***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: CONTEXT Infants born prematurely are at risk for a perinatal encephalopathy characterized by white and gray matter injuries that affect subsequent cortical development and neural connectivity and potentially increase risk for later psychiatric disorder . OBJECTIVE To determine the relation of perinatal brain injury , as detected by neonatal head ultrasound , to psychiatric disorders in adolescents who were born prematurely . DESIGN Prospect i ve cohort . SETTING Community . PARTICIPANTS Adolescent survivors of a population -based low-birth-weight ( < 2000 g ; 96 % preterm ; born 1984 - 1987 ) cohort ( n = 1105 ) screened as neonates with serial head ultrasounds .  Neonatal head ultrasound abnormalities were categorized as either ( 1 ) germinal matrix and /or intraventricular hemorrhage or ( 2 ) parenchymal lesions and /or ventricular enlargement . Of 862 eligible survivors , 628 ( 72.9 % ) were assessed at age 16 years . The sample consisted of 458 nondisabled survivors assessed in person . Main Outcome Measure Adolescent current and lifetime psychiatric disorders assessed with parent report on the Diagnostic Interview Schedule for Children-IV . RESULTS Compared with no abnormality , germinal matrix/intraventricular hemorrhage increased risk for current major depressive disorder ( odds ratio , 2.7 ; 95 % confidence interval , 1.0 - 6.8 ) and obsessive-compulsive disorder ( 9.5 ; 3.0 - 30.1 ) . Parenchymal lesions/ventricular enlargement increased risk for current attention-deficit/hyperactivity disorder-inattentive type ( odds ratio , 7.6 ; 95 % confidence interval , 2.0 - 26.5 ) , tic disorders ( 8.4 ; 2.4 - 29.6 ) , and obsessive-compulsive disorder ( 7.6 ; 1.39 - 42.0 ) . Parenchymal lesions/ventricular enlargement were not related to lifetime attention-deficit/hyperactivity disorder-inattentive type , but all other relations were similar for lifetime disorders . Control for other early risk factors did not alter these relations . Most of these relations persisted with control for concurrent cognitive or motor problems . CONCLUSION In preterm infants , 2 distinct types of perinatal brain injury detectable with neonatal head ultrasound selectively increase risk in adolescence for psychiatric disorders in which dysfunction of subcortical-cortical circuits has been implicated Umbilical cord blood ( UCB ) , rich in stem/progenitor cells , is partially eliminated from the bloodstream during childbirth because the cord is immediately clamped . We hypothesize that transfusion of autologous UCB to premature infants after delivery could serve as an adjuvant modality for preventing the development of prematurity-related complications . We r and omly enrolled 20 preterm infants born before 32 weeks of gestational age ( GA ) , all of whom developed anemia , necessitating transfusion of red blood cells ( RBCs ) . Two groups , matched for GA , were selected : ( 1 ) infants ( n = 5 ) who underwent UCB transfusion once within 5 days of birth ( mean ± st and ard deviation , 3.2 ± 1.9 days ) and ( 2 ) infants ( n = 15 ) from whom UCB was not collected ( e.g. , lack of consent ) . The latter served as controls and received allogeneic RBC transfusions ( 7.8 ± 3.9 days after birth ) . Selected prematurity-related complications were monitored . Two weeks after UCB/RBC transfusion , peripheral blood sample s were collected , and the concentrations of 41 selected growth factors and their receptors were analyzed using a multiplex protein array .  UCB transfusions were found to be both feasible and tolerable . Intraventricular haemorrhage was diagnosed in two of five ( 40 % ) UCB recipients , but was found in thirteen of fifteen RBC recipients ( 86.7 % ) . Twenty-two plasma proteins ( e.g. , insulin-like growth factors , stem cell factor , epidermal growth factors ) were found with significantly different concentrations in UCB recipients compared to controls . Results demonstrate safety and feasibility of UCB transfusion in a small group of very premature neonates and should be interpreted as preliminary speculation . Transfusion of UCB could induce a specific humoral effects , and this could serve as an adjuvant modality for prevention of prematurity complications Background Little is known about the effects of induced pluripotent stem cell ( iPSC ) treatment on acute cerebral inflammation and injuries after intracerebral hemorrhage ( ICH ) , though they have shown promising therapeutic potentials in ischemic stoke . Methods An ICH model was established by stereotactic injection of collagenase VII into the left striatum of male Sprague-Dawley ( SD ) rats . Six hours later , ICH rats were r and omly divided into two groups and received intracerebrally 10 μl of PBS with or without 1 × 106 of iPSCs . Subsequently , neural function of all ICH rats was assessed at days 1 , 3 , 7 , 14 , 28 and 42 after ICH . Inflammatory cells , cytokines and neural apoptosis in the rats ’ perihematomal regions , and brain water content were determined on day 2 or 3 post ICH . iPSC differentiation was determined on day 28 post ICH . Nissl+ cells and glial fibrillary acidic protein (GFAP)+ cells in the perihematoma and the survival rates of rats in two groups were determined on post-ICH day 42 . Results Compared with control animals , iPSCs treatment not only improved neurological function and survival rate , but also result ed in fewer intracephalic infiltrations of neutrophils and microglia , along with decreased interleukin (IL)-1β , IL-6 and tumour necrosis factor-alpha ( TNF-α ) , and increased IL-10 in the perihematomal tissues of ICH rats . Furthermore , brain oedema formation , apoptosis , injured neurons and glial scar formation were decreased in iPSCs-transplanted rats . Conclusions Our findings indicate that iPSCs transplantation attenuate cerebral inflammatory reactions and neural injuries after ICH , and suggests that multiple mechanisms including inflammation modulation , neuroprotection and functional recovery might be involved simultaneously in the therapeutic benefit of iPSC treatment against hemorrhagic stroke OBJECTIVE To assess the safety and feasibility of allogeneic human umbilical cord blood (hUCB)-derived mesenchymal stem cell ( MSC ) transplantation in preterm infants . STUDY DESIGN In a phase I dose-escalation trial , we assessed the safety and feasibility of a single , intratracheal transplantation of hUCB-derived MSCs in preterm infants at high risk for bronchopulmonary dysplasia ( BPD ) . The first 3 patients were given a low dose ( 1 × 10(7 ) cells/kg ) of cells , and the next 6 patients were given a high dose ( 2 × 10(7 ) cells/kg ) . We compared their adverse outcomes , including BPD severity , with those of historical case-matched comparison group . RESULTS Intratracheal MSC transplantation was performed in 9 preterm infants , with a mean gestational age of 25.3 ± 0.9 weeks and a mean birth weight of 793 ± 127 g , at a mean of 10.4 ± 2.6 days after birth . The treatments were well tolerated , without serious adverse effects or dose-limiting toxicity attributable to the transplantation . Levels of interleukin-6 , interleukin-8 , matrix metalloproteinase-9 , tumor necrosis factor α , and transforming growth factor β1 in tracheal aspirates at day 7 were significantly reduced compared with those at baseline or at day 3 posttransplantation . BPD severity was lower in the transplant recipients , and rates of other adverse outcomes did not differ between the comparison group and transplant recipients . CONCLUSION Intratracheal transplantation of allogeneic hUCB-derived MSCs in preterm infants is safe and feasible , and warrants a larger and controlled phase II study In a previous study of preterm infants requiring mechanical ventilation for the respiratory distress syndrome , we demonstrated a striking association of fluctuating cerebral blood-flow velocity in the first day of life with the subsequent occurrence of intraventricular hemorrhage . Because this fluctuating pattern could be eliminated by muscle paralysis , we conducted a prospect i ve study of preterm infants receiving mechanical ventilation for the respiratory distress syndrome in which we evaluated the effect of paralysis and this flow-velocity pattern on the incidence and severity of intraventricular hemorrhage .  Twenty-four infants with the fluctuating pattern in the first hours of life were identified and r and omly selected to serve as controls ( 10 ) or to be subjected to muscle paralysis ( 14 ) . Intraventricular hemorrhage developed in all 10 control infants but in only 5 of the 14 infants subjected to muscle paralysis . Moreover , in 4 of the 5 paralyzed infants in whom hemorrhage developed , it did so after cessation of the paralysis . Seven of the 10 control infants had Grade III hemorrhage , the most severe variety of intraventricular hemorrhage , whereas none of the paralyzed infants had Grade III hemorrhage . We conclude that elimination of fluctuating cerebral blood-flow velocity in preterm infants with respiratory distress syndrome markedly reduces the incidence and severity of intraventricular hemorrhage Objective . Bronchopulmonary dysplasia ( BPD ) is the endpoint of many intervention trials in neonatology , yet the outcome measure when based solely on oxygen administration may be confounded by differing criteria for oxygen administration between physicians . We previously reported a technique to st and ardize the definition of BPD between sites by using a timed room-air challenge in selected infants . We hypothesized that a physiologic definition of BPD would reduce the variation in observed rates of BPD among different neonatal centers . Methodology . A total of 1598 consecutive inborn premature infants ( 501–1249 g birth weight ) who remained hospitalized at 36 weeks ' postmenstrual age were prospect ively assessed and assigned an outcome with both a clinical definition and physiologic definition of BPD . The clinical definition of BPD was oxygen supplementation at exactly 36 weeks ' postmenstrual age . The physiologic definition of BPD was assigned at 36 ± 1 weeks ' postmenstrual age and included 2 distinct sub population s. First , neonates on positive pressure support or receiving > 30 % supplemental oxygen with saturations between 90 % and 96 % were assigned the outcome BPD and not tested further . Second , those receiving ≤30 % oxygen or effective oxygen > 30 % with saturations > 96 % underwent a room-air challenge with continuous observation and oxygen-saturation monitoring . Outcomes of the room-air challenge were “ no BPD ” ( saturations ≥90 % during weaning and in room air for 30 minutes ) or “ BPD ” ( saturation < 90 % ) . At the conclusion of the room-air challenge , all infants were returned to their baseline oxygen levels . Safety ( apnea , bradycardia , increased oxygen use ) and outcomes of the physiologic definition versus the clinical definition were assessed . Results . A total of 560 ( 35.0 % ) neonates were diagnosed with BPD by the clinical definition of oxygen use at 36 weeks ' postmenstrual age . The physiologic definition diagnosed BPD in 398 ( 25.0 % ) neonates in the cohort . All infants were safely studied . There were marked differences in the impact of the definition on BPD rates between centers ( mean reduction : 10 % ; range : 0–44 % ) . Sixteen centers had a decrease in their BPD rate , and 1 center had no change in their rate . Conclusions . The physiologic definition of BPD reduced the overall rate of BPD and reduced the variation among centers . Significant center differences in the impact of the physiologic definition were seen , and differences remained even with the use of this st and ardized definition . The magnitude of the change in BPD rate is comparable to the magnitude of treatment effects seen in some clinical trials in BPD . The physiologic definition of BPD facilitates the measurement of BPD as an outcome in clinical trials and the comparison between and within centers over time Individuals born very preterm ( VPT ) are at increased risk of perinatal brain injury and long-term cognitive and behavioral problems . Executive functioning , in particular , has been shown to be impaired in VPT children and adolescents . This study prospect ively assessed executive function in young adults who were born VPT ( <33 weeks of gestation ) [ n = 61 ; mean age , 22.25 ( + /-1.07 ) years ; range , 20.62 - 24.78 years ] and controls [ n = 64 ; mean age , 23.20 ( + /-1.48 ) years ; range , 19.97 - 25.46 years ] . Tests used comprised the Wechsler Abbreviated Scale of Intelligence ( WASI ) , the Hayling Sentence Completion Test ( HSCT ) , the Controlled Oral Word Association 
    Output:
    
Currently no evidence is available to show the benefits or harms of stem cell-based interventions for treatment or prevention of GM-IVH in preterm infants