Kornimate/medical-research-clean huggingface dataset:
risk evaluation by coronary cta and artificial intelligence based functional analyzing techniques - i

Conditions: Coronary Artery Disease

Summary: this study is a multicenter, retrospective imaging study. the study intends to retrospectively enroll patients with acute myocardial infarction who had received coronary cta in a certain time-window before this event. all coronary cta will be analyzed by anatomic, functional and radiomic analysis, assisted by artificial intelligence. the purpose of this study is to establish a coronary artery disease risk stratification system by coronary cta.

coronary angiography has been the gold standard for the diagnosis of coronary heart disease and pci decision-making. however, the value of cag in risk stratification is limited due to its invasive nature and lack of ability to evaluate coronary physiology and plaque characteristics, which often leads to over-treatment or under-treatment. in recent years, with the development and improvement of imaging technology, the resolution and diagnostic accuracy of coronary artery cta have been greatly improved, and the subsequent anatomy and function (non-invasive ct-ffr, etc.) have made the assessment of coronary artery lesion risk multi-dimensional. comprehensive and accurate coronary artery cta scan plays a positive role in establishing the appropriate standard for pci and improving the prognosis of patients. however, the existing problems of coronary artery cta are insufficient imaging studies, complex image analysis, inconsistent diagnostic criteria, and insufficient clinical evidence. this study is one of the series of clinical studies on the topic of "risk evaluation by coronary computed tomography and artificial intelligence based functional analyzing techniques (recognize)". the purpose of the study is to establish a coronary artery disease risk stratification system by coronary cta and anatomic, functional and radiomic analysis, assisted by artificial intelligence.

Eligibility criteria:
inclusion criteria: * age between 18-80 years old * received coronary ct angiography 3 months to 5 years prior to acute coronary myocardial infarction. ccta identified coronary atherosclerotic plaques with diameter stenosis ≥ 10% exclusion criteria: * familial hypercholesterolemia * prior history of percutaneous coronary intervention (pci) or coronary artery bypass graft (cabg) * prior history of myocardial infarction before the recent event * severe liver or renal insufficiency

Keywords: coronary cta ct-ffr artificial intelligence risk stratification
surgeons' satisfaction with the surgical training program in egypt

Conditions: Satisfaction

Summary: in egypt, the evidence for quality processes has not been established yet in the current training programs for surgery residents. there are no published articles discussing career satisfaction among surgical residents. therefore, we are going to conduct a self-designed survey in egyptian university hospitals to measure residents' satisfaction and display views about their undergraduate surgical education, surgical education during internship year, post-graduate training program, and extracurricular activity during medical school.


Eligibility criteria:
inclusion criteria: * we will include the egyptian academic surgeons, within their first 8 years after their graduation. we will include surgeons in general surgery and other surgery subspecialties such as orthopedic surgery, neurosurgery, urology, and plastic surgery exclusion criteria: * we will exclude surgeons who received part of their training program abroad.

Keywords: satisfaction training program egypt cross-sectional multi-center
stress and pain in people living with hiv

Conditions: HIV; Depression; Cannabis Use Disorder; Stress; Pain

Summary: this is a basic human experimental study utilizing 4 groups of individuals with and without hiv and complex morbidities of cannabis use disorder and major depression who will participate in 2 sessions of the yale pain stress task (ypst) and follow-up phase to assess drug use and mood symptoms.

this study aims to address research gaps using a powerful and novel cross-diagnostic approach with multiple complementary approaches to examine the overarching hypothesis that plwh+cm exhibit impaired stress-related hpa and hpa-immune function due to alterations in epigenetic mechanisms, and these stress-related hpa-immune and related epigenetic aberrations predict distress, craving and substance use symptoms underlying plwh complex morbidities. this hypothesis will be tested using a combined human experimental stress challenge approach with prospective longitudinal assessment of daily distress, and substance use symptoms as well as assessment of chronic stress (c-stress), social determinants of health (sdoh), and resilience in experimental cohorts of plwh with and without cm and those without hiv with and without cm.

Eligibility criteria:
inclusion criteria: * good health as verified by screening examination * able to read english and complete study evaluations and provide informed written and verbal consent. additional criteria plwh * hiv-1 lab test positive * undetectable viral load * good art adherence additional criteria by group: plwh +cm: * cb positive urine toxicology * meet dsm-5 criteria for cud and mdd as assessed using scid-i. hc * hiv-1 test negative * urine toxicology negative * no major medical and psychiatric diagnoses based on dsm-v. plwh only: * hiv-1 test positive * urine toxicology negative * no major medical and psychiatric diagnoses based on dsm-v. cm only: * hiv-1 test negative * urine toxicology positive * meet dsm-5 criteria for cud and mdd as assessed using scid-i exclusion criteria: * meet primary, current moderate and severe criteria for other sud including cocaine, alcohol, opiates, sedatives, nicotine * current use or past history of cocaine or opioid use disorder * history of any psychotic disorder * current diagnoses of bipolar disorder and ptsd * psychotic or otherwise severely psychiatrically disabled (i.e., suicidal, homicidal, current mania) * significant underlying medical conditions such as cerebral, renal, thyroid or cardiac pathology that would interfere with study participation * medications with known central effects on hpa axis and cytokines/immune function * women who are pregnant, nursing or those using hormonal birth control that affect hpa axis cortisol responses.
impact of subgingival instrumentation on psychological distress and mental health status in bruxers with periodontitis

Conditions: Periodontal Diseases; Bruxism; Periodontitis; Distress, Emotional

Summary: bruxism is a non-functional repetitive jaw-muscle activity characterized by grinding or clenching the teeth. bruxism, characterized by the involuntary grinding or clenching of teeth, is a prevalent parafunctional habit affecting individuals of all ages. stress, anxiety, and depression are the psychological factors most commonly associated with the presence of bruxism.

bruxism, characterized by the involuntary grinding or clenching of teeth, is a prevalent parafunctional habit affecting individuals of all ages. although the etiology is not known exactly, it has been suggested that bruxism is a multifactorial disorder. periodontitis, a prevalent inflammatory condition affecting the periodontium, has been linked to bruxism in several studies. the coexistence of bruxism and periodontitis poses unique challenges in clinical management of periodontitis. also, as periodontitis became chronic, the occurrence of depression increased. stress, anxiety, and depression are the psychological factors most commonly associated with the presence of bruxism. therefore, this study aims to investigate impact of subgingival instrumentation on psychological distress and mental health status in bruxers with periodontitis.

Eligibility criteria:
inclusion criteria: * systemically healthy patients * patient having periodontitis with bruxism * age between 30-50 years exclusion criteria: * history of mental health disorder * history of systemic disease * history of drugs having the potential impact on periodontal status like phenytoin, cyclosporin, calcium-channel blockers or antidepressant drugs * pregnant or lactating females
molecular markers and genetic markers in patients undergoing radiation therapy for cancer

Conditions: Hematopoietic/Lymphoid Cancer; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific

Summary: rationale: studying samples of tumor tissue from patients with cancer in the laboratory may help doctors learn more about changes that occur in dna and identify biomarkers related to cancer. purpose: this research study is looking at molecular markers and genetic markers in patients undergoing radiation therapy for cancer.

objectives: primary * determine local-regional control in patients undergoing radiation therapy for cancer, as a function of expression of specific molecular/genetic markers. secondary * determine complications of radiation therapy for patients undergoing radiation therapy for cancer. outline: previously collected tissue samples are analyzed using immunohistochemical staining and other molecular/genetic study methods to detect markers, including p53, cyclin d1, her-2-neu, bcl-2/bax, and egfr. patient charts are also reviewed with emphasis on local-regional relapse.

Eligibility criteria:
disease characteristics: * diagnosis of cancer * undergoing radiation therapy for malignant disease patient characteristics: * not specified prior concurrent therapy: * see disease characteristics

Keywords: unspecified adult solid tumor, protocol specific unspecified childhood solid tumor, protocol specific hematopoietic/lymphoid cancer
nice morning- safety and efficacy observational study of telmisartan in hypertensive patients in multicenters

Conditions: Hypertension

Summary: the purpose of this observational study is to survey the safety and effectiveness of the product under the real condition of usual practice in taiwanese hypertensive patients. during the 8-week observation, the safety profiles and the clinical evaluation in between doses through blood pressure (bp) measurement for overall effectiveness of telmisartan therapy will be concluded.


Eligibility criteria:
inclusion criteria: 1. male or female. 2. aged 20 to 80 years old. 3. patients meet one of following two criteria: 1. adult essential hypertensive either newly diagnosed and untreated, or previously treated and uncontrolled patients; sitting blood pressure: systolic blood pressure (bp) \> 140 mmhg but \ 90 mmhg but \< 110 mmhg). 2. patients who are assessed to benefit from the intake of angiotensin ii receptor blocker (arb) monotherapy or as add-on medication. exclusion criteria: 1. patients with contraindications to telmisartan use (as per the micardis® tablets package insert). 2. known hypersensitivity to the active ingredient or to any of the excipients of micardis® tablets. 3. any other clinical condition which, in the opinion of the attending physician, would not allow safe administration of the study medications.
breast lymph node mapping

Conditions: Breast Cancer

Summary: the purpose of this study is to map the arm lymphatic drainage system in the axilla with blue dye and the breast drainage system with a radioactive material. by identifying the arm lymphatics they can be protected during surgery and this may decrease the occurrence of lymphedema. the information obtained in this study may provide us with better surgical techniques to identify and protect the arm lymphatic drainage system in the axilla.

this study is a non-randomized phase ii study of the axillary reverse mapping (arm) procedure for patients presenting with breast cancer requiring lymph node evaluation. the study will enroll 100 subjects, and will have two study arms: one for patients requiring only the slnb procedure (roughly 67% of enrollees), and one for patients requiring a full alnd (roughly 33% of enrollees). for the analysis of study efficacy, each arm will be compared to its procedure-appropriate historical control for evidence of decrease in the 1-year lymphedema rate among patients undergoing slnb or alnd. additional data will be collected on the treatment population's (a) variability in location of arm lymphatics, and (b) incidence of sln crossover with arm lymphatics, along with success-rate data for identifying slns and arm lymphatics during slnb and/or alnd. this additional data will add to our level of knowledge and experience regarding lymph node surgery.

Eligibility criteria:
inclusion criteria: 1. 19-100 years old 2. not pregnant or breastfeeding 3. breast cancer requiring ln evaluation for the breast 4. willing participation following an informed consent process exclusion criteria: 1. patient \ 100 y/o 2. pregnant or breastfeeding 3. allergy to blue dye 4. locally advanced axillary disease 5. history of receiving neoadjuvant chemotherapy treatment 6. prior axillary surgery or radiation therapy

Keywords: sentinel lymph node biopsy (slnb) axillary lymph node dissection (alnd) lymphatics blue dye
pd-1 antibody combined neoadjuvant chemotherapy for ovarian cancer

Conditions: Ovarian Cancer; Neoadjuvant Chemotherapy; Anti-PD-1; Neoadjuvant Immunotherapy

Summary: the main purpose of this study is to validate the efficacy and safety of anti-pd-1 in combination with neoadjuvant chemotherapy in women with advanced ovarian cancer.


Eligibility criteria:
inclusion criteria: 1. histologically confirmed adenocarcinoma of ovary, fallopian tube, primary peritoneum (non-mucinous adenocarcinoma) 2. clinical stage iiic/iv, and iiic with suidan ct ≥3 or fagotti ≥8 3. eastern cooperative oncology group (ecog) performance status of 0 \~ 2 4. not received any immunotherapy before 5. willing to participate in this study, and sign the informed consent. exclusion criteria: 1. with other uncontrolled malignant tumors. 2. any disease requiring systemic treatment with a corticosteroid (prednisone or equivalent daily dose of \> 10mg) or other immunosuppressive agents during the 14 days prior to randomization.the use of topical substitute steroids (daily dose ≤10mg of prednisone or its equivalent) and prescription corticosteroids for short-term (≤7 days) prophylactic use or for the treatment of non-autoimmune conditions is permitted.has any active autoimmune disease or a history of autoimmunity. 3. a history of active autoimmune disease or autoimmune disease that may recur.enrolment was allowed for well-controlled type 1 diabetes, hypothyroidism requiring only hormone replacement therapy, well-controlled celiac disease, skin conditions (such as vitiligo, psoriasis, or alopecia) that did not require systemic treatment, or conditions that were not expected to recede without an external cause. 4. a history of interstitial lung disease, non-infectious pneumonia, or poorly controlled diseases (including pulmonary fibrosis, acute lung disease, etc.). 5. subjects with active hepatitis b (defined as positive hepatitis b virus surface antigen \[hbsag\] test result and hbv-dna test value higher than the upper limit of normal value in the laboratory of the research center) or hepatitis c (defined as positive hepatitis c virus surface antibody \[hcsab\] test result and positive hcv-rna test result). 6. known human immunodeficiency virus (hiv) infection (known to be hiv positive). 7. have received live vaccine within 30 days before the first administration.this includes but is not limited to the following: mumps, rubella, measles, varicella/herpes zoster (varicella), yellow fever, rabies, bcg and typhoid vaccines (inactivated virus vaccines are allowed). 8. with uncontrolled cardiac clinical symptoms or diseases. 9. allergic to any drug in this program. 10. at the discretion of the investigator, the subject has a history or current evidence of any disease, treatment or laboratory anomaly that may confuse the results, interfere with the participants' participation throughout the study, or is not in the best interest of the participants to participate in the study.
cognitive problems in veterans with heart failure

Conditions: Heart Failure; Cognition Disorders

Summary: we assessed the prevalence of cognitive/memory problems in veteran patients with heart failure, and evaluated its relationship to medication compliance.

heart failure (hf) is a costly, chronic, and complex condition that impacts veterans' quality of life, morbidity, and mortality. in the va population up to 20% of patients are readmitted for hf within 30 days. non-adherence to prescribed medication and self-care regimens in patients with hf is known to lead to increased morbidity, including readmissions. cognitive impairment (ci) has been shown to predict nonadherence in elderly people without hf, however, this link has not been studied in hf populations. in the non-veteran population, hf patients are known to have an increased prevalence of cognitive impairment (ci), however, no existing study has determined the extent and type of ci in veterans with hf. this pilot study was designed as a descriptive cross-sectional study as a pre-implementation effort with following goals: (1) determine the prevalence of ci in veterans with all-cause hf in an outpatient setting; (2) quantitatively describe the extent of ci in this population; (3) qualitatively describe neuropsychological domains affected by ci; (4) evaluate the association of ci with medication adherence and other clinical variables. all consenting eligible outpatients in our va hf clinic underwent a simple screening test for ci (saint louis university mental status exam). demographic and clinical variables were collected by patient interviews and chartg reviews, and included geriatric depression scale and questionnaires about medication-taking behaviors. all subjects were invited back for 30-day direct pill count of all their routinely prescribed medications. subjects who screened positive for ci were invited back for a modified battery of neuropsychological tests to determine the cognitive domains affected. subjects will also be followed after the 12-month study period to collect data on hospital readmissions.

Eligibility criteria:
inclusion criteria: * patients with established diagnosis of clinical heart failure * english-speaking * able to provide informed consent * able to participate in cognitive function testing * age over 18 exclusion criteria: * life expectancy \< 6 months * documented dementia requiring a caregiver

Keywords: heart failure cognitive disorders medication adherence patient readmissions
qlb vs. wound infiltration in cesarean section

Conditions: Analgesia; Cesarean Section

Summary: effective postoperative analgesia after cesarean section (cs) is important because it enables early ambulation and facilitates breast-feeding. a 2009 cochrane review concluded that wound infiltration with local analgesic after cs reduced opioid consumption. in addition, two regional anesthetic techniques, the transversus abdominis plane (tap) block and the quadratus lumborum block (qlb), have been shown in multiple studies to reduce post-operative opioid consumption after cs. a recent randomized controlled trial showed that qlb is more effective in reducing morphine consumption post-cs compared to tap. no randomized controlled trial to date, however, compared the analgesic effect of qlb with infiltration of the wound after cs. the objective of the study is to compare the analgesic effect of qlb type 2 with wound infiltration after cs.

effective postoperative analgesia after cesarean section (cs) is important because it enables early ambulation and facilitates breast-feeding. post-cs analgesia is usually multimodal. at our hospital, patients are routinely given a combination of parenteral paracetamol, metamizole and tramadol at fixed intervals with additional intravenous piritramide on demand. the well-known side effects of piritramide (nausea, vomiting, and sedation) may interfere with interaction between mother and child, breast-feeding and post-partum experience in a dose-dependent manner. alternative strategies to reduce rescue opioid analgesic consumption post-cs section are, therefore, required. a 2009 cochrane review concluded that wound infiltration with local analgesic after cs reduced opioid consumption. in addition, two regional anesthetic techniques, the transversus abdominis plane (tap) block and the quadratus lumborum block (qlb), have been shown in multiple studies to reduce post-operative opioid consumption after cs. a recent randomized controlled trial showed that qlb is more effective in reducing morphine consumption post-cs compared to tap. telnes et al. compared tap block with wound infiltration with local anesthetic following cs. they found no reduction in cumulative morphine consumption and more pronounced sedation associated with tap block. no randomized controlled trial to date, however, compared the analgesic effect of qlb with infiltration of the wound after cs. the objective of the study is to compare the analgesic effect of qlb type 2 with wound infiltration after cs.

Eligibility criteria:
inclusion criteria: * parturients scheduled for an elective caesarean delivery under spinal anaesthesia with an american society of anesthesiologists physical status i or ii, singleton pregnancy, and gestational age ≥ 37 completed weeks. exclusion criteria: * congenital or acquired coagulopathy. * allergy to local anaesthetics. * history of drug abuse.

Keywords: analgesia cesarean section quadratus lumborum block type 2 wound infiltration
safety and efficacy of patient controlled analgesia in the emergency department

Conditions: Pain

Summary: the aims of this study are to assess efficacy and safety of patient-controlled analgesia (pca) when applied to the emergency department setting and to compare the efficacy and safety of two pca dosing regimens.

the safety, efficacy, and dosing of pca will be assessed in a randomized trial with three treatment arms: 1. pca with 1.0 mg morphine demand dosing every 6 minutes, 2. pca with 1.5 mg demand dosing every 6 minutes and 3. a non-pca comparison group. all patients will receive a loading dose of 0.1 mg/kg morphine. all patients can receive additional analgesics as needed, at the discretion of the provider. we hypothesize that morphine supplied via pca will provide superior analgesia without a greater incidence of adverse events when compared to non-pca pain management; and that pca demand dosing of 1.5 mg will be superior to 1.0 mg without more adverse events.

Eligibility criteria:
inclusion criteria: * patients presenting to the ed with a chief complaint of abdominal pain of less than or equal to 7 days duration * age 18 to 65 years * patient deemed by the ed attending physician to require iv opioid analgesia exclusion criteria: * current use of prescription or non-prescription opioids * long-term use of opioids, chronic pain syndrome * clinician suspicion of opioid dependence/abuse * clinical suspicion of intoxication * pregnancy or breast-feeding * history of chronic obstructive pulmonary disease, history of sleep apnea, oxygen saturation \< 97% * systolic blood pressure \< 100 mm hg * use of monoamine oxidase inhibitors, phenothiazines, or tricyclic antidepressants * history of renal insufficiency/renal failure * prior allergic reaction to morphine * inability to provide informed consent * previous entry of patient into study

Keywords: pain analgesia analgesia, patient-controlled emergency medicine