***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: Youth in underserved , urban communities are at risk for a range of negative outcomes related to stress , including social-emotional difficulties , behavior problems , and poor academic performance .  Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities . This paper reports findings from a pilot r and omized controlled trial assessing the feasibility , acceptability , and preliminary outcomes of a school-based mindfulness and yoga intervention .  Four urban public schools were r and omized to an  intervention or wait-list control condition ( n = 97 fourth and fifth grade rs , 60.8 % female ) . It was hypothesized that the 12-week intervention would reduce involuntary stress responses and improve mental health outcomes and social adjustment . Stress responses , depressive symptoms , and peer relations were assessed at baseline and post-intervention . Findings suggest the intervention was attractive to students , teachers , and school administrators and that it had a positive impact on problematic responses to stress including rumination , intrusive thoughts , and emotional arousal BACKGROUND Adolescents with irritable bowel syndrome ( IBS ) frequently experience interference with everyday activities . Mind-body approaches such as yoga have been recommended as interventions for patients with IBS . Despite promising results among adult sample s , there have been limited studies exploring the efficacy of yoga with pediatric patients . OBJECTIVE To conduct a preliminary r and omized study of yoga as treatment for adolescents with IBS . METHODS Twenty-five adolescents aged 11 to 18 years with IBS were r and omly assigned to either a yoga or wait list control group . Before the intervention , both groups completed question naires assessing gastrointestinal symptoms , pain , functional disability , coping , anxiety and depression . The yoga intervention consisted of a 1 h instructional session , demonstration and practice , followed by four weeks of daily home practice guided by a video . After four weeks , adolescents repeated the baseline question naires . The wait list control group then received the yoga intervention and four weeks later completed an additional set of question naires . RESULTS Adolescents in the yoga group reported lower levels of functional disability , less use of emotion-focused avoidance and lower anxiety following the intervention than adolescents in the control group . When the pre- and postintervention data for the two groups were combined , adolescents had significantly lower scores for gastrointestinal symptoms and emotion-focused avoidance following the yoga intervention . Adolescents found the yoga to be helpful and indicated they would continue to use it to manage their IBS . CONCLUSIONS Yoga holds promise as an intervention for adolescents with IBS Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers BACKGROUND Various studies find relationships among anxiety and depressive disorders of adolescence and adulthood . This study prospect ively examines the magnitude of longitudinal associations between adolescent and adult anxiety or depressive disorders . METHODS An epidemiologically selected sample of 776 young people living in upstate New York received DSM-based psychiatric assessment s in 1983 , 1985 , and 1992 using structured interviews .  The magnitude of the association between adolescent and adult anxiety or depressive disorders was quantified using odds ratios generated from logistic regression analyses and from a set of latent Markov analyses . We focus on longitudinal associations among narrowly defined DSM anxiety or depressive disorders . RESULTS In simple logistic models , adolescent anxiety or depressive disorders predicted an approximate 2- to 3-fold increased risk for adulthood anxiety or depressive disorders . There was evidence of specificity in the course of simple and social phobia but less specificity in the course of other disorders . Results from the analyses using latent variables suggested that while most adolescent disorders were no longer present in young adulthood , most adult disorders were preceded by adolescent disorders . CONCLUSIONS An anxiety or depressive disorder during adolescence confers a strong risk for recurrent anxiety or depressive disorders during early adulthood . Most anxiety and depressive disorders in young adults may be preceded by anxiety or depression in adolescence Adolescence is a key developmental period for preventing substance use initiation , however prevention programs solely providing educational information about the dangers of substance use rarely change adolescent substance use behaviors . Recent research suggests that mind – body practice s such as yoga may have beneficial effects on several substance use risk factors , and that these practice s may serve as promising interventions for preventing adolescent substance use . The primary aim of the present study was to test the efficacy of yoga for reducing substance use risk factors during early adolescence . Seventh- grade students in a public school were r and omly assigned by classroom to receive either a 32-session yoga intervention  ( n = 117 ) in place of their regular physical education classes or to continue with physical-education-as-usual ( n = 94 ) . Participants ( 63.2 % female ; 53.6 % White ) completed pre- and post-intervention question naires assessing emotional self-regulation , perceived stress , mood impairment , impulsivity , substance use willingness , and actual substance use . Participants also completed question naires at 6-months and 1-year post-intervention . Results revealed that participants in the control condition were significantly more willing to try smoking cigarettes immediately post-intervention than participants in the yoga condition . Immediate pre- to post-intervention differences did not emerge for the remaining outcomes . However , long-term follow-up analyses revealed a pattern of delayed effects in which females in the yoga condition , and males in the control condition , demonstrated improvements in emotional self-control . The findings suggest that school-based yoga may have beneficial effects with regard to preventing males ’ and females ’ willingness to smoke cigarettes , as well as improving emotional self-control in females . However additional research is required , particularly with regard to the potential long-term effects of mind – body interventions in school setting s. The present study contributes to the literature on adolescence by examining school-based yoga as a novel prevention program for substance use risk factors OBJECTIVES Yoga and exercise have beneficial effects on  mood and anxiety .  γ-Aminobutyric acid (GABA)-ergic activity is reduced in mood and anxiety disorders . The practice of yoga postures is associated with increased brain GABA levels . This study addresses the question of whether changes in mood , anxiety , and GABA levels are specific to yoga or related to physical activity . METHODS Healthy subjects with no significant medical/psychiatric disorders were r and omized to yoga or a metabolically matched walking intervention for 60 minutes 3 times a week for 12 weeks . Mood and anxiety scales were taken at weeks 0 , 4 , 8 , 12 , and before each magnetic resonance spectroscopy scan . Scan 1 was at baseline . Scan 2 , obtained after the 12-week intervention , was followed by a 60-minute yoga or walking intervention , which was immediately followed by Scan 3 . RESULTS The  yoga subjects ( n = 19 ) reported greater improvement in mood and greater decreases in anxiety than the walking group ( n = 15 ) . There were positive correlations between improved mood and decreased anxiety and thalamic GABA levels . The yoga group had positive correlations between changes in mood scales and changes in GABA levels . CONCLUSIONS The 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise . This is the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety . It is also the first time that a behavioral intervention ( i.e. , yoga postures ) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales . Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety , the reported correlations are in the expected direction . The possible role of GABA in mediating the beneficial effects of yoga  on mood and anxiety warrants further study Adolescents with cardiac diagnoses face unique challenges that can cause psychosocial distress . This study compares a Mindfulness-Based Stress Reduction ( MBSR ) program to a video online support group for adolescents with cardiac diagnoses .  MBSR is a structured psycho-educational program which includes yoga , meditation , cognitive restructuring , and group support . A published feasibility study by our group showed significant reduction in anxiety following this intervention . Participants were r and omized to MBSR or video online support group  , and completed measures of anxiety , depression , illness-related stress , and coping pre- and post-6-session interventions . Qualitative data were obtained from post-intervention interviews . A total of 46 teens participated ( mean 14.8 years ; 63 % female ) . Participants had congenital heart disease and /or cardiac device ( 52 % ) , or postural orthostatic tachycardia syndrome ( 48 % ) .  Illness-related stress significantly decreased in both groups . Greater use of coping skills predicted lower levels of depression in both groups post- study completion . Higher baseline anxiety/depression scores predicted improved anxiety/depression scores in both groups . Each group reported the benefits of social support . The MBSR group further expressed benefits of learning specific techniques , strategies , and skills that they applied in real-life situations to relieve distress . Both the MBSR intervention and video support group were effective in reducing distress in this sample . Qualitative data eluci date d the added benefits of using MBSR techniques to manage stress and symptoms . The video group format is useful for teens that can not meet in person but can benefit from group support . Psychosocial interventions with stress management techniques and /or group support can reduce distress in adolescents with cardiac diagnoses Objective : To test feasibility of yoga within a high school curriculum and evaluate preventive efficacy for psychosocial well-being . Methods : Grade 11 or 12 students ( N = 51 ) who registered for physical education ( PE ) were cluster-r and omized by class 2:1 yoga : PE-as-usual . A Kripalu-based yoga program of physical postures , breathing exercises , relaxation , and meditation was taught 2 to 3 times a week for 10 weeks . Self-report question naires were administered to students 1 week before and after . Primary outcome measures of psychosocial well-being were Profile of Mood States — Short Form and Positive and Negative Affect Schedule for Children . Additional measures of psychosocial well-being included Perceived Stress Scale and Inventory of Positive Psychological Attitudes . Secondary measures of self-regulatory skills included Resilience Scale , State Trait Anger Expression Inventory-2 ™ , and Child Acceptance Mindfulness Measure . To assess feasibility , yoga students completed a program evaluation . Analyses of covariance were conducted between groups with baseline as the covariate . Results : Although PE-as-usual students showed decreases in primary outcomes , yoga students maintained or improved . Total mood disturbance improved in yoga students and worsened in controls ( p = .015 ) , as did Profile of Mood States-Short Form ( POMS-SF ) Tension-Anxiety subscale ( p = .002 ) . Although positive affect remained unchanged in both , negative affect significantly worsened in controls while improving in yoga students ( p = .006 ) . Secondary outcomes were not significant . Students  rated yoga fairly high , despite moderate attendance . Conclus 
    Output:
    
Conclusion : The studies review ed , while of weak to moderate method ological quality , showed that yoga , defined by the practice of postures , generally leads to some reductions in anxiety and depression in youth regardless of health status and intervention characteristics