Environmental Exposure

Researchers are studying the long-term effects of reducing household air pollution (HAP) from biomass fuel use on heart, lung, and immune health among women and children in semi-rural Bangladesh. The study evaluates whether a mobile phone-based behavioral change communication (mHealth BCC) intervention can increase the adoption and exclusive use of cleaner cooking fuel, Liquid Petroleum Gas (LPG). This research also investigates how lowering pollution exposure might influence immune responses to vaccines and subclinical cardiovascular and pulmonary changes. The study is a large household-level randomized controlled trial comparing two groups: one receiving the mHealth BCC intervention encouraging exclusive LPG use and a control group receiving no such intervention. Researchers will monitor personal and area levels of air pollutants like PM2.5 and black carbon before and after intervention, alongside detailed assessments including spirometry, chest X-rays, high-resolution CT scans, blood pressure, EKG, metabolic markers such as HbA1c and lipid profiles, and immune cell function. The intervention messages are delivered via mobile phone with frequency tailored to participant responses. Participants will be followed over two years with repeated measurements to assess pollutant exposure and health effects. Evaluations include lung function tests, imaging, cardiovascular markers, metabolic blood tests, and immune function assays. The study aims to provide insights into the health benefits of sustained LPG use and improved air quality. Total participation spans pre-intervention assessments through two years of follow-up, with ongoing monitoring of pollution exposure and health outcomes.

Researchers are studying the use of a 2,910 nm mid-infrared Fiber Laser (UltraClear, Acclaro Medical) to treat advanced perioral lines and wrinkles. The goal is to assess the laser's effectiveness for skin rejuvenation by using both superficial epidermis ablation and deeper skin layers' ablative and coagulative effects. The study also aims to evaluate safety and participant satisfaction with this resurfacing treatment for photodamaged skin and wrinkles. Participants will receive up to two treatments with the UltraClear laser, spaced 6 to 8 weeks apart. These treatments focus on improving the appearance of perioral lines and wrinkles using the laser's combined superficial and deep skin effects. Following treatments, participants will have follow-up visits at 1 month and 3 months to evaluate the results and any side effects. Throughout the study, researchers will measure improvements using multiple scales, including the Fitzpatrick Wrinkling and Degree of Elastosis Scale, Physician Global Aesthetic Improvement Scale, and assessments by independent photographic reviewers. Participants will also report their own perceptions of aesthetic improvement and satisfaction. Safety and overall aesthetic outcomes will be monitored during follow-ups, with the total participation lasting through the 3 months after the final treatment.

Healthcare professionals often face severe stress, which can lead to sick leave and affect their well-being. This research aims to evaluate whether a five-week internet-based compassion course can help reduce stress of conscience and work-related stress, while improving professional quality of life and self-compassion. The study compares this compassion course with a general internet-based cognitive behavioral therapy (CBT) stress management course and a waitlist group. Participants will be randomly assigned to one of three groups: a therapist-guided internet compassion course, a therapist-guided general internet CBT stress management course, or a waitlist for 10 weeks followed by the general CBT course. Both courses are structured self-help programs lasting five weeks, including weekly reports and therapist feedback delivered online. The compassion course focuses on compassion-focused therapy methods, while the CBT course uses traditional CBT techniques. Throughout the study, participants will complete assessments at baseline, 5, 10, and 15 weeks, and again at 6 months. These assessments measure changes in stress of conscience, professional quality of life, work-related stress, and self-compassion. Data are collected through self-assessment forms, and the study tracks progress over time to understand the effects of the courses. The total participation time spans up to 6 months to monitor longer-term outcomes and maintenance of benefits.

Researchers are investigating the use of Clemastine Fumarate combined with engineered sound to treat age-related central auditory processing disorder (CAPD), a condition affecting many people over 40 and causing difficulty hearing in noisy environments. This trial aims to test if the therapy, called Localized Oligodendrocyte Optimization Therapy (LOOT), which showed promise in animal studies, can improve hearing in noise for humans. The study is designed to compare the effectiveness of the drug with or without engineered sound in a controlled, randomized setting. Participants will be randomly assigned to one of four groups: Clemastine Fumarate with engineered sound, Clemastine Fumarate with placebo sound (white or pink noise), placebo drug with engineered sound, or placebo drug with placebo sound. The drug dosage is carefully controlled and given orally over 30 days, while participants listen to the assigned sound stimulation through headphones for one hour daily. The trial includes an adaptive design allowing adjustment of study arms based on interim results. Throughout the study, participants will undergo hearing tests to measure their ability to hear in noisy environments, both before and after treatment. Additional assessments include questionnaires on speech and tinnitus, auditory brainstem response tests, physical exams, blood tests, and EKGs to monitor health and safety. The treatment period lasts one month, with evaluations scheduled around weeks five or six. Safety and hearing improvements are carefully monitored to assess the therapy's impact.

Residents of Martin and Letcher Counties in Appalachian Kentucky face a serious health risk from exposure to disinfection by-products (DBPs) in their drinking water. These DBPs, including trihalomethanes, haloacetic acids, and chlorate, have been linked to health problems such as bladder cancer and cardiovascular birth defects. The research aims to better understand and reduce exposure to these harmful compounds through a community-focused approach involving multiple stakeholders and methods. The study involves two main programs: a Citizen Scientist Training Program and a Stakeholder Consultation Core Program. The training program lasts three years and includes in-home sampling and education on DBPs. The consultation core runs for five years, with participants attending quarterly meetings and discussions to share insights and experiences about DBP exposure and mitigation. These programs work together to engage the community in addressing the water contamination issue. Participants will be assessed on changes in their environmental health knowledge, attitudes, behaviors, and social network connections over a five-year period. Assessments occur at the start and throughout the study to track progress. The study also involves regular participation in meetings, training sessions, and in-home sampling activities. Overall, the study seeks to empower local residents with knowledge and tools to reduce their exposure to harmful drinking water contaminants over several years.

Researchers are investigating the use of ABM/P-15 bone graft compared to traditional bone graft in patients undergoing surgery for Adult Spinal Deformity (ASD). This study aims to improve clinical outcomes by promoting faster bone healing, reducing the need for additional surgeries, minimizing complications, and improving health-related quality of life. The trial is a prospective, randomized, controlled clinical study conducted at a specialized spine unit. Participants are randomly assigned to receive either the ABM/P-15 bone graft, which is a device combining anorganic bovine bone mineral with a synthetic peptide to enhance bone growth, or a standard bone graft made from locally harvested bone mixed with morselized allogenic femoral head. Both graft types are used during posterior spinal instrumentation and fusion surgery, with anterior support added as needed. The ABM/P-15 bone graft is placed on the spine structures and contained by the surrounding muscle. The study includes preoperative planning, surgery, and follow-up evaluations up to two years. Participants complete questionnaires before surgery and at 3 months, 1 year, and 2 years after surgery. They undergo X-rays at multiple time points and a CT scan one year after surgery to assess bone fusion and detect pseudarthrosis. Researchers track revision surgeries, adverse events, and cost-effectiveness during the study. Data on surgical details, complications, medication use, and rehabilitation are collected from medical records. The total participation lasts about two years, allowing for detailed assessment of outcomes and safety.

Researchers are evaluating whether short exercise breaks at work can prevent muscle and joint pain in workers. The study compares two types of exercise programs to see if strength exercises help workers move better and feel less pain, and whether they are more effective than stretching exercises. This quasi-experimental study is conducted in collaboration with Recuperación Funcional Gurea S.Coop.Peq at various companies in the Basque Country, focusing on musculoskeletal disorder prevention. Participants are divided into two groups based on their workplace or preference. One group performs a strength-based active pause program involving high-intensity resistance exercises targeting the shoulder, back, and legs using elastic bands or body weight. The other group follows a mobility active pause program with low-intensity joint mobility and static stretching exercises. Both programs last 8 weeks, with daily 5-minute sessions and one supervised session per week. Participants complete physical tests such as the 30-second Sit-to-Stand test and strength measures of handgrip and shoulder abduction at baseline, after 8 weeks, and again 3 months later. They also answer surveys about pain, work ability, and vitality using the Senior Working Life Questionnaire. Adherence to the intervention is monitored throughout the 8 weeks. The total study duration includes initial assessment, intervention, and follow-up evaluation up to 20 weeks.

Researchers are investigating how acute preoperative pain affects the development of chronic postsurgical pain (CPSP) in patients undergoing emergency orthopaedic or abdominal surgery. Unlike scheduled surgeries where preoperative pain lasts weeks or months, emergency surgery involves intense but short-term pain. This study aims to clarify the long-term impact of this acute pain on CPSP occurrence three months after surgery. Participants will be asked to complete a questionnaire 48 to 72 hours after surgery to share their pain experience and preoperative anxiety. Then, three months post-surgery, researchers will conduct a phone interview using a standardized questionnaire to assess the presence of chronic postsurgical pain. This approach allows evaluation of pain progression from acute to chronic phases following emergency surgery. During the study, patients' pain perception and anxiety levels shortly after surgery will be recorded, followed by a longer-term follow-up assessing the frequency of CPSP. The main measure is the occurrence of CPSP at three months. Participation involves questionnaires and phone interviews without additional treatments. The study is sponsored by Centre Hospitalier Universitaire, Amiens and is open to adults aged 18 and older undergoing emergency surgery.

The trial investigates risk factors and outcomes for patients who require acute surgical care, focusing on three specific conditions: acute pancreatitis, gastrointestinal bleeding, and perforated ulcer. Researchers aim to improve risk assessment tools and identify factors linked to complications or death, especially considering frailty, comorbidity, age, and gender. The study is observational and retrospective, analyzing patients admitted to Skåne University Hospital from 2009 to 2019. Patients are grouped based on the severity of acute pancreatitis (mild, moderate, severe), presence of gastrointestinal bleeding, perforated ulcer, age (above or below 70 years), use of prothrombotic medications, frailty score, and whether they needed reintervention. Treatments vary according to clinical decisions made during care, and the study observes these variations without assigning interventions. Participants' medical records from the hospital are reviewed to gather data on mortality, reintervention, and recurrent disease over five years. Additional measures include length of hospital stays, number of interventions, and complications. The study's results aim to inform future prospective studies on preventative care and treatment options. Participation involves no active treatments but detailed record analysis and long-term outcome monitoring.

Researchers are evaluating adaptive radiotherapy (ART) in patients with locally advanced gynecological cancers such as cervical, endometrial, and vaginal carcinomas. This study compares ART, a newer method that adjusts radiation doses based on daily anatomical changes, with standard image-guided radiotherapy (IGRT) where the radiation plan remains fixed. The goal is to understand how many patients benefit from ART and whether it can reduce radiation exposure to healthy tissues and safety margins. Participants receive either ART or standard IGRT during their radiotherapy treatment. ART involves online adaptation of the radiation dose distribution before each session using cone-beam CT scans and expert review by a radiation oncologist and medical physicist. Treatments are delivered over an initial 10 radiation fractions using the Ethos therapy device. If ART does not provide dosimetric advantages, the original treatment plan is used as in IGRT. The study includes an experimental adaptive radiotherapy arm and a standard IGRT comparator arm. During the study, participants will be monitored for side effects using established toxicity scales for rectal, bladder, skin toxicities, and lymph-edema from 2 weeks up to 5 years. Overall survival and progression-free survival will be assessed over 5 years. Researchers will compare dose distributions and analyze safety margins. The study is randomized and double-blinded, with involvement lasting through treatment and long-term follow-up for outcomes and safety.