***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 Sex differences in stress responses may be one mechanism underlying gender differences in depression . We hypothesized that men and women would show different adrenocortical responses to different stressors . In particular , we predicted that women would show greater responses to social rejection stressors , whereas men would demonstrate greater responses to achievement stressors . METHODS Following a rest session in which they habituated to the laboratory , 50 healthy volunteers ( 24 men and 26 women , mean age 19.1 , SD = 1.13 ) were r and omly assigned to achievement or rejection stress conditions . The achievement condition involved a mathematical and a verbal challenge ; the rejection condition involved two social interaction challenges .  Self-reported affect and salivary cortisol were measured throughout each stress session ( baseline , stress , and poststress periods ) . RESULTS There were no sex differences in mood ratings following the stressors ; however , cortisol responses showed the predicted gender by condition by time interaction . Men showed significantly greater cortisol responses to the achievement challenges , but women showed greater cortisol responses to the social rejection challenges . CONCLUSIONS Women appear more physiologically reactive to social rejection challenges , but men react more to achievement challenges . Women 's greater reactivity to rejection stress may contribute to the increased rates of affective disorders in women This study examined intra-individual change in testosterone , cortisol , and hormone-behavior relationships in response to a  rowing ergometer competition .  Forty-six members ( 23 females ) of a university crew team provided saliva sample s before , 20- and 40-min post-competition , as well as baselines on a non-competition day .  Behavioral assessment s included measures of previous rowing experience , dominance , competitiveness , bonding with teammates , pre- and post-competition mental state and performance . Men 's and women 's endocrine responses to this competitive setting were more different than alike and varied by level of competitive experience , the specific phase of the competitive event , and the particular hormone measured . Inter-individual differences in testosterone and cortisol were differentially associated with social affiliation with teammates but rarely with dominance or competitiveness . Theoretically , the findings support the integration of features of the ' tend and befriend ' model with the biosocial model of status , and suggest future research directions that may lead to clarification and refinement of those ideas Changes in cortisol concentration in response to exercise at 3 different intensities were quantified . Ten apparently healthy , recreationally active males participated . On 4 separate occasions , subjects were assigned a r and om order of 1-hour cycle ergometer bouts of exercise at 44.5 ± 5.5 % , 62.3 ± 3.8 % , and 76.0 ± 6.0 % ( mean ± SD ) of Vo2peak and a resting control session . Saliva sample s were collected before exercise at 10 , 20 , 40 , and 59 minutes of exercise and at 20 minutes of recovery . Differences in cortisol concentration were assessed via multivariate analysis of variance ( α= 0.05 ) Tukey post hoc analysis when indicated . During the highest-intensity exercise  session , cortisol was significantly higher at 59 minutes of exercise ( p = 0.004 ) and at 20 minutes of recovery ( p = 0.016 ) than at those same time points during the resting control session . No significant differences in cortisol concentration were noted among resting , low- , and moderate-intensity exercise . Exercise < 40 minutes in duration elicited no significant differences at any intensity . These data indicate that only exercise of high intensity and long duration results in significant elevations of salivary cortisol This study compares the anticipatory hormonal and psychological responses of 17 male judo players to an official competition  with the data obtained during eight resting sessions carried out at the same time of day , throughout an entire sports season .  Testosterone ( T ) and cortisol ( C ) levels  were determined 1 h and 30 min before competition , and mood , anxiety and expectancies were also evaluated . C levels and anxiety scores were concurrently higher before the contest than in resting conditions ; however , non-significant correlations between them were found . The anticipatory T response was not significant for the whole group . However , one group of subjects did display T increases , higher C levels , and higher motivation to win scores than the other group . Furthermore , this group also obtained a better outcome . Thus , this hormonal pattern and its relationships with psychological variables suggest an adaptive psychobiological response to a competition . Results are discussed in the context that neuroendocrine response to competition is associated with cognitive appraisal Systematic review s , a cornerstone of evidence -based medicine , are not produced quickly enough to support clinical practice . The cost of production , availability of the requisite expertise and timeliness are often quoted as major contributors for the delay . This detailed survey of the state of the art of information systems design ed to support or automate individual tasks in the systematic review , and in particular systematic review s of r and omized controlled clinical trials , reveals trends that see the convergence of several parallel research projects . We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review . Several projects focus on automating , simplifying and /or streamlining specific tasks of the systematic review . Some tasks are already fully automated while others are still largely manual . In this review , we describe each task and the effect that its automation would have on the entire systematic review process , summarize the existing information system support for each task , and highlight where further research is needed for realizing automation for the task . Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow . We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials , appraises them , extracts and synthesizes data , evaluates the risk of bias , performs meta- analysis calculations , and produces a report in real time The effects of short-term social support on cortisol levels and subjective responses to acute psychological stress were investigated in healthy adults ( total N = 66 ) . In anticipation of a public-speaking task in front of an audience , subjects received either no social support ( " no support " ) or social support from an opposite-sex stranger ( " stranger " ) or from their boyfriend or girlfriend ( " partner " ) . Support providers were instructed to enact both instrumental and emotional support during the 10-minute anticipation period . The results obtained suggest sex-specific effects of social support . Although men in the partner support condition showed significant attenuation of cortisol responses compared with unsupported and stranger-supported men , women showed no response decrement under stranger support . In contrast to men , women showed a tendency toward increased cortisol responses when supported by their boyfriends . The endocrine response differences between male and female subjects were unrelated to question naire-derived psychological variables . No sex and group differences in perceived stress , mood changes , or social desirability were observed . Although the overall level of subjective well-being throughout the experiment was elevated in the partner support condition , no sex or group differences were observed in perceived stress , well-being changes , and social desirability . Opposite to their cortisol responses , women rated both stranger and partner support attempts more favorably than did men . No significant correlations were observed between the perceived stressfulness of the situation , mood changes , and cortisol responses . These results provide preliminary evidence for sex-specific patterns of social support efficacy to acute psychological stress with respect to adrenocortical responses Although a rapid response habituation to repeated stress exposure is a key characteristic of the hypothalamus-pituitary-adrenal ( HPA ) axis , several studies document a substantial inter-individual variability of such HPA response patterns . In order to further investigate the individual differences in the habituation of this important neuroendocrine system to psychosocial stress , 54 male twin pairs were exposed to moderate psychosocial stress  on three occasions , each exposure separated by a 1-week interval . Additionally , an ACTH(1 - 24 ) stimulation test ( 1 microg ) and a dexamethasone suppression test ( 0.5 mg ) were performed . Although on average the expected decrease of mean cortisol and ACTH responses across stress exposures was observed , only 52 % of the subjects showed this well-documented general decline and almost 16 % of the participants even showed a response sensitization across sessions . Furthermore , a weak habituation was related to low cortisol responses to both the first stress exposure as well as the ACTH challenge . Moreover , genetic analyses did not reveal any evidence for a substantial heritability of the individual cortisol response habituation or an association between this habituation and two common polymorphisms in the glucocorticoid receptor gene In virtually all sports , participants " warm-up " prior to formal competition . Women athletes from a highly ranked varsity college volleyball team and , in a second study , a highly ranked varsity college tennis team gave saliva sample s before warm-up , at mid-warm-up ( volleyball ) or after warm-up ( tennis ) , and immediately after intercollegiate competition . For volleyball and tennis , warm-up was associated with a substantial elevation in saliva levels of testosterone which was carried over through the period of actual competition . Cortisol levels were relatively unchanged during warm-up , but typically rose during competition . Thus , as women prepare for athletic competition by warming up , testosterone levels rise in apparent anticipation of the coming contest and then remain high through the period of play . In volleyball and tennis , after- practice testosterone level was significantly higher than before- practice level , and practice session increases in testosterone ( but not cortisol ) were positively correlated with increases in testosterone during intercollegiate competition . When practice and competitive play share as yet undetermined key elements , individual differences in this endocrine response to " competition " appear stable across practice and intercollegiate competition 
    Output:
    
Summary / conclusion The anticipatory cortisol response before sport competition reflects moderate cortisol reactivity that prepares athletes optimally for the dem and s of sport competition via the influence on cognitive processes and attentional control .
However , both female athletes and international competitors did not demonstrate a significant anticipatory cortisol response , possibly due to differences in appraisal of the stress of sport competition