Bishkek

Researchers are studying the effect of rehabilitation at moderate altitude on airway resistance in patients with COPD. They will use the forced oscillation technique FOT to measure airway resistance parameters Rrs, Xrs, and 94Xrs. The study compares these parameters before and after a pulmonary rehabilitation cycle and also examines differences between low and moderate altitudes. Participants will be randomly assigned to one of three groups one receiving sham air ambient air via an oxygen concentrator, another receiving standardized supplemental oxygen therapy SSOT during training, and a third group training at moderate altitude. Oxygen or sham air will be delivered at 5 liters per minute through a nasal cannula using the EverFlo14 oxygen concentrator during endurance training sessions. During the study, participants will undergo pulmonary rehabilitation over a three-week cycle with measurements taken before and after this period. Assessments include changes in respiratory system resistance and reactance, as well as comparisons of these parameters at low and moderate altitudes. Researchers will monitor the participants clinical stability and oxygen saturation, ensuring adherence to study procedures. The total study duration includes baseline assessment, three weeks of rehabilitation, and follow-up measurements.

Central Asia is experiencing the fastest growing HIV epidemic globally, mainly affecting people who inject drugs PWID and their sexual partners. This research focuses on expanding opioid agonist therapies OAT in Kazakhstan, Kyrgyzstan, and Tajikistan, as scaling up OAT combined with antiretroviral therapy ART is considered the most cost-effective way to prevent new HIV infections. The study uses the NIATx implementation strategy guided by the Exploration-Planning-Implementation-Sustainment EPIS framework to understand and improve OAT delivery in this challenging healthcare context. The study involves training and coaching national experts and Chief Narcologists in these countries using NIATx tools and quality improvement techniques. This includes initial training sessions, ongoing coaching, and collaborative learning to overcome barriers and improve OAT entry and retention. The researchers will also conduct formative research to assess facilitators and barriers at client, program, and structural levels, aiming to create sustainable and locally adapted OAT models integrated with primary and HIV care. Participants include PWID meeting opioid dependence criteria, OAT delivery staff, and Chief Narcologists involved in OAT programs. Assessments include surveys, organizational evaluations, and focus groups, with ongoing monitoring of OAT census, new patient numbers, and dropout rates over 36 months. Stakeholder meetings will help guide implementation and policy changes to support sustainability. The total study duration includes long-term follow-up to assess implementation trajectories and outcomes.

Millions of people who normally live at low altitudes travel to high altitudes for work, tourism, or sports, exposing themselves to low oxygen levels that can cause acute mountain sickness AMS, a common altitude-related illness. This study focuses on understanding how the body adjusts to low oxygen by examining changes in blood plasma volume and how acetazolamide, a drug used to prevent AMS, affects these changes during rapid ascent to high altitude. Participants will receive either acetazolamide capsules 250 mg per day, split into two doses or placebo capsules that look identical. The medication begins 24 hours before ascending to 3600 meters and continues until the morning after spending two nights at that altitude. The study compares plasma volume changes in people taking acetazolamide versus placebo during this acute high-altitude exposure. During the study, plasma volume will be measured on the first day at low altitude 760 m and on the second and third days at high altitude 3600 m. Researchers will also assess differences related to sex, AMS symptoms, hormone levels, and arterial blood gases. The trial includes healthy men and women aged 18 to 44 years who live at low altitude, with monitoring before, during, and after the high-altitude exposure to understand physiological responses and treatment effects.

Researchers are evaluating a family-based prevention program designed to reduce the risk of child maltreatment and other adverse childhood experiences among families in Kyrgyzstan. This study aims to see if the integrated program improves childrens self-regulation, behavior, and school adaptation while also assessing whether the program is feasible and acceptable for families and schools. The research compares this program with enhanced standard school services to understand its effects on child and family outcomes. The intervention combines three evidence-based approaches strengthening families, improving co-parenting and father involvement, and economic empowerment. Delivered through 16 weekly group sessions in schools, the program includes skill-building exercises, discussions, role-plays, and workshops on financial literacy and asset-building. Trained school social workers lead the sessions to maintain program quality. Families assigned to the comparison group receive usual school services along with minimal material support like school supplies but no structured family or economic sessions. Participants will be randomly assigned to either the prevention program or standard school services. They will complete surveys at the start, after the 16-week program, and at the end of the school year, providing information on child behavior, parenting, family relationships, and financial well-being. The study measures outcomes using parent, youth, and teacher reports of child strengths and difficulties for up to 1.5 years after baseline. Results will guide future larger trials, with total participation lasting through the school year following the intervention.

Researchers are investigating how to increase the use of Opioid Agonist Therapy OAT in justice systems such as prisons and probation in Tajikistan, Kyrgyzstan, Moldova, and Georgia. The study aims to identify barriers to expanding OAT, which is used to help prevent HIV in people who inject drugs PWID. This project includes establishing a NIATx learning collaborative to support the scale-up of OAT and analyzing its growth using advanced data methods. The study involves two main parts Aim 1 focuses on creating NIATx learning collaboratives with prison OAT providers, including addiction specialists and primary care doctors. Data on OAT scale-up will be collected every six months from each countrys national OAT database, alongside surveys completed by prison narcologists. Aim 2 develops similar collaboratives with probation and prison officers, collecting data from national databases and surveying probation officers every six months. Researchers will also use observation and interviews for deeper understanding. Participants include prison OAT providers, probation officers, and people currently in probation who inject opioids. Data collection includes surveys, focus groups, and ethnographic observations over up to four years. The primary outcome is the number of participants receiving OAT, while secondary outcomes assess adherence to the NIATx protocol. The study is non-randomized and open-label, running from late 2024 through 2028 to evaluate how best to expand OAT services in these justice settings.

Researchers are studying how individual health behaviors and broader societal factors like environment, policies, and health system quality affect health outcomes such as death and the development of chronic diseases. This study also explores genetic influences on non-communicable diseases through both a cross-sectional and a prospective cohort approach. It aims to understand these relationships across different socioeconomic and health resource settings worldwide. Participants are adults aged 35 to 70 years at enrollment. The study involves observing various health-related behaviors, societal determinants including built environment, food and nutrition policies, psychosocial and socioeconomic factors, and tobacco use. Researchers will track the incidence of chronic diseases like cardiovascular disease, cancer, respiratory conditions, diabetes, kidney disease, obesity, hypertension, and injuries over time, without administering any specific treatments. Participants will be followed for an average of 10 years, during which researchers will monitor health events such as new cases of cardiovascular disease and other illnesses, hospitalizations, and mortality. Data will be collected on genetic factors and changes in risk factors like smoking and diet. The study measures the impact of health systems and environmental influences on outcomes. Participants will be involved through regular assessments but will not receive interventions as this is an observational study.

Researchers are evaluating the effectiveness and safety of embolizing the middle meningeal artery MMA using non-adhesive materials SQUID 12 and SQUID 18 in patients with chronic resistant migraine. This early phase study focuses on patients aged 35 to 59 who have had chronic migraines for at least a year and have not responded to other treatments. The goal is to see if this embolization procedure can reduce the number and severity of migraine days. The study involves a total endovascular embolization of specific branches of the middle meningeal artery depending on the location of migraine pain. If the migraine is on one side, the corresponding artery branch will be embolized if on both sides, both branches will be treated. The procedure aims to fully block blood flow in these branches using SQUID 12 and SQUID 18 materials. Participants will be monitored for up to 12 months after the embolization procedure. Researchers will track the number of migraine days, headache days, headache intensity, and associated symptoms like nausea or sensitivity to light and sound. Various scales including HIT-6 and MIDAS will assess the impact on daily life. Safety will also be closely observed through regular visits and assessments throughout the study period.