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 Beggs 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.

The GENESIS clinical study aims to map HLA genetic variation in the Greek population and evaluate possible correlations with selected underlying diseases. It is a multicenter, prospective, non-interventional clinical study targeting 12,000 subjects over an anticipated duration of 36 months, with the goal of creating a pilot HLA map for medical research and possible clinical applications. Each subject will complete one visit at a participating site and provide demographic information, including date of birth, gender, race, ancestry, height, and weight, as well as information about smoking or vaping, alcohol consumption, arterial blood pressure, diagnosed diseases, and current treatments. Recent clinical laboratory results from up to 12 months before sample collection may also be collected when available, including blood count, metabolic, liver enzyme, and biochemical parameters. Two buccal swabs will be collected from each subject for DNA extraction and HLA genotyping analysis. Selected DNA samples will also undergo low-pass whole genome sequencing to further investigate associations between the HLA region and autoimmune diseases. After the analysis is completed, an individualized ancestry report will be securely available to study subjects if they elect to access it.

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 evaluating the ViraSafe app, an enhanced version of the BRITE suicide safety planning app, to improve engagement with coping skills and safety planning among suicidal adolescents aged 13 to 24. This pragmatic randomized trial compares the new ViraSafe app integrated into the Vira behavior change platform with the original BRITE app, aiming to address rising youth suicide rates by using digital tools for intervention. The study focuses on youth who have experienced recent suicidal thoughts or attempts and are receiving care in clinical settings. Participants are randomly assigned to use either ViraSafe or BRITE. ViraSafe integrates safety planning and coping skills into a smartphone app with automated just-in-time reminders and daily distress ratings, supported by clinicians who can send additional nudges. The BRITE app offers self-monitoring, a safety plan, distress level ratings, and suggested coping activities based on distress. Both groups onboard the assigned app with a trained clinician or research staff. The trial lasts three months with assessments at baseline, one month, and three months. Participants complete virtual assessments including interviews and self-report measures at baseline, one month, and three months. Some participants using ViraSafe will take part in qualitative exit interviews for feedback. The study collects data on app engagement, technology acceptance, and suicide risk factors using standardized tools. Safety plans remain accessible throughout, and mental health indicators are monitored through self-reports and passive smartphone data. The total participation time is about three months, with ongoing support from clinical providers.

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 interventions 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 mgkg. 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 childrens 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.