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There will be no data monitoring committee since only the primary evaluator, the research team, and the coordinator assistant will have access to the clinical trial data. Additionally, this trial is a low-risk intervention, and participants are advised to report any unexpected or adverse effects to the research team. Adverse event reporting and harms {22} Silymarin is a flavonoid extracted from Silybum marianum, one of the most used medicinal herbs by individuals with liver diseases [ 16]. Silybum marianum has shown good tolerance and safety, with limited adverse effects reported in liver disease patients. The hepatoprotective, anti-inflammatory, antioxidant, and anti-fibrotic effects of silymarin have been studied in patients with cirrhosis associated with viral hepatitis, exposure to environmental toxins, alcoholic steatosis and NASH [ 17, 18, 19, 20].

a b McCloskey C.M.; Coleman, G.H. (1955). "β-d-Glucose-2,3,4,6-Tetraacetate". Organic Syntheses. ; Collective Volume, vol.3, p.434 I participants receive 700 mg silymarin + 8 mg vitamin E + 50 mg phosphatidylcholine, daily. C participants receive 700 mg maltodextrin + 8 mg vitamin E + 50 mg phosphatidylcholine, daily. Most other binary alloys are of little use: for example, silver–gold alloys are too soft and silver– cadmium alloys too toxic. Ternary alloys have much greater importance: dental amalgams are usually silver–tin–mercury alloys, silver–copper–gold alloys are very important in jewellery (usually on the gold-rich side) and have a vast range of hardnesses and colours, silver–copper–zinc alloys are useful as low-melting brazing alloys, and silver–cadmium– indium (involving three adjacent elements on the periodic table) is useful in nuclear reactors because of its high thermal neutron capture cross-section, good conduction of heat, mechanical stability, and resistance to corrosion in hot water. [53] Etymology Patients who meet any of the following criteria have not been included lactating or pregnant women, and women during their menacme, except for those who underwent definitive contraception such as hysterectomy or tubal ligation; patients with a previously established diagnosis of chronic disease including congestive heart failure, decompensated or severe lung disease, neoplasms, kidney disease, carriers of the human immunodeficiency virus (HIV), and advanced chronic liver diseases (Child-Pugh classification B and C) caused by any causal agent unrelated to NAFLD; recreational drug users; patients with an average intake of more than 20 g of alcohol per day and or a history of alcoholic disease in abstention for less than 6 months; use of prescribed medication including steroids, oestrogens, amiodarone, warfarin, anticonvulsants, antipsychotics, or chemotherapy drugs in the past 6 months; infections, surgery, trauma, or hospitalization in the past 30 days; chronic degenerative diseases of non-hepatic origin; and unavailability of previously obtained imaging tests with a diagnosis of NAFLD in its screening phase. Exclusion criteria In the final consultation, participants who no longer showed fatty infiltration received guidance on how to prevent the recurrence of NAFLD. Participants who showed evidence of NAFLD, regardless of the degree of steatosis, were referred to the outpatient follow-up clinic for continuation of their care provision with a hepatologist consultant and a registered nutritionist (Fig. 1). Plans to promote participant retention and complete follow-up {18b}

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Only patients who successfully completed the trial will have their data included in the final trial data analyses, and there will be no imputations for missing data. The data will be assessed by intention-to-treat, in which all participants who completed the trial are included in the statistical analyses and analyzed according to the group they were originally assigned, regardless of which group they were assigned to. Participants who drop out of the study due to illness, moving to another city, or inability to attend appointments or perform tests will be considered as protocol deviations and will be excluded from the data analyses. Plans to give access to the full protocol, participant-level data, and statistical code {31c} Silver complexes tend to be similar to those of its lighter homologue copper. Silver(III) complexes tend to be rare and very easily reduced to the more stable lower oxidation states, though they are slightly more stable than those of copper(III). For instance, the square planar periodate [Ag(IO 5OH) 2] 5− and tellurate [Ag{TeO 4(OH) 2} 2] 5− complexes may be prepared by oxidising silver(I) with alkaline peroxodisulfate. The yellow diamagnetic [AgF 4] − is much less stable, fuming in moist air and reacting with glass. [36] a b "The origins of coinage". britishmuseum.org. Archived from the original on 2 May 2019 . Retrieved 21 September 2015. The data will be treated anonymously and confidentially and at no time will the personal details of the participants be disclosed at any stage of the study. Plans for collection, laboratory evaluation, and storage of biological specimens for genetic or molecular analysis in this trial/future use {33} Meyer, Rudolf; Köhler, Josef & Homburg, Axel (2007). Explosives. Wiley–VCH. p. 284. ISBN 978-3-527-31656-4.

The PI as a blind evaluator and a coordinator assistant will coordinate all phases of the study, the randomization, and record-keeping of I and C participants. Patient and Public Involvement Groups (PPIG) were not involved in the design, recruitment, or execution of this trial, nor will they be involved in the reporting and dissemination of this research trial, with the exception of dissemination through their own social media channels if they wish. Composition of the data monitoring committee, its role and reporting structure {21a}

During the intervention and follow-up, participants are advised not to use any medication, supplement, tea or herbal supplement without prior medical and nutritional advice, and without prior notice to the research team. If they do, they are asked to inform the research team immediately, informing what was ingested and the date and dosage taken. Provisions for post-trial care {30} Cope, A. C.; Bach, R. D. (1973). "trans-Cyclooctene". Organic Syntheses. ; Collective Volume, vol.5, p.315 Fortnightly meetings were held with the group of researchers involved in the study to discuss development and question clarification. An independent researcher external to the research team will verify the data collected during the study. If any documents are missing or information is inconsistent, the Ethics Committee will be notified. Lastly, if there is any change in the study, the ethics committee, the journal, and ClinicalTrials will be notified immediately. Plans for communicating important protocol amendments to relevant parties (e.g., trial participants, ethical committees) {25} Fontenrose, Joseph (1974). "Work, Justice, and Hesiod's Five Ages". Classical Philology. 69 (1): 1–16. doi: 10.1086/366027. JSTOR 268960. S2CID 161808359.