***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 Osteoarthritis ( OA ) is the most common form of arthritis and the second most common cause of long-term disability among middle-aged and older adults in the United States .  Methylsulfonylmethane ( MSM ) is a popular dietary supplement used as a single agent and in combination with other nutrients , and purported to be beneficial for arthritis . However , there is paucity of evidence to support the use of MSM . METHODS A r and omized , double-blind , placebo-controlled trial was conducted . Fifty men and women , 40 - 76 years of age with knee OA pain were enrolled in an outpatient medical center . Intervention was MSM 3 g or placebo twice a day for 12 weeks ( 6g/day total ) . Outcomes included the Western Ontario and McMaster University Osteoarthritis Index visual analogue scale ( WOMAC ) , patient and physician global assessment s ( disease status , response to therapy ) , and SF-36 ( overall health-related quality of life ) . RESULTS Compared to placebo , MSM produced significant decreases in WOMAC pain and physical function impairment ( P<0.05 ) . No notable changes were found in WOMAC stiffness and aggregated total symptoms scores . MSM also produced improvement in performing activities of daily living when compared to placebo on the SF-36 evaluation ( P<0.05 ) . CONCLUSION MSM ( 3 g twice a day ) improved symptoms of pain and physical function during the short intervention without major adverse events . The benefits and safety of MSM in managing OA and long-term use can not be confirmed from this pilot trial , but its potential clinical application is examined . Underlying mechanisms of action and need for further investigation of MSM are discussed OBJECTIVE To determine the effects of feeding a diet supplemented with fish oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis . DESIGN R and omized , controlled , multisite clinical trial . ANIMALS 131 client-owned dogs with stable chronic osteoarthritis examined at 33 privately owned veterinary hospitals in the United States . PROCEDURES In all dogs , the dosage of carprofen was st and ardized over a 3-week period to approximately 4.4 mg/kg/d ( 2 mg/lb/d ) , PO . Dogs were then r and omly assigned to receive a food supplemented with fish oil omega-3 fatty acids or a control food with low omega-3 fatty acid content , and 3 , 6 , 9 , and 12 weeks later , investigators made decisions regarding increasing or decreasing the carprofen dosage on the basis of investigator assessment s of 5 clinical signs and owner assessment s of 15 signs . RESULTS Linear regression analysis indicated that over the 12-week study period , carprofen dosage decreased significantly faster among dogs fed the supplemented diet than among dogs fed the control diet . The distribution of changes in carprofen dosage for dogs in the control group was significantly different from the distribution of changes in carprofen dosage for dogs in the test group . CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in dogs with chronic osteoarthritis receiving carprofen because of signs of pain , feeding a diet supplemented with fish oil omega-3 fatty acids may allow for a reduction in carprofen dosage BACKGROUND Food supplemented with fish oil improves clinical signs and weight bearing in dogs with osteoarthritis ( OA ) . OBJECTIVE Determine whether increasing the amount of fish oil in food provides additional symptomatic improvements in OA . ANIMALS One hundred and seventy-seven client-owned dogs with stable chronic OA of the hip or stifle . METHODS Prospect i ve , r and omized clinical trial using pet dogs . Dogs were r and omly assigned to receive the baseline therapeutic food ( 0.8 % eicosopentanoic acid [ EPA ] + docosahexaenoic acid [ DHA ] ) or experimental foods containing approximately 2- and 3-fold higher EPA+DHA concentrations . Both veterinarians and owners were blinded as to which food the dog received . On days 0 , 21 , 45 , and 90 , serum fatty acid concentrations were measured and veterinarians assessed the severity of 5 clinical signs of OA . At the end of the study ( day 90 ) , veterinarians scored overall arthritic condition and progression of arthritis based on their clinical signs and an owner interview . RESULTS Serum concentrations of EPA and DHA rose in parallel with food concentrations . For 2 of 5 clinical signs ( lameness and weight bearing ) and for overall arthritic condition and progression of arthritis , there was a significant improvement between the baseline and 3X EPA+DHA foods ( P=.04 , .03 , .001 , .0008 , respectively ) but not between the baseline and the 2X EPA+DHA foods . CONCLUSIONS AND CLINICAL IMPORTANCE Increasing the amount of fish oil beyond that in the baseline food results in dose-dependent increases in serum EPA and DHA concentrations and modest improvements in the clinical signs of OA in pet dogs OBJECTIVE To assess the effect of food containing high concentrations of fish oil omega-3 fatty acids and a low omega-6-omega-3 fatty acid ratio on clinical signs of osteoarthritis in dogs . DESIGN R and omized , double-blinded , controlled clinical trial . ANIMALS 127 client-owned dogs with osteoarthritis in 1 or more joints from 18 privately owned veterinary clinics . PROCEDURES Dogs were r and omly assigned to be fed for 6 months with a typical commercial food or a test food containing a 31-fold increase in total omega-3 fatty acid content and a 34-fold decrease in omega-6-omega-3 ratio , compared with the control food . Dog owners completed a question naire about their dog 's arthritic condition , and investigators performed a physical examination and collected sample s for a CBC and serum biochemical analyses ( including measurement of fatty acids concentration ) at the onset of the study and at 6 , 12 , and 24 weeks afterward . RESULTS Dogs fed the test food had a significantly higher serum concentration of total omega-3 fatty acids and a significantly lower serum concentration of arachidonic acid at 6 , 12 , and 24 weeks . According to owners , dogs fed the test food had a significantly improved ability to rise from a resting position and play at 6 weeks and improved ability to walk at 12 and 24 weeks , compared with control dogs . CONCLUSIONS AND CLINICAL RELEVANCE Ingestion of the test food raised blood concentrations of omega-3 fatty acids and appeared to improve the arthritic condition in pet dogs with osteoarthritis OBJECTIVE To evaluate the effects of orally administered glucosamine hydrochloride (GlAm)-chondroitin sulfate ( CS ) and GlAm-CS-S-adenosyl-L-methionine ( SAMe ) on chemically induced synovitis in the radiocarpal joint of dogs . ANIMALS 32 adult mixed-breed dogs . PROCEDURE For 21 days , all dogs received a sham capsule ( 3 groups ) or GlAm-CS ( prior treatment group ) in a double-blinded study . Unilateral carpal synovitis was induced by injecting the right radiocarpal joint with chymopapain and the left radiocarpal joint ( control joint ) with saline ( 0.9 % NaCl ) solution . Joints were injected on alternate days for 3 injections . After induction of synovitis , 2 groups receiving sham treatment were given GlAm-CS or GlAm-CS-SAMe . Another group continued to receive sham capsules ( control group ) . Joint inflammation was quantified , using nuclear scintigraphy , before injection of joints and days 13 , 20 , 27 , 34 , 41 , and 48 after injection . Lameness evaluations were performed daily . RESULTS Dogs given GlAm-CS before induction of synovitis had significantly less scintigraphic activity in the soft-tissue phase 48 days after joint injection , significantly less uptake in the bone phase 41 and 48 days after joint injection , and significantly lower lameness scores on days 12 to 19 , 23 , and 24 after injection , compared with other groups . CONCLUSIONS AND CLINICAL RELEVANCE Analysis of results of this study suggest that prior treatment with GlAm-CS for 21 days had a protective effect against chemically induced synovitis and associated bone remodeling . Prior treatment with GlAm-CS also reduced lameness in dogs with induced synovitis Three experiments were conducted to investigate the effects of beta-glucan supplementation on  pig performance and immune function . In Exp . 1 , 100 weaned pigs ( 8.65 + /- 0.42 kg of BW and 28 + /- 2 d of age ) were used in a 35-d experiment to determine the effects of grade d levels of beta-glucan . Pigs were r and omly allotted to 1 of 5 treatments containing beta-glucan supplemented at 0 , 25 , 50 , 100 , or 200 ppm . Each treatment was replicated using 5 pens containing 4 pigs per pen . The ADG of pigs between d 14 to 28 and d 0 to 28 responded to dietary beta-glucan in a quadratic fashion ( P < 0.05 ) , whereas beta-glucan had no effect on ADFI and G : F in any period . In Exp . 2 , 80 crossbred pigs ( 8.23 + /- 0.56 kg of BW and 28 + /- 2 d of age ) were used in a 35-d experiment . Pigs were allotted to 1 of 2 dietary treatments ( 0 or 50 ppm of beta-glucan in the diet ) using 10 pens with 4 pigs per pen . Pigs treated with beta-glucan had greater ADG in the 14- to 28-d ( P = 0.05 ) and 0-to 28-d ( P = 0.035 ) periods . The ADFI of pigs receiving beta-glucan was increased ( P < 0.05 ) in the periods from 0 to 14 , 0 to 28 , and 28 to 35 d. The lymphocyte proliferation index in response to phytohemagglutinin ( P = 0.051 ) and concanavalin A ( P = 0.052 ) tended to decrease on d 14 in pigs supplemented with beta-glucan compared with pigs without supplementation . In Exp . 3 , 24 barrows ( 8.89 + /- 0.20 kg of BW and 28 d of age ) were used to investigate the immunological and somatotropic responses of pigs challenged with lipopolysaccharide ( LPS ) . Experimental treatments were arranged in a 2 x 2 factorial , with the main effects of LPS challenge ( saline vs. LPS ) and dietary addition of beta-glucan ( 0 vs. 50 ppm ) . Pigs were raised individually in metabolic cages . Pigs were fed 0 or 50 ppm of beta-glucan for 28 d and then challenged with LPS ( 25 microg/kg of BW ) or saline . After LPS injection , blood was obtained at 0 , 1.5 , 3 , 4.5 , 6 , and 7.5 h to determine cytokine production and the somatotropic response . Dietary beta-glucan increased plasma interleukin-6 at 1.5 , 3 , and 4.5 h and tumor necrosis factor-alpha at 3 and 4.5 h and increased plasma interleukin-10 from 3 to 7.5 h after LPS challenge . The beta-glucan treatments had no effect on growth hormone . In conclusion , beta-glucan can selectively influence performance and partially offer benefits on somatotropic axis and immune function in weaned piglets challenged with LPS OBJECTIVE To evaluate the use of a combination of avocado and soybean unsaponifiable ( ASU ) extracts for the treatment of experimentally induced osteoarthritis in horses . ANIMALS 16 horses . PROCEDURES Osteoarthritis was induced via osteochondral fragmentation in 1 middle carpal joint of each horse ; the other joint underwent a sham operation . Horses were r and omly allocated to receive oral treatment with ASU extracts ( 1:2 [ avocado-to-soybean ] ratio mixed in 6 mL of molasses ; n = 8) or molasses ( 6 mL ) alone ( placebo treatment ; 8) once daily from days 0 to 70 . Lameness , response to joint flexion , synovial effusion , gross and histologic joint assessment s , and serum and synovial fluid biochemical data were compared between treatment groups to identify effects of treatment . RESULTS Osteochondral fragmentation induced significant increases in various variables indicative of joint pain and disease . Treatment with ASU extracts did not have an effect on signs of pain or lameness ; however , there was a significant reduction in severity of articular cartilage erosion and synovial hemorrhage ( assessed grossly ) and significant increase in articular cartilage glycosaminoglycan synthesis , compared with placebo-treated horses . CONCLUSIONS AND CLINICAL RELEVANCE Although treatment with ASU extracts did not decrease clinical signs of pain in horses with experimentally induced osteoarthritis , there did appear to be a disease-modifying effect of treatment , compared with findings in placebo-treated horses . These objective data support the use of ASU extracts as a disease-mod 
    Output:
    
The strength of evidence was low for all nutraceuticals except for omega-3 fatty acid in dogs .
AND CLINICAL IMPORTANCE The evidence of efficacy of nutraceuticals is poor , with the exception of diets supplemented with omega-3 fatty acids in dogs .