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Comparison of baseline characteristics between group A and Group B patients.
GROUP B
(Mean±SD); P>0.05 indicates non-significance.In the Standard therapy group (Group A), two patients were lost to follow-up due to non-response to phone calls. In the Standard therapy group + PeaNoc XL group (Group B), one patient was lost to follow-up due to migration. Thus, 34 patients’ data were analyzed in Group A an...
PMC10521040
Effect of standard therapy and PeaNoc XL add-on to standard therapy.
PMC10521040
Effect of Standard and PeaNoc XL add-on therapy on WOMAC questionnaire.
BLOOD
The values are presented as mean±SD, and the level of significance is indicated as follows: P<0.01* (significant), P<0.05** (significant), and P<0.001*** (highly significant).Patient demographics were recorded for both groups after receiving informed consent. In the baseline assessment, no significant differences (P>0....
PMC10521040
Effect of standard and PeaNoc XL on biochemical parameters.
Values are presented as mean±SD. Statistical significance levels are indicated as follows: P<0.01* (significant), P<0.05** (significant), P<0.001*** (highly significant), and P>0.05 indicating non-significance.
PMC10521040
Efficacy of PeaNoc XL tablets on inflammatory cytokines
TNF-α, pain
INFLAMMATION
The values are presented as mean±SD. Significance levels are denoted as follows: P<0.01* (significant), P<0.05** (significant), and P<0.001*** (highly significant).The levels of inflammatory cytokines, including TNF-α, IL-6, IL-1β, and CRP, were assessed using the ELISA technique. The addition of PeaNoc XL to standard ...
PMC10521040
Safety and efficacy of PeaNoc XL tablets on arthritis index (WOMAC)
physical stiffness, pain
INFLAMMATION, ADVERSE DRUG REACTIONS
WOMAC questionnaire has three main areas such as pain score, joint stiffness, and physical stiffness. The addition of PeaNoc XL as an adjunct therapy demonstrated significant reductions in pain (P<0.001), joint stiffness (P<0.01), and physical stiffness (P<0.001) compared to baseline among patients with joint pain and ...
PMC10521040
Discussion
cognition, mood, and sleep, neurodegenerative, pain
TMJ, DISEASE, DISORDERS, COMMON COLD, CHRONIC PAIN, ALLERGIC REACTIONS
PEA is a bioactive lipid mediator resembling endocannabinoids that falls within the NAE fatty acid amide family. It is ubiquitously present in various tissues, including the brain. PEA is thought to be synthesized in response to cellular injury as a pro-homeostatic protective mechanism and its production is enhanced in...
PMC10521040
Key findings
TNF-α, inflammation, physical stiffness, arthritis, pain, joint stiffness
INFLAMMATION, ARTHRITIS
The findings of the present randomized, open-label interventional trial showed that PeaNoc XL tablets help in the reduction of pain, joint stiffness, and physical stiffness (WOMAC questionnaire).Inflammatory levels of TNF-α, IL1-β, IL-6, and CRP levels in patients with joint pain and inflammation were significantly red...
PMC10521040
Conclusions
inflammation, physical stiffness, arthritis, pain, joint stiffness
INFLAMMATION, ARTHRITIS
This randomized study showed that adding PeaNoc XL Tablet to standard therapy effectively reduced pain, joint stiffness, and physical stiffness in arthritis patients. It also resulted in significant reductions in inflammatory markers. PeaNoc XL Tablet demonstrates potential as a safe and effective option for managing j...
PMC10521040
Author contributions
All authors, including K. N. Nandakumar, Dr. E. Caston, Dr. R. C. Satish Kumar, Dr. T.M. Vijayakumar, S. V. Vishagan, Pankaj Negi, and A. Sukkur, made equal contributions to this report. They had full access to all the data in the study and took responsibility for ensuring the integrity and accuracy of the data analysi...
PMC10521040
Acknowledgements
Medical writing support for the manuscript was provided by DocMode Health Technologies Ltd., Mumbai. The researchers express their gratitude to the staff members of Pharmacy Practice & IIISM, Pharm D students, volunteers, nurses, and doctors who have made valuable contributions to this research.
PMC10521040
Data availability
PMC10521040
Underlying data
Figshare: master sheet peanoc xl 2.xlsx,
PMC10521040
Reporting guidelines
inflammation, arthritis, pain
INFLAMMATION, ARTHRITIS
Figshare: CONSORT checklist for “A randomized interventional clinical trial assessing the safety and effectiveness of PeaNoc XL tablets in managing joint pain and inflammation in arthritis patients”, Data are available under the terms of the
PMC10521040
References
Pain, physical stiffness, arthritis, chronic pain, pain, backpain, joint stiffness
CHRONIC PAIN, ARTHRITIS
This paper is done very accurately and very useful for clinical practice. Pain relief is very important, this paper reflects the proper usage of peanoc-xl and the potency of the medication. The generated data will be useful for future doctors to use the medicine in treating different chronic painful conditions.Is the ...
PMC10521040
Background
Numerous observational studies show associations between family meal frequency and markers of child cardiovascular health including healthful diet quality and lower weight status. Some studies also show the “quality” of family meals, including dietary quality of the food served and the interpersonal atmosphere during m...
PMC10112996
Methods/design
The
PMC10112996
Discussion
This study will be the first to our knowledge to use multiple innovative methods simultaneously including ecological momentary intervention, video feedback, and home visiting with CHWs within the novel intervention context of family meals to evaluate which combination of intervention components are most effective in im...
PMC10112996
Trial registration
This trial is registered in clinicaltrials.gov (Trial ID: NCT02669797). Date recorded 5/02/22.
PMC10112996
Supplementary Information
The online version contains supplementary material available at 10.1186/s12889-023-15504-2.
PMC10112996
Keywords
PMC10112996
Background
CVH, CVD
CVD, CHILDHOOD OBESITY, CARDIOVASCULAR DISEASE
Cardiovascular disease (CVD) is a highly prevalent public health problem [First, over two decades of observational cross-sectional and longitudinal research shows that family meal quantity (i.e., frequency) is associated with child health including higher diet quality, lower prevalence of unhealthy weight control behav...
PMC10112996
Theoretical framework
Family Systems Theory (FST) [
PMC10112996
Methods
The current study protocol was written following the guidelines of the Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) checklist (Additional file The SPIRIT diagram
PMC10112996
Study design
The The Family Matters Intervention Flowchart
PMC10112996
Study recruitment
Children (
PMC10112996
Inclusion criteria
CVD
Children ages 5–10, their primary caregiver (e.g., parent, grandparent, aunt) and at least one sibling.Children at high risk for CVD, defined as BMI ≥ 75th percentile [Children from African American/Black, Asian, Hispanic, Native American, or White households who speak Spanish or English.Children who consume ≤ 3 famil...
PMC10112996
Exclusion criteria
Children with medically necessary dietary restrictions (e.g., feeding tubes) or who are developmentally unable to participate (e.g., non-verbal).Non-custodial parent who lives with the child < 50% of the time.Children participating in a weight management study.
PMC10112996
Study arms and randomization
stress reduction
Families are randomized into one of three intervention Arms: (1) EMI; (2) EMI + Virtual HV with a CHW + Video Feedback; and (3) EMI + Hybrid HV with a CHW + Video Feedback. All Arms receive 16 weeks (4 months) of EMI stress reduction and family meal tip messages via smartphones. Arms 2 and 3 additionally receive eight ...
PMC10112996
Procedures and data collection
PMC10112996
Measures
This study has three primary child outcomes: BMI%ile [
PMC10112996
Blinding and investigator allocation concealment
BLIND
As with most behavioral interventions, it is not possible to double blind this RCT. However, this study incorporates measurement staff and investigator blinding as much as possible to minimize bias. For example, the intervention is administered by CHWs who are not involved with measurement team responsibilities or meet...
PMC10112996
Measurement team training and supervision
SESSION, INTERACTION
Measurement team members are trained, engage in role-plays, conduct mock visits, and are closely supervised by the measurement team director according to best practice [Training, certification, recertification, and ongoing supervision for measurement team members and intervention community health workersConducted 2–3 t...
PMC10112996
Retention plan
To minimize attrition in all study Arms, the following retention strategies are used, based on our successful prior studies with > 95% retention rate and best practice [
PMC10112996
Ethical considerations
The University of Minnesota’s Institutional Review Board (IRB) Human Subjects Committee approved all protocols used in the study. Prior to enrollment into the study, participants are provided with detailed information about the study by our research team via consent and assent forms including study aims and detailed pr...
PMC10112996
Regulatory oversight/monitoring
ADVERSE EVENTS, RECRUITMENT
All study modifications will be communicated with and regulated by the IRB. Even though the study is expected to pose minimal risk, the Data Safety Monitoring Board (DSMB), in collaboration with the study investigators will closely monitor recruitment, process evaluation, and retention activities. The DSMB will meet ye...
PMC10112996
Intervention
The
PMC10112996
Study arm #1: EMI
Parents randomized to study Arm 1 receive EMI text messages twice a day for 16 weeks via their smartphone. A study smartphone is provided for use if needed.
PMC10112996
EMI
Our prior research showed parental stress early in the day was associated with more controlling food parenting practices and serving more unhealthful foods (e.g., fast food) at dinner the same night [
PMC10112996
Study arm #2: EMI + Virtual Home Visiting (HV) with CHW + Video feedback
stress reduction
Parents randomized to study Arm 2 receive all elements of study Arm 1, in addition to home visiting by a CHW. Visits by CHWs are virtual via zoom and occur every-other-week (8 total) simultaneously with the 16 weeks of EMI. In between CHW home visits, families complete “Try-it-Yourself” activities (8 total) to reinforc...
PMC10112996
Video feedback
Every other week, starting during home visit three, families video-record and upload one family meal via their smartphone (6 total meals). CHWs watch videos in between home visits to identify specific clips to show family members at the next visit that highlight both strengths and growth areas regarding interpersonal i...
PMC10112996
“Try-it-Yourself” activities
stress reduction
Families are given food-related (e.g., recipes, meal planning strategies) and interpersonal (e.g., food prep with kids, family meal communication game, stress reduction) activities to try out in between visits to increase their self-efficacy in preparing family meals on their own and reinforce messages they are taught ...
PMC10112996
Study arm #3: EMI + Hybrid HV with CHW + Video feedback
Parents randomized to study Arm 3 receive all elements of study Arm 2, but they are delivered hybrid. Specifically, CHWs meet in-person with families every other HV and then virtually via zoom on the other weeks. Families also engage in two cooking demonstration activities with the CHW during in-person HVs to reinforce...
PMC10112996
Maintenance phase
After completing four months of the intervention, all study Arms transition to a two-month maintenance phase, based on best practice [
PMC10112996
Community Health Workers (CHWs) training and supervision
Interventionists are racially/ethnically diverse CHWs, with half being Spanish speaking. CHWs are trained/certified in MI [
PMC10112996
Statistical analysis plan
PMC10112996
Overview
This study is powered for three pairs of tests [
PMC10112996
Sample size and power computations
Study design features were accounted for in powering the study that required increases in sample size to minimize an inflated experiment-wise error rate (EER) due to three pairwise tests between each treatment arm for three primary outcomes (i.e., BMI%ile, neck circumference, and the Healthy Eating Index (HEI)). Accoun...
PMC10112996
Aim 1 (Primary Outcomes): examine intervention effects on markers of child CVH including BMI%ile, diet quality, neck circumference
Treatment condition mean differences on the three primary outcomes will be examined at the post-intervention primary endpoint (6 months after baseline). Sample size determination allows for primary outcome standardized effect size assessment of all three outcomes of at least 0.38, which is a small-to-moderate minimum d...
PMC10112996
Aim 2 (Secondary Outcomes): examine intervention effects on family, parental, and sibling factors
Family meal quantity and quality, food parenting practices and stress, and sibling BMI %ile outcomes are powered at similar levels as in Aim 1 with the ability to detect standardized effect sizes as small as 0.38.
PMC10112996
Sub-group exploratory analyses
Analyses exploring whether interaction effects depend on participant sex, race/ethnicity, and seasonality will also be conducted. These post-hoc analyses will examine whether the intervention has synergistic effects in specific populations or during different seasonal contexts. Post-hoc analyses will be conducted to ex...
PMC10112996
Other exploratory hypotheses
A model incorporating an interaction effect of treatment arm crossed with the change in family meal quality and quantity between observation periods will be used to evaluate if increases (or decreases) in the quality and quantity of family meals correspond with synergistically favorable (or unfavorable) child outcomes....
PMC10112996
Discussion
The
PMC10112996
Acknowledgements
The success of the
PMC10112996
Authors’ contributions
JB is the principal investigator of this trial. JB conceptualized the paper and wrote all drafts. ACT and KN assisted with writing the procedures and data collection plan and critically reviewed the paper. MA assisted with the intervention design and writing the process evaluation plan and critically reviewed the paper...
PMC10112996
Authors’ information
JB is a Professor and Vice Chair for Research in the Department of Family Medicine and Community Health at the University of Minnesota; the Principal Investigator of the Family Matters study; the Director of the Healthy Eating and Activity across the Lifespan (HEAL) Center; and Director of the Center for Women’s Health...
PMC10112996
Funding
BLOOD, HEART, LUNG
Research is supported by grant number R61/33 HL151978 from the National Heart, Lung, and Blood Institute (PI: Jerica Berge). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health.
PMC10112996
Availability of data and materials
The datasets generated from the study will be available from the corresponding author upon reasonable request.
PMC10112996
Declarations
PMC10112996
Ethics approval and consent to participate
The study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Institutional Review Board Human Subjects Committee at the University of Minnesota (IRB ID: STUDY00014632). All participants provide their written informed consent or assent before participating in the study. For ...
PMC10112996
Consent for publication
Not applicable.
PMC10112996
Competing interests
The authors declare that they have no competing interests.
PMC10112996
References
PMC10112996
Background
femoral head necrosis
The use of degradable magnesium screws to fix the bone flap implanted in the treatment of femoral head necrosis has achieved preliminary good therapeutic results. However, there is no conclusive evidence in the study to demonstrate whether biodegradable magnesium screws promote angiogenesis and no comparison has been m...
PMC10363316
Objective
ONFH
OSTEONECROSIS OF THE FEMORAL HEAD
To investigate the clinical efficacy and safety of biodegradable magnesium screws in pedicled vascularized iliac bone graft transfer (PVIBGT) for osteonecrosis of the femoral head (ONFH).
PMC10363316
Materials and methods
ONFH
GROUP B
A total of thirty-six patients (37 hips) with ONFH were recruited from March 2020 to July 2022. The study used a single-blind method, and patients who underwent PVIBGT were randomized into three groups: 12 patients (12 hips) were fixed with biodegradable magnesium screws (Group A), 12 patients (13 hips) were fixed with...
PMC10363316
Results
DISEASE
There was no statistically significant difference among these three groups in terms of types, gender, age, course of disease, surgical side, operation time, the length of stay (
PMC10363316
Conclusions
PVIBGT has a positive effect, especially with regard to improving blood supply of the femoral head. The fixation of biodegradable magnesium screws is reliable and safe in PVIBGT, and promote angiogenesis.
PMC10363316
Keywords
PMC10363316
Introduction
ONFH
OSTEONECROSIS OF THE FEMORAL HEAD, JOINT DISEASE
Osteonecrosis of the femoral head (ONFH) is a joint disease with high morbidity and the disability rate that affects young adults [The pedicled vascularized iliac bone graft transfer with the ascending branch of the lateral femoral artery (PVIBGT) is an important method in hip preserving [We set up a trail group (Group...
PMC10363316
Materials and methods
PMC10363316
Flowchart of study protocol
See Fig. Flowchart of the study
PMC10363316
Patient selection criteria
PMC10363316
Inclusion criteria
Patients must meet all of the following conditions.Age range: 18–55 years old (including 18 and 55 years old).Patients were in ARCO (Association Research Circulation Osseous) II and III.Patients understood the objective of the clinical trial, signed the informed consent form voluntarily, and agreed to complete the enti...
PMC10363316
Exclusion criteria
renal, adrenal dysfunction, and nervous system diseases, diabetes, coagulation dysfunction, malignant diseases, allergies, cardiovascular and cerebrovascular diseases
ALLERGIES, CHRONIC KIDNEY FAILURE, DISEASES, OSTEOPOROSIS, MALIGNANT DISEASE
Patients were excluded if they met one of the following conditions.Accompanied by an acute or serious infection;Patients had hypermagnesemia;Patients used glucocorticoids in the past three months;Patients with serious cardiovascular and cerebrovascular diseases, diabetes, coagulation dysfunction, mental and nervous sys...
PMC10363316
Ethical approval status
This prospective, randomized controlled study was registered in Chinese Clinical Trial Registry and approved by the Medical Ethics Committee of the Affiliated Hospital of Nanjing University of Chinese Medicine (2020NL-118-02). Written informed consents were obtained from all participants.
PMC10363316
Surgical methods
Debrided sclerosing, necrotic, necrosis
CAVITY, GROUP B, NECROTIC, NECROSIS
Operations were performed by the same surgeon (JRS) who has been engaged in hip preservation for more than three decades. After general anesthesia, the patients were placed in the supine position, and the affected hip elevated 30°. The operation position was selected on the connecting line between the anterior superior...
PMC10363316
Postoperative treatment and follow-up
PMC10363316
Postoperative treatment
BEND
Patients were instructed to bend and extend ankle joint, exercise quadriceps femoris, and do gastrocnemius isometric exercises after the operation. Patient began partial weight-bearing walk with the aid of walker 3 months after the operation, and conducted weight-bearing walk without walker 6 months after the operation...
PMC10363316
Post-operative follow-up
PMC10363316
Harris scores
hip joints
The postoperative functional recovery was evaluated through Harris score. The excellent and good rate is the proportion of Harris score above 80 points. 90–100 points are excellent, 80–89 points are good, 70–79 points are medium, and below 69 points are poor.Functional parameters were assessed separately by one orthope...
PMC10363316
Radiological evaluations
femoral head necrosis, ONFH, oedema, necrotic
COLLAPSE, OEDEMA, NECROTIC
X-ray: X-ray(orthopantomogram and frog-mogram) was taken on 1, 3, 6 months after surgery to assess the preoperative morphological location of necrotic areas, postoperative morphology, progression of ONFH and the amount of gas production of the magnesium screws.CT: The femoral head was evaluated by CT coronal measureme...
PMC10363316
Adverse post-operative complications
infection, fracture, non-healing
INFECTION, SUBCUTANEOUS EMPHYSEMA
We conducted post-operative follow-up to detect infection and non-healing of the incision. We evaluated serum magnesium ion level according to liver and kidney function, detect the deep veins of both lower limbs by ultrasound, detect subcutaneous emphysema and fracture of the magnesium screw by X-ray and CT.
PMC10363316
Efficacy evaluation indicators
femoral head collapse rate
(1) success rate of surgery; (2) radiological evaluation of the location of bone graft at 3 and 6 months after surgery; (3) Harris score of the patient before and 6 months after surgery; (4) femoral head collapse rate at 6 months after surgery; (5) observation of bone ingrowth by CT at 6 months after surgery; (6) obser...
PMC10363316
Statistical methods
SPSS 26.0 software was used for statistic analysis. The χ2 test or Fisher's exact probability method was used for comparison among three groups. One-way ANOVA was used for the comparison among groups, and independent samples
PMC10363316
Results
PMC10363316
General information
liver function abnormalities, idiopathic ONFH, femoral head necrosis, traumatic ONFH, pain, ONFH, alcoholic ONFH
GROUP B
A total of 36 patients met the selection criteria for inclusion in the study from March 2021 to July 2022. Three patients (3 hips) had mild liver function abnormalities during the course of the study. We reported this phenomenon to ethics committee, and they deemed it to have no serious impact on the trial. The 36 pati...
PMC10363316
Comparison of the operation time and hospital stay of patients in the three groups
All three groups of patients had successful surgery. The average operating time per side of the hip was 178.18, 179.42 and 183.18 min in Group A, B and C, respectively, and the patients' hospital stay was 18.18, 18.12 and 18.09 d, respectively, with no statistically significant difference among three groups (
PMC10363316
Harris score
GROUP B
Group A had a mean Harris score of 64.26 preoperatively and 80.03 at 6 months postoperatively. Group B had a mean Harris score of 66.40 preoperatively and 77.34 at 6 months postoperatively. Group C had a mean Harris score of 67.29 preoperatively and 76.03 at 6 months postoperatively. All three groups showed a statistic...
PMC10363316
Radiological results and evaluation
PMC10363316
Typical patients in three groups
left idiopathic ONFH, ONFH
GROUP B
Group A: The patient has left-sided hormonal ONFH. The patient’s hip was fixed with a biodegradable magnesium screw (4.0 mm diameter, 30 mm long) in the PVIBGT. More details are shown in Figs. Pre-operative (Pre-operative (Group B: The patient has bilateral hormonal ONFH.The patient underwent bilateral PVIBGTs with tw...
PMC10363316
Evaluation blood supply via DCE-MRI
left idiopathic ONFH, ONFH, abnormal hyperperfusion, necrotic
NECROTIC
Group A: Patient Yan X, male, 29 years old, with left-sided hormonal ONFH. The patient’s hip was fixed with a biodegradable magnesium screw. More details are shown in Figs. IAUGC and Ktrans synthetic pseudo-colour images. At 6 months postoperatively, there was a significant reduction in abnormal hyperperfusion in the ...
PMC10363316
Degradation rate and air production of biodegradable magnesium bone internal fixation screws
The degradation rate of biodegradable magnesium screws was approximately 10.32% at 3 months and 13.72% at 6 months postoperatively in Group A (Fig. The area of the intermuscular air space of the biodegradable magnesium screw was 0 cmPost-operative (Typical patients in Group A were followed up at 14 days (
PMC10363316
Analysis of serum biochemical indexes
The levels of serum potassium, sodium, calcium, phosphorus and magnesium ion were in normal range, and other indexes of kidney function were normal in Group A. More details are shown in Fig. Average serum potassium, sodium, calcium, phosphorus and magnesium ion levels in Group A patients preoperatively, 2-days postoper...
PMC10363316
Adverse reactions
fractures, non-healing
ADVERSE EVENTS, HIP INFECTION, DEEP VEIN THROMBOSIS
While two patients in Group A had poor healing of the surgical incision, other patients in Group A did not have any hip infection, non-healing incision, deep vein thrombosis in the lower limbs, or other adverse events. Group A had good biocompatibility and no fractures of the magnesium screws. Two patients with poorly ...
PMC10363316
Discussion
PMC10363316
Advantages of PVIBGT in hip preservation
ONFH
There are 8.12 million ONFH patients in China [
PMC10363316
Advantages of biodegradable magnesium screw-fixed bone flaps
PMC10363316
Biodegradable magnesium screw promotes osteogenesis and angiogenesis
GROUP B
MgDel Giorno et al [In the present study, we found that the improvement of Harris score was more significant in Group A than Group B and C. This indicates that the application of biodegradable magnesium screw to fix the iliac bone graft could promote the healing of the bone and facilitate recovery.
PMC10363316
Biodegradable magnesium fixation is more reliable
Han et al [Mild displacement of the bone graft occurred in two patients in Group C during follow-up. In the biodegradable magnesium screw group, there was no displacement of the grafted bone. These results suggest that the use of biodegradable magnesium screws for fixation of the iliac graft is an effective method to a...
PMC10363316