title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
|---|---|---|---|---|
Trendlines in proportion of women ages 20–24 married by exact age 18, DHS 1988–2019. | WEST | Bold, dotted lines show trendlines for each country. Light-shaded lines show available data, with earliest and latest datapoints represented for each country.It is additionally important to note that even if countries experienced a similar rate of decline in the proportion of girls married as children, population size ... | PMC10104334 | |
Intervention | The MTBA intervention was designed in 2015 and sought to empower girls, to raise awareness about the risks of child marriage, to improve girls’ access to sexual and reproductive health (SRH) services, and to support social norms favorable to girls’ education, economic engagement, and agency in marital decision-making. ... | PMC10104334 | ||
More Than Brides Alliance Theory of Change. | The program was implemented by local community-based organizations from 2017–2020 in India, Malawi, Mali, Niger and Pakistan. In each country, an international program partner served as the lead organization responsible for project management and administration and for providing technical assistance to local implementi... | PMC10104334 | ||
Methods | PMC10104334 | |||
Impact evaluation design | The evaluation followed a cluster randomized design in India and Malawi and a quasi-experimental (matched) design in Mali and Niger. A quasi-experimental design was used in Mali and Niger because the program aimed to build upon a previous intervention that had begun in 2015, so working in new (randomized) areas was not... | PMC10104334 | ||
Baseline demographics across samples, by Country. | *** p < .01**p < .05*p < .10 difference between comparison and intervention.In all settings, we conducted repeated household listings followed by cross-sectional surveys with random samples of adolescent girls ages 12–19 drawn from intervention and comparison villages at baseline (2016/7), midline (2018) and endline (2... | PMC10104334 | ||
More Than Brides Alliance program and research samples. | * If a village was smaller than 150 households, we created a village cluster grouping the small village to one or more neighboring villags within the same Panchayat. Village clusters were vetted by program partners. ** Enumeration Areas are geographic units defined by the Malawi National Statistical Office. We used thi... | PMC10104334 | ||
Randomization and study participants | Clusters were randomized to either intervention or comparison areas (Malawi and India). In India, we stratified by states and then randomized clusters within each state. After completion of a household listing, girls ages 12–19 were randomly selected within clusters using a random number generator in Stata or Excel for... | PMC10104334 | ||
Sample size and power analysis | We used the minimum detectable effect (MDE) approach to estimate sample sizes needed in each country. We used Optimal Design Software [ | PMC10104334 | ||
Study instruments | Adolescent surveys were designed to capture key outcomes related to educational attainment, livelihood experience, gender-equitable attitudes, educational and marriage-related aspirations, marital status and history, basic literacy and numeracy skills, and knowledge of topics including marriage laws and SRHR. The endli... | PMC10104334 | ||
Outcomes | ’ | The main outcome of interest was proportion ‘ever married’, measured as the proportion of girls in the sample who reported ever having been married or living together with a partner as if married, including girls who were separated or divorced at the time of the survey. We also examined the proportion of girls ‘ever en... | PMC10104334 | |
Variation in samples | In | PMC10104334 | ||
Statistical analysis | SE | Analyses were conducted in Stata SE 14.2 and included adjustments based on evaluation design and fidelity to randomization. We conducted difference-in-differences (DID) analyses using Stata SE 14.2 adjusted for the cluster design. In India and Malawi (where the intervention sites were randomized and balanced at baselin... | PMC10104334 | |
Ethics | Ethical and research clearance for this study was issued by the Institutional Review Board of the Population Council and by the National Committee on Research in the Social Sciences and Humanities (NCRSH) in Lilongwe (Malawi), the Written informed consent was obtained from all research participants prior to their invol... | PMC10104334 | ||
Results | PMC10104334 | |||
Impact on child marriage | In | PMC10104334 | ||
Difference-in difference results for proportion of girls ages 12–19 ever married, baseline to endline. | PMC10104334 | |||
Difference-in-differences, proportion of ever married girls ages 12–19. | *** p < .01**p < .05*p < .10.In | PMC10104334 | ||
Changes in proportion of girls ever married at baseline, midline, and endline. | Intervention areas shown in dark blue; comparisons in light blue. | PMC10104334 | ||
Impact on additional indicators | While the endline evaluation results did not find evidence that the MTBA intervention influenced child marriage prevalence in Malawi, Mali, or Niger, impact on other key indicators was detected. | PMC10104334 | ||
More Than Brides Alliance intervention impact evaluation results. | ADVERSE EFFECTS | In India, results show that the intervention increased the proportion of girls who were able to identify the legal age at marriage as well as the proportion of girls who were able to name at least three adverse effects of child marriage. The intervention additionally appeared to have increased knowledge of HIV, the pro... | PMC10104334 | |
Discussion | ADVERSE EFFECTS | The MTBA impact evaluation offered an important opportunity to understand how a program with the same basic design performs across four contexts characterized by divergent drivers of child marriage. As the results show, at the end of the MTBA intervention, the evaluation was able to detect program impact on child marri... | PMC10104334 | |
Limitations | There are a few key limitations to note. First, we acknowledge that there was a difference in research design in India and Malawi (cluster randomized cross sectional design) versus Mali and Niger (quasi experimental matched design). As such, the lack of results in Mali and Niger may be due in part to the challenges of ... | PMC10104334 | ||
Conclusion | particularwe | Child marriage is declining everywhere, but there are notable discrepancies in the changes observed between contexts: much of the change is driven by declines in countries where drivers of child marriage have been widely documented and where child marriage programs have a deeper history of engagement. On the question o... | PMC10104334 | |
References | PMC10104334 | |||
Introduction | abdominal obesity | VITAMIN D DEFICIENCY | Vitamin D deficiency has been reported to affect liver function biomarkers. This study was aimed to investigate the effect of consuming vitamin D fortified low-fat dairy products on liver function tests in adults with abdominal obesity.
| PMC10521569 |
Methods | Milk | OBESE | This total blinded randomized controlled trial was undertaken on otherwise healthy abdominally obese adults living in Mashhad, Iran. Milk and yogurt were fortified with 1500 IU vitamin D | PMC10521569 |
Results | A total of 289 participants completed the study (54% female). The groups were homogenous in terms of age, sex, weight, energy intake, and physical activity level ( | PMC10521569 | ||
Keywords | PMC10521569 | |||
Introduction | obesity, abdominal obesity, NAFLD, non-alcoholic fatty liver disease | OBESITY, NON-ALCOHOLIC FATTY LIVER DISEASE, VITAMIN D DEFICIENCY, LIVER DISEASES, CHRONIC LIVER DISEASE | Vitamin D is a fat-soluble vitamin that is derived from the diet and ultraviolet light skin exposure. Vitamin D is converted to its active forms by hydroxylase enzymes in the liver and kidneys [It should be noted that vitamin D deficiency is widely seen in patients with chronic liver disease, and it can be a risk facto... | PMC10521569 |
Materials and methods | PMC10521569 | |||
Study design | This report is a part of the pilot study entitled: Flow chart of the study | PMC10521569 | ||
Sample size | The sample size was calculated based on the power of 80%, effect size of 0.5. The sample size was calculated as 255 participants. After considering 10% dropout, the final sample size was determined as at least 280 participants (70 participants in each group) [ | PMC10521569 | ||
Ethics | This trial received ethical approval from the Research Ethics Committee of the Iran National Institute for Medical Research Development (protocol ID: IR.NIMAD.REC.1396.027). The study was also registered at the Iran Registry of Clinical Trials at | PMC10521569 | ||
Inclusion and exclusion criteria | sleep disorders, hepatic or renal dysfunctions, abdominal obesity, lactase deficiency, diabetes | DIABETES | Participants were recruited among Mashhad University of Medical Sciences (MUMS) staff, students, and their relatives who consented to take part in our study. Participants were middle-aged adults (30–50 years) with abdominal obesity (waist circumference of 80 cm or higher for females and 94 cm or higher for males) based... | PMC10521569 |
Procedure | RECRUITMENT | Recruitment occurred one month prior to the intervention (November 2018). The screening was conducted in three steps: (1) phone conversation, (2) visiting participants at the clinic and clarifying the study protocol, (3) visiting participants to obtain informed consent a few days after the initial visit. Then a general... | PMC10521569 | |
Anthropometric assessments | fat-free mass | CREST | Height was assessed using a wall stadiometer at baseline. A digital bio impedance analyzer (Tanita BC 418; Japan) was applied to evaluate weight, fat mass percentage (FM%), and fat-free mass percentage (FFM%) at baseline and after ten weeks of intervention. Body mass index was calculated using the following formula:Wai... | PMC10521569 |
Blood sample measurements | Pishgaman sanjesh- | After a 12-h over-night fasting, 20 ml of venous blood was taken from a brachial vein of eligible participants to evaluate serum levels of vitamin D, ALT, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and Gamma glutamyl transferase (GGT). All blood samples were collected in EDTA anticoagulant tubes in t... | PMC10521569 | |
Randomization and blinding | FM | Stratified block randomization was performed according to centers and sex, using a randomized block design with the ratio of 1:1:1:1. Participants were allocated to one of four groups as follows: fortified milk (FM), fortified yogurt (FY), plain milk (PM), and plain yogurt (PY). A staff member who was not involved in d... | PMC10521569 | |
Intervention | HOLIDAYS | For 10 weeks, each participant was given a portion of dairy product according to their groups (200 ml milk or 150 ml yogurt in a disposable plastic container). Participants were instructed to consume the products daily, as far as possible in front of the researcher in morning snack time (around 9–11 AM). For better bli... | PMC10521569 | |
Production of nano-encapsulated vitamin D | polydispersity | The nano-encapsulated formulation was produced by components included: Precirol (glyceryl palmitostearate) as the solid lipid, poloxamer 188 as the non-ionic surfactant, oleic acid as the liquid lipid, vitamin D as the bioactive fatty core, and deionized water. The first three components mentioned above are inactive in... | PMC10521569 | |
Post-intervention assessments | Post-intervention assessments took place immediately after the end of the intervention. All anthropometric and blood parameters that have been measured at baseline, including weight, BMI, serum vitamin D, ALT, AST, ALP, GGT, were measured. | PMC10521569 | ||
Statistics analysis | fasting blood glucose | The Kolmogorov–Smirnov test (KS test) was used to assess the normality of quantitative data. Quantitative variables were described as means ± standard deviation (SD), while the qualitative variables were expressed as percentage and frequency and were compared using the Chi-square test. The repeated measures analysis of... | PMC10521569 | |
Discussion | NAFLD, fatty liver, abdominal obesity, Milk, milk reduced hepatic apoptosis | FATTY LIVER, OBESE, BLIND, VITAMIN D DEFICIENCY | This study was the first study that assessed the effects of low-fat dairy products fortified with nano-encapsulated vitamin D on liver function parameters in adults with abdominal obesity. After ten weeks of intervention, treatment with vitamin D fortified dairy products was associated with a significant, increase in s... | PMC10521569 |
Conclusion | fortified milk | OBESE | The findings of this study indicated that both the fortified products improved serum vitamin D and that fortified milk might be a better choice in terms of improving liver enzymes in abdominally obese individuals.
| PMC10521569 |
Acknowledgements | This article is the part of a thesis of PhD student (Payam Sharifan) and the authors thank with grateful appreciation for the assistance and financial support provided by the National Institute for Medical Research Development (NIMAD) and the support of Mashhad University of Medical Sciences (MUMS) and Student Research... | PMC10521569 | ||
Author contributions | SE | This manuscript has been written by PS and MR. The data have been analyzed by SD and HV. The data have been gathered by MR, KRG, RH, MS, SE, RZ, MM, HG, ZK, and MB. The final manuscript has been reviewed by GF, MGM, and MR. | PMC10521569 | |
Funding | This work was supported by the National Institute for Medical Research Development (NIMAD), Tehran–Iran (Grant No. 957705). | PMC10521569 | ||
Availability of data and materials | Data can be supplied on request to the authors. | PMC10521569 | ||
Declarations | PMC10521569 | |||
Ethics approval and consent to participate | This trial received ethical approval from the Research Ethics Committee of the Iran National Institute for Medical Research Development (protocol ID: IR.NIMAD.REC.1396.027). The study was also registered at the Iran Registry of Clinical Trials at | PMC10521569 | ||
Consent for publication | All the authors of this paper have consented to its publication to this journal. | PMC10521569 | ||
Competing interests | The authors declare no competing interests. | PMC10521569 | ||
References | PMC10521569 | |||
Background | Missed appointments (“no-shows”) are a persistent and costly problem in healthcare. Appointment reminders are widely used but usually do not include messages specifically designed to nudge patients to attend appointments. | PMC10356735 | ||
Objective | To determine the effect of incorporating nudges into appointment reminder letters on measures of appointment attendance. | PMC10356735 | ||
Design | Cluster randomized controlled pragmatic trial. | PMC10356735 | ||
Patients | There were 27,540 patients with 49,598 primary care appointments, and 9420 patients with 38,945 mental health appointments, between October 15, 2020, and October 14, 2021, at one VA medical center and its satellite clinics that were eligible for analysis. | PMC10356735 | ||
Interventions | Primary care ( | PMC10356735 | ||
Main Measures | SECONDARY | Primary and secondary outcomes were missed appointments and canceled appointments, respectively. | PMC10356735 | |
Statistical Analysis | REGRESSION | Results are based on logistic regression models adjusting for demographic and clinical characteristics, and clustering for clinics and patients. | PMC10356735 | |
Key Results | Missed appointment rates in study arms ranged from 10.5 to 12.1% in primary care clinics and 18.0 to 21.9% in mental health clinics. There was no effect of nudges on missed appointment rate in primary care (OR = 1.14, 95%CI = 0.96–1.36, | PMC10356735 | ||
Conclusions | Appointment reminder letters incorporating brief behavioral nudges were ineffective in improving appointment attendance in VA primary care or mental health clinics. More complex or intensive interventions may be necessary to significantly reduce missed appointments below their current rates. | PMC10356735 | ||
Trial Number | ClinicalTrials.gov, Trial number NCT03850431. | PMC10356735 | ||
Supplementary Information | The online version contains supplementary material available at 10.1007/s11606-023-08131-5. | PMC10356735 | ||
KEY WORDS | PMC10356735 | |||
BACKGROUND | psychiatric | Missed appointments, frequently referred to as “no-shows,” are a longstanding challenge to providers and administrators in every healthcare system. In the Department of Veterans Affairs (VA), the largest integrated healthcare system in the USA, the national missed appointment rate was 14.9% from October 2020 to Septemb... | PMC10356735 | |
METHODS | PMC10356735 | |||
Design and Setting | WEST | We conducted a cluster randomized controlled pragmatic trial at the VA Portland Health Care System, which cares for approximately 85,000 patients across Oregon and southwest Washington, including two medical centers (Portland and Vancouver) and six satellite clinics (Hillsboro, Fairview, West Linn, Salem, Bend, and Nor... | PMC10356735 | |
Randomization and Masking | We conducted randomization at the provider (not patient) level by allocating to one of four nudge (intervention) arms or control arm (1:1:1:1:1), and stratifying by setting (primary care or mental health) and location (Portland, Vancouver, or other). A statistician (MN) masked to intervention information used block ran... | PMC10356735 | ||
Control Arm | The control arm consisted of routine appointment reminder letters providing the clinic name, location, provider, date and time of appointment, and contact information. Since reminder | PMC10356735 | ||
Main Measures | We used the VA Corporate Data Warehouse to identify eligible appointments and coded as completed, canceled (by patient), or missed (“no-show”). Appointments that could not be classified due to incomplete data were excluded (0.05%). The | PMC10356735 | ||
Statistical Analyses | REGRESSION | We first compared patient demographics and clinical characteristics between the control and intervention groups (both combined and individually), using counts and percentages for categorical variables and means and standard deviations (SD) for quantitative variables. We used standardized mean differences (SMD)The prima... | PMC10356735 | |
RESULTS | PMC10356735 | |||
Secondary Outcome | In both primary care and mental health, there was no effect of nudges on canceled appointment rate (Table In primary care, the cancelation rates for the intervention arms (all four nudge arms combined) and control arm, respectively, were 7.3% and 6.0%, again with a “reversed” OR of 0.92 (95%CI = 0.83–1.03, In mental he... | PMC10356735 | ||
Additional Analyses | MINOR | In primary care, modality of appointment (OR = 0.74, 95%CI = 0.57–0.98, For sensitivity analyses, results were generally very similar with two minor exceptions. First, in primary care, when restricting to the patients’ first appointment, the canceled appointment rate was lower for the intervention arms compared to the ... | PMC10356735 | |
DISCUSSION | Psychiatric comorbidity | In this yearlong pragmatic trial composed of tens of thousands of VA patients and their appointments in primary care and mental health, we found no effect of incorporating nudges in appointment reminder letters on measures relevant to outpatient appointment attendance, specifically the rate of missed appointments and r... | PMC10356735 | |
Acknowledgements | This material is based upon work supported (or supported in part) by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development (HSR&D) Service (grant number IIR 17-134). | PMC10356735 | ||
Data Availability | A de-identified, anonymized dataset resulting from this study may be shared. Requests for data access should be made in writing to the corresponding author and provide information on the purpose for accessing the data. | PMC10356735 | ||
Declarations | PMC10356735 | |||
Disclaimer | The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government. | PMC10356735 | ||
References | PMC10356735 | |||
BACKGROUND | sinusoidal obstruction syndrome | SINUSOIDAL OBSTRUCTION SYNDROME, COMPLICATION | Currently, no laboratory tests exist to stratify for the risk of developing sinusoidal obstruction syndrome (SOS), an early endothelial complication after hematopoietic cell transplantation (HCT). Risk biomarkers of SOS have not been verified in a prospective cohort accounting for differences between practices across i... | PMC10322680 |
METHODS | BLIND | Between 2017 and 2021, we prospectively accrued 80 pediatric patients across 4 US centers. Biomarkers were tested by ELISA blind to patient groupings and associated with SOS incidence on day 35 after HCT, and overall survival (OS) on day 100 after HCT. Cutpoints were identified using retrospective cohorts and applied t... | PMC10322680 | |
RESULTS | Combination of the 3 biomarkers measured on day 3 after HCT in the prospective cohort provided 80% (95% CI 55%–100%) sensitivity and 73% (95% CI 62%–83%) specificity for risk of SOS occurrence. Patients with low L-ficolin were 9 times (95% CI 3–32) more likely to develop SOS, while patients with high HA and ST2 were 6.... | PMC10322680 | ||
CONCLUSION | L-ficolin, HA, and ST2 levels measured as early as 3 days after HCT improved risk stratification for SOS occurrence and OS and may guide risk-adapted preemptive therapy. | PMC10322680 | ||
TRIAL REGISTRATION | ClinicalTrials.gov NCT03132337. | PMC10322680 | ||
FUNDING | NIH.
| PMC10322680 | ||
Introduction | ascites, hepatomegaly, VOD, pain, weight gain, sinusoidal obstruction syndrome | SINUSOIDAL OBSTRUCTION SYNDROME, ASCITES, VENO-OCCLUSIVE DISEASE, DISEASE, COMPLICATION, BLOOD DISORDERS, ENDOTHELIAL DYSFUNCTION | Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative therapy for blood disorders. However, the efficacy of this procedure has been impeded by early endothelial dysfunction that can lead to a severe and potentially lethal complication called sinusoidal obstruction syndrome (SOS), also known as v... | PMC10322680 |
Results | PMC10322680 | |||
Participant demographics. | Eighty pediatric patients were prospectively accrued from 4 US academic health centers: Indiana University School of Medicine, Texas Children’s Hospital, University of Michigan, and Children’s National Medical Center. This trial was registered at A total of 10 of 80 patients (12.5%) developed SOS. The median day after ... | PMC10322680 | ||
Biomarkers for SOS risk. | Levels of 3 biomarkers (L-ficolin, HA, and ST2) previously identified in a proteomic study (We next calculated the AUCs of the ROCs on day 3 and day 7 after HCT for each marker (Optimal cutpoints were determined by exhaustive grid search and Youden’s index based on a previous retrospective study. The retrospective stud... | PMC10322680 | ||
Biomarkers for prognosis of day 100 OS. | Next, we examined the ability of L-ficolin, HA, and ST2 on day 3 to predict OS by day 100 after HCT using the same cutpoints as for SOS risk. Patients with low L-ficolin, high HA, and high ST2 on day 3 had a lower OS on day 100 — L-ficolin: HR, 10.0 (95% CI 2.2–45.1), | PMC10322680 | ||
Associations of biomarkers with potential confounding and multivariable analysis. | tumor necrosis, infections, CRS, GVHD, Infections, weight gain, TMA | INFILTRATION, TUMOR NECROSIS, PLATELET REFRACTORINESS, FLUID RETENTION, THROMBOTIC MICROANGIOPATHY, RESPIRATORY FAILURE, INFECTIONS, INFECTIONS, REGRESSION, GVHD, PATHOGENESIS, COMPLICATIONS | Currently, the diagnosis of SOS includes clinical characteristics and measurement of bilirubin (Considering that several other potential complications could occur during the first 35 days, such as cytokine storm (CRS), even if subclinical; thrombotic microangiopathy (TMA), which is typically accompanied by endothelial ... | PMC10322680 |
Monitoring biomarkers following defibrotide treatment. | Six out of the 10 patients diagnosed with SOS were treated with defibrotide, and the 3 biomarkers were measured before defibrotide and 7, 14, and 21 days after defibrotide initiation. | PMC10322680 | ||
Discussion | MOF, GVHD, bleeding | BLEEDING, MOF, PATHOGENESIS, GVHD, COMPLICATIONS | Early identification with objective proteomic risk biomarkers may improve monitoring and management of SOS, with the goal to decrease risk of MOF. Because we have previously identified and validated L-ficolin, HA, and ST2 as SOS risk biomarkers, we next conducted measurements of L-ficolin, HA, and ST2 on days 3 and 7 a... | PMC10322680 |
Methods | PMC10322680 | |||
Patients. | HEPATIC DISEASE | Pediatric patients (up to 22 years old) of any sex, race, and ethnicity undergoing HCT for any indication who fulfill clinical criteria for high-risk of SOS at enrollment (i.e., history of hepatic disease, conditioning with busulfan or total body irradiation, ≥2 HCTs) were eligible for enrollment. Patients were recruit... | PMC10322680 | |
Sample collection, processing, and ELISA. | Plasma samples were prospectively collected on days 3 and 7 after HCT, prior to the onset of SOS. A window of ±3 days was authorized to avoid shipment on weekends; however, day 0 samples were taken several hours after the graft transfusion. ELISA procedures and parameters are described in | PMC10322680 | ||
Data and materials availability. | Biomarker raw data are available through a material transfer agreement with the Medical University of South Carolina; direct all inquiries to SP. All detection tools are available through commercial vendors. All data associated with this paper are present in the paper and/or in the supplemental materials. | PMC10322680 |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.