***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 
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    ***EXAMPLES*** 
    Input: INTRODUCTION The purpose of this study were to : ( a ) examine for possible ethnicity-related and gender-related differences in blood pressure ( BP ) in Mexican American and non-Hispanic White schoolchildren ; ( b ) compare auscultatory and oscillometric BP levels ; and ( c ) establish auscultatory BP st and ards using the width of the BP cuff based on the circumference of the arm in schoolchildren in K-12 . METHODS Participants were 6259 schoolchildren in kindergarten through 12th grade in the San Antonio , Texas , area .  Auscultatory and oscillometric BP readings  were obtained in r and om sequence , using BP cuff width 40 % to 50 % of the circumference of the upper arm . Averages of 3 readings were used for statistical analyses . RESULTS Auscultatory systolic pressures ( SPs ) in preadolescent Mexican American boys and girls were higher ( 1 to 3 mm Hg ) auscultatory ( SP ) than in their White counterparts , but the difference was clinical ly not important . Diastolic pressures ( DP ) showed no important differences . Auscultatory SPs in 13- to 18-year-old boys of both ethnic groups were significantly ( P < .05 ) higher ( 3 to 12 mm Hg ) than they were for girls , with no ethnic differences . Oscillometric SP was higher than auscultatory SP in children of all ages studied . Oscillometric ( DP ) was slightly lower ( 0 to 5 mm Hg ) than was auscultatory K4 and higher ( 4 to 5 mm Hg ) than was auscultatory K5 DP . DISCUSSION No important ethnicity-related difference was found for auscultatory BP , but significant gender-related differences ( boys greater than girls ) were found in SP in subjects ages 13 to 18 years . Differences in BP readings by oscillometric and auscultatory methods do not allow interchange of readings . This study provides , for the first time , auscultatory BP st and ards using BP cuff width 40 % to 50 % of the arm circumference BACKGROUND The " gold st and ard " employed for obtaining blood pressure ( BP ) for all the National Health and Nutrition Examination Surveys ( NHANES ) has been the mercury sphygmomanometer ( HgS ) . Because of environmental concerns , there is a need to explore an alternative to HgS. METHODS We compared the accuracy of the Welch Allyn 767 wall aneroid sphygmomanometer ( AnS ) to the HgS in children and adults and by BP cuff sizes . Each participant had three BP measurements per device recorded sequentially . The order of the devices and observer were r and om . A total of 727 individuals participating in the NHANES participated in the study . RESULTS The mean AnS readings were not statistically significantly different from those of the HgS with the exception of systolic BP ( SBP ) in aged 8 - 17 years ( mean difference 1.10 , s.d . 4.87 ) . There were no statistically significantly different by BP cuff sizes . Agreement for the prevalence of hypertension ( BP ≥140 systolic or diastolic ≥90 mm Hg ) was above chance ( κ = 0 . 81 ; sensitivity = 81 % ; specificity = 98 % ) with AnS readings underestimating by 1.66 % ( 18.33 vs. 20 % , P > 0.05 ) compared to the HgS reading . CONCLUSIONS With the exception of SBP in ages 8 - 17 years , the AnS device readings were not significantly different from HgS readings by age or BP cuff sizes selection . Agreement for hypertension classification is good . An accurate and well-calibrated AnS could therefore provide an acceptable alternative to the use of a HgS in surveys , although with appropriate caution given the 81 % sensitivity with regard to hypertension thresholds that was observed There is increasing evidence that blood pressure ( BP ) screening during adolescence may detect early evidence of hypertensive disease . Choice of instrumentation becomes important to maximize the accuracy and interpretive value of several serial readings . We therefore conducted two studies of adolescents , comparing auscultatory ( Baumanometer and R and om-zero ) , ultrasonic ( Arteriosonde 1216 )  , and infrasonic ( Physiometrics SR-2 ) devices . These instruments were compared serially ( Study 1 ) for older adolescents ( n = 48 ) . The Baumanometer , Arteriosonde 1216 , and Physiometrics SR-2 were compared both serially and simultaneously ( Study 2 ) for younger and older adolescents ( n = 24 ) . In both studies , the order of device presentation was completely counterbalanced . In Study 1 , reliability estimates were high ( r greater than 0.65 ) , with the exception of the Arteriosonde 1216 diastolic readings , and the Physiometrics SR-2 yielded significantly lower mean diastolic BP readings than the other devices . Diastolic Phase V readings taken with the R and om-zero were significantly higher when the R and om-zero was presented at the end of the sequence of instrument presentation . This order of presentation effect is probably attributable to the need for overinflation when using the R and om-zero device and may cause an overestimation of diastolic BP in the young . In Study 2 , again the Arteriosonde 1216 did not perform reliably in recording diastolic BP . Further , the Physiometrics SR-2 device , although reliable , yielded diastolic readings significantly lower ( p less than 0.001 ) than diastolic Phase IV readings taken both serially and simultaneously . ( ABSTRACT TRUNCATED AT 250 WORDS The Dinamap 845XT automatic blood pressure monitor , Dinamap 8100 ( an up date model ) , and two mercury sphygmomanometers were compared in 417 school-aged children examined in the spring of 1992 as part of the Bogalusa Heart Study . This study was conducted in the nearby community of Franklinton , Louisiana , to verify data obtained as part of a cross-sectional survey ( 1987 to 1988 ) of school-aged children in Bogalusa .  Systolic blood pressure levels were on the average 3 mm Hg higher on the Dinamap instruments than on the sphygmomanometers .  Mean levels of diastolic blood pressure using either Dinamap instrument were slightly higher until eight years of age and then were considerably lower than mercury sphygmomanometer fourth phase readings . Diastolic blood pressure levels on the Dinamap 8100 were 4 mm Hg lower than on the Dinamap 845XT . Height was identified as the predominant predictor variable of differences in diastolic blood pressure between the mercury sphygmomanometer and either Dinamap instrument . A 10 % r and om sample of children was reexamined each screening day in the cross-sectional survey to estimate measurement errors . The diastolic readings of the Dinamap 845XT had a lower intraclass correlation ( 0.68 ) compared to the mercury sphygmomanometers ( 0.83 fourth phase and 0.76 fifth phase ) . The Dinamap offers the ease of measuring systolic blood pressure although the diastolic blood pressure appears to be biased and especially low , particularly on the new 8100 model Aim To vali date Welch-Allyn Vital Sign Monitor , Dinamap Procare-120 and Data scope Accutorr Plus against auscultatory mercury sphygmomanometer in children aged 5–15 years old according to the International Protocol of European Society of Hypertension adapted for validation in children . Method One hundred and thirty two children were studied ( 44 for each device ; 67 boys , 65 girls ) . Each underwent seven sequential BP measurements on the right arm resting in the sitting position , alternately with the mercury sphygmomanometer read simultaneously by two independent , trained observers and the test device by a third observer . Results For the Welch-Allyn monitor , the mean±SD of differences ( device minus auscultatory BP ) were −4.39±4.82 mmHg for systolic blood pressure and −4.1±7.07 mmHg for diastolic blood pressure . The device failed phase 2.1 for both systolic blood pressure ( 55 , 91 and 98 % were within 5 , 10 and 15 mmHg , respectively ) and diastolic blood pressure measurements ( 46 , 82 and 95 % were within 5 , 10 and 15 mmHg , respectively ) . For the Dinamap device , the mean±SD of differences were −3.08±5.21 mmHg for systolic blood pressure and −4.61±9.35 mmHg for diastolic blood pressure . The device passed phase 2.1 for systolic blood pressure ( 71 , 96 and 98 % were within 5 , 10 and 15 mmHg , respectively ) but failed for diastolic blood pressure ( 51 , 72 and 91 % were within 5 , 10 , and 15 mmHg , respectively ) . For the Data scope device , mean±SD of differences were −0.9±4.33 mmHg for systolic blood pressure and −1.20±6.48 mmHg for diastolic blood pressure . The device passed phase 2.1 in that 84 , 97 and 99 % of systolic blood pressure , and 61 , 89 and 97 % of diastolic blood pressure readings were within 5 , 10 and 15 mmHg , respectively . It also passed phase 2.2 for both systolic blood pressure and diastolic blood pressure . Conclusion We performed an independent validation of three oscillometric BP devices in children . Overall Data scope Accutorr Plus passed , whereas Welch-Allyn Vital Sign Monitor and Dinamap Procare-120 failed an adapted IP-ESH OBJECTIVES The mercury sphygmomanometer has been the gold st and ard used for obtaining blood pressure ( BP ) for the National Health and Nutrition Examination Survey ( NHANES ) from 1960 to the present . However , due to environmental concerns and an increased use of automated oscillometric BP devices , NHANES has been exploring an alternative to using the st and ard mercury sphygmomanometer ( mercury ) to measure BP . METHODS The accuracy of Omron HEM-907XL BP readings was compared with that of mercury BP device readings for gender , age group , race and ethnicity , and body mass index categories and cuff-size subgroups . Each person had three BP measurements per device recorded sequentially . The order of the devices and readers were r and omly assigned . A total of 6,460 participants had three valid systolic readings , and 6,338 had three valid diastolic readings . RESULTS Omron and mercury measurements were correlated ( r = 0.92 , systolic BP ; r = 0.79 , diastolic BP ) . Overall , the mean between-device differences ( Omron and mercury ) were -1.6 mm Hg for systolic and -0.6 mm Hg for diastolic ( p < 0.05 for both ) . The mean between-device differences were less than or about 2 mm Hg for each subgroup : gender , age group , race and ethnicity , and body mass index categories , and cuff-size subgroups . The exceptions were mean systolic between-device differences for those using the extra-large BP cuff ( -3.1 mm Hg ) and obese individuals ( -2.6 mm Hg ) , and the mean diastolic between-device differences for the underweight group ( -3.5 mm Hg ) . Assuming mercury to be the gold st and ard , between-device agreements for the frequency of high BP ( 140/90 mm Hg or more ) and stage II high BP ( 160/100 mm Hg or more ) were above chance ( kappa = 0.72 for both ) . Omron underestimated the high BP frequency by 2.28 % and stage II high BP frequency by 0.77 % . CONCLUSIONS Lower estimates of high BP by the Omron device may require adjusting future national prevalence estimates accordingly to account for between-device differences 
    Output:
    
Conclusion : Oscillometric devices may serve as a suitable alternative to auscultation for initial BP screening in the pediatric population