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: BACKGROUND Moderate acute malnutrition ( MAM ) , defined as weight-for-length z score between -3 and -2 or midupper arm circumference between 11.5 and 12.5 cm , affects ∼33 million children aged < 5 y worldwide . OBJECTIVE The objective was to compare the effects of 4 dietary supplements for the treatment of MAM . DESIGN Twelve community health centers in rural Mali were r and omly assigned to provide to 1264 MAM children aged 6 - 35 mo one of 4 dietary supplements containing ∼500 kcal/d for 12 wk : 1 ) ready-to-use , lipid-based supplementary food ( RUSF ) ; 2 ) special corn-soy blend ( CSB++ ) ; 3 ) locally processed , fortified flour ( Misola ) ; or 4 ) locally milled flours plus oil , sugar , and micronutrient powder ( LMF ) . RESULTS In total , 1178 children ( 93.2 % ) completed the study . The adjusted mean ( 95 % CI ) change in weight ( kg ) from baseline was greater with RUSF than with the locally processed blends and was intermediate with CSB++ [ 1.16 ( 1.08 , 1.24 ) for RUSF , 1.04 ( 0.96 , 1.13 ) for CSB++ , 0.91 ( 0.82 , 0.99 ) for Misola , and 0.83 ( 0.74 , 0.92 ) for LMF ; P < 0.001 ] . For length change , RUSF and CSB++ differed significantly from LMF . Sustained recovery rates were higher with RUSF ( 73 % ) than with Misola ( 61 % ) and LMF ( 58 % ) , P < 0.0001 ; CSB++ recovery rates ( 68 % ) did not differ from any of the other groups . CONCLUSIONS RUSF was more effective , but more costly , than other dietary supplements for the treatment of MAM ; CSB++ yielded intermediate results . The benefits of treatment should be considered in relation to product costs and availability Background Previous studies have shown the benefits of ready-to-use supplementary food ( RUSF ) distribution in reducing the incidence and prevalence of severe acute malnutrition . Methods and Findings To compare the incidence of wasting , stunting and mortality between children aged 6 to 23 mo participating and not participating in distributions of RUSF  , we implemented two exhaustive prospect i ve cohorts including all children 60 cm to 80 cm , resident in villages of two districts of Maradi region in Niger ( n = 2238 ) . Villages ( 20 ) were selected to be representative of the population . All registered children were eligible for the monthly distributions between July and October 2010 . Age , sex , height , weight , and Mid-Upper Arm Circumference ( MUAC ) were measured at baseline and two weeks after each distribution ; the amount and type of distribution and the amount shared and remaining were also assessed . We compared the incidence of wasting , stunting , and mortality among children participating in the distribution ( intervention ) of RUSF  versus children not participating in the distribution ( comparison ) . The absolute rate of wasting was 4.71 events per child-year ( 503 events/106.59 child-year ) in the intervention group and 4.98 events per child-year ( 322 events/64.54 child-year ) in the comparison group . The intervention group had a small but higher weight-for-length Z-score gain ( −0.2z vs. −0.3z ) and less loss of MUAC than the comparison group ( −2.8 vs. −4.0 mm ) . There was no difference in length gain ( 2.7 vs. 2.8 cm ) . Mortality was lower for children whose households received the intervention than those who did not ( adjusted HR 0.55 , 95 % CI : 0.32–0.98 ) . Conclusions Short-term distribution with RUSF for children 6 to 23 months improve the nutritional status of children at risk for malnutrition . Fewer children who participated in the RUSF distribution died than those who did not BACKGROUND Childhood malnutrition is common in Malawi , and the st and ard treatment , which follows international guidelines , results in poor recovery rates . Higher recovery rates have been seen in pilot studies of home-based therapy with ready-to-use therapeutic food ( RUTF ) . OBJECTIVE The objective was to compare the recovery rates among children with moderate and severe wasting , kwashiorkor , or both receiving either home-based therapy with RUTF or st and ard inpatient therapy .  DESIGN A controlled , comparative , clinical effectiveness trial was conducted in southern Malawi with 1178 malnourished children . Children were systematic ally allocated to either st and ard therapy ( 186 children ) or home-based therapy with RUTF ( 992 children ) according to a stepped wedge design to control for bias introduced by the season of the year . Recovery , defined as reaching a weight-for-height z score > -2 , and relapse or death were the primary outcomes . The rate of weight gain and the prevalence of fever , cough , and diarrhea were the secondary outcomes . RESULTS Children who received home-based therapy with RUTF were more likely to achieve a weight-for-height z score > -2 than were those who received st and ard therapy ( 79 % compared with 46 % ; P < 0.001 ) and were less likely to relapse or die ( 8.7 % compared with 16.7 % ; P < 0.001 ) . Children who received home-based therapy with RUTF had greater rates of weight gain ( 3.5 compared with 2.0 g . kg(-1 ) . d(-1 ) ; difference : 1.5 ; 95 % CI : 1.0 , 2.0 g . kg(-1 ) . d(-1 ) ) and a lower prevalence of fever , cough , and diarrhea than did children who received st and ard therapy . CONCLUSION Home-based therapy with RUTF is associated with better outcomes for childhood malnutrition than is st and ard therapy Poor complementary feeding practice s are associated with stunting and growth faltering throughout the developing world . The objective was to compare the effect of using peanut-/soy-based fortified spread ( FS ) and corn porridge fortified with fish powder ( FP ) as complementary foods on growth in rural Malawian children . A total of 240 children were enrolled at the age of 6 mo and r and omized to receive FS or FP .  Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age . Children were followed monthly for anthropometry and fortnightly for the symptoms of fever , cough , or diarrhea until they were 18 mo old . Zn and Se status were assessed at 6 and 12 mo . The primary outcomes were the rates of weight and length gain from 6 - 12 mo and from 12 - 18 mo . Children who received FS gained 110 g more ( 95 % CI 220 to 10 ) from 6 - 12 mo of age than children receiving FP .  Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age , nor did statural growth from 6 to 12 mo or 12 to 18 mo . A total of 23 % of all children were Zn deficient at 6 mo of age and this increased to 37 % at 12 mo of age . Neither FS nor FP was associated with significantly improved Zn status .  FS was associated with better weight gain from 6 - 12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world BACKGROUND The World Health Organization recommends a liquid , milk-based diet ( F100 ) during the rehabilitation phase of the treatment of severe malnutrition . A dry , solid , ready-to-use food ( RTUF ) that can be eaten without adding water has been proposed to eliminate the risk of bacterial contamination from added water . The efficacies of RTUF and F100 have not been compared . OBJECTIVE The objective was to compare the efficacy of RTUF and F100 in promoting weight gain in malnourished children . DESIGN In an open-labeled , r and omized trial , 70 severely malnourished Senegalese children aged 6 - 36 mo were r and omly allocated to receive 3 meals containing either F100 ( n = 35 ) or RTUF ( n = 35 ) in addition to the local diet . The data from 30 children in each group were analyzed . RESULTS The mean ( + /- SD ) daily energy intake in the RTUF group was 808 + /- 280 ( 95 % CI : 703.8 , 912.9 ) kJ x kg body wt(-1 ) x d(-1 ) , and that in the F100 group was 573 + /- 201 ( 95 % CI : 497.9 , 648.7 ) kJ. kg body wt(-1 ) x d(-1 ) ( P < 0.001 ) . The average weight gains in the RTUF and F100 groups were 15.6 ( 95 % CI : 13.4 , 17.8 ) and 10.1 ( 95 % CI : 8.7 , 11.4 ) g x kg body wt(-1 ) x d(-1 ) , respectively ( P < 0.001 ) . The difference in weight gain was greater in the most wasted children ( P < 0.05 ) . The average duration of rehabilitation was 17.3 ( 95 % CI : 15.6 , 19.0 ) d in the F100 group and was 13.4 ( 95 % CI : 12.1 , 14.7 ) d in the RTUF group ( P < 0.001 ) . CONCLUSIONS This study indicated that RTUF can be used efficiently for the rehabilitation of severely malnourished children OBJECTIVE To determine if supplementation with corn-soya blend ( CSB ) or lipid-based nutrient supplement ( LNS ) improved the weight gain of moderately underweight infants and children when provided through the national health service . DESIGN A r and omised , controlled , assessor-blinded clinical trial . Infants and children were r and omised to receive for 12 weeks an average daily ration of 71 g CSB or 43 g LNS , providing 1188 kJ and 920 kJ , respectively , or no supplement ( control ) . Main outcome was weight gain . Secondary outcomes included changes in anthropometric indices and incidence of serious adverse events . Intention-to-treat analyses were used . SETTING Kukalanga , Koche , Katema and Jalasi health centres in Mangochi District , rural Malawi . SUBJECTS Underweight ( weight-for-age Z-score < -2 ) infants and children aged 6 - 15 months ( n 299 ) .  RESULTS Mean weight gain was 630 g , 680 g and 750 g in control , CSB and LNS groups , respectively ( P = 0·21 ) . When adjusted for baseline age , children receiving LNS gained on average 90 g more weight ( P = 0·185 ) and their weight-for-length Z-score increased 0·22 more ( P = 0·049 ) compared with those receiving no supplementation . No statistically significant differences were observed between the CSB and control groups in mean weight and length gain . CONCLUSIONS LNS supplementation provided during the lean season via through the national health service was associated with a modest increase in weight . However , the effect size was lower than that previously reported under more controlled research setting The objective of this study was to evaluate , within the context of a r and omized controlled trial of product effectiveness , the acceptability of new formulations of six corn-soy blended flours ( CSB ) and six lipid-based nutrient supplements ( LNS ) with different quantities of milk and qualities of soy for the treatment of children with moderate acute malnutrition ( MAM ) . Our study included 1546 children aged 6 - 23 months and involved question naires after one month of supplementation home visits and interviews with a sub- sample of 20 trial participants and their caretakers , and nine focus group discussion . All 12 products were well accepted in terms of organoleptic qualities and received good ratings . However , LNS were more appreciated by caretakers and children . Additionally , an effect of soy isolate was detected on child appreciation where products with high milk content also received better ratings .  CSB  were not consumed as readily ; 33.9 % ( n = 257 ) of children receiving CSB were reported to have leftovers compared to 17.3 % ( n = 134 ) of children receiving LNS ( p=<0.001 ) . Both CSB and LNS were referred to as foods with medicinal properties and perceived as beneficial to child health . They were both reported to have high priority in the daily feeding of the child . In conclusion , there were minimal differences in acceptability of the various CSB and LNS formulations , although CSB were less readily consumed and required smaller meal volumes . Since all products were well-accepted , decisions regarding whether the more expensive products should be used for the treatment of MAM will need to be based on their effect on child nutrition , growth and health . Future supplementary feeding programs in similar context s could furthermore consider introducing supplementary foods as a medical treatment , as this may increase adherence and decrease sharing St and ard nutritional treatment of moderate acute malnutrition ( MAM ) relies on fortified blended flours 
    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: BACKGROUND Moderate acute malnutrition ( MAM ) , defined as weight-for-length z score between -3 and -2 or midupper arm circumference between 11.5 and 12.5 cm , affects ∼33 million children aged < 5 y worldwide . OBJECTIVE The objective was to compare the effects of 4 dietary supplements for the treatment of MAM . DESIGN Twelve community health centers in rural Mali were r and omly assigned to provide to 1264 MAM children aged 6 - 35 mo one of 4 dietary supplements containing ∼500 kcal/d for 12 wk : 1 ) ready-to-use , lipid-based supplementary food ( RUSF ) ; 2 ) special corn-soy blend ( CSB++ ) ; 3 ) locally processed , fortified flour ( Misola ) ; or 4 ) locally milled flours plus oil , sugar , and micronutrient powder ( LMF ) . RESULTS In total , 1178 children ( 93.2 % ) completed the study . The adjusted mean ( 95 % CI ) change in weight ( kg ) from baseline was greater with RUSF than with the locally processed blends and was intermediate with CSB++ [ 1.16 ( 1.08 , 1.24 ) for RUSF , 1.04 ( 0.96 , 1.13 ) for CSB++ , 0.91 ( 0.82 , 0.99 ) for Misola , and 0.83 ( 0.74 , 0.92 ) for LMF ; P < 0.001 ] . For length change , RUSF and CSB++ differed significantly from LMF . Sustained recovery rates were higher with RUSF ( 73 % ) than with Misola ( 61 % ) and LMF ( 58 % ) , P < 0.0001 ; CSB++ recovery rates ( 68 % ) did not differ from any of the other groups . CONCLUSIONS RUSF was more effective , but more costly , than other dietary supplements for the treatment of MAM ; CSB++ yielded intermediate results . The benefits of treatment should be considered in relation to product costs and availability Background Previous studies have shown the benefits of ready-to-use supplementary food ( RUSF ) distribution in reducing the incidence and prevalence of severe acute malnutrition . Methods and Findings To compare the incidence of wasting , stunting and mortality between children aged 6 to 23 mo participating and not participating in distributions of RUSF  , we implemented two exhaustive prospect i ve cohorts including all children 60 cm to 80 cm , resident in villages of two districts of Maradi region in Niger ( n = 2238 ) . Villages ( 20 ) were selected to be representative of the population . All registered children were eligible for the monthly distributions between July and October 2010 . Age , sex , height , weight , and Mid-Upper Arm Circumference ( MUAC ) were measured at baseline and two weeks after each distribution ; the amount and type of distribution and the amount shared and remaining were also assessed . We compared the incidence of wasting , stunting , and mortality among children participating in the distribution ( intervention ) of RUSF  versus children not participating in the distribution ( comparison ) . The absolute rate of wasting was 4.71 events per child-year ( 503 events/106.59 child-year ) in the intervention group and 4.98 events per child-year ( 322 events/64.54 child-year ) in the comparison group . The intervention group had a small but higher weight-for-length Z-score gain ( −0.2z vs. −0.3z ) and less loss of MUAC than the comparison group ( −2.8 vs. −4.0 mm ) . There was no difference in length gain ( 2.7 vs. 2.8 cm ) . Mortality was lower for children whose households received the intervention than those who did not ( adjusted HR 0.55 , 95 % CI : 0.32–0.98 ) . Conclusions Short-term distribution with RUSF for children 6 to 23 months improve the nutritional status of children at risk for malnutrition . Fewer children who participated in the RUSF distribution died than those who did not BACKGROUND Childhood malnutrition is common in Malawi , and the st and ard treatment , which follows international guidelines , results in poor recovery rates . Higher recovery rates have been seen in pilot studies of home-based therapy with ready-to-use therapeutic food ( RUTF ) . OBJECTIVE The objective was to compare the recovery rates among children with moderate and severe wasting , kwashiorkor , or both receiving either home-based therapy with RUTF or st and ard inpatient therapy .  DESIGN A controlled , comparative , clinical effectiveness trial was conducted in southern Malawi with 1178 malnourished children . Children were systematic ally allocated to either st and ard therapy ( 186 children ) or home-based therapy with RUTF ( 992 children ) according to a stepped wedge design to control for bias introduced by the season of the year . Recovery , defined as reaching a weight-for-height z score > -2 , and relapse or death were the primary outcomes . The rate of weight gain and the prevalence of fever , cough , and diarrhea were the secondary outcomes . RESULTS Children who received home-based therapy with RUTF were more likely to achieve a weight-for-height z score > -2 than were those who received st and ard therapy ( 79 % compared with 46 % ; P < 0.001 ) and were less likely to relapse or die ( 8.7 % compared with 16.7 % ; P < 0.001 ) . Children who received home-based therapy with RUTF had greater rates of weight gain ( 3.5 compared with 2.0 g . kg(-1 ) . d(-1 ) ; difference : 1.5 ; 95 % CI : 1.0 , 2.0 g . kg(-1 ) . d(-1 ) ) and a lower prevalence of fever , cough , and diarrhea than did children who received st and ard therapy . CONCLUSION Home-based therapy with RUTF is associated with better outcomes for childhood malnutrition than is st and ard therapy Poor complementary feeding practice s are associated with stunting and growth faltering throughout the developing world . The objective was to compare the effect of using peanut-/soy-based fortified spread ( FS ) and corn porridge fortified with fish powder ( FP ) as complementary foods on growth in rural Malawian children . A total of 240 children were enrolled at the age of 6 mo and r and omized to receive FS or FP .  Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age . Children were followed monthly for anthropometry and fortnightly for the symptoms of fever , cough , or diarrhea until they were 18 mo old . Zn and Se status were assessed at 6 and 12 mo . The primary outcomes were the rates of weight and length gain from 6 - 12 mo and from 12 - 18 mo . Children who received FS gained 110 g more ( 95 % CI 220 to 10 ) from 6 - 12 mo of age than children receiving FP .  Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age , nor did statural growth from 6 to 12 mo or 12 to 18 mo . A total of 23 % of all children were Zn deficient at 6 mo of age and this increased to 37 % at 12 mo of age . Neither FS nor FP was associated with significantly improved Zn status .  FS was associated with better weight gain from 6 - 12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world BACKGROUND The World Health Organization recommends a liquid , milk-based diet ( F100 ) during the rehabilitation phase of the treatment of severe malnutrition . A dry , solid , ready-to-use food ( RTUF ) that can be eaten without adding water has been proposed to eliminate the risk of bacterial contamination from added water . The efficacies of RTUF and F100 have not been compared . OBJECTIVE The objective was to compare the efficacy of RTUF and F100 in promoting weight gain in malnourished children . DESIGN In an open-labeled , r and omized trial , 70 severely malnourished Senegalese children aged 6 - 36 mo were r and omly allocated to receive 3 meals containing either F100 ( n = 35 ) or RTUF ( n = 35 ) in addition to the local diet . The data from 30 children in each group were analyzed . RESULTS The mean ( + /- SD ) daily energy intake in the RTUF group was 808 + /- 280 ( 95 % CI : 703.8 , 912.9 ) kJ x kg body wt(-1 ) x d(-1 ) , and that in the F100 group was 573 + /- 201 ( 95 % CI : 497.9 , 648.7 ) kJ. kg body wt(-1 ) x d(-1 ) ( P < 0.001 ) . The average weight gains in the RTUF and F100 groups were 15.6 ( 95 % CI : 13.4 , 17.8 ) and 10.1 ( 95 % CI : 8.7 , 11.4 ) g x kg body wt(-1 ) x d(-1 ) , respectively ( P < 0.001 ) . The difference in weight gain was greater in the most wasted children ( P < 0.05 ) . The average duration of rehabilitation was 17.3 ( 95 % CI : 15.6 , 19.0 ) d in the F100 group and was 13.4 ( 95 % CI : 12.1 , 14.7 ) d in the RTUF group ( P < 0.001 ) . CONCLUSIONS This study indicated that RTUF can be used efficiently for the rehabilitation of severely malnourished children OBJECTIVE To determine if supplementation with corn-soya blend ( CSB ) or lipid-based nutrient supplement ( LNS ) improved the weight gain of moderately underweight infants and children when provided through the national health service . DESIGN A r and omised , controlled , assessor-blinded clinical trial . Infants and children were r and omised to receive for 12 weeks an average daily ration of 71 g CSB or 43 g LNS , providing 1188 kJ and 920 kJ , respectively , or no supplement ( control ) . Main outcome was weight gain . Secondary outcomes included changes in anthropometric indices and incidence of serious adverse events . Intention-to-treat analyses were used . SETTING Kukalanga , Koche , Katema and Jalasi health centres in Mangochi District , rural Malawi . SUBJECTS Underweight ( weight-for-age Z-score < -2 ) infants and children aged 6 - 15 months ( n 299 ) .  RESULTS Mean weight gain was 630 g , 680 g and 750 g in control , CSB and LNS groups , respectively ( P = 0·21 ) . When adjusted for baseline age , children receiving LNS gained on average 90 g more weight ( P = 0·185 ) and their weight-for-length Z-score increased 0·22 more ( P = 0·049 ) compared with those receiving no supplementation . No statistically significant differences were observed between the CSB and control groups in mean weight and length gain . CONCLUSIONS LNS supplementation provided during the lean season via through the national health service was associated with a modest increase in weight . However , the effect size was lower than that previously reported under more controlled research setting The objective of this study was to evaluate , within the context of a r and omized controlled trial of product effectiveness , the acceptability of new formulations of six corn-soy blended flours ( CSB ) and six lipid-based nutrient supplements ( LNS ) with different quantities of milk and qualities of soy for the treatment of children with moderate acute malnutrition ( MAM ) . Our study included 1546 children aged 6 - 23 months and involved question naires after one month of supplementation home visits and interviews with a sub- sample of 20 trial participants and their caretakers , and nine focus group discussion . All 12 products were well accepted in terms of organoleptic qualities and received good ratings . However , LNS were more appreciated by caretakers and children . Additionally , an effect of soy isolate was detected on child appreciation where products with high milk content also received better ratings .  CSB  were not consumed as readily ; 33.9 % ( n = 257 ) of children receiving CSB were reported to have leftovers compared to 17.3 % ( n = 134 ) of children receiving LNS ( p=<0.001 ) . Both CSB and LNS were referred to as foods with medicinal properties and perceived as beneficial to child health . They were both reported to have high priority in the daily feeding of the child . In conclusion , there were minimal differences in acceptability of the various CSB and LNS formulations , although CSB were less readily consumed and required smaller meal volumes . Since all products were well-accepted , decisions regarding whether the more expensive products should be used for the treatment of MAM will need to be based on their effect on child nutrition , growth and health . Future supplementary feeding programs in similar context s could furthermore consider introducing supplementary foods as a medical treatment , as this may increase adherence and decrease sharing St and ard nutritional treatment of moderate acute malnutrition ( MAM ) relies on fortified blended flours 
    Output:
    