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INTRODUCTION
gastrointestinal cancer
RECTAL ADENOCARCINOMA, GASTROINTESTINAL CANCER
Great progress in technique and device development has been made in endoscopic resection of early-stage gastrointestinal cancer with endoscopic mucosal resection and endoscopic submucosal dissection (ESD) (The synthetic self-assembling peptide, TDM-621 (3-D Matrix, Tokyo, Japan), is derived from nonliving sources and c...
PMC9889198
METHODS
This multicenter, randomized, open-label, parallel-group comparative trial was conducted from August 2017 to August 2019 with the approval of the Institutional Review Board of each facility in compliance with relevant laws and regulations, including the Declaration of Helsinki and the Japanese Ministerial Ordinance on ...
PMC9889198
Patients
gastric/colorectal cancer, cancer, hypersensitivity, blood coagulation
INFLAMMATORY BOWEL DISEASE, CARCINOMA OF THE STOMACH, CANCER, ULCERATION, HYPERSENSITIVITY
Patients for whom ESD was indicated (following the Japanese gastric/colorectal cancer treatment guidelines and the gastric/colorectal ESD/endoscopic mucosal resection guidelines) (The exclusion criteria were as follows: residual or local recurrent lesions, ulceration of the target lesions, poorly differentiated adenoca...
PMC9889198
Study protocol
JET
ESD-trained endoscopists who had performed more than 20 ESD procedures participated in the study (In the TDM-621 group, hemostasis was performed using TDM-621, and coagulation hemostasis was performed using hemostatic forceps (Coagrasper, Olympus, Tokyo, Japan) if hemostasis was not achieved within 3 minutes. TDM-621 w...
PMC9889198
Outcome measurements
bleeding
SECONDARY, EVENT, BLEEDING
The primary efficacy end point was the mean number of coagulations (performed with hemostatic forceps), as determined by the third-party evaluation committee.The secondary efficacy end points were the mean number of coagulations (determined by the operator), time from confirmation of a blood oozing event to the complet...
PMC9889198
Safety evaluation
ADVERSE REACTIONS, POSTOPERATIVE BLEEDING
The incidence of defects derived from TDM-621 treatment and AE (including abnormalities in clinical test values, postoperative bleeding for 7 and 28 days after ESD, and adverse reactions) were assessed for the evaluation of safety.
PMC9889198
Sample size and statistical analysis
SECONDARY, ADVERSE REACTIONS
The mean number of coagulations during ESD with hemostatic forceps (the primary efficacy end point) was assumed to be 3.1 in the control group and 2.1 in the TDM-621 group, based on our pilot study. Based on this assumed mean value, simulated data were created using random numbers according to a Poisson distribution. T...
PMC9889198
RESULTS
PMC9889198
Composition of patients
bleeding
BLEEDING
A total of 227 patients were enrolled from the 7 facilities and randomized (TDM-621 group, 112; control group, 115). Of them, 33 in both groups were excluded because of good clinical practice deviation, unavailability of record video, and misinclusion of bleeding in which bleeding source was identifiable after a single...
PMC9889198
Demographic and other baseline characteristics
Table Baseline demographic and clinical characteristics of the patients (PPS)
PMC9889198
Primary and secondary efficacy end points
SECONDARY
The mean number of coagulations (the primary efficacy end point) determined by the third-party evaluation committee was significantly higher in the control group (4.9 ± 5.2) than in the TDM-621 group (1.0 ± 1.4) (Effect of TDM-621 on the number of cauterizations with hemostats (PPS). Data are provided as mean ± SD. *Ot...
PMC9889198
Other end points
tumors
TUMORS
The amount of TDM-621 applied was 1.75 ± 2.14 mL according to the operator's determination, and the operability was evaluated as “appropriately applied to the target site” in 85 patients (98.8%), all but 1. All targeted tumors were successfully removed
PMC9889198
Safety results
post-ESD coagulation syndrome, fever, abdominal pain
ADVERSE REACTIONS, INFLAMMATION, ADVERSE EVENTS
The AE incidence rate was 39.6% in the TDM-621 group and 37.6% in the control group, with no significant differences between the groups. The incidence rate of adverse reactions was 1.0% in the TDM-621 group, and no adverse reactions were observed in the control group. No defects derived from TDM-621 occurred in any pat...
PMC9889198
DISCUSSION
blood spurting, bleeding, death, blood oozing
SECONDARY, RECTAL TUMORS, BLEEDING
This study showed that TDM-621 is a useful hemostatic peptide for blood oozing during ESD for gastric or rectal tumors and that severe AE do not occur with this peptide solution.This is the first multicenter, randomized, parallel-group comparative study to directly compare the efficacy and safety of TDM-621 with those ...
PMC9889198
Supplementary Material
PMC9889198
Study Highlights
PMC9889198
WHAT IS KNOWN
tumor, intraoperative bleeding
TUMOR, INTRAOPERATIVE BLEEDING
✓ Intraoperative bleeding occurs commonly with tumor resection, especially during rectal and gastric endoscopic submucosal dissection (ESD).✓ Management of intraoperative bleeding with hemostatic forceps is crucial to the success of ESD.✓ TDM-621, a synthetic, self-assembling peptide derived from nonliving sources, ma...
PMC9889198
WHAT IS NEW HERE
✓ The number of coagulations with hemostatic forceps was significantly reduced in those who received TDM-621 in this trial.✓ Hemostasis was achieved with TDM-621 alone in 62% of patients.
PMC9889198
REFERENCES
PMC9889198
1. Introduction
TNF-α, Psoriasis, hyperplasia, hereditary predisposition, Tumor necrosis, psoriasis
INFILTRATION, PSORIASIS, HYPERPLASIA, PROLIFERATION, INFLAMMATION, INFILTRATES, PSORIASIS, TUMOR NECROSIS, INFLAMMATORY SKIN DISEASE, PATHOGENESIS
These authors contributed equally to this work.Psoriasis is a chronic inflammatory skin disease with autoimmune pathological characteristics. Recent research has found a link between psoriasis, inflammation, and gut microbiota dysbiosis, and that probiotics and prebiotics provide benefits to patients. This 12-week open...
PMC10342574
2. Results and Discussion
PMC10342574
2.2. PASI, DLQI, and Anthropometric Measures
FM
As presented in Although we observed no significant difference between the two groups in terms of fat mass (FM) changes (
PMC10342574
2.3. Inflammatory Markers
psoriasis
PSORIASIS
The effects of probiotic and prebiotic supplementation on inflammatory markers are presented in The association between probiotic supplementation in patients with psoriasis and changes in inflammatory markers is yet an active research field, but preliminary findings have revealed promising effects [
PMC10342574
2.4. Metabolic Parameters
metabolic syndrome, low-density lipoprotein (LDL)-C
METABOLIC SYNDROME
After adjusting the cholesterol level results for sex, age, and baseline values, our results showed a significant difference between groups in total cholesterol (C), low-density lipoprotein (LDL)-C, and high-density lipoprotein (HDL)-C (Our study demonstrated that probiotic and prebiotic supplementation for 12 weeks re...
PMC10342574
2.5. Ultrasound Assessments
psoriasis
PLAQUE, PSORIASIS
Using the data generated from the high-frequency ultrasonography of psoriatic skin, we found significant differences in psoriasis plaque hydration, perilesional area hydration, and subepidermal low-echogenic band (SLEB) between the two groups (
PMC10342574
2.6. Gut Microbiota Changes
psoriasis
PSORIASIS
After 12 weeks of probiotic and prebiotic supplementation, we identified 12 markers that differed significantly from baseline, including changes in seven bacterial abundances (The Shannon index is a parameter used to assess gut microbiota bacterial diversity, with higher values signifying greater community diversity [B...
PMC10342574
2.7. Limitations
This study had several limitations that should be considered when interpreting the results. First, due to the relatively small sample size (
PMC10342574
3. Materials and Methods
PMC10342574
3.1. Ethical Considerations
This study was conducted according to the guidelines outlined in the Declaration of Helsinki, the Amsterdam Protocol, and Directive 86/609/EEC. The study protocol was approved by the Ethical Commission of the “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca (No. 267/06.30.2021). Prior to enrollment, al...
PMC10342574
3.3. Data Collection
psoriasis
BLOOD, PSORIASIS
Background demographic and psoriasis diagnosis data were collected at the screening visit. Blood was collected at the beginning (screening visit) and end (Week 12) of the study. Levels of serum TNF-α, IL-6, IFN-γ, IL-17A, IL-10, and insulin were determined using commercially available enzyme-linked immunosorbent assay ...
PMC10342574
3.4. Statistical Analysis
For normally distributed data, the mean and SD are reported; median and IQR are reported for non-normally distributed data. The paired-samples t-test and related-samples Wilcoxon signed rank test were used to detect differences among patients within the same group (i.e., from baseline to Week 12). Data from the interve...
PMC10342574
4. Conclusions
psoriasis
INFLAMMATION, PSORIASIS
According to our findings, probiotic and prebiotic supplementation enhanced the general health of patients with psoriasis who were receiving local anti-psoriatic treatment. First, probiotic and prebiotic supplementation significantly improved quality of life, as demonstrated by a reduction in PASI and DLQI scores. Seco...
PMC10342574
Author Contributions
Conceptualization, M.C.B., R.C., D.M., A.B. and A.C.; methodology, M.C.B., L.I.G. and A.B.; supervision, L.I.G., D.M. and A.C.; writing—original draft, M.C.B. and R.C.; writing—review and editing, L.I.G. and A.T. All authors have read and agreed to the published version of the manuscript.
PMC10342574
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca (No. 267/06.30.2021).
PMC10342574
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
PMC10342574
Data Availability Statement
The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical considerations.
PMC10342574
Conflicts of Interest
The authors declare no conflict of interest.
PMC10342574
References
tumor necrosis
TUMOR NECROSIS
Abundances that showed a significant difference (Design and flow of the study.Background characteristics.* Pearson’s chi-square test. ** Independent-samples DLQI and PASI comparison between the intervention and control groups.* Paired-samples Anthropometric data comparison between the intervention and control groups.* ...
PMC10342574
Subject terms
SCES, cord injury, torques
SECONDARY
Two persons with chronic motor complete spinal cord injury (SCI) were implanted with percutaneous spinal cord epidural stimulation (SCES) leads to enable motor control below the injury level (NCT04782947). Through a period of temporary followed by permanent SCES implantation, spinal mapping was conducted primarily to o...
PMC10091329
Introduction
SCES, cord injury
SPINAL CORD
Spinal cord epidural stimulation (SCES) may modulate spinal cord neural networks to enhance multiple functions after motor complete spinal cord injury (SCI)This case report describes early results of two persons with clinically sensory-motor complete and a motor complete SCI enrolled in a clinical trial investigating t...
PMC10091329
Study timeline.
SCES, EAW
Timeline of study phases for NCT04782947. After baseline outcome measures are assessed, temporary implantation occurs followed by 5 days of mapping. After removal of the temporary implant, participants are given 2 weeks rest and then receive the permanent implant. Permanent implant mapping occurs for 2 weeks, focusing ...
PMC10091329
Results
PMC10091329
Participant characteristics
Spinal Injury Association Impairment Scale [, traumatic SCI
Two men with clinically motor complete traumatic SCI (C8; 6 years post-injury [ID#: 0772] and T11; 9 years post-injury [ID#: 0773]), American Spinal Injury Association Impairment Scale [AIS] A and B, respectively) participated in a trial approved by the Hunter Holmes McGuire Veteran Affairs Medical Center ethical IRB c...
PMC10091329
Temporary and permanent implantation
SCES
Both participants underwent temporary SCES implantation (5 days) followed by permanent implantation 4 weeks later (Supplementary Figs. 
PMC10091329
Spinal mapping
Spinal mapping was carried out to identify optimal configurations (cathodal-anodal electrode arrangements and stimulation parameters) to enable multiple functions and movements without inducing unwanted activity
PMC10091329
Supine rhythmic EMGs.
SCES
Example electromyograms (EMGs) of left leg muscles (black traces) and right leg muscles (gray traces) while SCES is delivered in supine at various amplitudes to participant 0773, using the configuration shown on the left of the figure (black is the cathode and the red is the anode). In the left column of EMGs, SCES del...
PMC10091329
Voluntary motor activity
SCES, voluntary movements
Participant 0772 did not elicit intentional voluntary movements in supine or side lying positions. His legs moved in response to different SCES configurations following temporary implantation. On day 1 of temporary mapping, in the presence of percutaneous SCES, 0773 voluntarily flexed his right hip from a side lying po...
PMC10091329
Configuration for 0773 resulting in right leg flexion.
knee extension
Left leg muscles are depicted in black and right leg muscles in gray. Both plots occurred simultaneously but have been separated to better visualize different effects of voluntary effort between legs. At 1.3 mA, bilateral muscle activity was induced. However, when the participant volitionally attempted to flex his righ...
PMC10091329
Standing ability
SCES
In the first phase of the study, with SCES on, 0772 did not need to use his upper extremities for balance self-assistance in a standing position. In contrast when SCES was off, he needed to hold the parallel bars and use his upper extremities to self-assist balance. However, 0772 required maximal knee assistance and mo...
PMC10091329
Voluntary hip flexion and extension with trunk control (participant 0772) from a semi-standing position in a standing frame.
Panels
PMC10091329
0772 Exoskeleton sit-to-stands.
Electromyograms (EMGs) of lower extremity muscles of 0772 during active attempts to complete a sit-to-stand maneuver with the exoskeleton in “Squat” mode. In this mode, the exoskeleton will not passively complete a sit-to-stand for the user; rather, assistive torque is provided at the knees and hips which can enable th...
PMC10091329
0773 overground standing.
Electromyograms (EMGs) of lower extremity muscles of 0773 during overground standing in parallel bars.
PMC10091329
Exoskeleton-assisted walking and overground stepping
Using the aforementioned mapping procedures in the interim period, configurations for rhythmic activity did not yield locomotor-like muscle activity in supine position in that the bursting was synchronous across all muscles in both legs (i.e. lack of a reciprocal relationship between antagonistic muscles or left-right ...
PMC10091329
EAW enhancement figure.
EAW
Data points showing changes in exoskeleton-assisted walking (EAW) performance for two participants walking in “Adaptive” mode, a manufacturer setting which adjusts the amount of assistance provided to the user, and thus can result in variability in certain parameters of gait.
PMC10091329
EAW enhancement EMG figure.
SCES, EAW
Example electromyograms of one participant (0773) during exoskeleton-assisted walking (EAW) without or with spinal cord epidural stimulation (SCES). Left leg muscles are shown in black, right leg muscles are shown in gray. Without SCES, very little muscle activity occurs through the gait cycle, mainly in the right hams...
PMC10091329
Discussion
muscle mass, exoskeleton-provided, reduced exoskeleton-provided, flexion or extension torques, knee flexion, hip flexion, SCES, chronic motor complete SCI
Percutaneous SCES enabled motor control in two persons with chronic motor complete SCI. Both participants could also volitionally modulate induced flexion or extension torques on verbal instruction in a seated position. One participant (0773) initiated hip flexion, knee flexion, and ankle dorsiflexion in a supine lying...
PMC10091329
Methods
PMC10091329
Subjects
Spinal Injury Association Impairment Scale [, traumatic SCI
Two men with clinically motor complete traumatic SCI (C8; 6 years post-injury [ID#: 0772] and T11; 9 years post-injury [ID#: 0773]), American Spinal Injury Association Impairment Scale [AIS] A and B, respectively) participated in a trial approved by the Hunter Holmes McGuire Veteran Affairs Medical Center ethical IRB c...
PMC10091329
Inclusion and exclusion criteria
flexion knee contractures, neurological injury, traumatic motor complete SCI, scoliosis, areflexia, fracture, contracture, −3.5, ’ knee extensors, cardiovascular problems, Spinal Injury, cauda equina
UNCONTROLLED HYPERTENSION, TYPE II DIABETES MELLITUS, CARDIOVASCULAR DISEASE, SCOLIOSIS, ORTHOSTATIC HYPOTENSION, URINARY TRACT INFECTION
Participants may be included if they are between 18 and 60 years old, male or female, with traumatic motor complete SCI and level of injury of between C5 to T10, as determined the International Standards for Neurological Classification of SCI (ISNCSCI) exam. Participants’ knee extensors must respond to standard surface...
PMC10091329
Magnetic resonance imaging
Prior to enrollment in the trial, participants were asked to conduct magnetic resonance image (MRI; T2 Turbo Spin Echo with long band width; SIEMENS 1.5T) with the following scanning sequence (slice thickness: 3 mm, TR: 9350, TE: 102; flip angle: 150) for pre-screening purpose. MRI was conducted to verify the injury si...
PMC10091329
Interventions
PMC10091329
Implantation of epidural stimulation
SCES, pain
EVENTS, ENLARGEMENT
This is a 2-step process where temporary implantation precedes permanent implantation when indicated. The SCES system (Intellis Epidural Stimulator, Medtronic, Minneapolis, USA) was used to electrically stimulate the lumbosacral enlargement. During temporary implantation, two 8-electrode lead arrays were implanted util...
PMC10091329
Temporary implantation
MINOR
Participants were scheduled to perform the temporary implantation. After placing the participant in a prone position, the participant was implanted in a minor procedure room under fluoroscopy guidance. A nurse certified in sedation established IV access, place standard ASA monitors including noninvasive blood pressure ...
PMC10091329
Permanent implantation
pain
STERILE
Fourteen days following temporary implantation, two 8-electrode arrays of Vectris lead were implanted in an operating room (see the listed details about the Intellis System). The trial was undertaken in a sterile environment with the presence of a representative. Phase 1 of the permanent implantation is identical to th...
PMC10091329
The Intellis system has two main sets of components
fits, ®
STERILE, PAD
External components for IntellisModel 97715/97716 Wireless External NeurostimulatorThe Medtronic Model 97715/97716 Wireless External Neurostimulator (ENS) is part of a neurostimulator system used for intraoperative testing during lead placement and for trial stimulation outside of the operating room. The Medtronic Mod...
PMC10091329
Spinal segmental mapping
SCES, lower extremity muscle
RECRUITMENT, CONTRACTION, RECRUITMENT
Following both temporary and permanent implantation, participants were scheduled to perform the process of spinal segmental mapping. Spinal mapping is the process of identifying the right stimulation parameters (frequency, amplitude, and pulse duration) responsible for activation of the lower extremity muscle groups, p...
PMC10091329
Exoskeleton assisted walking
AUTONOMIC DYSREFLEXIA
Prior to training, a research assistant helped to fit the participant into the device starting with the shoes-support (distally) and then going up toward the trunk (proximally). The software was adjusted and progressed based on the need of each participant. Every effort was made to ensure that all straps were snug but ...
PMC10091329
Progression to the adaptability mode
EAW
This mode allows the exoskeleton to gradually lower the assistance provided to the participant based on their performance. In the adaptive assistance mode, the support ranges from 0 to 100%, with 100% means that the unit provides 100% support and assistance to ambulate. During sessions, SCES was turned on and we starte...
PMC10091329
Overground standing and ambulation without exoskeleton
Following the exoskeleton session, a follow-up-visit on the same day was conducted to provide over ground standing and walking experience. This started by allowing the subject to stand-up in a standing frame or between parallel bars and to do stepping for 10 feet assisted by a trained researcher. If the subject manages...
PMC10091329
Measurements
PMC10091329
Surface EMGs
After standard skin preparation, surface EMGs were used to record lower extremity and/or trunk muscles, depending on the task being tested. Muscles assessed for mapping and voluntary movement testing included bilateral vastus medialis, rectus femoris, tibialis anterior, hamstring, medial gastrocnemius, and gluteus medi...
PMC10091329
Exoskeleton-assisted walking performance
Exoskeleton-assisted walking performance variables - steps per minute, step length, and minimum assistance – are derived from data collected by the exoskeleton itself, and then automatically uploaded to the company’s online clinical database. Step length and minimum assistance are provided for each individual leg, wher...
PMC10091329
Overground ambulation
During post-interventions 1 and 2, overground ambulation without wearing the exoskeleton was tested using parallel bars over a 10-feet (3.05 m) walking distance.
PMC10091329
Peak isometric torque
SCES
This was evaluated using a Biodex isokinetic dynamometer (Shirely, NY). Participants were seated with both the trunk-thigh angle and the knee-thigh angle at 90°. After transferring using a ceiling lift, each participant was securely strapped to the test chair by a crossover shoulder harnesses and a belt across the hip ...
PMC10091329
Reporting summary
Further information on research design is available in the 
PMC10091329
Supplementary information
Supplementary InformationPeer Review FileReporting Summary
PMC10091329
Supplementary information
The online version contains supplementary material available at 10.1038/s41467-023-37845-7.
PMC10091329
Acknowledgements
DoD-CDMRP
The work is currently supported by the DoD-CDMRP clinical trial program award number # W81XWH-20-1-0845 (SC190107 CDMRP W91ZSQ) and Department of Veteran Affairs-SPiRE Program (B3456-P). We would like to thank Center for Rehabilitation Science Engineering Centre-VCU (Ronald Seel, PhD & David Cifu, MD) for providing sci...
PMC10091329
Author contributions
SCES, T.D.L.
A.S.G., D.L., and R.T initiated the project and designed the study protocol. L.L.G. and T.D.L. performed clinical assessments. R.T. Intraoperative placement of the SCES and subjects’ assessment. A.S.G., T.W.S., J.A.G., and A.A. contributed to data collection, analysis, and interpretation and drafted the manuscript with...
PMC10091329
Peer review
PMC10091329
Data availability
De-identified data of the two participants will be available upon direct communication with the corresponding author and upon receiving approval from the appropriate research committee from the Department of Veteran Affairs immediately following publication and available for 3 years. Source data, study protocol and inf...
PMC10091329
Competing interests
The authors declare no competing interests.
PMC10091329
References
PMC10091329
Key Points
PMC9857469
Question
CVD
CVD, CARDIOVASCULAR DISEASE
What are the impacts of an entirely plant-based vs a low-fat, reduced–animal product omnivorous diet on changes in 12-month and 24-month body weight and lipids among African American adults at risk for cardiovascular disease (CVD)?
PMC9857469
Findings
CVD
In this randomized clinical trial of 159 adults, participants in both groups saw similar improvements in body weight and CVD risk factor outcomes.
PMC9857469
Meaning
weight loss
CVD
Both plant-based and low-fat omnivorous soul food diets produced modest weight loss and CVD risk-related improvements among African American adults.This randomized clinical trial compares the effects of an entirely plant-based vegan or low-fat omnivorous diet on change in body weight and lipids during a 2-year interven...
PMC9857469
Importance
CVD, chronic disease
CVD, CARDIOVASCULAR DISEASE, CHRONIC DISEASE
More African American individuals die from cardiovascular disease (CVD) than any other chronic disease condition. Despite this disparity, African American individuals are underrepresented in nutrition and CVD interventions.
PMC9857469
Objective
To compare the effects of an entirely plant-based (vegan) or low-fat omnivorous (omni) diet on change in body weight and lipids during a 2-year intervention.
PMC9857469
Design, Setting, and Participants
weight loss, overweight or obesity
TYPE 2 DIABETES, THYROID DISEASE
The Nutritious Eating With Soul (NEW Soul) study was a 2-year, randomized clinical trial conducted in 2 cohorts (2018-2020 and 2019-2021) that took place in a university teaching kitchen in Columbia, South Carolina (before March 2020), and via online videoconference sessions (after March 2020). Participants included Af...
PMC9857469
Interventions
The intervention included weekly nutrition classes for 6 months biweekly classes for 6 months, and monthly classes for 12 months. Dietary interventions either emphasized no animal product intake (vegan) or a low-fat omnivorous diet (omni). Both dietary patterns emphasized soul food cuisine (traditional African American...
PMC9857469
Main Outcomes and Measures
Primary outcomes included change in body weight and lipid measures at 12 months.
PMC9857469
Results
There were 568 participants who completed an online screening questionnaire; 409 were excluded and 159 were randomized (77 to the vegan group and 82 to the omni group). Of the 159 participants (mean [SD] age, 48.4 [10.6] years; 126 female [79%]) who began the study, the main outcome of body weight was obtained for 121 ...
PMC9857469
Conclusions and Relevance
weight loss
CVD
In this randomized clinical trial examining weight loss and CVD risk factor reduction among African American adults, there were no differences between the groups, and the magnitude of changes overall was small.
PMC9857469
Trial Registration
ClinicalTrials.gov Identifier:
PMC9857469
Introduction
overweight or obesity, CVD
CVD, CARDIOVASCULAR DISEASE, CHRONIC DISEASE
In the US, African American individuals die from cardiovascular disease (CVD) more than any other chronic disease.Although several studiesThe Nutritious Eating With Soul (NEW Soul) study, a 2-year behavioral nutrition intervention among African American individuals with overweight or obesity, was conducted to address t...
PMC9857469
Methods
PMC9857469
Study Participants
The NEW Soul intervention, inclusion criteria, and measures have been described elsewhere.
PMC9857469
Measures
Measures for the NEW Soul intervention have been described elsewhere.
PMC9857469
Measures Assessed and the Time Points in the Nutritious Eating With Soul Study
PMC9857469