human
***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: It is hypothesized that vitamin D insufficiency in athletes might negatively affect sport performance . The objective of this study was to examine the effect of vitamin D3 supplementation on physical performance of adolescent swimmers with vitamin D insufficiency . Fifty-three adolescent competitive swimmers with vitamin D insufficiency ( serum 25-hydroxyvitamin-D concentrations ( 25(OH)D ) < 30 ng/ml , mean 24.2 ± 4.8 ng/ml ) were r and omized to receive 2,000 IU/day of vitamin D3 or placebo for 12 weeks . Swimming performance at several speeds , arm-grip strength , and one-legged balance , were measured before and after supplementation . The age-adjusted changes in performance variables during the study were compared between groups . 25(OH ) D concentrations at study end were significantly higher in the vitamin group compared with the placebo group ( 29.6 ± 6.5 ng/ml vs. 20.3 ± 4.2 ng/ml , p < .001 ) , yet only 48 % of the vitamin group became vitamin D sufficient with this dosing . No between-group differences were found in the changes of the performance variables tested . No significant differences in performance were found between participants that became vitamin D sufficient , and those who did not . No significant correlation was found between the change in serum 25(OH)D and age-adjusted balance , strength or swimming performance at study end . Vitamin D3 supplementation that raised serum 25(OH)D concentrations by a mean of 9.3 ng/ml above placebo in adolescent swimmers with vitamin D insufficiency , did not improve physical performance more than placebo IMPORTANCE Vitamin D deficiency has been associated with poor physical performance . OBJECTIVE To determine the effectiveness of high-dose vitamin D in lowering the risk of functional decline . DESIGN , SETTING , AND PARTICIPANTS One-year , double-blind , r and omized clinical trial conducted in Zurich , Switzerl and . The screening phase was December 1 , 2009 , to May 31 , 2010 , and the last study visit was in May 2011 . The date s of our analysis were June 15 , 2012 , to October 10 , 2015 . Participants were 200 community-dwelling men and women 70 years and older with a prior fall . INTERVENTIONS Three study groups with monthly treatments , including a low-dose control group receiving 24,000 IU of vitamin D3 ( 24,000 IU group ) , a group receiving 60,000 IU of vitamin D3 ( 60,000 IU group ) , and a group receiving 24,000 IU of vitamin D3 plus 300 μg of calcifediol ( 24,000 IU plus calcifediol group ) . MAIN OUTCOMES AND MEASURES The primary end point was improving lower extremity function ( on the Short Physical Performance Battery ) and achieving 25-hydroxyvitamin D levels of at least 30 ng/mL at 6 and 12 months . A secondary end point was monthly reported falls . Analyses were adjusted for age , sex , and body mass index . RESULTS The study cohort comprised 200 participants ( men and women ≥ 70 years with a prior fall ) . Their mean age was 78 years , 67.0 % ( 134 of 200 ) were female , and 58.0 % ( 116 of 200 ) were vitamin D deficient ( < 20 ng/mL ) at baseline . Intent-to-treat analyses showed that , while 60,000 IU and 24,000 IU plus calcifediol were more likely than 24,000 IU to result in 25-hydroxyvitamin D levels of at least 30 ng/mL ( P = .001 ) , they were not more effective in improving lower extremity function , which did not differ among the treatment groups ( P = .26 ) . However , over the 12-month follow-up , the incidence of falls differed significantly among the treatment groups , with higher incidences in the 60,000 IU group ( 66.9 % ; 95 % CI , 54.4 % to 77.5 % ) and the 24,000 IU plus calcifediol group ( 66.1 % ; 95 % CI , 53.5%-76.8 % ) group compared with the 24,000 IU group ( 47.9 % ; 95 % CI , 35.8%-60.3 % ) ( P = .048 ) . Consistent with the incidence of falls , the mean number of falls differed marginally by treatment group . The 60,000 IU group ( mean , 1.47 ) and the 24,000 IU plus calcifediol group ( mean , 1.24 ) had higher mean numbers of falls compared with the 24,000 IU group ( mean , 0.94 ) ( P = .09 ) . CONCLUSIONS AND RELEVANCE Although higher monthly doses of vitamin D were effective in reaching a threshold of at least 30 ng/mL of 25-hydroxyvitamin D , they had no benefit on lower extremity function and were associated with increased risk of falls compared with 24,000 IU . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01017354 Vitamin D insufficiency is common in athletes and may lower physical performance . Many cross-sectional studies associate vitamin D status with physical performance in athletes ; however , there have been few prospect i ve r and omized controlled trials with adequate statistical power to test this relationship , and none in the southern hemisphere . Thus , a prospect i ve double-blind , r and omized , placebo-controlled intervention trial was conducted involving 57 professional rugby union players in New Zeal and . Participants were r and omized to receive 50,000 IU of cholecalciferol ( equivalent to 3,570 IU/day ) or placebo once every two weeks over 11 - 12 weeks . Serum 25(OH)D concentrations and physical performance were measured at baseline , weeks 5 - 6 , and weeks 11 - 12 . Mean ( SD ) serum 25(OH)D concentrations for all participants at baseline was 94 ( 18 ) nmol/L , with all players above 50 nmol/L. Vitamin D supplementation significantly increased serum 25(OH)D concentrations compared to placebo , with a 32 nmol/L difference between groups at 11 - 12 weeks ( 95 % CI , 26 - 38 ; p < 0.001 ) . Performance in five of the six tests at study completion , including the primary outcome variable of 30-m sprint time , did not differ between the vitamin D supplemented and placebo groups ( p > 0.05 ) . Performance on the weighted reverse-grip chin up was significantly higher in players receiving vitamin D compared with placebo , by 5.5 kg ( 95 % CI , 2.0 - 8.9 ; p = 0.002 ) . Despite significantly improving vitamin D status in these professional rugby union players , vitamin D supplementation had little impact on physical performance outcomes . Thus , it is unlikely that vitamin D supplementation is an ergogenic aid in this group of athletes CONTEXT Improving vitamin D status may be an important modifiable risk factor to reduce falls and fractures ; however , adherence to daily supplementation is typically poor . OBJECTIVE To determine whether a single annual dose of 500,000 IU of cholecalciferol administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture . DESIGN , SETTING , AND PARTICIPANTS A double-blind , placebo-controlled trial of 2256 community-dwelling women , aged 70 years or older , considered to be at high risk of fracture were recruited from June 2003 to June 2005 and were r and omly assigned to receive cholecalciferol or placebo each autumn to winter for 3 to 5 years . The study concluded in 2008 . INTERVENTION 500,000 IU of cholecalciferol or placebo . MAIN OUTCOME MEASURES Falls and fractures were ascertained using monthly calendars ; details were confirmed by telephone interview . Fractures were radiologically confirmed . In a sub study , 137 r and omly selected participants underwent serial blood sampling for 25-hydroxycholecalciferol and parathyroid hormone levels . RESULTS Women in the cholecalciferol ( vitamin D ) group had 171 fractures vs 135 in the placebo group ; 837 women in the vitamin D group fell 2892 times ( rate , 83.4 per 100 person-years ) while 769 women in the placebo group fell 2512 times ( rate , 72.7 per 100 person-years ; incidence rate ratio [ RR ] , 1.15 ; 95 % confidence interval [ CI ] , 1.02 - 1.30 ; P = .03 ) . The incidence RR for fracture in the vitamin D group was 1.26 ( 95 % CI , 1.00 - 1.59 ; P = .047 ) vs the placebo group ( rates per 100 person-years , 4.9 vitamin D vs 3.9 placebo ) . A temporal pattern was observed in a post hoc analysis of falls . The incidence RR of falling in the vitamin D group vs the placebo group was 1.31 in the first 3 months after dosing and 1.13 during the following 9 months ( test for homogeneity ; P = .02 ) . In the sub study , the median baseline serum 25-hydroxycholecalciferol was 49 nmol/L. Less than 3 % of the sub study participants had 25-hydroxycholecalciferol levels lower than 25 nmol/L. In the vitamin D group , 25-hydroxycholecalciferol levels increased at 1 month after dosing to approximately 120 nmol/L , were approximately 90 nmol/L at 3 months , and remained higher than the placebo group 12 months after dosing . CONCLUSION Among older community-dwelling women , annual oral administration of high-dose cholecalciferol result ed in an increased risk of falls and fractures . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000658617 ; is rct n.org Identifier : IS RCT N83409867 OBJECTIVES To evaluate a dynamic form of weighted vest exercise suitable for home use and design ed to enhance muscle power , balance , and mobility . DESIGN A single-blind , r and omized , controlled trial . SETTING Outpatient exercise research facility situated within an academic long-term care center . PARTICIPANTS Twenty-one community-dwelling women aged 70 and older with a Short Physical Performance Battery ( SPPB ) score between 4 and 10 ( out of 12 ) . INTERVENTIONS Subjects were r and omized into a progressive resistance-training program using weighted vests for resistance with exercises design ed to be specific to mobility tasks and have a component performed at the fastest possible velocity ( Increased Velocity Exercise Specific to Task ( InVEST ) , n=11 ) or a control exercise group ( control , n=10 ) , which performed slow-velocity , low-resistance exercise . Both groups exercised three times a week for 12 weeks . MEASUREMENTS Changes in muscle power , balance , and physical performance were compared . RESULTS In comparison to control group , InVEST group manifested significant improvements ( P<.05 ) in leg power across measurements obtained at 75 % to 90 % of the one-repetition maximum . Both groups demonstrated significant improvements in chair st and and SPPB score from baseline , and the InVEST group showed significant improvements in gait speed and chair st and from baseline ( P<.05 ) . InVEST produced significantly greater changes in chair st and time than control ( P<.05 ) . CONCLUSION InVEST training appears be an effective means of enhancing leg power and chair rise in this population and is worthy of further investigation as a means of enhancing balance and mobility Data were pooled from four r and omized clinical trials with vitamin D performed in Tromsø with weight reduction , insulin sensitivity , bone density , and depression scores as endpoints . Serum lipids , glycated hemoglobin ( HbA1c ) , and high sensitivity C-Reactive Protein , ( HS-CRP ) were measured at baseline and after 6–12 months of supplementation with vitamin D 20 000 IU–40 000 IU per week versus placebo .  A total of 928 subjects who completed the interventions were included . At baseline the mean serum 25-hydroxyvitamin D ( 25(OH)D ) level in those given vitamin D was 55.9 ( 20.9 ) nmol/L and the mean increase was 82.4 ( 40.1 ) nmol/L. Compared with the placebo group there was in the vitamin D group at the end of the studies a slight , but significant , increase in HbA1c of 0.04 % , an increase in HS-CRP of 0.07 mg/L in those with serum 25(OH)D < 50 nmol/L , and in those with low baseline HDL-C and serum 25(OH)D < 50 nm 
    Output:
    
agent
CONCLUSIONS Vitamin D supplementation positively affected lower limb muscle strength in athletes , but not upper limb muscle strength or muscle power .
Different muscle groups and functions may respond differently to vitamin D supplementation .
***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: It is hypothesized that vitamin D insufficiency in athletes might negatively affect sport performance . The objective of this study was to examine the effect of vitamin D3 supplementation on physical performance of adolescent swimmers with vitamin D insufficiency . Fifty-three adolescent competitive swimmers with vitamin D insufficiency ( serum 25-hydroxyvitamin-D concentrations ( 25(OH)D ) < 30 ng/ml , mean 24.2 ± 4.8 ng/ml ) were r and omized to receive 2,000 IU/day of vitamin D3 or placebo for 12 weeks . Swimming performance at several speeds , arm-grip strength , and one-legged balance , were measured before and after supplementation . The age-adjusted changes in performance variables during the study were compared between groups . 25(OH ) D concentrations at study end were significantly higher in the vitamin group compared with the placebo group ( 29.6 ± 6.5 ng/ml vs. 20.3 ± 4.2 ng/ml , p < .001 ) , yet only 48 % of the vitamin group became vitamin D sufficient with this dosing . No between-group differences were found in the changes of the performance variables tested . No significant differences in performance were found between participants that became vitamin D sufficient , and those who did not . No significant correlation was found between the change in serum 25(OH)D and age-adjusted balance , strength or swimming performance at study end . Vitamin D3 supplementation that raised serum 25(OH)D concentrations by a mean of 9.3 ng/ml above placebo in adolescent swimmers with vitamin D insufficiency , did not improve physical performance more than placebo IMPORTANCE Vitamin D deficiency has been associated with poor physical performance . OBJECTIVE To determine the effectiveness of high-dose vitamin D in lowering the risk of functional decline . DESIGN , SETTING , AND PARTICIPANTS One-year , double-blind , r and omized clinical trial conducted in Zurich , Switzerl and . The screening phase was December 1 , 2009 , to May 31 , 2010 , and the last study visit was in May 2011 . The date s of our analysis were June 15 , 2012 , to October 10 , 2015 . Participants were 200 community-dwelling men and women 70 years and older with a prior fall . INTERVENTIONS Three study groups with monthly treatments , including a low-dose control group receiving 24,000 IU of vitamin D3 ( 24,000 IU group ) , a group receiving 60,000 IU of vitamin D3 ( 60,000 IU group ) , and a group receiving 24,000 IU of vitamin D3 plus 300 μg of calcifediol ( 24,000 IU plus calcifediol group ) . MAIN OUTCOMES AND MEASURES The primary end point was improving lower extremity function ( on the Short Physical Performance Battery ) and achieving 25-hydroxyvitamin D levels of at least 30 ng/mL at 6 and 12 months . A secondary end point was monthly reported falls . Analyses were adjusted for age , sex , and body mass index . RESULTS The study cohort comprised 200 participants ( men and women ≥ 70 years with a prior fall ) . Their mean age was 78 years , 67.0 % ( 134 of 200 ) were female , and 58.0 % ( 116 of 200 ) were vitamin D deficient ( < 20 ng/mL ) at baseline . Intent-to-treat analyses showed that , while 60,000 IU and 24,000 IU plus calcifediol were more likely than 24,000 IU to result in 25-hydroxyvitamin D levels of at least 30 ng/mL ( P = .001 ) , they were not more effective in improving lower extremity function , which did not differ among the treatment groups ( P = .26 ) . However , over the 12-month follow-up , the incidence of falls differed significantly among the treatment groups , with higher incidences in the 60,000 IU group ( 66.9 % ; 95 % CI , 54.4 % to 77.5 % ) and the 24,000 IU plus calcifediol group ( 66.1 % ; 95 % CI , 53.5%-76.8 % ) group compared with the 24,000 IU group ( 47.9 % ; 95 % CI , 35.8%-60.3 % ) ( P = .048 ) . Consistent with the incidence of falls , the mean number of falls differed marginally by treatment group . The 60,000 IU group ( mean , 1.47 ) and the 24,000 IU plus calcifediol group ( mean , 1.24 ) had higher mean numbers of falls compared with the 24,000 IU group ( mean , 0.94 ) ( P = .09 ) . CONCLUSIONS AND RELEVANCE Although higher monthly doses of vitamin D were effective in reaching a threshold of at least 30 ng/mL of 25-hydroxyvitamin D , they had no benefit on lower extremity function and were associated with increased risk of falls compared with 24,000 IU . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01017354 Vitamin D insufficiency is common in athletes and may lower physical performance . Many cross-sectional studies associate vitamin D status with physical performance in athletes ; however , there have been few prospect i ve r and omized controlled trials with adequate statistical power to test this relationship , and none in the southern hemisphere . Thus , a prospect i ve double-blind , r and omized , placebo-controlled intervention trial was conducted involving 57 professional rugby union players in New Zeal and . Participants were r and omized to receive 50,000 IU of cholecalciferol ( equivalent to 3,570 IU/day ) or placebo once every two weeks over 11 - 12 weeks . Serum 25(OH)D concentrations and physical performance were measured at baseline , weeks 5 - 6 , and weeks 11 - 12 . Mean ( SD ) serum 25(OH)D concentrations for all participants at baseline was 94 ( 18 ) nmol/L , with all players above 50 nmol/L. Vitamin D supplementation significantly increased serum 25(OH)D concentrations compared to placebo , with a 32 nmol/L difference between groups at 11 - 12 weeks ( 95 % CI , 26 - 38 ; p < 0.001 ) . Performance in five of the six tests at study completion , including the primary outcome variable of 30-m sprint time , did not differ between the vitamin D supplemented and placebo groups ( p > 0.05 ) . Performance on the weighted reverse-grip chin up was significantly higher in players receiving vitamin D compared with placebo , by 5.5 kg ( 95 % CI , 2.0 - 8.9 ; p = 0.002 ) . Despite significantly improving vitamin D status in these professional rugby union players , vitamin D supplementation had little impact on physical performance outcomes . Thus , it is unlikely that vitamin D supplementation is an ergogenic aid in this group of athletes CONTEXT Improving vitamin D status may be an important modifiable risk factor to reduce falls and fractures ; however , adherence to daily supplementation is typically poor . OBJECTIVE To determine whether a single annual dose of 500,000 IU of cholecalciferol administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture . DESIGN , SETTING , AND PARTICIPANTS A double-blind , placebo-controlled trial of 2256 community-dwelling women , aged 70 years or older , considered to be at high risk of fracture were recruited from June 2003 to June 2005 and were r and omly assigned to receive cholecalciferol or placebo each autumn to winter for 3 to 5 years . The study concluded in 2008 . INTERVENTION 500,000 IU of cholecalciferol or placebo . MAIN OUTCOME MEASURES Falls and fractures were ascertained using monthly calendars ; details were confirmed by telephone interview . Fractures were radiologically confirmed . In a sub study , 137 r and omly selected participants underwent serial blood sampling for 25-hydroxycholecalciferol and parathyroid hormone levels . RESULTS Women in the cholecalciferol ( vitamin D ) group had 171 fractures vs 135 in the placebo group ; 837 women in the vitamin D group fell 2892 times ( rate , 83.4 per 100 person-years ) while 769 women in the placebo group fell 2512 times ( rate , 72.7 per 100 person-years ; incidence rate ratio [ RR ] , 1.15 ; 95 % confidence interval [ CI ] , 1.02 - 1.30 ; P = .03 ) . The incidence RR for fracture in the vitamin D group was 1.26 ( 95 % CI , 1.00 - 1.59 ; P = .047 ) vs the placebo group ( rates per 100 person-years , 4.9 vitamin D vs 3.9 placebo ) . A temporal pattern was observed in a post hoc analysis of falls . The incidence RR of falling in the vitamin D group vs the placebo group was 1.31 in the first 3 months after dosing and 1.13 during the following 9 months ( test for homogeneity ; P = .02 ) . In the sub study , the median baseline serum 25-hydroxycholecalciferol was 49 nmol/L. Less than 3 % of the sub study participants had 25-hydroxycholecalciferol levels lower than 25 nmol/L. In the vitamin D group , 25-hydroxycholecalciferol levels increased at 1 month after dosing to approximately 120 nmol/L , were approximately 90 nmol/L at 3 months , and remained higher than the placebo group 12 months after dosing . CONCLUSION Among older community-dwelling women , annual oral administration of high-dose cholecalciferol result ed in an increased risk of falls and fractures . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000658617 ; is rct n.org Identifier : IS RCT N83409867 OBJECTIVES To evaluate a dynamic form of weighted vest exercise suitable for home use and design ed to enhance muscle power , balance , and mobility . DESIGN A single-blind , r and omized , controlled trial . SETTING Outpatient exercise research facility situated within an academic long-term care center . PARTICIPANTS Twenty-one community-dwelling women aged 70 and older with a Short Physical Performance Battery ( SPPB ) score between 4 and 10 ( out of 12 ) . INTERVENTIONS Subjects were r and omized into a progressive resistance-training program using weighted vests for resistance with exercises design ed to be specific to mobility tasks and have a component performed at the fastest possible velocity ( Increased Velocity Exercise Specific to Task ( InVEST ) , n=11 ) or a control exercise group ( control , n=10 ) , which performed slow-velocity , low-resistance exercise . Both groups exercised three times a week for 12 weeks . MEASUREMENTS Changes in muscle power , balance , and physical performance were compared . RESULTS In comparison to control group , InVEST group manifested significant improvements ( P<.05 ) in leg power across measurements obtained at 75 % to 90 % of the one-repetition maximum . Both groups demonstrated significant improvements in chair st and and SPPB score from baseline , and the InVEST group showed significant improvements in gait speed and chair st and from baseline ( P<.05 ) . InVEST produced significantly greater changes in chair st and time than control ( P<.05 ) . CONCLUSION InVEST training appears be an effective means of enhancing leg power and chair rise in this population and is worthy of further investigation as a means of enhancing balance and mobility Data were pooled from four r and omized clinical trials with vitamin D performed in Tromsø with weight reduction , insulin sensitivity , bone density , and depression scores as endpoints . Serum lipids , glycated hemoglobin ( HbA1c ) , and high sensitivity C-Reactive Protein , ( HS-CRP ) were measured at baseline and after 6–12 months of supplementation with vitamin D 20 000 IU–40 000 IU per week versus placebo .  A total of 928 subjects who completed the interventions were included . At baseline the mean serum 25-hydroxyvitamin D ( 25(OH)D ) level in those given vitamin D was 55.9 ( 20.9 ) nmol/L and the mean increase was 82.4 ( 40.1 ) nmol/L. Compared with the placebo group there was in the vitamin D group at the end of the studies a slight , but significant , increase in HbA1c of 0.04 % , an increase in HS-CRP of 0.07 mg/L in those with serum 25(OH)D < 50 nmol/L , and in those with low baseline HDL-C and serum 25(OH)D < 50 nm 
    Output:
    