***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 Supporting 21st century health care and the practice of evidence -based medicine ( EBM ) requires ubiquitous access to clinical information and to knowledge-based re sources to answer clinical questions . Many questions go unanswered , however , due to lack of skills in formulating questions , crafting effective search strategies , and accessing data bases to identify best levels of evidence . Methods This r and omized trial was design ed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system . Two of the search interfaces utilized a specific framework called PICO , which was design ed to focus clinical questions and to prompt for publication type or type of question asked . The third interface was the st and ard PubMed interface readily available on the Web . Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US . Thirty-one subjects were r and omized to one of the three interfaces , given 3 clinical questions , and asked to search PubMed for a set of relevant articles that would provide an answer for each question . The success of the search results was determined by a precision score , which compared the number of relevant or gold st and ard articles retrieved in a result set to the total number of articles retrieved in that set . Results Participants using the PICO templates ( Protocol A or Protocol B ) had higher precision scores for each question than the participants who used Protocol C , the st and ard PubMed Web interface . ( Question 1 : A = 35 % , B = 28 % , C = 20 % ; Question 2 : A = 5 % , B = 6 % , C = 4 % ; Question 3 : A = 1 % , B = 0 % , C = 0 % ) 95 % confidence intervals were calculated for the precision for each question using a lower boundary of zero . However , the 95 % confidence limits were overlapping , suggesting no statistical difference between the groups . Conclusion Due to the small number of search es for each arm , this pilot study could not demonstrate a statistically significant difference between the search protocol s. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results OBJECTIVE MicroRNAs ( miRNAs ) are involved in the regulation of adiposity , but functional studies have yielded inconclusive results . Examining the associations of circulating miRNAs levels with obesity and insulin sensitivity in humans may lead to improved insights . DESIGN AND METHODS  Serum  sample s collected from 112 obese and control subjects ( 50.0 % men ) were r and omly divided and combined into four pools ( 28 sample s in each obese or control pool ) . The genome-wide circulating miRNA profiles were detected via microarray . Elevated miR-122 was selected and vali date d in individual serum sample s from 123 obese ( 46.7 % men ) and 107 control ( 50.0 % men ) young adults . Associations between circulating miR-122 levels and parameters related to adiposity , insulin resistance , lipid profiles and hepatic enzymes were further assessed . RESULTS Thirty-four miRNAs were found to be expressed differently in the sera of obese patients compared with control subjects ( P<0.001 ) . Further analyses confirmed that obese patients had 3.07-fold higher circulating miR-122 levels than controls ( P<0.001 ) . Serum miR-122 levels were correlated with BMI ( r=0.469 ) , alanine aminotransferase ( r=0.634 ) , triglycerides ( r=0.448 ) , HDL-cholesterol ( r=-0.351 ) and homeostasis model assessment of insulin resistance ( r=0.401 , all P<0.01 ) . After controlling for confounding factors , miR-122 remained as an independent risk factor for insulin resistance ( OR=3.379 , 95 % CI=1.141 - 10.007 , P=0.028 ) . CONCLUSIONS Elevated circulating miR-122 is positively associated with obesity and insulin resistance in young adults . These findings provide a better underst and ing regarding the role of miRNAs in adiposity and insulin sensitivity PURPOSE Childhood obesity increases susceptibility to  type 2 diabetes ( T2D ) in adults .  Circulating microRNAs ( miRNAs ) in serum have been proposed as potential diagnostic biomarkers , and they may contribute to the progression toward T2D . Here , we investigated the possibility of predicting the future risk of adult T2D in obese children by using circulating miRNAs . BASIC PROCEDURES We performed miRNA high-throughput sequencing to screen relevant circulating miRNAs  in obese children . The expression patterns of targeted miRNAs were further explored in obese children and adults with T2D . To investigate the underlying contributions of these miRNAs to the development of T2D , we detected the impacts of the c and i date miRNAs on preadipocyte proliferation , insulin secretion by pancreatic β-cell , and glucose uptake by skeletal muscle cells . MAIN FINDINGS Three miRNAs ( miR-486 , miR-146b and miR-15b ) , whose expression in the circulation was most dramatically augmented in obese children and adult T2D patients , were selected for further investigation . Of these 3 miRNAs , miR-486 was implicated in accelerating preadipocyte proliferation and myotube glucose intolerance , miR-146b and miR-15b were engaged in the suppression of high concentration glucose-induced pancreatic insulin secretion , and they all contributed to the pathological processes of obesity and T2D . PRINCIPAL CONCLUSIONS Our results provide a better underst and ing of the role of circulating miRNAs , particularly miR-486 , miR-146b and miR-15b , in predicting the future risk of T2D in obese children 
    Output:
    
In conclusion , circulating miRNAs are promising diagnostic biomarkers of obesity-associated diseases such as NAFLD and type 2 diabetes already in childhood .