Layout table for study information Study Type : Interventional (Clinical Trial) ActualEnrollment : 144 participants Allocation: Randomized Intervention Model: Crossover Assignment Intervention Model Description: The primary endpoint at 4 months following the initial treatment will utilize a parallel group study design; however, an optional crossover is offered to subjects following this time point. Masking: Triple (Participant, Investigator, Outcomes Assessor) Masking Description: All individuals will be masked to treatment with the exception of the anesthesiologist administering the procedure who will choose which probe to use: the functional or sham. Of note, this individual could not be masked to treatment since the cryoneurolysis ice ball is visualized on ultrasound; and, the practitioner would see a lack of ice ball formation for the sham probes. Primary Purpose: Treatment Official Title: Cryoanalgesia to Treat Post-Amputation Phantom Limb Pain: A Multicenter, Randomized, Double-Masked, Placebo-Controlled, Definitive Human Subjects Clinical Trial Actual Study Start Date : March 23, 2018 Actual Primary Completion Date : August 17, 2021 Actual Study Completion Date : March 17, 2022 Arms and Interventions Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Arm Intervention/treatment Active Comparator: CryoneurolysisCryoneurolysis of the femoral and sciatic nerves (or their distal counterparts) in the residual limb: The cryoneurolysis device will be triggered using 3 cycles of 2-minute gas activation separated by 1-minute defrost periods. For active probes, the nitrous oxide will be deployed to the tip where a drop in temperature to -70C will result in cryoneurolysis. Device: CryoneurolysisCryoneurolysis of the femoral and sciatic nerves (or their distal counterparts) in the residual limb: The cryoneurolysis device will be triggered using 3 cycles of 2-minute gas activation separated by 1-minute defrost periods. For active probes, the nitrous oxide will be deployed to the tip where a drop in temperature to -70C will result in cryoneurolysis.Other Name: Cryoanalgesia Sham Comparator: Sham ComparatorSham cryoneurolysis of the femoral and sciatic nerves (or their distal counterparts) in the residual limb: The cryoneurolysis device will be triggered using 3 cycles of 2-minute gas activation separated by 1-minute defrost periods. However, for sham probes, the nitrous oxide is not deployed to the tip and therefore there is no drop in temperature resulting in cryoneurolysis. Device: Sham ComparatorSham cryoneurolysis of the femoral and sciatic nerves (or their distal counterparts) in the residual limb: The cryoneurolysis device will be triggered using 3 cycles of 2-minute gas activation separated by 1-minute defrost periods. However, for sham probes, the nitrous oxide is not deployed to the tip and therefore there is no drop in temperature resulting in cryoneurolysis.Other Name: placebo, control Outcome Measures Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Primary Outcome Measures : Average daily phantom pain intensity [ Time Frame: Baseline and 4 months later (difference between the two is the primary end point) ]The difference in average daily phantom pain intensity at baseline and 4 months following the initial intervention (measured with the NRS as part of the Brief Pain Inventory) Secondary Outcome Measures : Average daily phantom pain intensity [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]The difference in average daily phantom pain intensity at baseline and various time points other than the primary at 4 months Brief Pain Inventory [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]The difference in the Brief Pain Inventory between baseline and various time points Residual limb pain (frequency and duration) [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]Pain that originates from a part of the injured limb that remains intact Patient Global Impression of Change [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]A 7-point scale of change from baseline at various time points Beck Depression Inventory [ Time Frame: At baseline, 4 months, 12 months (and 4 months following crossover for those subjects who choose to the crossover treatment) ]21-question questionnaire evaluating depression with 4-5 multiple choice responses Non-painful phantom sensations (frequency and duration) [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]Sensations that feel to emanate from the missing limb, but are not described as pain Phantom limb pain (frequency and duration) [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]Pain perceived to emanate from part of the injured limb that no longer exists Residual limb pain (NRS) [ Time Frame: Endpoints will be evaluated at baseline and post-treatment (Day 0), Days 1 and 7; and Months 1, 2, 3, 4, and 12 [same for crossover subjects with the exception of the 12-month time point] ]Pain that originates from a part of the injured limb that remains intact. Worst, least, average, and current pain levels will be recorded at each time point Eligibility CriteriaGo to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Layout table for eligibility information Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria:
Enter the Phantom Masked Coordinator!!
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Ina sense, Murnau's film is about all of the things we worry about at 3 in themorning--cancer, war, disease, madness. It suggests these dark fears in thevery style of its visuals. Much of the film is shot in shadow. The corners ofthe screen are used more than is ordinary; characters lurk or cower there, andit's a rule of composition that tension is created when the subject of a shotis removed from the center of the frame. Murnau's special effects add to thedisquieting atmosphere: the fast motion of Orlok's servant, the disappearanceof the phantom coach, the manifestation of the count out of thin air, the useof a photographic negative to give us white trees against a black sky. 076b4e4f54
Building a Smarter Path in Web Development
The world of web development is growing rapidly, with new technologies, tools, and updates shaping how websites and applications are built. For beginners and professionals alike, staying on track requires more than just technical knowledge. It demands structured learning, smart use of online tools, and an awareness of industry standards like the Google Helpful Content Update. Alongside this, simple resources such as a word to html converter and creative web development project ideas play important roles in keeping the learning journey both effective and practical.
This blog explores how aspiring developers and content creators can combine all these elements to shape a successful career or project roadmap.
The Frontend Developer Roadmap: A Structured Guide
When entering the field of web development, the sheer number of technologies can be intimidating. A frontend developer roadmap solves this problem by offering a step-by-step guide for learning the essential skills required to build user-facing websites.
It begins with the basics of structure, styling, and interactivity, gradually expanding to frameworks, responsive design, performance optimization, and accessibility. Having such a roadmap provides clarity and prevents learners from feeling lost in an ocean of tutorials and trends.
More importantly, the frontend developer roadmap encourages consistent growth rather than rushing through flashy frameworks. By focusing first on fundamentals, developers ensure they can adapt to changing technologies while maintaining a strong foundation.
The Role of Web Development Project Ideas
Learning from a roadmap is effective, but true mastery comes from practice. This is where web development project ideas become essential. They provide opportunities to apply theory in practical ways, testing problem-solving abilities and encouraging creativity.
Project ideas can range from small experiments to larger, more structured builds. They give learners a chance to explore real-world challenges such as design consistency, user experience, and performance improvements. Moreover, each completed project strengthens a portfolio that can showcase skills to employers or clients.
By working on diverse web development project ideas, developers not only gain experience but also build confidence to face new challenges as they progress through their careers.
Efficiency Through Word to HTML Converters
While large projects capture most of the spotlight, small utilities like a word to html converter quietly enhance productivity. Many content creators draft text in word processors, and manually converting this text for web usage can be tedious. A converter solves this issue instantly, providing clean and structured output.
This tool not only saves time but also reduces the chances of errors during formatting. For businesses managing large amounts of content, it streamlines publishing. For learners, it highlights the connection between text formatting and the structure of a webpage.
Although it may seem like a simple tool, the word to html converter represents a larger principle: embracing efficiency wherever possible allows developers and content creators to focus on creativity and strategy rather than repetitive tasks.
Online Tools: The Digital Workspace
In the modern era, online tools are no longer optional—they are an integral part of web development. They enable collaboration, learning, and productivity without the barriers of complex installations or expensive software.
For beginners, online platforms provide an accessible entry point. They allow learners to experiment directly in the browser, test their knowledge, and share work easily. For professionals, online tools support teamwork, project management, and advanced testing.
These tools are also vital for remote collaboration, which has become a cornerstone of modern work culture. Whether for communication, design, testing, or deployment, they create a seamless workflow that mirrors the interconnected nature of the web itself.
The Google Helpful Content Update: Shaping Quality Standards
Beyond coding and tools, success in web development also depends on understanding how search engines evaluate websites. The Google Helpful Content Update is a significant shift in this area, emphasizing that websites should be built primarily for users rather than search engines.
This update rewards content that is original, insightful, and user-focused while penalizing sites that rely on low-value or automatically generated content. For developers and creators, this means aligning both design and content strategies with genuine helpfulness in mind.
A website built with excellent design but poor content will not perform well in rankings. Likewise, content-rich sites that ignore usability and accessibility will struggle to retain audiences. The Google Helpful Content Update reinforces the balance: both technology and content must serve the audience’s needs first.
Conclusion
Becoming a skilled web developer is a journey that requires balance: balance between learning and practice, between technology and usability, and between efficiency and creativity. A frontend developer roadmap offers clear direction, while web development project ideas bring knowledge to life. Tools like a word to html converter simplify daily tasks, and online tools open doors for collaboration and accessibility. Above all, awareness of updates like the Google Helpful Content Update ensures that developers create projects that truly serve their audiences.