***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: OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity AIM To determine the relationship between  periodontitis and overweight/obesity among Jordanians . MATERIAL AND METHODS A systematic r and om sample of 340 persons aged between 18 and 70 years was selected from those who accompanied patients during their visit to the outpatient clinics in the medical centre of Jordan University of Science and Technology in north of Jordan . All participants underwent periodontal examination  , had anthropometric measurements  , and completed the question naire .  Periodontitis was defined as presence of four or more teeth with one or more sites with probing pocket depth > or=4 mm and clinical attachment loss > or=3 mm . RESULTS Only 14 % of normal weight participants had periodontal disease whereas 29.6 % of overweight and 51.9 % of obese participants had periodontal disease . Periodontitis was more prevalent among subjects with high waist circumference ( WC ) and among subjects with high waist-to-hip ratio . After adjusting for important variables , only body mass index ( BMI ) -defined obesity [ odds ratio (OR)=2.9 , 95 % confidence interval ( CI ) : 1.3 , 6.1 ] , high WC ( OR=2.1 , 95%CI : 1.2 , 3.7 ) , and high fat per cent ( OR=1.8 , 95 % CI : 1.03 , 3.3 ) remained significantly associated with increased odds of periodontitis . CONCLUSION BMI -defined obesity , high WC , and high fat per cent were significantly associated with increased odds of having periodontitis OBJECTIVE To investigate the effect of conventional periodontal therapy on serum C-reactive protein ( CRP ) level and periodontal status in obese and normal-weight chronic periodontitis patients . METHODS This is a controlled clinical trial conducted at the King Abdulaziz University Faculty of Dentistry , Jeddah , Kingdom of Saudi Arabia between December 2009 and March 2011 . A total of 40 women affected with moderate to severe chronic periodontitis were selected ( 20 obese [ test group ] and 20 normal-weight [ control ] ) . Smokers , pregnant women , and subjects with any systemic disease were excluded . Serum CRP level and periodontal parameters , including clinical attachment level , probing depth , bleeding on probing and plaque scores were assessed at baseline , and 2 months after non-surgical periodontal treatment . RESULTS Periodontal therapy was effective in reducing gingival inflammation , as well as serum CRP level in the total sample and within each group . The pre-treatment mean level of serum CRP was 0.78 ( + /-0.51 ) and post- treatment was 0.55 ( + /-0.41 ) mg/l in the total sample ( p=0.001 ) . A tendency was observed toward a better systemic response to treatment in normal-weight compared to obese women , however , it was not statistically significant ( the mean changes in CRP levels after therapy were 0.28 [ + /-0.43 ] and 0.19 [ + /-0.32 ] mg/l ) . CONCLUSION Periodontal treatment is effective in reducing systemic inflammation as measured by serum CRP level , and obesity does not have a major negative impact on response to periodontal therapy BACKGROUND Earlier studies have shown an association between obesity and periodontitis , which is mediated by cytokine production . The aim of this study is to assess the role of obesity as a modifying factor on periodontal clinical parameters and on circulating proinflammatory cytokine levels in subjects undergoing non-surgical periodontal treatment .  METHODS Twenty-seven obese subjects and 25 normal-weight subjects were enrolled in this study . Subjects in both groups had generalized chronic periodontitis . The periodontal parameters measured before and 3 months after non-surgical periodontal therapy were : visible plaque index , bleeding gingival index , bleeding on probing , probing depth , and clinical attachment level . In addition , subjects underwent anthropometric measurements and serum analyses of fasting glucose , glycated hemoglobin , interleukin-1β , interleukin-6 , tumor necrosis factor-α , and interferon-γ . RESULTS Periodontal therapy significantly decreased visible plaque index , bleeding gingival index , bleeding on probing , probing depth of 4 to 6 mm , probing depth ≥7 mm , clinical attachment level of 4 to 6 mm , and clinical attachment level ≥7 mm in both groups ( P ≤0.05 ) . Circulating proinflammatory cytokines significantly decreased in obese and normal-weight subjects after periodontal treatment ( P ≤0.05 ) . However , interleukin-6 and tumor necrosis factor-α levels remained higher in obese subjects 3 months after treatment ( P ≤0.05 ) . CONCLUSION Obesity does not seem to play a negative role by interfering in the improvement of the periodontal clinical response or decreasing circulating proinflammatory cytokine levels after periodontal treatment 
    Output:
    
Statistical analysis demonstrated that periodontal therapy in obese subjects was effective to improve clinical outcomes .
No clinical differences between post-therapy results of obese and non-obese were observed .
Effects of periodontal therapy on inflammatory markers remain unclear .
Conclusions Periodontal treatment seems to be effective to improve healing in obese individuals .
Clinical relevance Periodontal treatment is effective to improve clinical and immunological periodontal parameters in adults .
Also , obesity seems to not modify the periodontal healing after treatment