Gambling Disorder

Researchers are studying how bite force and bone turnover markers change during the retention phase after orthodontic treatment in patients with different vertical facial growth patterns. The study compares patients with vertical (hyperdivergent) and horizontal (hypodivergent) craniofacial growth to understand relapse and bone remodeling processes over a 12-month retention period. This prospective clinical trial aims to provide insights into maintaining teeth alignment using retention appliances after fixed orthodontic treatment. The trial includes two groups of patients who have completed fixed orthodontic treatment and are ready for retainer delivery. Group 1 consists of patients with vertical growth patterns (FMA 26° or more), while Group 2 includes those with horizontal growth patterns (FMA 24° or less). Both groups will receive a Begg's retainer formed conventionally and delivered within 24 hours of debonding. Changes in bite force will be measured using a bite force device, and bone turnover markers CTX (bone resorption) and BALP (bone formation) will be assessed using ELISA at baseline and at 1, 3, 6, and 12 months after retainer delivery. Participants will undergo bite force measurements and biomarker testing at five timepoints during the 12 months retention phase: at retainer delivery, then after 1, 3, 6, and 12 months. Data on bone turnover markers and bite force changes will be collected and compared between the two groups. The study includes monitoring of functional occlusion, oral hygiene, and retainer compliance. The total participation time spans 12 months, during which researchers will assess both clinical and biochemical indicators of bone remodeling and bite function after orthodontic treatment.

Researchers are conducting the GENESIS clinical study to map the HLA genomic region in the Greek population and explore its possible links with various underlying diseases. This non-interventional, multicenter study aims to provide a pilot map of genetic variation in HLA that may be useful in medical research and clinical applications related to selected diseases. The study plans to include 12,000 participants over a total duration of 36 months. Each participant will attend one visit at a participating site during which they will provide demographic data, lifestyle information such as smoking and alcohol use, blood pressure measurements, details on diagnosed diseases and treatments, and recent laboratory test results if available. Buccal swab samples will be collected from each participant to extract DNA for HLA genotyping analysis. Selected samples will undergo further whole genome sequencing to investigate associations with autoimmune diseases. Participants will receive a personalized ancestry report after analysis completion. During the study visit, data collection includes demographic and health information, as well as laboratory and clinical test results from the past year. The genetic material from buccal swabs will be stored and processed for genetic analysis. Researchers will measure allele frequency of HLA alleles in the Greek population and assess the prevalence and risk associations of selected HLA-related diseases. The study's total duration is 36 months with results available at the end of this period.

Suicide is the second leading cause of death among youth, and rates in the US are rising despite prevention efforts. Researchers are evaluating a digital platform called Vira to improve how care is delivered to adolescents at high risk for suicide. This platform aims to use smartphone data and secure communication tools to better understand and manage risk factors like psychological distress, anhedonia, behavioral withdrawal, and sleep problems in young people receiving intensive outpatient treatment. The study compares two groups of adolescent patients aged 13 to 18 years old who are in an intensive outpatient Dialectical Behavior Therapy (DBT) program. One group uses the Vira platform, which collects data passively from smartphone sensors about activity, sleep, mobility, and mood-related language. Vira also prompts daily check-ins and supports practitioners with reminders to encourage behavior changes. The other group receives the usual treatment with the addition of a passive monitoring app called EARS. Participants will use their assigned app during their intensive outpatient treatment. Researchers will assess outcomes using tools like the Columbia Suicide Severity Rating Scale and Scale for Suicidal Ideation over six months. Other measures include anxiety, risky behaviors, sleep quality, mood, and pleasure scales at three and six months. The study monitors clinical outcomes to determine if the digital platform enhances care for youth at risk of suicide.

Researchers are evaluating a new type of cell therapy called autologous chimeric antigen receptor T (CAR-T) cells that target CD19, CD22, and BCMA in patients with relapsed or refractory multiple myeloma. This early-phase, open-label study aims to assess the safety and tolerability of this treatment and to find the highest dose that patients can safely receive. Additional goals include studying how the therapy behaves in the body, how long the CAR-T cells survive, and its effects on the disease. Participants will go through several phases including screening, collection of their immune cells (apheresis), a treatment to prepare their body (lymphodepletion), followed by a single intravenous infusion of the CAR-T cells. After the infusion, patients will be closely monitored for dose-limiting toxicities during the first 28 days and followed up for longer-term observations. The study uses a dose escalation approach to find the maximum tolerated dose. During the study, participants will have multiple assessments such as blood tests to measure the concentration and activity of CAR-T cells, immune markers, and signs of disease progression. Researchers will also track overall survival and progression-free survival over two years. Safety and response will be evaluated frequently from the day of infusion through follow-up visits. The total participation duration may extend up to the end of the study, which is expected in late 2027.

Researchers are investigating the effects of a multidomain lifestyle intervention to slow cognitive decline and dementia risk in elderly residents aged 60 to 80 in Zhejiang Province, China. The study builds on findings from Finland, where a similar approach combining physical activity, nutrition, cognitive training, social activities, and vascular risk management showed promise in healthy older adults at risk of cognitive decline. This trial aims to explore how such an intervention may change brain structure and function as well as cognitive abilities in an Asian population. Participants are randomly assigned to either a structured multidomain intervention group or a self-guided control group. The intervention group receives tailored nutritional guidance, cognitive training, physical exercises, and vascular risk monitoring, all adapted to Chinese cultural norms. The control group receives regular health education campaigns and basic health monitoring every 6 to 12 months. This trial runs for two years with ongoing assessments to evaluate the impact of these lifestyle changes. During the study, participants undergo various evaluations including cognitive tests measuring global and domain-specific cognition, neuroimaging scans like MRI and fMRI, laboratory blood tests, and physical performance measures such as grip strength and gait speed. Questionnaires assess quality of life, depression, sleep quality, and daily activities. Researchers also monitor cardiovascular health, dementia onset, and falls. This comprehensive monitoring will help determine the intervention's effects on brain health and daily functioning over the 24-month period.

Researchers are evaluating treatments for patients with colorectal cancer who experience early relapse within one year after completing adjuvant chemotherapy with XELOX or FOLFOX. These patients have a poor prognosis, limited treatment options, and most have tumors resistant to immune checkpoint inhibitor monotherapy. This phase II randomized trial aims to assess the safety and effectiveness of adding serplulimab, a PD-1 inhibitor, to second-line chemotherapy plus targeted therapy in this high-risk group. Participants will be randomly assigned to one of two groups: the experimental arm receiving serplulimab combined with FOLFIRI chemotherapy and targeted therapy, or the control arm receiving FOLFIRI plus targeted therapy alone. Treatment regimens vary based on tumor location and RAS mutation status, with cetuximab used for left-sided, RAS wild-type tumors and bevacizumab for right-sided, RAS mutant tumors. Serplulimab is administered intravenously every two weeks at 3 mg/kg. The study uses a Pick-the-Winner design to enroll 40 patients total. During the study, researchers will monitor progression-free survival over 12 months as the primary outcome. Secondary outcomes include objective response rate, disease control rate, overall survival over 36 months, and safety assessments using standard criteria. Exploratory analyses will examine tumor and blood biomarkers to identify predictors of response and resistance. Participants will undergo scheduled visits, treatments, laboratory tests, and assessments throughout the study period to evaluate these outcomes.

Researchers are studying patients with various behavioral addictions to better understand the factors that influence how these addictions develop and how well patients follow their treatment plans. This observational study focuses on patients seeking care at the University Hospital of Nantes, evaluating addictive behaviors along with social, clinical, and biological characteristics. The study observes patients over a long period without administering experimental treatments, tracking their condition and treatment adherence based on their regular care. There are no specific interventions or medications being tested, as the primary aim is to monitor the natural progression and management of behavioral addictions. Participants will be followed for up to 8 years to assess changes in their behavioral addictions. Researchers will collect data on clinical evaluations, sociodemographic information, and treatment compliance. The study emphasizes long-term observation to identify patterns and outcomes related to behavioral addiction evolution and care adherence.

Researchers are evaluating a mentalization-based parenting program called the Lighthouse MBT Parenting Program for parents with various mental disorders who are receiving adult mental health services. This trial compares this program to the usual care provided to these parents. The goal is to study both the short- and long-term effects of this intervention on parenting stress and related outcomes, addressing the high need for evidence-based support for parents with mental health conditions and their children. The study involves two groups: one receives the Lighthouse MBT Parenting Program, which includes a preparatory individual session followed by twelve weekly group sessions of two hours each. The other group receives care as usual, consisting of one or two sessions with family members, commonly offered in adult mental health services. Both interventions are provided alongside the participants' regular outpatient treatment. Participants will be assessed at the start of the study and again at 6, 12, and 24 months after starting the program. The research team will measure parenting stress using a standardized index and evaluate other factors such as children's psychological adjustment, family functioning, quality of life, parenting competence, and the severity of psychiatric symptoms. The study includes careful follow-up to monitor these outcomes over two years.

This research aims to develop and scientifically evaluate a set of self-assessment scales to support psychiatric diagnostics and follow-up in adults with psychiatric problems. These scales collect detailed information on symptoms, age of onset, symptom development, relation to external stress, and the impact on function and suffering. The goal is to create validated tools that help clinicians classify psychiatric conditions more effectively using fewer, optimized questions. Participants are recruited consecutively from five specific sites and asked to complete various item sets measuring relevant psychiatric symptoms. The study involves multiple groups, each responding to different item sets that are refined and validated over time using statistical methods. After optimizing individual item sets, the scales are combined and further tested to reduce the number of questions and dimensions needed for accurate assessment. Participants will answer sets of questions about their symptoms and experiences during multiple recruitment phases. Researchers analyze the responses to refine the scales, aiming for concise and reliable tools. The main outcome measure is the Scalability H index, which assesses the measurement quality of the scales. Participation involves completing questionnaires, with ongoing evaluation to improve the diagnostic support system.

The trial investigates the adaptation and pilot testing of the ATTACH2 parenting program, originally designed for in-person delivery, to an online web and mobile format. The program aims to improve children's mental, emotional, and behavioral health by strengthening the parent-child relationship, particularly for families affected by stressors like depression, addiction, domestic violence, and poverty. This transition responds to challenges posed by the COVID-19 pandemic limiting in-person services and seeks to provide safe, user-friendly virtual mental health support to vulnerable families. The ATTACH2 program consists of 10 to 12 weekly sessions, each about 45 minutes, delivered by trained facilitators such as nurses or social workers. The study involves co-designing virtual interfaces with parents and service providers through four phases: user engagement and design exploration, prototyping, software development, and pilot beta testing. The goal is to create a reliable minimum viable product for virtual delivery that incorporates user feedback and meets the needs of families and facilitators. Participants will be involved in pilot testing the virtual program, with assessments conducted before and after the intervention to measure changes in children's mental, emotional, and behavioral health using age-appropriate tools. Parent-child interaction quality will be assessed using the Parent Child Interaction Teaching Scale. Data will be collected through surveys and focus groups, and refinements will be made based on participant feedback. The study also includes dried blood sample collection for participating families in specific locations, and the total intervention period spans about 10 to 12 weeks.