cyrilzakka/clinical-trials huggingface dataset:
AI-Assisted System for Accurate Diagnosis and Prognosis of Breast Phyllodes Tumors

Breast phyllodes tumor (PT) is a rare fibroepithelial tumor, accounting for 1% to 3% of all breast tumors, categorized by the WHO into benign, borderline, and malignant, based on histopathology features such as tumor border, stromal cellularity, stromal atypia, mitotic activity and stromal overgrowth. Malignant PTs account for 18%-25%, with high local recurrence (up to 65%) and distant metastasis rates (16%-25%). Benign PT could progress to malignancy after multiple recurrences. Therefore, Early, accurate diagnosis and identification of therapeutic targets are crucial for improving outcomes and survival rates.

In recent years, there has been growing interest in the application of artificial intelligence (AI) in medical diagnostics. AI can integrate clinical information, histopathological images, and multi-omics data to assist in pathological and clinical diagnosis, prognosis prediction, and molecular profiling.AI has shown promising results in various areas, including the diagnosis of different cancers such as colorectal cancer, breast cancer, and prostate cancer. However, PT differs from breast cancer in diagnosis and treatment approach. Therefore, establishing an AI-based system for the precise diagnosis and prognosis assessment of PT is crucial for personalized medicine.

The research team, led by Dr. Nie Yan, is one of the few in Guangdong Province and even nationally, specializing in PT research. Their team has been conducting research on the malignant progression, metastasis mechanisms, and molecular markers for PT. The team has identified key mechanisms, such as fibroblast-to-myofibroblast differentiation, and the role of tumor-associated macrophages in promoting this differentiation. They have also identified molecular markers, including miR-21, α-SMA, CCL18, and CCL5, which are more accurate in predicting tumor recurrence risk compared to traditional histopathological grading.

The project has collected high-quality data from nearly a thousand breast PT patients, including imaging, histopathology, and survival data, and has performed transcriptome gene sequencing on tissue samples. They aim to build a comprehensive multi-omics database for breast PT and create an AI-based model for early diagnosis and prognosis prediction. This research has the potential to improve the diagnosis and treatment of breast PT, address the disparities in breast PT care across different regions in China, and contribute to the development of new therapeutic targets.


Eligibility Criteria:
Inclusion Criteria:

* Patients diagnosed with a phyllodes tumor of the breast

Exclusion Criteria:

* Blurred images, imaging artifacts
Lung Screening in People Cured of Hodgkin Lymphoma

A single site non-commercial study in which people treated for Hodgkin lymphoma survivors will be invited to have a single low dose CT of thorax for lung cancer screening


Eligibility Criteria:
Inclusion Criteria:

* Aged 18-80
* 5 year or more survivor of HL
* Any of: a) treated with radiotherapy for HL with radiation dose to the lung b) an alkylating agent containing chemotherapy regimen known to increase lung cancer risk
* Living within approximately 40 miles of The Christie Hospital

Exclusion Criteria:

* Previous diagnoses of malignant neoplasm of trachea, bronchus, lung, thymus or pleura
* A current diagnosis of metastatic cancer
* Residents in nursing homes or housebound
* Had a CT scan of the thorax within the last 12 months
* Pregnant women
* Unable to provide consent
Response to Medication Registry

To create a registry/database of patients who either have taken drugs that treat cardiovascular conditions or that have presented with cardiovascular symptoms that may be related to medication.

To create a registry/database of patients who either have taken drugs that treat cardiovascular conditions or that have presented with cardiovascular symptoms that may be related to medication. Potential enrollees are those receiving (presently or in the past) the medicine(s) of interest. Subjects will be identified from computerized Intermountain Healthcare records. Patients receiving a drug of interest, both with and without an ADE will be enrolled in approximately equal numbers. Outpatients will be contacted by mail and invited to participate. Interested subjects will be instructed to return the enclosed response card with their intent indicated. The registry coordinator will contact interested subjects and the project will be explained. Willing participants will be enrolled either in person or via mail with the assistance of the project coordinator. Persons presenting in person for enrollment will be given the choice of venipuncture or buccal swab for sample collection for DNA extraction. In all cases informed consent will be obtained before collecting samples.

Eligibility Criteria:
Inclusion Criteria:

* The patient must be \> 18 years of age.
* The patient or legally authorized representative must sign a written informed consent, prior to sample collection, using a form that is approved by the local Institutional Review Board.
* The patient must have taken a medication of interest or have presented with a cardiovascular symptom possibly related to medication. The current medications of interest are as follows:

  * ACE inhibitors
  * ARBs
  * Aldosterone Antagonists
  * Alpha-Andrenergic Agonists
  * Anticoagulants
  * B-Type Natriuretic Peptides
  * Beta-blockers
  * Calcium Channel Blockers
  * Cardiac Glycosides
  * Antiarrhythmics
  * Combination Drugs
  * Diuretics
  * Electrolyte/Mineral Replacements
  * Lipid-lowering Medications
  * Positive Inotropes
  * Vasodilators/Nitrates
  * Statins
  * Antibiotics
  * Anthrocyclines

Exclusion Criteria:

* There are no exclusion criteria for this registry.
Natural History Study of Adult Patients With Paroxysmal Nocturnal Hemoglobinuria of High-risk Hemolysis in China

This is a single-center observational study conducted in adult patients with paroxysmal nocturnal hemoglobinuria of high-risk hemolysis.

This observational study consists of two parts, one part is retrospective study which aims to collect medical chart data to calculate the mean change or mean incidence rates of LDH, hemoglobin, PNH-related symptoms and PNH-related events over 6 months.

The other part is cross-sectional study to detect the total C5 level in PUMCH at the latest follow-up visit in eligible PNH patients with high-risk hemolysis, to show the difference between eligible PNH patients and healthy people and to explore the related clinical factor influencing high-level total C5 using logistic regression model.


Eligibility Criteria:
Inclusion Criteria:

1. Meet the diagnostic criteria for paroxysmal nocturnal hemoglobinuria;
2. Age ≥ 18 years old;
3. PNH clone size of granulocytes or monocytes (CD59 or Flaer) ≥ 10%;
4. LDH≥1.5 ULN;
5. Accompanied by at least one PNH-related symptoms: fatigue, hemoglobinuria, abdominal pain, dyspnea, anemia symptoms, major adverse vascular events (including thrombosis), dysphagia, erectile dysfunction;
6. Transfusion-dependent PNH patients;
7. There are at least 6 months consecutive data of diagnosis and treatment after the data collection time point;
8. Patients agreed to participate in the study by signing informed consent or giving oral informed consent.

Exclusion Criteria:

1. Patients are under the treatment of the C1/C3/C5 complement inhibitors currently or in the past;
2. Patients have received bone marrow transplantation;
3. platelet count \<30\*10 9/L or absolute neutrophil count \<0.5\*10 9/L;
4. Patients have clinically significant heart, liver, or lung diseases, or have related medical history.
5. Patients have comorbidities of rheumatoid disease, HIV infection, active HBV infection, HCV infection and other diseases that affect the body's immune function;
6. Severe missing data in the records of diagnosis and treatment after the data collection time point;
7. Other patients who are not suitable to participate in the study.
Analgesia and Wound Healing Assessment Following Topical Morphine Applied to Patients With Cutaneous Cancer Related Pain

Cutaneous cancer-related pain is difficult to treat. These patients are often prescribed high systemic dosages of opioids. Yet, many patients continue to report pain while experiencing dose-limiting side effects. An alternative approach to systemic administration is to apply topical medications. The advantage of topical application is the potential of achieving good analgesia using low dosages with few, if any, systemic side effects. Current clinical data indicates, that topically applied morphine has an analgesic effect in patients with severe pain and that it may even improve wound healing. The clinical reports so far have been either case studies or double blind randomly controlled trials with a very small sample size of patients. There is still a great deal of information which is lacking about this modality of treatment regarding on the one hand, the mechanism of action and on the other, clinical issues. For example, is the mechanism of the effect actually peripheral? What is the adequate dose of analgesic medication for different types of skin conditions? Wound healing has not been quantified.

We will apply morphine topically to skin wounds of cancer and evaluate the effect of the treatment on pain, side effects, quantify wound healing, quantify morphine and its metabolites in blood and urine.

Should well controlled studies, demonstrate all or any of the peripheral effects of topical morphine, clinical application of this treatment modality would be possible. This could contribute towards better treatment of these patients, who have pain which is difficult to treat and can, at times, be intractable.


Eligibility Criteria:
Inclusion Criteria:

* Moderate to severe resting pain (scores above 5/10).
* Stable analgesic regimen.
* No surgical interventions planned during the study period.
* Able to self-assess pain and report it.
* Hospitalized or receiving home care for Stage I; out-patients or receiving home care for Stage II.
* Wound not infected or covered with necrotic tissue.

Exclusion Criteria:

* True sensitivity to opioids
The Anatomical Location, Cellular Origin and Molecular Basis of Gut-derived Glucagon Secretion

Delineation of the anatomical location, cellular origin and molecular basis of gut-derived glucagon secretion

Aim: to delineate the anatomical origin, the molecular structure and precursors, the regulation and the (patho-) physiological implications of gut-derived glucagon.

Eight totally pancreatectomised patients, eight type 2 diabetes patients and eight healthy controls (age 18-80, BMI \<30) with normal kidney and liver parameters and hgb\> 6.5 - will be included. The participants will each undergo one screening day and one study day including a gastroduodenoscopy. Multiple biopsies will be taken at several predefined locations in the upper gastrointestinal tract. These biopsies will be analysed with different techniques including immunohistochemical staining, quantitative polymerase chain reaction (qPCR-) analyses and more to search for glucagon. After the last biopsy has been collected, 50 g of glucose dissolved in 100 ml water is infused through the enteroscope into the most proximal part of the small intestine. Hereafter blood samples for glucagon and gut hormone analyses will be collected 15, 30 and 45 min after the glucose infusion.

Eligibility Criteria:
Inclusion Criteria:

* normal kidney function, normal liver function, normal hemoglobin levels

Exclusion Criteria:

* diabetes type 1, first degree relatives with type 2 diabetes
A Study of Ridaforolimus (MK-8669) in Combination With Dalotuzumab (MK-0646) Compared to Standard of Care Treatment in Estrogen Receptor Positive Breast Cancer Patients (MK-8669-041 AM3)

This is a two-part study that will determine, if: 1) the combination of ridaforolimus and dalotuzumab will improve progression-free survival compared to exemestane; and 2) the combination of ridaforolimus and dalotuzumab will improve progression-free survival compared to both ridaforolimus and dalotuzumab as single agents, in participants with breast cancer.


Eligibility Criteria:
Inclusion Criteria The prospective participant must meet, at least, all of the criteria below to be eligible for study participation.

The participant:

* Has a confirmed diagnosis of breast cancer that is metastatic or locally advanced and is estrogen receptor positive and human epidermal growth factor receptor 2 (HER-2) negative ;
* Is post-menopausal;
* Is at least 18 years of age;
* Has a life expectancy of at least 3 months;
* Has had a recurrence or progression of cancer after prior treatment and patient has received at least one line of endocrine therapy for metastatic disease, OR the patient's cancer has recurred within 6 months after the last dose of anastrozole or letrozole;
* Has an available archival tumor specimen;
* Has voluntarily agreed to participate by signing informed consent.

Exclusion Criteria If the prospective participant meets any of the criteria below (among others determined by the study staff) they will NOT be eligible for study participation.

The participant:

* Is receiving any other systemic tumor therapy;
* Has previously received rapamycin or rapamycin analogs;
* Has received prior treatment with insulin-like growth factor 1 receptor (IGF-1R) inhibitors, phosphoinositide 3-kinase (PI3K) inhibitors, or other experimental agents that target the PI3K, protein kinase B (AKT), or mammalian target of rapamycin (mTOR) pathways;
* Has known allergy to macrolide antibiotics;
* Has an active infection that requires antibiotics;
* Has significant or uncontrolled cardiovascular disease;
* Has poorly controlled Type 1 or 2 diabetes mellitus;
* Is known to be human immunodeficiency virus (HIV) positive;
* Has a known history of active Hepatitis B or C.
Point-of-Care Measurements of Platelet Inhibition After Clopidogrel Loading in Patients With Acute Coronary Syndrome: Comparison of Generic Clopidogrel Bisulfate (Plavitor®) With Original Clopidogrel Bisulfate (Plavix®)

This study demonstrates the effect of generic clopidogrel bisulfate (Plavitor®) in comparison with the original clopidogrel bisulfate (Plavix®) in patients with acute coronary syndrome.


Eligibility Criteria:
Inclusion Criteria:

1. Patients with unstable angina or non-ST elevation myocardial infarction
2. Patients who are planned coronary angiography
3. Age \>18 years, \<75 years
4. Patients who agree to the study protocol

Exclusion Criteria:

1. Recent treatment with clopidogrel or pletaal or glycoprotein IIb/IIIa Rc antagonist
2. Active bleeding (peptic ulcer, trauma or intra-cranial hemorrhage)
3. Allergy to antiplatelet agent
4. Bleeding diasthesis (blood coagulation disorders, uncontrolled severe hypertension, history of severe bleeding)
5. History of drug abuse or alcohol abuse
6. ST elevation myocardial infarction
7. Pregnancy
8. Low platelet count (\< 100,000 /L) or abnormal results of PT or PTT
9. Liver disease ( bilirubin \> 2 mg/dL, AST or ALT \> 100 IU)
10. Renal failure ( Cr \> 2.0 mg/dL)
11. Malignancy
12. Proton pump inhibitor, NSAIDs statin (except atorvastatin)
Relationship Between Clinical Tests and Clinical Outcomes After Motor Control Exercises Intervention

Nowadays, the research priority in low back pain area have been find subgroup of patients with the same characteristics that might achieve better outcomes in a specific intervention. However, even though the studies in this area have increased, questions of this nature remaining without an adequate answer, or with limited evidence. Therefore, the investigators propose to examine the ability of clinical tests, developed to assess alterations related to clinical lumbar instability, to identify subgroups of patients with non specific chronic low back pain that may have better outcomes after a motor control exercises intervention.

Changes relative to clinical instability are well established in individuals with non specific chronic low back pain. However, in this population, these changes vary widely, characterizing them as an heterogenous group. Motor Control Exercises (MCE) aims to improve the impaired coordination of deep and superficial muscles of the trunk, to reestablish the stability of the lumbar spine reducing the common alterations in this population, and are associated with reduction of pain and disability of patients with non specific chronic low back pain. To specific assessment of the changes found in this population, clinical tests are often used: in the assessment to identify motor control alterations; during intervention as parameter for treatment progress (e.g. to increase exercises difficulty); and after intervention, to ensure that there was normalization of the motor control. There are several clinical tests to assess changes relative to clinical instability, such as: Clinical Classification Scale (CCS) to assess abdominal muscles and the coordination between superficial and deep trunk muscles; Clinical Test of Thoracolumbar Dissociation (CTTD) to assess anterior/posterior tilt while maintain a constant position of thoracolumbar junction; and the Prone Instability Test (PIT) and Passive Lumbar Extension Test (PLET) used to detect structural lumbar instability.

Therefore, primary objectives of this study are: to investigate the ability of clinical tests in predict clinical outcomes, pain and disability, in motor control exercises program, and to investigate the association of two or more tests to predict clinical outcomes.

Eligibility Criteria:
Inclusion Criteria:

* between 18 and 60 years.
* non specific chronic low back (pain for more than 3 months) with pain intensity of at least 3 points measured by pain numerical rating scale (0-10) and disability of at least 6 points in the 24-item Roland Morris Disability Questionnaire (0-24).
* classified as low or medium risk though StarT Back Screening Tool

Exclusion Criteria:

* cardiovascular and neurological pathologies
* serious pathology in the spine and pelvic.
* previous spinal surgery of at least 1 year before the trial period.
* check-list with the red flags was performed to exclusion
* classified as high risk through StarT Back Screening Tool, due these patients have high psychological components and needed of specialized psychological attendance
Virtual Reality (VR) Treatment for Balance Problems in Traumatic Brain Injury (TBI)

The purpose of this study is to evaluate the effectivenes of a home-based physical therapy program designed to improve balance following traumatic brain injury by incorporating the use of a virtual reality system.


Eligibility Criteria:
Inclusion Criteria:

* Has sustained a documented TBI that required an inpatient rehabilitation program;
* is at least one year post TBI;
* is at least 18 and no more than 64 years of age at the time of enrollment;
* is English or Spanish speaking
* is at least three months beyond completion of formal PT, including acute inpatient rehabilitation, outpatient and home-based therapy;
* provides written medical clearance for participation in an in-home balance exercise program;
* ambulates independently within the home (with assistive devices and/or orthotics as needed);
* has active range of motion of bilateral upper extremities of at least 90 degrees of abduction to allow for control of the VR system;
* completes a 15 minute trial using a VR system in the absence of a negative physical or behavioral reaction;
* self-reports ongoing balance deficits and demonstrate such deficits by scoring at or below one standard deviation above the mean (75 or below) on the CB\&M; and
* provides informed consent, or has a guardian available to provide consent.

Exclusion Criteria:

* has a history of another medical illness or neurological disorder which may affect balance;
* has experienced a seizure within the last year;
* has a history of psychiatric disorder requiring hospitalization;
* is currently participating in another RCT;
* is currently using VR technology to address specific balance goals;
* is unable to travel to Craig for assessments throughout the study period;
* is unable to communicate effectively to complete standardized assessments;
* has cognitive impairment that precludes completion of baseline testing;
* is unavailable to participate in 12 continuous weeks of therapy;
* has no access to television able to connect to VR-gaming system; and
* reports inadequate space required for VR-gaming system sensors.
Erythema Toxicum Neonatorum in Newborns and the Development of Asthma

Erythema Toxicum Neonatorum (ETN) is a common skin finding that affects healthy full-term babies. Several authors have commented on the possible relationship between ETN and the development of atopic conditions, such as atopic dermatitis or respiratory disease later in life. There is a paucity of research addressing this issue.


Eligibility Criteria:
Inclusion Criteria:

* Children between the ages of 3-9 years who have had at least 2 asthma diagnoses within the last 2 years.
* Control subjects will be age matched and without an asthma diagnosis.

Exclusion Criteria:

* Children without accessible medical records
Effects of Brandt Daroff Exercises in Older Adults With Vertigo

Vertigo is among the most prevalent disorder in older adults around the world leads to dizziness and balance problems resulting in decreased quality of life. Brandt daroff exercises can accelerate vertigo recovery and prevent recurrence without taking drugs. Cawthorne Cooksey first presented vestibular exercises to improve neurophysiological habituation, improves balance in the elderly. This study aims to determine the effects of brandt daroff exercises with cawthorne cooksey exercises on balance, dizziness and functional parameters in older adults with vertigo.

This is a randomized controlled trial. Participants will be selected by non-probability convenience sampling technique, thirty two vertigo patients meeting the inclusion criteria will be randomly allocated into two equal groups (experimental and control) by online randomizer tool. The experimental group will receive brandt daroff exercises with cawthorne cooksey exercises and the control group will receive brandt daroff exercises alone. Treatment session of 60 min will be given 3 times a week for 6 weeks. The following assessment tool will be used Visual Analogue Scale and Dizziness Handicap Inventory for vertigo symptom severity, Berg Balance scale and Tinetti POMA for assessment of balance, Functional Independence Measure and IADL Tool for assessment of functional parameters. Assessment will be done at baseline and after 6 week. The data will be analyzed using SPPS software version. 25.

Eligibility Criteria:
Inclusion Criteria:

* Older adults 65or above.
* Both Male and Female.
* Symptoms suggested vertigo, confirmed by neurologist.
* Accepted to participate in study.
* DHI Scale: 36-42 (moderate handicap).

Exclusion Criteria:

* Patients having balance issues other than dizziness and vertigo.
* Middle or external ear diseases.
* Cerebrovascular diseases.
* Feet injuries including severe bruises, ulcers, open wounds or recent burns.
* Neck pain and cervical spine disease.
* History of serious musculoskeletal disease (arthritis, Alzheimer's disease, intervertebral disc degeneration).