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Real-world enrollment for a prospective clinico-genomic database using a pragmatic technology-enabled platform
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-04 DOI: 10.1016/j.conctc.2025.101446
Alexia Exarchos , Ariel B. Bourla , Maneet Kaur , Katja Schulze , Sophia Maund , Yi Cao , Yihua Zhao , Elizabeth H. Williams , Sarah C. Gaffey , Richard Zuniga , Shaily Lakhanpal , Vladan Antic , Michelle Doral , Johanna Sy , Neal J. Meropol , Anne C. Chiang

Background

Discovery and incorporation of predictive and prognostic biomarkers enhance outcomes for patients with cancer. Clinico-genomic datasets, which retrospectively link real-world clinical data to tumor sequencing data, are important resources for biomarker research, which has historically relied on robust research infrastructures exclusive to large academic centers. The objective was to evaluate the feasibility of a pragmatic, technology-enabled platform at community-based research sites for development of a prospective clinico-genomic database supported by centralized electronic health record (EHR)–based patient ascertainment and data processing.

Methods

Adults with stage IV or recurrent metastatic non-small cell lung cancer or extensive-stage small-cell lung cancer were enrolled at 23 US sites upon initiating a standard line of therapy. Enrollment rates were estimated from eligible populations at individual centers. Clinical data from routinely collected EHR documentation were centrally processed and normalized for quality control. Serial blood samples at pre-specified timepoints (baseline, during treatment and at disease progression/end of therapy) were used for circulating tumor DNA (ctDNA) genomic profiling.

Results

Between December 2019 and May 2021, 944 patients enrolled, representing ≈25 % of eligible patients. Eight-hundred seventeen of 944 (87 %), 406 of 606 (67 %) and 398 of 852 (47 %) participants provided qualifying samples for ctDNA testing at baseline, during treatment and at disease progression/end of therapy, respectively. Samples were provided at all three timepoints by 35 % of participants.

Conclusion

A community-based oncology patient cohort was rapidly enrolled, creating a real-world clinico-genomic dataset. This pragmatic study platform has potential research applications where prospective real-world data may contribute to evidence generation.
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引用次数: 0
Ten years of Women's Wellness research: Key lessons from conducting randomised controlled trials of a whole-of-lifestyle behavioural intervention
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-03 DOI: 10.1016/j.conctc.2025.101441
Sarah M. Balaam , Alexandra L. McCarthy , Natalie K. Vear , Mackenzie J. Petie , Debra J. Anderson , Janine P. Porter-Steele
Many women are diagnosed with breast cancer and while the survival of this cohort has improved, their likelihood of developing treatment-related chronic conditions is considerable. Over the last 10 years, our research group has developed and refined a whole-of-lifestyle intervention, the Women's Wellness after Cancer Program (WWACP), for women who have finished treatment for primarily breast and gynaecological cancers. Culturally-specific iterations of this program were recently completed with younger breast cancer survivors (aged <50 years) living in Australia, New Zealand/Aotearoa and Hong Kong.
Over the last decade, various approaches have been used to trial the WWACP, mostly randomised controlled trials. While this methodology is considered the gold standard to determine efficacy in health and medical research, its limitations in our interventional research are apparent. In this opinion article, we discuss these limitations as well as alternative options for the appropriate testing of behavioural studies in women treated for cancer. We also discuss how the contribution of informed consumer advocates and participant consumers has influenced changes to our study designs.
{"title":"Ten years of Women's Wellness research: Key lessons from conducting randomised controlled trials of a whole-of-lifestyle behavioural intervention","authors":"Sarah M. Balaam ,&nbsp;Alexandra L. McCarthy ,&nbsp;Natalie K. Vear ,&nbsp;Mackenzie J. Petie ,&nbsp;Debra J. Anderson ,&nbsp;Janine P. Porter-Steele","doi":"10.1016/j.conctc.2025.101441","DOIUrl":"10.1016/j.conctc.2025.101441","url":null,"abstract":"<div><div>Many women are diagnosed with breast cancer and while the survival of this cohort has improved, their likelihood of developing treatment-related chronic conditions is considerable. Over the last 10 years, our research group has developed and refined a whole-of-lifestyle intervention, the Women's Wellness after Cancer Program (WWACP), for women who have finished treatment for primarily breast and gynaecological cancers. Culturally-specific iterations of this program were recently completed with younger breast cancer survivors (aged &lt;50 years) living in Australia, New Zealand/Aotearoa and Hong Kong.</div><div>Over the last decade, various approaches have been used to trial the WWACP, mostly randomised controlled trials. While this methodology is considered the gold standard to determine efficacy in health and medical research, its limitations in our interventional research are apparent. In this opinion article, we discuss these limitations as well as alternative options for the appropriate testing of behavioural studies in women treated for cancer. We also discuss how the contribution of informed consumer advocates and participant consumers has influenced changes to our study designs.</div></div>","PeriodicalId":37937,"journal":{"name":"Contemporary Clinical Trials Communications","volume":"44 ","pages":"Article 101441"},"PeriodicalIF":1.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rationale and design for Healthy Hearts in Manufacturing (HHM): A pragmatic single-arm hybrid effectiveness-implementation study for hypertension management and tobacco cessation
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-03 DOI: 10.1016/j.conctc.2025.101444
Hanzi Jiang , Yao Tian , Jennifer Bannon , Amy E. Krefman , Lawrence C. An , Dustin D. French , Claude R. Maechling , Jane Holl , Richard Chagnon , Theresa L. Walunas , Christopher Burch , Anthony Musci , Darce Latsis , Dawn Carey , Megan McHugh

Background

Heart disease is the leading cause of mortality in the United States and contributes more than $320 billion annually in health care costs and lost productivity. Manufacturing employment is associated with higher rates of hypertension and smoking. Many large manufacturers provide health services to employees and their family members through worksite health centers (WHCs). Several quality improvement interventions for hypertension and tobacco cessation have shown to be effective in community-based primary care sites. The Healthy Hearts in Manufacturing (HHM) study aims to implement and test these interventions in WHCs.

Methods

Two organizations that operate WHCs at manufacturing sites volunteered to participate in the 58-month HHM research study. The HHM intervention involves monthly coaching to assist WHCs with implementing evidence-based strategies for hypertension management and tobacco cessation advocated by the Million Hearts initiative and the U.S. Preventive Services Task Force. A pragmatic, Type II hybrid effectiveness-implementation study design is used to evaluate HHM. The approach is inspired by the stepped-wedge cluster-randomized trial to assess intervention effectiveness. We will conduct interviews to identify facilitators and barriers to implementation and budget impact analysis to estimate the financial impact of the HMM interventions and the potential healthcare savings to companies and Medicare.

Results

Twelve WHCs were randomly selected to enroll in HHM. The WHCs are in nine states and provide primary care services for employees and family members of four manufacturing companies. Baseline patient smoking rates ranged from 13 % to 59 % across WHCs. The percentage of patients with blood pressure of 140/90 or greater ranged from 7 % to 56 % across WHCs.

Conclusion

This exploratory five-year research study will identify facilitators and barriers to implementing the HHM interventions in WHCs, evaluate the effectiveness of hypertension management and use of tobacco screening and cessation, and provide evidence of HHM's potential cost-effectiveness for employers and Medicare.
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引用次数: 0
A pilot randomized controlled study of integrated kidney palliative care and chronic kidney disease care implemented in a safety-net hospital: Protocol for a pilot study of feasibility of a randomized controlled trial
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-03 DOI: 10.1016/j.conctc.2025.101439
Jennifer S. Scherer , Wenbo Wu , Chen Lyu , Keith S. Goldfeld , Abraham A. Brody , Joshua Chodosh , David Charytan

Background

Chronic kidney disease (CKD) impacts more than 800 million people. It causes significant suffering and disproportionately impacts marginalized populations in the United States. Kidney palliative care has the potential to alleviate this distress, but has not been tested. This pilot study evaluates the feasibility of a randomized clinical trial (RCT) testing the efficacy of integrated kidney palliative and CKD care in an urban safety-net hospital.

Methods

This is a single-site pilot RCT designed to enroll 85 participants, with a goal of at least 60 completing the study. The inclusion criteria are adults 18 or older, who are either Spanish or English speakers, have an estimated Glomerular Filtration Rate (eGFR) of ≤30 mL/min/1.73 m2, and are receiving care at our safety net hospital. Participants will be randomized in permuted blocks of two or four to either the intervention group, who will receive monthly ambulatory care visits for six months with a palliative care provider trained in kidney palliative care, or to usual nephrology care. Primary outcomes are feasibility of recruitment, retention, fidelity to the study visit protocol, and the ability to collect outcome data. These outcomes include symptom burden, quality of life, and engagement in advance care planning.

Discussion

This pilot RCT will provide essential data on the feasibility of testing integrated palliative care in CKD care in an underserved setting. These outcomes will inform a larger, fully powered trial that tests the efficacy of our kidney palliative care approach.

Clinical trial registration

NCT04998110.
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引用次数: 0
Bridging the gap: Understanding Latino willingness to participate in public health and clinical trials research across diverse subgroups
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-03 DOI: 10.1016/j.conctc.2025.101440
Mary A. Garza PhD , Yan Li PhD , Craig S. Fryer DrPH , Luciana C. Assini-Meytin PhD , Segen Ghebrendrias MSN , Christina Celis Puga MPH , James Butler lll DrPH , Sandra C. Quinn PhD , Stephen B. Thomas PhD

Background

The underrepresentation of racial and ethnic minoritized populations in public health and clinical trials research remains a persistent issue. Yet, despite the growing body of literature investigating Latino participation in research, studies examining differences between Latino sub-groups remains limited. The purpose of this study was to investigate how knowledge, awareness and willingness to participate in research differs between US- born and immigrant Latinos.

Methods

We conducted a population-based household telephone survey with Latino adults (N = 1264), with 68 % Mexican/Mexican American, 11 % Central/South American, 8 % Puerto Rican and the remaining 13 % self-identified as “Other”. The “Building Trust Survey,” included valid standardized instruments designed to assess knowledge of research, human subjects' protections, previous participation in research, immigrant status (nativity), length of time in the US, and country of origin.

Results

The study found that Latinos who immigrated to the US as teens or young adults were more willing to participate in medical research than those born in the US. Willingness to "take" something in a study varied by Latino subgroup, immigration age, gender, and age. Analysis highlighted that Mexican/Mexican Americans (76 %) and Central/South Americans (74 %) indicated a willingness to participate in research but also were less likely to have been “Asked” to participate in research (9 % and 6 % respectively) compared to the other subgroups (p < .05).

Conclusions

Insights from this study will inform the development of culturally tailored interventions aimed at successfully recruiting and retaining Latino populations in public health and clinical trials research, thereby contributing to more equitable and representative health outcomes.
{"title":"Bridging the gap: Understanding Latino willingness to participate in public health and clinical trials research across diverse subgroups","authors":"Mary A. Garza PhD ,&nbsp;Yan Li PhD ,&nbsp;Craig S. Fryer DrPH ,&nbsp;Luciana C. Assini-Meytin PhD ,&nbsp;Segen Ghebrendrias MSN ,&nbsp;Christina Celis Puga MPH ,&nbsp;James Butler lll DrPH ,&nbsp;Sandra C. Quinn PhD ,&nbsp;Stephen B. Thomas PhD","doi":"10.1016/j.conctc.2025.101440","DOIUrl":"10.1016/j.conctc.2025.101440","url":null,"abstract":"<div><h3>Background</h3><div>The underrepresentation of racial and ethnic minoritized populations in public health and clinical trials research remains a persistent issue. Yet, despite the growing body of literature investigating Latino participation in research, studies examining differences <em>between</em> Latino sub-groups remains limited. The purpose of this study was to investigate how knowledge, awareness and willingness to participate in research differs between US- born and immigrant Latinos.</div></div><div><h3>Methods</h3><div>We conducted a population-based household telephone survey with Latino adults (N = 1264), with 68 % Mexican/Mexican American, 11 % Central/South American, 8 % Puerto Rican and the remaining 13 % self-identified as “Other”. The “Building Trust Survey,” included valid standardized instruments designed to assess knowledge of research, human subjects' protections, previous participation in research, immigrant status (nativity), length of time in the US, and country of origin.</div></div><div><h3>Results</h3><div>The study found that Latinos who immigrated to the US as teens or young adults were more willing to participate in medical research than those born in the US. Willingness to \"take\" something in a study varied by Latino subgroup, immigration age, gender, and age. Analysis highlighted that Mexican/Mexican Americans (76 %) and Central/South Americans (74 %) indicated a willingness to participate in research but also were less likely to have been “Asked” to participate in research (9 % and 6 % respectively) compared to the other subgroups (p &lt; .05).</div></div><div><h3>Conclusions</h3><div>Insights from this study will inform the development of culturally tailored interventions aimed at successfully recruiting and retaining Latino populations in public health and clinical trials research, thereby contributing to more equitable and representative health outcomes.</div></div>","PeriodicalId":37937,"journal":{"name":"Contemporary Clinical Trials Communications","volume":"44 ","pages":"Article 101440"},"PeriodicalIF":1.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“Common sense is hard work” but benefits from persistent collaboration: Lessons learnt from the development of The Collaborative Network for European Clinical Trials for Children (c4c) to support the conduct of paediatric clinical trials of medicines
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-03 DOI: 10.1016/j.conctc.2025.101442
Sabah Attar , Carla Peacock , Mandy Wan , Erin Halil , Chloe Bickerstaff , Lionel Tan , Hafsah Bhatti , Ricardo M. Fernandes , Regis Hankard , Mark A. Turner

Introduction

The Collaborative Network for European Clinical Trials for Children (c4c) is a public private partnership with a developed infrastructure across European sites to support the design and conduct of multi-national academic and industry paediatric clinical trials. This paper aims to review the learning points identified during co-development of c4c processes by academic and industry partners.

Methods

Study metrics were recorded. Learning points were captured during network development, categorized and included in a thematic analysis from which lessons learnt were identified.

Results

12 trials were supported by sites coordinated at national level and integrated at European level. A total of 9 CDA cycles were completed, resulting in 436 site CDAs signed in a median of 8.11 days. Lessons learnt included the importance of: relationship building by early engagement with partners; reducing misunderstanding by clear communication; flexibility, adaptability and experiential learning which are required for service improvement. Practical actions that infrastructure developers and users can take include operational planning with a view to fostering collaborations across stakeholders, sharing information about different approaches to clinical operations, and raising awareness of the need for explicit work on collaboration, communication, and planning. Traditionally, these activities are repeated for each trial. The use of a persistent network allows the benefits of collaboration to be recycled.

Discussion

Building a successful framework for collaboration allows dedication and determination to carry over from one study to another. The initial investment of time to share assumptions and “state the obvious” by each user will support future trials.
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引用次数: 0
Iron mother- protocol for a randomised controlled trial of daily versus alternate day ferrous fumarate for the treatment of iron deficiency anaemia in pregnancy
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-03 DOI: 10.1016/j.conctc.2025.101447
F.E. O'Toole , F.M. McAuliffe , J.M. Fitzgerald , G.A. Mealy , R. Petkute , L.A. Bolger , A. Murphy-Cruse , B. Soldati , M. Galligan , J.M. Walsh

Objective

Iron deficiency anaemia (IDA) is the commonest haematological problem in pregnancy and has implications for maternal, fetal, and childhood health. Treatment, despite being inexpensive and readily available, remains challenging with issues relating to compliance, tolerability, and effectiveness. There is a lack of consensus regarding the optimal dosing of oral iron replacement in pregnancy. Emerging evidence from non-pregnant populations suggest that alternate day dosing may be as effective.

Methods

We propose a phase IV open label randomised controlled non-inferiority trial of daily versus alternate day ferrous fumarate for a 4-week period for the treatment of confirmed iron deficiency anaemia in pregnancy. Our study population comprises singleton pregnancies between 14+0- and 34+0-weeks’ gestation with a haemoglobin (Hb) of <10.5g/dL and a ferritin of <30μg/L. The intervention is alternate day ferrous fumarate 305mg (100mg elemental iron) and the comparator is daily ferrous fumarate 305mg. The primary endpoint, change in Hb from randomisation to week 4, will be analysed by linear regression, adjusting for baseline Hb level. Analysis will be conducted by intention-to-treat analysis with per protocol sensitivity analysis. Sample size was calculated on the assumption of no difference between primary endpoint means, a Type 1 error rate of 0.025, a power of 90 %, a standard deviation of 0.83 g/dL and a non-inferiority margin of −0.4 g/dL. Under these assumptions, 92 subjects per treatment arm would be required to test for non-inferiority.

Conclusion

We hypothesise that alternate day iron in pregnancy will be as effective as daily iron for the treatment of iron deficiency anaemia.
{"title":"Iron mother- protocol for a randomised controlled trial of daily versus alternate day ferrous fumarate for the treatment of iron deficiency anaemia in pregnancy","authors":"F.E. O'Toole ,&nbsp;F.M. McAuliffe ,&nbsp;J.M. Fitzgerald ,&nbsp;G.A. Mealy ,&nbsp;R. Petkute ,&nbsp;L.A. Bolger ,&nbsp;A. Murphy-Cruse ,&nbsp;B. Soldati ,&nbsp;M. Galligan ,&nbsp;J.M. Walsh","doi":"10.1016/j.conctc.2025.101447","DOIUrl":"10.1016/j.conctc.2025.101447","url":null,"abstract":"<div><h3>Objective</h3><div>Iron deficiency anaemia (IDA) is the commonest haematological problem in pregnancy and has implications for maternal, fetal, and childhood health. Treatment, despite being inexpensive and readily available, remains challenging with issues relating to compliance, tolerability, and effectiveness. There is a lack of consensus regarding the optimal dosing of oral iron replacement in pregnancy. Emerging evidence from non-pregnant populations suggest that alternate day dosing may be as effective.</div></div><div><h3>Methods</h3><div>We propose a phase IV open label randomised controlled non-inferiority trial of daily versus alternate day ferrous fumarate for a 4-week period for the treatment of confirmed iron deficiency anaemia in pregnancy. Our study population comprises singleton pregnancies between 14+0- and 34+0-weeks’ gestation with a haemoglobin (Hb) of &lt;10.5g/dL and a ferritin of &lt;30μg/L. The intervention is alternate day ferrous fumarate 305mg (100mg elemental iron) and the comparator is daily ferrous fumarate 305mg. The primary endpoint, change in Hb from randomisation to week 4, will be analysed by linear regression, adjusting for baseline Hb level. Analysis will be conducted by intention-to-treat analysis with per protocol sensitivity analysis. Sample size was calculated on the assumption of no difference between primary endpoint means, a Type 1 error rate of 0.025, a power of 90 %, a standard deviation of 0.83 g/dL and a non-inferiority margin of −0.4 g/dL. Under these assumptions, 92 subjects per treatment arm would be required to test for non-inferiority.</div></div><div><h3>Conclusion</h3><div>We hypothesise that alternate day iron in pregnancy will be as effective as daily iron for the treatment of iron deficiency anaemia.</div></div>","PeriodicalId":37937,"journal":{"name":"Contemporary Clinical Trials Communications","volume":"44 ","pages":"Article 101447"},"PeriodicalIF":1.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of Ma'aljobon Aftimouni (Cuscuta Reflexa and whey) on HbA1c and blood glucose levels in patients with Type 2 Diabetes: A randomized triple-blind clinical trial Ma'aljobon Aftimouni (Cuscuta Reflexa和乳清)对2型糖尿病患者HbA1c和血糖水平的疗效:一项随机三盲临床试验
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-01 DOI: 10.1016/j.conctc.2024.101401
Fatemeh Mehrabi , Ali Safdari , Azam Moslemi , Mehdi Salehi , Ali Agharazi , Mohammad Reza Rezvanfar

Introduction and objective

Type 2 Diabetes is a common and chronic metabolic disease. Complementary and alternative medicine can provide a suitable option for demands for new treatments. Therefore, the present study aimed to investigate the effect of Persian medicine on the glycemic status of patients with Type 2 Diabetes.

Method

This randomized, controlled, and triple-blind trial study was conducted from November 2021 to August 2022 on 102 diabetic patients referred to the diabetes clinic in Iran. In this regard, patients with inclusion criteria were randomly divided into three groups Ma'aljobon with Aftimoun (n = 34), Ma'aljobon without Aftimoon (n = 34), and the control group (n = 34). The control group received a placebo of medicinal salt, light calcium carbonate, lactose, and carboxymethyl cellulose. In contrast, the treatment groups received 25 g of drug powder (in 250 cc of lukewarm water) on an empty stomach for 8 consecutive weeks. Patients' fasting blood sugar (FBS) levels and HbA1c were measured at the beginning and end of the intervention. Data were analyzed using SPSS 23, employing paired t-tests, ANOVA, and chi-square tests for comparison between groups.

Results

Data analysis was conducted on 90 patients with Type 2 Diabetes. The findings revealed a significant reduction in fasting blood sugar levels post-intervention in the Ma'aljobon Aftimouni group (134.27 ± 21.79 vs. 152.3 ± 31.37, mean difference 18.03 ± 5.63, 95 % CI: 6.53 to 29.53, p = 0.003). Additionally, a significant difference in HbA1c values was observed post-intervention in both the Ma'aljobon Aftimouni group (7.88 ± 0.77 vs. 8.09 ± 0.73, mean difference 0.21 ± 0.09, 95 % CI: 0.03 to 0.39, p = 0.031) and the Ma'aljobon without Aftimoun group (7.97 ± 0.84 vs. 8.25 ± 0.78, mean difference 0.28 ± 0.08, 95 % CI: 0.11 to 0.45, p = 0.002).

Conclusion

The findings showed that daily consumption of Ma'aljobon supplements on an empty stomach before breakfast may have a beneficial effect on the glycemic indices of patients. However, further studies seem to be necessary in this regard.
简介与目的:2型糖尿病是一种常见的慢性代谢性疾病。补充和替代医学可以为新疗法的需求提供合适的选择。因此,本研究旨在探讨波斯药对2型糖尿病患者血糖状态的影响。方法:这项随机、对照、三盲试验研究于2021年11月至2022年8月对伊朗糖尿病诊所的102例糖尿病患者进行了研究。为此,将符合纳入标准的患者随机分为Ma'aljobon联合Aftimoun组(n = 34)、Ma'aljobon不联合Aftimoon组(n = 34)和对照组(n = 34)。对照组服用药盐、轻质碳酸钙、乳糖和羧甲基纤维素的安慰剂。治疗组空腹给药25 g药粉(温水250 cc),连续8周。在干预开始和结束时测量患者的空腹血糖(FBS)水平和HbA1c。数据采用SPSS 23进行分析,组间比较采用配对t检验、方差分析和卡方检验。结果:对90例2型糖尿病患者进行数据分析。结果显示,Ma'aljobon Aftimouni组干预后空腹血糖水平显著降低(134.27±21.79 vs 152.3±31.37,平均差异18.03±5.63,95% CI: 6.53 ~ 29.53, p = 0.003)。此外,Ma'aljobon Aftimouni组干预后HbA1c值(7.88±0.77 vs 8.09±0.73,平均差值0.21±0.09,95% CI: 0.03 ~ 0.39, p = 0.031)与Ma'aljobon无Aftimouni组(7.97±0.84 vs 8.25±0.78,平均差值0.28±0.08,95% CI: 0.11 ~ 0.45, p = 0.002)差异有统计学意义。结论:每日早餐前空腹服用Ma'aljobon补充剂对患者的血糖指数有有益的影响。然而,在这方面似乎还需要进一步的研究。
{"title":"Efficacy of Ma'aljobon Aftimouni (Cuscuta Reflexa and whey) on HbA1c and blood glucose levels in patients with Type 2 Diabetes: A randomized triple-blind clinical trial","authors":"Fatemeh Mehrabi ,&nbsp;Ali Safdari ,&nbsp;Azam Moslemi ,&nbsp;Mehdi Salehi ,&nbsp;Ali Agharazi ,&nbsp;Mohammad Reza Rezvanfar","doi":"10.1016/j.conctc.2024.101401","DOIUrl":"10.1016/j.conctc.2024.101401","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Type 2 Diabetes is a common and chronic metabolic disease. Complementary and alternative medicine can provide a suitable option for demands for new treatments. Therefore, the present study aimed to investigate the effect of Persian medicine on the glycemic status of patients with Type 2 Diabetes.</div></div><div><h3>Method</h3><div>This randomized, controlled, and triple-blind trial study was conducted from November 2021 to August 2022 on 102 diabetic patients referred to the diabetes clinic in Iran. In this regard, patients with inclusion criteria were randomly divided into three groups <em>Ma'aljobon with Aftimoun</em> (n = 34), <em>Ma'aljobon without Aftimoon</em> (n = 34), and the control group (n = 34). The control group received a placebo of medicinal salt, light calcium carbonate, lactose, and carboxymethyl cellulose. In contrast, the treatment groups received 25 g of drug powder (in 250 cc of lukewarm water) on an empty stomach for 8 consecutive weeks. Patients' fasting blood sugar (FBS) levels and HbA1c were measured at the beginning and end of the intervention. Data were analyzed using SPSS 23, employing paired t-tests, ANOVA, and chi-square tests for comparison between groups.</div></div><div><h3>Results</h3><div>Data analysis was conducted on 90 patients with Type 2 Diabetes. The findings revealed a significant reduction in fasting blood sugar levels post-intervention in the Ma'aljobon Aftimouni group (134.27 ± 21.79 vs. 152.3 ± 31.37, mean difference 18.03 ± 5.63, 95 % CI: 6.53 to 29.53, p = 0.003). Additionally, a significant difference in HbA1c values was observed post-intervention in both the Ma'aljobon Aftimouni group (7.88 ± 0.77 vs. 8.09 ± 0.73, mean difference 0.21 ± 0.09, 95 % CI: 0.03 to 0.39, p = 0.031) and the Ma'aljobon without Aftimoun group (7.97 ± 0.84 vs. 8.25 ± 0.78, mean difference 0.28 ± 0.08, 95 % CI: 0.11 to 0.45, p = 0.002).</div></div><div><h3>Conclusion</h3><div>The findings showed that daily consumption of Ma'aljobon supplements on an empty stomach before breakfast may have a beneficial effect on the glycemic indices of patients. However, further studies seem to be necessary in this regard.</div></div>","PeriodicalId":37937,"journal":{"name":"Contemporary Clinical Trials Communications","volume":"43 ","pages":"Article 101401"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Left ventromedial prefrontal cortex inhibitory rTMS as an anti-stress intervention in opioid use disorder: Trial design 左腹内侧前额叶皮层抑制rTMS作为阿片类药物使用障碍的抗应激干预:试验设计。
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-01 DOI: 10.1016/j.conctc.2024.101414
Tabitha E. Moses , Danielle Lenz , Leslie H. Lundahl , Nicholas A. Mischel , Christine Rabinak , Mark K. Greenwald

Background

In people with substance use disorders (SUDs), stress-exposure can impair executive function, and increase craving and likelihood of drug-use recurrence. Research shows that acute stressors increase drug-seeking behavior; however, mechanisms underlying this effect are incompletely understood. The Competing Neurobehavioral Decisions System theory posits that persons with SUDs may have hyperactive limbic reward circuitry and hypoactive executive control circuitry.

Objective

To investigate how inhibitory repetitive transcranial magnetic stimulation (rTMS) targeting the left ventromedial prefrontal cortex (vmPFC) may alter stress-induced executive dysfunction, emotion dysregulation, and drug-seeking in people with opioid use disorder.

Methods

We will examine effects of a psychological stressor combined with inhibitory (1Hz) left vmPFC rTMS in participants (N = 24) receiving opioid agonist treatment. Participants undergo guided imagery of autobiographical stressors paired with 10 sessions of active vmPFC rTMS vs. sham (within-subject randomized crossover). Stress-induced dysfunction will be indexed with cognitive (e.g., executive function), affective (e.g., emotional arousal), and behavioral (e.g., opioid-seeking) measures pre- and post-rTMS. To confirm changes are associated with altered neural activity in targeted regions, we will measure event-related potentials during key tasks using EEG. We hypothesize that stressors will increase executive dysfunction, emotion dysregulation, and drug-seeking, and that left vmPFC inhibitory rTMS will decrease limbic activation, which could translate to reduced craving and drug-seeking.

Conclusion

Our findings should offer insights into how neural networks modulate drug-seeking and associated dysfunctions in people with SUDs. The results of this and similar studies can advance theory and neuromodulation interventions for people with SUDs.
背景:在物质使用障碍(sud)患者中,压力暴露可损害执行功能,增加对药物使用的渴望和复发的可能性。研究表明,急性压力源会增加寻求药物的行为;然而,这种效应背后的机制尚不完全清楚。竞争神经行为决策系统理论认为,患有sud的人可能有过度活跃的边缘奖励回路和不活跃的执行控制回路。目的:探讨针对左侧腹内侧前额叶皮质(vmPFC)的抑制性重复经颅磁刺激(rTMS)如何改变阿片类药物使用障碍患者应激性执行功能障碍、情绪失调和药物寻求。方法:我们将研究心理应激源联合抑制性(1Hz)左vmPFC rTMS对接受阿片类激动剂治疗的参与者(N = 24)的影响。参与者接受自传体应激源的引导图像,与10次主动vmPFC rTMS和假rTMS配对(受试者内随机交叉)。压力诱发的功能障碍将与rtms前后的认知(如执行功能)、情感(如情绪唤醒)和行为(如寻求阿片类药物)测量指标相关联。为了确认这些变化与目标区域的神经活动改变有关,我们将使用EEG测量关键任务期间的事件相关电位。我们假设压力源会增加执行功能障碍、情绪失调和药物寻求,而左vmPFC抑制rTMS会减少边缘激活,这可能转化为减少渴望和药物寻求。结论:我们的发现应该为神经网络如何调节sud患者的药物寻求和相关功能障碍提供见解。这项研究和类似研究的结果可以促进理论和对sud患者的神经调节干预。
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引用次数: 0
Corrigendum to “Protocol for double-blind RCT of acupuncture for vulvodynia” [Contemp. Clin. Trials Commun. (2022) 1–8 101029]
IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-02-01 DOI: 10.1016/j.conctc.2024.101422
Judith M. Schlaeger , Marie L. Suarez , Jennifer E. Glayzer , William H. Kobak , Monya Meinel , Alana D. Steffen , Larisa A. Burke , Heather A. Pauls , Yingwei Yao , Miho Takayama , Hiroyoshi Yajima , Ted J. Kaptchuk , Nobuari Takakura , David Foster , Diana J. Wilkie
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引用次数: 0
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Contemporary Clinical Trials Communications
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