractures
* Capitellar-Trochlear fractures
* Olecranon Fractures

Exclusion Criteria:

* Associated Traumatic Brain Injury
* Burn Injuries associated with elbow trauma
* History of Gastric Ulcers
* Documented allergies to any Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
* Severe Asthma
* Previous operative fixation to affected elbow
* Participation in other research study
* Inability to speak / understand English