human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The persistent diarrhoea-malnutrition syndrome ( PDM ) remains a leading cause of morbidity and mortality in hospitals in re source -poor countries . In view of the benefits of elemental or oligomeric feeds in inflammatory bowel diseases , we performed a r and omized controlled trial of an exclusive diet of amino acid-based elemental feed ( AAF ) compared with st and ard nutritional rehabilitation ( based on skimmed milk and then soya ) for PDM . Treatment was given for 4 weeks in the malnutrition ward of the University Teaching Hospital , Lusaka , in a single-blind study . Intestinal and systemic infections were treated with routine therapies . The main outcome measures were weight gain , recovery from diarrhoea , and mortality .  Two hundred children ( 106 HIV seropositive , 90 HIV seronegative ) were r and omized ; 155 children completed therapy , 39 died , and six were lost to follow-up . At r and omization , they were severely malnourished : median baseline weight-for-age z-score was -4.0 ( interquartile range , IQR -4.4 , -3.5 ) ; 9 per cent were underweight , 23 per cent had marasmus , 47 per cent had kwashiorkor , and 21 per cent had marasmic-kwashiorkor .  Weight gain was greater in the AAF group ( median gain in weight-for-age z-score was 1.23 , IQR 0.89 - 1.57 ) compared with the control group ( 0.87 , IQR 0.47 - 1.25 ; p=0.002 ) , although calorie intakes were higher in the control group . The increase in haemoglobin concentration was also greater in the AAF group ( 0.8 g/dl , IQR 0 - 1.8 ) than in the control group ( 0.3 , IQR -0.6 , -1.6 ; p=0.04 ) . Diarrhoea frequency and global recovery scores improved equally in both treatment groups and mortality did not differ . A diet of reduced molecular complexity was associated with significantly improved weight gain Background As a result of inappropriate feeding , poor health and hygiene , and poor caring practice s , the nutritional status of many young infants deteriorates with advancing age . Objective To explore the effectiveness of a nutrition education package to prevent malnutrition among young children . Methods A community-based , r and omized , controlled trial was conducted among 605 normal and mildly malnourished children aged 6 to 9 months in 121 Community Nutrition Centers ( CNCs ) of the Bangladesh Integrated Nutrition Project ( BINP ) in four regions of Bangladesh from 2000 to 2002 . The intervention group received weekly nutrition education based on the nutrition triangle concept of UNICEF for 6 months , whereas the control group received regular BINP services . Both groups were observed for a further 6 months to assess the sustainability of the effects . Information on socio-economic status , feeding patterns , morbidity , and anthropometric features was collected . Results A significant increase in the frequency of complementary feeding was observed in the intervention group as compared with the control group , and the increase was sustained throughout the observation period . The intervention group had a higher weight gain than the control group after the end of the intervention ( 0.86 vs. 0.77 kg , p = 0.053 ) and after the end of the observation period ( 1.81 vs. 1.39 kg , p < .001 ) . The proportion of normal and mildly malnourished children was greater in the intervention group than in the control group after the end of the observations ( 88.9 % vs. 61.5 % , p < .001 ) . Nutrition education successfully prevented malnutrition in all the areas . Variation in the outcome of nutrition education among the regions was observed . Conclusions This culturally appropriate nutrition education package based on the nutrition triangle model effectively prevented growth faltering and malnutrition among young children OBJECTIVE To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients ( MM ) on  Hb concentration of young children . DESIGN In a nutrition centre that we opened in their villages , children received either MM supplement ( containing iron , zinc , vitamin A , vitamin C and iodine ) with the improved gruel ( MMGG ) or the improved gruel only ( GG ) , twice daily , 6 d/week , for 6 months . We assessed baseline and endpoint Hb concentration and anthropometric indices . SETTING Kongoussi , a rural and poor district of Burkina Faso . SUBJECTS In a community-based trial , we r and omly assigned 131 children aged 6 - 23 months with Hb concentrations in the range of 80 - 109 g/l into two groups . RESULTS The groups did not differ significantly at baseline . Mean baseline Hb concentration was 89·2 ( sd 6·5 ) g/l and 90·3 ( sd 8·4 ) g/l in the GG and the MMGG , respectively ( P = 0·42 ) . It increased to 104·1 ( sd 11·4 ) g/l in the GG ( P < 0·001 ) and 107·6 ( sd 14·7 ) g/l in the MMGG ( P < 0·001 ) . The between-group difference of 3·5 ( 95 % CI -1·0 , 8·1 ) g/l in mean ( sd ) endpoint Hb concentration was not significant ( P = 0·13 ) . The endpoint anthropometric indices were not different between the groups . CONCLUSIONS This MM supplement  had no additional effect on Hb concentration . Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine BACKGROUND & OBJECTIVE In protein-energy malnutrition ( PEM ) there is a significant impairment of immunity , both cell-mediated and humoral , which may be reversed with nutritional rehabilitation . With the use of probiotics like curd ( dahi ) and micronutrient-rich leaf protein concentrate ( LPC ) , this immune recovery may be hastened . This study was conducted to assess the impact of supplementation of curd and LPC on nutritional status , and immunity as assessed by anthropometry , haemoglobin , ferritin levels , T- cell sub population and C-reactive protein ( CRP ) , in children suffering from PEM . METHODS Eighty moderate to severely malnourished children ( 1 - 5 yr ) were r and omized to receive either curd or LPC in addition to WHO recommended two-step diet over 15 days . Nutritional , immunological and haematological parameters were measured before and after supplementation and compared within the groups . RESULTS The change in weight , haemoglobin level and CD4:CD8 T-cell sub population was significant in both the groups after supplementation . Response of CRP was blunted in PEM . Serum ferritin decreased significantly after supplementation in both groups . INTERPRETATION & CONCLUSION Curd and LPC when added to diet of malnourished children , may have therapeutic value by accelerating immune recovery . More studies need to be done on a larger sample to confirm these findings To measure the success rate of three different strategies used in Médecins Sans Frontières large-scale therapeutic nutritional rehabilitation programme in Niger , we analysed three cohorts of severely malnourished patients in terms of daily weight gain , length of stay , recovery , case fatality and defaulting . A total of 1937 children aged 6 - 59 months were followed prospect ively from 15 August 2002 to 21 October 2003 . For the three cohorts , 660 children were maintained in the therapeutic feeding centre ( TFC ) during the entire treatment , 937 children were initially treated at the TFC and completed treatment at home and 340 children were exclusively treated at home . For all cohorts , average time in the programme and average weight gain met the international st and ards ( 30 - 40 days , > 8 g/kg/day ) . Default rates were 28.1 , 16.8 and 5.6 % for TFC only , TFC plus home-based and home-based alone strategies , respectively . The overall case fatality rate for the entire programme was 6.8 % . Case fatality rates were 18.9 % for TFC only and 1.7 % for home-based alone . No deaths were recorded in children transferred to rehabilitation at home . This study suggests that satisfactory results for the treatment of severe malnutrition can be achieved using a combination of home and hospital-based strategies Summary Background Fast weight gain and linear growth in children in low-income and middle-income countries are associated with enhanced survival and improved cognitive development , but might increase risk of obesity and related adult cardiometabolic diseases . We investigated how linear growth and relative weight gain during infancy and childhood are related to health and human capital outcomes in young adults . Methods We used data from five prospect i ve birth cohort studies from Brazil , Guatemala , India , the Philippines , and South Africa . We investigated  body-mass index , systolic and diastolic blood pressure , plasma glucose concentration , height , years of attained schooling , and related categorical indicators of adverse outcomes in young adults . With linear and logistic regression models , we assessed how these outcomes relate to birthweight and to statistically independent measures representing linear growth and weight gain independent of linear growth ( relative weight gain ) in three age periods : 0–2 years , 2 years to mid-childhood , and mid-childhood to adulthood . Findings We obtained data for 8362 participants who had at least one adult outcome of interest . A higher birthweight was consistently associated with an adult body-mass index of greater than 25 kg/m2 ( odds ratio 1·28 , 95 % CI 1·21–1·35 ) and a reduced likelihood of short adult stature ( 0·49 , 0·44–0·54 ) and of not completing secondary school ( 0·82 , 0·78–0·87 ) . Faster linear growth was strongly associated with a reduced risk of short adult stature ( age 2 years : 0·23 , 0·20–0·52 ; mid-childhood : 0·39 , 0·36–0·43 ) and of not completing secondary school ( age 2 years : 0·74 , 0·67–0·78 ; mid-childhood : 0·87 , 0·83–0·92 ) , but did raise the likelihood of overweight ( age 2 years : 1·24 , 1·17–1·31 ; mid-childhood : 1·12 , 1·06–1·18 ) and elevated blood pressure ( age 2 years : 1·12 , 1·06–1·19 ; mid-childhood : 1·07 , 1·01–1·13 ) . Faster relative weight gain was associated with an increased risk of adult overweight ( age 2 years : 1·51 , 1·43–1·60 ; mid-childhood : 1·76 , 1·69–1·91 ) and elevated blood pressure ( age 2 years : 1·07 , 1·01–1·13 ; mid-childhood : 1·22 , 1·15–1·30 ) . Linear growth and relative weight gain were not associated with dysglycaemia , but a higher birthweight was associated with decreased risk of the disorder ( 0·89 , 0·81–0·98 ) . Interpretation Interventions in countries of low and middle income to increase birthweight and linear growth during the first 2 years of life are likely to result in substantial gains in height and schooling and give some protection from adult chronic disease risk factors , with few adverse trade-offs . Funding Wellcome Trust and Bill & Melinda Gates Foundation To assess the impact of intensive nutrition education ( INE ) with or without the provision of micronutrient powder ( MNP ) on the nutritional status of mildly wasted children in Nias , Indonesia , two groups of mildly wasted ( > = -1.5 to < -1.0 WHZ ) children aged > = 6 to < 60 months in the Church World Service ( CWS ) project areas were assigned by village r and omization to receive INE ( n=64 ) or INE+MNP ( n=51 ) in a weekly program . Another two groups of mildly wasted children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program ( NNE ) with or without MNP ( n=50 both respectively ) . WHZ , weight , height , haemoglobin ( Hb ) level , and morbidity data were assessed at admission , during the study , and at individual discharge .  Children 's weight gain ( g/kg body weight/day ) was highest in INE+MNP group ( 2.2±2.1 ) , followed by INE ( 1.1±0.9 ) , NNE+MNP ( 0.3±0.5 ) and NNE ( 0.3±0.4 ) group . In both MNP intervention groups ( INE+MNP , NNE+MNP ) , supplements significantly increased Hb value ( g/L ) of respective children ( 10.0±10.0 ; p<0.001 and 3.0±8.0 ; p<0.05 respectively ) . Proportion of children who reached discharge criterion was highest among the INE+MNP ( 70.6 % ; n=36 ) , followed by INE ( 64.1 % ; n=41 ) , NNE+MNP ( 26.0 % ; n=13 ) , and NNE ( 20.0 % ; n=10 ) groups ( p<0.001 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The persistent diarrhoea-malnutrition syndrome ( PDM ) remains a leading cause of morbidity and mortality in hospitals in re source -poor countries . In view of the benefits of elemental or oligomeric feeds in inflammatory bowel diseases , we performed a r and omized controlled trial of an exclusive diet of amino acid-based elemental feed ( AAF ) compared with st and ard nutritional rehabilitation ( based on skimmed milk and then soya ) for PDM . Treatment was given for 4 weeks in the malnutrition ward of the University Teaching Hospital , Lusaka , in a single-blind study . Intestinal and systemic infections were treated with routine therapies . The main outcome measures were weight gain , recovery from diarrhoea , and mortality .  Two hundred children ( 106 HIV seropositive , 90 HIV seronegative ) were r and omized ; 155 children completed therapy , 39 died , and six were lost to follow-up . At r and omization , they were severely malnourished : median baseline weight-for-age z-score was -4.0 ( interquartile range , IQR -4.4 , -3.5 ) ; 9 per cent were underweight , 23 per cent had marasmus , 47 per cent had kwashiorkor , and 21 per cent had marasmic-kwashiorkor .  Weight gain was greater in the AAF group ( median gain in weight-for-age z-score was 1.23 , IQR 0.89 - 1.57 ) compared with the control group ( 0.87 , IQR 0.47 - 1.25 ; p=0.002 ) , although calorie intakes were higher in the control group . The increase in haemoglobin concentration was also greater in the AAF group ( 0.8 g/dl , IQR 0 - 1.8 ) than in the control group ( 0.3 , IQR -0.6 , -1.6 ; p=0.04 ) . Diarrhoea frequency and global recovery scores improved equally in both treatment groups and mortality did not differ . A diet of reduced molecular complexity was associated with significantly improved weight gain Background As a result of inappropriate feeding , poor health and hygiene , and poor caring practice s , the nutritional status of many young infants deteriorates with advancing age . Objective To explore the effectiveness of a nutrition education package to prevent malnutrition among young children . Methods A community-based , r and omized , controlled trial was conducted among 605 normal and mildly malnourished children aged 6 to 9 months in 121 Community Nutrition Centers ( CNCs ) of the Bangladesh Integrated Nutrition Project ( BINP ) in four regions of Bangladesh from 2000 to 2002 . The intervention group received weekly nutrition education based on the nutrition triangle concept of UNICEF for 6 months , whereas the control group received regular BINP services . Both groups were observed for a further 6 months to assess the sustainability of the effects . Information on socio-economic status , feeding patterns , morbidity , and anthropometric features was collected . Results A significant increase in the frequency of complementary feeding was observed in the intervention group as compared with the control group , and the increase was sustained throughout the observation period . The intervention group had a higher weight gain than the control group after the end of the intervention ( 0.86 vs. 0.77 kg , p = 0.053 ) and after the end of the observation period ( 1.81 vs. 1.39 kg , p < .001 ) . The proportion of normal and mildly malnourished children was greater in the intervention group than in the control group after the end of the observations ( 88.9 % vs. 61.5 % , p < .001 ) . Nutrition education successfully prevented malnutrition in all the areas . Variation in the outcome of nutrition education among the regions was observed . Conclusions This culturally appropriate nutrition education package based on the nutrition triangle model effectively prevented growth faltering and malnutrition among young children OBJECTIVE To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients ( MM ) on  Hb concentration of young children . DESIGN In a nutrition centre that we opened in their villages , children received either MM supplement ( containing iron , zinc , vitamin A , vitamin C and iodine ) with the improved gruel ( MMGG ) or the improved gruel only ( GG ) , twice daily , 6 d/week , for 6 months . We assessed baseline and endpoint Hb concentration and anthropometric indices . SETTING Kongoussi , a rural and poor district of Burkina Faso . SUBJECTS In a community-based trial , we r and omly assigned 131 children aged 6 - 23 months with Hb concentrations in the range of 80 - 109 g/l into two groups . RESULTS The groups did not differ significantly at baseline . Mean baseline Hb concentration was 89·2 ( sd 6·5 ) g/l and 90·3 ( sd 8·4 ) g/l in the GG and the MMGG , respectively ( P = 0·42 ) . It increased to 104·1 ( sd 11·4 ) g/l in the GG ( P < 0·001 ) and 107·6 ( sd 14·7 ) g/l in the MMGG ( P < 0·001 ) . The between-group difference of 3·5 ( 95 % CI -1·0 , 8·1 ) g/l in mean ( sd ) endpoint Hb concentration was not significant ( P = 0·13 ) . The endpoint anthropometric indices were not different between the groups . CONCLUSIONS This MM supplement  had no additional effect on Hb concentration . Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine BACKGROUND & OBJECTIVE In protein-energy malnutrition ( PEM ) there is a significant impairment of immunity , both cell-mediated and humoral , which may be reversed with nutritional rehabilitation . With the use of probiotics like curd ( dahi ) and micronutrient-rich leaf protein concentrate ( LPC ) , this immune recovery may be hastened . This study was conducted to assess the impact of supplementation of curd and LPC on nutritional status , and immunity as assessed by anthropometry , haemoglobin , ferritin levels , T- cell sub population and C-reactive protein ( CRP ) , in children suffering from PEM . METHODS Eighty moderate to severely malnourished children ( 1 - 5 yr ) were r and omized to receive either curd or LPC in addition to WHO recommended two-step diet over 15 days . Nutritional , immunological and haematological parameters were measured before and after supplementation and compared within the groups . RESULTS The change in weight , haemoglobin level and CD4:CD8 T-cell sub population was significant in both the groups after supplementation . Response of CRP was blunted in PEM . Serum ferritin decreased significantly after supplementation in both groups . INTERPRETATION & CONCLUSION Curd and LPC when added to diet of malnourished children , may have therapeutic value by accelerating immune recovery . More studies need to be done on a larger sample to confirm these findings To measure the success rate of three different strategies used in Médecins Sans Frontières large-scale therapeutic nutritional rehabilitation programme in Niger , we analysed three cohorts of severely malnourished patients in terms of daily weight gain , length of stay , recovery , case fatality and defaulting . A total of 1937 children aged 6 - 59 months were followed prospect ively from 15 August 2002 to 21 October 2003 . For the three cohorts , 660 children were maintained in the therapeutic feeding centre ( TFC ) during the entire treatment , 937 children were initially treated at the TFC and completed treatment at home and 340 children were exclusively treated at home . For all cohorts , average time in the programme and average weight gain met the international st and ards ( 30 - 40 days , > 8 g/kg/day ) . Default rates were 28.1 , 16.8 and 5.6 % for TFC only , TFC plus home-based and home-based alone strategies , respectively . The overall case fatality rate for the entire programme was 6.8 % . Case fatality rates were 18.9 % for TFC only and 1.7 % for home-based alone . No deaths were recorded in children transferred to rehabilitation at home . This study suggests that satisfactory results for the treatment of severe malnutrition can be achieved using a combination of home and hospital-based strategies Summary Background Fast weight gain and linear growth in children in low-income and middle-income countries are associated with enhanced survival and improved cognitive development , but might increase risk of obesity and related adult cardiometabolic diseases . We investigated how linear growth and relative weight gain during infancy and childhood are related to health and human capital outcomes in young adults . Methods We used data from five prospect i ve birth cohort studies from Brazil , Guatemala , India , the Philippines , and South Africa . We investigated  body-mass index , systolic and diastolic blood pressure , plasma glucose concentration , height , years of attained schooling , and related categorical indicators of adverse outcomes in young adults . With linear and logistic regression models , we assessed how these outcomes relate to birthweight and to statistically independent measures representing linear growth and weight gain independent of linear growth ( relative weight gain ) in three age periods : 0–2 years , 2 years to mid-childhood , and mid-childhood to adulthood . Findings We obtained data for 8362 participants who had at least one adult outcome of interest . A higher birthweight was consistently associated with an adult body-mass index of greater than 25 kg/m2 ( odds ratio 1·28 , 95 % CI 1·21–1·35 ) and a reduced likelihood of short adult stature ( 0·49 , 0·44–0·54 ) and of not completing secondary school ( 0·82 , 0·78–0·87 ) . Faster linear growth was strongly associated with a reduced risk of short adult stature ( age 2 years : 0·23 , 0·20–0·52 ; mid-childhood : 0·39 , 0·36–0·43 ) and of not completing secondary school ( age 2 years : 0·74 , 0·67–0·78 ; mid-childhood : 0·87 , 0·83–0·92 ) , but did raise the likelihood of overweight ( age 2 years : 1·24 , 1·17–1·31 ; mid-childhood : 1·12 , 1·06–1·18 ) and elevated blood pressure ( age 2 years : 1·12 , 1·06–1·19 ; mid-childhood : 1·07 , 1·01–1·13 ) . Faster relative weight gain was associated with an increased risk of adult overweight ( age 2 years : 1·51 , 1·43–1·60 ; mid-childhood : 1·76 , 1·69–1·91 ) and elevated blood pressure ( age 2 years : 1·07 , 1·01–1·13 ; mid-childhood : 1·22 , 1·15–1·30 ) . Linear growth and relative weight gain were not associated with dysglycaemia , but a higher birthweight was associated with decreased risk of the disorder ( 0·89 , 0·81–0·98 ) . Interpretation Interventions in countries of low and middle income to increase birthweight and linear growth during the first 2 years of life are likely to result in substantial gains in height and schooling and give some protection from adult chronic disease risk factors , with few adverse trade-offs . Funding Wellcome Trust and Bill & Melinda Gates Foundation To assess the impact of intensive nutrition education ( INE ) with or without the provision of micronutrient powder ( MNP ) on the nutritional status of mildly wasted children in Nias , Indonesia , two groups of mildly wasted ( > = -1.5 to < -1.0 WHZ ) children aged > = 6 to < 60 months in the Church World Service ( CWS ) project areas were assigned by village r and omization to receive INE ( n=64 ) or INE+MNP ( n=51 ) in a weekly program . Another two groups of mildly wasted children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program ( NNE ) with or without MNP ( n=50 both respectively ) . WHZ , weight , height , haemoglobin ( Hb ) level , and morbidity data were assessed at admission , during the study , and at individual discharge .  Children 's weight gain ( g/kg body weight/day ) was highest in INE+MNP group ( 2.2±2.1 ) , followed by INE ( 1.1±0.9 ) , NNE+MNP ( 0.3±0.5 ) and NNE ( 0.3±0.4 ) group . In both MNP intervention groups ( INE+MNP , NNE+MNP ) , supplements significantly increased Hb value ( g/L ) of respective children ( 10.0±10.0 ; p<0.001 and 3.0±8.0 ; p<0.05 respectively ) . Proportion of children who reached discharge criterion was highest among the INE+MNP ( 70.6 % ; n=36 ) , followed by INE ( 64.1 % ; n=41 ) , NNE+MNP ( 26.0 % ; n=13 ) , and NNE ( 20.0 % ; n=10 ) groups ( p<0.001 
    Output:
    