cyrilzakka/clinical-trials huggingface dataset:
Detection of COPD in Primary Care

Chronic obstructive pulmonary disease (COPD) is a common chronic disease with a significant medical and economic impact. Its prevalence is increasing and is estimated at 7.5% of people over 40 in France. COPD is responsible for a significant impairment of quality of life and was the 3rd leading cause of death in the world in 2010 when it was 4th place 20 years ago.

However, about 75% of patients with COPD are not diagnosed. Spirometry is the only examination for the diagnosis of COPD. Patients identified at risk for COPD are insufficiently using spirometry and general practitioners (GPs) underestimate the severity of COPD when they do not practice spirometry in their patients. COPD is often diagnosed too late, the disease being discovered at the stage of complications requiring hospitalization. The underdiagnosis is mainly due to poor knowledge of patients, their difficulty in accessing a specialist performing spirometry, their reluctance to perform spirometry, and the insufficient involvement of general practitioners.

Currently in France, targeted screening for COPD and diagnosis in primary care is a major challenge. The international (GOLD 2014) and French (HAS 2014) recommendations do not indicate a systematic screening in the general population for COPD but advocate targeted screening of patients by five questions to identify risk factors and symptoms of COPD. The presence of at least one of these factors in an adult over the age of 40 requires spirometry.

Recent studies suggest the relevance of finding primary care variables for smoking and respiratory symptoms in order to identify new cases of COPD.

However, the impact of the use of these questionnaires on the prevalence of diagnoses of COPD in general practice has not been demonstrated. Moreover, the heterogeneity of the provision of care according to the territories limits a fast or easy access (distance) to the spirometry.

It is therefore necessary to evaluate in primary care the interest of a targeted screening of COPD and the interest of a coordination of care for the realization of a spirometry, in order to improve the rate of diagnosis of the disease.


Eligibility Criteria:
Inclusion Criteria:

* Patients with health insurance
* Non-opposition to participation in the study

Exclusion Criteria:

* COPD known and confirmed by spirometry
* Asthma known and confirmed by spirometry
* Patient not having the physical or mental ability to perform spirometry
* Pregnant woman
* Patient under protection
* Patient already included in the study
The Application of Spasmolytic in PCLE Examination of Superior Gastrointestinal Endoscope

Scopolamine butylbromide might be helpful for the outcome of superior gastrointestinal endoscope examination.

The peristalsis of gastrointestinal tract has a adverse affection on the process of the PCLE examination .Scopolamine butylbromide is a widely used spasmolytic，which can reduce the peristalsis of gastrointestinal tract effectly.The application of it may benefit the images'quality ,the acurrate of diagnosis and shorten the examination time.

Eligibility Criteria:
Inclusion Criteria:

* outpatients attending endomicroscopy
* able to give written informed consent

Exclusion Criteria:

* coagulopathy
* acute upper digestive tract bleeding
* pregnancy or breast feeding
* allergy to fluorescein sodium
* impaired renal function
Vertical Climbing (CLMBR) Exercise for Chronic Low Back Pain

This is a randomized control trial of vertical climbing ergometer exercise for individuals with chronic low back pain. Using a parallel-arm design, participants will be randomized to 8 weeks of supervised exercise using either the vertical climbing ergometer (CLMBR) or a recumbent cycling ergometer. This feasibility study will examine the safety, tolerability, and efficacy of vertical climbing exercise for individuals with chronic low back pain.


Eligibility Criteria:
Inclusion criteria:

* Provision of signed and dated informed consent form
* Stated willingness to comply with all study procedures and availability for the duration of the study
* Confirmed chronic (\>12 weeks) low back pain at screening assessment (based on patient history)
* Ability to comply with the current Mount Sinai Health system COVID-19 requirements for research participants (e.g., vaccination, masks)

Exclusion criteria:

* Criteria will be evaluated during the clinical evaluation at the screening visit. All determinations will be the decision of the study physician:
* Less than 2/10 low back pain on 0-10 numeric rating scale for average pain over past 7 days at baseline assessment
* Any cardiovascular or musculoskeletal contraindication to exercise
* Impaired balance contraindicating exercise
* Known psychological illnesses or cognitive impairments contraindicating exercise or preventing the ability to complete study assessments
* Current pregnancy
* Current medications or new medications commenced that may impact the ability for change to be detected in study
* Any other contraindication in the opinion of the study physician
Comparison of Immediate Implant Placement With Titanium Mesh Versus Collagen Membrane in Type II Socket: A Randomized Clinical Trial

Statement of the problem: Immediate implant placement is faced with several problems. One of the most important issues is dealing with defects in the buccal plate of bone in the esthetic zone.

Aim: The aim of this study is to assess the buccal bone thickness after augmentation with titanium mesh and xenograft upon flapless immediate implant placement.

Statement of the problem: Immediate implant placement is faced with several problems. One of the most important issues is dealing with defects in the buccal plate of bone in the esthetic zone.

Aim: The aim of this study is to assess the buccal bone thickness after augmentation with titanium mesh and xenograft upon flapless immediate implant placement.

Materials and Methods: This parallel arm, randomized controlled clinical trial will involve systemically free patients with remaining roots or badly decayed teeth in the anterior region and buccal bone deficiency requiring implant placement. They will be randomly allocated to two equal groups. Group A (test group, n=10) will receive immediate implants (grafting with xenograft covered by titanium mesh covered by collagen membrane), while group B (test group, n=10) will receive immediate implants (grafting with xenograft covered by collagen membrane). The parameters ( buccal bone thickness \& soft tissue thickness will be assessed at 6 \& 12 months. Postoperative pain and swelling will be recorded daily by the patient for the 1st two weeks post surgically. Postoperative medication will be prescribed to the patient and postoperative instructions will be explained in detail. Follow-up will be performed to assess the parameters and to ensure performing proper oral hygiene. Data collected will be tabulated and statistically analyzed.

Eligibility Criteria:
Inclusion Criteria:

1. Patients who have at least one remaining root or badly decayed tooth in anterior maxilla.
2. Systemically free patients (American Society of Anesthesiologists I; ASA I)
3. Patients aged from 21 to 50 years old
4. Buccal bone partial deficiency (extraction socket type II)
5. Good oral hygiene
6. Accepts the follow-up period (cooperative patients)
7. Patient accepts to provides an informed consent

Exclusion Criteria:

1. Patients with habits that may jeopardize the implant longevity and affect the results of the study such as parafunctional habits such as bruxism
2. Smokers
3. Pregnant and lactating females
The Effects of Functional Strengthening in Spastic Cerebral Palsy

Functional strengthening exercises have been proven to be effective in patients with spastic cerebral palsy. However, which exercise is the most effective is unknown. The aim of this study is to examine the effectiveness of three different progressive functional exercise programs in children with unilateral and bilateral spastic cerebral palsy.

Children with Cerebral Palsy have weakness in thier muscles due to cortical lesions leading to deficiencies in motor control, balance and functional abilities. All children with Cerebral Palsy have shown to present with foot and ankle disorders; the ankle dorsi and plantar flexor muscles are both problematic; the plantarflexors are usually spastic and the dorsiflexors are usually not active enough and usually these muscle problems lead to problems in the childrens' gait abilities. When rehabilitation programs are examined, the results of exercises addressing these problems do not have precise answers. Functional strengthening exercises have been proven to be effective in patients with spastic cerebral palsy. However, which exercise is the most effective is unknown. Which muscle goup has the most effect on gait, balance and functional activities is still unclear. Therefore, the investigator's aim in planning this study is to examine the effectiveness of three progressive functional exercise programs in children with unilateral and bilateral spastic cerebral palsy.

Eligibility Criteria:
Inclusion Criteria:

* Accepting to participate in the study,
* Being between 5-15 years old,
* Having a diagnosis of Spastic Cerebral Palsy,
* Being level I-II according to GMFCS,

Exclusion Criteria:

* Having limited cooperation which prevents participation in the study,
* Refusing to participate in the study,
* Having an orthopedic disorder or systemic illness which prevents movement in the lower extremities,
* Having a Botulinum toxin application in the last 3 months
Screening for Hemoglobinopathies in Pregnant Women

This prospective monocentric study project is to identify hemoglobinopathies in pregnant women in order to optimize antenatal care and to investigate the prevalence of hemoglobinopathies in pregnant women in Switzerland.


Eligibility Criteria:
Inclusion Criteria:

* pregnant women seen at the Frauenklinik at University Hospital Basel

Exclusion Criteria:

* pregnant women with already known hemoglobinopathy
* refusal of participation
Effect of Water Exchange Method on Single-balloon Enteroscopy

Enteroscopy, including double balloon enteroscopy (DBE), single balloon enteroscopy (SBE) and spiral enteroscopy (SE) currently, have shown good performances in small bowel diagnostics and seem to be useful in the clinical routine. However, enteroscopy is a time-consuming procedure. During common practice, large volumes of air need to be insufflated for good visualization. It leads to significant distention of the small bowel during the examination, which makes further intubation more technically challenging because of the formation of distended bowel loops and acute angulations and limits the maximal intubation length. According to the published data, the oral insertion depth of different kinds of enteroscopy is limited to approximately 240 cm. The total examination rate range form 18% to 86% for DBE and 0% to 11% for SBE.

It is thought that the intubation depth in small bowel determines the diagnostic yield and the following treatment. The deeper the enteroscopy is advanced into the small bowel, the more lesions may be found and treated. In order to improve the intubation depth of balloon enteroscopy, several methods, such as carbon dioxide insufflation and decompression side tube-equipped device, have been tried and showed positive effects. CO2 insufflation could also reduce severe pain during DBE and residual gas retention after the procedure because of rapid absorption. However, it is not known how much CO2 insufflation can decrease the distention of small bowel and the formation of bowel loops.

Recently, the use of water infusion in lieu of air insufflation has been shown to facilitate completion of colonoscopy, even in potentially difficult patients with prior abdominal or pelvic surgery. Water exchange method obviates excessive lengthening of the colon and the formation of acute angulation, which may cause less pain and easier intubation during scope insertion. Recently, water exchange method was also tried in two patients undergoing SBE via antegrade route in our center. Distal ileum 8cm near to ICV and the cecum was reached respectively (unpublished data), indicating water exchange be a useful method for deep intubation of SBE.

Here a prospective, randomized, controlled trial was designed to investigate whether, compared with CO2 insufflation method, water exchange method could increase the intubation depth and diagnostic yield in patients undergoing SBE.


Eligibility Criteria:
Inclusion Criteria:

* Suspected small-bowel disease

Exclusion Criteria:

* Prior small-bowel surgery
* Total examination of small bowel not planned when image modalities showed
* lesions obviously located on duodenum, proximal jejunum or distal ileum
* High-risk esophageal varices
* Pregnancy or lactation
* Inability to tolerate sedation or general anesthesia because of comorbidities
* Inability to provide informed consent
Effects of Petroleum Compounds on Psychological Health and Cognitive Functions

Over the last decade, awareness of the effects of hydrocarbon fuels on neurodegenerative disorders has increased significantly, as they are ubiquitous environmentally toxic chemicals that affect the central nervous system and result in irreversible neuronal damage, as many hydrocarbons can cross the blood-brain barrier through multiple pathways and cause direct toxicity.

Petrol stations are establishments that retail liquid fuels derived from petroleum, alcohol, and other automotive fuels, with equipment available for their measurement and storage. This process, linked to gasoline distribution, can be a significant source of volatile organic compounds (VOCs), such as benzene, toluene, ethylbenzene, and xylene isomers (BTEX), the primary volatile hydrocarbons derived from petroleum.

Headache, fatigue, dizziness, respiratory tract infections, skin allergies, eye infections, and impairment of memory have been experienced by a few people immediately following exposure to some solvents. CNS depression is a common physiological outcome caused by high exposure to some VOCs. General anaesthetic effects, and as a most severe outcome, unconsciousness and, in some cases, death, may occur at the end.

Long-term exposure to organic solvents may cause permanent central nervous system disturbances, a condition called chronic solvent encephalopathy (CSE).

Cognitive symptoms and neuropsychological signs, or issues with memory, focus, and learning, are the hallmarks of CSE, which is underdiagnosed and characterized by these symptoms as well as possible side effects like headaches, fatigue, balance issues, and mild depression. If exposure stops, though, the illness will not worsen.

We are discovering more about the importance of nutrition and its impact on an individual's susceptibility to illness progression. Diet has been suggested to have an important role in cognitive health and the development of dementia. However, most of the intervention studies conducted to date have mainly assessed the effect of dietary supplements on cognitive function.

The toxicity of inhaled vapours is due to their biotransformation into reactive oxygen species, and several studies have highlighted the capacity of whey protein to increase glutathione (GSH), suggesting that this complex mixture is capable of boosting GSH synthesis, thus reducing oxidative stress.

Eligibility Criteria:
Inclusion Criteria:

* Workers in direct contact with petroleum compounds in petroleum stations.
* Working for at least 8 continuous hours daily for at least 2 years before enrollment in the study.
* Participants have willingness to participate and have no history for substance abuse

Exclusion Criteria:

* Working for less than 2 years with interrupted exposure.
* The exposure of workers to petroleum compounds is indirect.
* History of psychological and neurodegenerative diseases before starting this job.
* Patients with medical conditions like renal or cardiovascular diseases.
* Individuals with known allergies or contraindications to study supplements.
Infant Severe Sepsis and Bacterial Meningitis in Malawi

This study aims to improve the outcome of infants (\<2 months) with severe sepsis and meningitis at the Queen Elizabeth Central Hospital, Blantyre, Malawi.

Currently WHO recommends the treatment of infant severe sepsis and bacterial meningitis with 14 to 21 day course of penicillin and gentamicin as first line. The second line treatment is cefotaxime or ceftriaxone.

Severe bacterial infections are common in infants under 2 months of age and the mortality is very high (\~50%). There are several reasons for this; one is that the first line antibiotics used are no longer as effective as they used to be. Bacterial resistance to the first line antibiotics has increased and some infections especially of the central nervous system may only be partly treated and not eradicated by present therapy. First line treatment is cheap and available but requires 4 injections a day, for at least 14 days, a total of 58 injections. Many mothers find this number too much and abscond. The investigators second line therapy is ceftriaxone which is also available and cheap and the advantage of being given as a daily injection. The disadvantage is that it can cause (reversible) jaundice particularly in premature babies and it must not be given with calcium products. The investigators do not give calcium to the investigators infants as the investigators cannot routinely check electrolytes. All the most common causes of bacterial meningitis in this age group in the investigators setting are sensitive to ceftriaxone.

The investigators wish to undertake an open randomized trial of penicillin and gentamicin v ceftriaxone as first line treatment for infant meningitis. The investigators are able to monitor for side effects.

The investigators hypothesise that the ceftriaxone arm will have 20% less deaths that the penicillin and gentamicin group.


Eligibility Criteria:
Inclusion Criteria:

* Children less than 2 months
* Suspicion of bacterial meningitis
* Parental/guardian informed consent

Exclusion Criteria:

* Infant with hyperbilirubinaemia
* Infant requiring calcium
* Infant know to be hypersensitive to any of the three drugs
* Infant who has been an inpatient for more than 72 hours
* Infant with congenital central nervous system abnormalities
Tracking Depression Symptoms With a Health Chatbot

The goal of this research is to bridge a significant "effectiveness" gap in the treatment of depression. The investigators have developed a chatbot which will assist in performing measurement-based care (MBC) via Facebook Messenger. Participants will be randomized to either Usual Care or Usual Care with additional Chatbot Care.

The goal of this research is to bridge a significant "effectiveness" gap in the treatment of depression. The investigators will be looking specifically at depressed women soon after they give birth, otherwise known as known as perinatal depression. Measurement-based care (MBC) which involves the use of quantitative assessments for depression screening, diagnosis, and symptom monitoring is recognized as one of the keys to depression management. MBC can be difficult to implement within the clinical setting due to the administrative overhead and close follow-up required. It is reasonable to hypothesize that low rates of MBC adoption are responsible for low rates of adequate depression care.

The investigators have developed an automated conversational agent or "chatbot" (CB) for delivering MBC via Facebook Messenger. The investigators hypothesize that the use of CB-MBC, which combines a conversational interface with state-of-the-art quantitative assessments, will improve depression symptom severity for patients with perinatal depression. If successful, this project will provide primary care physicians with a new and inexpensive method for delivering better and safer care to their patients with depression. This study works to determine the impact of the chatbot in improving depression outcomes for patients under treatment for perinatal depression.

Eligibility Criteria:
Inclusion Criteria:

* Provider Subject Cohort: residents and attendings from University of Chicago Medical Center OBGYN and NorthShore Hospital OBGYN clinics.
* Patient Subject Cohort:

  1. Age ≥ 18 years and able to and demonstrate English reading literacy of at least 8th-grade level (REALM-R ≥ 6)
  2. Postnatal women newly diagnosed or receiving treatment for non-psychotic unipolar depression with a severity-based entry criterion of moderate to severe (EPDS ≥ 12)
  3. Willing to participate and able to give written informed consent
  4. Must own a smart phone with a data plan
  5. Must have a Facebook account and Facebook Messaging app on phone (or willing to create account/download app today)
  6. Sufficient cognitive ability to provide self-report data on a computer touchscreen/ standard computer with minimal assistance

Exclusion Criteria:

* Provider Subject Cohort: None
* Patient Subject Cohort:

  1. Subjects with documented dysthymia or Axis II diagnoses
  2. Subjects with self-reported or documented history of: anorexia or bulimia, obsessive compulsive disorder or prior hospitalization for suicidal ideation
  3. Active suicidality as determined by clinician
  4. Non-English speakers
Targeted Video Messaging About Emergency Contraception

This research study will assess the real-world effectiveness of Facebook advertising as a strategy to reach women of reproductive age who are at risk of unintended pregnancy with a brief educational intervention about emergency contraception (EC).

This research study will assess the real-world effectiveness of Facebook advertising as a strategy to reach women of reproductive age who are at risk of unintended pregnancy with a brief educational intervention about emergency contraception (EC). The investigators will assess whether a video or website link has superior reach, engagement, and return on investment (measured as cost per click) through a Facebook ad campaign. The investigators will also ensure that both modalities of consumer engagement (website and video) are efficacious at ensuring adequate and improved knowledge of emergency contraception through a laboratory-environment trial.

Eligibility Criteria:
Inclusion Criteria:

* Women
* 18 to 29 years old
* Living or seeking care in or around Boston, MA
* Able to participate in an in-person visit at Planned Parenthood League of Massachusetts (PPLM) Boston Health Center
* English fluency
* Have at least one social media account (i.e. Facebook, Instagram, Twitter, Pinterest, YouTube, Snapchat)
* Endorse using social media at least once a week

Exclusion Criteria:

* PPLM staff
* Currently or ever employed in the reproductive health field
* Currently using long-acting reversible contraception (LARC)
* History of permanent sterilization (by participant or sexual partner)
* Previous participation in the study
The Effect of Oxytocin on the Acquisition and Consolidation of Trauma-Associated Memories

The purpose of the study is to examine whether oxytocin and oxytocin receptor gene polymorphism affect the development of intrusive memories, a cardinal symptom of PTSD.


Eligibility Criteria:
Inclusion Criteria:

* healthy female volunteers
* German on a native level

Exclusion Criteria:

* former or present disorder according to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5)
* any physical illnesses
* any medication intake (except oral contraceptive)
* history of traumatic experience, e.g. history of sexual abuse or rape
* pregnancy or lactation period
* follicular phase of menstrual cycle for all women not using oral contraceptives