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: OBJECTIVE : To examine whether cycled lighting ( CL ) conditions during neonatal care in very preterm infants ( < 32 weeks ’ gestational age [ GA ] ) decrease crying and fussing behavior , improve the consolidation of sleep , and influence activity behavior at 5 and 11 weeks ’ postterm corrected age ( CA ) compared with preterm infants cared for in dim lighting ( DL ) conditions . METHODS : Thirty-seven preterm infants were r and omly assigned to  CL  ( 7 am–7 pm lights on , 7 pm–7 am lights off [ n = 17 ; mean GA : 30.6 ± 0.95 weeks ; 9 girls ] ) or DL ( lights off whenever the child is asleep [ n = 20 ; GA : 29.5 ± 2.1 weeks ; 8 girls ] ) conditions . Sleeping , crying , and activity behavior was recorded by using parental diaries and actigraphy at 5 and 11 weeks ’ CA . RESULTS : A significant reduction of fussing ( 59.4 minutes/24 hours [ ±25.8 minutes ] ) and crying ( 31.2 minutes/24 hours [ ±14.4 minutes ] ) behavior and a trend to higher motor activity during daytime was found in CL-exposed infants at 5 and 11 weeks ’ CA compared with infants cared for in DL conditions . No significant difference between groups was observed for sleep behavior at 5 and 11 weeks ’ CA . Infants in CL conditions showed a trend to improved daily weight gain ( average : 3.6 g/d ) during neonatal care compared with DL conditions . CONCLUSIONS : CL conditions in neonatal care have beneficial effects on infant ’s fussing and crying behavior and growth in the first weeks of life . This study supports the introduction of CL care in clinical neonatal practice Day-night cycled light improves health outcomes in preterm infants , yet the best time to institute cycled light is unclear . The hypothesis of this study was that extremely preterm infants receiving early cycled light  would have better health and developmental outcomes than infants receiving  late cycled light .  Infants born at ≤28 weeks gestation were r and omly assigned to early cycled light ( ECL ) starting at 28 weeks postmenstrual age [ PMA ] or late cycled light ( LCL ) , starting at 36 weeks PMA . Daylight was 200 - 600 lux and night was 5 - 30 lux . Primary outcomes were weight over time and length of hospitalization . Secondary outcomes were hospital costs , sleep development , and neurodevelopment at 9 , 18 , and 24 months corrected age . Of 121 infants r and omized , 118 were included in analysis . Weight gain in the two groups did not differ significantly but increased across time in both groups . In PMA weeks 36 - 44 , the mean weight gain was 193.8 grams in the ECL group compared to 176.3 grams in the LCL group . Effect sizes for weight were Cohen d = 0.26 and 0.36 for 36 and 44 weeks PMA . Infants in the ECL group went home an average of 5.5 days earlier than the LCL group , but this difference was not statistically significant . There were no group differences on neurodevelopmental outcomes . Although statistically non-significant , clinical ly important differences of improved weight gain and decreased hospital stay were observed with ECL . The small observed effect sizes on weight during hospitalization should be considered in future cycled light research with extremely preterm infants . © 2017 Wiley Periodicals , PURPOSE Premature infants lack the tactile stimulation they would have otherwise experienced in the womb . Infant massage is a developmentally supportive intervention that has been documented for several decades to have a positive effect on both full term and preterm infants . The purpose of this study was to assess the short and long term benefits of massage on stable preterm infants . METHODS A quasi experimental design was used , 66 infants were recruited from two university hospitals with tertiary level NICUs ; 32 infants received the massage therapy by their mothers . Data collection by a research er blind to the infants ' group assignments included weight at discharge , pain responses on the PIPP scale at discharge , length of stay in hospital , neuro-developmental outcome ( Bayley scores ) and breastfeeding duration at 12 months corrected age . RESULTS Infants who were massaged had significantly lower scores on the PIPP after a heel-stick compared to before the massage and had lower PIPP scores at discharge compared to the control group . Massaged infants had higher cognitive scores at 12 months corrected age . Weight gain , length of stay , breastfeeding duration and motor scores did not differ between groups . CONCLUSION Stable preterm infants benefit from massage therapy given by their mothers and may be a culturally acceptable form of intervention to improve the outcomes of preterm infants Objective : To investigate in a r and omised controlled trial the effect of basic elements of developmental care ( incubator covers and positioning aids ) on growth and neurodevelopment in infants born at < 32 weeks . Method : Infants were r and omised within 48 h of birth to a developmental care ( DC ) or st and ard care ( C ) group . Outcome measures at 1 and 2 years corrected age were growth , st and ardised neurological examinations , and mental ( MDI ) and psychomotor ( PDI ) development ( Dutch version of the Bayley Scales of Infant Development II ) . Results : 192 infants were recruited ( DC = 98 ; C = 94 ) . Thirteen infants ( DC = 7 , C = 6 ) were excluded because they were admitted for < 5 days or died within the first 5 days . In total , 179 infants met the inclusion criteria .  In-hospital mortality was 12/91 ( 13.2 % ) in the DC group and 8/88 ( 9.1 % ) in the C group . Assessment s were carried out on 147 children ( DC = 74 , C = 73 ) at 1 year and 142 children ( DC = 72 , C = 70 ) at 2 years . No significant difference in growth , neurological outcomes or MDI was found . A positive trend in PDI at 1 year ( p = 0.05 ) did not continue once the children reached 2 years . There was no difference found when neurological and developmental scores were combined . Conclusions : Basic developmental care has no positive effect on neurological and mental development or growth at 1 and 2 years of age in infants born at < 32 weeks . A positive effect on psychomotor development at 1 year did not continue at 2 years of age . Trial registration number : IS RCT N84995192 OBJECTIVE To evaluate associations between neonatal intensive care unit ( NICU ) room type ( open ward and private room ) and medical outcomes ; neurobehavior , electrophysiology , and brain structure at hospital discharge ; and developmental outcomes at 2 years of age . STUDY DESIGN In this prospect i ve longitudinal cohort study , we enrolled 136 preterm infants born < 30 weeks gestation from an urban , 75-bed level III NICU from 2007 - 2010 . Upon admission , each participant was assigned to a bedspace in an open ward or private room within the same hospital , based on space and staffing availability , where they remained for the duration of hospitalization . The primary outcome was developmental performance at 2 years of age ( n = 86 infants returned for testing , which was 83 % of survivors ) measured using the Bayley Scales of Infant and Toddler Development , 3rd Edition . Secondary outcomes were : ( 1 ) medical factors throughout the hospitalization ; ( 2 ) neurobehavior ; and ( 3 ) cerebral injury and maturation ( determined by magnetic resonance imaging and electroencephalography ) . RESULTS At term equivalent age , infants in private rooms were characterized by a diminution of normal hemispheric asymmetry and a trend toward having lower amplitude integrated electroencephalography cerebral maturation scores ( P = .02 ; β = -0.52 [ CI -0.95 , -0.10 ] ) . At age 2 years , infants from private rooms had lower language scores ( P = .006 ; β = -8.3 [ CI -14.2 , -2.4 ] ) and a trend toward lower motor scores ( P = .02 ; β = -6.3 [ CI -11.7 , -0.99 ] ) , which persisted after adjustment for potential confounders . CONCLUSION These findings raise concerns that highlight the need for further research into the potential adverse effects of different amounts of sensory exposure in the NICU environment The Infant Health and Development Program is a r and omized clinical trial to test the efficacy of educational and family support services and pediatric follow-up , offered during the first 3 years of life , in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites ( N = 985 ) . It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems , specifically visual-motor and spatial skills and receptive language skills . These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning . Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12 , 24 , and 36 months ( Bayley Scales of Infant Development ( including the Mental and Motor scales ) at 12 and 24 months ; the Stanford-Binet , Peabody Picture Vocabulary Test , and Beery Test of Visual Motor Intergration at 36 months ) . Our results reveal that , although intervention benefits accrue across cognitive domains at 24 and 36 months , gains are most pronounced for receptive language and visual-motor and spatial skills How should health care professionals choose among the many therapies cl aim ed to be efficacious for treating specific disorders ? The practice of evidence -based medicine provides an answer . Advocates of this approach urge health care professionals to base treatment choices on the best evidence from systematic research on both the efficacy and adverse effects of various therapeutic alternatives . Ideally , health care professionals would compare different treatments by referring to r and omized , double-blind , head-to-head trials that compared the treatment options . Although individual medications are typically well research ed when these placebo-controlled studies are performed , studies that directly compare treatments are rare . In the absence of direct head-to-head trials , other evidence comes from indirect comparisons of two or more therapies by examining individual studies involving each treatment . This article provides an introductory review of methods of such indirect comparisons of therapies across studies , provides examples of how these methods can be used to make treatment decisions , and presents a general overview of relevant issues and statistics for readers interested in underst and ing these methods more thoroughly OBJECTIVE . This was a r and omized , controlled trial to investigate the effect of Newborn Individualized Developmental Care and Assessment Program on growth , cognitive , psychomotor , and neuromotor development at 1 and 2 years in infants born at < 32 weeks ’ gestational age . METHODS . Infants were r and omly assigned within 48 hours of birth to the  newborn individualized developmental care and assessment program group ( intervention ) or basic developmental care group ( control group [ ie , incubator covers and nests ] ) . At 1 and 2 years ’ corrected age , growth was measured and st and ardized neurologic examinations were administered . Mental and psychomotor development was assessed by using the Dutch version of the Bayley Scales of Infant Development II . Neurologic outcome , Psychomotor Developmental Index , and Mental Developmental Index scores were combined a total outcome measure . RESULTS . One hundred sixty-eight infants were recruited ( intervention : 84 ; control : 84 ) . Four infants ( newborn intervention : 3 ; control : 1 ) were excluded because they were admitted less than or died within the first 5 days , leaving a total of 164 infants who met inclusion criteria .  In-hospital mortality was 8 of 81 in the intervention group and 3 of 83 in the control group . At 1 year of age 148 children ( intervention : 70 ; control : 78 ) and at 2 years of age 146 children ( intervention : 68 ; control : 78 ) were assessed . There was no significant difference in growth at 1 and 2 years of age . There was no significant difference found in neurologic outcomes or mental and psychomotor development at 1 and 2 years of age . When neurologic outcome , Mental Developmental Index and Psychomotor Developmental Index scores were combined , there still remained no significant difference . CONCLUSIONS . Newborn individualized developmental care and assessment program developmental care showed no effect on growth or neurologic , mental , or psychomotor development at 1 and 2 years of age in infants born at < 32 weeks . Duration of the intervention was not associated with neurologic and developmental outcome Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND To determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years . METHODS A prospect i ve phase-lag study was performed at an Austrian neonatal intensive care unit ( NICU ) . From January 2003 to December 2005 ( study period of conventional care ) and January 2007 to December 2009 ( study period of developmental care ) , we enrolled all infants born in Tyrol at less than 32 weeks of gestation . During this period a total of 261 of 359 preterm infants ( participation rate 72.7 % ) completed the follow-up visit at 2 years of age ; there were 124 children in the 
    Output:
    
agent
Conclusion Current evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants , especially at 12 months of age .
***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 : To examine whether cycled lighting ( CL ) conditions during neonatal care in very preterm infants ( < 32 weeks ’ gestational age [ GA ] ) decrease crying and fussing behavior , improve the consolidation of sleep , and influence activity behavior at 5 and 11 weeks ’ postterm corrected age ( CA ) compared with preterm infants cared for in dim lighting ( DL ) conditions . METHODS : Thirty-seven preterm infants were r and omly assigned to  CL  ( 7 am–7 pm lights on , 7 pm–7 am lights off [ n = 17 ; mean GA : 30.6 ± 0.95 weeks ; 9 girls ] ) or DL ( lights off whenever the child is asleep [ n = 20 ; GA : 29.5 ± 2.1 weeks ; 8 girls ] ) conditions . Sleeping , crying , and activity behavior was recorded by using parental diaries and actigraphy at 5 and 11 weeks ’ CA . RESULTS : A significant reduction of fussing ( 59.4 minutes/24 hours [ ±25.8 minutes ] ) and crying ( 31.2 minutes/24 hours [ ±14.4 minutes ] ) behavior and a trend to higher motor activity during daytime was found in CL-exposed infants at 5 and 11 weeks ’ CA compared with infants cared for in DL conditions . No significant difference between groups was observed for sleep behavior at 5 and 11 weeks ’ CA . Infants in CL conditions showed a trend to improved daily weight gain ( average : 3.6 g/d ) during neonatal care compared with DL conditions . CONCLUSIONS : CL conditions in neonatal care have beneficial effects on infant ’s fussing and crying behavior and growth in the first weeks of life . This study supports the introduction of CL care in clinical neonatal practice Day-night cycled light improves health outcomes in preterm infants , yet the best time to institute cycled light is unclear . The hypothesis of this study was that extremely preterm infants receiving early cycled light  would have better health and developmental outcomes than infants receiving  late cycled light .  Infants born at ≤28 weeks gestation were r and omly assigned to early cycled light ( ECL ) starting at 28 weeks postmenstrual age [ PMA ] or late cycled light ( LCL ) , starting at 36 weeks PMA . Daylight was 200 - 600 lux and night was 5 - 30 lux . Primary outcomes were weight over time and length of hospitalization . Secondary outcomes were hospital costs , sleep development , and neurodevelopment at 9 , 18 , and 24 months corrected age . Of 121 infants r and omized , 118 were included in analysis . Weight gain in the two groups did not differ significantly but increased across time in both groups . In PMA weeks 36 - 44 , the mean weight gain was 193.8 grams in the ECL group compared to 176.3 grams in the LCL group . Effect sizes for weight were Cohen d = 0.26 and 0.36 for 36 and 44 weeks PMA . Infants in the ECL group went home an average of 5.5 days earlier than the LCL group , but this difference was not statistically significant . There were no group differences on neurodevelopmental outcomes . Although statistically non-significant , clinical ly important differences of improved weight gain and decreased hospital stay were observed with ECL . The small observed effect sizes on weight during hospitalization should be considered in future cycled light research with extremely preterm infants . © 2017 Wiley Periodicals , PURPOSE Premature infants lack the tactile stimulation they would have otherwise experienced in the womb . Infant massage is a developmentally supportive intervention that has been documented for several decades to have a positive effect on both full term and preterm infants . The purpose of this study was to assess the short and long term benefits of massage on stable preterm infants . METHODS A quasi experimental design was used , 66 infants were recruited from two university hospitals with tertiary level NICUs ; 32 infants received the massage therapy by their mothers . Data collection by a research er blind to the infants ' group assignments included weight at discharge , pain responses on the PIPP scale at discharge , length of stay in hospital , neuro-developmental outcome ( Bayley scores ) and breastfeeding duration at 12 months corrected age . RESULTS Infants who were massaged had significantly lower scores on the PIPP after a heel-stick compared to before the massage and had lower PIPP scores at discharge compared to the control group . Massaged infants had higher cognitive scores at 12 months corrected age . Weight gain , length of stay , breastfeeding duration and motor scores did not differ between groups . CONCLUSION Stable preterm infants benefit from massage therapy given by their mothers and may be a culturally acceptable form of intervention to improve the outcomes of preterm infants Objective : To investigate in a r and omised controlled trial the effect of basic elements of developmental care ( incubator covers and positioning aids ) on growth and neurodevelopment in infants born at < 32 weeks . Method : Infants were r and omised within 48 h of birth to a developmental care ( DC ) or st and ard care ( C ) group . Outcome measures at 1 and 2 years corrected age were growth , st and ardised neurological examinations , and mental ( MDI ) and psychomotor ( PDI ) development ( Dutch version of the Bayley Scales of Infant Development II ) . Results : 192 infants were recruited ( DC = 98 ; C = 94 ) . Thirteen infants ( DC = 7 , C = 6 ) were excluded because they were admitted for < 5 days or died within the first 5 days . In total , 179 infants met the inclusion criteria .  In-hospital mortality was 12/91 ( 13.2 % ) in the DC group and 8/88 ( 9.1 % ) in the C group . Assessment s were carried out on 147 children ( DC = 74 , C = 73 ) at 1 year and 142 children ( DC = 72 , C = 70 ) at 2 years . No significant difference in growth , neurological outcomes or MDI was found . A positive trend in PDI at 1 year ( p = 0.05 ) did not continue once the children reached 2 years . There was no difference found when neurological and developmental scores were combined . Conclusions : Basic developmental care has no positive effect on neurological and mental development or growth at 1 and 2 years of age in infants born at < 32 weeks . A positive effect on psychomotor development at 1 year did not continue at 2 years of age . Trial registration number : IS RCT N84995192 OBJECTIVE To evaluate associations between neonatal intensive care unit ( NICU ) room type ( open ward and private room ) and medical outcomes ; neurobehavior , electrophysiology , and brain structure at hospital discharge ; and developmental outcomes at 2 years of age . STUDY DESIGN In this prospect i ve longitudinal cohort study , we enrolled 136 preterm infants born < 30 weeks gestation from an urban , 75-bed level III NICU from 2007 - 2010 . Upon admission , each participant was assigned to a bedspace in an open ward or private room within the same hospital , based on space and staffing availability , where they remained for the duration of hospitalization . The primary outcome was developmental performance at 2 years of age ( n = 86 infants returned for testing , which was 83 % of survivors ) measured using the Bayley Scales of Infant and Toddler Development , 3rd Edition . Secondary outcomes were : ( 1 ) medical factors throughout the hospitalization ; ( 2 ) neurobehavior ; and ( 3 ) cerebral injury and maturation ( determined by magnetic resonance imaging and electroencephalography ) . RESULTS At term equivalent age , infants in private rooms were characterized by a diminution of normal hemispheric asymmetry and a trend toward having lower amplitude integrated electroencephalography cerebral maturation scores ( P = .02 ; β = -0.52 [ CI -0.95 , -0.10 ] ) . At age 2 years , infants from private rooms had lower language scores ( P = .006 ; β = -8.3 [ CI -14.2 , -2.4 ] ) and a trend toward lower motor scores ( P = .02 ; β = -6.3 [ CI -11.7 , -0.99 ] ) , which persisted after adjustment for potential confounders . CONCLUSION These findings raise concerns that highlight the need for further research into the potential adverse effects of different amounts of sensory exposure in the NICU environment The Infant Health and Development Program is a r and omized clinical trial to test the efficacy of educational and family support services and pediatric follow-up , offered during the first 3 years of life , in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites ( N = 985 ) . It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems , specifically visual-motor and spatial skills and receptive language skills . These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning . Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12 , 24 , and 36 months ( Bayley Scales of Infant Development ( including the Mental and Motor scales ) at 12 and 24 months ; the Stanford-Binet , Peabody Picture Vocabulary Test , and Beery Test of Visual Motor Intergration at 36 months ) . Our results reveal that , although intervention benefits accrue across cognitive domains at 24 and 36 months , gains are most pronounced for receptive language and visual-motor and spatial skills How should health care professionals choose among the many therapies cl aim ed to be efficacious for treating specific disorders ? The practice of evidence -based medicine provides an answer . Advocates of this approach urge health care professionals to base treatment choices on the best evidence from systematic research on both the efficacy and adverse effects of various therapeutic alternatives . Ideally , health care professionals would compare different treatments by referring to r and omized , double-blind , head-to-head trials that compared the treatment options . Although individual medications are typically well research ed when these placebo-controlled studies are performed , studies that directly compare treatments are rare . In the absence of direct head-to-head trials , other evidence comes from indirect comparisons of two or more therapies by examining individual studies involving each treatment . This article provides an introductory review of methods of such indirect comparisons of therapies across studies , provides examples of how these methods can be used to make treatment decisions , and presents a general overview of relevant issues and statistics for readers interested in underst and ing these methods more thoroughly OBJECTIVE . This was a r and omized , controlled trial to investigate the effect of Newborn Individualized Developmental Care and Assessment Program on growth , cognitive , psychomotor , and neuromotor development at 1 and 2 years in infants born at < 32 weeks ’ gestational age . METHODS . Infants were r and omly assigned within 48 hours of birth to the  newborn individualized developmental care and assessment program group ( intervention ) or basic developmental care group ( control group [ ie , incubator covers and nests ] ) . At 1 and 2 years ’ corrected age , growth was measured and st and ardized neurologic examinations were administered . Mental and psychomotor development was assessed by using the Dutch version of the Bayley Scales of Infant Development II . Neurologic outcome , Psychomotor Developmental Index , and Mental Developmental Index scores were combined a total outcome measure . RESULTS . One hundred sixty-eight infants were recruited ( intervention : 84 ; control : 84 ) . Four infants ( newborn intervention : 3 ; control : 1 ) were excluded because they were admitted less than or died within the first 5 days , leaving a total of 164 infants who met inclusion criteria .  In-hospital mortality was 8 of 81 in the intervention group and 3 of 83 in the control group . At 1 year of age 148 children ( intervention : 70 ; control : 78 ) and at 2 years of age 146 children ( intervention : 68 ; control : 78 ) were assessed . There was no significant difference in growth at 1 and 2 years of age . There was no significant difference found in neurologic outcomes or mental and psychomotor development at 1 and 2 years of age . When neurologic outcome , Mental Developmental Index and Psychomotor Developmental Index scores were combined , there still remained no significant difference . CONCLUSIONS . Newborn individualized developmental care and assessment program developmental care showed no effect on growth or neurologic , mental , or psychomotor development at 1 and 2 years of age in infants born at < 32 weeks . Duration of the intervention was not associated with neurologic and developmental outcome Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND To determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years . METHODS A prospect i ve phase-lag study was performed at an Austrian neonatal intensive care unit ( NICU ) . From January 2003 to December 2005 ( study period of conventional care ) and January 2007 to December 2009 ( study period of developmental care ) , we enrolled all infants born in Tyrol at less than 32 weeks of gestation . During this period a total of 261 of 359 preterm infants ( participation rate 72.7 % ) completed the follow-up visit at 2 years of age ; there were 124 children in the 
    Output:
    