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: BACKGROUND We analyzed the health-related quality of life ( HRQOL ) and its determinants in the first year after laparoscopic adjustable gastric b and ing ( LAGB ) .  The setting was 10 Italian public and private bariatric surgery centers . METHODS Data collected in an ongoing , prospect i ve , 3-year multicenter Italian study on the changes in HRQOL after LAGB were used . HRQOL was investigated using the Medical Outcomes Study Short-Form 36 question naire . Hunger , satiety , and the self-perceived effects of LAGB  were recorded . RESULTS A total of 334 patients were enrolled . The follow-up rate was 92.2 % . The percentage of excess weight loss was 39.6 % ± 25.8 % , with very few side effects or complications . Hunger in the morning ( 0 - 10 scale ) was 4.5 ± 2.7 before surgery and 3.8 ± 2.4 after 1 year ( P < .001 ) . Satiety after a meal ( 0 - 10 scale ) was 7.1 ± 2.7 before surgery and 8.2 ± 1.9 at 1 year ( P < .001 ) . The self-perceived effect of LAGB on caloric intake ( 0 - 10 scale ) was 8.4 ± 1.9 after 1 year . The scores for the 8 Medical Outcomes Study Short-Form 36 subscales were significantly improved after surgery . The physical component summary score was 52.6 ± 11.9 at baseline and 79.1 ± 15.6 after 1 year ( P < .001 ) . The corresponding mental component summary scores were 52.2 ± 12.3 and 76.5 ± 17.2 ( P < .001 ) . Greater physical component summary improvement was independently associated with a low initial physical component summary ( P < .001 ) , high satiety ( P = .002 ) , a high percentage of excess weight loss ( P = .013 ) , and a high self-perceived effect of the LAGB ( P = .026 ) . Greater mental component summary improvement was associated with a low initial mental component summary ( P < .001 ) , high satiety ( P < .001 ) , a low frequency of heartburn ( P = .004 ) , and a high percentage of excess weight loss ( P = .012 ) . CONCLUSIONS Significant improvements in HRQOL were observed in the first year after LAGB . A poor baseline HRQOL , a high efficacy of the b and ing in eating control , and better weight loss might influence HRQOL changes BACKGROUND Improvements in health-related quality of life ( HR-QoL ) occur after  bariatric surgery .  However , sustainability of these changes over time remains debated . METHODS Data collected in a prospect i ve 3-year multicenter Italian study on changes of HR-QoL after laparoscopic adjustable gastric b and ing were used .  HR-QoL has investigated with the SF-36 question naire .  Hunger , satiety , and the self-perceived effects of LAGB were recorded . RESULTS A total of 230 patients ( 53 male and 177 female ) were analyzed . Body mass index was 41.4±5.4 kg/m2 at baseline , declined to 33.8±5.8 kg/m2 12 months after surgery ( P<.001 ) , and further reduced to 31.9±5.1 kg/m2 36 months after surgery ( P<.001 versus 12 months ) . Scores in the SF-36 subscales were lower than in the general Italian population at baseline . The physical component summary score was 51.9±11.6 at baseline , improved to 79.2±15.4 at 12 months ( P<.001 ) , and stabilized to 79.8±15.6 at 36 months . The mental summary score was 52.3±11.8 at baseline , improved to 75.2±17.3 at 12 months ( P<.001 ) , and stabilized to 74.2±17.5 at 36 months . A decline>10 points between 12 and 36 months in the summary scores was observed in 22.0 % of the patients for PCS and in 26.8 % for MCS . In a multiple linear regression analysis , deterioration in HR-QoL in the 12 - 36 months period was associated to the presence of better HR-QoL values at 12 months and to a more pronounced reduction of the self-perceived effect of the b and ing at 36 months . CONCLUSION Improvements in HR-QoL observed in the first year after surgery maintained up to the third year after gastric b and ing BACKGROUND Being overweight or obese has substantial effects on individuals ' perceptions of their health and quality of life ( QoL ) . Generic measures often miss important QoL information , and existing obesity-specific instruments have shortcomings with respect to cross-cultural input , application to differing levels of severity , conceptual clarity , and patient burden . OBJECTIVE This study aim ed to develop culturally sensitive measures of QoL and symptoms in overweight or obese persons , both those trying to lose weight and those not trying to lose weight . METHODS Currently accepted criteria and guidelines for question naire development were streamlined and augmented to include cross-cultural input from 5 European countries and the United States . The preliminary pool of items was created based on qualitative interviews conducted in the United States , followed by an early check of item translatability and preharmonization across all language s. Ten additional qualitative in-country interviews were then conducted to produce further culture-specific items . This was followed by 2 forward and 1 backward translation , plus cognitive debriefing interviews in each country . Finally , an exp and ed international harmonization meeting was held to ensure inclusion of appropriate new items and their acceptability across all 6 cultures . RESULTS The procedures described result ed in development of the 41-item Obesity and Weight Loss Quality of Life question naire and the 20-item Weight-Related Symptom Measure . These question naires are subject to further psychometric validation . CONCLUSIONS Augmentation of the initial item-generation and international harmonization steps of question naire development through integration of cross-cultural input allowed greater validity of cross-cultural content while meeting time , budget , and re source constraints Background Severe obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life ( HRQoL ) . In addition to physiological factors , activity and participation , environmental factors , and personal factors are related to an individual ’s overall quality of life HRQoL. In Norway , a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management . The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course  , and explored how well sociodemographic variables , paid work , social support , personal factors , and surgery predicted HRQoL at 12-month follow-up . Methods A single-group longitudinal study was conducted . Data were collected by self-reported question naires . This article reports on those who had completed the question naire at the 12-month ( n = 69 ) follow-up . HRQoL was assessed with the EQ-5D . Other st and ardized instruments measured employment , social support , self-efficacy , and surgery . Results At the 12-month follow-up , participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS . Generalized linear model showed that having paid work , and social support were statistically significant predictors of HRQoL at the 12-month follow-up . Sex , self-efficacy , and surgery were not statistically significant associated with HRQoL. Conclusions Participation in paid work , and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL  in obese people 12 months after participating in a learning and mastery course . Trial registration The study is registered in Clinical Trials : NCT01336725 BACKGROUND There is a lack of adequate prospect i ve data on quality -of-life ( QOL ) and its predictors in patients undergoing laparoscopic sleeve gastrectomy ( LSG ) .  The aim of this study was to assess longitudinal changes in QOL after LSG with the use of the obesity-specific Moorehead-Ardelt II question naire ( MAII ) and to identify clinical parameters associated with QOL outcome . METHODS Morbidly obese patients consecutively admitted for LSG , over a 30-month period , were prospect ively studied . QOL was assessed using the vali date d Greek version of the MAII question naire and a visual analogueue scale ( VAS ) , preoperatively and at 6 , 12 , and 24 months postoperatively . Anthropometric data and obesity-related co-morbidities were recorded . RESULTS A total of 111 patients with a mean age 36.8±9.2 years were included . Mean preoperative body mass index ( BMI ) was 49.1±7.5 kg/m2 . Percentage excess BMI loss ( % EBL ) was 51.1±14.9 , 64.2±17.9 and 66.4±18.0 at 6 , 12 , and 24 months , respectively . Postoperatively , all obesity-related co-morbidities were significantly improved . MAII score increased from -.40±1.30 preoperatively to 1.75±.83 , 2.18±.80 , and 1.95±.71 at 6 , 12 , and 24 months postoperatively ( trend P<.001 ) . Preoperative median ( interquartile range ) VAS was 3 ( 1 ) increasing to 9 ( 2 ) , 10 ( 1 ) , and 9 ( 1 ) at 6 , 12 , and 24 months postoperatively ( P<.001 ) . % EBL and reduction in obesity-related co-morbidities , especially resolution of diabetes and sleep apnea , correlated significantly with higher QOL during the course of the study . CONCLUSION LSG , a safe and effective bariatric operation , results in sustained weight loss and significant improvements in QOL . Both weight loss and amelioration of co-morbidities contribute to higher level of postsurgical QOL BACKGROUND Few weight loss surgery trials have evaluated the changes in health-related quality of life ( HRQOL ) relative to obese individuals not participating in weight loss interventions . In a prospect i ve study at a bariatric surgery practice , we evaluated the 2-year changes in HRQOL in gastric bypass patients compared with 2 severely obese groups who did not undergo surgical weight loss .  METHODS A total of 308 gastric bypass patients were compared with 253 individuals who sought but did not undergo gastric bypass and 272 population -based obese individuals using the weight-related ( Impact of Weight on Quality of Life-Lite ) and general ( Medical Outcomes Study 36-item Short-Form Health Survey ) HRQOL question naires at baseline and 2 years of follow-up . RESULTS The percentage of weight loss was 34.2 % for the gastric bypass and 1.4 % for the no gastric bypass groups , with a .5 % gain for population -based obese group . Both measures of HRQOL showed greater improvements for the gastric bypass group , even after controlling for baseline differences . Effect sizes for changes in physical and weight-related HRQOL were very large for gastric bypass , but small to medium for the 2 comparison groups . Effect sizes for changes in the psychosocial aspects of HRQOL were moderate to very large for gastric bypass , but small for the 2 comparison groups . Of the gastric bypass patients , 97 % had meaningful improvements in the Impact of Weight on Quality of Life-Lite total score compared with 43 % of the no gastric bypass group and 30 % of the population -based obese group . CONCLUSION Dramatic improvements had occurred in weight-related and physical HRQOL for gastric bypass patients at 2 years after surgery compared with 2 severely obese groups who had not undergone surgery . These results support the effectiveness of gastric bypass surgery in improving patients ' HRQOL Objective To evaluate the impact of Roux-en-Y gastric bypass ( RYGB ) on quality of life in obese diabetic patients compared to st and ard medical therapy for type 2 diabetes mellitus . Methods We prospect ively studied two matched obese population s with type 2 diabetes . Thirty patients underwent laparoscopic RYGB and 31 received st and ard medical therapy combined with a diabetes support and education program ( DSE ) , consisting of educational sessions on diet and exercise . Groups were matched by age , gender , weight , glucostatic parameters , and use of glucose-lowering medications ( oral agents and insulin therapy ) . Health-related quality of life ( HRQOL ) was assessed using the normalized SF-36 question naire , and data were collected at baseline and at 12-month follow-up . Results Diabetic patients who underwent RYGB experienced a statistically significant increase in their overall HRQOL . However , the role-physical and mental health domains increased but did not reach statistical significance . Diabetic patients in the medical therapy and DSE group did not show any significant increase in HRQOL . The between-group differences for the HRQOL changes from baseline were significant , other than for role-physical and mental health domains . Percentage changes in glucostatic parameters , discontinuation of glucose 
    Output:
    
agent
Only outcomes of the IWQoL , SF-36 and OWQoL show QoL outcomes that exceed community norms .
The QoL is increased after bariatric surgery on both the short and long term .
However , due to the heterogeneity of the studies and the generality of the question naires is it hard to make a distinction between different surgeries and difficult to see a relation with medical profit .
***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: BACKGROUND We analyzed the health-related quality of life ( HRQOL ) and its determinants in the first year after laparoscopic adjustable gastric b and ing ( LAGB ) .  The setting was 10 Italian public and private bariatric surgery centers . METHODS Data collected in an ongoing , prospect i ve , 3-year multicenter Italian study on the changes in HRQOL after LAGB were used . HRQOL was investigated using the Medical Outcomes Study Short-Form 36 question naire . Hunger , satiety , and the self-perceived effects of LAGB  were recorded . RESULTS A total of 334 patients were enrolled . The follow-up rate was 92.2 % . The percentage of excess weight loss was 39.6 % ± 25.8 % , with very few side effects or complications . Hunger in the morning ( 0 - 10 scale ) was 4.5 ± 2.7 before surgery and 3.8 ± 2.4 after 1 year ( P < .001 ) . Satiety after a meal ( 0 - 10 scale ) was 7.1 ± 2.7 before surgery and 8.2 ± 1.9 at 1 year ( P < .001 ) . The self-perceived effect of LAGB on caloric intake ( 0 - 10 scale ) was 8.4 ± 1.9 after 1 year . The scores for the 8 Medical Outcomes Study Short-Form 36 subscales were significantly improved after surgery . The physical component summary score was 52.6 ± 11.9 at baseline and 79.1 ± 15.6 after 1 year ( P < .001 ) . The corresponding mental component summary scores were 52.2 ± 12.3 and 76.5 ± 17.2 ( P < .001 ) . Greater physical component summary improvement was independently associated with a low initial physical component summary ( P < .001 ) , high satiety ( P = .002 ) , a high percentage of excess weight loss ( P = .013 ) , and a high self-perceived effect of the LAGB ( P = .026 ) . Greater mental component summary improvement was associated with a low initial mental component summary ( P < .001 ) , high satiety ( P < .001 ) , a low frequency of heartburn ( P = .004 ) , and a high percentage of excess weight loss ( P = .012 ) . CONCLUSIONS Significant improvements in HRQOL were observed in the first year after LAGB . A poor baseline HRQOL , a high efficacy of the b and ing in eating control , and better weight loss might influence HRQOL changes BACKGROUND Improvements in health-related quality of life ( HR-QoL ) occur after  bariatric surgery .  However , sustainability of these changes over time remains debated . METHODS Data collected in a prospect i ve 3-year multicenter Italian study on changes of HR-QoL after laparoscopic adjustable gastric b and ing were used .  HR-QoL has investigated with the SF-36 question naire .  Hunger , satiety , and the self-perceived effects of LAGB were recorded . RESULTS A total of 230 patients ( 53 male and 177 female ) were analyzed . Body mass index was 41.4±5.4 kg/m2 at baseline , declined to 33.8±5.8 kg/m2 12 months after surgery ( P<.001 ) , and further reduced to 31.9±5.1 kg/m2 36 months after surgery ( P<.001 versus 12 months ) . Scores in the SF-36 subscales were lower than in the general Italian population at baseline . The physical component summary score was 51.9±11.6 at baseline , improved to 79.2±15.4 at 12 months ( P<.001 ) , and stabilized to 79.8±15.6 at 36 months . The mental summary score was 52.3±11.8 at baseline , improved to 75.2±17.3 at 12 months ( P<.001 ) , and stabilized to 74.2±17.5 at 36 months . A decline>10 points between 12 and 36 months in the summary scores was observed in 22.0 % of the patients for PCS and in 26.8 % for MCS . In a multiple linear regression analysis , deterioration in HR-QoL in the 12 - 36 months period was associated to the presence of better HR-QoL values at 12 months and to a more pronounced reduction of the self-perceived effect of the b and ing at 36 months . CONCLUSION Improvements in HR-QoL observed in the first year after surgery maintained up to the third year after gastric b and ing BACKGROUND Being overweight or obese has substantial effects on individuals ' perceptions of their health and quality of life ( QoL ) . Generic measures often miss important QoL information , and existing obesity-specific instruments have shortcomings with respect to cross-cultural input , application to differing levels of severity , conceptual clarity , and patient burden . OBJECTIVE This study aim ed to develop culturally sensitive measures of QoL and symptoms in overweight or obese persons , both those trying to lose weight and those not trying to lose weight . METHODS Currently accepted criteria and guidelines for question naire development were streamlined and augmented to include cross-cultural input from 5 European countries and the United States . The preliminary pool of items was created based on qualitative interviews conducted in the United States , followed by an early check of item translatability and preharmonization across all language s. Ten additional qualitative in-country interviews were then conducted to produce further culture-specific items . This was followed by 2 forward and 1 backward translation , plus cognitive debriefing interviews in each country . Finally , an exp and ed international harmonization meeting was held to ensure inclusion of appropriate new items and their acceptability across all 6 cultures . RESULTS The procedures described result ed in development of the 41-item Obesity and Weight Loss Quality of Life question naire and the 20-item Weight-Related Symptom Measure . These question naires are subject to further psychometric validation . CONCLUSIONS Augmentation of the initial item-generation and international harmonization steps of question naire development through integration of cross-cultural input allowed greater validity of cross-cultural content while meeting time , budget , and re source constraints Background Severe obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life ( HRQoL ) . In addition to physiological factors , activity and participation , environmental factors , and personal factors are related to an individual ’s overall quality of life HRQoL. In Norway , a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management . The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course  , and explored how well sociodemographic variables , paid work , social support , personal factors , and surgery predicted HRQoL at 12-month follow-up . Methods A single-group longitudinal study was conducted . Data were collected by self-reported question naires . This article reports on those who had completed the question naire at the 12-month ( n = 69 ) follow-up . HRQoL was assessed with the EQ-5D . Other st and ardized instruments measured employment , social support , self-efficacy , and surgery . Results At the 12-month follow-up , participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS . Generalized linear model showed that having paid work , and social support were statistically significant predictors of HRQoL at the 12-month follow-up . Sex , self-efficacy , and surgery were not statistically significant associated with HRQoL. Conclusions Participation in paid work , and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL  in obese people 12 months after participating in a learning and mastery course . Trial registration The study is registered in Clinical Trials : NCT01336725 BACKGROUND There is a lack of adequate prospect i ve data on quality -of-life ( QOL ) and its predictors in patients undergoing laparoscopic sleeve gastrectomy ( LSG ) .  The aim of this study was to assess longitudinal changes in QOL after LSG with the use of the obesity-specific Moorehead-Ardelt II question naire ( MAII ) and to identify clinical parameters associated with QOL outcome . METHODS Morbidly obese patients consecutively admitted for LSG , over a 30-month period , were prospect ively studied . QOL was assessed using the vali date d Greek version of the MAII question naire and a visual analogueue scale ( VAS ) , preoperatively and at 6 , 12 , and 24 months postoperatively . Anthropometric data and obesity-related co-morbidities were recorded . RESULTS A total of 111 patients with a mean age 36.8±9.2 years were included . Mean preoperative body mass index ( BMI ) was 49.1±7.5 kg/m2 . Percentage excess BMI loss ( % EBL ) was 51.1±14.9 , 64.2±17.9 and 66.4±18.0 at 6 , 12 , and 24 months , respectively . Postoperatively , all obesity-related co-morbidities were significantly improved . MAII score increased from -.40±1.30 preoperatively to 1.75±.83 , 2.18±.80 , and 1.95±.71 at 6 , 12 , and 24 months postoperatively ( trend P<.001 ) . Preoperative median ( interquartile range ) VAS was 3 ( 1 ) increasing to 9 ( 2 ) , 10 ( 1 ) , and 9 ( 1 ) at 6 , 12 , and 24 months postoperatively ( P<.001 ) . % EBL and reduction in obesity-related co-morbidities , especially resolution of diabetes and sleep apnea , correlated significantly with higher QOL during the course of the study . CONCLUSION LSG , a safe and effective bariatric operation , results in sustained weight loss and significant improvements in QOL . Both weight loss and amelioration of co-morbidities contribute to higher level of postsurgical QOL BACKGROUND Few weight loss surgery trials have evaluated the changes in health-related quality of life ( HRQOL ) relative to obese individuals not participating in weight loss interventions . In a prospect i ve study at a bariatric surgery practice , we evaluated the 2-year changes in HRQOL in gastric bypass patients compared with 2 severely obese groups who did not undergo surgical weight loss .  METHODS A total of 308 gastric bypass patients were compared with 253 individuals who sought but did not undergo gastric bypass and 272 population -based obese individuals using the weight-related ( Impact of Weight on Quality of Life-Lite ) and general ( Medical Outcomes Study 36-item Short-Form Health Survey ) HRQOL question naires at baseline and 2 years of follow-up . RESULTS The percentage of weight loss was 34.2 % for the gastric bypass and 1.4 % for the no gastric bypass groups , with a .5 % gain for population -based obese group . Both measures of HRQOL showed greater improvements for the gastric bypass group , even after controlling for baseline differences . Effect sizes for changes in physical and weight-related HRQOL were very large for gastric bypass , but small to medium for the 2 comparison groups . Effect sizes for changes in the psychosocial aspects of HRQOL were moderate to very large for gastric bypass , but small for the 2 comparison groups . Of the gastric bypass patients , 97 % had meaningful improvements in the Impact of Weight on Quality of Life-Lite total score compared with 43 % of the no gastric bypass group and 30 % of the population -based obese group . CONCLUSION Dramatic improvements had occurred in weight-related and physical HRQOL for gastric bypass patients at 2 years after surgery compared with 2 severely obese groups who had not undergone surgery . These results support the effectiveness of gastric bypass surgery in improving patients ' HRQOL Objective To evaluate the impact of Roux-en-Y gastric bypass ( RYGB ) on quality of life in obese diabetic patients compared to st and ard medical therapy for type 2 diabetes mellitus . Methods We prospect ively studied two matched obese population s with type 2 diabetes . Thirty patients underwent laparoscopic RYGB and 31 received st and ard medical therapy combined with a diabetes support and education program ( DSE ) , consisting of educational sessions on diet and exercise . Groups were matched by age , gender , weight , glucostatic parameters , and use of glucose-lowering medications ( oral agents and insulin therapy ) . Health-related quality of life ( HRQOL ) was assessed using the normalized SF-36 question naire , and data were collected at baseline and at 12-month follow-up . Results Diabetic patients who underwent RYGB experienced a statistically significant increase in their overall HRQOL . However , the role-physical and mental health domains increased but did not reach statistical significance . Diabetic patients in the medical therapy and DSE group did not show any significant increase in HRQOL . The between-group differences for the HRQOL changes from baseline were significant , other than for role-physical and mental health domains . Percentage changes in glucostatic parameters , discontinuation of glucose 
    Output:
    