Salem

Researchers are evaluating how chemotherapy affects thinking and brain function in older adults with breast cancer. The study aims to identify chemo-brain, which refers to cognitive changes caused by chemotherapy, and to find people most at risk for these effects. It focuses on assessing thinking abilities and brain images before and after chemotherapy treatment. Participants include three groups breast cancer patients receiving chemotherapy, breast cancer patients not receiving chemotherapy, and healthy volunteers. All participants undergo cognitive and functional assessments along with brain imaging using MRI or PET scans at various points before and after treatment or enrollment. During the study, participants complete memory and thinking tests and undergo brain scans before treatment, immediately after chemotherapy, and six months later. Researchers measure changes in cognitive performance and brain markers like amyloid and tau accumulation. The study monitors participants for cognitive effects related to chemotherapy and continues until January 2028.

Researchers are comparing the rates of surgical and minimally invasive interventions, as well as any harms, in Medicare beneficiaries treated with the MILD procedure versus those treated with interspinous process decompression IPD for lumbar spinal stenosis with neurogenic claudication. This observational study uses Medicare claims data to follow patients for 24 months after their initial procedure starting from January 1, 2017. The purpose is to evaluate outcomes between these two types of procedures without requiring prior patient enrollment or consent. The study includes two groups patients who received MILD, which is a percutaneous image-guided lumbar decompression performed under fluoroscopic guidance through a dorsal approach to the spine, and patients who received IPD, a different device-based decompression procedure. Data on reoperations and complications will be collected for both groups over a 24-month follow-up period using Medicare claims. Enrollment continues until the sponsor decides to stop. Participants involvement is passive as the study uses existing Medicare claims data. Researchers will monitor rates of harms related to the initial procedure and subsequent surgical or minimally invasive interventions over two years. No direct patient visits or interventions are conducted, and the study is exempt from institutional review board oversight. The total study duration extends to December 2026, covering cases treated since early 2017.

This research aims to improve outcomes for older patients undergoing colorectal surgery by testing a care transition intervention after hospital discharge. The study focuses on reducing hospital readmissions within 30 days, which often happen due to medication errors, surgical complications, or worsening chronic conditions. It evaluates a combined approach using the OSCAR co-management model and a care transition intervention CTI tailored for older adults. The intervention involves a surgery nurse coach providing support to patients and their families as they transition from hospital to home. The CTI includes in-person visits and phone calls over four weeks, addressing medication management, personal health records, timely follow-up care, and recognizing warning signs of health decline. This hybrid study combines geriatric surgical care with transition coaching to meet the unique needs of older colorectal surgery patients. Participants will have regular interactions with the nurse coach and complete assessments related to readmission or death within 30 days after discharge. The study also measures patient satisfaction, postoperative complications, and implementation factors such as reach, fidelity, and adoption over 12 months. The total participation involves monitoring the transition process and outcomes to assess the feasibility and effectiveness of the OSCAR-S care transition model.

Researchers are evaluating a personalized blood clot prevention plan compared to standard treatment in adults with peripheral artery disease PAD who have had procedures to restore blood flow to their legs. The study aims to find out if the personalized plan can lower blood clots, amputations, repeat procedures, bleeding, and death rates over one year. The study focuses on improving care by tailoring medication based on individual blood test results rather than using a uniform approach. Participants are randomly assigned to either the TARGET personalized plan or standard care after their procedure. The TARGET plan uses a blood test called Thromboelastography with Platelet Mapping TEG-PM to monitor platelet inhibition and adjust antiplatelet medications accordingly. Blood tests occur at 1 week and 1, 3, 6, 9, and 12 months after surgery, with medication changes made if platelet inhibition falls outside a specific therapeutic range. The standard treatment group receives usual care without medication changes based on these tests. During the 12-month study, participants have multiple blood tests and clinical monitoring to assess blood clotting and bleeding events. Researchers measure the occurrence of arterial thrombosis in the treated leg as the main outcome after one year. Secondary outcomes include amputation-free survival, death from any cause, repeat procedures, and bleeding events. The study involves ongoing medication adjustments, safety monitoring, and data collection to understand if the personalized approach offers benefits over standard treatment.

Researchers are evaluating if a new screening method that uses an artificial intelligence AI algorithm to analyze fundus photographs, combined with eye pressure measurement and visual field testing, can improve glaucoma screening. This study focuses on people with diabetes, who have a higher risk of glaucoma, by adding glaucoma screening to existing diabetic eye disease DED screenings. The goal is to detect glaucoma earlier to help prevent or delay vision loss. Participants will be assigned to one of two groups. One group will have fundus photographs analyzed by AI for signs of glaucoma and diabetic retinopathy, plus their intraocular pressure measured using an Icare tonometer. If glaucoma is suspected, they will also undergo virtual reality visual field testing using the Olleyes device. The other group will receive usual care with diabetic eye disease screening only, including AI assessment for diabetic retinopathy without additional glaucoma tests. During the study, participants will have their eye images taken, eye pressure measured, and if needed, visual field tested using a headset. Researchers will track how well glaucoma is detected within one year of the initial screening. They will also evaluate the cost-effectiveness of the combined screening, participant satisfaction, and knowledge about glaucoma. The study is conducted in community health settings and aims to make glaucoma screening more accessible and integrated with routine diabetic eye care.

This research focuses on dementia caregivers who provide in-home care, aiming to reduce their work-related stress and social isolation by creating a virtual reality platform for support. The VR-CARES project engages caregivers through a user-led design process to ensure the technology meets their needs and is accessible. It builds on Rendevers existing VR social engagement platform to enhance caregivers mental health, social connection, and job satisfaction. Participants will first learn and use the basic Rendever VR social engagement platform for about 4 to 8 weeks, engaging with clients and familiarizing themselves with VR activities. Next, they will use the specially developed VR-CARES platform for 8 weeks, which offers a virtual community space for caregivers to connect, share experiences, participate in group activities, and attend weekly support groups led by certified instructors. Caregivers receive training on using the VR systems and the new platform features remotely. Throughout the study, caregivers complete surveys and participate in focus groups at baseline, mid-point 8 weeks, and study end 16 weeks to assess usability, job satisfaction, empowerment, mental health, and social support. The study monitors adherence to the VR-CARES intervention and gathers detailed user experience data. Total participation lasts up to 16 weeks, with ongoing support and feedback guiding platform refinement.