Bishkek

Researchers are studying patients with COPD to evaluate how rehabilitation at moderate altitude affects airway resistance. The study measures airway resistance using the forced oscillation technique (FOT) by comparing parameters before and after a pulmonary rehabilitation cycle. It also examines differences in airway resistance between low altitude and moderate altitude environments. Participants will undergo endurance training while breathing standard ambient air or receiving oxygen via nasal cannula using an oxygen concentrator. The rehabilitation cycle occurs at moderate altitude, with oxygen or sham air provided during exercise to assess effects on airway resistance. During the study, airway resistance and respiratory system resistance (Rrs) will be measured at baseline and after the 3-week rehabilitation cycle. Researchers will monitor changes in lung function and compare results between low and moderate altitude settings. Participants' clinical stability and oxygen levels are also assessed to ensure safety throughout the study.

Central Asia is experiencing the fastest-growing HIV epidemic globally, mainly affecting people who inject drugs and their sexual partners. The trial focuses on expanding opioid agonist therapies (OAT) in Kazakhstan, Kyrgyzstan, and Tajikistan, using the Network for the Improvement of Addiction Treatment (NIATx) strategy guided by the Exploration-Planning-Implementation-Sustainment (EPIS) framework. This approach aims to overcome barriers in healthcare delivery systems and improve prevention and treatment of HIV and opioid use disorder in the region. The study involves training Chief Narcologists and other professionals in OAT delivery through NIATx tools and quality improvement techniques. This includes a 2-3 day training for coaches and ongoing support from a US-based super coach. Participants will identify targets for improving OAT entry and retention using Plan-Do-Study-Act cycles and collaborative learning. The program will adapt to local cultural and healthcare contexts to promote sustainable OAT scale-up. Participants will be assessed through surveys, focus groups, and organizational evaluations involving people who inject drugs and OAT delivery staff. Researchers will measure OAT coverage and retention over 36 months to understand implementation trajectories and program effectiveness. Stakeholder meetings will inform policy changes to support sustainable OAT integration into primary and HIV care settings, aiming to reduce new HIV infections and improve treatment outcomes.

Millions of people who live at low altitudes below 1,000 meters travel every year to high altitudes of 2,500 meters or more for work, tourism, or sports. These travelers face low oxygen levels, which can cause acute mountain sickness (AMS), a common altitude-related illness. This research focuses on understanding how the body adapts to low oxygen and the changes in blood volume that occur during this process, particularly the role of plasma volume changes and the effects of the drug acetazolamide in preventing AMS. The study compares two groups: one receiving acetazolamide and the other a placebo. Participants take 125 mg of acetazolamide twice daily, starting 24 hours before going to an altitude of 3,600 meters. The placebo group takes identical capsules on the same schedule. The goal is to see how acetazolamide impacts plasma volume changes caused by altitude exposure, as this drug may either increase fluid loss or reduce plasma volume contraction by improving oxygen levels. Participants are healthy men and premenopausal women aged 18 to 44 who live at low altitudes. They will be monitored for plasma volume on the first day at 760 meters and then on days two and three at 3,600 meters. Researchers will assess the changes in blood volume as their primary outcome. The study carefully tracks participants' health and responses during the altitude exposure to better understand the effects of acetazolamide and the body's adaptation to high altitude over this short period.

Researchers are conducting a randomized clinical trial to evaluate how acetazolamide affects sleep-disordered breathing in women compared to men traveling to a high altitude of 3600 meters. This study focuses on healthy adults aged 18 to 44 years who have no chronic diseases or regular medication needs and live at low altitudes below 1000 meters. The trial is designed to explore differences in sleep breathing patterns between genders under these conditions. Participants receive either acetazolamide or placebo capsules starting 24 hours before traveling to 3600 meters. The acetazolamide group takes 125 mg in the morning and 125 mg in the evening, while the placebo group receives matching capsules on the same schedule. The study is double-blind and placebo-controlled, ensuring unbiased assessment of the medication's effects. During the study, researchers measure the nocturnal oxygen desaturation index on the first night at both 760 meters and 3600 meters to assess sleep breathing quality. Participants are monitored for changes in breathing patterns and oxygen levels during sleep. The trial lasts through the travel period and measurement nights, focusing on the impact of acetazolamide on sleep-disordered breathing at high altitude.

Researchers are investigating how the phase of the menstrual cycle affects the occurrence of acute mountain sickness (AMS) in women traveling to high altitude. This prospective cohort study focuses on healthy women who are premenopausal and have regular menstrual cycles. The study aims to understand the relationship between menstrual cycle phases and the risk of developing AMS at an altitude of 3600 meters. Participants will travel to and remain for two days at an altitude of 3600 meters. During this time, they will be observed to assess the incidence of AMS in relation to their menstrual cycle phase. The study involves only one intervention, which is the exposure to the high-altitude environment. Women taking part in the study will undergo monitoring for AMS symptoms during the first three days at 3600 meters. The primary outcome measured is the incidence of AMS, evaluated using the Lake Louise Score (LLS) from day one to day three at altitude. Participants will be assessed for health status, menstrual cycle phase, and any symptoms of mountain sickness during their stay.

Researchers are studying how the phase of the menstrual cycle affects sleep-disordered breathing in women when they travel to high altitude. The study focuses on healthy, premenopausal women aged 18 to 44 years who normally live at low altitudes below 1000 meters. This prospective cohort study examines sleep issues related to breathing at an altitude of 3600 meters. Participants will travel to and stay for two nights at 3600 meters altitude. During this time, their sleep will be monitored to assess breathing patterns and nocturnal oxygen saturation. The study involves no additional treatments or interventions beyond the altitude exposure. Throughout the study, researchers will measure oxygen saturation during the first night at both low altitude (760 m) and high altitude (3600 m). Women will be evaluated for changes in sleep-disordered breathing related to their menstrual cycle phase. Participation involves staying at the high altitude location for two nights and undergoing oxygen saturation monitoring during sleep.

Researchers are conducting a randomized clinical trial to study how acetazolamide affects pulmonary artery pressure in healthy men and women traveling to high altitude (3600 meters). The study focuses on comparing the effects between women and men aged 18 to 44 years who live at low altitudes and have no significant health issues. The trial is designed to be double-blind and placebo-controlled to ensure reliable results. Participants receive either acetazolamide or a placebo starting 24 hours before traveling to 3600 meters. The acetazolamide dose is 125 mg taken twice daily, once in the morning and once in the evening. Those in the placebo group take identical-looking capsules on the same schedule. The study measures pulmonary artery pressure at specific times during the high-altitude stay, including day 2 at both 760 meters and 3600 meters. During the study, participants are monitored for pulmonary artery pressure changes and overall health status. Researchers collect relevant data to evaluate the drug's effects compared to placebo. The trial lasts through the altitude exposure and includes careful observation to ensure participant safety. All participants must meet specific health and lifestyle criteria to join, and the study aims to provide insights about managing altitude-related changes in pulmonary pressure.

Researchers are studying barriers to expanding Opioid Agonist Therapy (OAT) within justice systems, specifically prisons and probation sites in Tajikistan, Kyrgyzstan, Moldova, and Georgia. The goal is to improve access to OAT for people who inject drugs (PWID) and reduce HIV transmission. This project uses a collaborative learning model called NIATx to support OAT scale-up, with data analyzed using specialized growth analyses. The study involves creating NIATx learning collaboratives with prison OAT providers, including addiction care specialists and primary care doctors, and with probation and prison officers across the four countries. Data on OAT scale-up is collected from national databases every six months, along with surveys of prison narcologists and probation officers. Researchers also use ethnographic methods like observation and interviews with probation clients and staff to understand challenges and opportunities. Participants in this research complete surveys and may take part in focus groups. The study collects data over several years, measuring how many participants receive OAT during this time. Surveys are repeated every six months to track progress. The study also monitors implementation and gathers qualitative insights from staff and clients to support ongoing improvement of OAT programs within justice settings.

Researchers are studying how individual and societal factors affect health outcomes such as death and the development of chronic diseases across different socioeconomic and healthcare settings. This research also explores genetic influences on non-communicable diseases through both a cross-sectional and a long-term follow-up approach. The study focuses on understanding the impact of the built environment, food and nutrition policies, psychosocial and socioeconomic factors, tobacco use, and the quality of health systems. The study does not involve specific interventions but observes health-related behaviors including diet, physical activity, smoking, and alcohol use. It monitors how societal influences relate to risk factors and the occurrence of chronic diseases like cardiovascular disease and cancer. Genetic factors for non-communicable diseases are also investigated as part of this comprehensive analysis. Participants aged 35 to 70 are followed over an average of 10 years to assess the development of cardiovascular disease and other health outcomes. Researchers collect data on societal determinants, risk factors, and health behaviors, as well as genetic information. The study aims to understand how these elements relate to disease incidence and mortality, considering different health resource settings worldwide.

Researchers are evaluating the effectiveness and safety of embolizing the middle meningeal artery (MMA) using non-adhesive materials SQUID 12 and SQUID 18 to treat patients with chronic resistant migraine. This early phase 1 study focuses on individuals aged 35 to 59 years who have had chronic migraine for at least 12 months, with migraines resistant to both drug and non-drug treatments. The study follows guidelines from the Ministry of Health of the Russian Federation and the European Headache Federation for diagnosis and resistance. Participants will undergo total endovascular embolization of the frontal and parietal branches, and sometimes the occipital branch, of the middle meningeal artery to fully stop blood flow in that area. If migraine pain is on one side, only the same side's artery will be treated; if pain is on both sides, both arteries will be embolized. The treatment uses liquid embolic agents SQUID 12 and SQUID 18 during the procedure. During the study, participants' migraine days will be tracked from the 4 weeks before enrollment through 12 weeks after the embolization. Researchers will monitor the number of migraine days and assess treatment safety. Participants will complete headache diaries to record headache frequency and intensity, and safety will be closely observed throughout the 3-month post-procedure period.