cyrilzakka/clinical-trials huggingface dataset:
Radial Extracorporeal Shock Wave Therapy Versus Platelet-rich Plasma Injection for Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome (GTPS), is characterised by pain around the greater trochanter. Failure of first-line management for GTPS is followed by second-line treatments range from extracorporeal shock wave therapy (ESWT), corticosteroid or platelet-rich plasma (PRP) injections, and surgery. In a systematic reviews, PRP seems a viable effective and safe alternative option for GTPS after failed physical therapy. Also, positive results from previous systematic reviews involving radial ESWT (rESWT) as a treatment for GTPS.

In the literature review, there is no comparison of the effectiveness of ESWT and PRP injection in patients with GTPS. The aim of this study was to investigate the effects of rESWT and PRP injection on pain, hip disability, and quality of life in patients with GTPS

The pain and activities of daily living, referring to the previous week, and assessments of hip function (limping) and range of motion were evaluted by Harris Hip Score (HHS). The pain severity during rest and activity in the previous week was evaluted by Visual Analog Scale (VAS). The pain and activity limitation was evaluted by The Roles and maudsley (RM). The quality of life was evaluted by The EQ-5D-3L scale.

Eligibility Criteria:
Inclusion Criteria:

* \> 18 years old
* Complaining of pain located anterior, lateral or posterior to the great trochanter for more than 3 months
* Pain while lying on the affected side
* Local tenderness on palpation of the area of the great trochanter
* MRI evidence of gluteus minimus or medius tendinopathy
* Refractory to conservative management

Exclusion Criteria:

* Presence of signs and symptoms of another cause of regional hip pain.
* Full-thickness tear of the involved gluteal tendons, bursa, and intra-articular structures
* Evidence of concomitant injury to the involved lower extremity, including radiculopathy or radiculitis, ischial tuberosity avulsion
* Severe knee or hip osteoarthritis
* Previous hip surgery or use of ESWT for GTPS.
* Acute low back pain
* Implanted pacemaker
* Vascular, neurologic, rheumatic diseases.
* Any neoplastic disorders
* Blood coagulation disorders or use of antiplatelet or anticoagulant drugs
* Pregnancy.
Platelet Reactivity After Cessation of Clopid in the Setting of Coronary Stent Implantation I: PRACTICE I

Single center randomized parallel group study to determine if:

1. there is a temporary increase in platelet reactivity after abrupt discontinuation of clopidogrel due to a potential rebound phenomenon.
2. the effect of sudden discontinuation of clopidogrel 6 months post coronary angioplasty with adjunct drug eluting stent implantation compared to 12 month continuation of clopidogrel on platelet reactivity. And the association with MACE up to 12 months post coronary angioplasty.


Eligibility Criteria:
Inclusion Criteria:

* Patients, male or female, \> 18 years of age,
* Patients who are scheduled for an elective PCI with a drug eluting stent
* Patients willing to return for all required follow up visits.
* Patients live/work within a 60 mile radius of the Washington Hospital Center.

Exclusion Criteria:

* Patient has experienced an acute myocardial infarction within the preceding 48 hours of the subsequent angioplasty.
* Unprotected left main coronary disease with \>50% stenosis;
* Patients with renal failure requiring dialysis;
* Patients with a documented ejection fraction \< 30 percent at the time of subsequent PCI;
* Patient with a life expectancy less than 12 months or malignancy.
* Known allergies to aspirin or clopidogrel bisulfate (PlavixR) and that cannot be medically managed;
* Planned surgery or other indication for requiring the cessation of clopidogrel within 12 months of PCI;
* Any significant medical condition which in the investigator's opinion may interfere with the patient's optimal participation in the study.
* Patients with known history of bleeding diathesis;
* Prothrombin time \>1.5 times control; coumadin therapy
* Platelet count \<100 000/mm3;
* Hematocrit \<25%;
* Creatinine \>4.0 mg/dL;
* Thienopyridine use within 5 days of enrollment
* Glycoprotein (GP) IIb/IIIa use within 8 hours of enrollment or any indication were the operator will require GP IIb/IIIa inhibitor use during the hospitalization.
Change in Tongue Strength and Fatigue After Upper Airway Stimulation Therapy

Upper airway stimulation (UAS) is an effective surgical alternative for patients with obstructive sleep apnea (OSA) who fail continuous positive airway pressure (CPAP) therapy. This stimulation could lead to alterations in tongue strength and fatigability which could alter treatment outcome. The aim of the study is to investigate if UAS alters tongue strength and fatigability.


Eligibility Criteria:
Inclusion Criteria:

* 18 years old or older
* upper airway stimulation group: Upper airway stimulation system implanted at least 4 weeks ago
* OSA group: OSA confirmed by 18-channel inpatient overnight polysomnography (PSG)
* test group: No medical history for OSA and Epworth Sleepiness Scale (ESS) below 11

Exclusion Criteria:

* history of a neuromuscular disorder
* previous tongue surgery
Effect of Mindfulness Education in Primiparous Pregnant Women

While adaptation is generally achieved to the psychological changes that develop during pregnancy, some women may experience psychological changes such as contradiction, uncertainty, introversion, passive personality, addiction, fear, and anxiety in different periods of pregnancy. During this period, the fear of childbirth may also be experienced in pregnant women. Fear of childbirth or tokophobia is a phobic condition in which a woman avoids giving birth despite desperately wanting a baby. While fear of childbirth can have a negative impact on women's psychological health during pregnancy and birth experience, it is associated with negative obstetric outcomes and postpartum mental health problems. It is possible that the fear of childbirth reduces the mother's attachment to the fetus. Fear increases avoidant attachment and anxiety, which may be associated with lower commitment scores. There is a strong relationship between fear of childbirth and negative birth outcomes. Both affect the psychological well-being of the mother, adjustment to motherhood, and the quality of the mother's relationship with the baby. Knowing the fear of childbirth is important as it is associated with various health problems such as certain physiological and obstetric disorders and they can increase the possibility of emergency cesarean section. Mindfulness-based interventions combine elements of established cognitive behavioral therapy and psychoeducational content to support a self-effective approach to reduce stress-related symptoms and improve mental and physical well-being. Mindfulness-based practices that involve focusing on the present moment and accepting life without judgment are one of the effective ways to prepare for childbirth, help women feel more empowered and aware of their motherhood processes, and give mothers the opportunity to share knowledge and emotions. Mindfulness-based birth education intervention appears to be applicable for women and is associated with improvements in women's sense of control and confidence in giving birth.


Eligibility Criteria:
Inclusion Criteria:

* over 18 years
* 28-32. in gestational week
* First pregnancy
* Understands and speaks Turkish
* Single pregnancy
* Having at least primary school education

Exclusion Criteria:

* Having a high-risk pregnancy
* Receiving psychotherapy or medication in the last six months before the study
* with chronic disease Participating in childbirth preparation courses Planning a cesarean delivery with a diagnosed psychiatric illness Pregnant women with previous yoga and meditation experience Pregnant women with a high gestational age will be excluded from the study due to the possibility of giving birth before the end of the follow-up period
Sirolimus Combined With Low-dose Warfarin for the Treatment of Refractory PNH

Classical paroxysmal nocturnal hemoglobinuria(PNH) is mainly characterized by hemolysis and thrombosis, which reduced patients ' quality of life(QoL) greatly and even lead to death. Glucocorticoids and symptomatic supportive therapy are traditional treatments and the response rate is far from satisfactory. Eculizumab is an effective therapy but it is expensive and not available in China mainland.The investigators aim to explore the efficacy and safety of sirolimus for refractory classic PNH.

Classical paroxysmal nocturnal hemoglobinuria(PNH) is mainly characterized by hemolysis and thrombosis, which reduced patients ' quality of life(QoL) greatly and even lead to death. There is no ideal therapy except for eculizumab, expensive and not available in China mainland. Glucocorticoids and symptomatic supportive therapy are traditional treatments. The response rate is 30%, far from satisfactory. In recent years, T lymphocyte-mediated destruction of normal hematopoietic stem cells have been reported to involve the pathogenesis of PNH, making immunomodulatory drugs be potential effective treatments.

Sirolimus (rapamycin), produced by the bacterium Streptomyces hygroscopicus, is a mammalian target of Rapamycin (mTOR) inhibitor. mTOR is a serine/threonine kinase that regulates cell growth, proliferation, metabolism and survival. It has two interacting complex, mTORC1 and mTORC2. Sirolimus primarily inhibits mTORC1, has been demonstrated for its immunomodulatory effects and ability to improve hematopoietic stem cell function. Recently, sirolimus has been reported to be effective and well tolerated in the treatment of immune-mediated cytopenias, even in multi-immunosuppressants resistant patients. In addition, classical PNH patients have a higher risk of thrombosis especially in refractory ones and it is reasonable to use low-dose warfarin in the management of patients with classic refractory PNH.

In this study, it is anticipated to evaluate the effect of sirolimus combined with low-dose warfarin on patients with refractory classic PNH. The adverse effects and QoL on different time points were documented.

Eligibility Criteria:
Inclusion Criteria:

* age 18-70 years
* diagnosed with PNH and no thrombosis
* ineffective, relapsed or intolerant to conventional treatment (eg glucocorticoids, • • iron, folic acid, androgen, etc.)
* not available for hematopoietic stem cell transplantation
* ECOG≤2
* agreed to sign the consent forms

Exclusion Criteria:

* severe heart, liver and kidney dysfunction
* combined with thrombotic complications
* people who are pregnant and breastfeeding
* history of other immunosuppressive agents in recent 3 months
* Patients who are not eligible to participate in this trial due to any reason based • • • on the consideration of investigator
Clinical Power Testing Across Human Lifetime

We will determine when to transition from the common vertical jump to chair stand depending on age and physical activity levels.

Assessing individuals' power, while it is useful in measuring fitness and performance levels, often requires expensive materials. Vertical jump height has been used to assess peak power output using specific regression equations. The issue with this test, although it is often used with older persons, is that it is not practical or useful in assessing the power output in elderly adults due to possible injury risk and lack of familiarity with providing a maximal jump performance. Power is important for elderly adults; because, higher power output in elderly adults has been shown to highly correlate with overall functionality, the ability to do activities of daily living (ADL), and a reduction in fall probability. A recent study examined the capacity of a regression equation to quantify power in elderly adults using a sit-to-stand test and determined; however, the sit-to-stand lacks the difficulty and exhibits a ceiling effect in younger individuals. Therefore, this study will attempt to determine when to transition from the vertical jump to the sit-to-stand, so that the differences in chronological versus physiological age may be determined during aging, and conversely, during improvements through physical or other interventions.

Eligibility Criteria:
Inclusion Criteria:

* between 18 and 89 years old willing to commit to two days of testing

Exclusion Criteria:

* severe musculoskeletal impairment,
* neurological impairment that would affect balance,
* severe cognitive impairment (Mini-mental 19 or below),
* unstable chronic disease state,
* severe vestibular problems
* severe orthostatic hypotension,
* Simultaneous use of cardiovascular, psychotropic and antidepressant drugs.
* Adults unable to consent
* Prisoners
* Pregnant females
VR in Neurosurgery: Planning, Training & Communication

This prospective study analyzes the broad impact of virtual reality (VR) assistance on aneurysm surgeries through two primary focuses: first, it evaluates VR-assisted clip planning by examining its clinical outcomes in the operative management of aneurysms, and second, it investigates the role of VR-assisted patient-informed consent, including its effects on patient comprehension, the patient-doctor relationship, and anxiety.

Over the last years, increasing innovations and accessibility to virtual reality (VR) and augmented reality (AR) technologies have contributed to the relevance of these tools in daily life and medical research activities. Surgical specialties play a key role in introducing these technologies into clinical practice, with additional applications and research fields.

In neurosurgery, VR-based surgical planning for aneurysm management has shown the potential to enhance patient safety, reduce surgery times, and improve clinical outcomes. Recently, a few studies have shown that patients can also benefit from using VR applied to IC, although the current patient-oriented use of VR remains scarce.

With the increasing demand for concepts like shared decision-making and patient-centered care, optimal IC is more relevant than ever. A pilot study (NCT) on VR-based IC at the investigators' institution demonstrated feasibility and indicated positive outcomes based on the investigators' questionnaire. Building on these findings, this prospective study aims to evaluate the broad impact of VR assistance on aneurysm surgeries by focusing on two main aspects: VR-assisted clip planning, including its effects on patient safety, operative times, and clinical outcomes, and VR-assisted patient-informed consent, examining subjective patient comprehension, the patient-doctor relationship, and anxiety. Additionally, the study will assess the cost-benefit ratio and feasibility of VR-based approaches in a routine clinical setting. Ultimately, VR may foster a better understanding of complex procedures, optimize the perioperative process for both patient and surgeon, reduce anxiety, and improve patient safety.

Eligibility Criteria:
Inclusion Criteria:

* The patient is able to give written consent (or written consent by legal representative)
* Preoperative imaging demonstrating intracranial pathology
* Cognitively able to provide answers for the questionnaires

Exclusion Criteria:

* No informed consent
* Adult patients without the power of judgement
A Hybrid Effectiveness-implementation Trial of a High School-based Executive Function Treatment for Autistic Youth

This study will test the effectiveness of a school-based cognitive behavioral executive function (EF) intervention, Unstuck \& On Target High School (UOT:HS), for transition-age youth with autism spectrum disorder (ASD). UOT:HS was designed to be embedded in high schools and delivered by school staff to improve generalization of skills, increase access to mental health care, and fill a gap in evidence-based approaches to support postsecondary transition. UOT:HS targets flexibility and planning skills and focuses on key functions needed for adult success across 25, 1-hour lessons. School staff will be trained to deliver UOT:HS, study staff will provide ongoing check-ins, and parents will be offered home extensions for each lesson and two trainings to generalize skills to the home environment. Behavioral and parent-report data will be collected prior to intervention, post-intervention, and at 4-to-6-month follow-up.


Eligibility Criteria:
Inclusion Criteria:

1. Cognitive/Behavioral capacity to benefit and understand Unstuck material as determined by teacher guided by probes related to pragmatic language that align with verbal demands of the curriculum.
2. Evidence of autism supported by at least one of the following:

   * Eligible and/or receiving school-based services or supports for autism
   * Prior clinical diagnosis of autism from a qualified health professional (as indicated by parent report)
   * Demonstrates characteristics of autism consistent with DSM-5, as judged by a clinical autism expert, based on all available information gathered through the screening, consenting, and testing process (including information gathered through the Social Communication Questionnaire via parent/teacher report, and SRS-2,)
3. Capacity to benefit and understand unstuck material as determined by teacher

Exclusion Criteria:

1. Students must have a level of proficiency in English to complete questionnaires and study procedures in English. Parents must have a level of proficiency in English or Spanish to complete questionnaires and study procedures in English or Spanish.
2. Student is not able to participate in UOT:HS due to their schedule or ability to benefit from curriculum material as determined by teacher.
TRENDY Follow-up: Study on Endothelial Function in Subjects With Type 2 Diabetes Mellitus

Basal nitric oxide (NO) activity plays a pivotal role in the regulation of glomerular hemodynamics, and in animal experiments its alteration has been associated with morphological changes characteristic of diabetic nephropathy. The investigators aimed to assess in a prospective study: 1. basal NO activity of renal vasculature and 2. renal hemodynamics to examine whether impairment of basal NO activity of the renal vasculature is related to development and progression of diabetic nephropathy and other cardiovascular endpoints.


Eligibility Criteria:
Inclusion Criteria:

* Type 2 Diabetes mellitus

Exclusion Criteria:

* Macroalbuminuria
* Symptomatic cardiovascular disease
Pediatric Acute Respiratory Distress Syndrome Ventilation Bundle

Mortality rates in children with pediatric acute respiratory distress syndrome (PARDS) are higher in Asia compared to other regions. In adults with acute respiratory distress syndrome, the only therapy that improves mortality rates is a lung protective ventilation strategy. The pediatric ventilation recommendations by the Pediatric Acute Lung Injury Consensus Conference (PALICC) are extrapolated from evidence in adults, including ventilation with low tidal volume, low peak/plateau pressures and high end expiratory pressure. A recent retrospective study of ventilation practices in Asia including Singapore showed that a majority of patients with PARDS were being ventilated with high tidal volume, high peak pressure and low end expiratory pressure, not in compliance with PALICC recommendations. We postulate that currently used ventilation strategies could have contributed to the high PARDS mortality rates in Asia. We aim to determine if implementing a ventilation bundle comprising PALICC recommendations lowers PARDS and pediatric intensive care unit (PICU) mortality rates.

We implement a PARDS ventilation bundle compliant with PALICC recommendations. The bundle contains a daily checklist for ventilation targets and reference tables listing targeted tidal volumes and end expiratory pressure-fraction of inspired oxygen titration. We will recruit mechanically ventilated patients who meet PARDS criteria. After a one-month implementation period, we will collect patient data over the subsequent 18 months, and compare them with the corresponding data in the 24 months prior to the implementation. The primary outcome is PARDS mortality, defined as number of deaths out of PARDS cases. Secondary outcomes are feasibility of ventilation bundle implementation, ventilator (VFD) and intensive care unit (IFD) free days and PICU mortality (number of deaths out of PICU admissions).

Eligibility Criteria:
Inclusion Criteria:

* fulfill criteria for PARDS
* mechanically ventilated

Exclusion Criteria:

* perinatal lung disease
Different Low-flow Sevoflurane Anesthesia Techniques

After reaching 1 MAC level with 4 lt / min fresh gas flow and 2.5% sevoflurane concentration in the initial stage in 35 patients, anesthesia maintenance will be continued with 0.5 lt / min fresh gas flow and 2 -4% sevoflurane concentration with the target of 1 MAC. For 35 patients, after reaching 1 (MAC) level with 1 lt / min fresh gas flow and 8% sevoflurane concentration in the initial phase, maintenance of anesthesia will be continued with 0.5 lt / min fresh gas flow and 2 -4% sevoflurane concentration, targeting 1 MAC.

The primary aim of this study is to compare the instantaneous and total consumption of sevoflurane using 2 different concentrations and different minute / fresh gas flow to fill the system in the initial phase of anesthesia. Its secondary purpose is to compare the depth of anesthesia and hemodynamic parameters between the two groups.

A total of 70 patients between the ages of 18-65 will be included in the study.in 2.5 % sevoflurane grup After reaching 1 MAC level with 4 lt / min fresh gas flow and 2.5% sevoflurane concentration in the initial stage in 35 patients, anesthesia maintenance will be continued with 0.5 lt / min fresh gas flow and 2 -4% sevoflurane concentration with the target of 1 MAC. in sevoflurane 8 % group for 35 patients, after reaching 1 (MAC) level with 1 lt / min fresh gas flow and 8% sevoflurane concentration in the initial phase, maintenance of anesthesia will be continued with 0.5 lt / min fresh gas flow and 2 -4% sevoflurane concentration with the target of 1 MAC. . The depth of anesthesia for both groups will be measured by the Bispectral Index (BIS). BIS values between 40 and 60 are appropriate values for general anesthesia, for this value 1 MAC sevoflurane inhalation anesthesia and remifentanil infusion (0.1-0.3mcg / kg / min) will be used.

Eligibility Criteria:
Inclusion Criteria:

* Patients between the ages of 18-65
* ASA1,2,3 group patients
* Patients under general anesthesia
* Patients scheduled for elective surgery

Exclusion Criteria:

* The patient's refusal to participate in the study
* Patients with less than 90 minutes of total anesthesia time
* Patients whose total anesthesia time exceeds 180 minutes
The Effect of Wearable Vibration Therapy on Shoulder Functionality in Individuals Receiving Adjuvant Radiotherapy After Breast Cancer Surgery

The aim of our study is to investigate the effect of vibration therapy to be applied to patients undergoing breast cancer surgery and adjuvant radiotherapy on upper extremity joint range of motion, muscle strength, grip strength, pain, functionality, and quality of life.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosed with breast cancer, undergoing breast-conserving surgery or having a total mastectomy and undergoing axillary lymph node dissection during surgery
* Cases that will start radiotherapy after surgery
* Being over 18 years old
* Absence of limitation in shoulder joint range of motion in preoperative evaluations.
* No speech and hearing problems
* Volunteering of the patients included in the study

Exclusion Criteria:

* Having previously undergone ipsilateral or contralateral breast cancer surgery
* Presence of active or metastatic cancer focus
* Presence of a neurological disease or orthopedic surgery affecting upper extremity functionality
* Carrying a pacemaker
* Presence of infection and open wound
* Finding a post-surgical drain
* Cases with mental and cooperation problems