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: INTRODUCTION Iron deficiency , associated with a decline in cognitive function , is the most common nutritional deficiency globally . The present study aim ed to identify the impact of weekly iron supplements on the attention function of female students from a high school in North Khorasan Province , Iran . METHODS This was a blind , controlled , clinical trial study , involving 200 female students who were chosen using the stratified r and omised sampling method . First , laboratory studies were performed to detect iron consumption limitations . Next , the 200 students were divided r and omly and equally into case and control groups . The case group was treated with 50 mg of ferrous sulfate twice a week for 16 weeks . We compared both groups ' data on attention , iron status and erythrocyte indices . Question naires were used to collect demographic data , while clinical data was collected using complete blood count and Toulouse-Piéron tests . Data was analysed using descriptive statistics , as well as paired and independent t-tests . RESULTS The mean attention scores of the case and control groups were 104.8 ± 7.0 and 52.7 ± 9.6 , respectively ( p < 0.001 ) . The mean haemoglobin levels of the two groups were 12.5 ± 0.9 and 11.2 ± 1.0 , respectively ( p < 0.001 ) . Compared to the control group , the attention scores and haemoglobin concentrations of the case group were found to be improved by approximately 90 % and 10 % , respectively . CONCLUSION Oral iron supplements ( 50 mg twice a week for 16 weeks ) were able to improve the attention span and haematologic indices of female high school students Background Poor adherence to micronutrient supplementation often limits the effectiveness of public health programs . While predictors of adherence to micronutrient supplementation during pregnancy are well documented , information on adherence to preconception supplements is scarce . The objective of this study was to describe the predictors of adherence to preconception and prenatal micronutrient supplementation among women participating in a r and omized control trial in Vietnam . Methods Adherence data were collected prospect ively from a double blind r and omized controlled trial in rural Vietnam . Five thous and eleven women of reproductive age were r and omized to receive preconception supplements for weekly consumption containing either : Folic Acid , Iron and Folic Acid ( IFA ) , or Multiple Micronutrients .  Women who became pregnant received prenatal IFA supplements for daily consumption through delivery . Village health workers visited participants ’ homes every two weeks to deliver supplements and record consumption and side effects . Multivariate logistic regression was used to assess individual , household , and programmatic predictors of supplement adherence . Results Adherence was high with 78 and 82 % of the women consuming more than 80 % of the preconception and prenatal supplements , respectively . Women of minority ethnicity ( OR = 0.78 95 % CI = 0.67 , 0.91 ) and farmers ( OR = 0.71 95 % CI = 0.58 , 0.88 ) were less likely to consume > 80 % of the preconception supplements while socioeconomic status ( SES ) ( OR = 2.71 highest vs. lowest quintile ; 95 % CI = 2.10 , 3.52 ) was positively associated with > 80 % adherence in the entire preconception sample with available information ( n = 4417 ) . Women in their first pregnancy had lower prenatal adherence compared to multiparous women . At the programmatic level , each village health worker visit was associated with higher odds of > 80 % adherence by 3–5 % before pregnancy and 18 % during pregnancy . Conclusions Key determinants of adherence included SES , ethnicity , occupation ( farmer ) and parity which may be helpful for targeting women for counseling on supplement adherence . Increased contact with village health workers was positively associated with  adherence  to micronutrient supplementation both before conception and during pregnancy indicating the need for re sources to support community outreach to women of reproductive age . Trial registration NCT01665378 . Registered on August 12 , 2012 Objective : To assess if a weekly dose of iron and folic acid along with vitamin C , in the workplace would reduce the prevalence of anaemia . Methodology : A multi-pronged intervention was carried out to reduce the prevalence of anaemia among workers of 7 apparel manufacturing factories using a regime consisting of a supervised single dose of albendazole ( 400 mg ) followed by a weekly dose of dried ferrous sulphate ( 150 mg ) , folic acid ( 0.5 mg ) and vitamin C ( 100 mg ) . Workers were provided information on the causes of anaemia and its prevention . The total duration of the intervention was 16 weeks . Haemoglobin levels of a r and omly selected sample of workers were tested before and after the intervention using a computerized non-cyan-meth-haemoglobin method . Results : Of the 10810 workers who were enrolled a sample of 515 workers was r and omly selected for the blood investigations . At the end of the intervention ( 18 weeks after the first blood sample was collected ) only 361 out of the 515 who had been enrolled a little more than 16 weeks earlier still remained in the factories and among women 279 out of 385 enrolled were still working in the factories . In the 385 unmatched sample s the number of anaemic women had reduced from 141 before the intervention to 79 after - mean haemoglobin increasing from 12.2 to 13.0 ( p < 0.001 ) and in the 279 paired sample s prevalence of anaemia had reduced from 105 to 58 - mean haemoglobin increasing from 12.1 to 13.0 ( p < 0.001 ) . Conclusions : Our results demonstrated that in re source poor regions , where prevalence of anaemia is high , the workplace may be considered an ideal location to give a weekly supervised dose of iron , folic acid and vitamin C to effectively tackle the problem and probably improve worker efficiency Objective Preconception micronutrient interventions may be a promising approach to reduce anemia and iron deficiency during pregnancy , but currently we have limited data to inform policies . We evaluated whether providing additional pre-pregnancy weekly iron-folic acid ( IFA ) or multiple micronutrient ( MM ) supplements compared to only folic acid ( FA ) improves iron status and anemia during pregnancy and early postpartum . Methods We conducted a double blind r and omized controlled trial in which 5011 Vietnamese women were provided with weekly supplements containing either only 2800 μg FA ( control group ) , IFA ( 60 mg Fe and 2800 μg FA ) or MM ( 15 micronutrients with similar amounts of IFA ) . All women who became pregnant ( n = 1813 ) in each of the 3 groups received daily IFA ( 60 mg Fe and 400 μg FA ) through delivery . Hematological indicators were assessed at baseline ( pre-pregnancy ) , during pregnancy , 3 months post-partum , and in cord blood . Adjusted generalized linear models were applied to examine the impact of preconception supplementation on anemia and iron stores , using both intention to treat and per protocol analyses ( women consumed supplements ≥ 26 weeks before conception ) . Results At baseline , 20 % of women were anemic , but only 14 % had low iron stores ( ferritin < 30 μg/L ) and 3 % had iron deficiency ( ferritin < 12 μg/L ) . The groups were balanced for baseline characteristics . Anemia prevalence increased during pregnancy and post-partum but was similar among intervention groups . In intention to treat analyses , prenatal ferritin was significantly higher among women receiving MM ( geometric mean ( μg/L ) [ 95 % CI ] : 93.6 [ 89.3–98.2 ] ) and IFA ( 91.9 [ 87.6–96.3 ] ) compared to control ( 85.3 [ 81.5–89.2 ] ) . In per protocol analyses , women receiving MM or IFA  had higher ferritin 3 months postpartum ( MM 118.2 [ 109.3–127.8 ] ) , IFA 117.8 [ 108.7–127.7 ] vs control 101.5 [ 94.0–109.7 ] ) and gave birth to infants with greater iron stores ( MM 184.3 [ 176.1–192.9 ] ) , IFA 189.9 [ 181.6–198.3 ] vs control 175.1 [ 167.9–182.6 ] ) . Conclusion Preconception supplementation with MM or IFA result ed in modest increases in maternal and infant iron stores but did not impact anemia . Further research is needed to characterize the etiology of anemia in this population and identify effective interventions for reducing prenatal anemia . Trial Registration Clinical Trials . Gov Background Low birth weight and maternal anemia remain intractable problems in many developing countries . The adequacy of the current strategy of providing iron-folic acid ( IFA ) supplements only during pregnancy has been question ed given many women enter pregnancy with poor iron stores , the substantial micronutrient dem and by maternal and fetal tissues , and programmatic issues related to timing and coverage of prenatal care . Weekly IFA supplementation for women of reproductive age ( WRA ) improves iron status and reduces the burden of anemia in the short term , but few studies have evaluated subsequent pregnancy and birth outcomes .The Preconcept trial aims to determine whether pre-pregnancy weekly IFA or multiple micronutrient ( MM ) supplementation will improve birth outcomes and maternal and infant iron status compared to the current practice of prenatal IFA supplementation only . This paper provides an overview of study design , methodology and sample characteristics from baseline survey data and key lessons learned . Methods / design We have recruited 5011 WRA in a double-blind stratified r and omized controlled trial in rural Vietnam and r and omly assigned them to receive weekly supplements containing either : 1 ) 2800 μg folic acid 2 ) 60 mg iron and 2800 μg folic acid or 3 ) MM . Women who become pregnant receive daily IFA , and are being followed through pregnancy , delivery , and up to three months post-partum . Study outcomes include birth outcomes and maternal and infant iron status . Data are being collected on household characteristics , maternal diet and mental health , anthropometry , infant feeding practice s , morbidity and compliance . Discussion The study is timely and responds to the WHO Global Expert Consultation which identified the need to evaluate the long term benefits of weekly IFA and MM supplementation in WRA . Findings will generate new information to help guide policy and programs design ed to reduce the burden of anemia in women and children and improve maternal and child health outcomes in re source poor setting s . Trial registration RATIONALE It has been suggested that in pregnant women weekly iron supplements are as effective as daily supplements in preventing iron deficiency anaemia ( IDA ) . OBJECTIVE To compare the effectiveness of prophylactic antenatal oral iron supplements given weekly , thrice weekly and daily in preventing IDA in pregnancy . DESIGN A r and omised control trial . SETTING University antenatal clinic , ( UANC ) Galle . SUBJECTS AND METHOD An oral iron supplement containing 100 mg of elemental iron was r and omly given weekly ( n = 26 ) thrice weekly ( n = 35 ) and daily ( n = 31 ) to 92 women who were 14 to 24 weeks pregnant .  Haemoglobin ( Hb ) , serum ferritin ( SF ) and haematocrit ( Hct ) were assessed before and after 12 to 20 weeks of supplementation and a logistic regression analysis carried out . RESULTS The risk of developing anaemia was significantly higher in the weekly ( odds ratio 15 , 95 % CI 1.4 - 165.6 , p < 0.03 ) and possibly higher in the thrice weekly ( odds ratio 3 , 95 % CI 0.3 - 30.3 , p = 0.3 ) groups . The risk of developing iron deficiency ( SF < 12 micrograms/l ) was also significantly higher in the weekly ( odds ratio 18 , 95 % CI 2.8 - 115.5 , p < 0.003 ) and thrice weekly ( odds ratio 10 , 95 % CI 1.6 - 64.8 , p < 0.02 ) groups . CONCLUSION Prophylactic oral iron supplements when given intermittently were not effective in preventing iron deficiency anaemia in pregnancy BACKGROUND Although iron deficiency is a major cause of anemia , other micronutrient deficiencies may also play a role . OBJECTIVE We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh . DESIGN Anemic ( hemoglobin < 12.0 g/dL ) girls ( n = 197 ) aged 14 - 18 y from rural schools in Dhaka District were entered into a r and omized double-blind trial and received twice-weekly supp 
    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: INTRODUCTION Iron deficiency , associated with a decline in cognitive function , is the most common nutritional deficiency globally . The present study aim ed to identify the impact of weekly iron supplements on the attention function of female students from a high school in North Khorasan Province , Iran . METHODS This was a blind , controlled , clinical trial study , involving 200 female students who were chosen using the stratified r and omised sampling method . First , laboratory studies were performed to detect iron consumption limitations . Next , the 200 students were divided r and omly and equally into case and control groups . The case group was treated with 50 mg of ferrous sulfate twice a week for 16 weeks . We compared both groups ' data on attention , iron status and erythrocyte indices . Question naires were used to collect demographic data , while clinical data was collected using complete blood count and Toulouse-Piéron tests . Data was analysed using descriptive statistics , as well as paired and independent t-tests . RESULTS The mean attention scores of the case and control groups were 104.8 ± 7.0 and 52.7 ± 9.6 , respectively ( p < 0.001 ) . The mean haemoglobin levels of the two groups were 12.5 ± 0.9 and 11.2 ± 1.0 , respectively ( p < 0.001 ) . Compared to the control group , the attention scores and haemoglobin concentrations of the case group were found to be improved by approximately 90 % and 10 % , respectively . CONCLUSION Oral iron supplements ( 50 mg twice a week for 16 weeks ) were able to improve the attention span and haematologic indices of female high school students Background Poor adherence to micronutrient supplementation often limits the effectiveness of public health programs . While predictors of adherence to micronutrient supplementation during pregnancy are well documented , information on adherence to preconception supplements is scarce . The objective of this study was to describe the predictors of adherence to preconception and prenatal micronutrient supplementation among women participating in a r and omized control trial in Vietnam . Methods Adherence data were collected prospect ively from a double blind r and omized controlled trial in rural Vietnam . Five thous and eleven women of reproductive age were r and omized to receive preconception supplements for weekly consumption containing either : Folic Acid , Iron and Folic Acid ( IFA ) , or Multiple Micronutrients .  Women who became pregnant received prenatal IFA supplements for daily consumption through delivery . Village health workers visited participants ’ homes every two weeks to deliver supplements and record consumption and side effects . Multivariate logistic regression was used to assess individual , household , and programmatic predictors of supplement adherence . Results Adherence was high with 78 and 82 % of the women consuming more than 80 % of the preconception and prenatal supplements , respectively . Women of minority ethnicity ( OR = 0.78 95 % CI = 0.67 , 0.91 ) and farmers ( OR = 0.71 95 % CI = 0.58 , 0.88 ) were less likely to consume > 80 % of the preconception supplements while socioeconomic status ( SES ) ( OR = 2.71 highest vs. lowest quintile ; 95 % CI = 2.10 , 3.52 ) was positively associated with > 80 % adherence in the entire preconception sample with available information ( n = 4417 ) . Women in their first pregnancy had lower prenatal adherence compared to multiparous women . At the programmatic level , each village health worker visit was associated with higher odds of > 80 % adherence by 3–5 % before pregnancy and 18 % during pregnancy . Conclusions Key determinants of adherence included SES , ethnicity , occupation ( farmer ) and parity which may be helpful for targeting women for counseling on supplement adherence . Increased contact with village health workers was positively associated with  adherence  to micronutrient supplementation both before conception and during pregnancy indicating the need for re sources to support community outreach to women of reproductive age . Trial registration NCT01665378 . Registered on August 12 , 2012 Objective : To assess if a weekly dose of iron and folic acid along with vitamin C , in the workplace would reduce the prevalence of anaemia . Methodology : A multi-pronged intervention was carried out to reduce the prevalence of anaemia among workers of 7 apparel manufacturing factories using a regime consisting of a supervised single dose of albendazole ( 400 mg ) followed by a weekly dose of dried ferrous sulphate ( 150 mg ) , folic acid ( 0.5 mg ) and vitamin C ( 100 mg ) . Workers were provided information on the causes of anaemia and its prevention . The total duration of the intervention was 16 weeks . Haemoglobin levels of a r and omly selected sample of workers were tested before and after the intervention using a computerized non-cyan-meth-haemoglobin method . Results : Of the 10810 workers who were enrolled a sample of 515 workers was r and omly selected for the blood investigations . At the end of the intervention ( 18 weeks after the first blood sample was collected ) only 361 out of the 515 who had been enrolled a little more than 16 weeks earlier still remained in the factories and among women 279 out of 385 enrolled were still working in the factories . In the 385 unmatched sample s the number of anaemic women had reduced from 141 before the intervention to 79 after - mean haemoglobin increasing from 12.2 to 13.0 ( p < 0.001 ) and in the 279 paired sample s prevalence of anaemia had reduced from 105 to 58 - mean haemoglobin increasing from 12.1 to 13.0 ( p < 0.001 ) . Conclusions : Our results demonstrated that in re source poor regions , where prevalence of anaemia is high , the workplace may be considered an ideal location to give a weekly supervised dose of iron , folic acid and vitamin C to effectively tackle the problem and probably improve worker efficiency Objective Preconception micronutrient interventions may be a promising approach to reduce anemia and iron deficiency during pregnancy , but currently we have limited data to inform policies . We evaluated whether providing additional pre-pregnancy weekly iron-folic acid ( IFA ) or multiple micronutrient ( MM ) supplements compared to only folic acid ( FA ) improves iron status and anemia during pregnancy and early postpartum . Methods We conducted a double blind r and omized controlled trial in which 5011 Vietnamese women were provided with weekly supplements containing either only 2800 μg FA ( control group ) , IFA ( 60 mg Fe and 2800 μg FA ) or MM ( 15 micronutrients with similar amounts of IFA ) . All women who became pregnant ( n = 1813 ) in each of the 3 groups received daily IFA ( 60 mg Fe and 400 μg FA ) through delivery . Hematological indicators were assessed at baseline ( pre-pregnancy ) , during pregnancy , 3 months post-partum , and in cord blood . Adjusted generalized linear models were applied to examine the impact of preconception supplementation on anemia and iron stores , using both intention to treat and per protocol analyses ( women consumed supplements ≥ 26 weeks before conception ) . Results At baseline , 20 % of women were anemic , but only 14 % had low iron stores ( ferritin < 30 μg/L ) and 3 % had iron deficiency ( ferritin < 12 μg/L ) . The groups were balanced for baseline characteristics . Anemia prevalence increased during pregnancy and post-partum but was similar among intervention groups . In intention to treat analyses , prenatal ferritin was significantly higher among women receiving MM ( geometric mean ( μg/L ) [ 95 % CI ] : 93.6 [ 89.3–98.2 ] ) and IFA ( 91.9 [ 87.6–96.3 ] ) compared to control ( 85.3 [ 81.5–89.2 ] ) . In per protocol analyses , women receiving MM or IFA  had higher ferritin 3 months postpartum ( MM 118.2 [ 109.3–127.8 ] ) , IFA 117.8 [ 108.7–127.7 ] vs control 101.5 [ 94.0–109.7 ] ) and gave birth to infants with greater iron stores ( MM 184.3 [ 176.1–192.9 ] ) , IFA 189.9 [ 181.6–198.3 ] vs control 175.1 [ 167.9–182.6 ] ) . Conclusion Preconception supplementation with MM or IFA result ed in modest increases in maternal and infant iron stores but did not impact anemia . Further research is needed to characterize the etiology of anemia in this population and identify effective interventions for reducing prenatal anemia . Trial Registration Clinical Trials . Gov Background Low birth weight and maternal anemia remain intractable problems in many developing countries . The adequacy of the current strategy of providing iron-folic acid ( IFA ) supplements only during pregnancy has been question ed given many women enter pregnancy with poor iron stores , the substantial micronutrient dem and by maternal and fetal tissues , and programmatic issues related to timing and coverage of prenatal care . Weekly IFA supplementation for women of reproductive age ( WRA ) improves iron status and reduces the burden of anemia in the short term , but few studies have evaluated subsequent pregnancy and birth outcomes .The Preconcept trial aims to determine whether pre-pregnancy weekly IFA or multiple micronutrient ( MM ) supplementation will improve birth outcomes and maternal and infant iron status compared to the current practice of prenatal IFA supplementation only . This paper provides an overview of study design , methodology and sample characteristics from baseline survey data and key lessons learned . Methods / design We have recruited 5011 WRA in a double-blind stratified r and omized controlled trial in rural Vietnam and r and omly assigned them to receive weekly supplements containing either : 1 ) 2800 μg folic acid 2 ) 60 mg iron and 2800 μg folic acid or 3 ) MM . Women who become pregnant receive daily IFA , and are being followed through pregnancy , delivery , and up to three months post-partum . Study outcomes include birth outcomes and maternal and infant iron status . Data are being collected on household characteristics , maternal diet and mental health , anthropometry , infant feeding practice s , morbidity and compliance . Discussion The study is timely and responds to the WHO Global Expert Consultation which identified the need to evaluate the long term benefits of weekly IFA and MM supplementation in WRA . Findings will generate new information to help guide policy and programs design ed to reduce the burden of anemia in women and children and improve maternal and child health outcomes in re source poor setting s . Trial registration RATIONALE It has been suggested that in pregnant women weekly iron supplements are as effective as daily supplements in preventing iron deficiency anaemia ( IDA ) . OBJECTIVE To compare the effectiveness of prophylactic antenatal oral iron supplements given weekly , thrice weekly and daily in preventing IDA in pregnancy . DESIGN A r and omised control trial . SETTING University antenatal clinic , ( UANC ) Galle . SUBJECTS AND METHOD An oral iron supplement containing 100 mg of elemental iron was r and omly given weekly ( n = 26 ) thrice weekly ( n = 35 ) and daily ( n = 31 ) to 92 women who were 14 to 24 weeks pregnant .  Haemoglobin ( Hb ) , serum ferritin ( SF ) and haematocrit ( Hct ) were assessed before and after 12 to 20 weeks of supplementation and a logistic regression analysis carried out . RESULTS The risk of developing anaemia was significantly higher in the weekly ( odds ratio 15 , 95 % CI 1.4 - 165.6 , p < 0.03 ) and possibly higher in the thrice weekly ( odds ratio 3 , 95 % CI 0.3 - 30.3 , p = 0.3 ) groups . The risk of developing iron deficiency ( SF < 12 micrograms/l ) was also significantly higher in the weekly ( odds ratio 18 , 95 % CI 2.8 - 115.5 , p < 0.003 ) and thrice weekly ( odds ratio 10 , 95 % CI 1.6 - 64.8 , p < 0.02 ) groups . CONCLUSION Prophylactic oral iron supplements when given intermittently were not effective in preventing iron deficiency anaemia in pregnancy BACKGROUND Although iron deficiency is a major cause of anemia , other micronutrient deficiencies may also play a role . OBJECTIVE We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh . DESIGN Anemic ( hemoglobin < 12.0 g/dL ) girls ( n = 197 ) aged 14 - 18 y from rural schools in Dhaka District were entered into a r and omized double-blind trial and received twice-weekly supp 
    Output:
    