***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 Green tea polyphenols ( GTPs ) have significant antioxidant and antiinflammatory activities , and prior short‐term studies suggest that these compounds may improve photoaging skin . OBJECTIVES To evaluate the long‐term effects of oral GTPs on the clinical and histologic characteristics of photoaging skin . MATERIAL S AND METHODS Double‐blind , placebo‐controlled trial of 56 women aged 25 to 75 r and omized to 250 mg GTPs or placebo twice daily for 2 years . A blinded dermatologist scored the appearance of photodamaged facial skin at 0 , 6 , 12 , and 24 months . A blinded dermatopathologist scored the histologic characteristics of sun‐exposed arm skin at 0 and 24 months . RESULTS Clinical assessment of facial skin revealed that the GTP group had significant improvement in overall solar damage at 6 months ( p=.02 ) and significant improvement in erythema and telangiectasias at 12 months ( p=.02 ) . The placebo group did not have significant improvements in these parameters at 6 months or 12 months . There were no statistically significant differences in other photoaging parameters at 6 , 12 , or 24 months in the GTP or placebo groups . Histopathologic analysis of sunexposed arm skin showed no statistically significant difference in photoaging parameters in the GTP group or the placebo group at 24 months . CONCLUSIONS Long‐term supplementation with oral GTPs was not superior to placebo in improving clinical or histologic photoaging parameters after 24 months of use . Funding and material s for this study were provided by Nu Skin , Provo , Utah . Dale Kern is an employee of Nu Skin International To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results A double-blind , placebo-controlled trial was conducted to clinical ly evaluate the effect of soy isoflavone aglycone on the aged skin of middle-aged women . Twenty-six women volunteers in their late 30s and early 40s were r and omly assigned to receive either a test food ( 13 women , the test food group ) or a placebo food ( 13 women , the control group ) . These groups were given the test food ( 40 mg of soy isoflavone aglycone per day ) and placebo , respectively , for 12 wk . The extent of linear and fine wrinkles at the lateral angle of the eyes was selected as the major evaluation criterion to assess the effects of foods , and the wrinkles ' area ratio was used as the evaluation parameter . The extent of skin microrelief at the lateral angle of eyes and that of malar skin elasticity were used as secondary evaluation criteria , and the skin microrelief 's area ratio and recovery of skin elasticity were used as the respective evaluation parameters . These parameters were assessed 4 , 8 , and 12 wk after the start of the test food or placebo intake . The test food group showed a statistically significant improvement of fine wrinkles at week 12 ( p<0.05 ) and of malar skin elasticity at week 8 ( p<0.05 ) , compared with the control group . Although there was no significant difference between the test food group and the control group regarding effects on skin microrelief at lateral angle of the eyes , a significant intragroup improvement was observed at week 8 in the test food group ( p<0.05 ) . As for the test food safety , none of the subjects presented adverse symptoms during the study period or discontinued the intake of the test food . These data indicate that the oral intake of 40 mg soy isoflavone aglycones per day improves the aged skin of middle-aged women This study evaluates the efficacy and tolerability of an investigational study cream composed of 3 ingredients ( green and white teas , mangosteen , and pomegranate extract ) , Vitaphenol Skin Cream ( La Jolla Spa MD , La Jolla CA ) , as compared to a placebo cream in rejuvenating facial skin . Twenty healthy females between the ages of 35 and 65 with demonstrable facial wrinkling , achieving a Rao-Goldman wrinkle scale score of 2 or above , applied either Vitaphenol Skin Cream or placebo cream to a r and omized half of their face twice daily for 60 days and returned for follow-up after 2 weeks . Twice as many subjects indicated an enhancement of skin texture ( eg , reduction in pore size , roughness , and touch ) with the usage of Vitaphenol versus placebo . In all , 41 % of the study subjects preferred the half of their face that had been receiving Vitaphenol , while only 0.06 % of the subjects favored the placebo side . PRIMOS images from periorbital skin treated with Vitaphenol demonstrated an average improvement in skin smoothness of 1 mm3 , whereas skin treated with placebo showed an average decrease in smoothness or an increase in skin roughness of 0.9 mm3 . The addition of 3 antioxidants , green and white teas , mangosteen , and pomegranate , have an additive effect to enhance the improvement of age-related changes in the skin BACKGROUND Green tea extracts have gained popularity as ingredients in topical skin care preparations to treat aging skin . Green tea polyphenolic compounds have significant antioxidant and anti-inflammatory activities , and studies suggest that these extracts help mediate ultraviolet radiation damage . OBJECTIVE To evaluate the effects of a combination regimen of topical and oral green tea supplementation on the clinical and histologic characteristics of photoaging . METHODS Forty women with moderate photoaging were r and omized to either a combination regimen of 10 % green tea cream and 300 mg twice-daily green tea oral supplementation or a placebo regimen for 8 weeks . RESULTS No significant differences in clinical grading were found between the green tea-treated and placebo groups , other than higher subjective scores of irritation in the green tea-treated group . Histologic grading of skin biopsies did show significant improvement in the elastic tissue content of treated specimens ( p<.05 ) . CONCLUSION Participants treated with a combination regimen of topical and oral green tea showed histologic improvement in elastic tissue content . Green tea polyphenols have been postulated to protect human skin from the cutaneous signs of photoaging , but clinical ly significant changes could not be detected . Longer supplementation may be required for clinical ly observable improvements Hormones play a central role in skin appearance and are implicated in skin aging . Recently , along with the remarkable increase in interest in natural products , the application of phytohormones in antiaging products has become very important . In this context , we developed date palm kernel extract . Date palm kernel is rich in phytohormones and we investigated the antiaging properties of date palm kernel in this in vivo study on wrinkles . Ten healthy women volunteers , between the ages of 46 and 58 years , applied the cream formula with 5 % date palm kernel or placebo on the eye area twice a day for 5 weeks . The evaluation was made both clinical ly and by silicon replica analysis followed by statistical analysis using the Wilcoxon test . Silicon replica results showed that topical application of date palm kernel reduced the total surface of wrinkles by 27.6 % ( p = 0.038 ) . Moreover , date palm kernel reduced the depth of wrinkles by 3.52 % ( p = 0.0231 ) . These results are statistically significant and were clinical ly confirmed where visual improvement was seen in 60 % of the volunteers treated . This in vivo study demonstrates that date palm kernel exhibits a significant antiwrinkle effect and is therefore of interest in antiaging skin care products Recently , it has become indispensable for anti-aging active ingredients to provide a visible and immediate smoothing antiwrinkle effect . In Quercus suber , suberin is the most important structural component of cork cell walls . Studies have shown that suberin is made up mostly of hydroxycarboxylic acids and that it is endowed with many special mechanical and chemical properties that evoke a possible smoothing effect on the surface of the skin . Therefore , we were interested in investigating the effect of this cork extract on the skin 's surface in a double-blind clinical study . The study was conducted in 15 healthy volunteers , aged 22 to 52 years . The volunteers applied a gel formula with 3 % of cork extract , or placebo gel , on each forearm . Skin surface roughness was evaluated visually by pictures and by silicone replicas 1 and 2 h after application , followed by statistical analysis using the matched-pairs McNemar statistical test . McNemar analysis of the pictures revealed that application of cork extract on the skin result ed in a highly significant reduction of roughness 1 h after application . This effect was observed in 73.3 % of volunteers . Two hours after cork extract application , a highly significant improvement of skin roughness was found in 78.6 % of volunteers . Moreover , silicone replica treatment confirmed significant improvement in average of roughness at 2 h. These results demonstrate that cork extract provides a remarkable and highly significant tensor and smoothing effect on the skin , which could be of great use in anti-aging skin care products R and omized , controlled trials ( RCTs ) of herbal interventions often inadequately describe important aspects of their methods ( 1 - 4 ) . Although the quality of reporting of these trials may be improving with time , many still lack important information , particularly about the composition of the herbal intervention ( 4 , 5 ) . Crude herbal drugs are natural products and their chemical composition varies depending on several factors , such as geographic source of the plant material , climate in which it was grown , and time of harvest . Commercially available herbal medicinal products also vary in their content and concentration of chemical constituents from batch to batch and when products containing the same herbal ingredient are compared among manufacturers ( 6 - 14 ) . Even when herbal products are st and ardized for content of known active or marker compounds to achieve more consistent pharmaceutical quality , there is variation in the concentrations of other constituents . These variations can result in differences in pharmacologic activity in vitro ( 15 ) and in bioavailability in humans ( 16 ) . Mindful of these issues , we elaborated on the 22-item checklist of the Consoli date d St and ards of Reporting Trials ( CONSORT ) statement ( 17 ) to help authors and editors improve reporting of RCTs of herbal interventions . Methods We developed these reporting recommendations in 3 phases that included premeeting item generation , a consensus meeting , and postmeeting feedback . The individuals who participated are listed in the Appendix . To generate items , 1 investigator conducted telephone interviews of 16 participants with expertise in the method and reporting of RCTs ( 5 participants ) , pharmacognosy ( 4 participants ) , herbal medicinal products ( 5 participants ) , medical statistics ( 1 participant ) , and herbal product manufacturing ( 1 participant ) . The investigator asked participants to suggest revisions to existing CONSORT checklist items and also to additional items required for reporting trials of herbal interventions . He asked participants to nominate revisions or new items on the basis of empirical evidence that not reporting the item would bias estimates of treatment effect . When no empirical evidence was available , commonsense reasoning was acceptable . After completing all telephone calls , the investigator thematically grouped items and circulated them by e-mail to each participant for review . Fourteen participants attended the consensus meeting . The meeting began with a review of the premeeting checklist item suggestions . We emphasized minimizing item elaborations and additions and basing elaborations on evidence whenever possible . Each item suggestion was presented and followed by debate for its inclusion , deletion , or modification . This process was repeated until all items were review ed and a consensus emerged . After the consensus meeting , we circulated a draft summary report to all participants to ensure that it accurately represented decisions made during the consensus meeting . We then circulated the report to the wider CONSORT Group for input and revised it on the basis of their suggestions . Ethical approval was obtained from The University of Toronto Health Sciences Ethics Review Committee on 23 January 2004 . Financial support for the consensus meeting was provided by the Canadian Institutes of Health Research . The funding body had no role in the design , conduct , or analysis of this study and did not influence the decision to su bmi t the manuscript for publication . All research ers are independent of the funders . Results The group did not recommend any new CONSORT checklist items or modifications in the CONSORT flow diagram . We did , however , elaborate on 9 of the 22 CONSORT checklist items to enhance their relevance to trials of herbal interventions ( Table , Figure ; Appendix Table ) , including minor recommendations for 8 items ( item 1 [ title and abstract ] , item 2 [ background ] , item 3 [ participants ] , item 6 [ outcomes ] , item 15 [ baseline data ] , item 20 [ interpretation ] , item 2 
    Output:
    
In summary , there is some weak evidence to suggest that several botanical extracts may be effective in reducing the appearance of skin aging but no evidence that this effect is enduring .