Hanover

Researchers are evaluating the usability of the Cogito digital therapeutics development platform. This platform is designed to help researchers create evidence-based behavioral therapies for any health condition and population using a drag-and-drop interface without programming skills. The initial focus of this study is to test Cogito's usability in building a digital therapeutic for substance use disorders (SUDs). Participants will complete an interactive tutorial introducing Cogito and how to create sample guides, activities, and surveys. They will then explore Cogito's functions through a "functionality scavenger hunt" that guides them through creating new guides, activities, and surveys. Finally, participants will complete surveys to provide feedback on their experience using the platform. During the study, participants' feedback on Cogito's usability will be collected immediately after the usability session using the System Usability Scale. The study involves completing tutorials, guided activities, and surveys to assess how well the platform supports building digital therapeutics. This research aims to gather important information to improve Cogito for developing treatments for substance use disorders and other health conditions.

Suicide is a leading cause of death among adolescents, with a significant rise in suicide rates among youth aged 10 to 14 years between 2007 and 2017. Emergency departments often serve as critical points for youth experiencing suicidal thoughts or attempts, but many face psychiatric boarding while waiting for inpatient care due to limited bed availability. This research evaluates the I-CARE digital health intervention, designed to support youth during this vulnerable boarding period by teaching evidence-based psychosocial skills. The I-CARE program is a brief, digital intervention consisting of seven tablet-based animated videos and workbook exercises rooted in cognitive-behavioral and dialectical behavior therapies. It is facilitated by non-mental health professionals, such as licensed nursing assistants, who provide one-on-one safety supervision. Participants are randomized to receive either standard safety supervision alone or I-CARE alongside standard supervision during their boarding period while awaiting psychiatric inpatient transfer. Participants will be assessed at hospital admission, discharge (approximately 72 hours post-admission), and at 30, 60, and 90 days after discharge. Researchers will measure depression, anxiety, stress, and suicide risk using validated scales. The study also monitors safety and recovery progress over time to evaluate the intervention's ability to reduce suicidal thoughts and improve mental health outcomes during and after boarding. The trial includes adolescents aged 12 to 17 presenting with suicide attempt, ideation, or self-harm who are medically stable and English-speaking.

Researchers are studying childhood obesity risk during the preschool years (ages 2 to 5) by examining how children's eating behaviors and parental feeding styles interact. The study focuses on how certain appetitive traits linked to overeating and genetic risk for obesity relate to coercive parental feeding practices, such as strict food restriction and emotional feeding. The goal is to understand how these factors together influence children's weight gain over time. The study follows a group of children starting at age 2.25 to 3 years and assesses them every 6 months until they reach 5 years old. Researchers will measure children's genetic risk for obesity using specific gene markers and use objective methods like eye-tracking to see how much attention children pay to food cues. They also assess children's overeating by observing eating when not hungry. Parental feeding practices are closely examined to explore their impact on children's eating behaviors and weight. Participants will undergo repeated evaluations every 6 months for up to 2.5 years. These include assessments of parental feeding methods, children's appetitive traits, overeating behaviors, and body fat levels. The study aims to monitor how these factors change and relate to each other over time. Findings may help develop strategies for parents to support healthy eating habits in young children, especially considering genetic differences in obesity risk.

Surgical site infections (SSIs) cause increased health problems, longer hospital stays, and higher healthcare costs. This research focuses on controlling infections caused by ESKAPE pathogens, a group of bacteria known for their resistance and ability to cause infections during surgery. The study aims to test how well a detailed preventive program works to reduce the spread of these bacteria and lower infection rates after orthopedic joint and spine surgeries. It also seeks the best way to apply these preventive measures widely across hospitals in the country. The study compares different ways of delivering the preventive strategies during the surgical period, such as one-on-one technical assistance or team-based coaching. These strategies include improving hand hygiene, catheter handling, environmental cleaning, and patient decolonization, all guided by specialized software to detect bacterial transmission. Hospitals participating in the trial adopt these programs, and the effectiveness of each part is evaluated over active and sustainability phases involving thousands of surgical patients. Participants in the study include elective orthopedic total joint and spine surgery patients at selected hospitals. Researchers will monitor bacterial transmission and infection rates using detailed surveillance methods during and after surgery. They will also assess how well the preventive programs are implemented and sustained over time. The overall participation involves thousands of patients, with careful tracking of infection events and outcomes to support safer surgery practices nationally.

Researchers are investigating whether a non-invasive brain stimulation method called transcranial temporal interference stimulation (tTIS) can reduce negative emotions and how care providers' expectations influence these effects. The study aims to find out if active tTIS works better than a sham (inactive) version and whether positive treatment messages enhance the benefits compared to negative ones. This study includes healthy participants and medical trainees to explore these questions using a carefully designed experimental setup. The study consists of two experiments with multiple sessions. In the first experiment, 30 participants undergo four sessions combining active or sham tTIS with positive or negative placebo messaging. Active tTIS delivers two high-frequency signals creating a targeted brain interference for 20 minutes, while sham tTIS mimics this without real stimulation. In the second experiment, 160 participants split into patient and doctor groups experience sessions with sham tTIS only, with patients receiving either a social placebo intervention or none. Doctors are trained to deliver the sham treatment and placebo messaging, interacting closely with patients to influence their expectations. Participants complete negative affect tasks before and after each session while researchers collect brain imaging, physiological data, and behavioral measures. Assessments include cognitive effort, fear, and pain ratings recorded shortly after each stimulus. Physiological monitoring involves heart rate, breathing, skin conductance, and other measurements. All sessions are spaced to reduce order effects, with all testing completed within one month. This thorough approach helps researchers understand the neural and social mechanisms behind treatment expectations and emotional responses.

Researchers are evaluating two different approaches to involving patients, the public, and clinicians in qualitative research. This study compares Consultative PPCI, which uses traditional advisory boards, with Collaborative PPCI, a new participatory approach called PAQ. The trial focuses on three real-world qualitative studies addressing pediatric mental health, cancer screening, and serious illness, aiming to understand how these approaches affect engagement and trust, especially among historically underrepresented groups. Participants will be randomly assigned to either the Consultative or Collaborative PPCI groups within each of the three study topics. Both groups will engage with research teams throughout the research process, including design, data collection, analysis, and sharing results. The trial will be conducted over 18 months, with separate facilitators guiding each PPCI approach to ensure consistent delivery and support. During the trial, participants will take part in research activities using computers or smartphones and contribute to all stages of the qualitative studies. Researchers will measure participant engagement using the Patient Engagement in Research scale (PEIRS-22) after 18 months. The study will also assess partnership trust and patient-centeredness, with data collected from participants across diverse backgrounds to explore how experiences vary by characteristics. The trial includes ongoing monitoring and support to facilitate active involvement throughout the study period.

Researchers are studying how the brain processes thermal pain and how a placebo cream might affect pain perception at different body sites. This study uses functional magnetic resonance imaging (fMRI) with a within-subject crossover design to explore the brain's somatotopic representation of pain and how it changes before and during painful thermal stimulation. The trial aims to better understand pain anticipation, sensation, and aversion, and how placebo treatments influence these processes in the brain. Participants will receive thermal pain stimuli at eight different body sites while undergoing fMRI scans. They will experience both a placebo cream, described as an analgesic, and a control cream, described as having no effect, applied before pain tasks. The study includes two hours of fMRI scanning: the first hour isolates different aspects of pain processing, and the second hour tests how these components respond to the placebo versus control cream during pain delivery. Throughout the study, participants will be assessed for pain unpleasantness and intensity using the Bartoshuk Labeled Magnitude Scale immediately after each pain trial. Researchers will also monitor brain activity patterns related to pain sensation and aversion. Participants must complete screening questionnaires, tolerate scanning procedures, and abstain from alcohol and substances before participation. The study focuses on short-term pain responses during the scanning session.

Researchers are evaluating how transcranial direct current stimulation (tDCS) applied to the left primary motor cortex affects thermal pain perception, pain-related decision making, and placebo effects. This double-blind randomized crossover study involves up to 50 adult participants aged 18 to 55 who complete four sessions: one pain calibration session and three experimental sessions with anodal, cathodal, or sham tDCS. The study explores how these brain stimulation conditions influence pain ratings and social decision-making related to pain and monetary offers. Each participant undergoes one of three tDCS treatments per full session, with the order randomized. The tDCS device delivers 2 mA current for 20 minutes using electrodes placed on specific scalp regions. Before and after stimulation, participants experience pain testing involving heat applied to the forearm, using temperatures individualized during calibration to their pain tolerance. After stimulation, participants complete decision-making tasks and social placebo pain tests inside an MRI scanner, involving choices about accepting pain for money for themselves or others and receiving heat stimulation based on these decisions. Participants start with a pain calibration session to identify their pain and tolerance thresholds using multiple heat trials on the forearm. During full sessions, they complete pain testing before and after tDCS, decision-making tasks with randomized pain and monetary offers, and social placebo response tasks. Researchers measure pain ratings using a visual scale after heat stimuli and monitor participants' responses to social and monetary influences on pain perception. Sessions are spaced at least five days apart, with follow-up evaluations planned up to one month after testing.

Researchers are exploring how feeling in control and the type of environment affect how people experience pain, anxiety, and behavior. The study focuses on how control over pain and threat-related settings changes pain perception, anxiety levels, bodily responses, and task performance. It aims to understand if control over pain, even with the same painful stimulus, can reduce pain feelings, how safe or threatening environments impact brain activity and anxiety, and how people perform and remember tasks under these conditions. This work may help explain how placebo effects involving control, context, emotions, and distraction influence pain and anxiety. Participants will explore three distinct virtual rooms: one safe with no pain, one with controllable pain where they can press a button to reduce pain, and one with uncontrollable pain that cannot be avoided. They will perform a maze-navigation task in each room, requiring them to activate lever sequences to escape. This setup measures pain control, motivation, and behavior under threat. The study includes several sessions: initial consent and familiarization with pain calibration and virtual rooms, a main MRI session with threat learning and controllability testing, followed by sessions testing extinction of learned associations and reversal or generalization of threat conditions. During the study, participants report pain and anxiety ratings frequently while physiological responses like skin conductance, breathing, and heart rate are recorded. Brain activity is monitored using functional MRI as they perform tasks. Memory for visual details of the rooms is also tested. Researchers observe how pain, anxiety, and behavior change with control and context, and how these learned responses adapt or persist when conditions change. The study typically completes within about one month and aims to capture how humans manage pain and threat in complex environments.