Clinical trials

39

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Condition / disease
Location
Status: Not yet recruiting

Self-administered Neurostimulation Intervention for Firefighter Traumatic Stress to Reduce Alcohol Use: Pilot Study

The goal of this clinical trial is to evaluate the feasibility, acceptability, and appropriateness of a transcutaneous auricular neurostimulation (tAN) protocol in firefighters who engage in heavy drinking, have at least a mild alcohol use disorder, and report above-average posttraumatic stress symptoms (PTS). The main questions it aims to answer are: * How feasible do firefighter participants rate the study procedures on the Feasibility of Intervention Measure? * How do firefighter participants rate the acceptability of the study procedures (Acceptability of Intervention Measure) and the appropriateness of the tAN device (Intervention Appropriateness Measure)? Researchers will compare an active tAN condition (receiving therapeutic stimulation from the Sparrow device) to an active sham condition (receiving stimulation below a therapeutic level) to see if the intervention reduces PTS symptom severity and heavy drinking events, and to evaluate the clinical effects on insomnia, mental health symptoms, and quality of life. Participants will: * Use the Sparrow device for at least 1 hour/day for 5 days/week throughout a 4-week treatment phase. * Complete daily measures of traumatic event exposure, PTS symptom severity, alcohol use, and trauma-related drinking motivations. * Complete audio journals capturing their experience with symptoms and the device. * Wear sensors to record heart rate, heart rate variability, and sleep data throughout the intervention phase. Complete assessments immediately following treatment (Week 4) and one month later (Week 8).

Participants needed: 20
Trial details
Age: 18-64Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Oct 9, 2026
Eligibility criteria

Active-duty firefighter aged 18 to 64 years old. [+3]

Currently engaged in evidence-based PTSD psychotherapy or AUD-focused counseling... [+8]

Status: Not yet recruiting

Promoting Adherence to Chemotherapy Handling Guidelines Among Oncology Nurses

Chemotherapy exposure is a serious occupational hazard affecting oncology nurses. Oncology nurses' adherence to chemotherapy handling guidelines is essential to prevent their exposure to chemotherapy. The goal of this research is to develop, validate, and pilot test an intervention "Workplace program to Improve Safe Handling of hazardous drugs" (WISH), to promote adherence to chemotherapy handling guidelines among oncology nurses. The WISH intervention includes two components: an educational component and debriefing sessions on chemotherapy exposure incidents. First, the research team will use a mixed-methods approach to develop an online educational component on chemotherapy safety, establish the content validity of the educational content based on experts' evaluation, and establish the face validity of the educational content by conducting three qualitative focus group with oncology nurses (n=4-6 nurses per group) or individual interviews. Next, the research team will test the feasibility and acceptability of the intervention using a pilot randomized controlled trial with two groups of oncology nurses, an intervention group (n= 30) and a control group (n=30). We will obtain quantitative and qualitative measures of the intervention feasibility and acceptability. The output is an intervention program targeted to train nurses on safe chemotherapy handling guidelines. Findings will be disseminated through peer-reviewed publications and presentations. The intermediate outcome is the adoption of the intervention program by healthcare institutions to train nurses on chemotherapy handling guidelines. The end outcome is promoting adherence to chemotherapy handling guidelines among oncology nurses.

Participants needed: 60
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Sep 3, 2026Locations: 1
Eligibility criteria

being at least 18 years old [+3]

None

Status: Recruiting

K01 Impacts of Lingual Endurance Exercise

The goal of this clinical trial is to learn whether a tongue endurance exercise program can improve swallowing function in adults with dysphagia after a stroke. It also aims to explore how this exercise may affect brain structure and connectivity involved in swallowing. The main questions it aims to answer are: Primary Aim: Does lingual endurance exercise improve swallowing function compared to a sham therapy? Secondary Aim: Does lingual endurance exercise lead to changes in brain structure or neuroplasticity, as measured by MRI? Researchers will compare a group receiving tongue endurance exercises to a sham therapy group to see whether the treatment improves tongue function, swallowing. Participants will: * Complete a baseline swallowing assessment and MRI * Be randomly assigned to either the lingual exercise or sham therapy group * Complete 8 weeks of home-based tongue exercise therapy * Return for follow-up swallowing assessments * A subgroup of participants will complete a pre-treatment and post-treatment MRI.

Participants needed: 70
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Sep 4, 2026Locations: 1
Eligibility criteria

1) 3-6 months since most recent diagnosis of ischemic, confirmed from clinical i... [+1]

1) ≤18 years of age [+2]

Status: Recruiting

Post-Stroke Sensory Reweighting on Walking and Balance Outcomes

The primary objective of this proof-of-concept study is to longitudinally track the development of post-stroke sensory reweighting (PSR), identify associated structural neuroanatomical correlates, and investigate their relationship to walking and fall outcomes.

Participants needed: 45
Trial details
Age: 18+Biological sex: AllType: ObservationalSponsor: University of CincinnatiUpdated: Sep 2, 2026Locations: 1
Eligibility criteria

First ever clinical stroke [+3]

Pre-stroke dependence (modified Rankin Scale score of 3 or more) [+8]

Status: Recruiting

Treatment With Endovascular Intervention for STroke Patients With Existing Disability

TESTED will compare the risks and benefits of endovascular thrombectomy (EVT) to medical management (no EVT) in ischemic stroke patients who have a blockage in one of the large blood vessels in the brain and have a moderate-to-severe disability prior to their stroke.

Participants needed: 1,060
Trial details
Age: 18+Biological sex: AllType: ObservationalSponsor: University of CincinnatiUpdated: Sep 2, 2026Locations: 35
Eligibility criteria

Adult patients (≥18 years) [+7]

Known diagnosis of a terminal cancer or terminal illness at the time of stroke [+2]

Status: Recruiting

Hormonal Responses to a Mixed Meal in People With Cystic Fibrosis

In this exploratory study, the hormonal responses to a mixed meal will be examined in people with cystic fibrosis. The aim of this study is to find correlates with impaired glucose tolerance that is associated with this population.

Participants needed: 61
Trial details
Age: 18-45Biological sex: AllType: ObservationalSponsor: University of CincinnatiUpdated: Aug 25, 2026Locations: 1
Eligibility criteria

Diagnosed with cystic fibrosis [+3]

Transplant recipient [+9]

Status: Recruiting

Optimizing CNS DHA Delivery in Elderly Adults at Risk for Dementia

The purpose of this placebo-controlled trial is to compare the effects of 24-weeks supplementation with LPC-DHA and TAG-DHA on cerebrospinal fluid and blood DHA levels, as well as biomarkers of central neurodegenerative and neurotrophic activity, in elderly adults experiencing early signs of cognitive/memory decline including those with mild cognitive impairment (MCI). Extant evidence supports our overarching hypothesis that LPC-DHA supplementation will be more effective than TAG-DHA for increasing central (CSF) DHA levels and improving biomarker profiles in elderly adults. To assess this hypothesis, the following aims are proposed: SPECIFIC AIM 1: To compare the effects of LPC-DHA and TAG-DHA supplementation on peripheral and CSF DHA levels in elderly adults experiencing early signs of cognitive/memory decline. SPECIFIC AIM 2: To compare the effects of LPC-DHA and TAG-DHA supplementation on neurotrophic and neurodegenerative biomarkers. Secondary Aim: To investigate whether changes in CSF DHA levels correlate with changes in objective measures of executive functioning and episodic memory performance.

Participants needed: 153
Trial details
Age: 55-82Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Aug 19, 2026Locations: 1
Eligibility criteria

men and women 55 to 82 years old; [+5]

diagnosis of dementia due to AD, Parkinson's disease, frontotemporal dementia, m... [+6]

Status: Recruiting

Study of Letrozole in Recurrent Gliomas

The purpose of this study is to determine the ability of letrozole to penetrate the blood brain barrier and concentrate in gliomas.

Participants needed: 39
Trial details
Phase: Early Phase 1Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Aug 18, 2026Locations: 1
Eligibility criteria

Radiographically, histologically or cytologically confirmed recurrent brain high... [+12]

Patients may not be receiving any other investigational agents. [+3]

Status: Recruiting

Integrative Medicine in Pain Management in Sickle Cell Disease, 2.0

The proposed research is to determine the clinical efficacy and neurobiological mechanisms of acupuncture analgesia in patients with sickle cell disease.

Participants needed: 120
Trial details
Age: 14-80Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Aug 12, 2026Locations: 1
Eligibility criteria

Any gender [+9]

Subjects with Covid-19 suspicion or confirmation [+12]

Status: Recruiting

Modulating Spinal Interoceptive Pathways to Evaluate Their Role and Therapeutic Potential in MDD Symptomatic Domains

Spinal interoceptive pathways (SIPs) convey bodily signals to an interoceptive system in the brain and their dysregulation is linked to major depressive disorder (MDD). Current treatments are partially effective and the role of SIPs in MDD is vastly unexplored. Preliminary data suggests that SIPs are feasible therapeutic targets in MDD. The central hypothesis is that non-invasive spinal cord stimulation will modulate SIPs to elucidate their role and therapeutic potential in MDD using an R61/33 phased innovation approach. R61 phase specific aims (SA). The specific goal will be to evaluate spinal and brain-based SIPs target engagement markers of transcutaneous spinal direct current stimulation (tsDCS) in MDD with two SAs: SA1) To determine tsDCS SIPs modulation using laser-evoked potentials (LEPs) as electroencephalography (EEG)- based neural measures of target engagement. SA2) To evaluate optimal tsDCS dose based upon tolerability and SIPs target engagement markers. Anodal tsDCS will be evaluated as a tool to modulate SIPs in MDD. SIPs (Aδ and C fibers) can be evaluated via LEPs as neural measures (EEG) elicited in MDD-relevant brain regions within an interoceptive system. Prior data shows anodal tsDCS inhibits SIPs and LEPs N2 component will be assessed as tsDCS engagement markers. Adults with MDD (n=67) will participate in a double-blind, crossover, sham-controlled study to evaluate tsDCS at 0,2.5,3, and 3.5 mA. The working hypothesis is that tsDCS will induce a change in LEPs (SA1) in a dose-dependent and tolerable manner (SA2), supporting their use as SIPs engagement markers. Go/No-Go milestones: Compared to sham, the active tsDCS dose that induces a change in LEPs at a preestablished threshold will be evidence of SIPs engagement and "Go" criteria for the R33 phase.

Participants needed: 67
Trial details
Phase: Phase 1, Phase 2Age: 18-60Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Aug 3, 2026Locations: 1
Eligibility criteria

18 to 60 yrs., inclusive, [+8]

Treatment resistance during current depressive episode (>2 treatment trials at a... [+17]

Status: Recruiting

Measurement Properties of Mechanical Cost of Walking for Individuals With Walking Impairment

Walking impairment following neurologic injury can increase the energy cost of walking threefold, acting as a functional barrier to independence. The goal of this cross-sectional study is to determine the measurement properties of a novel biomechanical cost of walking measure in chronic stroke capable of pinpointing the origins of movement inefficiencies. This research aims to: 1. determine the convergent validity of biomechanical cost of walking with functional measures in relation to metabolic cost of walking, 2. determine the reliability of biomechanical cost of walking in relation to metabolic cost of walking, 3. determine the responsiveness of biomechanical cost of walking in relation to metabolic cost of walking. Individuals with walking impairment from stroke will complete three 5-minute comfortable speed treadmill walking trials. The 3rd walking trial will be against resistance to increase cost of walking. This single session study will compare the metric properties of biomechanical cost of walking in relation to metabolic cost of walking.

Participants needed: 18
Trial details
Age: 30-80Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Jul 6, 2026Locations: 1
Eligibility criteria

Age 30-80 years at the time of consent [+7]

Hospitalization for cardiac or pulmonary disease within past 3 months [+6]

Status: Recruiting

Intraoperative Neuromonitoring (IONM) and Bipolar Electrocautery (BE) During Axillary Lymph Node Dissection (ALND)

The purpose of this study is to determine whether the implementation of existing neurosurgical techniques of intraoperative neuromonitoring (IONM) and the replacement of monopolar electrocautery with bipolar electrocautery (BE), during ALND, will improve the early identification of nerves that have been implicated in the cause of neuropathically-mediated post-surgical pain syndrome (PSPS).

Participants needed: 6
Trial details
Age: 18-70Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Jul 1, 2026Locations: 1
Eligibility criteria

Patients ages 18-70 years old. [+2]

Patients having any previous axillary surgery other than percutaneous breast bio... [+11]

Status: Recruiting

Phase I/ II Trial Combining PD-1 Inhibition and Neoadjuvant Proton or Photon Radiation Therapy in Recurrent Head and Neck Squamous Cell Carcinoma

The purpose of the Phase I study is to see if it is safe to use X-ray photon radiation (XRT) and proton radiation (PT) before surgery in patients with recurrent head and neck squamous cell carcinoma (rHNSCC). The purpose of the Phase II study is to see if using XRT or PT before immunotherapy (pembrolizumab) prior to surgery benefits patients with recurrent head and neck squamous cell carcinoma (rHNSCC).

Participants needed: 40
Trial details
Phase: Phase 1, Phase 2Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Jul 1, 2026Locations: 1
Eligibility criteria

Patients must have histologically or cytologically confirmed recurrent head and... [+14]

Patients who have metastatic disease. [+7]

Status: Not yet recruiting

Safety And Effectiveness Of NaviFUS System With Bevacizumab In Recurrent Glioblastoma

This study will evaluate the safety and early effectiveness of the NaviFUS system with concomitant microbubble administration in conjunction with BEV in recurrent GBM patients.

Participants needed: 10
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Jun 4, 2026Locations: 1
Eligibility criteria

Adult male/female patients ≥ 18 years of age. [+23]

1) Previous treatment with an inhibitor of vascular endothelial growth factor (V...

Status: Recruiting

Early Neuromodulation in Traumatic Brain Injury

The two goals of the proposed study are: (1) To determine how brain activity changes with cognitive recovery over time from acute to chronic phases of traumatic brain injury (TBI). (2) To determine how the time of anodal transcranial electrical stimulation (A-tES) administration affects cognitive performance and brain activity in TBI. To achieve these study goals, the investigators will conduct a pilot clinical trial over three years in which the investigators aim to recruit 60 patients with moderate to severe TBI at the University of Cincinnati Medical Center (UCMC). During the acute phase of TBI, all participants will complete clinical questionnaires and perform 2 cognitive computer tasks while their brain activity is recorded. Half of the participants will be randomly selected to receive A-tES for 15 minutes while performing cognitive tasks and the other half will receive sham stimulation. All participants will be followed for 6 months. During their 3-month follow-up, the investigators will perform another session where all participants complete the questionnaires and receive A-tES while performing cognitive tasks during brain recording. In their last visit at 6 months post-injury, all participants will complete the questionnaires and cognitive tasks with brain recording but no stimulation treatment. From the collected data, the investigators will determine if time from brain injury correlates with brain activity during performance of cognitive tasks. The investigators will also assess the efficacy of early A-tES treatment for improving cognitive task performance and clinical test ratings at 6 months post-injury in comparison to A-tES delivered during the 3-month follow-up visit.

Participants needed: 60
Trial details
Age: 18-80Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Jun 3, 2026Locations: 1
Eligibility criteria

Moderate to severe TBI: Glasgow Coma Scale (GSC) in the 3-12 range and greater t... [+3]

Persistent bilateral non-reactive pupils or other evidence of non-survivable inj... [+1]

Status: Recruiting

Neuroimaging Reveals Treatment-related Changes in DLD

Children with developmental language disorders (DLD, aka specific language impairment), a prevalent pediatric disorder, experience hallmark grammar deficits with life-long impacts on educational and occupational outcomes. While effective and early interventions can mitigate the impact of DLD, not enough is known about the neural basis of DLD in young children, yet is needed to inform the design of more individualized interventions. This project uses neuroimaging, along with behavioral methods, with the goal of better understanding the memory-language mechanisms that underlie grammar learning and impairment, while also considering their association to treatment-related changes in preschoolers with DLD.

Participants needed: 100
Trial details
Age: 48-71Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 26, 2026Locations: 6
Eligibility criteria

ages 48-71 months [+9]

receiving co-occurring speech-language or other intervention for communication [+2]

Status: Not yet recruiting

Minocycline In Neurocognitive Outcomes - Sickle Cell Disease

Sickle cell disease (SCD) is a common, inherited blood disorder that primarily affects people of African Ancestry. It has a lot of complications including neurological complications. The neurological complications of SCD are particularly devastating and lead to cognitive decline even in the absence of overt brain injury. In such cases, it is thought that inflammation in the brain maybe partly responsible for the cognitive decline. The main reasons for this research study are to see 1) how safe and 2) how well minocycline works to try to stop/reverse cognitive decline in people with SCD. People with SCD are at risk for changes in their brain over time that can cause problems with learning, memory, and attention. Part of the reason for this is inflammation within the brain. Minocycline may be able to stop these brain changes by stopping this brain inflammation. Minocycline is a second-generation tetracycline antibiotic that has been shown to both inhibit neuroinflammation and improve cognitive function in a variety of neurodegenerative and psychiatric disorders but has not yet been studied in SCD. We are proposing here, a pilot double-blinded, randomized controlled trial to examine the tolerability and early efficacy of minocycline in adults with SCD at two dosing regimens (200 mg and 300 mg daily) versus placebo over one year. Participants will undergo a neuropsychological exam using the NIH Toolbox Cognition Battery at both study enrollment and exit (after one year) to assess for changes/stability of cognition. Participants will receive monthly phone calls/text messages to assess for adverse events and will be seen every three months for pill counts and routine laboratory monitoring. The primary outcome will be a comparison of adverse events across the two dosing strategies versus placebo. Early evidence for cognitive benefit will also be assessed from the results of the NIH Toolbox.

Participants needed: 30
Trial details
Phase: Phase 1Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 14, 2026
Eligibility criteria

adults with other SCD genotypes (HbSC or HbS- β+thalassemia), [+6]

Status: Recruiting

Lattice Radiotherapy for Dose-Escalated Palliation of Bulky Tumors

The purpose of this research study is to determine if lattice radiation therapy (LRT) will provide better treatment for bulky (large) tumors than current standard of care radiotherapy.

Participants needed: 37
Trial details
Phase: Phase 2Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 4, 2026Locations: 1
Eligibility criteria

Solid tumor malignancy with a clinical indication for radiation [+8]

Patients receiving cytotoxic chemotherapy or known radiosensitizing agents withi... [+5]

Status: Recruiting

Rim Plate to Buttress Plate for Posterior Wall Acetabular Fractures With and Without Inter-fragmentary Screws

The hypothesis of this study is that the Rim Plate method utilizing interfragmentary screws placed through the plate will result in superior fixation, a lower rate of loss of reduction of the fracture fragment, better anatomic healing of the articular (joint) surface, a decreased rate of early post-traumatic arthritic changes of the joint (cartilage) surface, and improved functional outcomes.

Participants needed: 60
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 4, 2026Locations: 1
Eligibility criteria

Skeletally mature males and females, ≥ 18 years old and with age less than 65 ye... [+5]

Patients not suitable for internal fixation (severe osteoarthritis, rheumatoid a... [+7]

Status: Recruiting

Increased Home-based Physical Therapy Adherence Using BAND Connect's VirtuaCare™ Platform

This study aims to enhance at-home therapy by introducing a new device called the BAND Connect's VirtuaCare™ platform. The study aims to determine whether patients can improve their adherence to at-home exercises using this device. Currently, research indicates that only 35% of patients undergoing physical therapy treatment fully comply with their prescribed plans of care, often neglecting their at-home exercises. To address this issue, a set of smart exercise tools called VirtuaCare™ has been developed. This platform provides patients with instructions on performing at-home exercises and offers real-time biofeedback to help them adjust their form if necessary. The study seeks to evaluate the effectiveness of BAND CVCP in assisting patients and improving their overall success with at-home therapy.

Participants needed: 60
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Apr 29, 2026Locations: 1
Eligibility criteria

Dr. Brian Grawe will perform surgery, and participants will be undergoing post-o... [+2]

Unplanned surgical procedure [+8]

Status: Recruiting

Study to Evaluate the Safety and Efficacy of AM3101 to Augment Meniscal Healing

The purpose of this clinical trial is to assess the safety and efficacy of AM3101 to facilitate meniscal repair and reduce the incidence of non-healing complications and morbidities associated with a failed meniscal repair. This is a prospective, randomized, controlled, double-blinded, multi-center study.

Participants needed: 74
Trial details
Phase: Phase 1, Phase 2Age: 18-40Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 4, 2026Locations: 3
Eligibility criteria

Male or female ≥ 18 and ≤ 40 years old at time of screening. [+5]

Have any concomitant ligament injury requiring surgical repair or reconstruction... [+10]

Status: Recruiting

Continuous Passive Motion Following Fixation of Pelvic and Knee Fractures

The investigators will directly compare the visual analog scale scores and narcotic pain medication requirements in the patients who have continuous passive motion (CPM) versus those who do not during the course of the hospital admission following an open reduction internal fixation surgery for acetabular fracture, supracondylar femur fracture, or a tibial plateau fracture.

Participants needed: 100
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 4, 2026Locations: 1
Eligibility criteria

Age 18 or greater [+2]

Injury to either lower extremity that affects the patient's ability to weight be... [+3]

Status: Recruiting

HIT-Stroke Trial 2

People who had a stroke at least 6 months prior and who still have difficulty with walking will each be randomly assigned to receive either moderate or vigorous intensity walking exercise. Both protocols will be performed individually with a physical therapist for 45 minutes, 3x/week for 12 weeks. Measures including walking function will be assessed at baseline (PRE), after 4, 8 and 12 weeks of training (12WK) and at 3-month follow up (3moPOST), by raters who are unaware of the participant randomization.

Participants needed: 156
Trial details
Age: 30-85Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: May 1, 2026Locations: 3
Eligibility criteria

Age 30-85 years at time of consenting [+7]

Exercise testing uninterpretable for ischemia or arrhythmia (e.g. resting ECG ab... [+15]

Status: Recruiting

Early Pelvic Floor Physical Therapy for Women Undergoing Pelvic Radiation for Gynecologic Malignancies

This is a single arm phase II study in which 28 patients who will be undergoing definitive pelvic external beam radiation therapy for cervical cancer will receive pelvic floor physical therapy 4 weeks after completing radiation therapy.

Participants needed: 28
Trial details
Age: 18+Biological sex: FemaleType: InterventionalSponsor: University of CincinnatiUpdated: Apr 23, 2026Locations: 1
Eligibility criteria

Participants must be female. [+4]

Any previous therapeutic pelvic radiation. [+1]

Status: Recruiting

Prefrontal Glutamatergic Modulation by NAC and MBCT for Depression in Youth

The primary goal is to investigate to what extent changes in glutamate and glutathione modulation and functional integration between brain networks associated with emotion and attention regulation are associated with treatment response in mildly depressed youth.

Participants needed: 160
Trial details
Phase: Phase 3Age: 15-24Biological sex: AllType: InterventionalSponsor: University of CincinnatiUpdated: Mar 11, 2026Locations: 1
Eligibility criteria

age between 15 years, 0 months to 24 years, 11 months old; [+4]

significant suicidal risk, defined by suicidal ideation of type 3, 4 or 5 on the... [+13]