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Procedure
ATTRITION
This study was a randomized controlled study. Group randomization was used to divide the 3 participating schools into control, treatment as usual (TAU), and intervention groups. Measures were obtained at baseline and 42 days later. Participants in both the TAU and intervention groups received an approximately 10-minute...
PMC10337294
Statistical Analysis
The descriptive characteristics of participants along with attrition reasons are reported. Pearson correlation coefficients, independent samples
PMC10337294
Discussion
time-based, depression, Anxiety
REGRESSION, REGRESSION, ATTRITION
The focus of this study was on time-specific attrition in an adolescent mHealth intervention. We hoped to build on previous work while focusing on the type, frequency, and time of usage in order to better understand why adolescent attrition from mHealth interventions is generally as excessive as it is, with a market sa...
PMC10337294
Abbreviations
mobile healthtreatment as usual
PMC10337294
Backgroud
respiratory depression, pain
RESPIRATORY DEPRESSION
ciprofol is a new type of intravenous anesthetic, which is a tautomer of propofol, with the characteristics of less injection pain, less respiratory depression and higher potency, but little clinical experience. The aim of this study was to observe the efficacy and safety of the application of ciprofol in ambulatory su...
PMC10039513
Methods
loss of consciousness
ADVERSE EVENTS, SECONDARY
128 patients were selected to undergo gynecological day surgery under general anesthesia, and the patients were randomly divided into the ciprofol group and the propofol group, with 64 cases in each group. During anesthesia induction, the ciprofol group was infused at a time limit of 0.5 mg/kg for one minute, and the p...
PMC10039513
Results
loss of consciousness of the ciprofol
ADVERSE EVENTS
The overall incidence of adverse events was significantly lower in the ciprofol group compared with the propofol group (56.2% vs. 92.2%,P < 0.05). The success rate of anesthesia induction of ciprofol and propofol group was 100.0%. The time of loss of consciousness of the ciprofol group was longer than that of the propo...
PMC10039513
Conclusions
ADVERSE EVENTS
Compared with propofol, ciprofol had a similar anesthetic effect in gynecological ambulatory surgery, and the incidence of adverse events in the ciprofol group was lower.
PMC10039513
Keywords
PMC10039513
Introduction
Day surgery has become popular in different countries because of its advantages in reducing hospitalization time, improving bed utilization and reducing hospitalization costs. With the development of medical technology, the proportion of day surgery is growing rapidly. Guidelines from the Association of Anaesthetists a...
PMC10039513
Materials and methods
PMC10039513
Secondary outcomes included
loss of consciousness
(1) success rate of induction of anesthesia,(2) the time of loss of consciousness (time of initiation of study drug infusion to MOAA/S ≤ 1), (3) time of awakening (time of drug discontinuation to extubation), (4) study drug top-up doses, (5)rescue drug use.
PMC10039513
Sample size and statistical analysis
ADVERSE EVENTS
In type I error 0.05(bilateral), Power of test is 80%.The overall incidence of adverse events was approximately 36.4% in the ciprofol group, and 60.6% in the propofol group.Finally a total of 128 patients were includeda in this study.Using SPSS 25. 0 Statistical software for data analysis. normal distribution measureme...
PMC10039513
Results
T 5:5, loss of consciousness, 05Figure, hypotension, intraoperative adverse
ADVERSE EVENTS
128 patients were included in this study. Data from 128 patients were obtained for statistical analysis (Fig.   A fow chart of the current trial Comparison of the general situation of the two groups of patientsA total of 137 adverse events occurred in 128 patients, of which 44 adverse events occurred in 64 patients in ...
PMC10039513
Acknowledgements
The authors would like to thank the volunteers who took part in the trial, as well as the staff that assisted with the trial at the site.The authors would like to thank all the reviewers who participated in the review.
PMC10039513
Author contributions
Yan Man, Fanceng Ji designed the study.,Yan Man,Hongyi Xiao, Teng Zhu recruited patients and collected datas, Yan Man performed statistical processing and wrote the manuscript. Fanceng JI revised the manuscript. All authors read and approved the manuscript in its final version.
PMC10039513
Funding
Nil.
PMC10039513
Data Availability
The datasets generated and analysed during the current study are not publicly available due to institutional restrictions but are available from the corresponding author on reasonable request.
PMC10039513
Declarations
PMC10039513
Ethics approval and consent to participate
The present study was approved by the Ethics Committee of Weifang People’s Hospita(2021037), and was registered in the Chinese Clinical Trial Registry.( ChiCTR2100053444). Informed consent was obtained from all subjects or their legal guardian. The study protocol followed the CONSORT guidelines. The study protocol was ...
PMC10039513
Consent for publication
Not applicable.
PMC10039513
Competing interests
The authors declare that they have no conficts of interest.
PMC10039513
Abbreviations
gamma-aminobutyric acid-Abody mass indexsystolic blood pressuremean arterial pressurediastolic blood pressureheart ratenon-invasive blood pressure electrocardiogrampulse oxygen saturationbispectral indexModified Observer’s Assessment of Alertness/Sedationpost anesthesia care unitheart ratetidal volumefraction of inspir...
PMC10039513
References
PMC10039513
Introduction
obesity, overweight, weight loss
OBESITY
Based on the latest estimates and according to the World Health Organization, overweight and obesity affects almost 60% of adults in the European Union countriesWeight loss regimes rely on creating an energy deficit—where energy intake is lower than energy expenditure. However, this approach proves challenging for many...
PMC10597999
Methods
PMC10597999
Design
MAY
This was a single-center, double-blind, three parallel group, block randomized, placebo-controlled trial, followed by an open phase conducted at Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden, between October 2021 and February 2022. The study was conducted according to the Declaration...
PMC10597999
Subjects
Voluntary individuals who were 18–45 years old and met the criteria of BMI 26.0 to less than 30 kg/mParticipants were provided economic compensation for their participation.
PMC10597999
Tested compound
Dietary supplement consisting of capsules withholding bacteria with probiotic properties called AB001 (de Faire Medical AB, Stockholm Sweden). It contains strains of Due to ethical reasons, all participants received a pamphlet with general advice regarding recommended food and eating pattern based on Swedish guidelines...
PMC10597999
Procedures
If inclusion criteria were fulfilled, no exclusion criteria were identified, and written informed consent was obtained, the individual was included in the study. Participants were randomized to (a) double dose probiotics (four capsules probiotic per day), (b) single dose probiotics (two capsules probiotic per day and t...
PMC10597999
Randomization and masking
Participants were randomly assigned (1:1:1) to single dose probiotics, double dose probiotics, or placebo using a fixed block size of nine participants and stratified for sex. Participants were randomized to (a) four capsules of probiotics per day or (b) two capsules of probiotics per day and two capsules of placebo, o...
PMC10597999
Clinical investigation
Clinical investigation was performed at baseline and at 3-month, and 6-month follow-up and included a medical examination that included cardiorespiratory and abdominal examinations was performed. In addition, weight was measured with a digital scale (Tanita BWB-800, Tanita Corp., Japan), height was measured with a wall...
PMC10597999
Blood samples
infection, hemolysis, sinusitis
INFECTION, HEMOLYSIS, SINUSITIS
Clinical laboratory tests were drawn at fasting state at baseline, 3-month follow-up, and 6-month follow-up and included; leukocyte concentration, MCH, platelets, mean cell [erythrocytes] volume (MCV), erythrocyte concentration, erythrocyte volume fraction (EVF), hemoglobin, high-sensitivity C-reactive protein (hs-CRP)...
PMC10597999
Statistical analyses
PMC10597999
Power calculation
Sample size calculation for this three-armed placebo-controlled study is performed in STATA software based on alpha = 0.0500 and power = 0.8000. Estimated change in body weight; Mean change in the placebo group = 0.00 kg, Mean change in single dose probiotic group = − 2.00 kg, Mean change in double dose probiotic group...
PMC10597999
Descriptive and outcome statistics
SECONDARY
Data was checked for normality and presented with mean and standard deviation or median and interquartile range whenever appropriate. Descriptive data are presented with both measures with a marking of whether data was considered as normally distributed or not. Categorical variables are presented with frequencies and p...
PMC10597999
Role of funding
The funder, de Faire Medical AB (Sweden), manufacturer of the studied probiotic AB001 and provided matching placebo at no cost. Further, the funder provided Karolinska Institutet financial compensation for study-related expenses such as costs for analyses of blood samples and study subject reimbursement. The funder of ...
PMC10597999
Adherence
obstipation, vomiting and gastrointestinal pain
OBSTIPATION, ADVERSE EVENT
All 81 included participants remained to the 3-month follow-up. At the 3-month follow-up, 54 participants identified from the single or double dose of probiotic groups in the blinded phase were asked to continue with a higher dose of probiotics. Six participants declined further participation, two participants started ...
PMC10597999
Secondary aims
SECONDARY
Changes in secondary aim variables and differences between groups after 3 and 6 months are provided in Tables
PMC10597999
BMI
After 3 months were there no differences in BMI changes between the investigated groups (p = 0.89), nor within each group (all p > 0.05). After 6 months there was a decrease in BMI from baseline to 6-month follow-up of 0.48 kg/m
PMC10597999
Waist circumference
There were no differences in change in waist circumference after 3 months between the investigated groups (p = 0.41). For those who continued with triple dose probiotics (n = 45), the waist circumference decreased from baseline to 6-month follow-up by 2.8 cm, p = 0.002.
PMC10597999
Blood pressure
All groups decreased their blood pressure from baseline to 3-month follow-up, all p < 0.05, but the decrease was not different between the groups, both p > 0.75. Fort those who continues with triple dose probiotics (n = 45), the systolic and diastolic blood pressure decreased from baseline to 6-month follow-up by 6.9 m...
PMC10597999
Blood lipids
There were no changes in the levels of total cholesterol, LDL after 3 and 6 months, and no differences between the groups, all p > 0.05.Both the placebo and the double dose probiotic group decreased the level of HDL from baseline to the 3-month follow-up with a mean (SD) of 0.10 (0.14) mmol/L, p < 0.001 and 0.11 (0.23)...
PMC10597999
Glucose metabolism
During the first 3 months, no group changed on average the level of fasting glucose, HbA1c or insulin from baseline, and no changes between the groups were observed (all p > 0.05). For those who continued with triple dose probiotics, there was a borderline statistically significant decrease from baseline in fasting glu...
PMC10597999
Liver enzymes
MINOR
No group changed on average the level of ALT from baseline to the 3-month follow-up (all p > 0.05), and no changes between the groups were observed (p = 0.79). At the 6-month follow-up, a minor increase in ALT levels from baseline was observed, + 0.07 µkat/L (p = 0.038). There were no differences between the groups, p ...
PMC10597999
Inflammatory marker
There were no changes in hsCRP after 3 or 6 months, and no differences between the groups, all p > 0.05.
PMC10597999
Vitamins
There were no changes in fat-soluble vitamins at 3-month not 6-month follow-up.
PMC10597999
Blood cell composition
No changes in blood cell composition, neither between nor within groups, were observed after 3 months. After 6 months there was no change in the levels of leukocytes, mean corpuscular volume, mean corpuscular hemoglobin, or thrombocytes. However, there was a marginal decrease in the levels of erythrocytes, hemoglobin, ...
PMC10597999
Bowel habits
nausea, flatulence, gastrointestinal problems
Individuals who reported changes in bowel habits any time during the study were prevalent and similar between the groups; Placebo group 70.4%, single dose probiotic group 66.6%, double dose probiotic group 66.6%, triple dose probiotic group 68.9% (p = 0.99). The most common reported changes in bowel habits were changes...
PMC10597999
Excluded participant
obstipation, gastrointestinal symptoms, gastroenteritis, stomachache
ADVERSE EVENTS, OBSTIPATION, GASTROENTERITIS
One individual, a male, who received double dose AB001 during phase one, was excluded due to adverse events. He reported on day 159 that he had severe stomachache, obstipation, and concurrent vomiting. There was no gastroenteritis observed among friends and family. The study team instructed him to stop taking probiotic...
PMC10597999
Discussion
inflammation, weight gain, overweight, overweight or obesity, heredity, weight loss
INFLAMMATION, MINOR
In this study, we assess the impact of the probiotic compound AB001 on weight loss among individuals with overweight. During the initial 3-month double-blinded placebo-controlled phase, no difference in weight was observed between the groups using placebo, single dose, or double dose of the compound. During the second ...
PMC10597999
Conclusion
weight loss
In this trial testing probiotics for weight loss, no effect was observed after the double-blinded 3-month phase. For those who received double dose for 3 months who continued with triple dose for another 3 months in the open study phase, a modest but significant weight loss of approximately 2 kg or 0.7 BMI units was ob...
PMC10597999
Supplementary Information
The online version contains supplementary material available at 10.1038/s41598-023-45395-7.
PMC10597999
Acknowledgements
We would like to thank all study individuals for their participation in the trial. Also, a great acknowledgement to our research nurse Monika Grzeskowiak for your phenomenal engagement.
PMC10597999
Author contributions
Conceptualization: P.D., C.M., E.H. Investigation: P.D., R.R.P., C.M., E.H. Data curation: E.H. Formal analyses: E.H. Project administration: E.H. Resources: P.D., R.R.P., C.M., E.H. Writing—original draft: E.H. Writing—review and editing: P.D., R.R.P., C.M.
PMC10597999
Funding
Open access funding provided by Karolinska Institute. The funder, de Faire Medical AB (Sweden), manufacturer of the studied probiotics and provided matching placebo at no cost. Further, the funder provided Karolinska Institutet financial compensation for study-related expenses such as costs for analyses of blood sample...
PMC10597999
Data availability
The datasets generated and analyzed during the current study are not publicly available due to lack of informed consent, but de-identified datasets are available from the corresponding author on reasonable request.
PMC10597999
Competing interests
PD, CM, EH
CM is acting as a scientific advisor for the sponsoring company de Faire Medical AB. EH have reviewed research data from other trials sponsored by de Faire Medical AB. PD and RRP declare no competing interests.
PMC10597999
References
PMC10597999
Background:
Bile duct
ABDOMINAL SEPSIS, COMPLICATIONS
Bile duct injury (BDI) is one of the serious complications of cholecystectomy procedures, which has a disastrous impact on long-term survival, health-related quality of life (QoL), healthcare costs as well as high rates of litigation. The standard treatment of major BDI is hepaticojejunostomy (HJ). Surgical outcomes de...
PMC10389623
Methods:
blood loss, abdominal sepsis, sepsis, post-cholecystectomy, HJ
BLOOD LOSS, ABDOMINAL SEPSIS, SEPSIS, SECONDARY
This is a multicenter, multi-arm, parallel-group, randomized trial that included all consecutive patients treated with HJ for major post-cholecystectomy BDI from February 2014 to January 2022. Patients were randomized according to the time of reconstruction by HJ and abdominal sepsis control into group A (early reconst...
PMC10389623
Results:
sepsis
SEPSIS, ABDOMINAL SEPSIS, SECONDARY, COMPLICATIONS
Three hundred twenty one patients from three centres were randomized into three groups. Forty-four patients were excluded from the analysis, leaving 277 patients for intention to treat analysis. With univariate analysis, older age, male gender, laparoscopic cholecystectomy, conversion to open cholecystectomy, failure o...
PMC10389623
Conclusion:
ABDOMINAL SEPSIS
Early reconstruction after abdominal sepsis control can be done safely at any time with comparable results for delayed reconstruction in addition to decreased total cost and improved patient QoL.
PMC10389623
Keywords:
PMC10389623
Introduction
Bile duct injury, sepsis, friable oedematous non-dilated common bile duct, HighlightsEarly bile duct
ABDOMINAL SEPSIS, SEPSIS, COMPLICATIONS
HighlightsEarly bile duct injury reconstruction after sepsis control can be done safely at any time.It has comparable results for delayed reconstruction.It has decreased re-intervention and admission, total hospital stays, and total cost.It results in improved patient quality of life early.Bile duct injury (BDI) is one...
PMC10389623
Methods
This is a multicenter, multi-arm, parallel-group, randomized controlled trial (RCT). Ethics committee approval for the study was obtained from all centres. The study was registered in ClinicalTrials.gov (ID: NCT05436626). This work has been reported in line with the Consolidated Standards of Reporting Trials (CONSORT, ...
PMC10389623
Trial design and participants
PTD, Sepsis, cholangitis, inflammation, cholestasis, sepsis, post-cholecystectomy
SEPSIS, CHOLANGITIS, INFLAMMATION, CHOLESTASIS, SEPSIS
This study included all consecutive patients treated with an HJ for post-cholecystectomy BDI from February 2014 to January 2022 in 10 tertiary centres in Egypt. The inclusion criteria included patients diagnosed with type E1 to E4 BDIGroup A (Early reconstruction without sepsis control): all the included patients were ...
PMC10389623
Data collection
Data collected included patient demographics, clinical presentations, initial cholecystectomy details, BDI criteria, operative details, postoperative course, and follow-up.
PMC10389623
Preoperative assessment
jaundice, post-cholecystectomy tachycardia, fever, abdominal pain
BILE LEAK
BDI was suspected in patients who presented with post-cholecystectomy tachycardia, fever, abdominal pain, jaundice, bile leak, or abdominal bile collections
PMC10389623
Operative techniques
The standard reconstruction technique was the Roux-en-Y HJ. It was performed as wide as possible, not under tension, and with good edge vascularity. It can be achieved by end-to-side or the Hepp–Couinaud approach. A division of the hilar plate and partial resection of segment IV were done when indicated to lengthen the...
PMC10389623
Postoperative management
biliary stricture
BILE LEAK
Patients were transferred to the general surgical wards or the ICU according to their postoperative state. They received antibiotics intraoperatively and continued postoperatively for 10 days. Oral fluid intake was encouraged once intestinal sounds were audible. The daily follow-up plane include the following of the vi...
PMC10389623
Follow-up
late-onset stricture
Patients were followed-up during the first three months, biweekly, then monthly, during the first year, and then annually. The reconstruction was assessed especially for late-onset stricture by the clinical evaluation during each visit and laboratory, and radiologically (MRCP) when indicated.
PMC10389623
Outcomes and manoeuvers
cholangitis, blood loss, liver abscess, jaundice, HJ
CHOLANGITIS, BLOOD LOSS, BILE LEAKAGE, BILE LEAK, LIVER ABSCESS, SECONDARY
The primary outcome was a successful reconstruction rate. The secondary outcomes were blood loss, HJ diameter, operative time, drainage amount, drain and stent duration, postoperative LFTs, morbidity and mortality, number of admissions and interventions, hospital stay, patient QOL, and total cost.The index treatment wa...
PMC10389623
Sample size calculation
We calculated the sample size with a power of 80% and a reliability of 0.05. We found that 81 patients should be included in each group. Eligible patients were randomly divided according to a computer-generated random number (Fig. Flow of participants in the RCT According to CONSORT. RCT, randomized controlled trial.
PMC10389623
Statistical analysis
We used IBM SPSS statistics for Windows v. 25 (SPSS Inc.). We presented categorical data as numbers and percentages (%), and continuous data as either mean and SD for normally distributed data and median and interquartile range for non-normally distributed data. We used the one-way ANOVA, Kruskal–Wallis H test, and χ
PMC10389623
Results
PMC10389623
Overall series
post-cholecystectomy
From 440 patients were evaluated for post-cholecystectomy BDI, 277 patients were included in the study and classified into three groups [89 patients (32.1%) in group A, 105 patients (37.9%) in group B, and 83 patients (30%) in the group C]. Our centres are tertiary referral centres in Egypt, which serve six governments...
PMC10389623
Preoperative data
SIRS, bile duct injury, bilirubin.mean ±
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
Patient’s criteria, initial cholecystectomy criteria, and BDI criteria are summarized in Table Patients demographics, initial cholecystectomy, and bile duct injury criteria.Bold numerals indicate a statistically significant difference.ASA, American Society of Anesthesiologists; EQ-5D, Euro Quality of life-5 dimentions ...
PMC10389623
Operative data
PTD, SIRS
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
There were statistically significant differences regarding all the operative parameters among the three groups except the type of index repair and SGPT level, which showed no statistically significant differences among the three groups (Table Operative data.Bold numerals indicate a statistically significant difference....
PMC10389623
Postoperative data
There were no statistically significant differences regarding the median time to resume oral intake on POD3 among the three groups, the mean time for stent removal, the mortality, and the follow-up duration. The median follow-up was two years, and the date of the last follow-up was recorded in April 2022. All the remai...
PMC10389623
Clavien–Dindo classification of postoperative complications
ARDS, DVT
DEEP VENOUS THROMBOSIS, POSTOPERATIVE COMPLICATIONS, WOUND INFECTION, COMPLICATION, URINARY TRACT INFECTION, UTI, ARDS, ACUTE RESPIRATORY DISTRESS SYNDROME, COMPLICATIONS, DVT
Clavien–Dindo grade 1 was the most common complication (42.7%) in large part to wound infection, followed by grade III (25.1%). There were statistically significantly higher grade I and grade III complication rates in group A when compared with groups B and C. At the same time, there were no differences in the remainin...
PMC10389623
Postoperative success rate
sepsis, Anastomotic stricture
SEPSIS
The incidence of successful reconstruction was statistically significantly lower in group A (80.9%) compared with groups B (92.4%) and C (91.6%), which subsequently reflected in the incidence of re-intervention that was statistically significantly higher in group A (34.8%) compared with groups B (18.1%) and C (20.5%). ...
PMC10389623
Univariate and multivariate analysis for successful reconstruction
Study variables associated with successful reconstruction at the Univariate and multivariate analysis for risk factors for successful reconstruction.Bold number: indicate the significant result.ASA, American Society of Anesthesiologists; BDI, bile duct injuty; HJ, hepaticojejunostomy; PTD, percutaneous transhepatic dra...
PMC10389623
Discussion
abdominal sepsis
ABDOMINAL SEPSIS, POSTOPERATIVE COMPLICATIONS
The incidence of BDI has significantly increased internationally during the past 15 yearsEl Nakeeb On the contrary, A large retrospective multicentre studyMany papers revealed that abdominal sepsis control is a critical preventive measure for postoperative complications and reconstruction failureThe literature has a hi...
PMC10389623
Patient demographics
gallstones
GALLSTONES
This study revealed a higher incidence of BDI in females (62.8%), which may be attributed to the high incidence of gallstones and cholecystectomies in females, consistent with many papers
PMC10389623
Operative data
dilated bile duct
STRICTURE
Surgical reconstruction is the most effective treatment of major BDI with optimal long-term outcomesContrary to popular belief, some studies reported that dilated bile duct did not prevent stricture after HJThe use of trans-anastomotic stents is still debatable
PMC10389623
Postoperative morbidity and mortality
Published studies reported 1.5–3 months for stent removal after doing a cholangiogram and ensuring anatomical and functional patency of the anastomosisThe reported rate of postoperative morbidity after BDI reconstruction ranged from 15% to 65%Dominguez-Rosado A recent meta-analysisDegeforde Even though the cost burden ...
PMC10389623
Univariate and multivariate analysis
Two studiesMany previous studiesThe optimal time for BDI reconstruction remains controversial. Some authors advise delayed repairMany papersTwo studiesGad Two recent studiesTwo recent studiesSeveral studies
PMC10389623
Strengths and limitations of the study
vascular injury, intrahepatic stones, trans-anastomotic external jejunal stents, biliary stricture, liver cell failure
ABDOMINAL SEPSIS, BILIARY CIRRHOSIS, COMPLICATIONS
Our study has several strengths. To the best of our knowledge, this is one of the early RCTs evaluating the impact of reconstruction time and abdominal sepsis control on reconstruction success. It exclusively considers HJ reconstruction and excludes other reconstruction methods, creating a homogenous study. We investig...
PMC10389623
Conclusion
sepsis
ABDOMINAL SEPSIS, SEPSIS
In conclusion, the results of this multicenter RCT revealed that avoidance of conversion to open surgery, controlled abdominal sepsis, avoidance of pre-referral repair attempts, wide anastomotic stoma, trans-anastomotic stent, and repair by a skilled HBS in tertiary centres are the most crucial factors associated with ...
PMC10389623
Ethical approval
Ethical committee approval (Faculty of Medicine—South Valley University) for the study was obtained with this identification number: (SVU/MED/SUR011/4/489). The study was registered in the ClinicalTrials.gov database with this identification number: NCT05436626
PMC10389623
Source of funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
PMC10389623
Author contribution
Study concept and design: All authors. Data collection: All authors. Analysis and interpretation of data: M.A. O. Writing and literature review: M.A.O. Review and corrections: M.A. O., A.A. R., E.A.A. Final approval of the version: A.A.R.
PMC10389623
Conflicts of interest disclosure
We certify that there is no conflict of interest with any financial/ research/academic organization, with regards to the content/research work discussed in the manuscript.
PMC10389623
Guarantor
Dr. Mohammed Ahmed Omar.
PMC10389623
Data statement
All data statement are available when requested.
PMC10389623
Provenance and peer review
Not commissioned, externally peer-reviewed.
PMC10389623
Supplementary Material
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website, Published online 20 April 2023
PMC10389623
References
PMC10389623
Introduction
Child marriage remains a significant human rights issue globally, with an estimated 12 million girls married before age 18 each year [Over the past several decades, data show declines in child marriage globally—with the proportion of girls married by age 18 decreasing from 25% in 2008 to 21% in 2018 [
PMC10104334