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Stroke Impact Scale (SIS): PaReSiS UKH

- 05.12.16 - 1 Formular, 9 Itemgruppen, 60 Datenelemente, 2 Sprachen

Itemgruppen: 33. physical difficulties, 34. Memory and ability to think, 35. Mood and Feelings, 36.Communicating and understanding, 37. Everyday activities, 38. Mobility, 39. Ability to use the hand most influenced by stroke, 40. Ability to do things, that give life a meaning, 41. Recovery from stroke

Stroke Impact Scale (SIS): PaReSiS UKH Rehabilitation Study: "Partizipatives Rehabilitationsprozessmanagement, PaReSiS Schlaganfall in Sachsen-Anhalt" Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät Institut für Gesundheits- und Pflegewissenschaft Projekt: Partizipatives Rehabilitationsprozessmanagement „Schlaganfall in Sachsen-Anhalt“ Magdeburger Straße 8 06097 Halle (Saale), Germany E-Mail: paresis@medizin.uni-halle.de

Brain and Central Nervous System Tumors NCT00978458 On-Study - E3F05 Neurologic Function Status and KPS Form - 2901661v1.0 - E3F05 Neurologic Function Status and KPS Form

- 08.01.15 - 1 Formular, 7 Itemgruppen, 22 Datenelemente, 1 Sprache

Itemgruppen: Header Module, ON TREATMENT, OFF TREATMENT, Amendment, Vital Status, Patient Characteristics, Footer Module

E3F05 Neurologic Function Status and KPS Form Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6C76FF0A-A486-4EDB-E040-BB89AD4325FA

E3F05 Brain On-Study Form NCT00978458

- 16.06.15 - 1 Formular, 8 Itemgruppen, 43 Datenelemente, 1 Sprache

Itemgruppen: Header Module, Patient demographics, Data amendment, Patient Description Pre-Registration Hematology/Chemistry, Prior Brain Surgery, Motivation for Study Entry, Adverse Events present at time of registration (pre-treatment), Comments

E3F05 Brain On-Study Form NCT00978458 Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6C76FF0A-A556-4EDB-E040-BB89AD4325FA

On-Study - Metastatic Brain Cancer - On-Study Form - 2287553v3.0 - Metastatic Brain Cancer - On-Study Form

- 09.01.15 - 1 Formular, 10 Itemgruppen, 64 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, Brain: Form Administration, Non-CNS: Initial Disease Description, Brain: Current Disease Description, Brain: Concomitant Medications, Metastatic Brain: Prior Health History, Metastatic Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Brain: Prior Treatment - CNS RT, Brain: Prior Treatment - CNS Surgery

Metastatic Brain Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF3A8ACE-5457-4C56-E034-0003BA3F9857

On-Study - Primary Brain Cancer - On-Study Form Recurrent Treatment - 2293986v3.0 - Primary Brain Cancer - On-Study Form Recurrent Treatment

- 09.01.15 - 1 Formular, 9 Itemgruppen, 62 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, Brain: Form Administration, Brain: Recurrent Disease Description, Brain: Neurologic Function, Brain: Concomitant Medications, Brain: Prior Health History, Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Comments

Primary Brain Cancer - On-Study Form Recurrent Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DA7FB-264B-3B94-E034-0003BA3F9857

On-Study - Primary Brain Cancer - On-Study Form Newly Diagnosed Patients - 2293729v3.0 - Primary Brain Cancer - On-Study Form Newly Diagnosed Patients

- 09.01.15 - 1 Formular, 7 Itemgruppen, 45 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, Brain: Form Administration, Brain: Disease Description, Brain: Neurologic Function, Brain: Prior Health History, Brain: Concomitant Medications, Brain: Prior Surgical Treatment for Primary Site

Primary Brain Cancer - On-Study Form Newly Diagnosed Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51E77B9-7E48-3A03-E034-0003BA3F9857

Brain and Central Nervous System Tumors NCT00890747 On-Study - AMC-061 On Study Form (F02) - 2935131v1.0 - AMC-061 On Study Form (F02)

- 09.01.15 - 1 Formular, 6 Itemgruppen, 46 Datenelemente, 1 Sprache

Itemgruppen: Header Module, HIV History, History of Malignancy for study, HIstory of Other Malignancy, Antiretroviral Therapy, Comments

AMC-061 On Study Form (F02) Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=71988CF7-F9B0-68F0-E040-BB89AD4358A1

Tolerability, pharmacokinetics, and brain Dopamine D3 receptor occupancy of increasing repeat doses of GSK618334 in healthy adults NCT01036061 - Repeat Telemetry Abnormalities

- 20.09.21 - 1 Formular, 1 Itemgruppe, 78 Datenelemente, 1 Sprache

Itemgruppe: Repeat Telemetry Abnormalities

Study ID: 108414 Clinical Study ID: DBU108414 Study Title: TXA107979: A placebo-controlled, single blind, randomized two part study to investigate the tolerability, pharmacokinetics, and brainDopamine D3 receptor occupancy of increasing repeat doses ofGSK618334 for up to 21 days in healthy volunteers. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01036061 https://clinicaltrials.gov/ct2/show/NCT01036061 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: GSK618334 Study Indication: Substance Dependence Documentation part: Repeat Telemetry Abnormalities

Tolerability, pharmacokinetics, and brain Dopamine D3 receptor occupancy of increasing repeat doses of GSK618334 in healthy adults NCT01036061 - Holter ECG Results

- 20.09.21 - 1 Formular, 1 Itemgruppe, 79 Datenelemente, 1 Sprache

Itemgruppe: Holter ECG Results

Study ID: 108414 Clinical Study ID: DBU108414 Study Title: TXA107979: A placebo-controlled, single blind, randomized two part study to investigate the tolerability, pharmacokinetics, and brainDopamine D3 receptor occupancy of increasing repeat doses ofGSK618334 for up to 21 days in healthy volunteers. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01036061 https://clinicaltrials.gov/ct2/show/NCT01036061 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: GSK618334 Study Indication: Substance Dependence Documentation part: Holter ECG Results

Tolerability, pharmacokinetics, and brain Dopamine D3 receptor occupancy of increasing repeat doses of GSK618334 in healthy adults NCT01036061 - Visit Documentation 21

- 30.05.18 - 1 Formular, 15 Itemgruppen, 101 Datenelemente, 1 Sprache

Itemgruppen: Date and Type of Visit, Investigational Product, Vital Signs, ECG, Meal, Pharmacokinetics Blood, Pharmacokinetics Urine, Haematology, Clinical Chemistry, Urinalysis - Local, Urinalysis - Local: Dipstick Details, Urinalysis - Local: Microscopy Details, Questionnaires, PET Scan Post Dose 1, PET Scan Post Dose 2

Study ID: 108414 Clinical Study ID: DBU108414 Study Title: TXA107979: A placebo-controlled, single blind, randomized two part study to investigate the tolerability, pharmacokinetics, and brainDopamine D3 receptor occupancy of increasing repeat doses ofGSK618334 for up to 21 days in healthy volunteers. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01036061 https://clinicaltrials.gov/ct2/show/NCT01036061 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: GSK618334 Study Indication: Substance Dependence Documentation part: Visit Documentation 21 Specification: PET LDD

Tolerability, pharmacokinetics, and brain Dopamine D3 receptor occupancy of increasing repeat doses of GSK618334 in healthy adults NCT01036061 - Visit Documentation 19

- 30.05.18 - 1 Formular, 10 Itemgruppen, 50 Datenelemente, 1 Sprache

Itemgruppen: Date and Type of Visit, Vital Signs, ECG, Haematology, Clinical Chemistry, Urinalysis - Local, Urinalysis - Local: Dipstick Details, Urinalysis - Local: Microscopy Details, Questionnaires, Investigational Product

Study ID: 108414 Clinical Study ID: DBU108414 Study Title: TXA107979: A placebo-controlled, single blind, randomized two part study to investigate the tolerability, pharmacokinetics, and brainDopamine D3 receptor occupancy of increasing repeat doses ofGSK618334 for up to 21 days in healthy volunteers. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01036061 https://clinicaltrials.gov/ct2/show/NCT01036061 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: GSK618334 Study Indication: Substance Dependence Documentation part: Visit Documentation 19 Specification: PET RD Day 3-Day 10

Tolerability, pharmacokinetics, and brain Dopamine D3 receptor occupancy of increasing repeat doses of GSK618334 in healthy adults NCT01036061 - Visit Documentation 20

- 30.05.18 - 1 Formular, 2 Itemgruppen, 9 Datenelemente, 1 Sprache

Itemgruppen: Date and Type of Visit, Investigational Product

Study ID: 108414 Clinical Study ID: DBU108414 Study Title: TXA107979: A placebo-controlled, single blind, randomized two part study to investigate the tolerability, pharmacokinetics, and brainDopamine D3 receptor occupancy of increasing repeat doses ofGSK618334 for up to 21 days in healthy volunteers. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01036061 https://clinicaltrials.gov/ct2/show/NCT01036061 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: GSK618334 Study Indication: Substance Dependence Documentation part: Visit Documentation 20 Specification: PET RD Day 11-15

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