***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 / objectives : This trial evaluated the safety and effectiveness of the Orbera Intragastric Balloon as an adjunct to lifestyle intervention . Subjects/ methods : In this multicenter , r and omized , open-label clinical trial , 255 adults with a body mass index of 30–40 kg m−2 were treated and outcomes were assessed up to 12 months . Participants were r and omized to endoscopic placement of an intragastric balloon plus lifestyle or lifestyle intervention alone . Balloons were removed at 6 months and lifestyle intervention continued for both groups through 12 months . At 9 months , co primary end points were two measures of weight loss . Results : At 6 months , weight loss was −3.3 % of total body weight ( −3.2 kg ) in the lifestyle arm vs −10.2 % ( −9.9 kg ) in the balloon plus lifestyle arm ( P<0.001 ) ; at 9 months ( 3 months postballoon removal ) , weight loss was −3.4 % ( −3.2 kg ) vs −9.1 % ( −8.8 kg , P⩽0.001 ) ; and at 12 months , −3.1 % ( −2.9 kg ) vs −7.6 % ( −7.4 kg , P⩽0.001 ) . For the primary end points , at 9 months , mean percent loss of weight in excess of ideal body weight ( s.d . ) at 9 months was 26.5 % ( 20.7 ) ( P=0.32 ) and 9.7 % ( 15.1 ) in the balloon and control groups , respectively . Also , 45.6 % ( 36.7 , 54.8 ) of the subjects r and omized to the balloon achieved at least 15 % loss of weight in excess of ideal body weight greater than the control group ( P<0.001 ) . The majority of balloon subjects experienced adverse events ; 86.9 % nausea , 75.6 % vomiting , 57.5 % abdominal pain and 18.8 % had their device removed before 6 months because of an adverse event or subject request . Five subjects ( 3.1 % ) in the balloon group had a gastric abnormality at the time of device removal , and no ulcers were found . Conclusions and relevance : Intragastric balloon achieved greater short-term weight loss at 3 and 6 months postballoon removal than lifestyle intervention alone . Adverse gastrointestinal events were common Objectives : The AspireAssist System ( AspireAssist ) is an endoscopic weight loss device that is comprised of an endoscopically placed percutaneous gastrostomy tube and an external device to facilitate drainage of about 30 % of the calories consumed in a meal , in conjunction with lifestyle ( diet and exercise ) counseling . Methods : In this 52-week clinical trial , 207 participants with a body-mass index ( BMI ) of 35.0–55.0 kg/m2 were r and omly assigned in a 2:1 ratio to treatment with AspireAssist plus Lifestyle Counseling ( n=137 ; mean BMI was 42.2±5.1 kg/m2 ) or Lifestyle Counseling alone ( n=70 ; mean BMI was 40.9±3.9 kg/m2 ) . The co- primary end points were mean percent excess weight loss and the proportion of participants who achieved at least a 25 % excess weight loss . Results : At 52 weeks , participants in the AspireAssist group , on a modified intent-to-treat basis , had lost a mean ( ±s.d . ) of 31.5±26.7 % of their excess body weight ( 12.1±9.6 % total body weight ) , whereas those in the Lifestyle Counseling group had lost a mean of 9.8±15.5 % of their excess body weight ( 3.5±6.0 % total body weight ) ( P<0.001 ) . A total of 58.6 % of participants in the AspireAssist group and 15.3 % of participants in the Lifestyle Counseling group lost at least 25 % of their excess body weight ( P<0.001 ) . The most frequently reported adverse events were abdominal pain and discomfort in the perioperative period and peristomal granulation tissue and peristomal irritation in the postoperative period . Serious adverse events were reported in 3.6 % of participants in the AspireAssist group . Conclusions : The AspireAssist System was associated with greater weight loss than Lifestyle Counseling alone Background We would expect information on adverse drug reactions in r and omised clinical trials to be easily retrievable from specific search es of electronic data bases . However , complete retrieval of such information may not be straightforward , for two reasons . First , not all clinical drug trials provide data on the frequency of adverse effects . Secondly , not all electronic records of trials include terms in the abstract or indexing fields that enable us to select those with adverse effects data . We have determined how often automated search methods , using indexing terms and /or textwords in the title or abstract , would fail to retrieve trials with adverse effects data . Methods We used a sample set of 107 trials known to report frequencies of adverse drug effects , and measured the proportion that ( i ) were not assigned the appropriate adverse effects indexing terms in the electronic data bases , and ( ii ) did not contain identifiable adverse effects textwords in the title or abstract . Results Of the 81 trials with records on both MEDLINE and EMBASE , 25 were not indexed for adverse effects in either data base . Twenty-six trials were indexed in one data base but not the other . Only 66 of the 107 trials reporting adverse effects data mentioned this in the abstract or title of the paper . Simultaneous use of textword and indexing terms retrieved only 82/107 ( 77 % ) papers . Conclusions Specific search strategies based on adverse effects textwords and indexing terms will fail to identify nearly a quarter of trials that report on the rate of drug adverse effects BACKGROUND & AIMS The effects of bariatric surgery in patients with nonalcoholic fatty liver disease ( NASH ) are not well established . We performed a prospect i ve study to determine the biological and clinical effects of bariatric surgery in patients with NASH . METHODS From May 1994 through May 2013 , one hundred and nine morbidly obese patients with biopsy-proven NASH underwent bariatric surgery at the University Hospital of Lille , France ( the Lille Bariatric Cohort ) .  Clinical , biological , and histologic data were collected before and 1 year after surgery . RESULTS One year after surgery , NASH had disappeared from 85 % of the patients ( 95 % confidence interval [ CI ] : 75.8%-92.2 % ) . Compared with before surgery , patients had significant reductions in mean ± SD body mass index ( BMI , from 49.3 ± 8.2 to 37.4 ± 7 ) and level of alanine aminotransferase ( from 52.1 ± 25.7 IU/L to 25.1 ± 20 IU/L ) ; mean levels of γ-glutamyltransferases were reduced from 51 IU/L before surgery ( interquartile range [ IQR ] , 34 - 87 IU/L ) to 23 IU/L afterward ( IQR , 14 - 33 IU/L ) and mean insulin resistance index values were reduced from 3.6 ± 0.5 to 2.9 ± 0.5 ( P < .01 for each comparison ) . NASH disappeared from a higher proportion of patients with mild NASH before surgery ( 94 % ) than severe NASH ( 70 % ) ( P < .05 ) according to Brunt score . In histologic analysis , steatosis was detected in 60 % of the tissue before surgery ( IQR , 40%-80 % ) but only 10 % 1 year after surgery ( IQR , 2.5%-21.3 % ) ; the mean nonalcoholic fatty liver disease score was reduced from 5 ( IQR , 4 - 5 ) to 1 ( IQR , 1 - 2 ) ( each P < .001 ) . Hepatocellular ballooning was reduced in 84.2 % of sample s ( n = 69 ; 95 % CI : 74.4 - 91.3 ) and lobular inflammation in 67.1 % ( n = 55 ; 95 % CI : 55.8 - 77.1 ) . According to Metavir scores , fibrosis was reduced in 33.8 % of patients ( 95 % CI : 23.6%-45.2 % ) . Patients whose NASH persisted 1 year after surgery ( n = 12 ) had lost significantly less weight ( change in BMI , 9.1 ± 1.5 ) than those without NASH ( change in BMI , 12.3 ± 0.6 ) ( P = .005 ) . Patients who underwent laparoscopic gastric b and ing  lost less weight ( change in BMI , 6.4 ± 0.7 ) than those who underwent gastric bypass ( change in BMI , 14.0 ± 0.5 ) ( P < .0001 ) , and a higher proportion had persistent NASH ( 30.4 % vs 7.6 % of those with gastric bypass ; P = .015 ) . CONCLUSIONS Bariatric surgery induced the disappearance of NASH from nearly 85 % of patients and reduced the pathologic features of the disease after 1 year of follow-up . It could be a therapeutic option for appropriate morbidly obese patients with NASH who do not respond to lifestyle modifications . More studies are needed to determine the long-term effects of bariatric surgery in morbidly obese patients with NASH ABSTRACT Background : Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity . Aim : To evaluate endoscopic sleeve gastroplasty ( Apollo method ) using a suturing method directed at the greater curvature , as well as the perioperative care , two year safety and weight loss . Method : Prospect i ve single-center study over 154 patients ( 108 females ) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation . Of the154 initial patients , 143 were available for 1-month of follow-up , 133 for 6-month , 64 for 12-month and 28 completed the 24 month assessment . Follow-up was carried out by a multidisciplinary team ( nutritionist and psychologist ) . Outcomes evaluated were : change in BMI ; change in body weight ( TBWL ) ; % of loss of initial body weight ( % TBWL ) ; % of excess body weight loss ( % EWL ) ( segregated in > or < 25 % and adverse effects . Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure . Results : Mean age was 44.9 ( 23 - 69 ) years . At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2 . TBWL , % TBWL and % EWL were of 21.3 kg , 19.5 % and 60.4 % respectively . 85.7 % of patients achieve the goal of > 25 % % EWL . There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Conclusion : Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective , safe and well tolerated procedure for obesity treatment , at least for two years of follow-up BACKGROUND & AIMS : Although bariatric surgery is the most effective therapy for obesity , only a small proportion of c and i date s undergo this surgery . Endoscopic sleeve gastroplasty ( ESG ) is a minimally invasive procedure that reduces the size of the gastric reservoir . We investigated its durability and effects on body weight and gastrointestinal function in a prospect i ve study of obese individuals . METHODS : Twenty‐five obese individuals ( 21 female ; mean body mass index , 35.5 ± 2.6 kg/m2 ; mean age , 47.6 ± 10 years ) underwent ESG with endoluminal creation of a sleeve along the gastric lesser curve from September 2012 through March 2015 at the Mayo Clinic in Rochester , Minnesota . Subjects were followed for a median period of 9 months . We measured changes in body weight and recorded adverse events ; patients were assessed by endoscopy after 3 months . Four participants underwent pre‐ESG and post‐ESG analyses to measure solid and liquid gastric emptying , satiation ( meal tolerance ) , and fasting and postpr and ial levels of insulin , glucose , and gut hormones . RESULTS : Subjects had lost 53 % ± 17 % , 56 % ± 23 % , 54 % ± 40 % , and 45 % ± 41 % of excess body weight at 6 , 9 , 12 , and 20 months , respectively , after the procedure ( P < .01 ) . Endoscopy at 3 months showed intact gastroplasty in all subjects . After ESG , physiological analyses of 4 participants showed a decrease by 59 % in caloric consumption to reach maximum fullness ( P = .003 ) , slowing of gastric emptying of solids ( P = .03 ) , and a trend toward increased insulin sensitivity ( P = 
    Output:
    
In a systematic review and meta- analysis , we found ESG to produce clinical ly significant weight loss that was reproducible among independent centers and to have a low rate of severe adverse events .