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 Bariatric surgery is a powerful treatment of severe obesity . During the past several years , a greater appreciation for the need for multidisciplinary care to optimize outcomes has developed , and a number of studies have been started to examine the role of postoperative interventions used in combination with surgery . The purpose of the present study was to investigate the hypothesis that the provision of postoperative dietary counseling , delivered by a registered dietitian , would lead to greater weight loss and more positive improvements in dietary intake and eating behavior compared with st and ard postoperative care . The study was performed at an academic medical center . METHODS Eighty-four individuals who underwent bariatric surgery were r and omly assigned to receive either dietary counseling or st and ard postoperative care for the first 4 months after surgery . The participants completed measures of macronutrient intake and eating behavior at baseline and 2 , 4 , 6 , 12 , 18 , and 24 months after surgery . RESULTS The patients who received dietary counseling achieved greater weight loss than those who received st and ard postoperative care that did not involve this counseling , although this difference did not reach statistical significance . Patients in the dietary counseling arm did report significant changes in several eating behaviors believed to be important to successful long-term weight maintenance . CONCLUSION The results of our pilot study provide some support for the efficacy of early postoperative dietary counseling to improve outcomes after bariatric surgery ABSTRACT The purpose of this study was to examine the effect of a 12-week resistance training programme on fat-free mass ( FFM ) , muscle cross-sectional area , muscular strength and muscle quality in women who underwent Roux-en-Y gastric bypass surgery . Participants were 16 women ( mean age = 44.9 ± 10.2 years ) from bariatric surgical groups who were r and omly assigned into either a  control or an intervention group  . Air displacement plethysmography measured FFM and magnetic resonance imaging measured quadriceps muscle cross-sectional area and whole thigh muscle cross-sectional area . Muscular strength and quality was assessed using an estimated 1-Repetition Maximum assessment . All measurements were collected twice , at baseline and at a 12-week follow-up . There were significantly greater improvements in leg press strength ( mean differences = 55.4 % , P < 0.001 , Cohen ’s d = 2.4 ) , leg extension strength ( mean differences = 18.0 % , P = 0.014 , Cohen ’s d = 0.86 ) and leg press muscle quality ( mean differences = 54.5 % , P < 0.001 , Cohen ’s d = 1.9 ) in the intervention group compared to the control group following the resistance training programme . The resistance training intervention significantly improved muscular strength and quality ; however , it did not illicit changes in FFM or muscle cross-sectional area in women who underwent Roux-en-Y gastric bypass surgery OBJECTIVE Bariatric surgery results in significant weight loss and reduces cardiovascular morbidity . However , a large variation in postsurgery weight loss is seen . Physical activity promotes weight loss in nonsurgically treated subjects with obesity . The aim of this study was to investigate the effects of 6 months of supervised physical training following Roux-en-Y gastric bypass surgery ( RYGB ) on body weight and cardiovascular risk markers . METHODS Sixty participants eligible for RYGB were included . Six months post surgery , the participants were r and omly assigned to either twice-weekly supervised physical training sessions in a fitness center ( INT ) or a control group ( CON ) for 26 weeks . Before surgery and 6 , 12 , and 24 months after surgery , the participants underwent an examination program that included  anthropometric measurements , blood pressure , heart rate , blood sample s  , and an  abdominal computed tomography scan .  RESULTS RYGB significantly reduced body weight and improved cardiovascular risk markers ( all P < 0.01 ) . The supervised physical training intervention result ed in a 4.2-kg ( CI : -0.2 to -8.3 kg ) lower body weight in INT compared with CON at the study end ( P = 0.042 ) . The high-density lipoprotein concentration was significantly higher in INT than in CON at the termination of the intervention , but this was not maintained at the 24-months examination . CONCLUSIONS Physical training following RYGB improves weight loss and cardiovascular health Higher preoperative physical activity ( PA ) strongly predicts higher post-operative PA in bariatric surgery ( BS ) patients , providing rationale for preoperative PA interventions ( PAIs ) . However , whether PAI-related increases can be maintained post-operatively has not been examined . This study compared PA changes across pre- ( baseline , post-intervention ) and post-operative ( 6-month follow up ) periods in participants r and omized to 6 weeks of preoperative PAI or st and ard care control ( SC ) . Of 75 participants initially r and omized , 36 ( PAI n=22 ; SC n=14 ) underwent BS .  Changes in daily bout-related ( ⩾10-min bouts ) moderate-to-vigorous PA ( MVPA ) and steps were assessed via the SenseWear Armb and monitor . PAI received weekly counseling to increase walking exercise . Retention ( 86 % ) at post-operative follow up was similar between groups . Intent-to-treat analyses showed that PAI vs SC had greater increases across time ( baseline , post-intervention , follow up ) in bout-related MVPA minutes/day ( 4.3±5.1 , 26.3±21.3 , 28.7±26.3 vs 10.4±22.9 , 11.4±16.0 , 18.5±28.2 ; P=0.013 ) and steps/day ( 5163±2901 , 7950±3286 , 7870±3936 vs 5163±2901 , 5601±3368 , 5087±2603 ; P<0.001 ) . PAI differed from SC on bout-related MVPA at post-intervention ( P=0.016 ; d=0.91 ) , but not follow up ( P=0.15 ; d=0.41 ) , and steps at post-intervention ( P=0.031 ; d=0.78 ) and follow up ( P=0.024 ; d=0.84 ) . PAI participants maintained preoperative PA increases post-operatively . Findings support preoperative PAIs and research to test whether PA changes can be sustained and influence surgical outcomes beyond the initial post-operative period Importance Bariatric surgery is a life-changing treatment for patients with severe obesity , but little is known about its association with interpersonal relationships . Objectives To investigate if relationship status is altered after bariatric surgery . Design , Setting , and Participants Changes in relationship status after bariatric surgery were examined in 2 cohorts : ( 1 ) the prospect i ve Swedish Obese Subjects ( SOS ) study , which recruited patients undergoing bariatric surgery from September 1 , 1987 , to January 31 , 2001 , and compared their care with usual nonsurgical care in matched obese control participants ; and ( 2 ) participants from the Sc and inavian Obesity Surgery Registry ( SOReg ) , a prospect i ve , electronically captured register that recruited patients from January 2007 through December 2012 and selected comparator participants from the general population matched on age , sex , and place of residence . Data was collected in surgical departments and primary health care centers in Sweden . The current analysis includes data collected up until July 2015 ( SOS ) and December 2012 ( SOReg ) . Data analysis was completed from June 2016 to December 2017 . Main Outcomes and Measures In the SOS study , information on relationship status was obtained from question naires . In the SOReg and general population cohort , information on marriage and divorce was obtained from the Swedish Total Population Registry . Results The SOS study included 1958 patients who had bariatric surgery ( of whom 1389 [ 70.9 % ] were female ) and 1912 matched obese controls ( of whom 1354 [ 70.8 % ] were female ) and had a median ( range ) follow-up of 10 ( 0.5 - 20 ) years . The SOReg cohort included 29 234 patients who had gastric bypass surgery ( of whom 22 131 [ 75.6 % ] were female ) and 283 748 comparators from the general population ( of whom 214 342 [ 75.5 % ] were female ) , and had a median ( range ) follow-up of 2.9 ( 0.003 - 7.0 ) years . In the SOS study , the surgical patients received gastric b and ing ( n = 368 ; 18.8 % ) , vertical b and ed gastroplasty ( n = 1331 ; 68.0 % ) , or gastric bypass ( n = 259 ; 13.2 % ) ; controls received usual obesity care . In SOReg , all 29 234 surgical participants received gastric bypass surgery . In the SOS study , bariatric surgery was associated with increased incidence of divorce/separation compared with controls for those in a relationship ( adjusted hazard ratio [ aHR ] = 1.28 ; 95 % CI , 1.03 - 1.60 ; P = .03 ) and increased incidence of marriage or new relationship ( aHR = 2.03 ; 95 % CI , 1.52 - 2.71 ; P < .001 ) in those who were unmarried or single at baseline . In the SOReg and general population cohort , gastric bypass was associated with increased incidence of divorce compared with married control participants ( aHR = 1.41 ; 95 % CI , 1.33 - 1.49 ; P < .001 ) and increased incidence of marriage in those who were unmarried at baseline ( aHR = 1.35 ; 95 % CI , 1.28 - 1.42 ; P < .001 ) . Within the surgery groups , changes in relationship status were more common in those with larger weight loss . Conclusions and Relevance In addition to its association with obesity comorbidities , bariatric surgery – induced weight loss is also associated with changes in relationship status Background We have previously reported on the benefits of Pre-Surgical Exercise Training ( PreSET ) on physical fitness and social interactions in subjects awaiting bariatric surgery ( BS ) . However , data are needed to know whether these benefits are maintained post-BS . Objectives The purpose of this paper was to evaluate the effect of PreSET on physical activity ( PA ) level , physical fitness , PA barriers , and quality of life ( QoL ) 1 year ( 1-Y ) after BS . Methods Of the 30 participants r and omized into two groups ( PreSET and usual care ) , 25 were included in the final analysis . One year after BS , time spent in different PA intensities and number of steps were assessed with an accelerometer . Before BS and until 1-Y after BS , physical fitness was assessed with  symptom-limited cardiac exercise test , 6-min walk test ( 6MWT ) , and sit-to-st and , half-squat , and arm curl tests . QoL , PA barriers , and PA level were evaluated with question naires . Results The number of steps ( 7460 vs 4287 ) and time spent in light ( 3.2 vs 2.2 h/day ) and moderate ( 0.6 vs 0.3 h/day ) PA were higher in the PreSET group 1-Y after BS . The changes in 6MWT heart cost ( 1.3 vs 0.6 m/beats/min ) , half-squat test ( 38.8 vs 10.3 s ) , and BMI ( − 16.8 vs − 13.5 kg/m2 ) were significantly greater in the PreSET group compared to those in the usual care group . No other significant difference between groups was observed . Conclusion The addition of the PreSET to individual lifestyle counseling seems effective to improve PA level and submaximal physical fitness 1-Y after BS . Studies with larger cohorts are now required to confirm these results .The trial was registered at clinical trials.gov ( NCT01452230 ) BACKGROUND AND AIMS Obesity and physical inactivity are both associated with low- grade inflammation and endothelial dysfunction .  Bariatric surgery improves markers of inflammation and endothelial function , but it is unknown if physical training after bariatric surgery can improve these markers even further . Therefore , we aim ed to investigate the effects of Roux-en-Y gastric bypass ( RYGB ) followed by physical training on markers of low- grade inflammation and endothelial function . METHODS Sixty patients approved for RYGB underwent examinations pre-surgery , 6 , 12 , and 24 months post-surgery . Six months post-surgery , they were r and omized 1:1 to an intervention group or a control group . The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks . Fasting blood sample s were analyzed for concentrations of interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , intercellular adhesion molecule 1 ( ICAM-1 ) , tissue-type plasminogen activator antigen ( t-PA : Ag ) and von Willebr and factor ( vWF ) . RESULTS RYGB markedly improved markers of inflammation ( IL-6 , CRP ) ( p 
    Output:
    
agent
Preoperative and post-operative intensive interventions improved symptoms of depression and anxiety , quality of life , diastolic blood pressure , and resting heart rate but not lipids or glycaemic measures .
***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 Bariatric surgery is a powerful treatment of severe obesity . During the past several years , a greater appreciation for the need for multidisciplinary care to optimize outcomes has developed , and a number of studies have been started to examine the role of postoperative interventions used in combination with surgery . The purpose of the present study was to investigate the hypothesis that the provision of postoperative dietary counseling , delivered by a registered dietitian , would lead to greater weight loss and more positive improvements in dietary intake and eating behavior compared with st and ard postoperative care . The study was performed at an academic medical center . METHODS Eighty-four individuals who underwent bariatric surgery were r and omly assigned to receive either dietary counseling or st and ard postoperative care for the first 4 months after surgery . The participants completed measures of macronutrient intake and eating behavior at baseline and 2 , 4 , 6 , 12 , 18 , and 24 months after surgery . RESULTS The patients who received dietary counseling achieved greater weight loss than those who received st and ard postoperative care that did not involve this counseling , although this difference did not reach statistical significance . Patients in the dietary counseling arm did report significant changes in several eating behaviors believed to be important to successful long-term weight maintenance . CONCLUSION The results of our pilot study provide some support for the efficacy of early postoperative dietary counseling to improve outcomes after bariatric surgery ABSTRACT The purpose of this study was to examine the effect of a 12-week resistance training programme on fat-free mass ( FFM ) , muscle cross-sectional area , muscular strength and muscle quality in women who underwent Roux-en-Y gastric bypass surgery . Participants were 16 women ( mean age = 44.9 ± 10.2 years ) from bariatric surgical groups who were r and omly assigned into either a  control or an intervention group  . Air displacement plethysmography measured FFM and magnetic resonance imaging measured quadriceps muscle cross-sectional area and whole thigh muscle cross-sectional area . Muscular strength and quality was assessed using an estimated 1-Repetition Maximum assessment . All measurements were collected twice , at baseline and at a 12-week follow-up . There were significantly greater improvements in leg press strength ( mean differences = 55.4 % , P < 0.001 , Cohen ’s d = 2.4 ) , leg extension strength ( mean differences = 18.0 % , P = 0.014 , Cohen ’s d = 0.86 ) and leg press muscle quality ( mean differences = 54.5 % , P < 0.001 , Cohen ’s d = 1.9 ) in the intervention group compared to the control group following the resistance training programme . The resistance training intervention significantly improved muscular strength and quality ; however , it did not illicit changes in FFM or muscle cross-sectional area in women who underwent Roux-en-Y gastric bypass surgery OBJECTIVE Bariatric surgery results in significant weight loss and reduces cardiovascular morbidity . However , a large variation in postsurgery weight loss is seen . Physical activity promotes weight loss in nonsurgically treated subjects with obesity . The aim of this study was to investigate the effects of 6 months of supervised physical training following Roux-en-Y gastric bypass surgery ( RYGB ) on body weight and cardiovascular risk markers . METHODS Sixty participants eligible for RYGB were included . Six months post surgery , the participants were r and omly assigned to either twice-weekly supervised physical training sessions in a fitness center ( INT ) or a control group ( CON ) for 26 weeks . Before surgery and 6 , 12 , and 24 months after surgery , the participants underwent an examination program that included  anthropometric measurements , blood pressure , heart rate , blood sample s  , and an  abdominal computed tomography scan .  RESULTS RYGB significantly reduced body weight and improved cardiovascular risk markers ( all P < 0.01 ) . The supervised physical training intervention result ed in a 4.2-kg ( CI : -0.2 to -8.3 kg ) lower body weight in INT compared with CON at the study end ( P = 0.042 ) . The high-density lipoprotein concentration was significantly higher in INT than in CON at the termination of the intervention , but this was not maintained at the 24-months examination . CONCLUSIONS Physical training following RYGB improves weight loss and cardiovascular health Higher preoperative physical activity ( PA ) strongly predicts higher post-operative PA in bariatric surgery ( BS ) patients , providing rationale for preoperative PA interventions ( PAIs ) . However , whether PAI-related increases can be maintained post-operatively has not been examined . This study compared PA changes across pre- ( baseline , post-intervention ) and post-operative ( 6-month follow up ) periods in participants r and omized to 6 weeks of preoperative PAI or st and ard care control ( SC ) . Of 75 participants initially r and omized , 36 ( PAI n=22 ; SC n=14 ) underwent BS .  Changes in daily bout-related ( ⩾10-min bouts ) moderate-to-vigorous PA ( MVPA ) and steps were assessed via the SenseWear Armb and monitor . PAI received weekly counseling to increase walking exercise . Retention ( 86 % ) at post-operative follow up was similar between groups . Intent-to-treat analyses showed that PAI vs SC had greater increases across time ( baseline , post-intervention , follow up ) in bout-related MVPA minutes/day ( 4.3±5.1 , 26.3±21.3 , 28.7±26.3 vs 10.4±22.9 , 11.4±16.0 , 18.5±28.2 ; P=0.013 ) and steps/day ( 5163±2901 , 7950±3286 , 7870±3936 vs 5163±2901 , 5601±3368 , 5087±2603 ; P<0.001 ) . PAI differed from SC on bout-related MVPA at post-intervention ( P=0.016 ; d=0.91 ) , but not follow up ( P=0.15 ; d=0.41 ) , and steps at post-intervention ( P=0.031 ; d=0.78 ) and follow up ( P=0.024 ; d=0.84 ) . PAI participants maintained preoperative PA increases post-operatively . Findings support preoperative PAIs and research to test whether PA changes can be sustained and influence surgical outcomes beyond the initial post-operative period Importance Bariatric surgery is a life-changing treatment for patients with severe obesity , but little is known about its association with interpersonal relationships . Objectives To investigate if relationship status is altered after bariatric surgery . Design , Setting , and Participants Changes in relationship status after bariatric surgery were examined in 2 cohorts : ( 1 ) the prospect i ve Swedish Obese Subjects ( SOS ) study , which recruited patients undergoing bariatric surgery from September 1 , 1987 , to January 31 , 2001 , and compared their care with usual nonsurgical care in matched obese control participants ; and ( 2 ) participants from the Sc and inavian Obesity Surgery Registry ( SOReg ) , a prospect i ve , electronically captured register that recruited patients from January 2007 through December 2012 and selected comparator participants from the general population matched on age , sex , and place of residence . Data was collected in surgical departments and primary health care centers in Sweden . The current analysis includes data collected up until July 2015 ( SOS ) and December 2012 ( SOReg ) . Data analysis was completed from June 2016 to December 2017 . Main Outcomes and Measures In the SOS study , information on relationship status was obtained from question naires . In the SOReg and general population cohort , information on marriage and divorce was obtained from the Swedish Total Population Registry . Results The SOS study included 1958 patients who had bariatric surgery ( of whom 1389 [ 70.9 % ] were female ) and 1912 matched obese controls ( of whom 1354 [ 70.8 % ] were female ) and had a median ( range ) follow-up of 10 ( 0.5 - 20 ) years . The SOReg cohort included 29 234 patients who had gastric bypass surgery ( of whom 22 131 [ 75.6 % ] were female ) and 283 748 comparators from the general population ( of whom 214 342 [ 75.5 % ] were female ) , and had a median ( range ) follow-up of 2.9 ( 0.003 - 7.0 ) years . In the SOS study , the surgical patients received gastric b and ing ( n = 368 ; 18.8 % ) , vertical b and ed gastroplasty ( n = 1331 ; 68.0 % ) , or gastric bypass ( n = 259 ; 13.2 % ) ; controls received usual obesity care . In SOReg , all 29 234 surgical participants received gastric bypass surgery . In the SOS study , bariatric surgery was associated with increased incidence of divorce/separation compared with controls for those in a relationship ( adjusted hazard ratio [ aHR ] = 1.28 ; 95 % CI , 1.03 - 1.60 ; P = .03 ) and increased incidence of marriage or new relationship ( aHR = 2.03 ; 95 % CI , 1.52 - 2.71 ; P < .001 ) in those who were unmarried or single at baseline . In the SOReg and general population cohort , gastric bypass was associated with increased incidence of divorce compared with married control participants ( aHR = 1.41 ; 95 % CI , 1.33 - 1.49 ; P < .001 ) and increased incidence of marriage in those who were unmarried at baseline ( aHR = 1.35 ; 95 % CI , 1.28 - 1.42 ; P < .001 ) . Within the surgery groups , changes in relationship status were more common in those with larger weight loss . Conclusions and Relevance In addition to its association with obesity comorbidities , bariatric surgery – induced weight loss is also associated with changes in relationship status Background We have previously reported on the benefits of Pre-Surgical Exercise Training ( PreSET ) on physical fitness and social interactions in subjects awaiting bariatric surgery ( BS ) . However , data are needed to know whether these benefits are maintained post-BS . Objectives The purpose of this paper was to evaluate the effect of PreSET on physical activity ( PA ) level , physical fitness , PA barriers , and quality of life ( QoL ) 1 year ( 1-Y ) after BS . Methods Of the 30 participants r and omized into two groups ( PreSET and usual care ) , 25 were included in the final analysis . One year after BS , time spent in different PA intensities and number of steps were assessed with an accelerometer . Before BS and until 1-Y after BS , physical fitness was assessed with  symptom-limited cardiac exercise test , 6-min walk test ( 6MWT ) , and sit-to-st and , half-squat , and arm curl tests . QoL , PA barriers , and PA level were evaluated with question naires . Results The number of steps ( 7460 vs 4287 ) and time spent in light ( 3.2 vs 2.2 h/day ) and moderate ( 0.6 vs 0.3 h/day ) PA were higher in the PreSET group 1-Y after BS . The changes in 6MWT heart cost ( 1.3 vs 0.6 m/beats/min ) , half-squat test ( 38.8 vs 10.3 s ) , and BMI ( − 16.8 vs − 13.5 kg/m2 ) were significantly greater in the PreSET group compared to those in the usual care group . No other significant difference between groups was observed . Conclusion The addition of the PreSET to individual lifestyle counseling seems effective to improve PA level and submaximal physical fitness 1-Y after BS . Studies with larger cohorts are now required to confirm these results .The trial was registered at clinical trials.gov ( NCT01452230 ) BACKGROUND AND AIMS Obesity and physical inactivity are both associated with low- grade inflammation and endothelial dysfunction .  Bariatric surgery improves markers of inflammation and endothelial function , but it is unknown if physical training after bariatric surgery can improve these markers even further . Therefore , we aim ed to investigate the effects of Roux-en-Y gastric bypass ( RYGB ) followed by physical training on markers of low- grade inflammation and endothelial function . METHODS Sixty patients approved for RYGB underwent examinations pre-surgery , 6 , 12 , and 24 months post-surgery . Six months post-surgery , they were r and omized 1:1 to an intervention group or a control group . The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks . Fasting blood sample s were analyzed for concentrations of interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , intercellular adhesion molecule 1 ( ICAM-1 ) , tissue-type plasminogen activator antigen ( t-PA : Ag ) and von Willebr and factor ( vWF ) . RESULTS RYGB markedly improved markers of inflammation ( IL-6 , CRP ) ( p 
    Output:
    