***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: OBJECTIVES The purpose s of this study were to report the neurodevelopmental , neurosensory , and functional outcomes of 1151 extremely low birth weight ( 401 - 1000 g ) survivors cared for in the 12 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network , and to identify medical , social , and environmental factors associated with these outcomes . STUDY DESIGN A multicenter cohort study in which surviving extremely low birth weight infants born in 1993 and 1994 underwent neurodevelopmental , neurosensory , and functional assessment  at 18 to 22 months ' corrected age . Data regarding pregnancy and neonatal outcome were collected prospect ively . Socioeconomic status and a detailed interim medical history were obtained at the time of the assessment . Logistic regression models were used to identify maternal and neonatal risk factors for poor neurodevelopmental outcome . RESULTS Of the 1480 infants alive at 18 months of age , 1151 ( 78 % ) were evaluated . Study characteristics included a mean birth weight of 796 + /- 135 g , mean gestation ( best obstetric date s ) 26 + /- 2 weeks , and 47 % male . Birth weight distributions of infants included 15 infants at 401 to 500 g ; 94 at 501 to 600 g ; 208 at 601 to 700 g ; 237 at 701 to 800 g ; 290 at 801 to 900 g ; and 307 at 901 to 1000 g. Twenty-five percent of the children had an abnormal neurologic examination , 37 % had a Bayley II Mental Developmental Index < 70 , 29 % had a Psychomotor Developmental Index < 70 , 9 % had vision impairment , and 11 % had hearing impairment . Neurologic , developmental , neurosensory , and functional morbidities increased with decreasing birth weight . Factors significantly associated with increased neurodevelopmental morbidity included chronic lung disease , grade s 3 to 4 intraventricular hemorrhage/periventricular leukomalacia , steroids for chronic lung disease , necrotizing enterocolitis , and male gender . Factors significantly associated with decreased morbidity included increased birth weight , female gender , higher maternal education , and white race . CONCLUSION ELBW infants are at significant risk of neurologic abnormalities , developmental delays , and functional delays at 18 to 22 months ' corrected age Background While research on exercise interventions during anticancer treatment is well-established in adults , only very few studies exist in children . However , pediatric patients experience great limitations to being physically active , and appropriate interventions are desired . ProcedureThe present study aim ed at investigating the effects of individualized exercise interventions during inpatient stays on pediatric patients with a malignant bone tumor . The parameter of interest was  physical activity ( PA ) . Patients ’ PA during home stays was assessed 6 weeks as well as 3 , 6 , 12 , and 18 months post-surgery . Patients were distinguished into an intervention  group and a  control group . All patients received endoprosthetic replacement of the affected bone in the same institution . Results A constant increase in all PA parameters was observed during follow-up . Exercise interventions were possible and appeared worthwhile . The intervention group showed better PA results at all measurements ; however , no significant differences between groups were found . Furthermore , differences decreased especially after the cessation of the intervention . General problems in reaching appropriate power and compliance were observed . Conclusions Individualized exercise interventions in pediatric bone tumor patients are possible and appear to be beneficial . Such interventions should be implemented in adjuvant care ; however , future research is needed to underst and more about the effects of different interventions Purpose : To describe the effect of therapeutic yoga on child and parental reports of quality of life in children hospitalized with oncological diagnoses . Methods : Six children participated in 5 yoga sessions  over 2 months . The PedsQL 4.0 was administered to each child and participating parent/caregivers at baseline and after completion of the yoga intervention . The Wilcoxon nonparametric rank test measured individual differences over time . Results : Statistically significant differences ( P < .05 ) were found in child perception of gross motor function . Conclusion : These feasibility study data suggest that therapeutic yoga positively affected child perception of gross motor function measured on the PedsQL 4.0 . Further studies are needed , including a r and omized control trial and with a larger number of participants , to clarify and confirm the effect of therapeutic yoga The authors prospect ively assessed anxiety , depression , and behavior in children with st and ard‐risk acute lymphoblastic leukemia ( SR‐ALL ) during the first year of therapy and identified associated risk factors Background Fatigue is an important problem in paediatric cancer patients and yoga may be an effective intervention . The primary objective was to determine the feasibility of individualized yoga for hospitalized children receiving intensive chemotherapy . Methods We included English-speaking children and adolescents aged 7–18 years receiving intensive chemotherapy or haematopoietic stem cell transplantation ( HSCT ) . Yoga was conducted three times weekly for three weeks . The primary outcome was feasibility , defined as ability to deliver at least 60 % of planned sessions . Secondary outcomes were parent-reported Pediatric Quality of Life Inventory ( PedsQL ) Multidimensional Fatigue Scale , Fatigue Scale-Parent , PedsQL Generic Core Scales and PedsQL Acute Cancer Module . Results Between January and October 2013 , 11 patients were enrolled . Median age was 14.0 ( range 7.7 - 16.4 ) years and 6 ( 55 % ) were boys . Yoga was feasible with 10/11 participants meeting the threshold for feasibility . The median number of yoga sessions was 9 ( range 3–13 ) . No adverse events were attributed to yoga . Mean ± st and ard deviation for the day 21 proxy-reported PedsQL general fatigue scores was 55.6 ± 15.5 . Qualitative comments suggested design changes for future yoga studies . Conclusions Individualized yoga is feasible for inpatient children receiving intensive chemotherapy . Future work will include development and conduct of a r and omized trial for fatigue amelioration . Trial registration Clinical Trials.gov NCT02105389 The aim was to evaluate the effects of additional exercises during inpatient stays on bone mass in pediatric bone tumor patients . 21 patients were non-r and omly allocated either to the  exercise group ( n = 10 ) or the control group ( n = 11 ) . DXA of the lumbar spine , the non-affected femur and both calcanei was performed after completion of neoadjuvant chemotherapy ( baseline ) , as well as 6 and 12 months after baseline . Bone mineral content ( BMC ) , bone mineral density ( BMD ) and height-corrected lumbar spine Z-scores were determined . Group changes after 6 and 12 months were compared by covariance analyses . Additionally ,  daily physical activities ( PA )  were assessed by means of accelerometry . After adjusting for initial age , height and weight , mean reductions in lumbar spine and femoral BMC were lower in the exercise group ( not significant ) . Effect sizes during the observational period for lumbar spine and femur BMC were generally small ( partial η² = 0.03 ) . The exercise group demonstrated substantially higher PA levels in terms of gait cycles per day , per hour and moderate PA ( activities above 40 gait cycles per minute ) . Additional exercises for bone tumor patients are feasible during hospitalization . Though the intervention did not influence BMC , it appeared beneficial regarding PA promotion with respect to volume and intensity The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer . Relevant studies were identified by entering the following search terms into Pubmed : aerobic training ; resistance training ; stretching ; pediatric ; children ; AND cancer . Reference lists in retrieved manuscripts were also review ed to identify additional trials . We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses . Nine included children with an acute lymphoblastic leukemia ( ALL ) diagnosis , and six children with mixed cancer diagnoses . Generally , interventions tested were either in-hospital supervised exercise training or home based programs design ed to promote physical activity . Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness , improved muscle strength and flexibility , reduced fatigue and improved physical function . Generalizations to the entire childhood cancer and childhood cancer survivor population s are difficult as most of the work has been done in children during treatment for and among survivors of ALL . Additional r and omized studies are needed to confirm these benefits in larger population s of children with ALL , and in population s with cancer diagnoses other than ALL PURPOSE The purpose of this controlled trial was to assess the effect of an approximately 3-wk intrahospital exercise intervention performed during inpatient hospitalization for pediatric allogeneic hematopoietic stem cell transplant ( HSCT ) on ( i ) immune cell recovery and ( ii ) body composition . METHODS Immune ( i.e. , blood counts of leukocytes , monocytes , lymphocytes , and lymphocyte sub population s ) and anthropometric variables ( i.e. , body mass , body mass index , and estimated fat-free mass ) were measured before and after ( + 15 and 30 d ) HSCT . Seven children ( 5 boys and 2 girls ; age ( mean + /- SD ) = 8 + /- 4 yr ) with high-risk cancer performed an individualized training program ( aerobic + resistance exercises ) in their isolated hospital rooms . We also assessed a control group ( n = 13 ; 9 boys and 4 girls ; age = 7 + /- 3 yr ) with similar medical conditions and following the same transplant protocol . RESULTS In both groups , the dendritic cell count decreased from pre-HSCT to + 15 d post-HSCT and thereafter ( up to + 30 d ) remained stabile ; however , the posttransplant decrease was more abrupt in the control group than that in the intervention group ( -87 % vs -63 % , respectively , from pre-HSCT to + 15 d ) . The rest of the immune cell parameters measured showed a similar response from pre-HSCT to post-HSCT in both groups . We found a significant effect of the interaction group x time for all anthropometric variables ( weight , body mass index , body fat , and fat-free mass ) , indicating an increase over the hospitalization period only in the intervention group , for example , body mass increased from 32.9 + /- 18.7 kg pre-HSCT to 35.4 + /- 18.6 kg at + 30 d in the intervention group versus a decrease from 30.2 + /- 16.6 to 29.3 + /- 6.3 kg in the control group . CONCLUSION Our findings support the feasibility of exercise training interventions during hospitalization , including immunocompromised children Properly conducted r and omised trials can aid clinical decision-making by providing unbiased estimates of the average size of treatment effects . This paper , the first of two , discusses how readers of clinical trials can extract simple estimates of treatment effect size from trial reports when trial outcomes are measured on a continuous scale . When making decisions about therapy for individual patients , these estimates can be modified on the basis of patient characteristics . Modified estimates of treatment effect size can be used to determine if the effect of treatment is likely to be large enough to be " clinical ly worthwhile " . This approach optimises clinical decision-making by combining unbiased estimates of the size of treatment effect from clinical trials with clinical intuition and patient preferences 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 
    Output:
    
There was evidence that physical activity interventions during the intense phase of cancer treatment were acceptable to parents and children , safe and successfully implemented .
A trend of positive effects across all aspects of functioning was noted .