Clinical trials

The goal of this clinical trial is to determine whether hydroponic spinach (HS) versus conventional spinach (CS) smoothies produce differential post-consumption effects on salivary nitrate availability and blood pressure in adults. The main questions it aims to answer are: Do hydroponic spinach (HS) and conventional spinach (CS) smoothies produce differential post-consumption salivary nitrate availability responses in adults when consumed in equal volumes? Do hydroponic spinach (HS) and conventional spinach (CS) smoothies produce differential post-consumption blood pressure responses in adults when consumed in equal volumes? Participants will: Consume hydroponic spinach (HS) and conventional spinach (CS) smoothies on two separate study days. Attend two laboratory visits at the university, scheduled within a 1-2 week period. Undergo check-ups and study measurements during each visit (e.g., blood pressure and saliva sampling).

Background. Healthcare professionals can now diagnose the earliest stages of Alzheimer's disease (early-AD) and new drugs are effective at slowing the disease. The National Health Service (NHS) in the United Kingdom has started to develop plans for how to implement these key achievements into clinical practice, so that patients can receive timely diagnosis and treatment. Cognitive assessments measure someone's memory and thinking skills and are required for an early-AD diagnosis. There are concerns that the NHS does not have the workforce to deliver cognitive assessments, and that this will delay early-AD diagnosis and treatment. Memory nurses are the largest staffing group in memory services. I have developed a plan for memory nurses to deliver full cognitive assessments. This would prevent delays to early diagnosis and treatment. Research Aims. This research will use a co-design approach. This involves working with service users and memory nurses to co-develop and evaluate a new cognitive assessment and cognitive training course for nurses. Research Methods. The cognitive assessment and training course will be evaluated using service-user and nurse feedback. 120 older adults with subjective memory complaints will be asked to complete a cognitive assessment, a brain scan, and a blood test. We will use this information to tell us if the cognitive assessment is good enough. Patient and Public Involvement. This proposal was co-developed with older adults and memory nurses. The adapted cognitive assessment and the cognitive training will be co-created with ten older adults and five memory-nurses, who will consult on all stages of the project. Dissemination. The research findings will be published in academic journals and conferences, and an information-sheet will be created for the public. The cognitive training resources will be made freely available. We will use the results of this research to request funding to translate the cognitive assessment into an NHS approved health-technology.

Nitrogen starts to have narcotic properties depths below 30m and can cause symptoms such as euphoria, impaired judgement and impaired neuromuscular coordination. This is an important safety and performance consideration for divers working at depth. 'Dry dive' experiences (also known as 'pot dives') are frequently run by DDRC Healthcare for dive clubs or students who wish to experience nitrogen narcosis and the effects of pressure in a more controlled environment than underwater. The purpose of this study is to investigate the effect of this narcotic effect on oculomotor, vestibular and motor performance by asking participants to perform tasks whilst in the chamber at depth. There will be two groups of participants - those who have had no previous decompression illness or issues with their balance/ inner ear, and divers who have previously sustained an inner ear decompression sickness (IEDCS). It is theorised that divers who have previously sustained an IEDCS injury will struggle more with tasks involving balance and co-ordination under the effect of narcosis. This is because around 60% of divers with IEDCS will have some long-lasting damage to their inner ear and nitrogen narcosis impairs areas of the brain that are being used to compensate for the injury. Therefore, it is possible that inner ear symptoms such as dizziness or disorientation may recur temporarily whilst at depth. Understanding if these divers are at risk will help guide safety advice for returning to diving in the water after an IEDCS injury. If participants decide to take part, they will be asked to complete a medical screening form to ensure that they are safe to undertake a dive in the chamber. They will also be sent some information by DDRC Healthcare including a disclaimer/ consent form which will outline any potential risks or considerations regarding the dive. When participants attend DDRC Healthcare for the planned 'dry' dive they will be shown around the chamber room, and the procedure will be explained. They may ask questions at any point if they have any queries or concerns. The whole session including the dive will take up to 2 hours in total. Prior to entering the chamber, participants will have electrodes attached to areas on their face, head and neck. These will track hand and eye movement and postural stability. Once comfortable, participants will enter the chamber, inside they will be accompanied by a researcher/dive doctor and a chamber attendant. Before the chamber is compressed participants will be asked to perform a series of tasks that the researcher will assist with. The chamber will then be compressed to the equivalent of 40m for a maximum time of 10 minutes, at 40m the series of tasks will be repeated. The chamber will then be slowly decompressed to 6m and then to 3m giving a total time of 36 minutes for the whole dive. For the last 18 minutes participants will breathe oxygen from a mask. Once at surface the series of tasks will be repeat for a third time. Tasks: 1) Recording of eye movements: a. Looking forward with eyes closed b. Following a moving target on a screen c. Looking forward whilst head is moved from left to right by researcher 2) 9-hole peg test (placing pegs into a board and then removing them again) 3) Finger to nose test (pointing to and from a target on a screen and nose) 4) Trial making test (paper and pencil test identifying a sequenced pattern) 5) Postural sway (standing with feet together with eyes open and then closed).

OVERVIEW While antimicrobial mouthwashes are proven to be clinically effective for management of certain oral microbial diseases, recent studies suggest tha, in addition to targeting bacteria responsible for gum diseases such as gingivitis and periodontitis, they may harm healthy bacteria and disturb the balance and protective role of the oral microbiome (dysbiosis). Most findings on the oral microbiome and mouthwashes involve chlorhexidine use, demonstrating that it may induce dysbiosis and compromise the host oral microenvironment . A recent study completed in 2025 has shown that CPC mouthwash can also inhibit nitrate synthesis in the mouth. However there remains a need for further research on other agents used in mouthrinses, such as hydrogen peroxide, essential oils, to determine whether their clinical effectiveness in managing oral disease is accompanied by changes to the oral microbiome. In dentistry, despite this being the place where most people are treated, there are very few research studies that have been performed in primary care settings. Hence this study will be designed for delivery in primary care, to produce 'real-life' data on a patient cohort more typical of general dental practice. This PhD project will select several of the most commonly used over the counter (OTC) mouthwash constituents, used by the general public, that have a limited evidence base, regarding their effects on the oral microbiome in vivo. . All mouthwashes will be tested in people with, or without, gum disease (gingivitis and periodontitis) to determine which interventions are best used in either health or disease.

The goal of this clinical trial is to determine whether sodium bicarbonate fluoride toothpaste can help maintain periodontal health in adults who have undergone non-surgical periodontal treatment. The main question it aims to answer is: Does daily use of toothpaste affect the following outcomes: clinical oral health (plaque scores, gingival bleeding scores and periodontal pocket depths), salivary biochemical markers and the oral microbiome. Outcomes measures will be recorded at 0,3, and 6 months, during which time participants will receive either the treatment or placebo toothpaste and undergo oral hygiene instruction and PMPR over 6 months.

The digestion of carbohydrates begins in the mouth through the salivary enzyme amylase which breaks food starches into maltose and disaccharides. The mouth also has a large community of microorganisms which include bacteria, fungi, viruses and protozoa that can also assist in the digestion of carbohydrates. Mouthwashes containing antibacterial compounds such as chlorhexidine are used to kill oral bacteria, but current evidence indicates that a majority of these bacteria are essential for human health. The aim of this study is to investigate whether chlorhexidine mouthwash can also affect the digestion of carbohydrates. At least 25 individuals will be recruited. Participants will visit the laboratory in two occasions. A saliva and blood sample (fingertip to measure blood glucose) will be taken at baseline. Then, using a randomized, cross-over and double-blind design, the participants will rinse their mouth for two minutes with a placebo or chlorhexidine mouthwash. Then, participants will eat 50 g of white bread and blood glucose will be measured (fingertips) every 30 min for the following 2 hours. Another saliva sample will be collected at the end of each test.

This study explores the potential of transcranial ultrasound stimulation (TUS) as an innovative therapeutic approach for individuals with Alcohol Use Disorder. By targeting specific brain regions associated with compulsive behaviors and reward dysfunction, the researchers aim to assess the safety and efficacy of TUS in reducing symptoms and enhancing cognitive flexibility.

This study consists of two parts: Part One: De-identified Database The goal of this part is to establish a research database containing de-identified data about People with Intellectual Disabilities (PwID) and epilepsy, collected from three NHS sites across England and Wales. Researchers will gather information from participants' medical records, including clinical details, epilepsy history, and medications, and will enter this data into a secure database where all identifying details are removed. This part of the study aims to determine whether it's possible to identify eligible participants, collect complete datasets for each participant, and identify any issues that may affect the quantity and quality of data. These findings will help inform a potential future study that could involve 20 or more sites. Part Two: Research Register The goal of this part is to create a research register of individuals with PwID and epilepsy. Participants will be approached and asked for their consent to collect their personal and clinical data, which will help identify those willing to take part in future ethically approved research projects. As in Part One, researchers will collect data from medical records. Participants who consent to be included in the register may be contacted by external researchers for future studies. The aim is to facilitate national collaboration by enabling data sharing between research projects, thereby improving the ability to answer more questions and enhance patient care. This part of the study will test whether it's possible to determine screening and recruitment rates at each site, develop and evaluate recruitment processes, and assess how researchers leading other approved studies can obtain permission to use the register. Additionally, it will evaluate whether it's possible to collect a complete dataset for each participant.

Inner Ear Decompression sickness (IEDS) accounts for 20% of all types of decompression sickness (the bends) in divers. The condition commonly affects the peripheral vestibular system (inner ear). IEDS results in acute symptoms of dizzyness (vertigo) and imbalance. Even with the recommended treatment of hyperbaric oxygen therapy some people do not recovery fully. However, even in the presence of a permanent vestibular deficit many people can show a behavioural recovery where symptoms improve over time. Recovery can be aided by vestibular rehabilitation (VR) which is now routine for acute IEDS but was not provided before 2021, and is not widespread across the UK (United Kingdom) or world, meaning people may have a suboptimal recovery. This project will investigate if and how people recover after an acute episode of IEDS and whether people who had IEDS in the past show changes in the central (brain) processing of vestibular function and in symptoms of dizziness, balance and posture. This project has two main parts. Part one is a prospective observational study where people with an acute onset of IEDS are serially monitored while they are receiving hyperbaric treatment and VR over 10-14 days. Part two is a retrospective observational study where who have had IEDS in the past 15 years are re-assessed in a one-off session. The tests in both parts involve clinical tests and specialist eye movement recordings that assess vestibular function. We will also determine the site of any vestibular pathology by using selective stimulation of the vestibular end organ or nerve and assess whether there are any changes in how the structure and function of central vestibular pathways in the brain. In people with chronic IEDS with vestibular symptoms we will offer participants a course of VR over 12 weeks and assess whether this is associated with any improvement in symptoms.