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: The incidence of asthma has been positively associated with obesity . Asthma comprises diverse “ phenotypes ” reflecting heterogeneity in a number of characteristics , including response to therapy . The present authors examined whether body mass index ( BMI ) influenced the response to placebo , as well as to two asthma controller medications . A post hoc analysis was performed , pooling data from four double-blind , placebo-controlled studies r and omising 3,073 moderate asthmatic adults to montelukast ( n = 1,439 ) , beclomethasone ( n = 894 ) or placebo ( n = 740 ) . The primary end point was asthma control days ; other end points were forced expiratory volume in one second , β-agonist use and nocturnal awakening . Analyses were conducted using BMI classification into normal ( < 25.0 kg·m−2 ; 52 % of patients ) , overweight ( 25–29.9 kg·m−2 ; 32 % ) and obese ( ≥30.0 kg·m−2 ; 16 % ) categories , as well as BMI as a continuous variable . The treatment groups were balanced for BMI , demographic characteristics and parameters of asthma control .  The placebo response for all end points was generally lower with increasing BMI . Similarly , the response to the inhaled corticosteroid decreased , whereas the response to the leukotriene antagonist remained stable . In conclusion , post hoc data from the present study suggested that body mass index may influence the natural history of asthma control ( as reflected by response to placebo ) and may differentially influence response to the two active agents , warranting explicit testing in future prospect i ve studies BACKGROUND Maternal intake of vitamin D in pregnancy is a potentially modifiable but understudied risk factor for the development of asthma in children . OBJECTIVE We investigated whether maternal vitamin D intake in pregnancy is associated with decreased risks of  wheezing symptoms in young children . DESIGN Subjects were from a birth cohort recruited in utero with the primary objective of identifying associations between maternal diet during pregnancy and asthma and allergies in children . A r and om sample of 2000 healthy pregnant women was recruited while attending antenatal clinics at the Aberdeen Maternity Hospital , Scotl and , at approximately 12 wk gestation . Maternal vitamin D intake was ascertained from a food-frequency question naire completed at 32 wk of gestation . The main outcome measures were wheezing symptoms , spirometry , bronchodilator response , atopic sensitization , and exhaled nitric oxide at 5 y. RESULTS Respiratory details through 5 y and maternal food-frequency- question naire data were available for 1212 children . In models adjusted for potential confounders , including the children 's vitamin D intake , a comparison of the highest and lowest quintiles of maternal total vitamin D intake conferred lower risks for ever wheeze [ odds ratio ( OR ) : 0.48 ; 95 % CI : 0.25 , 0.91 ] , wheeze in the previous year ( OR : 0.35 ; 95 % CI : 0.15 , 0.83 ) , and persistent wheeze ( OR : 0.33 ; 95 % CI : 0.11 , 0.98 ) in 5-y-old children . In addition , lower maternal total vitamin D intakes in pregnancy were also associated with decreased bronchodilator response ( P = 0.04 ) . No associations were observed between maternal  vitamin D intakes and spirometry or exhaled nitric oxide concentrations . CONCLUSION Increasing maternal vitamin D intakes during pregnancy may decrease the risk of wheeze symptoms in early childhood OBJECTIVE To estimate the independent contribution of birth weight to asthma prevalence among children younger than 4 years in the United States and to compare the magnitude of its effect on asthma between African American and white children . DESIGN Cross-sectional analysis using the 1988 National Maternal-Infant Health Survey and 1991 Longitudinal Follow-up Survey . SETTING United States . PATIENTS Eight thous and seventy-one subjects , selected from a r and omized , systematic population -based sample and weighted to be nationally representative , who completed both initial and longitudinal follow-up surveys and reported information on asthma diagnosis . MAIN OUTCOME MEASURES Birth weight and other sociodemographic factors linked to birth outcome were analyzed for independent association with physician-diagnosed asthma by age 3 years . RESULTS The prevalence of asthma varied by birth weight category : 6.7 % in children 2500 g or more at birth , 10.9 % in children 1500 to 2499 g at birth , and 21.9 % in children less than 1500 g at birth ( very low birth weight [ VLBW ] ) ( P<.001 ) . Some of the characteristics shown to be independently associated with asthma included : VLBW ( odds ratio [ OR ] , 2.9 ; 95 % confidence interval [ CI ] , 2.3 - 3.6 ) , moderately low birth weight ( OR , 1.4 ; 95 % CI , 1.1 - 1.8 ) , and African American race ( OR , 1.9 ; 95 % CI , 1.6 - 2.4 ) . In stratified analyses , the independent association between VLBW and asthma in white and African American population s was : OR(white ) , 3.1 ( 95 % CI , 2.2 - 4.3 ) and OR(African American ) , 2.5 ( 95 % CI , 2.0 - 3.3 ) . The prevalence of VLBW , however , was tripled in African American compared with white children ( 1.8 % vs 0.6 % ) . CONCLUSIONS These data confirm findings of other studies that identify a strong independent association between low birth weight and asthma . For this 1988 national birth cohort , an estimated 4000 excess asthma cases were attributable to birth weight less than 2500 g. Although the strength of the independent association between VLBW and asthma was smaller in the African American population , the substantially increased prevalence of VLBW in this community may contribute to the disproportionately increased prevalence of asthma among African American children AIM Gastroesophageal reflux disease ( GERD ) is a common disorder in the Western population , but detailed population -based data in China are limited . The aim of this study was to underst and the epidemiology of symptomatic gastroesophageal reflux ( SGER ) in adults of Xi'an , a northwestern city of China , and to explore the potential risk factors of GERD . METHODS Symptoms suggestive of GERD , functional dyspepsia ( FD ) , irritable bowel syndrome ( IBS ) , upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified r and om sample s of 2789 residents aged 18 - 70 years in Xi'an by using a st and ardized  question naire . METHODS With a response rate of 91.8 % , the prevalence of SGER was 16.98 % ( 95 % CI , 14.2 - 18.92 ) in Xi'an adults , and no gender-related difference was observed ( P<0.05 ) . SGER was more common among subjects aged 30 - 70 years than in those aged 18 - 29 years ( P<0.01 ) . The prevalence of SGER in rural , urban and suburban subjects was 21.07 % , 17.44 % and 12.12 % , respectively , and there was a significant difference between rural , urban and suburban regions ( P<0.05 ) . Compared with subjects without SGER , the prevalence of symptoms suggestive of FD and IBS , pneumonia , asthma , bronchitis , laryngitis , pharyngitis , chronic cough , wheeze , globus sensation , oral ulcer and snore was significantly increased in subjects with SGER ( P<0.01 ) . Heavy smoking ( OR=5.76 ; CI , 3.70 - 6.67 ) , heavy alcohol use ( OR=2.85 ; CI , 1.67 - 4.49 ) , peptic ulcer ( OR=5.76 ; CI , 3.99 - 8.32 ) , cerebral palsy ( OR=3.97 ; CI , 1.97 - 8.00 ) , abdominal operation ( OR=2.69 ; CI , 1.75 - 4.13 ) , obesity ( OR=2.16 ; CI , 1.47 - 3.16 ) , excessive food intake ( OR=1.43 ; CI , 1.17 - 1.15 ) , sweet food ( OR=1.23 ; CI , 0.89 - 1.54 ) , and consumption of coffee ( OR=1.23 ; CI , 0.17 - 2.00 ) were independently associated with SGER . The episodes of GERD were commonly precipitated by dietary factors ( 66.05 % ) , followed by body posture ( 26.54 % ) , ill temper ( 23.72 % ) , fatigue ( 22.32 % ) and stress ( 10.93 % ) . CONCLUSION GERD is common in Xi'an 's adult population with a mild or moderate degree . The etiology and pathogenesis of GERD are probably associated with FD , IBS , and some respiratory , laryngopharyngeal and odontostological diseases or symptoms . Some lifestyles , diseases and dietary factors are the risk factors of GERD The purpose of this study was to analyse tracking ( i.e. relative stability over time/predictability of future values by early measurements ) of lung function parameters and their longitudinal relationship with lifestyle ( smoking , alcohol consumption , daily physical activity , neuromotor and cardiopulmonary fitness , and dietary intake of retinol and polyunsaturated fatty acids ( PUFA ) ) . Data were obtained from the observational Amsterdam Growth and Health Study , a longitudinal study with six repeated measurements between ages 13 - 27 yrs ( n=167 ) . The statistical analyses were carried out with generalized estimating equations . The following " stability " coefficients were found : for forced vital capacity ( FVC ) in males 0.66 ( 95 % confidence interval ( CI ) : 0.54 - 0.77 ) and in females 0.51 ( 95 % CI : 0.43 - 0.60 ) ; for forced expiratory volume in one second ( FEV1 ) in males 0.65 ( 95 % CI : 0.50 - 0.80 ) , in females 0.53 ( 95 % CI 0.46 - 0.60 ) ; for peak expiratory flow ( PEF ) in both males and females 0.41 ( 95 % CI : 0.31 - 0.51 ) . Positive relationships were found between alcohol consumption and FVC and FEV1 and between neuromotor fitness and PEF and ( only for males ) with FVC and FEV1 . Physical activity was inversely related to PEF and the intake of PUFA positively related to FVC and FEV1 . Smoking was related to a decrease in FVC and FEV1 ; changes in physical activity positively correlated to changes in FVC . In conclusion , high to moderate stability/tracking was observed for forced vital capacity and forced expiratory volume in one second ; for peak expiratory flow it was slightly lower . Preventive strategies regarding improvements of lung function should focus on smoking cessation and improving daily physical activity Leptin is a pleiotropic hormone believed to regulate body weight . Its function in wasting during inflammatory disease in humans is unknown . We studied the effect of repeated tumor necrosis factor ( TNF ) infusion on serum leptin levels in six patients with solid tumors .  TNF infusion on day 1 result ed in an increase in serum leptin levels from 3.1 ( SEM + /- 0.28 ) ng/mL to 5.2 ( SEM + /- 0.6 ) ng/mL after 12 h ( P < 0.001 ) . The serum levels returned to baseline within 24 h. Similar results were obtained when TNF was infused on subsequent days . The study shows that leptin serum levels are under control of TNF It has been suggested that changes in dietary habits , particularly increased consumption of omega-6 polyunsaturated fatty acids ( PUFA ) and decreased consumption of omega-3 PUFAs may explain the increase in atopic disease seen in recent years . Furthermore , it seems possible that it is mainly prenatal or very early life environmental factors that influence the development of allergic diseases . It has also been suggested that intrauterine risk factors may act differently if mother themselves suffer from allergic disease . The aim of this study was to investigate whether the consumption of fish , butter and margarine during pregnancy might influence the development of allergic sensitizations in the offspring . The study population was divided into the offspring of allergic and non-allergic mothers . This was a retrospective cohort study enrolling 295 offspring of allergic mothers and 693 of non-allergic mothers . Information regarding maternal intake of fish , butter and margarine during pregnancy as well as other prenatal and perinatal confounding factors were retrospectively assessed by parental report via a st and ardized question naire . Atopy was determined by skin-prick tests ( SPT ) to eight prevalent inhalant allergens and two foods . In the allergic mothers ' group there is no clear correlation between maternal intakes of fish , butter and margarine  
    Output:
    
agent
***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: The incidence of asthma has been positively associated with obesity . Asthma comprises diverse “ phenotypes ” reflecting heterogeneity in a number of characteristics , including response to therapy . The present authors examined whether body mass index ( BMI ) influenced the response to placebo , as well as to two asthma controller medications . A post hoc analysis was performed , pooling data from four double-blind , placebo-controlled studies r and omising 3,073 moderate asthmatic adults to montelukast ( n = 1,439 ) , beclomethasone ( n = 894 ) or placebo ( n = 740 ) . The primary end point was asthma control days ; other end points were forced expiratory volume in one second , β-agonist use and nocturnal awakening . Analyses were conducted using BMI classification into normal ( < 25.0 kg·m−2 ; 52 % of patients ) , overweight ( 25–29.9 kg·m−2 ; 32 % ) and obese ( ≥30.0 kg·m−2 ; 16 % ) categories , as well as BMI as a continuous variable . The treatment groups were balanced for BMI , demographic characteristics and parameters of asthma control .  The placebo response for all end points was generally lower with increasing BMI . Similarly , the response to the inhaled corticosteroid decreased , whereas the response to the leukotriene antagonist remained stable . In conclusion , post hoc data from the present study suggested that body mass index may influence the natural history of asthma control ( as reflected by response to placebo ) and may differentially influence response to the two active agents , warranting explicit testing in future prospect i ve studies BACKGROUND Maternal intake of vitamin D in pregnancy is a potentially modifiable but understudied risk factor for the development of asthma in children . OBJECTIVE We investigated whether maternal vitamin D intake in pregnancy is associated with decreased risks of  wheezing symptoms in young children . DESIGN Subjects were from a birth cohort recruited in utero with the primary objective of identifying associations between maternal diet during pregnancy and asthma and allergies in children . A r and om sample of 2000 healthy pregnant women was recruited while attending antenatal clinics at the Aberdeen Maternity Hospital , Scotl and , at approximately 12 wk gestation . Maternal vitamin D intake was ascertained from a food-frequency question naire completed at 32 wk of gestation . The main outcome measures were wheezing symptoms , spirometry , bronchodilator response , atopic sensitization , and exhaled nitric oxide at 5 y. RESULTS Respiratory details through 5 y and maternal food-frequency- question naire data were available for 1212 children . In models adjusted for potential confounders , including the children 's vitamin D intake , a comparison of the highest and lowest quintiles of maternal total vitamin D intake conferred lower risks for ever wheeze [ odds ratio ( OR ) : 0.48 ; 95 % CI : 0.25 , 0.91 ] , wheeze in the previous year ( OR : 0.35 ; 95 % CI : 0.15 , 0.83 ) , and persistent wheeze ( OR : 0.33 ; 95 % CI : 0.11 , 0.98 ) in 5-y-old children . In addition , lower maternal total vitamin D intakes in pregnancy were also associated with decreased bronchodilator response ( P = 0.04 ) . No associations were observed between maternal  vitamin D intakes and spirometry or exhaled nitric oxide concentrations . CONCLUSION Increasing maternal vitamin D intakes during pregnancy may decrease the risk of wheeze symptoms in early childhood OBJECTIVE To estimate the independent contribution of birth weight to asthma prevalence among children younger than 4 years in the United States and to compare the magnitude of its effect on asthma between African American and white children . DESIGN Cross-sectional analysis using the 1988 National Maternal-Infant Health Survey and 1991 Longitudinal Follow-up Survey . SETTING United States . PATIENTS Eight thous and seventy-one subjects , selected from a r and omized , systematic population -based sample and weighted to be nationally representative , who completed both initial and longitudinal follow-up surveys and reported information on asthma diagnosis . MAIN OUTCOME MEASURES Birth weight and other sociodemographic factors linked to birth outcome were analyzed for independent association with physician-diagnosed asthma by age 3 years . RESULTS The prevalence of asthma varied by birth weight category : 6.7 % in children 2500 g or more at birth , 10.9 % in children 1500 to 2499 g at birth , and 21.9 % in children less than 1500 g at birth ( very low birth weight [ VLBW ] ) ( P<.001 ) . Some of the characteristics shown to be independently associated with asthma included : VLBW ( odds ratio [ OR ] , 2.9 ; 95 % confidence interval [ CI ] , 2.3 - 3.6 ) , moderately low birth weight ( OR , 1.4 ; 95 % CI , 1.1 - 1.8 ) , and African American race ( OR , 1.9 ; 95 % CI , 1.6 - 2.4 ) . In stratified analyses , the independent association between VLBW and asthma in white and African American population s was : OR(white ) , 3.1 ( 95 % CI , 2.2 - 4.3 ) and OR(African American ) , 2.5 ( 95 % CI , 2.0 - 3.3 ) . The prevalence of VLBW , however , was tripled in African American compared with white children ( 1.8 % vs 0.6 % ) . CONCLUSIONS These data confirm findings of other studies that identify a strong independent association between low birth weight and asthma . For this 1988 national birth cohort , an estimated 4000 excess asthma cases were attributable to birth weight less than 2500 g. Although the strength of the independent association between VLBW and asthma was smaller in the African American population , the substantially increased prevalence of VLBW in this community may contribute to the disproportionately increased prevalence of asthma among African American children AIM Gastroesophageal reflux disease ( GERD ) is a common disorder in the Western population , but detailed population -based data in China are limited . The aim of this study was to underst and the epidemiology of symptomatic gastroesophageal reflux ( SGER ) in adults of Xi'an , a northwestern city of China , and to explore the potential risk factors of GERD . METHODS Symptoms suggestive of GERD , functional dyspepsia ( FD ) , irritable bowel syndrome ( IBS ) , upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified r and om sample s of 2789 residents aged 18 - 70 years in Xi'an by using a st and ardized  question naire . METHODS With a response rate of 91.8 % , the prevalence of SGER was 16.98 % ( 95 % CI , 14.2 - 18.92 ) in Xi'an adults , and no gender-related difference was observed ( P<0.05 ) . SGER was more common among subjects aged 30 - 70 years than in those aged 18 - 29 years ( P<0.01 ) . The prevalence of SGER in rural , urban and suburban subjects was 21.07 % , 17.44 % and 12.12 % , respectively , and there was a significant difference between rural , urban and suburban regions ( P<0.05 ) . Compared with subjects without SGER , the prevalence of symptoms suggestive of FD and IBS , pneumonia , asthma , bronchitis , laryngitis , pharyngitis , chronic cough , wheeze , globus sensation , oral ulcer and snore was significantly increased in subjects with SGER ( P<0.01 ) . Heavy smoking ( OR=5.76 ; CI , 3.70 - 6.67 ) , heavy alcohol use ( OR=2.85 ; CI , 1.67 - 4.49 ) , peptic ulcer ( OR=5.76 ; CI , 3.99 - 8.32 ) , cerebral palsy ( OR=3.97 ; CI , 1.97 - 8.00 ) , abdominal operation ( OR=2.69 ; CI , 1.75 - 4.13 ) , obesity ( OR=2.16 ; CI , 1.47 - 3.16 ) , excessive food intake ( OR=1.43 ; CI , 1.17 - 1.15 ) , sweet food ( OR=1.23 ; CI , 0.89 - 1.54 ) , and consumption of coffee ( OR=1.23 ; CI , 0.17 - 2.00 ) were independently associated with SGER . The episodes of GERD were commonly precipitated by dietary factors ( 66.05 % ) , followed by body posture ( 26.54 % ) , ill temper ( 23.72 % ) , fatigue ( 22.32 % ) and stress ( 10.93 % ) . CONCLUSION GERD is common in Xi'an 's adult population with a mild or moderate degree . The etiology and pathogenesis of GERD are probably associated with FD , IBS , and some respiratory , laryngopharyngeal and odontostological diseases or symptoms . Some lifestyles , diseases and dietary factors are the risk factors of GERD The purpose of this study was to analyse tracking ( i.e. relative stability over time/predictability of future values by early measurements ) of lung function parameters and their longitudinal relationship with lifestyle ( smoking , alcohol consumption , daily physical activity , neuromotor and cardiopulmonary fitness , and dietary intake of retinol and polyunsaturated fatty acids ( PUFA ) ) . Data were obtained from the observational Amsterdam Growth and Health Study , a longitudinal study with six repeated measurements between ages 13 - 27 yrs ( n=167 ) . The statistical analyses were carried out with generalized estimating equations . The following " stability " coefficients were found : for forced vital capacity ( FVC ) in males 0.66 ( 95 % confidence interval ( CI ) : 0.54 - 0.77 ) and in females 0.51 ( 95 % CI : 0.43 - 0.60 ) ; for forced expiratory volume in one second ( FEV1 ) in males 0.65 ( 95 % CI : 0.50 - 0.80 ) , in females 0.53 ( 95 % CI 0.46 - 0.60 ) ; for peak expiratory flow ( PEF ) in both males and females 0.41 ( 95 % CI : 0.31 - 0.51 ) . Positive relationships were found between alcohol consumption and FVC and FEV1 and between neuromotor fitness and PEF and ( only for males ) with FVC and FEV1 . Physical activity was inversely related to PEF and the intake of PUFA positively related to FVC and FEV1 . Smoking was related to a decrease in FVC and FEV1 ; changes in physical activity positively correlated to changes in FVC . In conclusion , high to moderate stability/tracking was observed for forced vital capacity and forced expiratory volume in one second ; for peak expiratory flow it was slightly lower . Preventive strategies regarding improvements of lung function should focus on smoking cessation and improving daily physical activity Leptin is a pleiotropic hormone believed to regulate body weight . Its function in wasting during inflammatory disease in humans is unknown . We studied the effect of repeated tumor necrosis factor ( TNF ) infusion on serum leptin levels in six patients with solid tumors .  TNF infusion on day 1 result ed in an increase in serum leptin levels from 3.1 ( SEM + /- 0.28 ) ng/mL to 5.2 ( SEM + /- 0.6 ) ng/mL after 12 h ( P < 0.001 ) . The serum levels returned to baseline within 24 h. Similar results were obtained when TNF was infused on subsequent days . The study shows that leptin serum levels are under control of TNF It has been suggested that changes in dietary habits , particularly increased consumption of omega-6 polyunsaturated fatty acids ( PUFA ) and decreased consumption of omega-3 PUFAs may explain the increase in atopic disease seen in recent years . Furthermore , it seems possible that it is mainly prenatal or very early life environmental factors that influence the development of allergic diseases . It has also been suggested that intrauterine risk factors may act differently if mother themselves suffer from allergic disease . The aim of this study was to investigate whether the consumption of fish , butter and margarine during pregnancy might influence the development of allergic sensitizations in the offspring . The study population was divided into the offspring of allergic and non-allergic mothers . This was a retrospective cohort study enrolling 295 offspring of allergic mothers and 693 of non-allergic mothers . Information regarding maternal intake of fish , butter and margarine during pregnancy as well as other prenatal and perinatal confounding factors were retrospectively assessed by parental report via a st and ardized question naire . Atopy was determined by skin-prick tests ( SPT ) to eight prevalent inhalant allergens and two foods . In the allergic mothers ' group there is no clear correlation between maternal intakes of fish , butter and margarine  
    Output:
    