Kornimate/medical-research-clean huggingface dataset:
mirai-mri: comparing screening mri for patients at high risk for breast cancer identified by mirai and tyrer-cuzick

Conditions: Breast Cancer

Summary: accurate risk assessment is essential for the success of population screening programs and early detection efforts in breast cancer. mirai is a new deep learning model based on full resolution mammograms. mirai is a mammography-based deep learning model designed to predict risk at multiple timepoints, leverage potentially missing risk factor information, and produce predictions that are consistent across mammography machines. mirai was trained on a large dataset from massachusetts general hospital (mgh) in the united states and found to be significantly more accurate than the tyrer-cuzick model, a current clinical standard. the primary aim of this study is to prospectively quantify the clinical benefit (i.e. mri/cem cancer detection rate) of mirai-based guidelines and to compare them to the current standard of care. 1. conduct a prospective study where patients who are identified as high risk by mirai guidelines are invited to receive supplemental mri within 12 months. 2. compare cancer outcomes between patients only identified as high risk by mirai and patients identified as high risk by existing guidelines the secondary aim is to study the impact of new guidelines by race and ethnicity, to ensure equitable improvements in cancer screening.


Eligibility criteria:
inclusion criteria: * women who were identified as high risk on the retrospective study (dating from 2017-2023) using mirai will be recruited and consented for the prospective study * women over 40 years of age identified as high risk according to traditional guidelines will also be potentially eligible for this study * following consent and enrollment in the study, a participant will subsequently receive the following: 1. these patients will be invited to receive a supplemental mri examination currently considered the most sensitive test for breast cancer detection. 2. any positive diagnosis on mri will be followed by biopsy to confirm 'truth" of diagnosis. * to be selected, a given record must include the following: 1. a report of a routine screening mammogram or diagnostic mammogram, and availability of the dicom images from that report with the pacs system. 2. reports of all follow up screening and diagnostic studies documented on pacs. 3. some may have interventional procedures (as long as all of these are done at one of umass sites) and documentation of these biopsy results in the hospitals ehr. exclusion criteria: * under age 40. women under 40 years are not routinely xrayed with a mammogram. * xray breast cancer screening imaging study that has artifacts, corruption, or other image quality degradation. * pregnant patients because they do not routinely receive screening mammogram * adult male patients with breast cancer

Keywords: breast cancer screening artificial intelligence
end of life in the critically ill patient

Conditions: Terminal Illness; Intensive Care Unit Syndrome

Summary: the purpose of this multicentric study is to evaluate the perception of the quality of the end of life in intensive care units seen from the side of the caregivers, trough the caesar scale.

more than 20% of deaths occur in hospital after a stay in intensive care units; up to half of them happens as result of a treatment limitation. ensuring end-of-life quality is important, not only because is a moral duty of all caregivers, but also to prevent negative effects in close relatives of dead patients. in an assessment of quality of in-hospital deaths involving 3793 patients, only 35% of the deaths were judged to be of acceptable quality by the nurses. assessment tools have been developed recently on this topic. most studies have focused on the perception of end-of-life quality by close relatives, particularly through the caesar scale in the most recent one. the main purpose of this multicentric study is to evaluate the perception of the quality of the end-of-life in intensive care units seen from the side of the caregivers, in relation to the new french legislative framework.

Eligibility criteria:
inclusion criteria: * caregivers of intensive care unit whose patient has recently deceased exclusion criteria: * refusal of participation by caregivers * refusal of participation by family of deceased patient * patient in cardiac arrest at the time of icu admission. * age of deceased patient was under 18 years * patient in brain death

Keywords: critical care
the effects of wellbutrin (bupropion) on residual and cognitive symptoms in ssri-treated depression

Conditions: Depression; Major Depressive Disorder; Unipolar Depression

Summary: many people with depression are treated with a serotonin-specific reuptake inhibitor anti-depressant (ssri) and feel 'better'. although many people feel 'better', they do not feel completely 'well'. often, individuals continue to complain of cognitive problems such as lack of attention, diminished motivation, and impaired problem-solving. this study looks at whether residual and cognitive symptoms of depression in individuals are affected by the addition of wellbutrin (bupropion).

as many as 65-75% of treated patients continue to experience residual symptoms of depression. cognitive impairments feature frontal cognitive dysfunction. many experts believe that executive functions are better predictors of functional level than psychiatric diagnoses. frontal cognitive impairment and changes in neuroimaging are seen in individuals depleted of tryptophan, a serotonin precursor. these cognitive changes do not improve following serotonin-specific reuptake inhibitor treatment and at least one study has found that executive dysfunction predicts non-response to fluoxetine. in many patients, remission of mood symptoms in depression requires medications to target non-serotonergic neurotransmitter systems. brain areas mediating executive functions receive rich noradrenergic inputs, and norepinephrine is known to be intimately involved in many of the executive functions. a better understanding of serotonergic and catecholaminergic interactions would enable evidence-based treatment of depression which maximizes executive cognitive functions. this study examines the hypothesis that individuals treated with wellbutrin will have higher scores on tests of executive functions and lower scores on depression indices.

Eligibility criteria:
inclusion criteria: * depression * ssri-treated exclusion criteria: * bipolar disorder * serotonin-norepinephrine reuptake inhibitor (snri) or bupropion treatment * treatment-resistant depression * seizure disorder * bulimia or anorexia nervosa * pregnancy

Keywords: depression serotonin norepinephrine ssri wellbutrin bupropion executive function residual symptoms
maternal eed and aflatoxin birth outcomes study uganda

Conditions: Birth Weight; Pregnancy Preterm; Aflatoxins Toxicity; Inflammatory Response

Summary: this prospective cohort study focuses on the relationship between maternal environmental enteric dysfunction (eed) and maternal aflatoxin b1 exposure and birth outcomes, particularly infant anthropometry and gestational age, in mukono, uganda.

the problem of stunting, which has long-term health and economic consequences both at the individual and population level, persists in low and middle income countries (lmics). it has been recognized that an estimated 20% of stunting begins in-utero. although poor maternal nutrition during pregnancy is often blamed, it has been hypothesized that maternal eed status and maternal aflatoxin exposure during pregnancy may also play a role. however, to date, there have been no studies which have attempted to show the association between eed in pregnant women and negative birth outcomes. furthermore, few studies have examined the association between maternal aflatoxin exposure during pregnancy and negative birth outcomes. in this prospective cohort study, pregnant women were enrolled at their first prenatal visit and birth outcome data was assessed within 48 hours of delivery. eed was measured via lactulose: mannitol (l:m) ratios and serum concentrations of antibodies to the bacterial components flagellin and lipopolysaccharide (lps). aflatoxin exposure was assessed by measuring the serum concentration of afb1-lysine adduct from a blood sample taken at enrollment. data on covariates were obtained from two surveys, one at enrollment and one three weeks prior to participant's estimated date of delivery. the specific aims of this study were as follows: 1. to evaluate the relationship between markers of eed in pregnancy and negative birth outcomes, including low birth weight, stunting at birth, small head circumference, and premature delivery. 2. to evaluate the relationship aflatoxin b1 exposure in pregnancy and negative birth outcomes, including low birth weight, stunting at birth, small head circumference, and premature delivery.

Eligibility criteria:
inclusion criteria: * carrying a singleton pregnancy * 18-45 years old * residing within 10 kilometers of mukono town exclusion criteria: * younger than 18 years old or older than 45 years old * hiv-positive (verified via routine rapid hiv test conducted at first prenatal visit) * severely malnourished (defined as bmi \<16.0 kg/m\^2) * severely anemic (defined as hb \<7 g/dl) * planning to move away from mukono district prior to delivery

Keywords: aflatoxin b1 environmental enteric dysfunction l:m test pregnancy linear growth faltering birth outcomes uganda
cardiovascular impairments and obstructive sleep apnea syndrome

Conditions: Subclinical Cardiovascular Impairments; Obstructive Sleep Apnea Syndrome

Summary: which are the anthropometric parameters and/or of severity of the syndrome of apnea of sleep (sas) which make it possible to anticipate occurred of vascular anomalies, anatomical and/or functional precociously found among patients sas? secondary objectives: 1. which are the anthropometric parameters and/or of severity of sas allowing to anticipate occurred of early of the cardiac function and/or rhythmic anomalies found among patients sas? 2. do there exist biological markers who allow to anticipate the early vascular lesions or the anomalies beginners of the cardiac function? 3. which are the cardiovascular effects of a treatment of sas by continuous positive pressure (pc) after 3 to 6 months of treatment? 4. do the identified early cardiovascular attacks and/or the biological anomalies make it possible to predict occurred of cardiovascular events in this population of patients carrying sas (followed longitudinal at 5 years)?


Eligibility criteria:
inclusion criteria: * male or female from 18 to 78 years old * patients with obstructive sleep apnea syndrome (apnea/hypopnea index \> 15) * ambulatory patients * patients who have signed the inform consent form * patients with health insurance exclusion criteria: * body mass index upper or equal to 30 * cardiovascular pathology except blood pressure hypertension * known or treated diabetes * pathologies with consequence on blood pressure regulation * drugs intakes with consequence on blood pressure regulation * patient with chronic obstructive pulmonary disease * atrial fibrillation or more than 10/minute extrasystoles * bedridden patients or patients with decreased mobility * patients working at night or with shift work * patients with carotid stenting or surgery history * patients unable to sign the inform consent form * patients already treated by cpap or dental appliance for osas in the last 6 months * pregnant or suckling female * patients under supervision or trusteeship * patients taking part in another clinical trial

Keywords: cardiovascular risks oxidative stress systemic inflammation endothelial function peripheral arterial tone positive airway pressure
vagus nerve stimulation and labor

Conditions: 36-40 haftalık Hamile

Summary: the vagus nerve innervates both the uterus and the cervix. it is thought that a successful and positive birth experience can be achieved by stimulating the vagus nerve at the desired level. making instinctive sounds such as singing, humming, and various exercises are methods that stimulate the vagus nerve. in this project, an application protocol based on polyvagal theory and including breathing, relaxation and voice exercises was prepared. video-supported application material will be developed in line with the prepared protocol. the video-assisted vagus nerve stimulation intervention is called vagal active tone (vat). vat is a new method in the literature and for which we have limited information about labor. this project aimed to determine the effect of vagus nerve stimulation based on polyvagal theory on labor pain, anxiety, oxytocin, cortisol levels, duration and perception of birth. this study was planned as a randomized controlled experimental study. the number of samples was calculated using the g\*power 3.1.9.6 program. after the power analysis, it is aimed to reach a total of 50 people, 25 in the intervention group and 25 in the control group. data will be collected with personal information form, labor monitoring form, hormone levels monitoring form, visual analogue scale, state anxiety scale, facial anxiety scale and mother's birth perception scale. it is aimed to produce new and original evidence-based information with the use of vat intervention based on polyvagal theory. it is thought that this intervention, which can be easily accessed and applied by pregnant women whenever they want, will contribute positively to labor pain, anxiety, oxytocin and cortisol levels, and the duration and perception of birth. keywords: labor, oxytocin, cortisol, vagus nerve stimulation, midwife


Eligibility criteria:
inclusion criteria : women who volunteer to participate in the study, are primiparous and in the 28-32nd week of pregnancy, normal vaginal birth, single fetus and cephalic presentation, 19 years of age or older, communicate in turkish will be included in the study. exclusion criteria: women with obstetric complications (placenta previa, preeclampsia, premature rupture of membranes, oligohydramnios, polyhydramnios, presentation disorder, intrauterine growth retardation, i̇ntrauterine dead fetus, macrosomic baby, fetal distress, etc.), have a psychiatric diagnosis, have a systemic disease, have a heart and brain pacemaker, have epilepsy, have vision and hearing problems, attend a childbirth preparation class, undergo medical procedures for any reason at birth will be excluded from the study.

Keywords: emek oksitozin kortizol vagus sinir stimülasyonu ebe
identification and semi-quantification of ki-67 protein expression status

Conditions: Breast Cancer

Summary: the purpose of the study is the identification and semi-quantification of ki-67 protein expression level in breast cancer tissues by the genasis gopth system as compared to manual reading of the same slides. the imaging system is intended for diagnostic use as an aid to the pathologist in the detection, counting and classifying er/pr ihc stained samples

the anti ki-67 is a semi-quantitative immunohistochemical (ihc) assay to identify the ki-67 protein expressions in formalin-fixed, paraffin-embedded human breast cancer tissue specimens. results from the ki-67 test is indicated as an aid in the assessment of the protein status of breast cancer patients. while the p53 kit provides the antibody that offer direct visualization and semi-quantification of the protein expression through a brightfield microscope, the genasis gopath system is designed to complement the routine workflow of the pathologist in the analysis and review of immunohistochemically stained histologic slides.

Eligibility criteria:
inclusion criteria: * slides with nuclear borders of tumor nuclei that is distinguishable, and having good integrity. exclusion criteria: * slides that have lots of background that interfere with the analysis

Keywords: immunohistochemical ki-67 breast cancer ihc
calcitriol or placebo in men for prostate cancer active surveillance

Conditions: Prostatic Neoplasms; Prostate Cancer

Summary: after the diagnosis of prostate cancer, many men alter their lifestyle or diet or use various supplements in an attempt to retard the growth of their cancer. while there is limited data on the use of diet and supplements to alter the risk of prostate cancer, even less is known regarding the ability of diet or supplements to alter progression. for men who have elected active surveillance, the investigators propose to investigate the ability of vitamin d to retard the growth of prostate cancer.

men will be randomized to each of two arms for a total of 24 subjects: calcitriol alone (dn101, 45 micrograms once weekly) or placebo. baseline laboratory assays, including serum psa, serum and urine calcium and creatinine, will be performed and the epic questionnaire (expanded prostate cancer index composite, validated hrqol tool for prostate cancer patients) will be completed. patients will also undergo prostate needle biopsy \[4 cores taken under transrectal ultrasound (trus) guidance\] to establish baseline levels of gene expression. follow-up at the end of 2 weeks (just prior to the third dose) will include a history and physical, and a repeat of all baseline blood and urine tests. follow-up at 3 months will include a history and physical, repeating all blood and urine tests, and the epic questionnaire. at 6 months, in addition to the history and physical, blood and urine tests, and the epic questionnaire, a trus-guided prostate needle biopsy will be performed. this will be a standard 12-core scheme and 4 of these cores will be used for laboratory analysis. renal ultrasounds will again be performed on men in the calcitriol arms to look for stones. patients who show no evidence of clinical progression will be offered to remain on study, in their designated treatment arm, for an additional 6 months. any patient exhibiting clinical progression at any time will be withdrawn from the study and offered standard treatment options. for patients remaining on study at 12 months, an end-of-study biopsy will be requested (12-core scheme with 4 cores used for laboratory analysis)

Eligibility criteria:
inclusion criteria:- untreated prostate adenocarcinoma by an extended biopsy (\>8 needle cores on systematic prostate biopsy) within 1 year of the screening date * psa \<10.0 ng/ml * gleason sum 6 or \<2 mm gleason pattern 4 * no more than 33% of biopsy cores positive exclusion criteria:- prior or concurrent treatment for prostate cancer * use of finasteride, dutasteride, saw palmetto * use of nsaids, cox-2 inhibitors and/or aspirin, soy or vitamin d supplements for more than 7 days over the one month prior to study * kidney disease, hypercalcemia or renal stones * ecog performance status \>1 * uncontrolled hypertension, unstable angina, history of transient ischemic attack (tia), history of stroke.
psa levels and biopsy samples after implant radiation and hormone therapy in patients with stage i or stage ii prostate cancer

Conditions: Prostate Cancer

Summary: rationale: studying samples of blood and tissue from patients with prostate cancer after receiving implant radiation therapy and luteinizing hormone-releasing hormone agonist may help doctors identify biomarkers related to cancer and help doctors predict how patients will respond to treatment. purpose: this laboratory study is looking at psa levels and biopsy samples after undergoing implant radiation therapy and luteinizing hormone-releasing hormone agonist therapy in patients with stage i or stage ii prostate cancer.

objectives: * to analyze biopsy results at 36 months after permanent iodine i 125 implantation therapy and luteinizing hormone-releasing hormone (lhrh) agonist therapy for patients with untreated intermediate-risk prostate cancer. outline: patients received luteinizing hormone releasing-hormone (lhrh) agonist therapy and permanent iodine i 125 implantation on protocol jusmh-bri-gu05-01. patients undergo blood sample collection and tissue biopsy for biomarker/laboratory analysis at 36 months after receiving brachytherapy and releasing-hormone agonist therapy. psa levels and biopsy results are compared.

Eligibility criteria:
disease characteristics: * histologically or cytologically confirmed prostate cancer * previously untreated disease prior to participation on protocol jusmh-bri-gu05-01 * intermediate-risk disease as defined by the following: * clinical stage \< t2c * prostate-specific antigen (psa) ≤ 20 ng/ml * gleason score \< 8 * previously enrolled on protocol jusmh-bri-gu05-01 patient characteristics: * ecog performance status 0-1 * life expectancy ≥ 3 months * wbc ≥ 2,000/μl * hemoglobin ≥ 10.0 g/dl * platelet count ≥ 100,000/μl * serum creatine level ≤ 2.0 mg/dl * alt and ast ≤ 100 iu/l * no other cancer requiring treatment * no poorly controlled hypertension (i.e., diastolic blood pressure ≥ 120 mm hg) * no severe psychiatric disorders, including schizophrenia or dementia * no poorly controlled diabetes * considered appropriate for study participation, as determined by the principal investigator or clinical investigator prior concurrent therapy: * no prior drugs for benign prostatic hyperplasia (other than antiandrogen therapy) * no prior surgery for prostate cancer * no concurrent steroid drugs (except for ointment) * no other concurrent antiandrogen therapy

Keywords: stage i prostate cancer stage iib prostate cancer stage iia prostate cancer
soft tissue release with and without vaginal dilators on pain and sexual function in genitio pelvic pain

Conditions: Genito-Pelvic Pain/Penetration Disorder

Summary: study will be a randomized clinical trial which will incorporate two different interventions soft tissue release and vaginal dilators use would be administered to the women with genito pelvic pain. subjects meeting the predetermined inclusion criteria will be divided into two groups using lottery method. assessment will be done using gpppd, vancouver visual analogue scale, female sexual function index and pelvic floor impact questionnaire. subjects in one group will be treated with soft tissue release and vaginal dilators. and the other will be treated with soft tissue release only. each subject will receive a total 09 treatment sessions, with 03 treatment sessions per week. measurements will be recorded at baseline, 5th and 9th treatment session.

painful sexual intercourse is a common female health problem. it is a complex disorder that often goes neglected. it can be further categorized into superficial or deep, and primary or secondary. superficial is limited to the vulva or vaginal entrance, while deep means the extension of pain into the deeper parts of the vagina or lower pelvis. deep dyspareunia is frequently associated with deep penetration. primary pain initiates at the start of sexual intercourse, while in secondary, pain begins after some time of pain free sexual activity this study will be a randomized clinical trial which will incorporate two different interventions soft tissue release and vaginal dilators use would be administered to the women with genito pelvic pain. subjects meeting the predetermined inclusion criteria will be divided into two groups using lottery method. assessment will be done using gpppd, vancouver visual analogue scale, female sexual function index and pelvic floor impact questionnaire . subjects in one group will be treated with soft tissue release and vaginal dilators. and the other will be treated with soft tissue release only. each subject will receive a total 09 treatment sessions, with 03 treatment sessions per week. measurements will be recorded at baseline, 5th and 9th treatment session. recorded values will be analyzed for any change using spss21.

Eligibility criteria:
inclusion criteria: * women age 20 to 40 years * patient fulfilling dsm5 gpppd criteria * pain in genitals before during or after intercourse * pain greater than 4 on a 10cm visual analogue scale exclusion criteria: * • history of pathological conditions like infections * endometriosis * tumors * major psychiatric disorders * painful bladder syndrome * surgery of pelvic organs * any ongoing treatment of genito pelvic pain.