Clinical trials

The goal of this clinical trial is to evaluate the effectiveness of a short-term, group-based Brief Behavioral Therapy for Insomnia (BBTI) intervention in chronic psychiatric patients at a hospital day ward.The main questions it aims to answer are: 1. Does the BBTI-based group intervention improve subjective sleep quality and reduce the severity of insomnia? 2. Does the intervention have a positive effect on psychological well-being and cardiometabolic/physical functions? Researchers will compare an experimental group to a waitlist control group to see if the intervention improves sleep quality, reduces insomnia-perpetuating behaviors, and enhances overall health status across various timeframes. Participants will: 1. Attend four sessions that cover sleep structure education, relaxation techniques (including acupressure), sleep-promoting diet principles, and the proper use of sedative-hypnotic medications. 2. Write a daily sleep diary. 3. Complete three times of structured self-report questionnaires. 4. Undergo physiological and physical function assessments.

Upper limb hemiparesis is the most common sequelae in patients, severely impacting their independence and quality of life. Transcranial electrical stimulation (tCES) is a non-invasive and safe treatment, which uses a low direct current or alternating current to change the excitability of the cerebral cortex. It can induces long-term potentiation-like or long-term depression-like effects, thereby modulating the cortical excitability. In recent years, researchers have developed high-definition (HD) devices, which integrate high definition ring electrode configurations and incorporate direct current with theta burst stimulation waveforms. Diverging from traditional transcranial direct current stimulation (tDCS), which applies weak currents (0.5-2 mA) through two large sponge electrodes (25\~35 cm\^2) externally to the scalp for widespread non-specific cortical stimulation, HD-tES employs an array of small-area electrodes (1 cm\^2) to control current distribution over localized cortical regions, thereby enhancing spatial accuracy. However, there is a lack of studies validating the optimal waveform for HD-tES, as well as clinical evidence in subacute stroke populations. The optimal unilateral versus bilateral stimulation modes and their neurological mechanisms for stroke rehabilitation also remain uncertain.

End-stage renal disease patients needs a functional vascular access to receive hemodialysis and prolong their lives. Arteriovenous fistula (AVF) is priority consideration for hemodialysis, which is a connecting a superficial vein to a nearby artery and allowing this vein to enlarge and increase in internal diameter under arterial circulation. Unfortunately, 30-50% of fistulae fail to mature. Vascular calcification and stenosis were considered for early failure. The perivascular fat of artery can be predicted successful AVF maturation. However, Few previous studies have compared AVF maturation between perivascular the fat of cephalic vein or removal during the AVF surgery. This study evaluated whether the effect of AVF inflammation and preexisting vascular fibrosis is associated to perivascular the fat of cephalic vein. Investigators will also verify inflammation by analysis of blood and tissue samples, the association of pre-existing fibrosis, and the clinical correlation with AVF early failure. This study will enroll patients with chronic kidney disease stage 5 and stage 6 who will need maintenance-hemodialysis (HD) from Nov 2021 to Dec 2022. Investigators will use the preoperative ultrasound assessment tool to confirm the feasibility of the arm vessels for the creation of a native AVF. As a prospective randomized controlled trial of perivascular fat preservation or removal during the AVF surgery, a study assistant will help the randomization and explain the informed consent to the patient . The subjects are randomly split into two groups: the experimental group will have the perivascular fat of the target cephalic vein preserved the control group will have the fat removed before the AVF anastomosis. The survey will enroll 100 adult patients and categorize them into groups according to each AVF maturation, JAS, or FTM (see definition below) by 3 - 12 after the surgery.

This pilot randomized controlled trial evaluates the effectiveness of combining social robot-assisted intervention with physical board games to improve socio-emotional skills in children with Autism Spectrum Disorder (ASD). Children with ASD often face challenges in emotion recognition, emotional regulation, and social interaction. This study aims to investigate whether integrating an interactive social robot (Kebbi) into board game activities can enhance children's social engagement, emotional comprehension, and cooperative behaviors compared to conventional occupational therapy. Participants will be randomly assigned to either the robot-assisted board game group or the conventional occupational therapy group.

Despite decades of research, no definitive, effective biological treatments exist for core symptoms of Autism Spectrum Disorder (ASD). Emerging evidence suggests that conventional Transcranial Magnetic Stimulation (TMS) targeting the dorsolateral prefrontal cortex or posterior superior temporal sulcus may reduce repetitive behaviors, but its efficacy on social communication remains inconsistent. Deep Transcranial Magnetic Stimulation (dTMS) allows for the stimulation of deeper brain structures. Deep social brain networks, such as the medial prefrontal cortex (mPFC), play a critical role in social cognition and mentalizing processes. Targeting the mPFC with dTMS holds potential for improving core impairments in social cognition among individuals with ASD. This pilot study aims to evaluate the efficacy of dTMS on social cognition, mPFC-related functional connectivity, and clinical symptoms (autism severity, stereotyped behaviors, sensory symptoms, and emotion regulation).

The goal of this observational study is to compare two localization methods used before surgical stabilization of rib fractures (SSRF): mixed reality (MR) and ultrasound-guided. Main Research Question Before SSRF, does MR help surgeons mark rib fracture locations more accurately (in centimeters) and faster than ultrasound-guided? Participants After the study ends, all participants will keep follow-up at the thoracic surgery clinic. The team will record wound healing and pain scores for use in the observational study.

This study aims to examine how the six Accreditation Council for Graduate Medical Education (ACGME) core competencies and AI literacy are reflected in medical students' self-assessment narratives following small-group discussions. A mixed-methods design will be used to analyze approximately 500 de-identified self-assessment reflection reports submitted by fourth-year medical students who completed an integrated pathology and pharmacology small-group discussion course at National Taiwan University during the 2023-2026 academic years.

This study will examine whether a reablement approach can help people receiving community-based long-term care maintain or improve their independence, daily functioning, and quality of life. Approximately 300 adults from eight long-term care facilities across Taiwan will participate. The 12-week reablement program includes group and individualized activities designed to support mobility, cognitive function, daily activities, and social participation. Participants' physical and cognitive function, daily living abilities, emotional well-being, quality of life, and personal goals will be assessed before and after the program. The study will also include observations and interviews with care providers, participants, and family members to understand their experiences with the program and identify factors that support successful implementation. The findings are expected to help develop a practical reablement model for community-based long-term care in Taiwan and provide guidance for improving care quality, independence, and healthy aging.

Perinatal anxiety and depression are common mental health concerns that may negatively affect maternal well-being, infant development, and family functioning. Mindfulness-based interventions have shown beneficial effects on reducing psychological distress during pregnancy; however, maintaining attention and engagement during mindfulness practice may be challenging for some pregnant women. This randomized controlled trial aims to evaluate the feasibility and effectiveness of an integrated virtual forest environment and mindfulness-based intervention for improving mental health in perinatal women. Pregnant women between 20 and 24 weeks of gestation will be randomly assigned to either an experimental group receiving virtual reality (VR)-based forest mindfulness intervention or a control group receiving conventional mindfulness intervention. Both groups will participate in a 9-week mindfulness program and receive app-based mindfulness practice. The experimental group will additionally receive immersive VR forest-based mindfulness sessions during prenatal visits. Outcomes including anxiety, depression, mindfulness awareness, physiological indicators, and intervention acceptability will be assessed during pregnancy and postpartum follow-up.

Post-cardiac arrest mortality remains high and proper care after cardiopulmonary resuscitation is an important clinical challenge. This prospective observational cohort aims to (1) identify the factors that affect short-term and long-term survival in post-cardiac arrest survivors and (2) investigate the patients and their families' health-related quality of life and psychological well-being.

This study will examine whether visiting the National Taiwan Museum can support the social and emotional well-being of autistic adults. The research team plans to recruit 90 autistic adults aged 18 to 50 from the Department of Psychiatry at National Taiwan University Hospital. Participants must have average-range intellectual ability and be able and willing to complete the study activities and assessments. People with serious physical or mental health conditions that would prevent full participation will not be included. Participants must also agree to audio and video recording during the activities. After an outpatient doctor confirms eligibility, participants will complete questionnaires and choose one of three museum participation options: 1. Visit the museum once independently. 2. Join five guided museum visits with group discussions. 3. Invite a friend to visit the museum together. Each group will include about 30 participants. For the guided group, each session will last about 90 minutes and include a professional museum tour, a question-and-answer period, time for independent exploration, and a group discussion. Participants will be encouraged to select exhibits that interest them, record their observations, share their thoughts, listen to others, and respond to different viewpoints. The five planned museum themes include Taiwan's history and identity, relationships between people and nature, architecture and living spaces, human evolution and the future, and attitudes toward money and financial planning. The discussions will explore everyday topics such as stereotypes, personal values, preferred living environments, hopes for the future, and managing money. Participants will complete questionnaires before and after the program. These questionnaires will assess areas such as autistic characteristics, social communication, empathy, sensory experiences, comfort with social touch, emotional skills, loneliness, anxiety, depression, and anxiety during social interaction. Participants will also rate how enjoyable, comfortable, safe, interesting, and socially engaging they found the museum activities. The researchers will compare participants' results before and after the program. They will also compare the three participation options to determine whether independent visits, guided group activities, or visiting with a friend produce different outcomes. The overall goal is to understand whether museum-based activities can be used as a form of social prescribing to improve social participation, emotional well-being, confidence, and quality of life among autistic adults.

Enhanced Recovery After Surgery (ERAS) is a multidisciplinary perioperative care program designed to reduce surgical stress, accelerate postoperative recovery, and improve clinical outcomes. This prospective, non-randomized study aims to evaluate the effectiveness of an ERAS program in patients undergoing gynecologic surgery at National Taiwan University Hospital Hsin-Chu Branch. Patients who choose to participate in the ERAS program will receive perioperative care according to the institutional ERAS protocol, while those who choose conventional perioperative care will serve as the comparison group. Perioperative outcomes, postoperative recovery, postoperative complications, pain scores, and other clinical outcomes will be compared between the two groups to evaluate the clinical impact of implementing an ERAS program.

This exploratory study investigates whether perceptual learning using blurred Gabor stimuli can improve uncorrected distance visual acuity in children aged 6-10 years with low myopia. Participants will be randomly assigned to a training group or control group. The training group will undergo individualized visual perceptual learning through a digital Vision Training System (VTS) for approximately 3 months. The study will also evaluate changes in refraction, contrast sensitivity, visual crowding, Chinese reading acuity with eye movements, and sweep visual evoked potentials (sVEPs).

Restorative visual rehabilitation is frequently used to enhance the visual development and function of children with low vision. An important strategy within this field is visual stimulation, which is particularly used for infants and toddlers with low vision, as well as for children who have both developmental disabilities and low vision.This study has two primary objectives.The first objective is to examine the effect of using intensive, specific, and flickering black-and-white checkerboard patterns to enhance visual function in children with mild to moderate low vision. The second objective is to develop a visual stimulation program tailored for children with severe or profound multiple disabilities and visual impairments, and to evaluate its effectiveness. For both objectives, the visual stimulation intervention will be provided through either in-person or remote delivery

This study aims to evaluate a visual interactive LINE chatbot designed to support self-management of treatment-related side effects among patients with advanced lung cancer receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. Patients receiving EGFR-TKI treatment often experience long-term side effects that require ongoing self-management. In this randomized controlled trial, participants will be assigned to receive either usual care alone or usual care plus access to the LINE chatbot intervention, which provides visualized and interactive educational content for symptom monitoring and self-care. The primary outcome of this study is self-management ability related to EGFR-TKI-associated side effects. Secondary outcomes include quality of life during treatment and overall satisfaction with the LINE chatbot intervention.

Pediatric emergency department (ED) visits often cause significant anxiety and stress for young patients due to unfamiliar environments and invasive medical procedures. Non-pharmacological interventions, such as distraction, are vital for reducing pediatric anxiety and improving procedural outcomes. This study evaluates the effectiveness of a non-wearable, immersive audiovisual distraction system (LG StanbyME display) in alleviating pediatric anxiety during emergency department care, compared to standard care. The main questions it aims to answer are: Does non-wearable audiovisual distraction reduce anxiety levels in pediatric emergency patients compared to standard care? Does the intervention improve physiological indicators of distress, such as Heart Rate Variability (HRV)? Participants will: Be randomly assigned to either the non-wearable audiovisual distraction group or the routine care group. Undergo continuous physiological monitoring (HRV) and clinical anxiety assessment (mYPAS-SF) during their ED visit.

The proposed project will combine functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to identify neurobiological mechanisms underlying how repetitive transcranial magnetic stimulation (rTMS) applied to the primary motor cortex modulates maladaptive neuroplasticity following neuropathic pain.

Osimertinib is a standard first-line treatment for patients with metastatic non-small cell lung cancer harboring an epidermal growth factor receptor exon 19 deletion or exon 21 L858R mutation. Although osimertinib can provide effective disease control, most patients eventually experience disease progression, and the primary lung tumor may remain an important site of treatment resistance. This multicenter, randomized, open-label phase III trial will evaluate whether surgical removal of the primary lung tumor, in addition to continued osimertinib treatment, prolongs progression-free survival in patients with EGFR-mutated oligometastatic non-small cell lung cancer. All participants will initially receive osimertinib 80 mg orally once daily for 12 weeks. Participants who have a partial response or stable disease according to RECIST version 1.1 and remain suitable for surgery will be randomly assigned in a 1:1 ratio to continue osimertinib alone or to undergo primary lung tumor resection followed by resumption of osimertinib. The study will also evaluate overall survival, safety, pathologic response, quality of life, patterns of disease progression, and changes in molecular biomarkers.

This prospective clinical study aims to establish normative values of knee ligament stiffness across different ethnic populations using shear wave elastography (SWE) and to investigate biomechanical alterations associated with knee osteoarthritis (OA). Healthy adults and patients with symptomatic knee OA will undergo standardized SWE examinations of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL), together with clinical assessments. For patients who subsequently receive clinically indicated ultrasound-guided injection therapy, follow-up SWE and clinical evaluations will be performed to investigate changes in ligament stiffness after treatment.

This randomized controlled superiority study will be conducted during 2023-2025. The eligible participants are adult people living with HIV (PLWH) who are newly diagnosed with early syphilis. Participants will be randomized in a 1:1 ratio to receive single-dose benzathine penicillin G (BPG) (2.4 MU intramuscularly once) plus doxycycline (100 mg orally twice daily for 7 days) or single-dose BPG. The primary outcome is serologic response, defined as a decline of rapid plasma reagin (RPR) titer by 4-fold or greater, at week 24 and week 48; and the secondary outcomes include microbiologic response of syphilis and bacterial sexually transmitted infections (STIs) assessed by nucleic-acid amplification test (NAAT) at week 4.

The goal of this observational study (modified Delphi consensus study) is to establish an international expert consensus on professional standards for medical visualization in medical visualization experts from from around the world, each with a minimum of five years of relevant professional experience. The specific objectives are: 1. to develop and validate core consensus statements on professional standards for medical visualization (consensus threshold ≥75%). 2. to quantify the distribution of divergence in professional opinion. Participants will: Fill out a short background survey about their job title, training, work setting, location, and experience with AI image tools. Rate 10 statements about medical visualization standards on a scale from 1 (Strongly Disagree) to 5 (Strongly Agree). These statements cover three topics: accuracy, accessibility, and ethics. Participants will complete up to 3 rounds of anonymous online surveys. Write comments to explain why they disagree with any statement they rate 1 or 2. Between rounds, review a summary showing their own earlier ratings and the group's overall results (with no names attached). Then, re-rate any statements the group has not yet agreed on.

To evaluate the effectiveness of the E-MOTE Emotional Care Program, delivered through the Kebbi robot and the LINE Official Account, for patients newly diagnosed with gynecologic cancer undergoing surgery. The primary outcomes are psychological distress , and the secondary outcomes are physical symptoms, stress index, and quality of life.

The goal of this clinical trial is to investigate the safety and efficacy of applying low-intensity focused ultrasound targeting the nucleus accumbens in individuals with opioid or amphetamine use disorders. The main questions it aims to answer is: \- Low-intensity focused ultrasound targeting the nucleus accumbens demonstrates sufficient safety and predictable therapeutic efficacy in individuals with opioid or amphetamine use disorders. Participants will: * Received Low-intensity focused ultrasound neuromodulation once * Visit the clinic for checkups and asessment at 1 week, 1 month, 3 months, 6 months, 9 months, 1 year, 1.5 years, and 2 years after received Low-intensity focused ultrasound neuromodulation.

Lung cancer ranks as the leading cause of cancer-related deaths globally and is among the most common malignancies. In recent years, the advancements in immune checkpoint inhibitors have marked a significant breakthrough in the immunotherapy of lung cancer. However, immunotherapy is a relatively new treatment modality, and ongoing clinical trials continue to explore its efficacy. Due to a lack of knowledge about immunotherapy-related care, patients often experience uncertainty and anxiety regarding its effectiveness, resulting in associated care needs. A total of 160 lung cancer patients were included in the study. The research findings revealed statistically significant correlations (p \< 0.05) between the severity of disease, symptomatology, overall health status, functional capacity, cognitive function, disease progression, mood, and general supportive care needs, as well as specific needs of lung cancer patients. Regarding factors influencing care needs, it was found that general supportive care needs were significantly influenced by marital status, average personal monthly income, and disease progression. Additionally, age, surgical history, functional capacity, and cognitive function significantly influenced specific care needs. Based on these statistical findings, it is crucial for nursing staff to closely monitor changes in patients' symptoms and mood and provide timely care and support. Furthermore, future interventions should focus on addressing the heightened needs of lung cancer patients, thereby reducing their dissatisfaction along the cancer treatment journey.

"Social brain" refers to brain regions dedicated to processing social information and enabling us to recognize and evaluate others' mental states. The social brain hypothesis suggests that our brains evolve to navigate complex social systems. The social brain is hypothesized to consist of a distributed network including the posterior superior temporal sulcus (pSTS), the dorsal and ventral medial prefrontal cortices (dmPFC and vmPFC), ACC and posterior cingulate cortex (PCC), the amygdala, the orbital frontal cortex (OFC), and the fusiform gyrus (FG), TPJ, inferior occipital gyrus (IOG), and the insula. Each region serves distinct role while works together to support social processing, including perceiving, interpreting, and generating responses to the intentions, dispositions, and behaviors of others.